Question about PEG tube

junklady
junklady Member Posts: 88 Member
edited March 2014 in Head and Neck Cancer #1
Hi-I need info on peg tube. Husband has end stage laryngeal cancer and down the road will probably need peg tube when he can't swallow anymore. I need to stay 3 steps ahead of everything. What kind of Dr. puts the tube in? Is it an out patient procedure? How do you take pain medication through the tube? Also how do you take all the other meds, such as the ones for high blood pressure and cholesterol, acid reflux, constipation? Are there liquid forms for all of these? Which is a better way to feed, gravity feed or syringe? Please give me all the info you have. I want to be prepared before the day comes. Everyone here on the site seems to have a lot of insight because they have experienced this. I would rather hear this from anyone here than our lame Dr. Thank you.
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Comments

  • rmkbrad
    rmkbrad Member Posts: 176
    #2
    Hello
    It is a GI doctor that puts it in, it is an outpatient procedure, they can prescribe liquid medication. And some of the meds can be crused or desolved and put through with a syringe. The oncology departments will help you with the meds as well as the other doctors you will be dealing with. Just remember when you get it to flush it at least three times a day. Hopes this helps.

    Brad
  • dogsrule
    dogsrule Member Posts: 96
    #3
    PEG tube
    I am sorry to hear that your husband is end stage. The doctor that put my tube in was a surgeon. My ENT. I went into the hospital and he did under anestesia. I stayed one night in the hospital only because it was late when he finished. The next morning I had some pain that would come and go,like someone was grabbing and holding the peg for just a few seconds. That disappeared after a few hours. I used the gravity feed method. It only took about 5 minutes to put a can of food in. It's good to get alot of water thru also. I would cruch up my medication and put it in a syringe filled with water and let it go in.If it got stuck I would pump the tube a little to let the air go in and out and it would dislodge it. You can get a pill crusher but some meds are hard to crush in them. I would cut some of the bigger pills in halve and then crush them up with spoons and put them in the peg. I hope this is helpful.
    God Bless
    Jo
  • ljoy
    ljoy Member Posts: 94
    #4
    Peg
    You do have to be put to sleep briefly to insert the tube. It is better if you can get it before treatment starts while you are still feeling good. Once treatment begins and your thoat get sore it is harder on the patient. As stated earlier, the cancer center should train you on the use of the tube.
  • Kimba1505
    Kimba1505 Member Posts: 557
    #5
    ljoy said:

    Peg
    You do have to be put to sleep briefly to insert the tube. It is better if you can get it before treatment starts while you are still feeling good. Once treatment begins and your thoat get sore it is harder on the patient. As stated earlier, the cancer center should train you on the use of the tube.

    Do it yourself?
    JunkLady, I am very sorry to hear that your husband is end stage. My thoughts are with you as his wife and caregiver. You will get good advice here...details that the doctors don't tell you.
    I am the caregiver also, and I have a PEG question...can the person with the PEG do all of this him/herself? Mark had a feeding tube through his nose following surgery and I did all the feedings...but he was also very limited after surgery.
  • Glenna M
    Glenna M Member Posts: 1,576
    #6
    Peg tube
    A gastroenterologist is usually the doctor who inserts the Peg tube, it is really a rather simple procedure that is done on an outpatient basis at the hospital. There was no pain involved and I was not given any pain medication as it is not usually necessary.


    Gravity feed or syringe feeding is mostly decided by your preferences. Do you want to keep pouring the liquids into the syringe or go for the convenience of the gravity feeding. Just hook the bag up and you are done until that bag empties. It's strictly a personal preference, may I suggest you try both to see which is easier and less messy for you to do.

    Please be careful if you are going to crush any pills up and dissolve them in water to feed through the tube as some pain meds are not meant to be crushed, time released pills will have a much stronger affect if they are crushed. I would ask the doctor for any of his medication that can be supplied in liquid form. If they are pill form only, ask the doctor if it is okay to crush them.

    Your doctor should provide you with the instructions on how to use and clean the peg tube. Make sure they explain the procedure for cleaning the wound around the peg also as this will become an important part of your daily procedures. If you still have any questions after talking to the doctors everyone here will be more than willing to help you.

