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Discussion Starter · #1 ·
I've already talked to the home health nurse 2x today and don't want to bug her again. I have a heplock in for home iv fluids and the thing is a major PITA, i'm about ready to ask for a PICC line and a pump and its only been in 24 hours. I just took my first shower with it in and since they didn't leave me any shower gloves I figured I would just put a large ziplock on it with the zipper cut off then tape it well (nurses suggestion). Well, it didn't work and that hand pretty much got as wet as the free hand. Do I need to have the dressing changed or the site moved? everything seems as sticky as ever but my hand was nice and wrinkled which tells me it got pretty wet and the netting tube stuff I had over it holding the tubes and stuff was pretty wet. Now i'm wondering if I should give up on the idea of picking up large plastic gloves (I have small hands) and taping them shut is a bad idea and just save my money and see if the nurse can find some non latex shower gloves. fwiw I took off the netting and dried my hand as best I could and I don't see any water vapor on the tagaderm plastic thingy thats directly over the site.
 

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Not a nurse, but extremely well versed in home IV fluids during pregnancy

The tegaderm they put over your site is fairly waterproof, if that's not peeling off you're probably fine. Leave the netting off so it can dry nicely and don't cover it back up until everything is nice and dry. Just be careful in the meantime. If your line is still flowing you're in good shape.
I've had 3 picc lines now and I will say they're way easier, especially if you have super crummy veins like mine. Also with Molly's pregnnacy I was super sick until after 20 weeks, so the picc was essential. Even with the picc line when you shower you need to remove your dressing and redress it when you're done.
 

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Discussion Starter · #3 ·
I have fantastic veins in my hands but none in my arms. How long did you have the IV before you got the PICC? Home health was surprised the Dr has ordered fluids for 2 weeks with just an IV, they expected a PICC would be placed. Is it normal to place a PICC so quickly? Is it less painful? This thing already feels like a bad bruise but the site looks good so i'm not asking for it to be moved at this point but I learned last night I can't let it run all night. I tried and didn't get much sleep, I keep doing something that was preventing it from flowing everytime I feel asleep. I set the flow rate for 250ml/hr and there was only 500ml left in the bag so it should have taken 2 hours. 5 hours later there was still 100ml in the bag! I said screw it and disconnected and went to sleep. I've managed to drink about 16oz of fluid in the last 16 hours which is pretty good but I can tell i'm starting to get dehydrated again so i'm going to have to hook it back up and it drives me nuts having to sit here waiting 4 hours for a bag to empty during the day (supposed to be hooked up 8 hours day) Anyway, is the PICC that much easier? The nurse said you get a pump then which will better control the flow rate and will tell you when the thing is occluded which seems to be a problem for me. I don't want to sit there and stare at the drip all night or be hooked up 24-7 because it keeps getting kinked and making it take forever.
 

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Well, the picc hurts a lot more to have inserted but they freeze your site first. It's achey for a couple days after insertion as well. The do need to use a flourascope though, so it's a bit of radiation but since it gets threaded right to your chest cavity, they need to know it's in the right spot.
I always had a pump with a plain IV as well. Home health care told me I had to run mine at 250 an hour too--but I was getting 3 or 4 bags a day so that would mean being hooked to a pump 24/7. My doctor ok'd doing bolus's so I used to run them in at 750 an hour.
You will need your site changed every 3 days, so I would say if you have nothing in your arms, you're going to need a picc.
Are you getting anti nausea meds by IV?
 

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Discussion Starter · #5 ·
The Dr ordered Reglan IV but i'm allergic so i've just been taking phenagrin (sp?) orally but have it available rectally if I need it. They gave it to me through my IV at the hospital and i've been able to take it by mouth since. I'm just glad I've been able to eat this time around, just wish I could drink. Feel like i'm going to be a sack of potato's by the time this is over because the neasua is mild as long as i'm laying down, its when I stand still for a min (like standing in line at the store) or I start moving around a lot like housework that it gets severe.

ps: figured out what I was doing while sleeping that was stopping the flow because I just did it watching TV. If I bend my wrist backwards which I tend I tend to do while sleeping it blocks the flow. I'm going to try a splint type thing to keep me from bending it and see if that works.
 

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Shannon's right about the dressing. If it's intact, it's fine. OTOH, if it keeps getting wet, the tegaderm will eventually peel. The PICC lines are a better choice, IMO, as they're for longer term use. Peripheral IVs should be changed (site, tubing, drsg) every 3days. You may run out of viable sites on your hands and arms after 6 or 7 changes. I'd opt for the PICC, but remember that it's a central line so the risk of complications is greater.
 
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