Picc line advice please

Dear Ellen, 

I have had a picc line put in yesterday under u. s which went fine and I had my 2nd IV oxaliplatin in the chemo unit. Reading up on your information page on picc lines it mentions having a chest Xray afterwards. I didn't have a CXR should I be concerned. Presumably it's fine as my chemo went through without any difficulties as far as I know. 

Also do you have any advice regarding what can be lifted with the arm with the picc line in. I am thinking shopping bags of groceries. As I live alone I do most things for myself and the supermarket isn't too far from me to walk to.

Many thanks for any help you can give me,


  • Hi LouLoubelle64,

    Thank you for getting in touch with us. I’m glad to see that you’re a member of a few other groups within the Online Community. There’s nothing quite like getting support from others who have been through similar or the same as yourself. I hope you’ve found the groups helpful.

    I’m glad to hear that the PICC line insertion went fine for you. Our information on PICC lines was revised in 2018 when it was common practice to have a chest x-ray to check the site of the line. Since then things have changed in some areas. Our information is due to be revised again soon. I have passed on to the information team what you have shared with us, so thank you for letting us know.

    A new system is used called the Sherlock 3CG Tip Confirmation System. This is where they use magnetic and electrocardiographic (ECG) tracking of the PICC line tip. If this is done successfully then there is no need for chest x-ray confirmation and the PICC line can be used straight away, minimising delays.

    If during the confirmation process there is no noticeable P wave picked up on the ECG test, then the person will be sent for a chest x-ray to confirm the tip placement. Hope that makes sense.

    It might be useful to speak to your hospital team about how they checked the placement of your PICC line. It could be that they carried out the above process.

    It’s difficult for us to advise people on what they can do as we are unable to review you or your PICC line. Why don’t you give your hospital team or chemotherapy unit a call and have a chat with them about specific PICC line aftercare.

    Generally, you can go about your normal day to day activities, try not to do anything too strenuous as we don’t want the PICC line to dislodge. Sometimes, people use a bandage to keep their PICC line secure and covered.

    Please know that you can give us a call on the support line too to chat things over. The nurses are on the support line 7days a week 8am-8pm. As well as providing information, we also provide a listening ear.

    All the best with the rest of your chemotherapy treatment and take care.

    Best wishes and take care,

    Kayleigh-Cancer Information Nurse Specialist
  • Many thanks for the reply Kayleigh. As far as I could tell the picc was inserted under ECG guidance and U. S. Unfortunately yesterday morning I woke up with severe heart palpitations and some chest tightness and slight pain. So after after advice from the chemo nurse attended GP for an ECG. She referred me straight to AMU at my local hospital. They did a chest Xray and ECG and blood tests. They cxr was fine and picc is in the correct place. The ECG showed some arrthymias which the Dr's were a bit concerned about. They are going to refer me to a cardiologist for a 72 hr halter monitor.

    They also gave me a low dose of lorezepam to take for the anxiety. I am feeling a bit better today but it is a bit scary having to go through all this when you are on your own at home. I have struggled to get help in the past which you may read if you look at my profile. 

    I need to try and be more positive that their will be an end to this living nightmare. 

    Thank you so much for your help 


    Best wishes 
  • Hi ,

    Thanks for getting back in touch with us. I’m glad that you found answer to your previous question helpful.

    We’re glad to read that you were able to be seen at your local hospital for assessment.

    Arrhythmias or heart rhythm problems are quite common, and most people can lead a normal life if it’s properly diagnosed. The most important thing is that you’re being referred to a cardiologist to be assessed.

    Have you let your chemo nurse know the results of your recent investigations and the fact that you are to be assessed?

    Some chemotherapy drugs can cause problems with the way that the heart works. Even although you’re feeling better it’s important that you let them know that you’re having further investigations.

    If you have any new, persistent or worsening symptoms whilst you’re having chemotherapy it’s important that you contact your 24 hour-urgent chemotherapy number immediately. They won’t mind if it’s nothing to worry about they would rather you did this than wait. Chemotherapy has side effects and it’s always better to be safe and seek medical advice.

    It’s understandable why you’re feeling scared and anxious. Having palpitations and chest tightness is scary, especially as you live alone. I can see that you have said that you need to try to be more positive, but this is easier said than done.

    It’s also essential that you do get help and support with your emotions. It can help to make an appointment with your GP in the first instance. They will be able to offer you support.

