Feeding tube

stevenl

Hi all,
Just tried to flush my feeding tube for the 1st time. It has been in since Wednesday last week. So far other than losing control of my life, this is the only thing that scares me.
It still has the bandages on it from surgery and I have asked everyone, being the Ro nurse, the MO nurse and the Rns where i get my amiphostine infusion, how and what I need to do to take care of it. Go back to the Gen Surgeon Friday and I am sure he will take the bandages off and maybe the stitches. Everyone told me to sit up and use the syringe like a funnel and let the water flow in via gravity. It did not work. I don't want to seem like a child, but I don't like this thing. I guess it is just something new and I gotta get used to it. I know I can put the plunger in and push the water in and everything will probably be fine, I guess I just need some reassurance and advice from some of you pros to calm me down about something that deep down I know is good for me. Please give me a little help if you can.

Thanks
Steve

MarineE5

Flushing your Feeding Tube ( Peg Tube )
Steve,

I had a Peg Tube that was located just below my left ribs, but toward the center top of my stomach. The Peg Tube is suppose to be flushed at least twice a day whether you use it for feeding or not. You will have a bigger problem if it gets clogged.

What I did was stand in front of my kitchen sink. With a bowl of room temperature water in that bowl, I would have the plunger in the syringe and draw the water into the syringe. Act as if you just filled a needle and hold the syringe so the noozle is pointed toward the ceiling over the sink and push as much of the air out of the syringe. Having the flexable hose from the Peg tube untaped from my chest, unsnap the cap and insert the nozzle of the syringe. Hold the syringe nozzle to the tubing with your thumb and forefinger and slowly push in the plunger with your other hand. Don't go fast as this can cause you to get a upset stomach if done to fast. DON'T use COLD or HOT water as this too will cause you discomfort.

Push at least 2 syringes full of water thru twice a day as I mentioned, being used or not. This will help keep the Tube from getting blocked up. If for some reason it does. You can try ginger ale in the syringe and the bubbles help clean the hose and PEG out when you try flushing.

If you have any questions, you have my number and you can give me a ring tomorrow, as I am headed off to sleep now. I hope this is of help to you.

My Best to You and Everyone Here

Chefdaddy

Hope this helps
Hello Steve,

I started using my PEG to feed myself yesterday.

I have been flushing it everyday since it was put in back in December of 2009.

I fill a sanitary container with luke warm water and I draw up water with a 60cc syringe and remove the air before connecting it to the tubes valve. I then open the valve and then
un-clip the clasp on the tube and start slowly pressing the water in. I then re-squeeze the clasp around the tube and then I disconnect the syringe and with the valve still in the open position I stand over the bathtub and shake the remaining water out that would be trapped otherwise between the clasp and the valve.

The idea of using the syringe as a funnel doesn't work, at least not for me. When a nurse tells me a way to use some of this implanted hardware I immediately ask them if they have ever had one. If the answer is no, well, grain of salt!

I hope this helps, the PEG is a life saver, I have lost way too much weight for only being in treatment a couple weeks, so far 42lbs.

Also, when you start using your canned liquid food go very very slow, my ENT said to take an hour for the first can, I did and it wasn't long enough, I had some discomfort but now it's become easier. I notice more energy after just one can, the ENT wants me to try to get two in a day.

God Bless you my friend

Mike

MarineE5

Gravity Feeding
Steve,

As you mentioned in your post, I used the gravity feeding method. Before feeding with my nutrition, I would flush the tube twice then sit down in a chair so I could do my gravity feeding.Sitting in a chair, I would have my 2 cans of nutrition handy. I used the Syringe with the plunger removed. I would sit and have the flexable tubing in my left hand with the cap undone, but the end folded over to grimp the hose so no fluid would escape.

