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History
Created by Dr. Khursheed Jeejeebhoy, TPN has only been available for the last 40 years. TPN was created and refined to meet the needs of Dr. Jeejeebhoy’s patient, 34 year old Judy Taylor.

In the 1970’s, when Taylor’s intestinal blood clots destroyed her intestines, she was left to starve to death in a Toronto hospital. Her doctors sent her to Dr. Jeejeebhoy, an intern with the University of Toronto who was quickly building a name for himself with his intravenous nutrition work. With his team and Taylor with her immense dedication as a patient, Dr. Jeejeebhoy perfected a way to sustain life indefinitely without the requirement of food or water, and eventually moved to make it possible outside of the hospital.

For the next 30 years, Dr. Jeejeebhoy toured the world, training doctors how to administer and use the system, and with Taylor’s help, taught patients how to live with it and minimize it’s intrusion.

Living with TPN
Approximately 40,000 people use TPN at home in the United States, and because TPN requires anywhere form 10-16 hours to be administered, daily life can be affected. Although daily lifestyle can be changed, most patients agree that these changes are better than staying at the hospital. Many different types of pumps exist to limit the time the patient is “hooked-up”. Usually a backpack pump is used, allowing for mobility. The time required to be connected to the IV is dependent on the situation of each patient; some require once a day, or five days a week.

It is important for patients to avoid as much TPN related change as possible in their lifestyles. This allows for the best possible mental health situation; constantly being held down can lead to resentment and depression. Physical activity is also highly encouraged, but patients must avoid contact sports (equipment damage) and swimming (infection). Many teens find it difficult to live with TPN due to issues regarding body image and not being able to participate in activities and events.

Hunger
Because patients are being fed intravenously, the subject does not physically eat, resulting in intense hunger pangs. The brain uses signals from the mouth (taste and smell), the stomach/G.I. Tract (fullness) and blood (nutrient levels) to determine conscious feelings of hunger. In cases of TPN, the taste, smell and physical fullness requirements are not met, and so the patient experiences hunger, despite the fact that the body is being fully nourished. In cases where the patient eats food despite the inability, they can experience a wide range of complications.

Pregnancy
Pregnancy can cause major complications when trying to properly dose the nutrient mixture. Because all of the baby’s nourishment comes from the mother’s blood stream, the doctor must properly calculate the dosage of nutrients to meet both recipient’s needs and have them in usable forms. Incorrect dosage can lead to many adverse, hard-to-guess effects, such as death, and varying degrees of deformation or other developmental problems.

It is recommended that parenteral nutrition administration begin after a period of natural nutrition so doctors can properly calculate the nutritional needs of the fetus. Otherwise, it should only be administered by a team highly skilled doctors who can accurately guess the fetus’ needs.