What should we expect with getting PEG, Types of PEG's, Care, and How to use?

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cureitall66
cureitall66 Member Posts: 913
edited October 2012 in Head and Neck Cancer #1
We're expecting a PEG to be placed soon. Can you tell us how to expect this to be placed, what types there are, how are they used with putting food in and is it limited to just Ensure/Boost type products, or can you used blended foods you make. And also, what kind of care(cleaning/bathing) should we expect?
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  • Ladylacy
    Ladylacy Member Posts: 773 Member
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    PEG
    My husband has had a PEG tube twice. First time it was outpatient. They went down his throat into his stomach and then the tube came out his stomach. He had this PEG tube from August 2010 until May 2011. Never had a problem with it but then too he never put anything in the PEG tube other than the Nutren 1.5 he was on. He crushed his pills, put them in water and then put into the PEG tube.

    Second time one was inserted and the same procedure was followed except he had to spent the night. Don't know why to be truthful but this was the way they did it (different doctors, different place for treatment the second time). This PEG tube was inserted in May 2012 and he still has it. He is able to swallow again, after a dilation but the doctor decided he wanted him to keep the tube until January when he has a check-up just in case his throat starts to close again. Once again he only used the Nutren and water in the tube. No problems so far. He is swallowing the Nutren now and does use the PEG tube with water to keep it open. People do blend food and put in the tubes but we were told not to, so we didn't. As far as cleaning, he uses peroxide around the outside occasionally and for the first week or two he used neospirin(?) cream in the morning and evening.

    Sharon
  • boardwalkgirl
    boardwalkgirl Member Posts: 269
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    I had outpatient surgery to
    I had outpatient surgery to have my peg tube and port put in. The surgeon explained to me that they scope down your throat and shine a light in your stomach so they know where to make the incision from the outside to put the peg tube in. I went home within an hour or two. Pretty sore for the first week. They prescribed Jevity to use in my tube which was delivered by a Home Health agency and covered by insurance. I put my meds thru it, crushing the pills and mixing them with water or liquid meds. I also would put extra water thru it if I was unable to drink enough fluids. I had mine removed about 6 weeks after I finished treatment. Done in the doctor's office, numbed the area around the tube, gave it a yank and it was out. Little sore for a couple of days. As much as I didn't want one, I was glad to have it in the middle of treatment when I just couldn't eat and drink enough. Wishing you the best of luck with yours.
  • blackswampboy
    blackswampboy Member Posts: 341
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    right, use hydrogen peroxide
    right, use hydrogen peroxide to clean when necessary. after it heals, should also be able to shower as normal.

    as far as I know, PEG is a specific type of tube. you'll insert a large syringe into the tube, pour your nutrition product into that, and let gravity do the work. I've never had to use the syringe plunger, but it is important to flush the tube with water after feeding.

    you can get prescription nutrition products shipped to your door--such as Osmolite and Jevity (both from Abbott). there are others.

    I believe some people prepare their own blended foods. personally, I reckon that would make tracking nutrients and calories every day more difficult. using a base of six cans of Osmolite per day, I know exactly what I'm getting in calories, and I've been able to gain back 20 lbs. entirely via the tube.

    I don't love the thing, but it works.
  • NoDuck
    NoDuck Member Posts: 134
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    THE PEG
    It will be like this site -- wish you didn't have to have it but glad you found it.

    My hubby had tonsil cancer and doc did not want to do the usual placement of running the tube down his throat for fear of dislodging cancer cells and implanting them in his stomach. So while the placement was still outpatient, it was general anesthetic. The way we understood it is that they still ran the small tube with the light on the end down his throat but instead of also running the larger stomach tube down his throat and punching it through to the outside, they went in from the outside with the stomach tube.

    We had a heck of a time getting him used to the food. We used Nutren 2.0. He started using the tube about 4 weeks into teatment and by then was suffering extreme nausea. The key we found was smaller feedings more often. When things got really rough, we used a continuous feed pump. He wasn't doing anything anyway besides sleeping in the recliner so he could get a slow drip feeding that didn't upset his stomach.

    For cleaning, we used hydrogen peroxide wipes. We use a trach tube gauze pad. It has the slit and hole precut but you can just use regular gauze pads and cut them yourself. After the first week or so, showering is fine.

    The PEG will be a lifesaver. Hubby is 3 months post treatment and still uses it. Just in the past week has he started eating real food. Taste buds are just now starting to come back.

    I think there is another thread about peg tubes in the Superthread at the top of this discussion board.