I would then raise the end up higher then the incision sight and insert the syringe so it was in the position of a Funnel, kind of like pouring oil in a car. I would then pour one can in slowly. You can adjust the flow of the canned nutrition into your stomach by raising or lowering the syringe hieght in relationship to the incision site. Try to pace yourself to one can per 10 minutes to start. See if it upsets your stomach. If it does, you might have to take 15 minutes per can. 10 minutes worked good for me, anything faster made me burp and upset my stomach alittle. Once you are done with the nutrition, flush your Tube with 2 syringes of water again. This flushing before feeding and after feeding does 2 things.

1- it helps clean the hose and PEG, keeping the nutrition from caking in the hose. 2- helps a little bit with Hydration. During treatments, we need 64 ozs of fluid daily.

My Best to You and Everyone Here

sweetblood22

checked in to help you out...
but the guys beat me to it. Sounds like they got you covered. My PEG is where Marine's is. I never had sitches or bandages on mine though, so I am wondering if yours is in a different place? Maybe your wife can help you the first time? My step mom helped me, then I was on my own. Just remember to go slow.

Fire34

Flushing Feeding Tube
Steve
I dont know if this will help as I am now 3 months out. During my concurrent chemo/rad my throat became swollen so bad i couldnt swallow at all and they placed a tube. They initially started me out with a gravity bag but that was too slow. For me the gravity feed thru a 60 cc syringe worked best. As mentioned in previous posts I was also advised to flush daily even though there werent any days i did not use mine. I had mine for approx. 3 months. The only bandage I had on mine was a little gauze for weeping from the incision.
And no you are not losing control of your life. I thought the same after my third week of chemo/rad and if not for my wife and it looks like your wife is just as supportive as mine was. I dont know what i would have done without mine

ratface

Fire34 said:

Flushing Feeding Tube
Steve
I dont know if this will help as I am now 3 months out. During my concurrent chemo/rad my throat became swollen so bad i couldnt swallow at all and they placed a tube. They initially started me out with a gravity bag but that was too slow. For me the gravity feed thru a 60 cc syringe worked best. As mentioned in previous posts I was also advised to flush daily even though there werent any days i did not use mine. I had mine for approx. 3 months. The only bandage I had on mine was a little gauze for weeping from the incision.
And no you are not losing control of your life. I thought the same after my third week of chemo/rad and if not for my wife and it looks like your wife is just as supportive as mine was. I dont know what i would have done without mine

It becomes routine
Go ahead and flush it. I would stand next to the kitchen sink and just fill the damn thing with water. Aspirate a bit to remove air. Undo the stopper as you squeeze on the tubing to prevent spills. Insert syringe tightly. Hopefully you have the one with the ears that gives you a nice hold. Push fluid through slowly. Repeat if remaining fluid is not clear, hopefully you haven't just downed some red wine. Hold tubing again while squeezing. Remove plunger. Replace plug.

Gravity feeding never worked for me. It's like watching paint dry. Bolus feeding is the way to go. You don't enjoy the food anyway and there are more exciting things to do in life. Push through slowly using same procedure as flushing. You may get some eruptions here so use a towel over your lap while sitting. Use the syringes with the ear flaps if possible. Gives you something to exert force on to push the plunger down.

You don't have to use it. This is only if it hurts like hell to swallow. Even simpler is just drinking the supplements down when pain permits. Pretty soon you will be doing it while watching TV or reading or having dinner with friends. Great conversation starter.

delnative

ratface said:

It becomes routine
Go ahead and flush it. I would stand next to the kitchen sink and just fill the damn thing with water. Aspirate a bit to remove air. Undo the stopper as you squeeze on the tubing to prevent spills. Insert syringe tightly. Hopefully you have the one with the ears that gives you a nice hold. Push fluid through slowly. Repeat if remaining fluid is not clear, hopefully you haven't just downed some red wine. Hold tubing again while squeezing. Remove plunger. Replace plug.

