TPN 18 years post op

I posted about a month ago about starting tube feed due to bowel resectioning that needs repair and causing eating issues. I did not tolerate tube feed so I'm back on liquid diet, which I started March 5th. My surgeon won't do repair until protein levels are up. He scheduled surgery for Monday pending blood work, levels are still too low so he postponed surgery for at least 2 more weeks. My dietitian has recommended TPN. Has anyone had any experience with this? I work in hospital so I know what's involved just haven't experienced it myself. Any help would be appreciated.

No experience with it, personally, but just wanted to wish you luck with the procedure. I hope you continue to heal and get well.

Hi Katherine, Yes, I had TPN briefly,3 days, to build me up hgb was so low, did not and would not tell me what it was originally even on discharge... I also received 2 units PRBC's.(HGB was under 9 when released.- felt so renewed, i was ready to go back to working 2 shifts, full time, LOL).

If you can get it approved and done you will feel SO MUCH better, it will aid your healing for the surgery that is required..

This was. while in hospital for intestinal twist.- one of two i have had. at about 13-14 years post op..think it was 2000, not quite 14 years. I had .to have..labs had to be done every morning to verify and allow pharmacist to give right balance.I received one mixed bag of lipids and minerals and the other had MVI+? in it...they alternated and ran slowly... was long lists of supplements on each bag...similar to what is on a tube feeding formula container...

The Doctor that did my Obesity surgery literally wrote the book on use of TPN.It is a textbook for Doctors. His name is/was George Cowan. He taught Obesity surgery procedures in Memphis and over the world...including Russia.. AS Part of the surgery he did he placed a stoma in the old part(reduced capacity) stomach, marked with surgical clips... for access by g tube, should any unforseen medical event occur. His rationale was: "it cost 3$ to place it at time of surgery, and if someone was in accident and required who had had gastric revision- it could lessen the impact/suffering of placing such a devise.years after the WLS...

After mom had a massive stroke we needed to access hers and she had a continuous tube feeding@ low rate. Her Doctors were reluctant "to access an "old device" (placed 18 years earlier,) and wanted to know "what if it doesn't work because it's old". I told them" it isn't as old as she is.Use it. we will cross the problem bridge when we get to it.".. it worked flawlessly.

Like you I have had some serious issues in past but no more surgery.

Thankfully...both twists were un-kinked with gastric decompression.Low intermittent suction x5 days. I could exactly pinpoint location of twist.. mine were caused by gastric intolerances,(banana's ,shaken-To remove some carbination-Cola) and a case of gastritis in progress.

Becoming more aware of intestinal health and being proactive in my own treatment has stopped any further torsion..Once early gastritis symptoms develop I go to a Rice and ice water only...for at least 36 hours and take Prevacid at 30mg dose q 12 hours for 3 days , then 15mg q 12 for 3 days.

. I have not found a lactose free-nut free, legume and soy free- high protein, so when i begin my high protein after being on such restriction i have 4-5 eggs poached for breakfast- and breakfast lasts til i get them down...

..My prescribed protein intake is a minimum of 90 grams.i eat 2 main meals and a snack,most days...My pouch remains small around 4-6 oz unless i have a gastric event....if i have large amount of edema my intake drops to about 2.5 oz-3 for the day until the edema subsides.. Prevacid works faster for me than any other PPI, i can usually feel some relief in a few hours. No one understands why...

Thank you so much for info. Sounds like you have also been through a lot. Makes me feel like Im not alone in this journey. I finally got approved for surgery!! Its this coming Monday. They never started TPN, but may have PPN while in hospital. I was on it for a few days in March and it really helped. Doctor is doing bowel resectioning and also said something about the clips you mentioned in case peg tube is needed in the future. I have gotten down to 121lbs so hoping to put some weight on after surgery and hopefully go back to solid food.

Hi Katherine,

Glad you have gotten approval and will soon be getting this fixed .I have had a few brief episodes. you need to be very alert to mineral intake and absorbtion.. generally citrate forms are better utilized. with you having such intolerances - your surgeon can help assist you to get and keep on the road to healing.

The WLS is often thought of as a easy fix- There is no such thing-as an easy fix. Each one costs us something personally. Not only in $$ but in all aspects of our lives. Each body is different and responds differently to the same procedure. Our surgeon is trying to give each of us the best fit for our situation..sometimes the experience they have is able to give us the best guidance and sometimes our bodies rebel.

My Mom had essentially the same surgery,same surgeon, hospital,support staff- i had 6 months before i did. our bodies reacted differently to different foods.. i could eat chicken, she could not . she could drink regular milk-+ eat cheese and nuts, i could not.

The end result of our surgery ..with the RNY, +procedure extra's ..Dr Cowan called a "Memphis Gastric Bypass". To distal end of esophagus, i have a pouch,w/ 6 ft of straight gut /small intestine attached( no gastric juices /digestion in this section...parallel- an old stomach( w/stoma for any future needs) hooked to small intestine. and routed in to small intestine mentioned w/pouch...both attached to 10 ft small intestine that digests, and i have2 ft remaining of large intestine. my gall bladder was (bad)removed at time of surgery and appendix was removed.

Dr Cowan placed a band at top of esophagus., and at the bottom of pouch.( this enables anything caught to be removed via scope through mouth). to prevent /protect /from large food pcs being caught down in distal sections of intestine....in the narrow strictures that occur with healing of many re-sectioned places.

...The one at the base of esophagus gives me issue, large capsules feel as if they are caught-even when they are not..large round pills and "000" capsules are hard for me to swallow.

I had mineral deficiency even with taking supplements rx'd. i have lost most of my teeth from cracking. at one time was diagnosed as osteopenia- have corrected that with mineral and D3.I take a desiccated liver for anemia.it has all needed to absorb iron that my body lacks. These are things you should avoid...and treat promptly..should they occur.

When i had surgery,10-96 my blood sugar was terribly unstable.Lows of 25-45 were common every morning. Now what is termed pre-diabetes.was told control sugar or you will be on insulin injections in 5 years.. 40 years later still am prediabetic. Before....My knees hurt ,ankles weak, began pushing 300lbs..had to do something all diets/ eating plans i tried nothing worked. metabolism 40% lower than normal.working 9-13 hours on feet daily.I had gastric distresses- then Has not changed still have those plus some.more.

Since my surgery i have been able to work doing heavy physical work...in a whse. (hand unloading 18 wheelers and containerized freight)... Before i was a nurse for 20 years..I wanted out bad...Loved nursing care-hated the politics of hospital settings...I have been able to help take care of My MIL and My husband during xtended illness. then later Hubs and i took care of my parents until their death after DM became totally disabled and dependent. It has been several years since that and more health crisis w/family have occurred. i have been able to give support where needed.

Being aware of personal response to foods and food groups has helped me mitigate further gastritis...will help you to anticipate reactions and minimize bad ones in the future.. A physical diet diary can be a wonderful tool.to compare /trace symptoms and relationships to intake over the long haul..

take care of yourself. write down and make copies of all your Surgeons instructions... follow those guidelines a s close as you possibly can. also write down specific questions/answers re: intake immediately and then for long term maintainence of your desired weight.

Had TPN for a bit after exploding my appendix a few years ago. Gained some weight, mostly water, a little "real", lost it over a few months. Seemed to go OK for me but your mileage may vary.

Audrey