Hickman catheter is being placed to feed Frank (TPN)

[Dianejt]

Complication from last months surgery has caused a abdominal fissulla in Frank. In the morning they are going to be placing a Hickman catheter in his chest so they can do TPN. He has lost 22 lbs since April 3rd's surgery & he is so weak. I'm just wondering how much more he can take. And then there is the next surgery to remove his remaining kidney , how will he possibly rebound enough to be able to do this ? His remaining kidney needs to come out as it is filled with tumors. Sorry I'm rambling but my mind is so filled. How hard is this surgery on ones body as I'm so concerned if he is strong enough for this, but he needs to get nutrition.

[Rerun]

Yes, he needs to get nutrition and you will be amazed how much he can take.  I suggest you stay with him as much as you can because the hospital staff won't care as much as you and won't notice drastic changes in his breathing, reactions, etc like you will.  Stay close and ask questions and demand answers.

[Dianejt]

You are talking bad reactions right? What should I look for?

[Rerun]

You will just notice things because you are there more.  Shift changes come and go and they may mark on the chart swelling in the legs, but you can tell the doctor that it has gotten worse or better.  You can tell them that he seems more uncomfortable than yesterday etc.  Just be the constant monitor that they don't have time for.  If you notice blood or urine on the sheets tell them you want them changed!  They may not do it and leave it for the day shift etc.  You have to be his nurse even though they are getting paid plenty for doing it.  Frustrating as it may be.

Anybody have any other suggestions?

[Dianejt]

Yes Rerun I have been Franks advocate as he has been in & out of the hospital for many years now. I swiped a surgical marker when he had his AV fissulla done & I write on his left arm No BP No Blood draws. We have had many great nurses & some bad. I'm sure in his records it says how I can be a BITCH when needed. I would like to hear what I should be looking for as far as reactions to this procedure. Has anyone else had to be TPN? I'm scared as this delays getting the rest of the cancer out of him,  & I wonder how much he will be able to take as he has been through way more than anyone should.

[jbeany]

I did TPN for several months - no food or water by mouth.  I don't know about the Hickman procedure - I had a PICC line in my arm that I used to hook up.  If a Hickman is similar, it wasn't much to feed the line in - they used an ultrasound to thread in the plastic tubing.  I was unconscious for another procedure at the time, but there wasn't any pain at the entrance site. 

The TPN will help him.  They can adjust his calorie count and add whatever he needs for vitamins to the daily bag of nutritional supplement.  They actually had to lower my calorie count to keep me from gaining weight, so they certainly can do the opposite for your hubby.  The biggest issue I had with TPN is that it doesn't have enough protein - my albumin levels stayed low until I started eating again.

Hope it helps!
 

[monrein]

Thinking of you both and hoping that Frank will regain his strength.  Sounds as though you're a great advocate and Rerun is so right...another set of eyes observing and bringing attention to things is very crucial.