Gravity feeding never worked for me. It's like watching paint dry. Bolus feeding is the way to go. You don't enjoy the food anyway and there are more exciting things to do in life. Push through slowly using same procedure as flushing. You may get some eruptions here so use a towel over your lap while sitting. Use the syringes with the ear flaps if possible. Gives you something to exert force on to push the plunger down.

You don't have to use it. This is only if it hurts like hell to swallow. Even simpler is just drinking the supplements down when pain permits. Pretty soon you will be doing it while watching TV or reading or having dinner with friends. Great conversation starter.

Your friend the PEG
Boy, does this bring back some memories. The PEG gave me the creeps at first, too, and at first I had my wife help me flush the tube. But after I got used to it it was no big deal. As a matter of fact, when I couldn't swallow pills anymore I was able to grind them up, dissolve them in water and put them through the PEG. (Check with your doc before doing this: Some meds are meant to dissolve slowly, and grinding them up would give you too much, too fast.)
Remember, the PEG is your friend.
And, when you have it removed it leaves a really cool scar.

--Jim in Delaware

debbiejeanne

sweetblood22 said:

checked in to help you out...
but the guys beat me to it. Sounds like they got you covered. My PEG is where Marine's is. I never had sitches or bandages on mine though, so I am wondering if yours is in a different place? Maybe your wife can help you the first time? My step mom helped me, then I was on my own. Just remember to go slow.

flushing tube
Also, always remember to pinch the tube closed when you aren't using it. My tube sounds different also. I never had stitches or bandages on mine. Good luck all with the tube, it really isn't hard. In fact, it is probably the easiest part of this entire ordeal.
God Bless,
Debbie

debbiejeanne

delnative said:

Your friend the PEG
Boy, does this bring back some memories. The PEG gave me the creeps at first, too, and at first I had my wife help me flush the tube. But after I got used to it it was no big deal. As a matter of fact, when I couldn't swallow pills anymore I was able to grind them up, dissolve them in water and put them through the PEG. (Check with your doc before doing this: Some meds are meant to dissolve slowly, and grinding them up would give you too much, too fast.)
Remember, the PEG is your friend.
And, when you have it removed it leaves a really cool scar.

--Jim in Delaware

sense of humor
Jim, I absolutely love your sense of humor. It always makes me laugh out loud. Now you've made me want to hurry up and be done with this tube so I can show off my new cool scar.....lol.
God Bless,
Deb

delnative

debbiejeanne said:

sense of humor
Jim, I absolutely love your sense of humor. It always makes me laugh out loud. Now you've made me want to hurry up and be done with this tube so I can show off my new cool scar.....lol.
God Bless,
Deb

Aw, shucks
Weren't nothin', ma'am.
If I didn't have a sense of humor, I don't know how I would've gotten through all this.
Besides, laughter is good for the soul.

--Jim, still smiling in slower lower Delaware

Kent Cass

debbiejeanne said:

sense of humor
Jim, I absolutely love your sense of humor. It always makes me laugh out loud. Now you've made me want to hurry up and be done with this tube so I can show off my new cool scar.....lol.
God Bless,
Deb

My experience
Stitches? Not sure what you mean by that, Steve- I had none. Tube was put in me, and I had pain due to the breech of my abdominal wall, but that was mostly due to a previous injury/tear to that wall in the vicinity. The only opening in my skin is where the PEG goes into me, and so there's no stitches. Did have stitches above the Port, but not the PEG.

I flushed with bottled water and the large syringe- shooting the water at a gradual pace. As for the feeding, it was pouring the 4.0 formula into the large syringe (minus the plunger part of said syringe).

Of note: all my nutrition was thru the PEG from weeks #1-#8, though I was able to sip water and swallow pills that I chopped-up. Thought about grinding the pills, and even pouring some of the liquid morph into, but never did. Vicodin was all right, chopped, as was Xanax.

