J-Tube Vs.Tpn Port Line

My father is a 64 year old smoker who was diagnosed with linitis plastica a month ago.  Needless to say, my entire family is devastated as he was being treated for a bleeding ulcer and gastritis since January 2007.  We have been given a bleak prognosis (6-12 months with chemo) and we are debating whether to have a J-tube inserted into his jejunum or a TPN line inserted  below his clavicle.  Quite literally, we are receiving conflicting advice from two very reputable cancer hospitals and we are in a quandry.  My dad is 5'10" tall and weighs only 140 pounds.  On a daily basis, he is only eating 3 Ensures, some broth and juice and a few crackers.  We are fearful of the J-tube causing infection but we are also afraid the TPN therapy won't be nourishing enough and will only be a temporary solution.

Since this is such a rare disorder, we are thankful to have discovered this message board, and any information, insights or experience relating to our dilemma would be greatly appreciated.  Thank you. 

My only experience is with TPN.  My DH does not have a small intestine so a feeding tube was not an option. 

TPN is extremely expensive so make sure it is insurance covered.  TPN can also be a source of infection.  Having said that, so far (3 months) are experience has been ok and getting better.  We run the TPN in the evening and overnight.  My  DH is not hungry.  At first he continued to lose weight but then stabilized and started gaining some back.  I understand the TPN can be hard on the liver and needs to be closely monitored but people have lived on it successfully (even working and traveling) for years.

Best wishes in whatever your decision is.

My brother- stage 3 stomach cancer, had J-tube first then later using TPN since tumor caused abstruction from down steam. Personally, I would recommend you to use J- tube.

 regards,

Hi

Sorry to hear about your father. I would recommend the j tube, Its easy to take care of and I belive a chance for infection is less. The tpn has a high glucose contents which can raise ones blood glucose level and may require insulin. Also, with the extra glucose in the tpn one is prone to infection. Hope this helps make a decision for you and your dad.

This is just an update for anyone in the future who finds this message because they're in the same situation....

 We (buckeye girl is my sister) ended up having a j-tube inserted into my father's intestines. We feel it was a life-saving decision and we were happy we opted for the j-tube rather than the TPN. It was very easy to feed him, manipulate the tube, and operate the pump. However, it became clogged frequently....even after flushing with water, coca cola, cranberry juice, etc. I do think plunging with a syringe would have helped!

  After surgery, I highly recommend you ask the nurse to instruct you precisely on how to use the tube and pump before you leave the hospital! I have read a few stories where people have been sent home without sufficient discharge instructions! At least, make sure you have a home health nurse visit you to check to make sure you are doing everything correctly.

 My father's tube never became infected and didn't really bother him with the exception of the clogging!

Take care!