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Left Arm Pain - with and post-picc
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Left Arm Pain - with and post-picc

I dont' know if this is vascular, neurological, or what so I'm posting it here.

I had a picc line in my left arm from June 10th through August 22nd of this year. During that time, I had pain in that arm (inside of the upper arm and armpit), but was assured by my doctor and the nurses that it was first from the insertion and then from overuse and to rest it. The pain ranged from a dull ache to a sharp pain (particularly in the armpit area) and would occasionally radiate down into my chest.

Since the picc has been removed, the pain has continued to occur, more so when I use the arm but also for no particular reason whatsoever. I'm also having aching pain in the left shoulder and left side of my neck, as well as having areas of reduced sensitivity to touch. The arm doesn't seem to be swollen or discolored and I haven't noticed any loss of mobility or strength (other than what the pain limits). The darn thing just hurts!

It took 4 tries for them to insert the picc because it kept "catching" on something and I'm wondering if they didn't manage to damage something in there.

I've talked to my doctor about the residual pain and she suggested it might be "phantom pain" from having the picc and didn't care to pursue the subject further. I don't buy into that as the inside of my arm and armpit are tender when pressed on.  This is the area where the picc ran, btw.

Had a whole range of heart studies done (EKG, stress test, echocardiogram) and while anomalies were found, I was told these were perfectly normal variants and everything was fine.  So that's not an issue.

Does anyone have any suggestions as to what this might be or how to go about getting it diagnosed since my dr seems to think it's all in my head?

This is really beginning to cramp my style.

Thanks in advance.
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Ok, after some investigation, figure this is probably phlebitis.

Will be running it by my neuro when I see him on the 18th, just to rule out any possible nerve damage problems.

You are right about there being other causes too.

Since you had a PICC line in your left arm the pain could be due to infection in the vein in which the line was inserted. Did you have fever anytime after the insertion of PICC.  Also can you feel any lump in your armpit? This lump could be enlarged lymph nodes that are tender.

You are worried about nerve damage, maybe rightly so. The area that could be damaged is the network of nerves in your armpit called ‘brachial plexus’. http://www.ninds.nih.gov/disorders/brachial_plexus/brachial_plexus.htm  Please go through this link to see the details of this kind of injury. Such injuries generally heal with time and physiotherapy.

I would also advise you to examine your breast for any lump, tenderness etc.

Please discuss these possibilities with your general physician and neurologist and undergo complete clinical examination.

Let me know what your doctors say. Let us know if you need more help.

Thank you for your reply. :)

I did the examinations you recommended and there aren't any painful or unusual lumps in my armpit or breast, thank goodness.  I did, however, notice the vein in question was hard to the touch in areas in my arm (particularly where the acute pain radiates from) and in my armpit.  

Since I could feel the catheter moving through the armpit area during insertion (that was highly unpleasant), once again I'm wondering if they didn't at least damage the vein.  The guidewire also literally crumpled during one attempt.  The last 2 inches of it were all zig-zagged (I looked - bad idea).  Again, more opportunity for damage?  Needless to say, I never want to have to go through that experience again.

There were no unusual fevers after the picc insertion or while the picc was in.  I'm not sure if my immunoglobulin anomalies would make any difference in a response to infection tho.  IgG1 deficient, very low IgG4, low IgA.  I'm planning on having further studies done to investigate this particular issue.

Thank you for the link.  The picc was placed in the brachial vein and it wouldn't be a surprise, considering the difficult insertion, if this was a contributing factor.  It would certainly explain the pain and loss of sensitivity.

I will definitely be bringing this up to my neruo.  In the meantime, I will talk to my doctor about getting an ultrasound of the area to rule out vascular issues.  Will post as I find out any additional information.

Thank you again.

I am glad we are on the right track. I am also very sorry to learn about the clumsy attempts to put your PICC.

I would suggest you see your neurology specialist soon. I know you are going to. Yes, it will be a good idea to get your Immunoglobulin status checked once. Also please ask your physician to rule out phlebitis or inflammation of the vein as that took the most injury, is now engorged and hard to feel. More than that, I find difficult to say without examining.
Please let me know if there is anything else you wish to know and will be looking out for your posts about your health. Most important, do not worry. Solution is just round the corner.

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