I thought I would have another belly button when the PEG is removed- not a scar. So, now I'm wondering which it'll be. Would appreciate any info on this.

kcass

delnative

Kent Cass said:

My experience
Stitches? Not sure what you mean by that, Steve- I had none. Tube was put in me, and I had pain due to the breech of my abdominal wall, but that was mostly due to a previous injury/tear to that wall in the vicinity. The only opening in my skin is where the PEG goes into me, and so there's no stitches. Did have stitches above the Port, but not the PEG.

I flushed with bottled water and the large syringe- shooting the water at a gradual pace. As for the feeding, it was pouring the 4.0 formula into the large syringe (minus the plunger part of said syringe).

Of note: all my nutrition was thru the PEG from weeks #1-#8, though I was able to sip water and swallow pills that I chopped-up. Thought about grinding the pills, and even pouring some of the liquid morph into, but never did. Vicodin was all right, chopped, as was Xanax.

I thought I would have another belly button when the PEG is removed- not a scar. So, now I'm wondering which it'll be. Would appreciate any info on this.

kcass

Well, Kent
Since you asked: The scar I referred to looks rather like the entry wound from a small-caliber bullet -- maybe a .22 or a .25. (Thank goodness there's no exit wound!)
I didn't have any stitches, either, so all I have is this funny-looking little dark dot to the northwest of my navel.
I look at it as the civilian equivalent of the Purple Heart.

--Jim in Delaware

Kent Cass

delnative said:

Well, Kent
Since you asked: The scar I referred to looks rather like the entry wound from a small-caliber bullet -- maybe a .22 or a .25. (Thank goodness there's no exit wound!)
I didn't have any stitches, either, so all I have is this funny-looking little dark dot to the northwest of my navel.
I look at it as the civilian equivalent of the Purple Heart.

--Jim in Delaware

Thanks
Thanks you, Jim. Slug was in my gut (now) for over a year! That is cool, you know. I had kinda hoped it wouldn't be a lint-trap twin of my belly button, but another post some time ago kinda made it seem like that would be the case. Now all I gotta do is make a cut in the vicinity on my back to represent where the bullet exited my body...It's a rough and tumble life us survivors have lived, dodging bullets and mixing it up with the rougher elements! Thank you, Jim. Much appreciated.

kcass

stevenl

Kent Cass said:

Thanks
Thanks you, Jim. Slug was in my gut (now) for over a year! That is cool, you know. I had kinda hoped it wouldn't be a lint-trap twin of my belly button, but another post some time ago kinda made it seem like that would be the case. Now all I gotta do is make a cut in the vicinity on my back to represent where the bullet exited my body...It's a rough and tumble life us survivors have lived, dodging bullets and mixing it up with the rougher elements! Thank you, Jim. Much appreciated.

kcass

Nuts
You guys are great. Thanks for the help. flushed it. Still spooky. Probably will be next time. But it will get better. I was having a real hard time with the general surgeon on getting released from the hospital. I don't know if it has stitches to be honest. I do know the port does. These went in on Wednesday and the gen. surgeon came in Thursday morning after being told that I had a dry run for radiation at 10:30, and then a dentist appt. He was not going to guarantee his precious port if I went to the dentist. Said I ran a high risk of infection. Mind you, I had already spoken with all of my medical team RO, MO, ENT and dentist. The dental work was deep cleaning and some implants, no more extractions or anything to jeopardize my upcoming treatment. Can you believe I forgot to consult with the general surgeon? Hell even the ent after talking to the dentist said every time I swallowed I was putting the port at more risk of infection due to the condition of my mouth, than not having the work done. (3 Abscesses). So I was pretty upset and probably was not listening as to what installation had to be stitched in. Yea there are bandages on it and they are still on it and I go see him tomorrow and he is going to show me what I need to know. Then hopefully I will be done with this doctor until at least removal. And by the way, i have some clean and some new teeth. By the time I got through with em they were trying to get the window open and throw me out of the hospital.

