The TPN Process

If you missed my first article on TPN, you can find it here: "What Is TPN?" In this article, I'll talk a bit more about the ongoing process of TPN and my personal experience with it.

TPN is a process

A process that is monitored very frequently with lab tests and check-ins with nutritionists and dietitians.

This involves daily checks with certain care team members involved in my case. Sometimes it’s a day worth of just appointments and back-to-back phone calls with each member of the team. Changes can be made to the formula at any time, but it takes quite some time for pharmacists to calculate what the dietician prescribes for each bag.

TPN volume and duration

The volume of TPN can also be changed. Some bags are the size of a regular bag of saline and others are quite large, making it hard to carry around in any backpack. Infusion rates can be changed to what’s best for the patient.

TPN patients usually end up with several changes in their TPN rotation, such as the speed of the formula being introduced into the blood and the rate of the pump that determines how long it infuses for.

TPN longevity can be very short for some – just a few weeks. Others have to do it for months. There are also patients who are NPO (nothing by mouth) permanently that live solely on TPN. My doctor's goal is to have me completely off TPN in 2 months.

My progress with TPN

I'm already about 1-2 months in and have finally started to make some progress. It's pretty great that we have a potential end date in mind, but it feels like the last couple of months have been years.

I've been hospitalized and ventured to the ER many times so far these past few months. Scary just doesn't seem to fit the situation. BUT, I can tell you that my TPN use has made a difference. I'm no longer passing out frequently due to low blood pressure and dehydration and have even gained most of my weight back now.

I feel lucky that this round of TPN will be fairly short and I'm grateful to have my care team make these decisions for me when I wasn't cognitively able to, due to how sick I was.

Malnutrition's effects: mental state, muscle loss

Malnutrition definitely affected my neurological state and that was a terrifying experience, aside from the extreme pain of rapid muscle atrophy (muscle loss). I still experience the aches and pains, as I have not gotten my muscle back which will take some time.

I'm doing all that I can do to try to keep my stamina up, but I really struggle with the pain of muscle atrophy and massive fatigue. I might be pretty weak, but I'm happy I'm finally responding after the first 2 months that were absolutely dreadful. I couldn't even hold up a backpack of the very large bags of TPN when I began them. Grateful that this is slowing down a little bit now.

Have you ever been on TPN? What type of catheter/central line did they choose for you?