IV therapy

[tilly2321]

Hi all,
We are ttc and I am scared to death since last time I was so sick and didn't take anything. this time I am going to take medicine for sure, but am not quite sure what will work. I will try everything. May main question is, can you get home IV therapy early on? I got two IV's last time and I felt just wonderful after I had them for about two days. It really helped me and I think that might be the ticket this time too. can you get home IV treatments right off the bat if you have a history of HG?
Can someone tell me more about this type of treatment? A nurse comes to your house? Once a day, once a week? How does it all work?
Thanks,
Elaine

[emily]

I am setting up for home health care. But a friend of mine who is a medical student said they can put a port in and you can run your own IV's and home when you feel like you need them rather than depending on home health care to do it. I think this would be the way to go if there were no issues with medications by IV or a PICC or anything. Has anyone done this?

Emily

[mammaclare]

With a PICC, you can also run your own fluids. A port, or central line, is generally reserved for very sick patients-someone who has had a PICC infect, or for chemotherapy and other very harsh drugs. It has to be "installed" (for lack of a better word) by a small surgery, so it is much more invasive than a PICC line.

Personally, from what I know of peripheral and central lines, I would still choose a peripheral IV with a site change every few days unless I required TPN, and then would choose a PICC. I personally wouldn't even consider a central line unless I was extremely ill and all else failed.

As for home health, I agree with what Emily has done--talk with your doctor or midwife ahead of time and get all the paperwork and such completed and ready to fax straight over to a home health agency as soon as you may need it. That way, the wait may only be a couple hours to get supplies delivered and a nurse visit. And, hopefully you have a doc/MW who is willing to let YOU call the shots on when you need fluids--especially as you have been through this before. If I do it again, I want to be the one to call in and simply say "I need an IV" and then get it ASAP without having to defend myself or prove dehydration or anything.

[mlexi]

I have had two Hg pregnancies and Ivs with both. Peripheral IVs failed both times. I have small veins when I am healthy so throw dehydration into the mix and my veins are useless. I had a central line placed surgically during my first pregnancy. I was very frightened at first but eventually my family and I became quite good at caring for the line. In my second pregnancy I had a central line placed after the doctors and nurses falied to place a peripheral IV after six or seven attempts. This central line became infected and I became septic. I was in the hospital for nearly two weeks with a bloodstream infection. I was then on peripheral IVs for two more weeks. Unfortunately, my IVs were infiltrating constantly and my condition was worsening. The doctors felt I needed to have a feeding tube placed but would not do so because they believed I would not survive another infection.

So all in all, my suggestion is to get hydrated as quickly as possible and be on peripheral IVs if your body can handle having it changed frequently. If you are placed on a central line closely monitor your vitals for any sign of infection.

[jjbeck]

I had a PICC the 1st time around and we changed fluids and did IV meds at home. For me, it did not help other than kept me from getting dehydrated.
The second time around when HG began setting in I began the usual meds, but this time, my OB wanted me to go into the office for IV fluids whenever I needed them. I didnt need an appt or to go to the er...though a couple of times I did end up there.
Though I realize the imp of staying hydrated, I agree with Clare and would not even consider a PICC unless all else failed.
This last time around...I vowed I would not even think about the PICC and if it came down to it, I was going to opt for the GI tube instead.

[Necia]

This is my second pregnancy and I just had a PICC put in yesterday. I've tried Phenergen, Reglan and anything else my doctor will prescribe, except for Zofran. It's way expensive and I have some friends that have had serious side effects, so I opted not to do that one. The procedure for the PICC was a lot more invasive than I anticipated! I am only 7 weeks, but we are trying to get control of my HG a lot sooner than with my first. I am able to give myself fluids and medicine through my PICC anytime and I only have to go to the doctor once a week for a dressing change. For me, it seems like staying hyrdrated is half the battle, so we chose to go this route. I would not suggest doing it, unless you have exhausted all other possibilities. It requires a lot of preparation and time to keep from getting infection. I have a 2 year old, who thinks he is a big help, but is really more of a hinderance in trying to keep everything sterile. I am still very sore and bled a lot, so today might not be the best day to talk about it. I just hope it continues to give me the relief that I crave!

Necia

[HGx3]

Your ob will ultimately decide how often/how much meds and care you need, but it helps if you ASK when you know you need it. I did ok with perp ivs daily/and every other day with my 1st 2 pgs. By the time I got to pg3, I required a picc b/c I had no viens left and they could not start ivs on me. After the 2nd picc got infected, I refused a central and wasnt brave enough to try an ng tube. Good luck.

[Kariinbliss]

This is what the doc is trying for me now, after 14 pounds off my 5'2" , 135 pound frame..... they put in an iv and gave me 2 bags of fluid, one with Phenergan, one without. Sent me home and are having a home health nurse ( a personal friend of mine) come every night with 2 bags, one with the Phergan. It certainly won't CURE hg, but it will keep me hydrated, and the meds will allow me to sleep through the night. I also have Phenergan suppositories to take during the day, since you can't possibly throw up a suppository! LOL Let's hope this helps!!!

