TPN pain

• By Peggypeg
• Posted April 27, 2008 at 4:00 am

Hi Tricia,

Sorry your daughter is going througvh this horrible pain. Any unexplained pain needs investigation. Pain in a line like that is a huge warning sign and there should be some urgent investigation as to why this is happening. Sorry but it is not "normal" and so something is wrong.
Let us know asap what happens and really hope she feels better soon.

Chris
www.mypeggypeg.blogspot.com

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• By michdey
• Posted April 27, 2008 at 4:01 am

Tricia,

How long has the port/picc line been in? I hate to tell you this but pain inside the site is the first indication I had an infection. In fact, I had MRSA. There was no outside indication of infection--redness, puss, etc and my blood counts were okay--white blood cell count, etc but the pain got so bad, they removed the port and once it was removed, the tip of the catheter was tested and it was positive for MRSA. I had it removed three weeks ago and I am still having pain from it. I wouldn't take a chance with it--especially if your daughter is susceptible to infection or is on prednisone like I was. I would insist on speaking to your surgeon asap. Believe me I know that the surgeon is sometimes impossible to get a hold of but they must have someone covering them or if not, bring her to the ER--it is not something to fool around with. They can always put in another one in another site but it is better than becoming septic in the blood. I almost died from being septic and waiting too long to do anything about it (only waited a couple of days). Good luck to you.

Michelle

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• By JenD
• Posted April 27, 2008 at 10:08 am

Hi,

Michelle is right. It may be an infection in the line. The other possibility is that the TPN bag is still too cold. If the bag hasn't been left out to warm up enough for me it really aches going in. Also, sometimes the vein will spasm during infusions and this can be relieved with a heating pad against her arm.

Those are the main causes I can think of. The first thing to do is have her checked for infection.

Good luck,
Jen

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• By stekcsf
• Posted April 27, 2008 at 11:02 am

o'k thanks everyone....i'm new to all this and just scared to have her hurt more. but I see we need to get this checked out

thanks all
tricia

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• By stekcsf
• Posted April 27, 2008 at 11:31 am

just a thought friends.......she hasn't been moving her arm where the iv goes in by her shoulder...i mean relly not moving it. we try and try to get her too...but it hurts....and she's 11..... could it be just atrophy? i know we need to have it checked but what do you think about it hurting b/c she hasn't moved it?

thanks tricia

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• By bettemarie
• Posted April 27, 2008 at 3:12 pm

Hi,

My Name is Bette, I've been on TPN and other infusion therapy since 1989. I had two different PICC lines removed, due to pain in the arm. One time, the Midline (shorter length then a PICC line) irritated the vein because it released the medication & TPN into a smaller more narrow area of the vein, verses into a larger diameter area like the superior vena cava or right atrium of the heart. A second time, the PICC line was removed due to pain and eventually tingling and numbness in my fingers. This occurred for two reasons, 1) an area of the vein a few inches above the entrance site became narrowed, and 2) up higher in my chest part of the subclavian vein was narrowed from a previous central line. This did not allow the fluid from my infusions to flow very well though the vein, causing some of the infusion to leak out of the vein irritating the nerves and muscles in the surrounding area. My arm did not look swollen.
The PICC line was placed at a local hospital due to an emergency hospitalization. I knew something was not right and called my Interventional Radiologist at a distant hospital who places and cares for all my central lines, and has more experience in dealing with people with lines for the long term/many many years, verses just hospital stays or a short while. He got me in immediately and performed a test with dye; to see if the line was still emptying in the correct spot, to see if it was intact and had no holes or leaks, and to see how the veins looked.
Due to the narrowing in my veins, my left side can no longer be used for access.
Just this past year, I had an infection along the tract of my central line, and this was painful in my chest along the tract of the catheter and down into my arm and hand. With this, I had no fever, and no redness or drainage at the exit site. My Infectious disease doctors hospitalized me and were proactive with saving the line, and we were successful.

E-mail me if you have any questions: Bettemarie@aol.com

Bette

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• By SeussRN1
• Posted April 28, 2008 at 11:38 am

I had been on TPN for about a year and then weaned off for about 6 mo then had to go back on tpn. The first line I had in for 6 mo then had arm and shoulder pain - the MD was worried about about a clot so they did a doppler study to check and removed the line and replaced it with another I had that one for 6 mo and never had any other issues with it.

The nurse in me would either get a hold of the surgeon or go to the ER to have it evaluated. You could have your home health nurse call and speak with the office nurse - sometimes that works. Pain is not normal and should be investigated ASAP. It could be anything from blood clot to infection to simple irritation of the vein by a the catheter that the body is not happy having. After all it is a foregin object in the body.

Good luck!
Beth

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• By stekcsf
• Posted April 28, 2008 at 6:36 pm

thank all!!!! Well we got it checked and so far the DR. thinks it's just from scar tissue forming around the cuff that holds it in. He spent an 1hr. with us talking it all through and HE even changed her dressing to make it more comfortable. He said she needs to use that arm more. If it's not better next week we go back for dye study.

thanks to everyone, because of your advice and replies I felt I went into the DR. office informed and new some what if's to ask about.
thaks thanks!!!!

tricia

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