    My best to you and your husband - Glenna
  • Fire34
    Fire34 Member Posts: 365
    #7
    Kimba1505 said:

    Do it yourself?
    JunkLady, I am very sorry to hear that your husband is end stage. My thoughts are with you as his wife and caregiver. You will get good advice here...details that the doctors don't tell you.
    I am the caregiver also, and I have a PEG question...can the person with the PEG do all of this him/herself? Mark had a feeding tube through his nose following surgery and I did all the feedings...but he was also very limited after surgery.

    Feedings
    Kimba
    Yes, I was able to do the feedings thru the PEG myself. I started out doing feedings with the bag and let gravit (sort of like an IV). That was just way too slow so after that I was able to just put the formula in the 30 cc syringe that comes with the tube. You can still control the speed with the clamp on the tube. They were wanting me to do 3 cans/feeding and this was just that much faster. I was inpatient during my concurretn chemo/rad but the week I was home I was still able to do things myself. My better half just like you would always I mean always ge checking on me LOL

    Junklady
    Just make sure your husband is put out completely, I mean completely as I wasn't. Mine was put in outpatient they put a small slit in your abdomen and insert a guide wire to help pull the tube in. Best Wishes & Prayers
    Dave
  • rozaroo
    rozaroo Member Posts: 665
    #8
    Glenna M said:

    Peg tube
    A gastroenterologist is usually the doctor who inserts the Peg tube, it is really a rather simple procedure that is done on an outpatient basis at the hospital. There was no pain involved and I was not given any pain medication as it is not usually necessary.


    Gravity feed or syringe feeding is mostly decided by your preferences. Do you want to keep pouring the liquids into the syringe or go for the convenience of the gravity feeding. Just hook the bag up and you are done until that bag empties. It's strictly a personal preference, may I suggest you try both to see which is easier and less messy for you to do.

    Please be careful if you are going to crush any pills up and dissolve them in water to feed through the tube as some pain meds are not meant to be crushed, time released pills will have a much stronger affect if they are crushed. I would ask the doctor for any of his medication that can be supplied in liquid form. If they are pill form only, ask the doctor if it is okay to crush them.

    Your doctor should provide you with the instructions on how to use and clean the peg tube. Make sure they explain the procedure for cleaning the wound around the peg also as this will become an important part of your daily procedures. If you still have any questions after talking to the doctors everyone here will be more than willing to help you.

    My best to you and your husband - Glenna

    Peg Tube
    I was admitted to the hospital as an outpatient where they put me under anesthetic to install
    the peg! I found it very uncomfortable but I had never had an operation before so I am not an expert. They gave me a presciption for pain meds that helped. Hubby paid attention to all of the detail's. I did not need to use my tube untill way into the latter part of radiation treatment's.I tried to eat as much as I could, which really helped through treatment. Then the switch came on. No longer could swallow & food taste was off. I learned how to feed myself & we used a pump in which the food is run by electricity & a back up battery.
    That way I can set the speed on the pump according to what my stomach can handle. It is very easy to manage as it is repetitive. Not difficult at all to handle! I jst had to get over the queasy stuff of cleaning my stomah sp.I had to toughen up in a hurry lol!
  • D Lewis
    D Lewis Member Posts: 1,581 Member
    #9
    rozaroo said:

    Peg Tube
    I was admitted to the hospital as an outpatient where they put me under anesthetic to install
    the peg! I found it very uncomfortable but I had never had an operation before so I am not an expert. They gave me a presciption for pain meds that helped. Hubby paid attention to all of the detail's. I did not need to use my tube untill way into the latter part of radiation treatment's.I tried to eat as much as I could, which really helped through treatment. Then the switch came on. No longer could swallow & food taste was off. I learned how to feed myself & we used a pump in which the food is run by electricity & a back up battery.
    That way I can set the speed on the pump according to what my stomach can handle. It is very easy to manage as it is repetitive. Not difficult at all to handle! I jst had to get over the queasy stuff of cleaning my stomah sp.I had to toughen up in a hurry lol!

