PICC or Hickman Port? Insurance approved limited IV abx. What should I do?

[Antares in NYC]

Ok, so my insurance has approved a short course of IV antibiotics... less than what I expected. It's a start, though.

In order to do this, they need to install an IV line that goes close to the heart, and they are telling me of two types: Hickman line enters from the chest, straight to the superior vena cava, near the heart.
The PIIC enters through the arm, also straight into the superior vena cava.

Needless to say, I'm freaked out about this. Not fond of the idea of having a tube inserted into my ticker.

I would appreciate it if anyone could help me figure out what method should be better:

- Which one is less invasive?
- Which one does restrict my lifestyle and activity?
- Which one is safer and less prone to issues?

I would appreciate some help with this matter, thanks.

 

[Antares in NYC]

I also have another question for those hat have been dealing with IV antibiotics and insurance approvals...

Apparently my insurance has only approved one month of IV abx treatment. Since IV abx treatment tends to be much longer than that, how does this work? What happens after the month of therapy? Is is worth it to have a Hickman line into my heart if the insurance would only cover one month worth of medicine? Do insurance companies have to renew it month to month? Is that how it works?

While I felt elated that my insurance approved IV abx, suddenly I'm becoming increasingly anxious as the details of this approval start to become less than optimal. Sigh...

Anyone has experience dealing with this?

 

[Gingergrrl]

I am not an expert but back in May when I was in hospital they wanted me to get a PICC line for MCAS to get IV Benadryl. Long story short I declined b/c of the risks and also wasn't able to leave hospital with home health in place to monitor it (b/c I was 7 hrs away from home) so hospital felt it would be unsafe for me.

If you are only getting IV for one month can you get a mid line or a peripheral line? In my case the mid line was not an option b/c of the PH of Benadryl and they switched me to IM injections and after that to pills.

I know I am going a bit off track but my point was if you are only doing one month of IV, can you go with less risky option?

 

[Kati]

Ok, so my insurance has approved a short course of IV antibiotics... less than what I expected. It's a start, though.

In order to do this, they need to install an IV line that goes close to the heart, and they are telling me of two types: Hickman line enters from the chest, straight to the superior vena cava, near the heart.
The PIIC enters through the arm, also straight into the superior vena cava.

Needless to say, I'm freaked out about this. Not fond of the idea of having a tube inserted into my ticker.

I would appreciate it if anyone could help me figure out what method should be better:

- Which one is less invasive?
- Which one does restrict my lifestyle and activity?
- Which one is safer and less prone to issues?

I would appreciate some help with this matter, thanks.

First you mention hickman port, you are speaking of 2different apparatus.

a Hickman line is usually 3 lumen of tubing coming out of the upper chest area. You access them bia the tubes. It is used for complicated cases such as bone marrow transplants
A port or port-o-cath is an implanted device which is accessed via a needle (you will feel the needle poking the skin every time it's accessed. The port can be left inside the body for years. It needs to be accessed at least monthly in order to be 'flushed' to make sure it doesn't get clogged.

Both are inserted by physicians druting a 20 minutes procedure. You will get x-ray during the procedure to guide the physician.

less invasive: picc line. It can be inserted by specially trained nurse and requires chast x-ray to confirm placement.
For a picc line what is important to know is that you will need weekly dressing changes usually done by a community health nurse. You need to cover the dressing to keep it dry when you shower. It is not recommended you immerse the limb in water ( like bathing or swimming for instance).

The picc line is prone to vein inflammation in the begining. This is because you are inserting a foreing body in a vein, your vein and arm will become inflamed at first. You will need to use a heating pad and anti-inflammatories at first, and your arm might be sore and swollen.

The port is thene that will be most invisible but perhaps a bump below your clavicle. You will also have a 1.5 inch scar from insertion. It would be the one that restricts your activities least. Once in a while people will have problem with their port. As a nurse I have seen a few of them, for PICC also. Getting clogged up is the most common. For port they can flip around. In that case only surgical intervention will make it work. But it is fairly rare. PICC line, infection. Inflammation of the arm. It needs maintenance and it's always 'there'.

i hope it helps.

i am not someone who has good veins, so if I needed regular IV therapy, personally I would go for a port.

Note: I did not discuss here the differences in costs and whether it matters for you.