Post Whipple: how long before your stomach "woke up"?

Posted by CarynS @caryns, Nov 29, 2021

Had Whipple (pylorus-preserving) with IORT on 11/10. They replaced my SMV with a bovine vein, so a few additional steps added to the standard Whipple. My stomach isn't tolerating any food, apparently I have delayed gastric emptying. Plus at one point i had an infection, the source of which was not determined. Tomorrow they are sending me "home" (nearby hotel for the time being) with TPN being provided by an outside company.

My question is, for those who had the Whipple, how long did it take for your stomach to start functioning? And how did you know?

Interested in more discussions like this? Go to the Pancreatic Cancer group.

My wife was in ICU for 9 days and I seem to remember it took about 7 days they removed the stomach drain

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My stomach drain has been gone for a while but that didn't have any impact. No NG tube though, just rejecting the gastric juices and bile accumulated

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@caryns

My stomach drain has been gone for a while but that didn't have any impact. No NG tube though, just rejecting the gastric juices and bile accumulated

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I wonder if @marvinjsturing @chess17109 @dianamiracle @susan2018 @dakotarunner @jeanne5009 @beachdog have any thoughts to add to @charliegolfrep's.

What has your care team suggested, Caryn?

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You didn't mention if they took your gall bladder. We've all heard that you can live without a spleen, a gall bladder etc but rarely ever heard the impact on one's life afer these are gone. In my wife's case, the removal of the gall bladder may have been more impactful than the distal pancreatectomy and various resections. Be sure that you consult a gastroenterologist if you don't get info you need from the surgeons or oncologists. Creon might be needed to overcome pancreatic insufficiency and cholestyramine might be needed to offset the bile dumping. The surgical recuperation can take much longer than the surgeon says and the medications require trial and error to determine what works for you.

You mentioned IORT. Do they have you taking protonix to protect your stomach?

Be patient. Good luck and prayers for you and your family.

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@caryns

My stomach drain has been gone for a while but that didn't have any impact. No NG tube though, just rejecting the gastric juices and bile accumulated

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I had Whipple in Mar. of 2019. It seemed like I fought with build up of food, etc. in my stomach for quite a while. I made the bad mistake of eating too much too soon. It was quite a tussle for a bit. You will have bear with it, and pretty much all of a sudden the problem goes away. Easy for me to say, huh? I am now almost 3 years out and feel great. I have gained back 30 of the 54 lbs. I lost. Life will gt better, and without Whipple, life for me would have been over at this time. Touch base with me on this site in a month or so. I am pulling and praying for you.

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Thank you all for you hard earned knowledge about best way to recuperate from the Whipple. My husband and I may be facing this within the next month. Any suggestions about how to prepare and questions to ask???

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@dakotarunner

I had Whipple in Mar. of 2019. It seemed like I fought with build up of food, etc. in my stomach for quite a while. I made the bad mistake of eating too much too soon. It was quite a tussle for a bit. You will have bear with it, and pretty much all of a sudden the problem goes away. Easy for me to say, huh? I am now almost 3 years out and feel great. I have gained back 30 of the 54 lbs. I lost. Life will gt better, and without Whipple, life for me would have been over at this time. Touch base with me on this site in a month or so. I am pulling and praying for you.

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@dakotarunner thanks so much for your response. I need a little encouragement. I was released from the hospital yesterday and it seems everything I try to put in comes right back up. Good to know there is an end point to this, whenever that will be for me. It's really hard to know what to expect with this when everyone responds so differently in recovery.

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@beachdog

You didn't mention if they took your gall bladder. We've all heard that you can live without a spleen, a gall bladder etc but rarely ever heard the impact on one's life afer these are gone. In my wife's case, the removal of the gall bladder may have been more impactful than the distal pancreatectomy and various resections. Be sure that you consult a gastroenterologist if you don't get info you need from the surgeons or oncologists. Creon might be needed to overcome pancreatic insufficiency and cholestyramine might be needed to offset the bile dumping. The surgical recuperation can take much longer than the surgeon says and the medications require trial and error to determine what works for you.

You mentioned IORT. Do they have you taking protonix to protect your stomach?

Be patient. Good luck and prayers for you and your family.

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They did remove my gall bladder.

I think I was on protonix while in the hospital but I don't see it in my take home meds. I should ask about that.

Thanks for your prayers.

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@caryns

@dakotarunner thanks so much for your response. I need a little encouragement. I was released from the hospital yesterday and it seems everything I try to put in comes right back up. Good to know there is an end point to this, whenever that will be for me. It's really hard to know what to expect with this when everyone responds so differently in recovery.

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How are you doing today, Caryn? Are things settling down?

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No better no worse. Still eating almost nothing by mouth. Had another episode of emptying my stomach the wrong way around, to put it mildly. Mayo nurse i have been messaging tells me this is all within the range of normal, just need time and healing

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Hello Caryn: I am a pancreatic and breast cancer survivor and Registered and Licensed Dietitian (still practicing) in our state (MN.) Here is the short story. (Please let your MDs guide you.) I took Creon, a pancreatic enzyme, each time I ate, per my MD orders. Be sure to follow the medication direction, if your MD prescribes this med. I ate a lot of fast digesting carbohydrates, read that to mean "a lot of sugar containing" foods. Odd for a dietitian, but I could digest them without much difficulty. Eat small meals. Don't overload with fiber and/or volume of foods, including fiber. I had to eat what I could tolerate. Stay hydrated. Eat adequate protein. (Think about using a supplement, such as Boost, etc.) I do not work for any medical nutritional company and am not promoting one product over the other. Try and see what you like and can tolerate. The process of the gut adapting will take time. Be patient and pat yourself on the back a lot. At almost 15 years out, I see a Mayo Gastroenterologist for guidance. I also use my experience as a Dietitian to help me. There are other things I can teach you, but I don't want you to be overwhelmed. Just take it very easy, please. And here is to your good healing. Mayr Boros, RDN, LD.

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@caryns If there's an issue getting a prescription for Creon ( or the cost is too high), our nutritionist recommended an alternative from Vital Nutrients. We haven't tried it yet because our insurance has been covering the Creon so far. (3 x 36000 unit Creon 3x/day is retail $12000 per quarter!) The Creon manufacturer Abbvie also has a coupon for $5 copay but cannot be used by Medicare patients. Good luck. Dosing for Creon is going to be trial and error and the amount you need might change over time.

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