    PEG tube and feeding pump
    I also used the pump to feed. I recommend it very highly. During chemo, when I wasn't feeling too well, it seemed to be easier on my stomach to feed slowly. Also, I found the hand-held syringes to be large and unwieldy, and difficult to depress the plunger. They would stick.

    I would pump two cans during the day, one morning and one afternoon, over a period of about 3/4 of an hour each. I would fill the pump bag with three cans of Jevity at bedtime, set the pump on a slower speed, and pump the three cans while I slept. You can time the completion of pumping to coincide with your usual wake-up time.

    Now I am beyond the chemo nausea, I'm not doing the slow pumping overnight any more. I was also able to transition back to the syringes during a recent camping trip, but I still find the pump to be easier on my hands.

    I got my PEG halfway through my chemo/rads. I was referred to a gastroenterologist, who immediately scheduled me for the outpatient procedure. No anesthesia was required, they just gave me enough meds to relax me and put me in snooze mode. I was out in no time, and able to begin using the PEG almost immediately. No pain. No discomfort. It's been a real life-saver for me.

    Ask the gastroentero doc to prescribe the pump for you. Mine was completely covered by insurance. If you are prescribed the pump, the pump supplier will provide and deliver the food and feeding bags. Absent the pump, you will have to order your own food and it may or may not be covered by insurance that way. At least, that is how Shield Health Care does it in northern California.

    Best of luck. Send me a private message if you have more questions.

    Deb L.
  • Kent Cass
    Kent Cass Member Posts: 1,898 Member
    #10
    D Lewis said:

    PEG tube and feeding pump
    I also used the pump to feed. I recommend it very highly. During chemo, when I wasn't feeling too well, it seemed to be easier on my stomach to feed slowly. Also, I found the hand-held syringes to be large and unwieldy, and difficult to depress the plunger. They would stick.

    I would pump two cans during the day, one morning and one afternoon, over a period of about 3/4 of an hour each. I would fill the pump bag with three cans of Jevity at bedtime, set the pump on a slower speed, and pump the three cans while I slept. You can time the completion of pumping to coincide with your usual wake-up time.

    Now I am beyond the chemo nausea, I'm not doing the slow pumping overnight any more. I was also able to transition back to the syringes during a recent camping trip, but I still find the pump to be easier on my hands.

    I got my PEG halfway through my chemo/rads. I was referred to a gastroenterologist, who immediately scheduled me for the outpatient procedure. No anesthesia was required, they just gave me enough meds to relax me and put me in snooze mode. I was out in no time, and able to begin using the PEG almost immediately. No pain. No discomfort. It's been a real life-saver for me.

    Ask the gastroentero doc to prescribe the pump for you. Mine was completely covered by insurance. If you are prescribed the pump, the pump supplier will provide and deliver the food and feeding bags. Absent the pump, you will have to order your own food and it may or may not be covered by insurance that way. At least, that is how Shield Health Care does it in northern California.

    Best of luck. Send me a private message if you have more questions.

    Deb L.

    PEG
    Had the old-fashioned kind in early 09- used the big syringe to pour the Formula into, rather than a pump and bags. And, United Healthcare did not cover my cans of Formula- NW Illinois/Iowa. And, yes, an outpatient procedure done by a Surgeon, in my case, who also installed my Power Port. BE ADVISED- there are several types of PEGS- the balloon type might be the coolest, according to the Surgeon- but that isn't what I had for 15-months.

    As for the pain meds- I never did put into my PEG. Able to sip water, and jerk my head back- I opted to chop my pills up and take 'em the regular way. YOU MUST REMEMBER TO KEEP THE SWALLOWING THING GOING- TO KEEP ALL THE ESOPHAGUS PARTS FUNCTIONING. Larynx is of the windpipe- not the esophagus, but they do get close to each other. And, yes- very sorry to hear "end stage." Very sorry.


    kcass
  • Lena Rose
    Lena Rose Member Posts: 73
    #11
    Kent Cass said:

    PEG
    Had the old-fashioned kind in early 09- used the big syringe to pour the Formula into, rather than a pump and bags. And, United Healthcare did not cover my cans of Formula- NW Illinois/Iowa. And, yes, an outpatient procedure done by a Surgeon, in my case, who also installed my Power Port. BE ADVISED- there are several types of PEGS- the balloon type might be the coolest, according to the Surgeon- but that isn't what I had for 15-months.

