Fluid issues

[Guest guest]

Hi all,

I've had kind of a bad week with syncope and low BP's and needing IV

fluid. I tried florinef and I didn't have any improvement in the

BP's but I was much more symptomatic and felt worse and stayed in

bed. Maybe it was part of the objective? But the syncope is getting

worse, with a low irregular heart rate along with inaudible BP, which

goes back to normal with an IV fluid bolus.

So the plan is that I'm going to have a PICC line placed for fluid to

buy us time to decide on a more permanent solution. I have

gastroparesis that hasn't responded to meds yet so oral fluids is out.

So now the question is, J tube or port? Cardiology doesn't care, as

long as I get enough fluid. Metabolism would prefer enteral fluid

and GI is voting for IV. I'm still waiting for nephrology's input but

my guess it'll be the same as cardiology's.

I get a vote too. That's what I'm struggling with. I know IV

hydration works, but do I want to take the risk? 's been

septic and it's no fun. My mom's had central lines since 1975 and

she has very little access left. I'd probably need daily fluid at

least through the summer and that would mean staying accessed.

J tube seems less risky from the infection standpoint but what if my

jejunum doesn't have normal motility? We already experienced that

with . The J tube was put too high and when they tried to

move it they found that she had so many adhesions that moving it

would probably cause obstructions elsewhere. So now she has a j tube

that is of limited usefulness. She never tolerated full feeds

through it. Now she hardly tolerates anything. But it seems like I

could do fluids through a J and then throw the glucerna in there if I

wanted to eat something that I know sits in my stomach for a long

time and not have to worry about my sugar dropping.

Another choice would be to have the j tube and port placed at the

same time, leave the port unaccessed, and give fluid boluses as

needed.

Any thoughts?

Thanks

Heidi