Friday 28 June 2013

PICC Lines



"It goes all the way up to a vein in my shoulder" "Oh my god. I couldn't deal with that"


As a young patient, I was admitted to the hospital several times for bowel rest. Basically this meant getting TPN or total parental nutrition. IV food. The veins in your hands, wrists, and forearms are too small to accept this broken down supplement, the particles are far too large. However, the veins in the front of your shoulder ARE big enough. In order to access these veins they gave me peripherally inserted central catheter (PICC). 

How this works, is in the crux of your elbow, they start an IV, but not just any regular IV. These IV tubes are a good 30cm long. By using a guide wire, a doctor threads it up into the larger vein in your shoulder, and BOOM. You've got a PICC line. Doesn't sound so bad right?

Well, my experience (now when I look back on it, was quite funny) was less than fun. 

She didn't actually look like this, but this is how I imagine her
The PICC insertions were done by this one, old, Polish doctor. She was great at what she did, but holy crap she was scary. She also only did the insertions after her day's work...which ended up being at about 11pm. So there I am, 12 years old, extremely ill, dehydrated, and they're telling me I have to be awake at 11pm to get a giant ass needle stuck up my arm! Lovely. The during my first PICC insertion I fainted. My mother tells me that the doctor was yelling at me in her thick Polish accent "NO PASS OUT. STAY AWAKE. STAY AWAKE." Each one of my insertions lasted between 1 and 2 hours. After they are sure the PICC is in, they send you down to the x-ray department to make sure it's in the right spot. I went down for my x-ray, and during my x-ray I fainted again. I'm obviously good with needles, eh?

That's basically the story of my first two PICC insertions. The third one went a little differently. It began like the first two, anxiety, needles, prodding, guiding. It seemed to last for hours. Truth was it did. It lasted a full two hours. What happened was when they inserted the PICC line, they found it hard to navigate the veins in my shoulder, they kept trying but the guidewire got caught in me. I'm not sure how this happened, why this happened, or how they solved it. I was a bit preoccupied trying not to cry or faint. This time they were unsuccessful. 

The next day I was sent down to some sort of imaging machine where they injected my veins with radioactive dye so that they could figure out a path to send the PICC down. They shot me up full of that dye only to discover that my veins in my shoulder are so damaged from the first two PICC lines that now it looks like I have balls of spastic wire instead of veins. And that my friends, was the end of my experience with PICC lines. 
Pretty much my veins right here.