    As for the pain meds- I never did put into my PEG. Able to sip water, and jerk my head back- I opted to chop my pills up and take 'em the regular way. YOU MUST REMEMBER TO KEEP THE SWALLOWING THING GOING- TO KEEP ALL THE ESOPHAGUS PARTS FUNCTIONING. Larynx is of the windpipe- not the esophagus, but they do get close to each other. And, yes- very sorry to hear "end stage." Very sorry.


    kcass

    Different PEGS
    Kent-thanks for noting that there are several types of PEGS. We had no idea until after my husband had one put in. We were surprised that the tube is about 2 feet long.
  • junklady
    junklady Member Posts: 88 Member
    #12
    D Lewis said:

    PEG tube and feeding pump
    I also used the pump to feed. I recommend it very highly. During chemo, when I wasn't feeling too well, it seemed to be easier on my stomach to feed slowly. Also, I found the hand-held syringes to be large and unwieldy, and difficult to depress the plunger. They would stick.

    I would pump two cans during the day, one morning and one afternoon, over a period of about 3/4 of an hour each. I would fill the pump bag with three cans of Jevity at bedtime, set the pump on a slower speed, and pump the three cans while I slept. You can time the completion of pumping to coincide with your usual wake-up time.

    Now I am beyond the chemo nausea, I'm not doing the slow pumping overnight any more. I was also able to transition back to the syringes during a recent camping trip, but I still find the pump to be easier on my hands.

    I got my PEG halfway through my chemo/rads. I was referred to a gastroenterologist, who immediately scheduled me for the outpatient procedure. No anesthesia was required, they just gave me enough meds to relax me and put me in snooze mode. I was out in no time, and able to begin using the PEG almost immediately. No pain. No discomfort. It's been a real life-saver for me.

    Ask the gastroentero doc to prescribe the pump for you. Mine was completely covered by insurance. If you are prescribed the pump, the pump supplier will provide and deliver the food and feeding bags. Absent the pump, you will have to order your own food and it may or may not be covered by insurance that way. At least, that is how Shield Health Care does it in northern California.

    Best of luck. Send me a private message if you have more questions.

    Deb L.

    Thanks for all the info on PEG
    Thanks to all of you for the quick responses and great info on the PEG. I'm going to print this and keep it for reference. I will probably be asking a lot more questions down the road. Everyone here has been wonderful. It's nice to know people who have gone through this. I feel like we are friends, although we may never meet in person, we are drawn here because of the awful disease of cancer. Heartfelt thanks again.
  • Unknown
    Unknown
    #13
    junklady said:

    Thanks for all the info on PEG
    Thanks to all of you for the quick responses and great info on the PEG. I'm going to print this and keep it for reference. I will probably be asking a lot more questions down the road. Everyone here has been wonderful. It's nice to know people who have gone through this. I feel like we are friends, although we may never meet in person, we are drawn here because of the awful disease of cancer. Heartfelt thanks again.

    This comment has been removed by the Moderator
  • lady4darknight
    lady4darknight Member Posts: 90 Member
    #14
    junklady said:

    Thanks for all the info on PEG
    Thanks to all of you for the quick responses and great info on the PEG. I'm going to print this and keep it for reference. I will probably be asking a lot more questions down the road. Everyone here has been wonderful. It's nice to know people who have gone through this. I feel like we are friends, although we may never meet in person, we are drawn here because of the awful disease of cancer. Heartfelt thanks again.

