Mark-- For as much as I almost always agree with you, I ask you to take a look at this posting again and almost all the PEG postings that are on the board. You are always in the minority when it comes to championing the no PEG position. The fact is that while patient's reactions to treatments vary wildly, and some develop acute mucocitis and swallowing issues, and others do not, loss of body weight is an indicator of something going wrong. That something is that the patient is NOT GETTING THE PROPER NUTRITION.
That someone is a tough guy and deals with the pain and discomfort of trying to get by on minimal food, or that someone's doctor didn't do the obvious, does not appeal to me as an argument that carries much weight. You, as much as any other person, have often said there is no need to go through unnecessary pain during this process. The PEG eliminates part of that pain. You have also been a proponent of getting proper nutrition in many of your posts. For most patients, especially the elderly, and those with little lean body mass to loose, going the no PEG route is not good for them. And while you lost 18% of your body weight which is significant, clearly your treating doctors felt that it was not critical. Likely your young age, physical fitness, plenty of muscle tissue, etc. etc. played a part in their decision. But as a younger, physically fit man, you might consider that your experience is not the most common one, and that your unique strengths made the no PEG decision a doable thing. But the majority of major institutions have weight loss guidelines that they will not go beyond. Once the patient's nutritional intake (easily represented by body weight fluctuations) dips too low, they doctors are going to intervene regardless of the patient's desires. Believe me I fought the idea of a PEG with them, but in the end, it no longer was my choice. I suspect that the point at which this becomes a line in the sand, (somewhere between 10 to 20%) is unique to the institution, and factors such as the persons overall health and age, and lean body mass ratios etc. all come into play. But from my own personal experience I look back (with a more knowledgeable eye) and I think, what the hell was I so resistant to? It was the best thing that I did during my treatment. Yeah, it was weird seeing that tube hanging out in front of me, but it enabled me to level off the loss of lean body mass, and provide my body (in the broadest sense from musculature to immune system) to do the best possible job of repair and recovery.
