TPN (parenteral IV nutrition) at home

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risto
Posts: 54
Joined: Wed Jan 06, 2016 2:28 am
Location: USA

TPN (parenteral IV nutrition) at home

Postby risto » Sat Mar 24, 2018 3:28 pm

My DW had surgery February 3, exactly 7 weeks ago, for small bowel obstruction. She had an internal hernia in the descending mesocolon. She was in the hospital 37 days and is now on TPN (Total Parenteral Nutrition) at home, and can only eat very small amounts. She has pain digesting food rather than fullness. She had a few days of vomiting around a week ago but that has resolved on its own. I keep hoping that she will be able to resume her normal eating and get off the TPN but I don't see much sign of that yet.

We are doing OK with the TPN at home. There is a company that sends us supplies weekly. They come via UPS shipment and the TPN bags are on ice. They need to be stored in the fridge. The vitamins come in 2 small vials which I must inject into the TPN bag. All procedures have to be done sterile so I need to use alcohol wipes on everything, use hand sanitizers and wear gloves. The infusion pump is very small and they provide a small back pack which holds the TPN bag and the pump. The infusion is 12 hours which we have been doing at night, usually starting around 8:30pm. It takes quite a bit of manual dexterity and finger strength so my DW is not able to begin the infusion herself. In the morning, however, she can remove it, do the flush, and cap the line, so she does this while I'm at work in the morning. Then we get a visit weekly from home nursing to change the dressing on the PICC line and draw some blood samples. Everything is closely monitored. We check blood glucose, weight, and temperature twice a day.

Questions for those who have done home TPN: how long have you been on it? Is/was your procedure similar to the above? Have you experienced any of the risks such as infection or liver issues? If you've had the same kind of pain and discomfort after eating, how long does it take to get over that? Have you been able to do chemo while on TPN? If you've been on TPN due to digestive pain, which chemo was it, and does the chemo make it a lot worse? Thanks in advance.
DW Dx 7/15, 41 yo, st IV, 3+ liver mets: 11.3 cm, 7cm, 3cm. MSS.
KRAS, APC, SMAD4, TP53 mut.
7/15-10/15: FOLFOX+bev. x8
11/15-12/15: SIRT (Y90)
1/16: Toxic Hepatitis, chemo break
4/16: Liver resec. fail
5/16-7/16: FOLFIRI x6
8/16: Liver resec.
8/16-11/16: FOLFIRI x6
2/17: IMRT/Xeloda x25
4/17: LAR
6/17: CT: Progression. Peri, Lung, Liver mets. FOLFIRI x6
9/17: FOLFIRI+Bev x5.
11/17: CT: Stable. 5FU+bev. maintenance x5
1/18-2/18: Surgery for SBO
5/18: ascites, acute liver injury

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: TPN (parenteral IV nutrition) at home

Postby Lee » Sun Mar 25, 2018 5:17 pm

Sorry no one has responded yet. There have been people in the past who have been on TPN nutrition. Do a search in the "Search this Forum" tab. At least it will give you a starting point. I'm also hoping by bumping this thread back up to the top, someone who has some knowledge will respond. Sometimes on the weekend, people don't always check in.

Good luck,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 16 years and counting!

jep
Posts: 260
Joined: Sun Jun 11, 2017 7:45 pm
Location: New England, USA

Re: TPN (parenteral IV nutrition) at home

Postby jep » Sun Mar 25, 2018 7:31 pm

Hello...my husband was on TPN in the hospital for a few weeks, and was then put on TPN at home for at least 4 weeks, I believe....the procedure you outlined sounds like the instructions we were given as well...my husband's liver has been fine, and he didn't have any infection issues that were related to the TPN (that we know of)...I know that the docs would not have started chemo while my husband was on TPN, but he was extremely thin and weak, and he also had 2 surgical drains, so chemo was delayed for longer than we would have liked....ask your onc about chemo, but I'm thinking they'll want your wife to be stronger before starting...

Those were very hard months for us, but it will get better....my husband is now swimming and exercising and doing really well....this entire journey is still surreal to me...it sounds like you're really on top of things! Be careful when injecting the vitamins into the TPN spout....I accidentally stuck myself with the needle which had poked through the other side of the spout....
-jep
Stage IV CC 5/16/17
Loc: recto-sig
Type: Adenocarcinoma
Size: 7.4 cm
Grade: G3
TNM: T3N2M1
LNs: 8/20
BL CEA: .9
LVI: present
Perineural invasion: present
LAR margins: clear (w/in microns)
Folfox (8/17-1/18)
Scope 6/18 - CLEAR! - 2 polyps
PET 10/17/18: 3 pos LNs
Irino + Vecti (11/18)
CEA: 1.7 (2/19)
Xel + rad (5/19)
Surgery: 8/21/19 (aborted)
P1 Trial 10/19 - 12/19
Bypass 12/6/19
Folfox + vecti 1/2/19 - 4/3/20
Kid Fail 5/1/20
Folfiri + Avastin 5/20 - 6/20
bypass 6/29/20
Stivarga 7/18/20 -
Home 9/10/20


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