    PEG questions
    Hi I havent been on for a bit because of my treatment but came on looking for PEG answers. I got mine 3 weeks ago and no longer need it to feed as I can eat and swallow slowly. But what I can't find out is can I just flush it periodiotly if I am not using it and what do you use to hold the tube to your stomach? The hospital gave me a pair of those net panties with the crotch cut out and it is very uncomfortable and hot. I hope to have it removed when I go back on the 2nd of Aug but need answers.
    Thank you Debbie
  • D Lewis
    D Lewis Member Posts: 1,581 Member
    #15
    lady4darknight said:

    PEG questions
    Hi I havent been on for a bit because of my treatment but came on looking for PEG answers. I got mine 3 weeks ago and no longer need it to feed as I can eat and swallow slowly. But what I can't find out is can I just flush it periodiotly if I am not using it and what do you use to hold the tube to your stomach? The hospital gave me a pair of those net panties with the crotch cut out and it is very uncomfortable and hot. I hope to have it removed when I go back on the 2nd of Aug but need answers.
    Thank you Debbie

    Hi, Debbie
    After I quit using my PEG, the doctor recommended I flush it with water once a day. I would flush it two or three times per day. You can coil the tube in a loop and tape it to itself with Nexcare clear plastic flexible tape. You can coil it and tape it to your stomach, but it will leave a sticky tape residue that you will need to scrub off with alcohol. I swung mine up and tucked it under the bottom of my bra.

    My gastro doctor told me she wanted to see me maintain my weight for a month without using the tube, before she would agree to remove it. Because I wasn't using it any more, I had her trim it off and then re-cap it, to a length that worked best for tucking it up under my bra.

    Deb
  • CajunEagle
    CajunEagle Member Posts: 408
    #16
    D Lewis said:

    Hi, Debbie
    After I quit using my PEG, the doctor recommended I flush it with water once a day. I would flush it two or three times per day. You can coil the tube in a loop and tape it to itself with Nexcare clear plastic flexible tape. You can coil it and tape it to your stomach, but it will leave a sticky tape residue that you will need to scrub off with alcohol. I swung mine up and tucked it under the bottom of my bra.

    My gastro doctor told me she wanted to see me maintain my weight for a month without using the tube, before she would agree to remove it. Because I wasn't using it any more, I had her trim it off and then re-cap it, to a length that worked best for tucking it up under my bra.

    Deb

    Debbie
    I flushed mine at least twice a day with water when I was not using it for nourishment. Also, my Dr. said I must maintain or gain weight for one month before it could be removed. I used Nexcare Paper Tape and coiled it on my right rib cage. Paper Tape was utilized due to other types of tape would leave an itchy rash. The Paper tape also did not leave as much glue residue on the skin, and was much easier to remove than other types.

    Larry
  • Kent Cass
    Kent Cass Member Posts: 1,898 Member
    #17
    lady4darknight said:

    PEG questions
    Hi I havent been on for a bit because of my treatment but came on looking for PEG answers. I got mine 3 weeks ago and no longer need it to feed as I can eat and swallow slowly. But what I can't find out is can I just flush it periodiotly if I am not using it and what do you use to hold the tube to your stomach? The hospital gave me a pair of those net panties with the crotch cut out and it is very uncomfortable and hot. I hope to have it removed when I go back on the 2nd of Aug but need answers.
    Thank you Debbie

    Paper tape Debbie
    Is used to hold the gauze, as well as the tube itself, Debbie: I was using 3x3 gauze I custom-cut, and 4x4 paper tape from Walgreen's. For the gauze: cut a line from one side to the center, then make a small square cut at the end of that line, slide it under the PEG flap that's up against your stomach's outside, so that the square is around the tube between the flap and skin, then tape the 4 outer sides of the gauze. I used to change my gauze every two days, and would wash the area near where the tube goes inside with Peroxide.

    kcass
  • Unknown
    Unknown
    #18
    Kent Cass said:

    Paper tape Debbie
    Is used to hold the gauze, as well as the tube itself, Debbie: I was using 3x3 gauze I custom-cut, and 4x4 paper tape from Walgreen's. For the gauze: cut a line from one side to the center, then make a small square cut at the end of that line, slide it under the PEG flap that's up against your stomach's outside, so that the square is around the tube between the flap and skin, then tape the 4 outer sides of the gauze. I used to change my gauze every two days, and would wash the area near where the tube goes inside with Peroxide.

    kcass

    This comment has been removed by the Moderator
  • barb962
    barb962 Member Posts: 2
    #19
    Kent Cass said:

    Paper tape Debbie
    Is used to hold the gauze, as well as the tube itself, Debbie: I was using 3x3 gauze I custom-cut, and 4x4 paper tape from Walgreen's. For the gauze: cut a line from one side to the center, then make a small square cut at the end of that line, slide it under the PEG flap that's up against your stomach's outside, so that the square is around the tube between the flap and skin, then tape the 4 outer sides of the gauze. I used to change my gauze every two days, and would wash the area near where the tube goes inside with Peroxide.

    kcass

    Peg Tube
    My husband had his feeding tube inserted the first of May and has been on it 100% for about 5 weeks now. He seems to have a hard time getting the food to go in. It was plugged completely one day so the home health care people told us to use the Coke and let it sit for a half an hour. I then pushed water through it and it finally cleared up. He puts his watered down Gevity in and uses the gravity feed. Sometimes it goes in quick and sometimes it is slow so we started pushing water through it when it slows down and that seems to clear it out.

    If you use the eledctric pump does it force the food in? If so, that may be the way to go. He was diagnosed with Stage 4 squamous cell (oral cancer) on April 16 and had his first chemo on May 8. He has already lost 35 pounds including ten pounds in the last two weeks. We changed from Gevity today to see if a different brand might settle his stomach and intestinal track down but we are starting to get very worried. He is 6' and down at 153 pounds with five more weeks of daily radiation and probably two more rounds of 6 in-hospitaldays with 24-hour day chemo for the full six days. He can't swallow very well and so everything is pretty much through the peg.

    Anyone have any ideas how we can get the food to go into the peg any easier?
  • D Lewis
    D Lewis Member Posts: 1,581 Member
    #20
    barb962 said:

    Peg Tube
    My husband had his feeding tube inserted the first of May and has been on it 100% for about 5 weeks now. He seems to have a hard time getting the food to go in. It was plugged completely one day so the home health care people told us to use the Coke and let it sit for a half an hour. I then pushed water through it and it finally cleared up. He puts his watered down Gevity in and uses the gravity feed. Sometimes it goes in quick and sometimes it is slow so we started pushing water through it when it slows down and that seems to clear it out.

    If you use the eledctric pump does it force the food in? If so, that may be the way to go. He was diagnosed with Stage 4 squamous cell (oral cancer) on April 16 and had his first chemo on May 8. He has already lost 35 pounds including ten pounds in the last two weeks. We changed from Gevity today to see if a different brand might settle his stomach and intestinal track down but we are starting to get very worried. He is 6' and down at 153 pounds with five more weeks of daily radiation and probably two more rounds of 6 in-hospitaldays with 24-hour day chemo for the full six days. He can't swallow very well and so everything is pretty much through the peg.

    Anyone have any ideas how we can get the food to go into the peg any easier?

    The pump
    Hi, Barb

    I found the feeding pump to be extremely useful. It pushes the food in slowly, and your hands are free to read, type, or do whatever. During chemo, I never vomited, but got nauseated very easily. I would use the pump to infuse the jevity, one can over a 1-hour period, or over a 1/2-hour period. Didn't get any stomach upset when I took it in slowly. I would also infuse three or four cans very slowly overnight. You can fill the feeding bag and set the pumping rate such that it takes 8 hours to empty. Then, the pump alarm goes off at about the same time as your morning alarm. You don't wake up hungry. And its a good way to get extra feedings in, when the day just doesn't seem long enough.

    Deb
  • CajunEagle
    CajunEagle Member Posts: 408
    #21
    D Lewis said:

    The pump
    Hi, Barb

    I found the feeding pump to be extremely useful. It pushes the food in slowly, and your hands are free to read, type, or do whatever. During chemo, I never vomited, but got nauseated very easily. I would use the pump to infuse the jevity, one can over a 1-hour period, or over a 1/2-hour period. Didn't get any stomach upset when I took it in slowly. I would also infuse three or four cans very slowly overnight. You can fill the feeding bag and set the pumping rate such that it takes 8 hours to empty. Then, the pump alarm goes off at about the same time as your morning alarm. You don't wake up hungry. And its a good way to get extra feedings in, when the day just doesn't seem long enough.

    Deb

    Pump
    I evidently didn't tape the pump "point" into the peg tube very well one night, and it came loose. Wow....what a mess.

    Now that was a profound post for # 100.

    Larry

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