Anthony came home Friday afternoon after an 11 day hospitalization. We’ve been busy the past couple of days trying to catch up on life and get use to Anthony’s care. He came home with a g-tube and a PICC line. He is getting about 80% of his nourishment via TPN and about 20% via his g-tube. He is tolerating only around 20cc an hour via the g-tube.
The surgeon would like to try inserting a post-pyloric tube or GD-tube on January 5th. He will try placing the tube in the duodendum at a point before the anastomosis (where the two ends of his small intestine were sutured together). Anthony obviously can not tolerate gastric feedings, but hopefully if they can place the tube beyond the pyloric sphincter he will be able to tolerate tube feedings and we can ween him off the TPN. He will be in the hospital again for a couple of days after the new tube is placed to be sure he can tolerate the feedings via the new tube. We will also continue the TPN until he is able to take in enough calories via the tube. We are not in a hurry to get him off the TPN, because he has lost a lot of weight. We’d like to beef him up a bit while he has the PICC line.
Shortly after Anthony got home all the feeding supplies were delivered and a visiting nurse came to show us how to manage the PICC line, feedings and pump. She was very nice and helpful. She came back on Saturday to watch me hang the TPN. I felt like I was back in nursing school, but didn’t mind a bit, since it’s been a long time since I’ve done any kind of IV. I guess I passed, since I was on my own today. The nurse will come in once a week on Mondays to assess him and change his PICC line dressing.
We are running the TPN 16 hours a day from 6pm – 10am and the G-tube feedings during the day. Of course, keeping his bowels moving is another important part of his care.
That’s about it for now. We are so happy to have Anthony home for Christmas. We will deal with the next procedure after the holidays.