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.
Cross Section of G-Tube Placement (ourlifeandsuch.blogspot.com)
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.
feet and g-tubes – WOW
Ken,
You truly are amazing!
Jane
Awesome job Ken!!!!! When Ryan recovers you need to go to medical school and somehow make the May and Vantrease families pay for the tuition!!! Still here and praying in Morgantown
Amazing!!! You know its really good that you know this stuff so when something like this happens you can fix it and not have to wait. Great Job!
Truly remarkable, that exercise takes quite a bit of skill, technique to execute, and of course not panic remaining calm and clear thinking as well!!! I send my kudos to you Ken for your preparing ahead for such an event and handling Ryan’s care probably better than a nurse of doc in the local ER room. I know that keeping the incision open is crucial. Your Son is so lucky for you are your family’s amazing care and dedication to Ryan!! God Bless You All, you continue to show depths of love that we all need to exemplify more in our lives. It’s too “easy” to get caught up in the negative of which I am quite guilty; your ability to act and execute under pressure is awesome Ken! Miracles DO happen, I know this to be true from personal experience. Your continuing passion and love for Ryan and your family is an inspiration despite all the horror you have had to endure. Peace and Love!
Fabulous! It took us forever to have the doctor take Jonathan’s g-tube out as if it were some big deal. By the time we left the hospital, we were doing all of Jonathan’s care and I know many other’s do too. I found out 30 minutes before we brought Jonathan home from the hospital that I would be giving IV antibiotics to him three times a day for a month!
Anyway, I love your details… they are very educational to me and actually I appreciate learning about them. When someone is critical and totally dependent, you want to know all you can! Also, I NEVER have time to do my feet but last night I soaked them in vinegar and water…. It worked! You da man! Thanks!
You have been promoted from Nurse Ken to Dr. Ken, or Dr. Dad, and we know you are up to the responsibility it carries! Well, what can I say — never knew we could learn so much from a blog! All goodness comes from God. You are a good man, and you are doing God’s work. All healing comes from God, too. As Psalm 37:5 tells us to do, we have committed ourselves to the Lord, and He is acting. Thank you, good Lord. What a good dad you have given Ryan and Kari, and a good husband for Sue. And you are the best kind of friend to us! Always here.
I know, I know — and the best son and son-in-law: brother and friend — you are indeed! God is blessing us.
We always carry a spare tube with Thomas- every minute of the day. I must admit that Thomas is 14 and has had one all of his life and I have never seen the graphic that you posted. The first time that I had to replace the g-tube, I was more afraid than when I changed his trach every week. The balloon will break, deflate, get tangeled in something and pull out totally inflated….One time it got pulled out as we were loading him into his van in his wheelchair- that was fun trying to fix it while on the ramp in the air while he was sitting up…..I am just thankful that we manage to catch it every time (knock on wood) and the hole has never closed up.
Dear Ken. Simply,simply amazing what you can do for that boy,Ryan!!!!! Again I’ll say Ryan is so lucky to have you and Sue for parents.Praying he has a good day and peace for you all…When Ryan hears all that you have done ,he will call you Dr.Dad~ Keep up the terrific work and God bless you and the family. Gail
Wow Ken way to go!!!! You didn’t panic either it sounds like. You just got in there and did what needed to be done just like you always do. I am so glad you thought to ask Dr. Rodriguez to show you what to do in case this happened. I know you are always thinking one step ahead. Way to go Dr. Diviney!!!!! I hope Ryan is comfortable and that you all are having a peaceful day. SHSP…..
You are on your way to the Nursing Supervisor job at the local ICU, way to go Ken. You have had a strutting kinda week there in Ashburn, keep it up buddy. Not sure Sue will be able to handle much more of you this week, good thing its Saturday and tomorrow starts a new week!