complications after CABG

My 69 y/o husband had CABG x3 w/ MV repair (ring) and ever since surgery 6 weeks ago is nauseaous with acute gagging & taste perversion (orange jello tastes like made of  100 oranges, same with cherry...). Is unable to take anything except ice chips & water. This began post op day 1 in the evening after starting on coumadin 10mg. After a 40 lbs. weight loss we stopped the coumadin on 2/16 as all his s & s point to coumadin and inserted a PICC line for TPN at home. Is maintaining wt on this so far. Only abnormal labs are alk. phos at 189, 165, 178 last three weeks. Fractionated indicated liver so scheduled for ct of abd. tomorrow. (no pain or jaundice) Has this ever occurred post CABG??? Could the anesthesia dulled/excited a cranial nerve causing the gagging??? Any tests to run to help pinpoint the cause of hyperactive gag reflex and nausea??? He cannot stay on TPN forever...Had thoracentesis for left pleural effusion 2 weeks ago with 1250 out. Was anemic post op but now up to 12 / 35. Feels tired and stomach growls as if hungry and says does feel hungry but nauseous at same time, and nausea wins over hunger. Our doctors are at a loss & say lets wait and see what happens???...??? any suggestions would be greatly appreciated!!
THANK YOU!!

[Michael J. McWilliams, M.D.]

Has this ever occurred post CABG???

I agree with having doctors work up the causes of nausea.  That being said, I have seen a lot of men specifically that had anorexia and nausea after a CABG.  I did not do a lot of the follow up visits at that stage of my training but was told that it often goes away as quickly as it started. I have not seen it persist that far after a CABG before but it is possible.

Could the anesthesia dulled/excited a cranial nerve causing the gagging???

I have not heard of that before.

Any tests to run to help pinpoint the cause of hyperactive gag reflex and nausea???

The best thing is to consult a GI doctor as it sounds like you have done.  If the GI evaluation is unremarkable, my approach would probably be the same -- wait and see.  It should get better.  I agree that long term TPN is no way to live and hopefully it will get better soon.  I have not heard of coumadin causing nausea before.

That is the best I can offer.  I hope that helps and good luck.