Using the PICC line

When I left the hospital I went directly to my house so that I could meet the nurse that was going to teach me how to use the PICC line. I had a friend that had one in the past and while I was a little bit unsure about using the PICC myself I sort of had an idea of how it worked. I got to my house just as my antibiotic and supplies were being delivered and the nurse came shortly thereafter.

The nurse explained that I really would not have anything to worry about as far as giving myself the medication because it was all written down for me and she was going to also teach me a simple way to remember it. She told me that I would be using the 'SASH' method to push the medication into the line. Using that method, I would first flush the line with normal saline, then would administer the antibiotic, then I would need to flush the line with saline again and finally I would need to use Heperin, a blood thinner so that the line would not clot.

Once she told me about the SASH method I was more confident because it sounded relatively simple. At that point the only part of the entire situation that had me concerned was the schedule that I would need to adhere to. The hospital always seemed to tell me that it was time for my antibiotic at the strangest hours, but before I was discharged the infectious disease doctor told me that I could adjust the schedule so that I could get some sleep. The nurse and I discussed that and altered the schedule slightly so that after the first couple days I would no longer need to wake up in the middle of the night to do it.

Once she had told me how to administer the medication it was time for me to try doing it, with her watching and available if I should need any help. I was able to do it absolutely fine and with minimal questions. After the dosage was administered she had stuck around for about an hour to monitor me for signs of a reaction to the medication. I did not have a bad reaction so she left, saying she would be back the following day to change the dressing.

The next morning the visiting nurse called me to schedule her visit so that she could again, re-admit me into their service, and so she could change my Wound VAC dressing. The visit was scheduled for a few hours later so that I would have time to give myself my antibiotic and could also shower. When I was in the hospital the surgeon had told me that he had placed antibiotic seeds into the wound and that they should be left alone, but that I was allowed to shower. Well, when I got out of my shower I was disturbed to see something that I can only describe as the white candies that are ontop of Sno-Caps chocolates laying on both my shower chair and on the bottom of the tub. I knew that the nurse was going to be arriving at any moment so while I was worried about what I had seen I did not dwell on it because I was confident that my nurse would be able to handle the situation. The nurse arrived and I immediately asked her to look in my shower so she could see what had happened. It turns out that what I was seeing were the antibiotic seeds. We called the office and explained what had happened, but that the nurse still saw some left in the wound. We were told that with the other medication I was taking that while it wasn't ideal that they had fallen out it was not anything to be overly concerned with. The nurse changed the VAC dressing and we scheduled her next visit for a few days later.

Again a Trip to the Operating Room

CAUTION!!!! This post has what may be considered a graphic photo!



I went into the next surgery fully anticipating the surgeon to remove a small portion of the bone. I was obviously upset that the infection had penetrated into the bone and also curious how it had managed to happen while I was on the Wound VAC.

This surgery was obviously going to be more invasive than the previous, so I was more heavily sedated for the procedure. As such, I do not remember anything until I was waking up in the recovery room. When I woke up I felt fine and was wheeled into my room, with the Wound VAC therapy already having been resumed. Being that the infection was in the bone I would need to be admitted to the hospital for a few days so that the infection could be grown in a lab, so that we could ensure that I was treated with the proper medication. In the meantime I was treated with a broad spectrum antibiotic intravenously.

When I was more alert a bit later that day my surgeon came in and explained that he did take a portion of the bone and while he was looking around he asked for a consult with one of the infectious disease doctors. The surgeon is basically responsible for making sure the wound closes, while the infectious disease doctor's responsibility is to treat the infection so that it would be able to close without all sorts of bacteria in it.

I met the infectious disease doctor and was comfortable with him from the beginning. No alarm bells were going off in my head about anyone that was now treating me. I was confident that with the combination of the two doctors that the wound was getting proper treatment and it would close, with time.

Around day four of my hospital stay the two doctors came into my room and said that they were going to discharge me the next day but that I would need to have something called a PICC line inserted first. The PICC line is a peripherally inserted central catheter. A small tube was to be inserted into my upper arm and threaded up into a major vein of the heart and is used to deliver antibiotics on a long term basis.

The next day a nurse came in to get me so that my PICC line could be inserted. Surprisingly, enough I was not especially nervous about this procedure, even though I would be awake and completely aware of the entire thing. Although the PICC line felt uncomfortable going in I would not necessarily call it a painful experience.



After my PICC was inserted I was brought back to my room to get some instruction on how to use the line. It turns out that after a visiting nurse did the initial dose with me that I personally would need to administer my medication myself. That was the only part that made me uneasy, but I figured that it would not be allowed if it weren't a relatively simple thing to do. I went home with the Wound VAC and PICC line and was told that a nurse would meet me at my home to administer the antibiotic with me and to teach me how to do it for myself from then on. The nurse for the PICC line would only come on a weekly basis to change the dressing and to draw labs to monitor the infection.