Having problems with my arm since FEC2, very sore and tender and hurts to stretch. Have one more FEC and 3 TAX’s to go, but nor sure my arm will hold up, so considering a PIC or Hickman line…unfortunately no port-a-caths in Shropshire.
Can anyone tell me the pros and cons of the two on offer? Are they painful to have inserted?
Is it true that TAX is not as hard on the veins ad FEC? and is it worth doing with only 4 more treatments to go?
Thanks
Hi noanie, I had a Hickman fitted after my 3xFEC and before 3xTax. A Picc line was never considered for me because my veins were already messed up by chemo - they couldn’t get blood any more and I couldn’t straighten my arm.
I’m going to copy and paste from a long reply I’ve given before on this subject to save the effort of typing it again!
Mine was done in theatre on the day ward - it has to be done in a sterile environment and is a bit more complex than a Picc line. I won’t hide it - having it put in was fairly traumatic but I was unusual because apparently my veins are unusually small and in peculiar places so it took a long time, almost two hours, but in most cases only takes about 15 minutes.
It’s usually done just under local, possibly with sedation. My surgeon doesn’t like to use sedation but he did give me some near the end as I was getting distressed, so if you’re offered it, I’d take it!
Usually they make an incision below your collarbone and put the end of the line into your vein and feed it up, through to just above your heart. This is done using ultrasound and was the part they struggled with on me as they couldn’t find a decent vein so in the end they had to put it in part way up my neck. The other end is then tunnelled under your skin and comes out at the top of your breast. This is the end they use for chemo. You have quite a long tube coming out and it’s held in place with a stitch. They then stitch the first hole closed (the one that they used to put it in).
The stitches in the entry hole are taken out after about 10 days and the one where the tube comes out after about 3-4 weeks. That’s to allow the skin a chance to knit onto the cuff that is on the line just inside.
My neck was stiff and the exit site was sore for a few days but it settled down quite quickly. It didn’t bother me at all after that and I hardly knew it was there.
It varies from unit to unit but I had clear, thin, waterproof dressings on mine and was able to shower as normal. I was always given a spare dressing so could change it myself midweek if I needed to. I had to go in once a week to have the line flushed with saline and some anti-clotting stuff put in. They also changed the dressing and checked it looked healthy, took a swab etc. You also have to do this with a Picc.
The line was just left dangling and I tucked it into my bra. I didn’t want it to get caught at night so wore a bra for a few days then got a couple of soft Mothercare sleep bras to wear (from Ebay) so I could tuck it away. I was then told about someone whose line got pulled out when her husband lay on it in his sleep so I was glad I’d taken precautions!
My line was used the next day for chemo and it was absolutely fantastic. I can honestly say that it was the best thing I could have done and if (God forbid) I ever need chemo again I’ll have one put in straight away. It was no trouble at all and made chemo and bloods so much easier and quicker.
It had to stay in for three weeks after chemo finished just in case I came down with an infection after my final chemo or needed bloods taken etc.
I’m sure you’ll be glad if you have it done and it will certainly save your veins from getting any worse. My arm is now a bit better although not brilliant - I wish I’d had the line in first. I believe Tax is easier on the veins but even so if I were you I’d go for a line.
Jane xxx
Hi Noanie, I had a PICC line inserted after FEC1. It wasn’t painful, because they give you local anaesthetic. It can make you dizzy for a minute or two afterwards, but that goes quickly. It usually doesn’t take very long. There was some discomfort after the anaesthetic wore off; you take paracetamol and warm your arm and shoulder. It took me a while to sort out comfortable clothing that didn’t rub or catch while still being warm enough during the winter, but in the end a softer version of a tubigrip plus a leg-sized tubigrip cut into segments took care of that. I needed a bit of extra padding under the plastic fittings.
On the other hand, pardon the pun, I didn’t have any vein damage to begin with but the nurses recommended the PICC as a precaution. I can’t tell you about TAX either, but having an IV does make the chemo a bit faster and easier, and they will use it for blood tests as well.
You should certainly ask about having a line; the nurses should be able to recommend one or the other.
Cheryl
Thanks Jane and Cheryl for your feedback. I’m a nervous wreck about getting this done, not sure which to worry about more.
Will call the chemo nurse tomorrow, having FEC 3 on Wednesday, so I hope they can do it before. I start 3 rounds of TAX next month, I hear that might be easier on the veins, but who knows…
Hope you are both OK.