1. Following discharge from the hospital, have a responsible adult drive you home. At home rest quietly for the remainder of the day.

2. You may resume your normal diet after the procedure. Drink extra fluids. Avoid alcoholic beverages or depressant drugs for 24 hours.

3. Do not take aspirin-containing products, ibuprofen, vitamin E, or blood-thinning products (*Coumadin) for the next 24 hours. You may take Tylenol (one to two tablets every four to six hours) for the mild discomfort at the site. If you develop severe pain, swelling, or redness at the catheter insertion sites, call Dr. Osterman's office at (305) 932-7800.

4. For the first few days after you receive your vascular access tube try to avoid strenuous activity. Once your incision heals, you should be able to resume normal daily activities.

5. Vascular access tubes may be of several types, which include a PICC, Hohn catheter, Groshong catheter, hickman catheter, or for hemodialysis a Vas-cath, Tesio catheter, Davol catheter, or Ash Split cath. A bandage will be required where the catheter exits the skin. Daily dressing changes will be required. Avoid bathing or showering for five days. Although not optimal, you may take a shower or bath if the catheter site is kept dry with a piece of plastic wrap adhered to the skin. Plastic food wrap is available at most stores. Immediately following showering or bathing, remove the plastic wrap and clean the tube exit site with hydrogen peroxide. Allow the skin to dry and place a sterile, dry gauze dressing over the incision, held in place with paper tape. Patients undergoing hemodialysis will have their dressings changed frequently during their dialysis procedures.

6. Remember that following the tube insertion you will experience some redness and tenderness in the area of the skin insertion site which normally subsides in the first 24 to 48 hours. Contact Dr. Osterman at (305) 932-7800 if you notice unusual changes in the skin area, such as swelling, redness, or soreness. If you experience pain, fever, chills, shortness of breath, or dizziness, contact the office immediately.

7. If you are unable to care for your catheter at home, arrangements may be made through your primary care physician for a Home Healthcare Nurse to visit and perform daily dressing changes. Notify our office if you need assistance in arranging for a Home Healthcare Nurse.

8. Many catheters are placed on a temporary basis. If a course of therapy requiring catheter access is completed, then contact our office to make arrangements for catheter removal.

In most cases Coumadin therapy may be re-started 3 days after the procedure. You may discuss this with Dr. Osterman after the procedure or call the office for instructions.