Best way to get crushed pills down G-tube into stomach
Had a G-tube installed 5 days ago with scant advice on feeding going forward. Had told them I had a FT for 17 months 10+ years ago, so maybe they figured I knew it all. NO. I was able to swallow chopped-up pills during my initial tx. But now, swallowing them is a coin toss as to whether or not they go down the right pipe.
Asked 2 Pharmacists and was told by the one what I had already figured: crush to powder and mix with water, then pour into tube. Sloppy. And, with the 3-4" of Jevity always showing at base of FT after drinking 2 of them for a couple hours- how the heck do I know if they're in my stomach, or mixed-in with the Jevity I see?
Any/all advice will be welcome. Doctors and Nurses have not offered any advice.
Thanks in advance.
Comments
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Hello Dave
When I had my treatment after while I could swallow nothing. I used a pill crusher like this--
https://www.cvs.com/shop/cvs-health-pill-crusher-plus-storage-prodid-715079
And crushed them and mixed with water into a separate container that I used for this purpose and sucked the mixture up with a 60cc syringe that the nurse navigator had given me and injected them into the feeding tube. Also used it to feed the liquid feeding solution if I wanted to inject it rather than let it run in by gravity. Also got my meds in liquid form if possible but they don't make liquid versions of everything. Capsules you just open and dump out. Time-release pills you can't use because they have to be swallowed and then they release and dissolve over time. God Bless
Example of 60cc syringe although you probably don't have to get them online your local drug store or Walmart may have them--
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We did same. Got pill
We did same. Got pill crusher, dissolved in separate small measuring cup, poured in feeding tube...voila. crushing is a PITA but what are you going to do. We chose to use syringe, took the plunger out and gravity fed the jevity. Was way quicker. We also received most meds liquid form, if available.
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Thanks
Have been using syringe tube after crushing- pouring into it from shot glass w/water & meds. Problem is some med granules stick to the shot glass side. So, end up pouring a lot of water in shot glass & syringe before I get it done.
Never thought of Sash's suggestion, and just might try.
Did buy a little funnel. Fits snug in the very top of FT opening. Plan to grind, then empty into funnel getting as muich to go in and down as possible, then pour water in top of little funnel. Trial and error to get the best way, I reckon.
Thank you.
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WBCwbcgaruss said:Hello Dave
When I had my treatment after while I could swallow nothing. I used a pill crusher like this--
https://www.cvs.com/shop/cvs-health-pill-crusher-plus-storage-prodid-715079
And crushed them and mixed with water into a separate container that I used for this purpose and sucked the mixture up with a 60cc syringe that the nurse navigator had given me and injected them into the feeding tube. Also used it to feed the liquid feeding solution if I wanted to inject it rather than let it run in by gravity. Also got my meds in liquid form if possible but they don't make liquid versions of everything. Capsules you just open and dump out. Time-release pills you can't use because they have to be swallowed and then they release and dissolve over time. God Bless
Example of 60cc syringe although you probably don't have to get them online your local drug store or Walmart may have them--
I have quite a few 60 ML syringes, and had not thought the way you describe would work- BUT, I sure am going to try. Sides of my neck have been spasming often due to lack of meds, and shooting it down the tube w/plenty of water so a clog doesn't develop does sound like the most efficient way.
Thank you.
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Best way
Did not try Sash's way, which I think would work. Did try the funnel- powder clogged the very narrow top (did not realize until then said was smaller in diameter than tube), which resulted in a little mess. Mixed w/water in shot glass, then used 60ML syringe. Felt the cold water going into stomach, but took a long time to feel the effect.
Now I'm crushing, pouring a little water in crushing tube and mixing-up with metal Y tool I had from work, then shooting into FT with a little 10ML syringe. For best effect I'm doing this a half hour or more before eating/drinking the Jevitys.
FYI: I'm pouring 7 Jevity 1.2s into me using a 60ML syringe tube. My digestive system, if you know what I mean, has been great! Logically, that was a big concern with a liquid diet. Back in tx 10 years ago I never was able to FT drink as many as I was supposed to, and the digestive system was barely functioning. 11 days out, now, after the FT was installed. Have not gained back any weight, and may have lost only a lb.- which is why I'm drinking apple juice to up my calorie intake, but what a relief the digestive system is a-okay.
