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What causes soreness in chest after picc line instertion? - Online Doctor Chats

Date : 09-Apr-2014
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2003
Answered : 1560 Questions
User:i had a picc line insterted 12hrs ago. i am having soreness from the catheder to the armpit and occasional chest pain. my throat just started to swell and hard to swallow. the hospital where i am currently at is not concerned. what can or should i do? is this normal?
Doctor:
Let me read your query for few minutes to be able to have a good discussion here.
Doctor:Hi there, are you currently IN the hospital?
User:yes
Doctor:Ok. Well. It is pretty common to have some arm and chest pain after picc line insertion.
Doctor:The line goes inside the vein all the way up to the armpit and beyond
Doctor:So the irritation from that ought to go down over the next few hours as the vein gets used to the irritation from the line
Doctor:As to the throat pain. May I ask if you are having any trouble breathing?
User:i started to have some chest pain but, breathing is okay
User:i also recieve medications every 3-4hrs. normally when the iv is flushed i taste the saline. i have not been able to taste the saline or othr medications very well in the last 1-3hrs
Doctor:Ok. When you say taste the saline? Do you mean you can taste it in your mouth?
User:it also does not feel like i am getting the medications. i get certain side affects with the pain meds but, i hav not had any of the normal side affects since the throat has swollen
Doctor:Ok, Can you tell me how this PICC line was inserted?
Doctor:Where is the insertion site?
User:yes taste in the mouth. i was still tasting those after the picc was inserted. taste stopped aftr throat swollen
Doctor:Ok. well the best and quickest way to make sure that your picc line is in the right place is to get an X-ray done. You will be able to see the line and where is is going very clearly and easily.
Doctor:Do you think that you could get them to do this for you?
User:yes, i just asked and they said xray was ordered. can you tell me what would be used to tell if the vein is clotted or torn around the cathedral site? is that by ultrasound?
Doctor:That would cause alot of bleeding and the picc line would be drawing blood when aspirated
Doctor:also, on x-ray, if the picc line has gone "through" the vein, the line will not travel in the expected course through the subclavian vein, instead it would take an alternate course
Doctor:PICC lines are lined with a special lining that shows up very well on x-ray. Not so easy to see on an ultrasound
Doctor:Did they give you any sedation or medications before putting in the line?
User:they did pull bloood back. i hav some bleeding around the site but, it is stopped. can you tell me how i can get transferred to different hospital if i can not get these issues addressed? i am having other issues with the original reason i am here. i was hospitalized 2wks ago at a different hospital for bleeding giant ulcer in duodeum and multiple ulcers in colon. i am at this hospital due to 2nd GI doc recommendation. my stomach has closed off so i cant eat or drink anything. are you familiar with how a patient can get transferred to a dif hospital?
User:no sedation. they just numbed the area where the line was inserted. was very painful to have put in
Doctor:I'm very sorry ma'am. I can answer questions relating to Medicine and the management of illness. But i'm in another country and am not familiar with your countries healthcare laws and insurance issues
Doctor:Ok. i asked about the sedation because I wanted to see if you might be having any side effects from sedation
User:ok, i understand. are you familiar with the stomach closing off due to a duodeum ulcer
Doctor:Yes, the inflammation from the ulcer blocks food from exiting the stomach
Doctor:They need to bring down that inflammation first by giving you medications that stop acid from being produced in your stomach and duodenum
User:no food is able to pass. only small traces of liquid. i have severe unbearable pain in stomach and has gotten worse during my stay at hospital but dr is not converned to look at anything. what should i have the dr look at?
Doctor:There are a few meds that you can use for this. Most of them belong to a class of meds called "Proton Pump Inhibitors"
Doctor:One of the commonly used ones is Pantoprazole
Doctor:They also need to rest your gut. So they won't let you eat or drink for awhile.
User:yes, i am XXXXXXX protonix right now. stomach pain has been worse since been onprotonix
User:yes, they told me i could not eat or drink for 3-6 months. this does not seem normal
Doctor:Ok. I understand. The Protonix will take some time to kick in. In the mean time, maybe you could discuss getting some pain meds with them
Doctor:No eating or drinking for 6 months?
Doctor:How do they plan to give you nutrition?
User:shouldnt my stomach be pumped to get rid of food sitting in there for a week. yes, they said up to 6months
User:they are expecting me to give myself iv bags at home with picc line
Doctor:Ok. Now i get it
Doctor:Well, see your body won't be able to absorb things very well through your gut right now. They have to wait till the swelling from that ulcer dies down
Doctor:It's better to let the gut rest instead of trying to operate. They would end out having to resect way too much bowel and i don't think you would have a good outcome even then
Doctor:I need more time to answer your questions to the best of my knowledge / to discuss your problem at length.
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