[Michelle]

I had a central line because all of my other viens- even my in my feet! were useless. My central line was not infected, and eventually it was my ticket to feeling better. After trying everything else, prednisone was given through the Central Line and then I felt better. When I could start taking the 10 mg pills orally, the central line was taken out....I did well until I tried to decrease my dose to 5mg. I was admitted again then I was hydrated through an IV- in my foot!..., given meds through the IV, then I was able to take meds orally again.

I remember when the Central Line was put in, I just cried. Not because it hurt, but because I felt in some way I had failed, and I was giving in. Now that I'm ttc again, I know I would have it put in again. I know there is a risk of infection...but for me it was a short term (2 week) treatment that made me able to live again. Well, o.k.- so I was able to walk around the house, and dress myself- huge improvement over a hospital bed.

I agree that a Central Line is a last resort.

[mrsbigdog]

This is my 3rd HG pregnancy. First time Dr. told me it was in my head so nothing was done. Second time I was on home IV theraphy for about two weeks and just had a regular IV line put in by the home health nurse and my husband was responsible for changing the bag as well as putting vitamins in it once a day and giving me compazine shots every 8 hours.

This time around I was sick at 5 weeks. Week 7 I made two ER visits for IVs because the insurance was taking too long to get the home health approved. I am now at almost 13 weeks and have been on home health IVs since week seven. I had a PICC line put in because they could not get a vein good enough to run an IV, much less change it every three days! I have had IVs round the clocks, 3 Ltr a day, since then. I also have vitamins and Zofran put into the IV bag. In addition I push Pepcid 1x/day and Reglan 3x/day through the IV line. The home health people come once a week to clean my PICC line and change the dressing. They also deliver all my supplies every Tuesday. We are personally responsible for all the IVs and meds which meant while I was VERY sick and out of it my husband would have to run home in the middle of the day to give meds or change IV bags! My mother helped out some evenings and my 16 year old (once even my 10 year old) also took their turns. Now I handle it myself.

It has worked ok for us and much better than trips to the ER or Dr. but be aware you will be responsible for much of your own treatment.

Donna

[Kariinbliss]

I just saw that my last post here was just a few days before my m/c. AFTER it (of course) a new doc found that I had taken Reglan and Zantac with my second pregnancy with good results. So if I end up getting pg again (say a prayer for me!) he will be putting in a PICC line and starting me on meds as soon as I start getting sick. Home health had already been approved back in June, so we should be able to get started pretty much immediately. Can anybody tell me exactly what is involved in getting a PICC line put in? We blew every vein possible before my m/c, so are not going the regular IV route should this happen again. I'd just like to know what I might be getting into! Thanks for sharing your experiences!!

[Beth B]

I don't know if it's the same for everyone, but I had a PICC line and can tell you my experience. I had to come to the hospital for a scheduled appt. - mine was in a room in the ER with a special PICC line nurse. I was there maybe 2 hours from arrival to departure, but the actual procedure took only a small amount of that time. He used some kind of hand-held scanner to find the veins in my left arm and marked some areas with marker. I had a shot of Novicaine (hardly felt that) and then he inserted the line on the inside of my arm, a few inches above the elbow. It took a few minutes, but I couldn't feel a thing. He used the scanner again to be sure it was in the right place, then taped the line to my arm. I had to go for an X-Ray to be sure the line wasn't too close to my heart - the hardest part, as I had to walk down to X-Ray! It was fine, so he taped it down more securely and sent me home. Before the procedure, another nurse talked me through everything I'd have to do at home with my line. I was completely overwhelmed by this and kept telling her so, but she must have had to do it anyhow. Luckily, my home health nurse was much more understanding and walked me through things step by step, day by day until I could handle it all. My arm was very sore for several days, and so were my neck and left shoulder (from the line being run through?). Once that soreness eased, though, I really couldn't feel the line at all. I ran IV fluids at night every other day, and had to inject Heparin in it twice a day to keep the line from clotting. The nurse came once a week to change the dressings - this hurt a bit because she had to peel all the adhesive bandages off my skin, and then use a disenfectant to wash the PICC site. My line clotted off twice - the first time the nurse came and was able to clear it, and the second time she couldn't. She said I'd have to go to the ER and they could hopefully clear it; I was improving by then, though, and had already gotten my doctor's permission that morning to remove the line if the nurse couldn't clear it, so she took it out, which didn't hurt at all. I have a little pink scar on my arm now - a permanent reminder of HG, I guess!

[Kariinbliss]

Thanks Beth!!! That doesn't sound nearly as scary as I had originally thought. (overactive imagination here!) Now if I ever do need one, I won't go into it with a huge fear of the unknown. Thanks again!

[mrsbigdog]

It does help to know. When I was sent to the hospital to get mine put in I was terrified because no one had told me what was going to be done. My was very similar to the previous post except I was sent to ER but they did not do them at my hospital. I set up an appointment with Radiology and the entire procedure was done in an xray room by a doctor who used both the xray (after covering most of me) and an ultrasound to check insertion and positioning. With the numbing shot it seemed much less worse than the 15 needle sticks I had had the two previous days! Mine is suppossed to allow then to draw blood as well as put in fluids but for some reason the drawing blood function is not working properly. I'm just living with it because I hope to have it only a few more weeks and blood drawing hasn't been happening so much since the HG is under control.