Again, thank you.
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Dave Keep trying
You will get the right combination sooner or later. Glad your digestive system is OK. I think the key for any of these drugs is to grind them up fine or if they are in a capsule they are already fine usually and mix them with pretty warm water and stir well till all is dissolved and then it has to be liquid and should go right through the tube. If not ground and dissolved you will have chunks and they will jam up. Good Luck Dave-god Bless
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Meds and feeding tube
It is important to always flush before and after using the feeding tube. It is also important to get plenty of plain water, numerous cups a day. It is quite easy to become dehydrated on a feeding tube. We use the 60 ml syringe and gravity for meds. I use a mortar and pestel, finer than grinding meds. All of husbands feeding tubes had an extra plugged opening for flushing a "plugged" tube. It is not difficult. Often just gently using the plunger is sufficient to unclog tubing. For a while, mixed meds and water with a spoon or two of pudding. The crushed meds stay suspended better in the thickened solution, negating the settling and the meds remaining in the shot glass. I use the little metal restaurant type sauce cups, about the size of a small shot glass for pouring into the syringe. Just the right size. Just be sure doctors and pharmasists remember you are crushing meds. Husband gets an iron supplement. It needs to be diluted or it will turn the feeding tube black.
Thats all I can think of at the moment. Hope it helps,
Crystal
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Well...
Thank you, Crystal, for the dehydration advice. Had wondered about that. Danged hassle is leaving the house for any length of time, of course. And I do wonder about the quality of the tap water I've been using. This morning I see medicine stuck to the bottom of the little 10ML syringe flat. Figure I did not grind the Sertraline well enough. And, discovered its a big mistake using carbonated flavored water- which foams up. Use that for flusing with 60ML. Plan on making a trip to get some "purified" water at local grocery store today.
Just frustrating. Looks like I've lost another couple lbs. in spite of getting a few more calories than the Dr. advised. Had another pill crusher crack at the base the first time I used it. Second Speech Therapist session= nothing done. Told her the mouth & tongue exercises have done nothing but aggravate the nerve damage on both sides of the neck, and the 2 meds for that being taken as they are have helped very little. She said she will call my Neurologist Monday AM, but do not see that going anywhere in an effort to improve the swallowing function. Local Nurses I've dealt with at the Home Supply and the Services stores/offices don't have a clue on the medicine w/FT.
And Russ- thanks for the warm water advice.
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No Problem Dave
You're going through a time of it. Crystal is right about flushing I think I was told to flush before putting in food or drugs and after. And she is spot on on the water and if you get a little over that is better to have a little more than not enough you will just go more. Sorry, you are losing weight hope it stabilizes soon. Some people on here I remember reading use a magic bullet or nutribullet or some other blender and make their own high-calorie drinks to put on weight. Dave check the super thread at the top of the page under NUTRITION / HEALTHY EATING / LIQUID NUTRITION TIPS: Have you ever tried Carnation Breakfast essentials and use whole milk for more fat and calories or similar products----
https://www.carnationbreakfastessentials.com/
Dave try to be patient and keep working with the speech therapist and nurses you are going through some changes and you will get adapted to it afterwhile. This stuff is not easy and there are no quick answers sometimes for these treatment after-effects they are a real pain-God Bless
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Our thoughts and prayers are with you
Hi Dave, You are in our thoughts and prayers to get well soon. Wondering if you ever tried BOOST VHC - very high calorie it has something like 560 calories in it and it helped me maintain my weight and this might help with you gaining some weight back. I agree with Russ the nutribullet or blender of some sort can really come in handy for making high calorie smoothies. I know things will get better for you and your speech and swallowing will improve.
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Thank you
Will check-out the Boost, Sabrina- that's a lot of calories.
