image taken from macmillan cancer support website
Hello All, thanks for visiting my site. I want to thank my family members for their support in helping me create this site. Having a PICC line for the first time and managing it is a life changing experience in itself. This site is about PICC line care and TPN management in a home setup, it's directed to both old and new patients of all age groups who wish to manage line care etc at home. The purpose of creating this website is to share my personal experiences from the time I first got the line placed up until now and it includes comprehensive information on every area of this whole process. I got my PICC line for TPN, therefore this site will also include some information and videos about TPN. I am not giving medical advice but I do hope that the information shared might be of help in some ways.
I got the first catheter placed in subclavian vein of my right upper arm and I have been on parenteral feeding for few years. The procedure takes about 20 mins and the radiology team took care of my needs at that moment and once the line was in, vital signs and blood work were monitored and I was started on minimal dose of protein(amino acids), sugar(dextrose) and fats(lipids) through my PICC line which were then increased every night for a few days before I was discharged to go home. From this point on, my home agency took over my care and I received their brochure, patient record file that is used by the nurse for regular visits on checking the vital signs, blood work etc and sending weekly supply of bags and other essential items of use. After 4 months, we started doing our own dressing and cap change, and nurse visit for blood work became monthly.
My first catheter was a PowerPICC polyurethane double lumen from BARD but it migrated out in few months. Now I have a silicone Groshong double lumen catheter which is supposed to be more resilient, I used the red lumen for blood draw, putting cathflo when line was clogged up and when some medical testing had to be done, medication can also be given through red lumen. I use the white lumen for TPN infusion. I switched to daytime infusion as I intend to get off TPN and am working on my oral intake as well.
Managing TPN at home can be a huge challenge especially for new patients and it can be best done when more people (caring family members or friends) are involved in learning and executing specific tasks, its critical to have enough information about TPN, home health agency and insurance etc both in advance and at the time you are ready to move forward with home care. However, for me it was like a new born baby thrown into a mothers lap and I had to learn everything from scratch. Trust me, it can be very daunting and challenging in the beginning however I got family support too. We went through major upheavals and so much running around during the first year and then gradually with time it became a routine. If I were to suggest someone, it's best to prepare yourself mentally for this process, talk to your doctor and nurses in detail, ask questions for the safety of your PICC line and always speak up for your rights when needed to make it a smooth sail. Again, I am only sharing what works for me, please use this information at your own discretion, use it as a guideline and do what you think is best for your care or as advised by your doctors. However, I'd be glad if my personal experiences can be of help to any individual on TPN.
How I found my Home Health Agency
When the decision was made for me to go on TPN, it was a difficult decision for me to choose a home health agency for my care. Of course, I had to go with someone who was covered by my insurance. But besides that, there were other factors. I wanted to find a home health agency that was personable, could give me the focus and attention and detail that I needed with me care, had a skilled staff and was flexible and open minded. We researched Oley.org and after reading good reviews from more than one member, we chose my current home health agency. It was a tough choice as they are in a different state. My doctor had recommended a well known, popular company that is also local to me. However, the break point was that I needed a smaller company that would allow me to participate in my care. I did not want to go with a very big company with set rules where I would have to wait a week or more to get a response. It is few years now and I am glad with my decision. From my experience, here are the factors to be considered when picking your home health agency.
1. Covered by insurance
2. Will provide skilled infusion nursing care with 24/7 support, especially for weekend on call emergency support
3. Is open to supplying you with newer and better products for your line care
4. Your doctor is comfortable working with them
5. Preferrably a local company as during bad weather or storms/hurricanes, you can get your supplies without having to worry about transit time. For such situation, most agencies liasion with other agencies local to you and request them to send out supplies in case of a weather emergency
6. Should send your supplies on time. With some initial difficulties with a different agency in the first 6 months, my current agency always ships my TPN and supplies on A.M delivery every week
7. You should have access to your pharmacist and dietician and be able to discuss your concerns via email, phone. With a few hiccups along the path, I now have a good relationship with my agency. They try to understand my need and are willing to consider any special requests.
After I picked my agency, their representative made a personal visit to the hospital where I was admitted after I got my PICC line placed. I was provided details of the process in previous visits including comprehensive information about all the supplies they could provide. As soon as I got home, my supplies were made available. A nurse/RN was assigned to me for home visits for initial training, dressing, cap change and blood draws.
Good luck with your search for the best Home Health Agency that suits your needs.