Best to all,
Steve

MaryRC

stevenl said:

Nuts
You guys are great. Thanks for the help. flushed it. Still spooky. Probably will be next time. But it will get better. I was having a real hard time with the general surgeon on getting released from the hospital. I don't know if it has stitches to be honest. I do know the port does. These went in on Wednesday and the gen. surgeon came in Thursday morning after being told that I had a dry run for radiation at 10:30, and then a dentist appt. He was not going to guarantee his precious port if I went to the dentist. Said I ran a high risk of infection. Mind you, I had already spoken with all of my medical team RO, MO, ENT and dentist. The dental work was deep cleaning and some implants, no more extractions or anything to jeopardize my upcoming treatment. Can you believe I forgot to consult with the general surgeon? Hell even the ent after talking to the dentist said every time I swallowed I was putting the port at more risk of infection due to the condition of my mouth, than not having the work done. (3 Abscesses). So I was pretty upset and probably was not listening as to what installation had to be stitched in. Yea there are bandages on it and they are still on it and I go see him tomorrow and he is going to show me what I need to know. Then hopefully I will be done with this doctor until at least removal. And by the way, i have some clean and some new teeth. By the time I got through with em they were trying to get the window open and throw me out of the hospital.

Best to all,
Steve

feeding tube
I dont know how to do a peg tube but my pediatric patient has a mickey button. Sometimes if her stomach is full of air the water and pediasure wont go down. Have to let it vent first. The gravity makes it all go down. I dont know what I will do when I have one, diferent when it is your own.
So when you had it put in... it wasnt as an outpatient?
I hope you are feeling good Steve. Have you been able to eat by mouth still?
Mary

stevenl

MaryRC said:

feeding tube
I dont know how to do a peg tube but my pediatric patient has a mickey button. Sometimes if her stomach is full of air the water and pediasure wont go down. Have to let it vent first. The gravity makes it all go down. I dont know what I will do when I have one, diferent when it is your own.
So when you had it put in... it wasnt as an outpatient?
I hope you are feeling good Steve. Have you been able to eat by mouth still?
Mary

Peg and port
Hi Mary,
My peg was radiology assisted and I was not an out patient. I stayed overnight. Yes I can still eat just had a hot ham and cheese sandwich. This was day 4 of treatment and I feel allright. It just takes the energy out of me so far but no bad effects yet.

Best,
Steve

sweetblood22

MaryRC said:

feeding tube
I dont know how to do a peg tube but my pediatric patient has a mickey button. Sometimes if her stomach is full of air the water and pediasure wont go down. Have to let it vent first. The gravity makes it all go down. I dont know what I will do when I have one, diferent when it is your own.
So when you had it put in... it wasnt as an outpatient?
I hope you are feeling good Steve. Have you been able to eat by mouth still?
Mary

maryrc
that's what i have now, one of those buttons. i had an appointment today, but couldn't go because of the 12" of snow. i have been getting an awful pain under my ribcage and out my back, i dunno if it is gas or what, but man it was bad today. feels like if i could get air out i would feel better. mary is there a way to let the gas out of this thing? how do you vent it? i am always very careful not to get air in my line when hooking up to my machine. had such a bad day today, i didn't even eat or drink much. not good. appt is rescheduled for tuesday.

Scambuster

stevenl said:

Peg and port
Hi Mary,
My peg was radiology assisted and I was not an out patient. I stayed overnight. Yes I can still eat just had a hot ham and cheese sandwich. This was day 4 of treatment and I feel allright. It just takes the energy out of me so far but no bad effects yet.

Best,
Steve

220ml per feed (6 -7 Fl Oz)
Hi Steve,

You have plenty of good advice here. I wanted to add that I couldn't take much more than about 6-7 fluid Oz per feed. I used the gravity feed method with a cup and tube setup which I hung from the rack in hospital and later at home a suction hook on a glass cabinet. I would read the news online while the feed went in.

