Artificial nutrition saves lives, mine included. Like any treatment it has risks, and knowing them is part of staying well. None of this is meant to frighten you. It is meant to help you spot a problem early and get help.
With TPN and central lines
Line infection
The most important risk. Germs can get into the line and into the blood, which can lead to sepsis. Watch for a temperature, shivers or feeling unwell, often soon after a feed is connected, and for redness or discharge where the line leaves the skin. Contact your team straight away. If you feel very unwell, are confused or are struggling to breathe, call 999 and tell them you have a central line.
Blocked or damaged line
Lines can block or crack. Follow your flushing routine, and if the line is damaged clamp it above the damage and contact your team.
Blood clots
A clot can form in the vein around the line. Swelling of the arm, neck or face on that side needs checking quickly.
Salts, fluid and sugar
Your levels of salts like sodium and potassium, your fluid balance and your blood sugar can go too high or too low. Some people need insulin while their feed runs. This is why you have regular blood tests. Some people feel shaky or light headed when a feed stops, as their blood sugar drops.
Liver and bones
Over a long time, TPN can affect the liver and the strength of the bones. Your team watches for this with blood tests and scans, and adjusts your feed.
With tube feeding
- Blocked tubes, usually prevented by regular flushing.
- A tube moving or coming out. A gastrostomy hole can start to close within an hour or two, so contact your team or A&E at once.
- Sore or infected skin around the stoma.
- Feed going into the lungs (aspiration), especially if lying flat. Sit up as advised during and after feeds.
- Tummy troubles such as sickness, bloating, diarrhoea or constipation. Tell your dietitian, as the feed can often be changed.
When feeding first starts
For someone who has gone a long time without enough food, starting feeds too quickly can upset the body's salts. This is called refeeding syndrome, and it is why feeds are built up slowly with careful blood tests at the start.
Remember: you know your own body. If something feels wrong, trust that feeling and ring your team. Nobody will think you are wasting their time.