Ryan receives all his hydration and nutrition through a gastric feeding tube, commonly called a g-tube. It is merely a tube inserted through a small abdomen incision into the stomach. Once the tube is in the stomach, a bubble is inflated with saline or distilled water to prevent it from pulling out.
As a general rule, these rarely have issues. The two primary malfunctions are from clogging or bubble deflation. Most clogs are resolved with something that looks a lot like a plastic pipe cleaner and some seltzer. The bubble, on the other hand, creates a fairly urgent need to remedy.
If the bubble deflates the tube will simply fall out, as happened to Ryan this morning. The incision will clot and close within a short time, just like any wound. In Ryan’s case, the bubble actually ruptured.
Back in September of last year, I asked Dr. Rodriguez to teach me how to handle a situation just as this. He taught me well and this training kicked-in and I handled it on auto-pilot.
As I was preparing to give him his 8:00 AM juice, water, medications, and supplements his tube dislodged and fell to the bed.
Fortunately, we prepared a kit in advance with everything needed to resolve it. I quickly (but thoroughly) cleaned the incision site with sterile water. Then, I placed sterile gauze (rolled-up like a Play-Doh snake) into the incision. This, essentially, buys me as much time as I need since the portal will maintain its integrity.
Maintaining a sterile environment, I opened a new g-tube. I tested the bubble for leaks by simply injecting 12cc – 15cc of sterile water and inspecting it. Once satisfied it was good, I withdrew the water back into the syringe. I lubricated the tip of the g-tube with sterile lubricating jelly. In one continuous motion, I removed the gauze and slipped the tube in past the deflated bubble. Ta-da! I returned the sterile water back to the bubble, slide the flange down to his stomach, and put triple antibiotic and dressing around the site. Again, ta-da!
The final step is to pull back his stomach content while listening with a stethoscope to ensure it is properly placed. It is.
So, why did I share all this with you? Two reasons. One, it helps paint another portion the mosaic of Ryan’s care. Two, I am bragging. Really, how many people do you know that can perform a g-tube procedure? I’ll be signing autographs later…
As a disclaimer, this is not to be taken as medical advice.