Drinking apple juice on top of the Jevity, and am getting more calories than the Dr. says I need.As for the Speech Therapist, I'm not looking for her being to help at all. The exercises she has me do just aggravate both sides of my neck, which is Rad damage I've been on 2 meds for years. Best thing I can do is still sip water and make many swallows even if I'm not swallowing anything.
With my figuring-out how to get the meds in me best, and working-out a routine, I am feeling more positive about the future.
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High calorie idea..If you
High calorie idea..If you are able to tolerate dairy an easy way to increase calories is to use coffee cream in a mixed drink. Check the labels in the dairy case. I made my husband blended drinks of coffee cream , whole milk, Greek yogurt add some honey, fruit, and a couple of teaspoons of flax seed or hemp hearts. Makes about two cups and it adds up to close to 2000 cals ! When he couldnt/ didnt feel like eating, it gave him close to his full 2500 cal target. Took most of the day to get it in him, but it worked.
The key is reading labels and choosing high calorie low volume items. 18% fat milk, Greek yogurt and honey are easy to,add calories to your diet in many ways. I have a huge list, if you need help, message me. All of these things can go thru a feeding tube if need be.
Take care
Deb
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Hi Dave,debbiel0 said:High calorie idea..If you
High calorie idea..If you are able to tolerate dairy an easy way to increase calories is to use coffee cream in a mixed drink. Check the labels in the dairy case. I made my husband blended drinks of coffee cream , whole milk, Greek yogurt add some honey, fruit, and a couple of teaspoons of flax seed or hemp hearts. Makes about two cups and it adds up to close to 2000 cals ! When he couldnt/ didnt feel like eating, it gave him close to his full 2500 cal target. Took most of the day to get it in him, but it worked.
The key is reading labels and choosing high calorie low volume items. 18% fat milk, Greek yogurt and honey are easy to,add calories to your diet in many ways. I have a huge list, if you need help, message me. All of these things can go thru a feeding tube if need be.
Take care
Deb
Hi Dave,
I am new here and haven't even completed my Profile & title page yet-- but I completely understand your problems.
In April & May, I had surgeries to remove my 6th SqCC tumor. This time, it came from Floor of mouth, grew up and invaded my reconstructed tongue Flap. What a mess cancer causes!
August 1st, I had my 4th Modified Baium Swallow study ( a little over a year post my Radiation treatments)-- and this one was the Worst yet, showing that I am aspirating Every-damn-thing, Thin liquids, Thickened liquids, and also puree/liquids.
( I have not Eaten food since March 2017. have am 100% G tube dependent)
This March/ April, I had my 5th case of aspiration pneumonia. And guess what cultured out? E. Coli. Yep, E. Coli in my lower lobe. They said I just have aspirated my stomach contents, at some point. I have Silent Aspiration, though, so when it happened, I couldn't even tell.
I weigh 76-77 pounds,....And that is Up from 64 pounds, on major surgery day April 25, 2017.
Stage III SqCC-- Tongue. Peripheral Invasion +. Tumor size 6.3 Centimeters by 3.1 Centimeters by 2.2 Centimeters Thick!! A huge monster that enveloped the entire tongue, base to tip, and invaded my Tonsil and my Submandibular Salivary glands. And gingiva. ( all was removed) Microvascular Reconstruction for free flap, from scapular tissue ( a 16 inch incision from my Back).....
Subtotal glossectomy. Bilateral neck dissection Rim Mandibullectomy. Tracheostomy. Dental extraxtions. Left parascapular tissue used for free flap. I was 64 pounds on surgery day, 7+ hours..... My tumor was Starving me ( I had had my G tube in for only 3 weeks then) and it was Smothering me-- my skin was Grey/ blue on surgery day......I was admitted Twice in 3 weeks leading up to surgery, one of those was for G tube and to help stabilize me, then second time by ambulance, my home health nurse called because of aspiration pneumonia.
Within 4 months of that surgery, ( posterior tongue margin was Less Than 1 Millimeter. Plus, I had PNI)-- I started having recurrences.....
This year, tumor #6. And my Radiation Oncologist took my case back before the Tumor Board and he gave me a new diagnosis: Field Cancerization.
