What's the criteria for needing a PICC?

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What's the criteria for needing a PICC?

Postby kungfumoose » Mar 12, 2013 1:10 pm

I've had 3 HG pregnancies so far. I've never had a PICC.

With my first daughter, I was diagnosed, but untreated except for a few IVs.
With my son, I was undiagnosed, but self-treated with Unisom, B6, and went to the ER for IVs.
This last pregnancy just about took me down. The first doctor reluctantly diagnosed me, and prescribed Zofran when I asked, and I continued the Unisom I had been taking since I got the positive. I ended up on another med, but i don't remember what it was. I continued to lose weight well into the second trimester, and honestly, I don't know how much I lost total, because it got to the point that I couldn't stand long enough to step on a scale, and when I was finally able to, I had already begun gaining weight again. I went from 222 lbs down to at least 199 lbs, which if I did my math right is a little more than 10%
I was so sick, I couldn't get up at all for weeks. My husband had to half-carry me to the bathroom on the rare occasion I had to pee, which was often less than once a day. There was a few weeks where I thought I was going to die. It scared me.

I have often wondered if a PICC would have helped me. The doctors didn't do anything other than prescribe meds for me. I had to go to the ER each time I needed an IV, and no other options were offered to me. I wonder at what point a PICC line is worth the risks associated with it (those risks scare me pretty bad, since they can be life-threatening themselves)
I would rather avoid a PICC if I can, but if its really something that is needed, I'm open to the option. I wonder if PICC lines are not as dangerous as I imagine, or if i really would have been helped by it. I want to be armed with that knowledge.
We are a military family, so I can't choose who my doctors are, and I would like to know what signs, and things to look for to determine if I should start advocating for a PICC next time.
Any info, on when a PICC is a good choice, and what the risks/benefits are, would be very appreciated. Thanks.
~Deborah, crazy cloth diaper sewing momma. (Hide your fabric!!)
2006 Elaina - Mderate HG 5 weeks-34 weeks
2008 Isaac - Mild HG 5weeks - 28 weeks
2010 "Rex" My sweet angel
2012 Angela - Severe HG (Mildly controlled with IVs and meds) 5 weeks until delivery
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Re: What's the criteria for needing a PICC?

Postby aaronsmommy » Mar 12, 2013 3:33 pm

A picc line is not really a treatment for hg. The criteria for needing a picc line would be if you needed IV access but the nurses have trouble finding a place to put the IV, or if you need TPN (which you can't do through a regular IV). You can get home health therapy with regular IVs if you don't need a picc line for one of those reasons.

It certainly sounds like you needed more aggressive therapy. Medications and peripheral IVs would have been a good place to start. PICC lines have about a 50% complication rate in pregnancy, and some of those complications, as you know are life threatening, so you are correct to be concerned about them. We are seeing more and more doctors who refuse to use them at all because of bad experiences. There are other catheter types that are an option if a PICC line isn't or if you have complications with them, they are harder to place, but have fewer infections.

I had one and wouldn't have survived without, but also had a blood stream infection that could have killed me.
Aimee

Aaron 12/4/02
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Re: What's the criteria for needing a PICC?

Postby BeautifulAshes » Jun 02, 2013 8:58 pm

I have had 4 HG pregnancies and I've gotten a PICC line with the last three. I'm not sure why it wouldn't be considered a treatment for HG. You can absolutely do all the treatments at home, home health only needs to come out once a week to help change the dressing. You do have to take care and watch for the first sign of infection, immediately switch the site of the PICC Line and start antibiotics right away if there are any but its the only way I make it thru my pregnancies. Zophran doesn't do anything for me, I generally require an injection of Phenergan every 4hrs and that blows thru your veins with regular IVs. With a PICC Line you can stay hydrated with fluids at home, take your meds thru the line if you can't tolerate them orally and continue to care for other children. I use a battery operated pump located in a back pack with my fluids and draw my meds and administer them to myself. Just make sure to tell the PICC team to put your line in your left arm if your right handed or vice versa, makes it easier to plug in your line, etc. yourself. It sounds complicated and dangerous but its not if used correctly and in a clean environment. I'd be more than happy to answer any questions you might have.
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Re: What's the criteria for needing a PICC?

Postby Fern » Jun 02, 2013 11:40 pm

Another option that many people don't know about is a midline. I had one with my 1st HG pregnancy and it did save my life. It is like a picc, but rather than being a central catheter (which means it goes into your heart) it goes only up your arm & into the armpit. For me, they used a picc but cut it shorter. It never leaked or got infected. I think the main risks of PICC are that it can irritate your heart, and it's more likely to lead to a very serious infection. Both those risks are bypassed with a midline. Some docs will tell you that midlines are only meant for 1-2 weeks, but in my case it was in for 10+ weeks with no problems. I would do it again in an instant. You can't do TPN through it, but all fluids, minerals and of course meds are fine.
Fern
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Re: What's the criteria for needing a PICC?

Postby teddi » Jun 24, 2013 11:46 pm

I'm not sure why it wouldn't be considered a treatment for HG


I want to clarify this.

A treatment is something (medication or procedure or other) that can alter the root cause and/or process of a disease or illness.

A PICC line itself, doesn't treat the HG. It's a method of putting things into your body but the line itself doesn't do anything to change or alter the course of the HG. Sometimes on these forums, as women are researching and reading they may not understand and think that the PICC itself IS the treatment- not just the delivery vehicle.

Peripheral IVs, PICCs, Midlines, central ports are just the means to your veins or arteries to put medications or fluids or TPN into your bloodstream. There are also NG or NJ tubes or G-tubes that can be used to put foods and medications into your intestinal tract.

PICCS can be great, they can help keep you hydrated and medicated and even fed. But they can and do have potentially life threatening complications (primarily the risk of sepsis- a blood stream infection, which can kill mom and baby both). I had a single lumen PICC with my twins. At the point we did it, I had the highly skilled infusion clinic nurses blow five veins...I was coming in for peripheral IVs every other day. I need continual access. I had mine in for 6 months to the day. I thought it was great (aside from the user induced air embolism my husband gave me).

Having been on these forums for years, we do continue to see a certain % of moms end up septic. I have learned to respect that the danger is very real, so for that reason they should be looked at as a last resort, or at least measured against other options.
Teddi
Bert , 3/2000 HG#1, wk 6 - birth, GB removed @ 16wks
Chloe & Kaylie, 12/2004 HG #2, wk 7 - birth, pre-E/pancreatitis
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~ Baby Chuckles~ July 2013
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