Greenbaum wants me on a PICC line stat--what other options might I have?

Backstory:  I've been having problems with vomiting since I got my surgery 7 months ago.  About 2 months ago, I started having leg swelling.  My pre-albumin was very low at that time.  Dr. G wanted to put me on Creon, but I tried to "eat" my way up by downing 150-180g of protein a day.  Some people have said that Dr. Greenbaum is treating his post-op complications very (too?) aggressively, and to consider that.

So, I had my blood drawn on Friday.  Dr. Greenbaum blew up my phone and email yesterday, saying that my pre-albumin is 9, my albumin is 2.4 and that I'm protein malnourished.  He wants me to get on a PICC line and IV nutrition, stat.  He says we're past the point of trying Creon now, and that if the IV nutrition doesn't work, he wants to lengthen my common channel.  

Obviously, I'm not getting what I need by mouth, so I do need some help.  Might there be other options that can help besides the PICC line?  I won't play fast and loose with my health and life, but I don't want to jump and get this if I don't really have to.  Any other ideas?  

Right now, I'm waiting on my PCP to call me back after he talks to Dr. Greenbaum.

I'm freaking completely out.

What are your worries about a PICC line? I loved mine, way better than IVs and it sounds like he needs to get you nutrition that bypasses your digestion altogether so a J tube isn't going to help here.

Why aren't you already on the way to the hospital? Seriously.

Nicole, I would go for the PICC line. If you are that protein deficient, sounds like a must-have. What are your concerns, or rather, why are you freaking out and second-guessing the recommendation?

In terms of the aggressive treatment of complications, I believe some posters have opined that Dr. Greenbaum tends to get overly concerned about his patients "losing too much weight" when they are still pretty far from goal and introduces enzymes for that reason alone.  But protein deficiency is a whole different beast. 

Nicole....if you need protein nutrition IV (TPN) you need a PICC line. They won't give you a choice. A regular peripheral IV line won't hold up. A PICC line is a blessing.

The added protein that you consumed....was it food or shakes?

Victorious-

I had protein malnutrition about 7 months out, too. No PICC line, but caught it in time for Creon. My cc is 75cm, the shortest my surgeon will do. She used to do shorter, but stopped because she had to do too many revisions. I asked her for shorter than 75, but she says she goes strictly by the Hess method now.

Creon is the equivalent of a pharmaceutical reversal - it replaces the enzymes in your stomach that now go through you biliopancreatic channel. Creon CAN cause weight gain, but it didn't with me.

Leg swelling is one of the key symptoms of protein malnutrition. From your numbers, you need to be in the hospital RIGHT NOW!! That said, once you get the PICC line and get stabilized, you can have home health nurses come and do the infusions at home. The other DSer in my hospital's support group had to have a PICC line and fluid infusions, too. She had previous stuff going on with her system, though. She had previously been shot in the stomach.

Don't play with this! The DS is a great tool, but if you don't stay on top of deficiencies, the DS can KILL YOU!

 Yeah, your levels are pretty scary.  Into the hossy w/you for a PICC line, sweets.  I'd STILL be downing shakes like nobody's business though.

please take care of this, it is a serious matter. And a PICC line is really the way to go with this. Be thankful that Greenbaum is keeping his eye on you. Some surgeons are operate and forget about you.

He's not over reacting.

Yep....Like they said.  I was in the hospital at 10 weeks out with severe mal-nutrition.  DO NOT let that go.  You need to be at the hospital now.  btw....The PICC line is nothing, in fact if I go in the hospital for more than a day for anything I want one... so much better than a conventional IV.

Prayers are with you... Get well,

Lynne

Dang, I must have hit the wrong reply button....sorry guys,

Lynne