Which Came First, The Chicken or The Egg?
My GI appointment on October 19th, 2021, started the largest debate that all my doctors still argue today which is, “did the Gastroparesis happen before or after starting TPN?”
I rolled to my appointment with my dad, and we took turns with me sometimes wheeling myself until I got tired and needed my dad to take over. The appointment was going to have both my GI doctor and dietician/nutritionist present.
This was the first time I was going to have an in-person appointment with this new doctor I had been assigned, who also was the head of the department of that hospital.
They first mentioned the results from the Gastric Emptying Study. They said it showed severe gastric delay but that they think it isn’t as severe as it was showing. They said that not being able to eat and being on TPN for so long likely was skewing the results of the test and I probably only had mild delay. They said I might’ve had some delay prior to TPN but not likely.
So, HERE’S the issue with this-
Gastroparesis could explain a lot of my symptoms and why I had such difficulty as I continued eating over time. The big problem is because they scheduled the test so far out from when I started TPN, they could be misattributing it to the TPN. My dad and I both discussed that my doctors would be handling things very differently had this test showed the same results and I had taken it the week I was discharged.
Every doctor I’ve seen believes a different timeline and I believe I did have gastroparesis before and that it likely mildly worsened with starting TPN. The other fact that people kept forgetting is I was still having things move through my digestive system daily. I had tons of pills that I had to take every day throughout the day that I had with water. I also had soup occasionally (used to be daily but stopped it after the GES test because of the flare). So, this disproved the statement as well.
They said they wanted to do another endoscopy and colonoscopy in April to look into some of the things that the other hospital had suggested.
During the physical exam they saw how inflamed my upper left abdomen was and thought it was rib cartilage inflammation. They diagnosed me with costochondritis and wanted me to up my dosage of Tylenol and then trial a high dose regiment of Ibuprofen (which I was cautious about trialing with all of my GI issues).
My dietician and GI doctor wanted me to trial pureed foods over the following week and gave me a diet plan to begin. On the list were things like mashed potatoes, apple sauce, and cream of rice.
My GI specialist had asked how many weeks I had been on the PICC line for and when I responded 17, they were shocked. They told me that they normally take patients off of it at 14 weeks and if they still can’t eat, then they’d get switched to a central line.
I was sent home with the information of what to trial eating and that if I couldn’t get my intake up, I’d have to get a central line placed.
They had also wanted to try taking me off of TPN for an hour to try and give my liver a break from constantly filtering the TPN.
Later that day I had my soup broth, but this time had a couple noodles. My stomach hurt but it was fairly tolerable since I had energy to take it. I did have some issues swallowing it but not too bad and I only had like 2 noodles.
Read what happens the following day when Emma trials eating mashed potatoes in, “Uh-Oh, I Ate Mashed Potatoes!”