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Feeding Tubes

11/25/2020

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Tube feeding can actually be comfortable, helpful and dignified, especially with help of Chloraseptic  (to prevent discomfort when pushing the tube down the throat) and small tubes (smaller than hospitals usually use, see below). It can be temporary or permanent.

The son of singer Neil Young (of Crosby, Stills, Nash and Young) lives on a feeding tube, with homemade organic food. He's happy.

In this video a young woman shows how she put a thin tube through her nose to her stomach every evening for years and took it out again in the morning, getting extra nutrition all night. She had intestinal problems, and needed more nutrition than she could swallow. She says it "helps you feel better." She could have left the tube in all day, but it was so easy to put in and out that she just left it in at night, with a bag of food formula slowly draining into her stomach while she slept.
youtube.com/watch?v=EbNOZt5VQdY
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In this video a young woman shows how she put a thin tube through her nose to her stomach every evening for years and took it out again in the morning, getting extra nutrition all night. She had intestinal problems, and needed more nutrition than she could swallow. She says it "helps you feel better." She could have left the tube in all day, but it was so easy to put in and out that she just left it in at night, with a bag of food formula slowly draining into her stomach while she slept.
youtube.com/watch?v=EbNOZt5VQdY

The main danger mentioned for nose tubes is putting them down into the lungs, rather than the stomach, which may cause coughing and produce acidic content, as the stomach does.

Nose tubes at home are very thin and flexible, a tenth of an inch in diameter (the size measurement is "8 French" and a French is a third of a millimeter). See below for suppliers. Thin tubes are right for feeding. Hospitals are used to much thicker, stiffer tubes, since they use them for sucking liquid from a stomach as well as feeding, and tubes must not collapse under suction. Hospitals' naso-gastric (NG) tubes are usually a quarter to a fifth of an inch diameter (14-18 French). You can ask your hospital to get the smaller tubes or you may need to get them yourself.  

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Hospitals insert thick tubes, often quickly, without anesthesia. The woman in the video above has this follow-up where she says she used Chloraseptic spray (an over-the-counter sore throat treatment, generic name is phenol) to numb her throat while she put a thin tube down, especially at first. If the hospital does not use it, you can ask a friend to get it at a drugstore. 
youtube.com/watch?v=56h3x6QTvlQ 

She also said that even in an emergency visit at the hospital, when they decided she needed extra nutrition, she insisted on putting the tube in herself, since hospital staff were too hurried and rough. She does say it feels very "odd" and can cause gagging the first few times, but not after a week.

Often patients are asked to swallow water while the tube goes down, to help it go down like a pill. If the patient is not allowed to swallow water, one video says to suck a dry straw. youtube.com/watch?v=S-GNi6YWID8

Tubes often have a stylet (guide wire, or plastic) to stiffen them during insertion. The stylet is pulled out before putting food in the tube. Nurses used to be advised to use stiff tubes and refrigerate them to make them even stiffer; but an alternative is a stylet to stiffen a flexible tube for insertion, while allowing the tube to be flexible in use.

You can find support groups and books. This site has an article on Catholic teaching about feeding tubes.

Getting Thin Nose Tubes

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You can find thin feeding tubes from Dealers (in alphabetical order) such as:
  • Edgepark,  
  • Health Products for You,
  • Medline,
  • Medsitis, 
  • NewLeaf, 
  • Southwest, 
  • Vitality.
Following are specialist sellers.:
  • ​Homelink (part of VGM) in Waterloo IA works with a national network of  home medical providers who may sell you what you need. They have a web inquiry form, or call 800-482-1993. (8-8 eastern, but try them 24/7)
  • Vygon (Advanced Medical Systems) makes tubes 4-16 French (a nineteenth to a fifth of an inch). 603-743-5988
  • Halyard (formerly Corpak and Kimberly-Clark) makes tubes 5-12 French (a fifteenth to a sixth inch)
  • Andersen makes tubes 10 or 16 French (an eighth or fifth of an inch) 800-523-1276.
Single nose tubes may be called levin, levine, dubhoff, dobhoff, dobbhoff, NG, ND, NJ, Corpak, etc. catheters or tubes. Those with pairs of tubes can be called Salem, Miller-Abbott or Cantor.
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Here is another young woman who had a tube surgically implanted through her skin and stomach, into her intestine (jejunum), a J-tube. She has had the tube 4 years, can eat some soft foods and liquids. She tried several suppliers of formula until she found one that her body accepted well. She gets some medicines in liquid form, dissolves some of her other pills, and grinds others. People must ALWAYS ASK the pharmacist before breaking, grinding or dissolving pills, since this usually gives a faster release, which can mean a sudden and fatal overdose.
youtube.com/watch?v=rKNCiSbUanw ​

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This is an earlier video by the same woman. Life was harder at that early stage, since she was grinding all her pills and had a nutritional formula which did not agree with her, so it had to go in slowly, and she was on it 24/7. It shows the difference good advice and adjustments can make. She says that when her tube was first put in, the doctors wanted to use local anesthesia. She insisted on general anesthesia and the doctors told her later she was right.
youtube.com/watch?v=92Co-O6Wnr0 

Feeding Tube Variations
If you have trouble eating, such as a broken jaw, muscle spasms, weakness, etc., you can get partial nutrition with an IV tube, or complete nutrition with nose or stomach tubes:
  • A nurse can place an intravenous (IV) tube to carry glucose, salts and medicine into a vein.
  • You can place a tube through your nose and swallow the end down your throat into your stomach (NG-naso-gastric), or a hospital can lead it all the way into your intestine (ND-naso-duodenal, or NJ-naso-jejunal). It can be flexible and thin: a tenth of an inch. You can also remove it any time.
  • An interventional radiologist or gastroenterologist can sew a larger tube through the skin into your stomach or intestine. It can appear as a small button on the skin or have several inches of tube sticking out. Radiologists operate directly on the stomach, as a PRG tube (Percutaneous Radiologic Gastrostomy). Gastroenterologists operate less conveniently down an endoscope in the esophagus, as a PEG tube (Percutaneous endoscopic gastrostomy). 
  • G-tubes go to the stomach (gastric). D and J-tubes go to the intestine (duodenum and jejunum).

TRAINING NURSES ON TUBE FEEDING

There are several instructional videos for nurses, often showing staff touching many surfaces (hair, nose, glasses, flashlight, stethoscope, cough, etc.) then handling the tube as it goes into the patient's nose and throat. The lack of cleanliness is another reason patients may want to insert their own tubes.
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Fine diameter tubes are for feeding. Larger diameters are for draining stomach contents. Video also shows a hospital pump to control flow of nutrition into the stomach.
https://www.youtube.com/watch?v=6f0VtagnbGs

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Slow insertion of tube. Trainer instructs nurse to document the length of tube left outside the patient.
https://www.youtube.com/watch?v=IIeq4I3pwHA

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Slow insertion of big tube by nurse trainee 
youtube.com/watch?v=lHp7osmgov8

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