Wednesday 11th January 2012, 11:30 AM
PICC line insertion
This is definitely one of those instances where having a "Jo" along for the ride really payed off. I knew that a PICC Line is a specific type of catheter and would be temporary or semi permanent, I was only half right.
Senior Staff Nurse Juan Roman introduced Jo and I to the Clinical Nursing Specialist Myleyne Frieres who's speciality would include performing this surgical procedure. The first thing she did was sit us down in a consultation room to watch a 10 minute DVD explaining about PICC lines and how patients feel about having them. Jo knew what was to come, she read all the stuff I'd been given, she knew I hadn't, she kept quiet. My ignorance was bliss.
To my dismay and a little horror PICC Lines aren't as I had thought, i.e. a larger type of butterfly needle like the ones that I have had for my CT and MRI and PET scans. I had 'not' read the notes I had been given and I had not taken on board what would be involved.
A PICC line is 45cm (18") of plastic tube, run from just inside the bicep, through a vein, and stops just before the heart. C.N.S. Myleyne showed me one, I did not smile.
The cancer Day Unit has it's own surgical room where C.N.S. Myleyne would perform the PICC Line insertion for me. I offed my shoes and top shirt but kept on my T-Shirt and everything else.
She inspected my inner arm and ran the Ultrasound scanner over it too. The image was on screen for no more than 2 seconds before she said "perfect just what I'm looking for" Wow ! that was quick "well I've done this so many of these I know exactly what I'm looking for".
She scrubbed up, donned a gown, gloves, mask and eye shield.
Next was my turn, lying on the 'bed come operating table'. She cleaned my arm three or four times, then with my arm held up, unfurled a full length surgical sheet, arm down and unfurled a second one with a cutout window. Surprisingly we are now over half way through the whole procedure.
Now the worst part, one 'jab' of local anesthetic. That was a tad 'ouchie' going in much deeper than the ones I had during my biopsy and for much longer. A minute or two later she started the insertion, I felt very little, not much more than having someone tapping their fingers on the inside of your upper arm.
One more little 'jab' of anesthetic and a quick view into the shoulder with the Ultrasound and it will all be over in another minute or two. "Did you feel that ?" It felt to me like I had been very gently touched on the arm with the very tip of a ball point pen. "Good that's exactly what it should feel like", "Right just tape this up, put a tube bandage on and were all done here". Myleyne looked up at the clock and said "just about ten minutes and we're all done now".
I had been led to expect to have the PICC Line in my left arm but because so many people instinctively 'coddle' their wounded/different feeling arm the practice is now to put the line in the dominant arm. There is a concern that as the blood flow is restricted ( due to having a tube in the vein ) and the natural tendency to 'coddle' the uncomfortable arm a blood clot is a real possibility. I was told I must use the arm as much as possible and as much as I would do normally. I asked whether it would be permissible to masturbate, Myleyne said yes, her eyes widened, her jaw dropped, and she screamed NO ! not in here, wait until you get home.
Myleyne sent me off for a chest X-Ray, like the dental X-Ray a week earlier this to is taken standing up and only takes a couple of minutes and was available to view immediately, I stood there and and was shown where my PICC Line was running through my arm, down my chest and nearly to my heart. It didn't bother me in the slightest. Back up at to see Myleyne for her assessment of the X-Ray, a big smile and a thumbs up from her and were done for the day.
I'm getting used to 'pipie' now. I can sleep pretty much normally on both sides and the dull ache has dissipated. It's very much like wearing and ill fitting watch over a small fresh bruise, occasionally uncomfortable and ever present. Bathing is a 'faff' as it mustn't get it wet due to the risk of infection.
As the PICC Line will be staying in my arm for the rest of my treatment, three or four months I'll just have to get used to it. One thing though, every now and again it does itch like hell.
Edited by Jo W, with thanks
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