    Deb
  • phrannie51
    phrannie51 Member Posts: 4,716
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    Everybody has pretty much covered it.....
    The cleaning (I used a mixture of saline solution and peroxide, and a qtip to clean around the hole)....Used the syringe to let gravity pull the Ensure into me. Boost is pretty thick, so I'd mix it with milk in a paper cup, so I could pour it into the syringe. Always flush the tube with water after eating. Ya know, I was totally creeped out by my tube...and they sent a Home Health nurse over to show me what to do with it...

    I was already in the hospital with a punctured lung (that happened when they put my port in)...but the surgery only took about 30 minutes, and they put me under twilight sedation...which isn't the same as general...felt the same tho. I had cramping for the first few days...got better each day, tho.

    I'm SO relieved he's getting a tube....they make all the difference is staying hydrated and fed...a person just has to treat themselves like a plant :)....water, and nutrition several times a day.

    p
  • cureitall66
    cureitall66 Member Posts: 913
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    I'm concerned greatly with....
    his swollen throat and them trying to place this PEG in.

    Are there two types of feeding tubes? I thought I saw someone post about a gravity bag?

    Which one can you put regular food (blended)into? Or is that not recommended? What about water?

    Also, how do you put medication in it...if it's a "time release" pill that can not be broke up? He is on a couple heart meds that are time released.
  • boardwalkgirl
    boardwalkgirl Member Posts: 269
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    I'm concerned greatly with....
    his swollen throat and them trying to place this PEG in.

    Are there two types of feeding tubes? I thought I saw someone post about a gravity bag?

    Which one can you put regular food (blended)into? Or is that not recommended? What about water?

    Also, how do you put medication in it...if it's a "time release" pill that can not be broke up? He is on a couple heart meds that are time released.

    I would consult a pharmacist
    I would consult a pharmacist about his medication. I checked with mine before I crushed any of them and I did have one that I took apart and put in applesauce every day as it just wouldn't mix up and go down the tube. The pharmacist can help you
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
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    PEG,,,
    Definitely one thing I can offer no advice on, other than to get one and use it if recommended, or needed...

    Matt, and I thought I already had you pegged...

    JG
  • phrannie51
    phrannie51 Member Posts: 4,716
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    Skiffin16 said:

    PEG,,,
    Definitely one thing I can offer no advice on, other than to get one and use it if recommended, or needed...

    Matt, and I thought I already had you pegged...

    JG

    For sure check with the pharmacist about time
    release pills (I wondered the same thing with medication)...I bought a mortar and pedstal off Amazon to crush up other meds....I also had to "bear" one pill that had to be taken whole...it was small, but I could still feel it going down.

    Water goes into the syringe just like the Ensure and Boost. I think Hondo's wife puree's real food for his tube, but it has to be the right consistancy or it'll just get stuck in there and gravity won't work. I'm sure you can use chicken broth or something like that to thin it out. I found this link with recipies here on CSN....and another one you can paste into your browser.

    http://csn.cancer.org/node/212987

    http://lucysrealfood.com/

    Another plus of a tube....if he does have to take one or two pills a day by mouth, that's all he has to do with his mouth/throat...everything else can go down the tube. It's really not as hard as I tried to make it when I first got it...but like I said, I was creeped out by it. Whenever I'd feed or water myself I could feel it in my esophagus, like it goes up then goes back down...

    p
  • CivilMatt
    CivilMatt Member Posts: 4,723 Member
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    PEGGED twice
    Cureitall66,

    Sounds like everyone covered the use; for me during heavy use it was 2 cans of Jevity at a time 2 times a day. I manged to drink one meal a day throughout treatments.

    The one thing everyone left out and to many of us the most important. How do you tie, hook , suspend or tape the thing up. It is a big wiggly snake your husband will get very familiar with. My method was the most lame, I used tape, I did not know (or care about at the time) all the cool ways people were dealing with it. Some one will have to help me here, but the best I heard of was buying some sort of clip from Staples and rigging it up to hold the PEG tube.

    THERE ARE NO PIERCINGS INVOLVED IN ANY OF THESE PROCEDURES!!!

    Best of luck. The PEG club meets on the last Friday of the month, smoothie drinkers and food eaters are welcome.

    Matt
  • D Lewis
    D Lewis Member Posts: 1,581 Member
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    CivilMatt said:

    PEGGED twice
    Cureitall66,

    Sounds like everyone covered the use; for me during heavy use it was 2 cans of Jevity at a time 2 times a day. I manged to drink one meal a day throughout treatments.

    The one thing everyone left out and to many of us the most important. How do you tie, hook , suspend or tape the thing up. It is a big wiggly snake your husband will get very familiar with. My method was the most lame, I used tape, I did not know (or care about at the time) all the cool ways people were dealing with it. Some one will have to help me here, but the best I heard of was buying some sort of clip from Staples and rigging it up to hold the PEG tube.