Note: Please visit youtube.com for all videos from this website. The content of the site should open in all common browsers like IE, Safari, Firefox, Chrome; in case the videos do not play from this site, visit youtube. Through this website I am only trying to share my personal experiences and not giving any medical advice whatsoever, so kindly/please use this information at your own discretion. Please use the web version if viewing on mobile device.
I got the first catheter placed in subclavian vein of my right upper arm and I have been on parenteral feeding for few years. The procedure takes about 20 mins and the radiology team took care of my needs at that moment and once the line was in, vital signs and blood work were monitored and I was started on minimal dose of protein(amino acids), sugar(dextrose) and fats(lipids) through my PICC line which were then increased every night for a few days before I was discharged to go home. From this point on, my home agency took over my care and I received their brochure, patient record file that is used by the nurse for regular visits on checking the vital signs, blood work etc and sending weekly supply of bags and other essential items of use. After 4 months, we started doing our own dressing and cap change, and nurse visit for blood work became monthly.
My first catheter was a PowerPICC polyurethane double lumen from BARD but it migrated out in few months. Now I have a silicone Groshong double lumen catheter which is supposed to be more resilient, I used the red lumen for blood draw, putting cathflo when line was clogged up and when some medical testing had to be done, medication can also be given through red lumen. I use the white lumen for TPN infusion. I switched to daytime infusion as I intend to get off TPN and am working on my oral intake as well.
Managing TPN at home can be a huge challenge especially for new patients and it can be best done when more people (caring family members or friends) are involved in learning and executing specific tasks, its critical to have enough information about TPN, home health agency and insurance etc both in advance and at the time you are ready to move forward with home care. However, for me it was like a new born baby thrown into a mothers lap and I had to learn everything from scratch. Trust me, it can be very daunting and challenging in the beginning however I got family support too. We went through major upheavals and so much running around during the first year and then gradually with time it became a routine. If I were to suggest someone, it's best to prepare yourself mentally for this process, talk to your doctor and nurses in detail, ask questions for the safety of your PICC line and always speak up for your rights when needed to make it a smooth sail. Again, I am only sharing what works for me, please use this information at your own discretion, use it as a guideline and do what you think is best for your care or as advised by your doctors. However, I'd be glad if my personal experiences can be of help to any individual on TPN.
How I found my Home Health Agency
When the decision was made for me to go on TPN, it was a difficult decision for me to choose a home health agency for my care. Of course, I had to go with someone who was covered by my insurance. But besides that, there were other factors. I wanted to find a home health agency that was personable, could give me the focus and attention and detail that I needed with me care, had a skilled staff and was flexible and open minded. We researched Oley.org and after reading good reviews from more than one member, we chose my current home health agency. It was a tough choice as they are in a different state. My doctor had recommended a well known, popular company that is also local to me. However, the break point was that I needed a smaller company that would allow me to participate in my care. I did not want to go with a very big company with set rules where I would have to wait a week or more to get a response. It is few years now and I am glad with my decision. From my experience, here are the factors to be considered when picking your home health agency.
1. Covered by insurance
2. Will provide skilled infusion nursing care with 24/7 support, especially for weekend on call emergency support
3. Is open to supplying you with newer and better products for your line care
4. Your doctor is comfortable working with them
5. Preferrably a local company as during bad weather or storms/hurricanes, you can get your supplies without having to worry about transit time. For such situation, most agencies liasion with other agencies local to you and request them to send out supplies in case of a weather emergency
6. Should send your supplies on time. With some initial difficulties with a different agency in the first 6 months, my current agency always ships my TPN and supplies on A.M delivery every week
7. You should have access to your pharmacist and dietician and be able to discuss your concerns via email, phone. With a few hiccups along the path, I now have a good relationship with my agency. They try to understand my need and are willing to consider any special requests.
After I picked my agency, their representative made a personal visit to the hospital where I was admitted after I got my PICC line placed. I was provided details of the process in previous visits including comprehensive information about all the supplies they could provide. As soon as I got home, my supplies were made available. A nurse/RN was assigned to me for home visits for initial training, dressing, cap change and blood draws.
Good luck with your search for the best Home Health Agency that suits your needs.
Note: Please visit youtube.com for all videos from this website. The content of the site should open in all common browsers like IE, Safari, Firefox, Chrome; in case the videos do not play from this site, visit youtube. Through this website I am only trying to share my personal experiences and not giving any medical advice whatsoever, so kindly/please use this information at your own discretion. Please use the web version if viewing on mobile device.