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Preemie with Short Bowel Syndrome KCat_the_Great Pennsylvania 2 posts
3rd Dec '08

So how does this situation strike you?



My friend has a preemie that has been in the hospital for seven months. She is currently on a tpn line because she has short bowel syndrome. She is not yet up to her full feeds.



The doctors say they are increasing her feeding slowly because if they do it quickly, she might start stooling all her food out and if that happened, they would have to "start over".



The thing is, doctors really like our insurance, and I can't help but worry that they may be keeping the baby in the hospital longer than necessary. Part of me wants to tell her to get a second opinion from someone who is not making money off of the baby being in the hospital.



I tend to mistrust the medical establishment, because my parents work in it and I've been in the room when they and 10 coworkers had conversations about how they all have to fudge records to trick the insurance companies into paying for things. Also, before managed care, my mom knew doctors that would routinely run tons of unnecessary medical tests to make money. After managed care it was the opposite problem: even when medical tests were needed, the insurance often wouldn't pay for them. It's frustrating that everything is so money oriented, but I guess that's just reality.



So, does this make sense to you? Is there anyone that has experience with short bowel syndrome?

J e s s i c a 3 kids; Sherwood, Oregon 36775 posts
3rd Dec '08

There is no way they would keep a child in the NICU to make money. A lot of professionals have to agree that a child needs hospitalization and they aren't going to all agree for the greater good of the 'business'. They get paid regardless, they don't need your friend's child for a paycheck. I'm sure the situation is feeling dismal and everyone is frustrated with the length of the stay, but this type of thinking won't help. If they want a second opinion, they should get it. But not because they think doctos are working the system.

Azaera 18 kids; Manitoba 1788 posts
4th Dec '08

I'd probably be worried about that kind of thing too, but in Canada we have healthcare so it's completely different. They get paid the same regardless. I would hope the doctors would have the best interests of the child in mind rather than a paycheque.

Drakesmom 1 child; North Carolina 126 posts
4th Dec '08

I would have to agree with Jessica. They wouldnt keep and child just to make money. It is a bad situation that your friends preemie is going thru. I know of a preemie boywho has been thru this because of NEC and one that was thought to have been born with her intestines outside her body however the defect closed inutero cutting off the intestines so she was born with short gut. They are trying to feed the little girl now and she keeps dumping which isnt pretty. She will be in the hospital until she can receive a transplant. The little boy for whatever reason didnt qualify for a transplant and was sent home on tpn and a broviac line. Most hospitals dont like to thisat allin his case he is being weaned off the tpn and being fed slowly by mouth until the intestines he has left can learn to absorb what he needs so he no longer needs the tpn. It will be a long proccess for her especially if she has to wait on a transplant. They definitely wouldnt keep her if it wasnt neccessary.

KCat_the_Great Pennsylvania 2 posts
5th Dec '08
Quoting J e s s i c a:
J e s s i c a 3 kids; Sherwood, Oregon 36775 posts
5th Dec '08
Quoting KCat_the_Great:
Azaera 18 kids; Manitoba 1788 posts
5th Dec '08

I'm not sure what short bowel syndrome is, but I know that at the hospital where my little one is at they will not send any baby home unless they are on full feeds and able to feed themself (nurse from breast or bottle) but I understand in the states they will sometimes send the baby home with a gavage tube and teach the parents how to feed them with the tube.. So it's probably completely different in the states

deathbycute Japan 1 posts
2nd Apr '12

My son was born 15 weeks early. He had nec and has had 7 bowel surgeries, a few central line placements, 5 major infections, and on and on and on.



the docs would not normally send a child home with tpn. Too many things could go wrong. Infection, part of the catheter breaking off and flowing into the heart, and so on. My son was on tpn for 8 months and could not handle feedings. They would get to a point and then the bowel would get overstimulated and they would have to stop, give the bowel a few days to rest and "reset" and then restart priming feed. Basically they had to start all over. We went through this over and over for months. This was not a ploy to get our money. I would physically see the results of the over stimulation (diarrhea).



Eventually I convinced the surgeons to give him a g tube so he could have continuous feeds. It's a lot of work but he can get his nutrition without dumping. We now do slow continuous feeds (26 ml an hour) and 30 ml of oral feeds every 3_4 hours. He's on a formula that (is painfully expensive) is easier to digest. It's called Elecare. It's pretty much designed for short gut babies. Elecare is about $50 a can so unless your insurance covers it you will be forking out a small foetune.