Appetite and low grade fever

Mtngirl7533

This is week 5 post esophagogastrectomy for my husband! He has been improving more every week in many ways, especially pain level decreasing! The thing that hasnt improved much however is his appetite! He doesnt feel very hungry and is just trying to take in calories to gain weight and strength! He is still on j tube feedings of course! He says when he eats, he feels slightly nauseated! Also he has carried a low grade fever for about a week now! 99.9 at highest! Mostly notable in aftrenoon and evening! I remember surgeon saying they dont worry too much unless it gets to 101. Anyways, looking through posts from ppl who have been through this, Ivor Lewis Surgery, I see that appetite has definitely been an issue and it takes time! As for the fever, not sure! Or the nausea! I have wondered why they didnt keep him on Protonix, as they had him on ot in the hospital? He never felt his acid reflux pre diagnosis but tested positive for Barrett’s! So I am going to ask surgeon at next appt coming up in week or so! Now, of we can get some weight back on him that would be wonderful! Know, I feel blessed he is alive and doing apparently well! That is major in itself as he had stage 111 adenocarcinoma at the GE Junction with lymph involvement! Does anyone know what types of tests he will undergo going forward as they watch him? The docs said he would be watched, especially first 5 yrs as I hear many cancer patients are! Btw, this site and wonderful people have been a blessing to me and my husband! I say prayers for all! God bless! 

paul61

Perhaps it could be minor gastroparesis induced by the j-tube?

Hello Mtngirl,

I am not sure what to suggest about the slight fever post-surgery.

I did however have some issues with nausea while learning to eat with my new digestive system while still using the “j-tube”. I often found that when I first got up in the morning I was slightly nauseated. I did my tube feeds during the night and I think that had something to do with the nausea. I also found that I was slightly nauseated after eating until I stopped my tube feeding during the night. I know that if the speed on the j-tube pump is set slightly too high it will cause nausea. But if your husband is not nauseated when he first gets up, (assuming he does his tube feed during the night), then my second suggestion would be that perhaps the nausea might be caused because his j-tube is pumping formula into his small intestine and his pyloric valve at the bottom of his stomaphagus is also trying to empty into his small intestine. I wonder if this may be causing minor short-term gastroparesis that will resolve once he stops using the j-tube. I know mine did. I also frequently had some abdominal discomfort after eating that also resolved after I stopped using my j-tube. Perhaps your surgeon can prescribe some anti-nausea medication like Zofran for a short period of time.

In terms of post-surgery follow up:

I had a CT scan of my chest and abdomen at 3 months, then for the next two years I had a CT scan, blood work, and physical exam every six months, for year three and four I had a CT scan, blood work, an endoscopy with biopsies, and physical exam every year. After year four I had a chest X-ray, blood work, an endoscopy with biopsies, and physical exam every year until year six when my oncologist said he did not need to see my anymore.

I now have an endoscopy with biopsies annually.

Best Regards,

Paul Adams

McCormick, South Carolina

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
Eight Year Survivor

Life may not be the party we hoped for, but while we are here we might as well dance!