I was always pressured to do up to 6 feeds a day but could usually only manage about 4 so my calorie intake was low as each feed for me was about 400 calories. I had to use Sunrider Vitashakes mixed with 220ml of Rice milk as the Nestle gunk the hospital had, played havoc and gave me shocking reflux and heavy mucus problems.

Earlier in it's use I did have to 'aspirate' the PEG tube before each feed. That is to check on pressure and fluid already in your stomach. At first the nurse did it. They would put the Syringe in the tube and actually suck out some fluid and see how much would come out. If only a bit (less than 50ml) they would just re-inject it. If more, they would take it out and dispose of it. I suppose you then get to know if your feeds or regular food is going down. If you're in hospital and/or on pain meds, you may get constipation which is a real **** (esp if you are on morphine) as that means movement of the food is slow. Tell your physician if you have this problem and get a fix.

Don't stress Steve, you will get used to the PEG. Mine was about 2 inches above and and inch left of my navel. I was a bad boy and didn't flush it as I was supposed to but had no ill effects. I had mine till about 3 months post treatment.

I didn't have stitches for the insert but one or two when they pulled it out. As such I probably have a smaller scar than those rugged types here that had the 'grit n pull' method of removal. I will still tell my kids "That's where Daddy got shot" when they are old enough.

Hang in there Steve, keep eating and talking and being as normal as you can for as long as you can. Don;t over do it and get plenty of rest if you need it. Hopefully you can cruise through but don't be hard one yourself if you hit any rough patches. I hit a lot and was hospitalized for nearly 4 weeks but am well over it all now and back at work. You can do it !!

Regds
Scambuster

stevenl

sweetblood22 said:

maryrc
that's what i have now, one of those buttons. i had an appointment today, but couldn't go because of the 12" of snow. i have been getting an awful pain under my ribcage and out my back, i dunno if it is gas or what, but man it was bad today. feels like if i could get air out i would feel better. mary is there a way to let the gas out of this thing? how do you vent it? i am always very careful not to get air in my line when hooking up to my machine. had such a bad day today, i didn't even eat or drink much. not good. appt is rescheduled for tuesday.

Pain
Hey sweet,
I have that awful pain sometimes too. I am the same it feels like serious gas or I don't know but it hurts. What is odd about me, and I know that the stomach is a big muscle basically, is that the inside of the tube feels stuck to the inside wall of my stomach, and I can feel my stomach cycling,?-- all of a sudden it feels like it separates and the pain almost goes completely away. Asked the all knowing, all seeing General Surgeon about this yesterday, and He simply said "NORMAL". You know, I guess he is right because all of the time before my peg I doubled over in pain about once an hour. NOT!!! It may be hidden in my writing the total disdain I have for this doctor. If so, I will try to express my feelings better, or may seek counseling.LOL Idid get some gas x and tried that last night and it did help. Eating, or FEEDING myself something seems to help too. Haven't been able to VENT it yet, except on this post so far.

Bless you Sweet
Steve

sweetblood22

stevenl said:

Pain
Hey sweet,
I have that awful pain sometimes too. I am the same it feels like serious gas or I don't know but it hurts. What is odd about me, and I know that the stomach is a big muscle basically, is that the inside of the tube feels stuck to the inside wall of my stomach, and I can feel my stomach cycling,?-- all of a sudden it feels like it separates and the pain almost goes completely away. Asked the all knowing, all seeing General Surgeon about this yesterday, and He simply said "NORMAL". You know, I guess he is right because all of the time before my peg I doubled over in pain about once an hour. NOT!!! It may be hidden in my writing the total disdain I have for this doctor. If so, I will try to express my feelings better, or may seek counseling.LOL Idid get some gas x and tried that last night and it did help. Eating, or FEEDING myself something seems to help too. Haven't been able to VENT it yet, except on this post so far.

Bless you Sweet
Steve

different pain
steve, i get that pain every once in a while, too. that one is more like a spasam. seems to happen more to me if i get too hungry. they both hurt.