By the This ay, I have Never smoked, not do the drink. And all my tumors have been HPV Negative. Negative for all types.
They have all been Invasive with positive margins ( except for one small one) and they are legitimizing tumors.
Anyway, Dave dear,-- I get it !!
So, my recent MBS study was August 1st, and then August 7th, I had an emergency esophAgEal dilation ...This was my 7 th one since December! It keeps closing up tight. Pinpoint stricture. Surgeon has to go in with a Guidewire, each time, and thread it through... Radiation effect keeps closing is down.
I am single. My dog is 14 years % 5 months old. She is retired from competition Obedience. I showed in the show ring for years... And she weighs more than I do!
Sorry for This too long, first post !
LitlCJdoll
This
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Auto correct
Oops, autocorrect mistakes-- supposed to be Perineural invasion.... And Keratinizing tumors.
Who cares? It's all bad.
Take care, Dave. We can give you lots of tips, for G tube use and care.
LitlCJdoll
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LitlCJdoll
WOW. You've had quite a time of it w/C, and I hope things get stable and you can gain some weight back, and ace the C for good. Wow.
I think I have the feedings routine down pretty good now. Biggest hassle, of course, is the danged meds crushing and mixing w/water and having to be home for any feedings.
Take my morning meds around Noon, then wait almost an hour before pouring in my first 2 Jevitys.
Then wash up and use the stool before taking another med.
Hit the road for a couple hours taking care of business (like PT, PCP visits, or visiting my 98 year old Dad w/groceries I get him), then back home to take another med.
Wait a while, then pour in a 3rd Jevity. Wait a while longer and pour in a 4th and half the 5th.
After an hour-plus, typically take a 2-hour nap.
Rise and take 3 meds, usually around Midnight.
Pour in the last 1-1/2 Jevitys around 2 AM, and hit the sack between 5-6 AM.
Know the hours may seem strange to most of you, but I'm single and worked 2nd shift over 30 of my 43 working years in my life- so these hours are friendly to me. Do wake up from all sleeps w/a few deep bronchial coughs, but the stuff is typically clear, now.
There is a great online site for FTs: Moffit Center. Just Google "G-tube feedings," of add how to do, and you should find it. Realized 2 Jevitys is the typical max after I found and read from the site.
Thanks to all who've tried to help.
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Feeding tube dependence and insurance
Medicare (and thus, insurance) cover costs for feeding when dependent. Took us 5 years to find the medicare ruling and to get insurance to pay for.
This really helped us when treatment deductibles were more than we made...
Crystal
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Crystalcaregiver wife said:Feeding tube dependence and insurance
Medicare (and thus, insurance) cover costs for feeding when dependent. Took us 5 years to find the medicare ruling and to get insurance to pay for.
This really helped us when treatment deductibles were more than we made...
Crystal
Thank you for that info. I turn 65 in late-November and plan to set-up a meeting with a Navigator for Medicare enrollment, so that is great news to hear, and does explain why my Insurance is paying for it now.
I DO HAVE A QUESTION, CRYSTAL: who do you get your FT Jevity, e.g., from? I get it thru a local Hospital system, and they charge my Insurance twice as much as I can get via Amazon! I know this for a fact because my PCP will not approve 1.5, so I bought a box- this way my daily feedings are five-1.2 and one-1.5 to get the calories I need. Think I'm still Aspirating a little of the stuff, perhaps due to all the water with the 5 meds I'm taking: 4/day, 3/day, 3/day and two 1/day.
AND: what is the "thickened solution" you mentioned you use in an above post?
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Medical supplier
Hi, Dave. We used a local medical supply. I believe I got their name from the insurance company.
The "thickener" was pudding! A home health care nurse put me on to it. I just kept pudding cups on hand. Only used a spoonful, so a cup lasted all day.
Hope this helps, Crystal
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Crystal
What type of pudding? It seems to me that it would be too thick to go down the tube, unless his tube is like the one I will get in a couple weeks. The one I have now is 21" long (for a reason unbeknownst to me that I plan on asking the Surgeon about).
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