    THERE ARE NO PIERCINGS INVOLVED IN ANY OF THESE PROCEDURES!!!

    Best of luck. The PEG club meets on the last Friday of the month, smoothie drinkers and food eaters are welcome.

    Matt

    Tie, hook, suspend, tape, ...
    All of the above. I used to tuck a loop of my tube up under the band of my bra... oh wait, sorry, that won't work. Other times, I'd tuck a loop of my peg into the waistband of my sweatpants. One doesn't want the long snaky thing popping out from under the clothes... my PEG tube was so long, I swear it reached most of the way to my knees.

    Go ahead and use surgical tape, but don't tape the PEG to your skin, as it can get very irritating. Also, it's a bit uncomfortable to be constantly scrubbing off the remnants of stickum that the tape leaves on your hide. I did loop the tube around and tape it to itself. The tube becomes a lot easier to tuck under clothes that way.

    Pam M may chime in later. She devised a clever necklace from dental floss and suspended the tube from her neck when she showered. I was able to get the surgical-taped tube-loop to hold for the duration of a shower. Then I would dry off the tube and change the tape.

    You will find a way.

    Deb
  • Kent Cass
    Kent Cass Member Posts: 1,898 Member
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    Skiffin16 said:

    PEG,,,
    Definitely one thing I can offer no advice on, other than to get one and use it if recommended, or needed...

    Matt, and I thought I already had you pegged...

    JG

    Yep-
    John covered it all, for him (!!!LOL!!!).

    Can say that we were advised awhile back that peroxide is not good to clean the area with. I used peroxide without any complications whatsoever, though. Think soap and water is now advised to use in cleaning the area around it every day with the dressing changes.

    I was also outpatient and used Jevity, only, in the 1.5 and 1.2 quantity. Worst of times for me was a struggle to get two in me per day, but at least it was something. All I did with my G-tube was pour the Jevity into a large empty syringe that I had feeding into the unplugged top of my tube, and let gravity take it down into my stomach. Men, typically, have less problems with the installation recovery than women do. Wise person take it easy for a couple days with the physical activity right after it gets put in. Breeches the abdominal wall mesh that nature installed, so there is a tear between the skin and tummy that can get aggravated.

    Best of luck going forward, and...get a couple little bottles of Coke ahead of time, just in case it gets backed-up and the blockage won't clear. Coke does fix it.

    kcass
  • George_Baltimore
    George_Baltimore Member Posts: 303
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    Kent Cass said:

    Yep-
    John covered it all, for him (!!!LOL!!!).

    Can say that we were advised awhile back that peroxide is not good to clean the area with. I used peroxide without any complications whatsoever, though. Think soap and water is now advised to use in cleaning the area around it every day with the dressing changes.

    I was also outpatient and used Jevity, only, in the 1.5 and 1.2 quantity. Worst of times for me was a struggle to get two in me per day, but at least it was something. All I did with my G-tube was pour the Jevity into a large empty syringe that I had feeding into the unplugged top of my tube, and let gravity take it down into my stomach. Men, typically, have less problems with the installation recovery than women do. Wise person take it easy for a couple days with the physical activity right after it gets put in. Breeches the abdominal wall mesh that nature installed, so there is a tear between the skin and tummy that can get aggravated.

    Best of luck going forward, and...get a couple little bottles of Coke ahead of time, just in case it gets backed-up and the blockage won't clear. Coke does fix it.

    kcass

    As of the moment, I still have electricity so I can respond
    Don't know how much longer Hurricane Sandy is gonna let me communicate. There is a G-tube which goes into the stomach. There is also a J-peg which empties into the jejunem (part of the small intestine). Most of us that have pegs are the g type. You can administer liquid food by gravity bag (what I prefer because you can take your time and reduce the chances of regurgitration) or the bolus method with a syringe. Pureed food would not work with a gravity bag. Whatever you do, do not crush time released medications. That defeats their purpose.
  • cureitall66
    cureitall66 Member Posts: 913
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    As of the moment, I still have electricity so I can respond
    Don't know how much longer Hurricane Sandy is gonna let me communicate. There is a G-tube which goes into the stomach. There is also a J-peg which empties into the jejunem (part of the small intestine). Most of us that have pegs are the g type. You can administer liquid food by gravity bag (what I prefer because you can take your time and reduce the chances of regurgitration) or the bolus method with a syringe. Pureed food would not work with a gravity bag. Whatever you do, do not crush time released medications. That defeats their purpose.

