Living Well with Long-Term IV Therapy

When IV therapy extends over weeks, months, or longer — whether for OPAT (IV antibiotics), TPN (IV nutrition), chemotherapy, or chronic infusion therapy — it stops being just a medical intervention and starts shaping your daily life. Schedules, activities, clothing choices, relationships, sleep, and self-image all become intertwined with your catheter and treatment.

This guide offers practical strategies for managing that reality and maintaining the best possible quality of life during long-term IV therapy.

Redefining “Normal” — At Least for Now

One of the most psychologically important steps in adapting to long-term IV therapy is accepting that your current situation is temporary or manageable — not permanent failure. Your “normal” has changed, but it can be a good normal with the right adjustments.

Patients who adapt well to long-term IV therapy tend to:

Find a routine that accommodates treatment without centering their entire life around it
Identify what they can control and focus on those areas
Grieve the things they cannot do right now while keeping their sights on the future
Ask for and accept help without shame
Connect with others who have similar experiences

None of this happens quickly or easily. Give yourself time.

Creating a Sustainable Daily Routine

The infusion schedule is the anchor of your day when you are on home IV therapy. Everything else — sleep, work, social life, meals — gets organized around it. The goal is to make the infusion fit your life as much as possible, rather than forcing your life to fit the infusion.

Choosing your infusion window

If your medication schedule has any flexibility (e.g., “give once daily” could be morning or evening), choose the time that disrupts your life least:

Overnight infusion (while you sleep): Best for working patients and those on TPN or long infusions. You are not conscious to be bothered by the pump, the tethering, or the time. Works best with a portable or bedside pump and long enough tubing to allow normal sleep positioning.
Evening infusion: Works well for shorter antibiotic courses (30–60 minutes). Anchor it to dinner or a TV show and it becomes a habit quickly.
Morning infusion: Works for some; less ideal for those who prefer flexibility in the morning.

Ask your infusion pharmacist and care team: “Is there any flexibility in the timing of this medication?” If the answer is no, you adapt to the fixed time. If yes, choose what works for your life.

Simplify where you can

Lay out all infusion supplies the night before
Keep your medication log open and accessible (not buried under other paperwork)
Set a phone alarm for flush times and infusion start times — remove the cognitive load of remembering

Sleep with an IV Catheter

Many patients worry about sleeping with a PICC or tunneled catheter. In practice, most patients sleep well:

Positioning: You can sleep in any position that is comfortable. Most people naturally move away from discomfort during sleep. There is no required “correct” sleeping position with a PICC or tunneled catheter.
Overnight infusions: Sleep normally. The pump is designed to run unattended. Tubing is long enough to allow turning and repositioning. If the pump alarms during the night, you will wake to it.
Protecting the line at night: A loose, comfortable sleeve over the PICC arm, or ensuring the tunneled catheter is secured against the body, prevents the catheter from getting caught in bedding.
Ports when not accessed: No special precautions needed for sleep. Normal sleeping positions are fine.

If you are genuinely uncomfortable at night due to the catheter, tell your care team — there may be adjustments to securement, positioning, or supplies that help.

Clothing and Dressing

Having an external catheter doesn’t have to significantly limit your wardrobe, but it does require some thought:

With a PICC

Long sleeves, cardigan-style layers, and wrap tops are the most versatile options
Tight long sleeves can be difficult to get over the dressing — wide sleeves are preferable
Sleeveless tops and short sleeves expose the dressing; there is nothing medically wrong with this, but some patients prefer to keep it covered for comfort and protection
Avoid putting tight compression sleeves, blood pressure cuffs, or restrictive bands on the PICC arm

With a tunneled catheter (Hickman)

The external lumens exit the chest and must be secured against the body when not in use
A snug undershirt or tank top with the lumens tucked inside holds them comfortably
Various catheter management products (catheter holders, pouches, belts) are available for keeping external lumens secure and unobtrusive under clothing
Button-up shirts and zip tops allow easy access to the lumens without undressing

With an implanted port

No clothing restriction when not accessed — the port is completely under the skin
During an access session (needle in place): the dressing needs to stay dry and uncovered; tops that open at the chest (button-up, zip, or stretchy wide neck) are practical for access visits

Work and Productivity

Many patients continue working — either in person or from home — during IV therapy. This is often possible with planning:

From home: Remote or hybrid work is often the most manageable arrangement during long treatment courses, particularly for overnight or long infusions.

