I wanted to write about my experience with getting the IV port put in my arm, and what has gone along with it. I've had it for starting on three weeks now, and it has been emotional. Ever hated something that was supposed to be good for you? Peas? Wearing a bra? Your husband? That pretty much sums up my feelings about this catheter, and it was definitely a huge piece of the reservation cake I was baking when it came to being treated for Lyme Disease.
I went to the Treatment and Procedures Department of the hospital to have it put in. I was alone; I thought it would be no big deal, it would only take a few minutes, and I could handle it on my own. The preparation began: warm blankets, an open-back gown, searching the TV for something effectively distracting (if I don't see the needle, I'm fine). I was getting a Peripherally Inserted Central Catheter, or PICC, meaning a tiny line would be threaded through a vein in my arm that loops above my heart. It would then have a port where I could get blood drawn or hook up my own IV so I could do my treatments myself at home. The ease of care was lost on me; it began to sound alarmingly invasive. I mulled it over as the nurses gathered their tools beyond the curtain.
A nurse came in and read to me from an informational pamphlet, and when she was done I realized I had just been pitched. Looking down at the pamphlet the complications seemed to be in huge type, and in absolutely enormous letters was a sentence that read something about a DNR order being waived for this procedure only. Sign here, saying you agree.
Is that what I should be worried about? I wondered. Nothing could dwarf the ignoring my right to not be resuscitated like doing something that would require me to be resuscitated in the first place! Shit, what had I gotten myself into? And with no one here with me to tell me how irrational I was for being scared of it!
What if a tiny poke was all the motivation my continuously palpitating heart needed to flop over and die? What if the nurse (not only a longtime technician but a one-time patient as well) accidentally pierced my vein and I bled to death in 7 seconds? What if one of those complications so enormously printed in the pamphlet happened and I was too ignorant to recognize it before it was too late? After grilling the nurse tearfully about other options, I nodded vigorously when offered a midline instead. I didn't know what the hell a midline was, but at least I didn't need to sign a paper about DNRs and the possibility of blood clots.
The nurses went about creating a sterile room. This was serious business. They draped me with sterile cloths, dressed in robes and masks. I tried to watch TV. My arm was washed with soap and water and swabbed with cold alcohol. An ultrasound was done and my arm marked for ease in differentiating vein from artery, and I felt a little poke as the numbing solution was administered, ironically enough. A big pinch as the catheter punctured the outer wall of the vein and then a few minutes of feeling nothing but a little pressure just above my elbow and they were done. They bandaged me, reassured me, and let me lay still for a bit so I could settle down and get my head together. Then I was off to the doctor's office to get my first IV treatment and a little bit of training on how to do it myself. I drove over there with no problems, just the normal tiny amount of discomfort that comes from having a foreign object sticking out of your skin.
While learning to infuse myself I found out a midline was the exact same thing as the PICC, only the line is about two inches shorter. It figures.
(*The picture above is owned by http://www.drugs.com/cg/peripherally-inserted-central-catheters-and-midline-catheters.html)
The first week was the worst; the discomfort in my arm was constant, and if I didn't turn just right it would pinch or pull and I had difficulty moving because of that. The first time I rolled over on it in my sleep and woke up with tingling fingers I panicked. I have to shower with a huge plastic glove that goes all the way to my shoulder roped off by a tight rubber band. (I could make it easier on myself and use Saranwrap, but I'm stubborn.) When I had the bandage changed the nurse's alcohol swab burned as if I'd stuck my arm in a fire. The hole in my arm oozed and my arm swelled. My fingers began to swell on my first treatment, and because I'm taking a penicillin derivative and am allergic to penicillin, I was apprehensive, to say the least, also unnecessarily. I was hyper vigilant and a pest to the nurses and learned to deal with all of it. But the truth is, it isn't worse than living with the symptoms of Lyme Disease. If this is all I have to suffer with to get rid of that, I think I'll take that any day.
Week two had me calling the nurse because I had some reddish-purple marks on my skin near the entry-point in my arm; apparently I had been moving around a little much and caused some slight bruising. The second bandage change was great...the damn thing itched so bad that the alcohol was like a giant scratching brush...it was just AAAAHHHHHH. My arm was still swollen but now the nurse put what I think she called a bio-patch on the wound to help with the oozing; now I didn't have to look at the hole anymore and everything seemed cleaner. At the beginning of week three now the bandage still itches something awful...but the pain and discomfort seems to have lessened considerably. I pull it around, the kids climb on me and bump it and for the most part, it's become like an extension of my body.
It is really easy to use, just as they told me it would be. I simply thaw my medicine for about an hour, clean the head of the tube with an alcohol pad (it has a valve to keep air from getting inside), flush with a syringe of saline, hook in the medicine, and sit still for about 30 minutes, watching TV, or I can even type. Then I unhook, flush with saline again, wrap it around my arm, and put it away under the little mesh-like sleeve that hides it. I'll post pictures at a later date, which may be helpful. With Lyme it is imperative that what you have to do be simple and easy to remember, and even on my worst days I barely have trouble with it at all.
It is also definitely itchy, annoying, and cumbersome, but not unbearable. Just as it becomes completely forgettable it will be time to take it out...and God help me that day, and the nurses who have to deal with me.
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