    Stay safe...
    Stay safe through the hurricane... and thank you for taking the time to give me your experience and tips. I appreciate it. I hope we get the hang of it as quick as he can get it. We are desperate just to get the thing in.
  • cureitall66
    cureitall66 Member Posts: 913
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    Kent Cass said:

    Yep-
    John covered it all, for him (!!!LOL!!!).

    Can say that we were advised awhile back that peroxide is not good to clean the area with. I used peroxide without any complications whatsoever, though. Think soap and water is now advised to use in cleaning the area around it every day with the dressing changes.

    I was also outpatient and used Jevity, only, in the 1.5 and 1.2 quantity. Worst of times for me was a struggle to get two in me per day, but at least it was something. All I did with my G-tube was pour the Jevity into a large empty syringe that I had feeding into the unplugged top of my tube, and let gravity take it down into my stomach. Men, typically, have less problems with the installation recovery than women do. Wise person take it easy for a couple days with the physical activity right after it gets put in. Breeches the abdominal wall mesh that nature installed, so there is a tear between the skin and tummy that can get aggravated.

    Best of luck going forward, and...get a couple little bottles of Coke ahead of time, just in case it gets backed-up and the blockage won't clear. Coke does fix it.

    kcass

    Thanks for the tips...
    Kcass,

    I've taken notes here from yours. Appreciate you sharing your experience with us. Hope to get this thing in place in the next few days.

    He was so stubborn up front about getting one. Thought he could do it on his own...now he regrets that decision. Hasn't ate in nearly 4 days. He's a hungry man!!
  • hwt
    hwt Member Posts: 2,328 Member
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    Thanks for the tips...
    Kcass,

    I've taken notes here from yours. Appreciate you sharing your experience with us. Hope to get this thing in place in the next few days.

    He was so stubborn up front about getting one. Thought he could do it on his own...now he regrets that decision. Hasn't ate in nearly 4 days. He's a hungry man!!

    Not sure
    Not sure what I had. Never referred to as PEG, seems like G-tube. They gave me twilight drug and put it in. Could not shower or swim with it. Not very cumbersome. Only did gravity feedings, tube too thin don't think I could have used anything but Ensure/Boost or the like in it. Was helpful to have pills crushed and added with syringe. Ditto on not using time released pills in the tube. I liked gravity feeding because of disposable bags really no clean up. Ran food thru then added water to bag and it ran thru. My incision is just under my breast. No pain for removal. Insertion point had a bandage over it and I changed it daily. Don't do gravity feeding while laying down and do not lay down for 30 minutes after feeding. I guess after 2 weeks in the hospital with it in my nose that I was thrilled to have it moved. My ONC wanted it in 12 weeks after tx but I had it taken out since I wasn't using it. Never regretted that.
  • Greend
    Greend Member Posts: 678
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    Types
    I have a G-Peg and this is one that goes directly into the stomach. The "gravity" you mentioned is where you add liquid to the 2 oz syringe and let it flow into the stomach. I did this for two years with Ensure etc. Now I just blend up my food and push it through the syringe.

    The other tube (I've not had this) is a J-Peg and it is my understanding that this tube is place into the intestine and I think it is gravity fed but I'm not certain. I know that there are tons of past discussions on this if you search on "PEG" at the top of the page.

    I never leave home without it.
  • George_Baltimore
    George_Baltimore Member Posts: 303
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    Greend said:

    Types
    I have a G-Peg and this is one that goes directly into the stomach. The "gravity" you mentioned is where you add liquid to the 2 oz syringe and let it flow into the stomach. I did this for two years with Ensure etc. Now I just blend up my food and push it through the syringe.

    The other tube (I've not had this) is a J-Peg and it is my understanding that this tube is place into the intestine and I think it is gravity fed but I'm not certain. I know that there are tons of past discussions on this if you search on "PEG" at the top of the page.

    I never leave home without it.

    Ta-Da, still have electric at 5:42pm
    HWT made a very good point about not laying down while feeding. Your husband will definitely not like it coming back up his esophagus. I also try to take it easy for half hour or so after a feeding. It's also adviseable not to bend over during that time.
  • CivilMatt
    CivilMatt Member Posts: 4,723 Member
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    picture worth 5 or 10 words
    Cureitall66,

    You can see a picture of my 2nd PEG taken from inside of my stomach on my expressions page

    Matt
  • cureitall66
    cureitall66 Member Posts: 913
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    CivilMatt said:

    picture worth 5 or 10 words
    Cureitall66,

    You can see a picture of my 2nd PEG taken from inside of my stomach on my expressions page

    Matt

    I'll check that out...
    He gets the PEG thursday. He's a little apprehensive about getting it put in. Tomorrow is Pic line...that too is scaring him. What a whirlwind...