Diary of a Crohn’s Flare: Getting a PICC line

What is a PICC line?

It is a peripherally inserted central catheter.  Which means (at least in my case), I went to the hospital for an out-patient procedure.  They admitted me and place me in a “day bed”.

They wheeled in an ultrasound machine and looked in my arm for some viable veins.  They stated before they started that they’d probably choose one of three named ones (they gave me the names but I don’t remember them).

 From UltraSoundpedia:

I had 4-5 obvious and large blood vessels.  At least one of these was the Brachial Vein, another was likely the Basilic Vein, and one was the Brachial Artery.  I'm not sure what the others were.

Runner’s side note: it turns out running causes a lot of good cardiovascular changes.  All three of these vessels were large, visible, and very viable (but they didn't intend to use the artery).  However, they said I had many viable “collateral” veins they could have used.  I forgot to ask which one they elected to use.

They likely used my Brachial vein

From OpenStax College.

A trio of medical professionals set up a sterile field, including putting a hair net and face mask on me and themselves.  They put on sterile gowns, hair nets, and face masks on themselves too.  They scrubbed my arm for a minimum of 30 seconds with an antiseptic.  I asked them what it was and got “something hexa something” but I don’t recall the name (It was probably Chlorhexidine).  It looked like iodine to me but other than feeling cool, it didn’t bother me at all J.

They shot my arm up with lidocaine to numb the skin and waited 30-60 seconds before shooting it up again with more lidocaine.  Within seconds after the second round of lidocaine, they cut an opening into my inner bicep and inserted the catheter into one of the major veins of my arm.  I felt a little pushing and pulling and a bit of wetness on my side (probably blood) but no pain or discomfort.

Then they covered the IV insertion point with a clear plastic / bandage with adhesive only on the edges of the patch.

Since then the site has been a bit uncomfortable most of the time.  During the first night, the site stung enough to interfere with my sleep.  I was told this was not normal and they check the PICC line insertion site.  The home health nurse didn’t see anything wrong with it.

A picture of the PICC line in my arm with a 100 ml (1 gram) bulb of Invanz IV antibiotic:

Close up of my PICC line:

Note that the bloody spot is where the line goes into my arm.  So far, it's remained a bit uncomfortable but easily tolerated.  When I move around more, the area bleeds.  All nurses encouraged me to continue using the arm, except:

1. Lift nothing heavier than a gallon of water
2. Don't engage in sudden movement (no volleyball for me).
3. and I added the restriction of not stretching to reach for things - this hurts a lot.

If you look carefully, you can see there is blood in the PICC line.  I'm told that I should flush this out when I notice it.  Honestly, I notice blood in the line almost every time that I look.  I could flush the line 5 times per day and still find blood in there, so I just flush it first thing in the morning and then again in the afternoon if I check and notice it.