Before I go on, let me first explain what TPN is, why Owen needs it, and how this change will effect our everyday living.
What is TPN?
Total Parenteral Nutrition, or TPN for short, is nutrition that is delivered directly into the blood stream. It is delivered through the blood stream because the GI tract is unable to absorb enough water, vitamins, and/or nutrients from breast milk or formula.
Positives of TPN:
Negatives of TPN:
I must say that I am extremely nervous to enter this new stage of Owen's health. TPN is not completely foreign to me because Owen was on TPN in the NICU and I was told that he probably would go home on it because he just wasn't able to handle his full feeds. However, in the end, he didn't go home on it and we were blessed with a baby who was able to grow and continue his feedings through his NG/Mic-key tubes. So, to have it re-introduced to us is extremely crazy.
With TPN we will have to have a place in the house which stays sterile. Owen will, most likely, get TPN 3 nights a week. So, the good news, he will not have to be hooked up to TPN all day and all night. However, the central line will be in place at all times.
The doctors have told me that there are two types of central lines they are considering. 1. Broviac 2. Port
1. Broviac: Broviacs are placed directly into a central vein, usually in the neck, upper chest or groin. The catheter proceeds to a position just above the heart. In general, a broviac is tunneled under the
2. Port: a small medical appliance that is installed beneath the skin. The port is usually inserted in the upper chest, just below the clavicle or collar bone, leaving the patients hands free. A catheter connects the port to a vein. Under the skin, the port has a septum through which drugs can be injected and blood samples can be drawn many times, usually with less discomfort for the patient than a more typical "needle stick". Complications: infection, blood clot developing in the device, mechanical failure (the device could brake), child's body growth could move it away from the appropriate place needed to work.
The port would have a less risk of infection, however, a worse result if it does get infected. Also, the port needs to be accessed with a needle each time you need to use it. This would have to be done by heath or I which we are not sure we are comfortable with. It would allow Owen to possibly be free from tubes/lines on days/nights he does not need to be hooked up. Would require less maintenance on a regular, day to day, basis.
There are many things to think about. Please pray Heath and I make the right decisions for Owen and his situation. Pray that Owen makes it through all these changes ok. If they decide he does need to be on TPN, both of these central lines will need to be surgically implanted which means anesthesia and recovery. Recovery has been a big hurdle for Owen and his gut motility in the past so we pray he comes through everything with his body working correctly so he doesn't have to be in the hospital for a long period of time.