J-Pouch and TPN

I hope I can help answer a few of these. I was on TPN for about six weeks after an obstruction surgery went bad because of adhesions; I lost a ton of weight (most of which I'm sure was muscular due to atrophy as I was hooked up to an NG tube, a G-tube and a wound vac for about a month of that time and was bedridden for the most part). Not sure if that's everyone's experience, but that was how it went down with me. As for B12, I tried taking it for a while when I couldn't maintain my hemoglobin counts, but it didn't really work for me, as my issue has more to do with ferretin storage. I now get Feraheme infusions every 6 weeks at my hematologist's clinic, which has helped a great deal. I did take VSL#3 for about a year, but stopped when I was put on Flagyl indefinitely, as one sort of counteracted the other and VSL really isn't cheap.

Hi Jessica and Michelle!
Bit of input, as I had a TPN for 2 months between my 2nd and 3rd j-pouch surgeries. Also, have question myself that I hope someone can answer.
While I was on TPN, I did gain some weight, but was okay because I had lost so much from not eating due to multiple blockages. I lost over 10 lbs. between surgery #2 and TPN. Once I gained back those 10 lbs though I only gained another 2-4 lbs over next 6 weeks. I know the pharmacist controls the calories in it, and initially set mine up for weight gain, and then reduced the sugars so I would just maintain healthy weight to go into surgery #3. It probably will level off as long as you are drinking enough liquid. If not, talk to prescribing pharmacist about reducing the calories in the TPN. Good luck! Hope you heal well! BTW, I am still maintaining that same weight range since surgery #3 though it does fluctuate by up to 4 lbs, depending on quality of my output.

My question- is there a problem taking Flagyl and VSL#3? I have been taking VSL#3 to prevent pouchitis since my takedown March 6. I assume and hope it helps, but I am going in for pouchoscopy next week and have been on Flagyl almost 3 weeks. Tried Cipro but that did not help- actually made me incontinent!
Reason for going on antibiotic is because I am still having 12-18 movements each day. Since antibiotic, that hasn't changed but I now can sleep 4 hours without having to get up for bathroom. Sleep is good! I thought that the VSL #3 was important when on antibiotics to prevent C-diff. You're right about it being expensive so would like to know others opinions on using VSL with Flagyl. Thanks much!
Laurie

Laurie-
There are differing opinions about the value of VSL while on antibiotics. Some folks try to space them apart, and others think the antibiotics make the VSL useless. I take them both, and I did get sick when I dropped my VSL dose below the maximum. It could have been a coincidence, though.

VSL seems to help prevent some kinds of pouchitis. However, I don't think anyone recommends VSL as a way to prevent C. diff. In general the probiotic recommended for that is S. Boulardi (that's what's in Florastor and some less expensive versions). Some good news: 1) S. Boulardi is *much* less expensive than VSL, 2) S. Boulardi isn't a bacterial probiotic, so it's quite reasonable to take while on antibiotics.

Thanks Scott! Do you think I could/ should add the Florastor or other cheaper version just when I'm on antibiotics? My Dr. and team don't think I need to be so worried about c-diff but I am-having that was worst ever!

Laurie, I don't really know how well the Florastor works to prevent C. diff. I take it (actually the CVS version, which is less expensive), but I have no idea if it does any good. If you're that worried about C. diff, maybe Florastor will give you some peace of mind.