    There are many ways that we can offer you support. I can see that you’ve already joined some of our groups and talking to others. That’s great to see as there is nothing quite like the support that you can get from others.

    You can call our Support Line on 0808-808-0000 and talk to one of our nurses. Our lines are open every day from 8am till 8pm.

    Best wishes and take care.

    Ellen-Macmillan Online Digital Nurse Specialist.

  • Many thanks for the reply Ellen, 

    I am feeling a bit better now. Just really tired out. My picc line dressings needed changing yesterday as there had been a leak. I had to go to the chemotherapy unit and they fitted me in to have it looked at. Today I noticed a leak again and phoned up the picc service who said it is probable I have a reaction to the part of the picc line that is in the skin of my arm. It aches quite a lot also which apparently isn't normal. Anyway I have an apt tomorrow to have that part changed so hopefully that will sort it out. I am a bit fed up with constantly going to the hospital but at the moment I don't have any choice.

    My palpitations have settled down a bit now. My troponion blood level was 6 initially which the doctor said was fine, but looking it up on line it seems that above 4 is abnormal. It seems the capictabine tablets affect the heart also. I can't help wondering should my heart have been checked before I started chemo?

    I will let the doctor know when I next see him.

    Best wishes 

    Best wishes 
  • i Louloubelle64,

    Thanks for getting back in touch with us.

    It’s understandable why you’re feeling a bit fed up. Going back and forward to hospitals can be difficult, but the main thing is your getting checked. Hopefully things will settle down soon.

    We’re glad that you’re feeling better and that the palpitations have settled down by now.

    It’s understandable why you’re asking questions and looking online to find answers. But the internet can’t replace the expertise of the doctors who are looking at your results. They have the results of your other tests when they are giving you your Triponin test results.

    Labs Online UK have this information about the Triponin test that can be helpful to look at. They say that Reference ranges are dependent on many factors, including patient age, sex, sample population, and test method, and numeric test results can have different meanings in different laboratories.;

    “Reference ranges are dependant on may factors, including patient age, sex, sample method and numeric test results can have different meanings in different laboratories

    The lab report containing your test result should include the relevant reference range for your test.”

    If your still concerned about your recent results, it’s important that you speak your doctor or specialist nurse who will be able to explain your result in more detail.

    Is also understandable why you can’t help wondering if your heart should have been checked before starting chemo.

    Our information about CAPOX (XELOX) states Capecitabine can affect the way your heart works. You may have tests to see how your heart is working before, during and sometimes after treatment.

    But it is still possible for your heart to be affected even if these tests are normal. Very rarely, this can lead to heart failure or a heart attack. The risk of this happening is very low (less than 1 in 100 (1%), but it is important that you know about it. Tell a doctor immediately if you have any of these symptoms at any time during treatment:

    • pain or tightness in your chest
    • breathlessness
    • changes to your heartbeat.
    • If you experience any of these symptoms, you should stop taking the Capecitabine tablets until you have spoken to your doctor. If you cannot get through to your doctor or the 24-hour number, the hospital has given you then call the NHS urgent advice number which is 111.

    Not all chemotherapy protocols recommend that an ECG/ Echo is carried out before starting this regime. It depends on the drugs used and the potential risk.

    Here is an example of a NHS hospital protocol for this regime.

    Some doctors may request a heart tests out with the chemotherapy protocol if the person has a history of heart problems.

    To put your mind at risk we would encourage you to talk to your oncologist about your recent heart test results. They will be able to discuss the hospital chemotherapy protocol for this regime and explain in more detail why heart tests are not routinely carried out.

    Best wishes and I hope you’re continuing to feel better and the issue with your PICC line has been resolved.

    Take care

    Ellen-Macmillan Online Digital Nurse Specialist.





  • Many thanks for your reply Ellen, 

    It was very helpful. I will discuss the issue with the oncologist when I see him next. I did need to go back to the hospital this morning to see the picc nurse and he redressed the line without the biopatch to see if I was reacting to that. I may have to go in on Sunday morning to have the Securacath changed as they said I could be reacting to the nickel in it. Just checked it now as I left it as long as I could before looking, and there is some serous fluid around the insertion site.

    They were very helpful this morning to me, as I was a bit anxious about going there without an apt. But glad I did as they were calling me to come in anyway. 

    Thanks again for the reassuring message 

    Best wishes