In person: Many people complete OPAT antibiotic courses while working in person. A once-daily antibiotic given in the evening, a clean dressing, and a port or well-secured PICC need not prevent most desk or office jobs.

Physical jobs: More challenging. Discuss specific restrictions with your care team. In some cases, temporary reassignment to lighter duties may be appropriate.

Communicating with your employer: You are not obligated to disclose your medical details. You may need to communicate that you have a medical situation requiring accommodations (flexible start times, ability to attend medical appointments, remote work options). In the US, FMLA (Family and Medical Leave Act) and ADA (Americans with Disabilities Act) may be relevant depending on your condition and employer.

If fatigue or treatment side effects affect your productivity: This is expected and real. Work with your employer on modified expectations for the treatment period. Pushing through severe fatigue without accommodations increases the risk of errors and burnout.

Talking about your IV or catheter

You are not obligated to explain your medical situation to anyone. For close family and friends, honest conversation tends to reduce the awkwardness. For acquaintances, a simple “I’m on some medication for a health issue” is entirely sufficient.

Physical intimacy

Long-term IV therapy does not need to end physical intimacy. Practical considerations:

Protect the dressing and catheter from pulling, direct pressure, or water during bathing with a partner
Ports when not accessed allow the most physical freedom
PICCs and tunneled catheters can be managed with care and communication
Discuss any concerns with your care team — these are normal, human questions and deserve honest answers

Most social activities can continue — restaurants, movies, visiting friends, events. Infusion schedules can usually be worked around a social life, particularly for evening or overnight infusions. The limiting factor is usually your underlying health and energy level, not the catheter itself.

Food and Nutrition During Treatment

Maintaining good nutrition supports your immune function, healing, wound recovery, and energy. Some points specific to IV therapy:

For patients on TPN: the TPN provides your complete nutrition. Your care team will advise on what, if anything, you can eat alongside TPN. Even small amounts of oral food — if tolerated — are beneficial for gut health.
For patients on IV antibiotics: eat normally. Some antibiotics are better tolerated with food. Report significant GI side effects (nausea, diarrhea) to your care team.
For cancer patients on chemotherapy: nausea, taste changes, and appetite loss are common. Small, frequent meals and foods that taste appealing to you (which may be different from your usual preferences) are the practical approach. See our chemotherapy guide for more detail.
Adequate protein intake supports wound healing and immune function — prioritize protein-rich foods (eggs, poultry, fish, legumes, dairy) even when appetite is reduced.

Planning Ahead for Life Events

Long-term IV therapy does not mean suspending your life entirely. Events — weddings, graduations, travel, family gatherings — can often be worked around a treatment schedule with planning:

Talk to your care team early: “I have an important event on X date — can we plan around this?”
For single special events: can a dressing change be timed to occur the day before? Can an infusion be scheduled to finish several hours before the event?
For travel: see our travel guide for comprehensive planning information

Setting Goals and Marking Progress

Long treatments can feel endless. Two strategies that help many patients:

Track the milestones. Mark off each week of treatment. Note when labs improve. Celebrate the halfway point. For OPAT patients, each completed dose is one dose closer to the end.

Set meaningful near-term goals. “I want to be well enough to attend my daughter’s concert in three weeks.” Goals that are meaningful to you provide motivation and context for the discomfort of treatment.

Resources and Community

Connecting with others who are managing similar situations can provide practical insights and emotional support that is difficult to get from even the most caring clinical team.

Oley Foundation (oley.org): US-based nonprofit supporting patients on home IV nutrition (TPN) and tube feeding. Extensive resources, peer network, and annual conference.
Cancer support organizations: Cancer Care (cancercare.org), American Cancer Society (cancer.org), and disease-specific organizations provide resources, counseling, and peer support for chemotherapy patients.
NORD (National Organization for Rare Disorders): For patients with rare conditions requiring long-term infusion therapy.
Online communities: Patient communities on platforms like Health Unlocked, Reddit (e.g., r/PICC), and disease-specific Facebook groups connect patients with lived experience.

This guide is for educational purposes and reflects general strategies. Individual circumstances vary enormously. Your specific care team, a social worker, and mental health professionals are your best resources for personalized support.