On December 7th, I got started on TPN again. This is my third time and I am getting to be an old hand at the routine. I am being infused over a 12hr cycle so the TPN starts in the evening and then finishes just as I get up in the morning which is very nice. It still interferes with sleeping somewhat but not having to carry the bag around all the time is very nice.
I started on 1000 calories per day which is a nice improvement over what I had been taking in. After a couple of days, they then advanced me to 1500 calories/day and that is where I am at now. With 1500 calories/day through TPN, I don't need to consume a huge amount of food to maintain or gain weight now.
As to eating, I am slowly feeling out my boundaries of what I can eat and what I cannot. My near term goal is to do fluids for breakfast and lunch with semi normal food for dinner. My first attempt at this was on Sunday, December 6th.
We had a belated birthday celebration for Stephanie and we got dinner from Five Guys. A hamburger is out of the question for me but they do make a grilled cheese sandwich which should be relatively easy to digest. I lucked out and they grilled my sandwich right where they had recently grilled some onions and that added a very nice hit of flavor to the sandwich. I also got extra cheese which added even more calories and I had a very happy tummy.
Monday night brought more real food and I had Kraft Mac-n-Cheese in the blue box. This meal also went very well and I continued to press forward. Tuesday night brought taco-Tuesday from Del Taco and the three crunchy tacos and a churro was a step too far, causing me to not eat much of anything on Wednesday.
I have found a new taste for tomato soup and there are some very good options out there for me to eat. I do sneak in a couple of club crackers with the soup but I am sure to chew them to a good mash before swallowing. I have lost my taste for cream of mushroom or cream of chicken soup somewhat but it certainly is better than nothing and a few crackers help them out as well.
I have been just having a large glass of orange juice for breakfast, skipping the cream of wheat but may add that in as time goes on as well. I often then supplement all of this with an ensure, jello, pudding, or some ice cream throughout the day. On a good day, I easily exceed 1000 calories of food consumed but bad days are often only a few hundred.
The weight will come and the fatigue will start to go away. Not immediately but I can be patient. I am currently hovering in the upper 130s for weight. According to BMI, I am severely underweight at this point (I would just barely be normal for someone 5' 9"). My current weight goal is to make it to 150 which puts me solidly into the normal weight category with a little bit of margin.
What is the long term plan? I don't know. I should be seeing my surgeon in early January and we can discuss some then. I don't know if I am operable at this point or if surgery could even resolve it. I do know that I need to be stronger before that could even happen either. If I can get to where I am eating one real meal (even a limited meal) a day, that is something I think I could tolerate for quite a while.
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