Note the 'For now' part of the original statement.
This is the broken end of my tube (the pink bit should be in my tube, not stuck like it’s been superglued to the giving set). And the other photo shows the tube I’ve just taken out - you can probably see that the end’s a nice shade of orange - smells like sick, which is always nice!
SO THIS IS ATTRACTIVE.
Someone on twitter asked for a removal video of the ng tube, and as the end broke off and got stuck in the giving set this morning (and I therefore have to replace the whole fucking thing) I decided to film it, eeeeven though I look rough as a dog (because I’ve only slept about 3 hours and have been worrying a little about loros).
Anywho, this is it…
Step 3: Tube Removal
Pretty much does what it says on the tin. First you’ve gotta remove the secure tape, obvious one (I use micropore tape and sometimes a sensitive plaster by my ear, both of which I change every couple of days - I’m allergic to most other plasters and tapes, particularly when used on my face). The tape did get a bit stuck on my hair as I pulled it off… I’m sleepy ok?! ;)
Then it’s just a case of slowly pulling it out. You may see snot/phlegm/stomach juices (don’t worry you won’t notice unless you look for it) and the end of the tube is discoloured because of stomach acid but it’s generally no big deal. The end of the tube is slightly bigger and stiffer than the rest so it makes some people gag a bit when it hits their gag reflex at the back of the throat - I don’t normally react but as I have a throat infection as well at the moment, my throat is the size of a pea and that tube was fighting to stay there! Haha.
The tube will now go straight in the bin as it’s broken and I have spares, but they can be reused for up to 2 months (no, not kidding!) - if you reuse the tube you just wash it with hot soapy water and use a syringe, making sure to squirt through and keep it clean on the inside as well as the out. You’d then flush it with plain sterile water and finally air, before kitchen roll drying the outer, replacing the guide wire and storing it in the original packaging or a clean tupperware tub in a safe place!
Hope this is helpful, sorry it’s a bit gross, can’t be glamorous 24/7…
This is the pH reference by the way - my stomach was at 3.0!
IT’SA ME, again.
Part 2: Checking The Position
Firstly I take a clean enteral 50ml syringe (oral syringe basically) and pump a small amount of air into the ng tube. As you may be able to hear, it sounds like a stomach rumble - it is! I pump air in to a) check there are no blockages and b) push the end of the tube from the stomach lining (sometimes it sticks). I then pull back on the syringe to suck out my glorious STOMACH JUICES. I test the juices on pH paper - if the paper is pink in colour at the top, it’s within the range. To prove that the tube is in the stomach and not the lungs, the pH should be 5 or below, that pH was 3.0, as you can see in the following photo post! The lungs are far more neutral than the stomach and have a higher pH, although you can have dodgy readings if you’re prone to acid reflux (acid from the stomach entering the lungs through regular vomiting or coughing etc). The floating bits of food tend to be the dead giveaway… If the tube is in the wrong place it should be removed immediately as feed in the lungs can KILL YOU!
After this I flush the line with sterile water. This gives the line a strange feeling in your throat - you can feel the cold sensation of the water without the wetness? Strange way to describe it, but anyone that’s had it will know what I mean! And that’s it, ready for bolusing (pushing things down with a syringe, like drinkable supplements or even some oral medication) and for setting up feed bags (concentrated liquid calories/protein/etc, in bags, dripping through a long line and a pump device)!
Hope this was insightful? Will endeavour to make a proper video some time, with feed pump and bolusing and some sort of voice over or commentary, when I get my voice back!
As it’s CF awareness month and I needed to put a feeding tube in, I thought I’d show you how I do it myself :)
Some CF patients need feeding tubes to help them gain weight - as we have problems with malabsorption, most CFers are on a high cal, high energy, high protein diet, and are told to consume between 3000 and 4000 cals A DAY! For those of us that struggle with regular food, shake and juice supplements we have NG feeding (nasogastric).
People with other conditions commonly use these too, including people with various stomach problems, those that have undergone major surgery and those recovering from eating disorders - I hope this shows them and everyone else how easy they are to put in yourself when you master the technique!
Part 1: Insertion (ps sorry for the noise my broken boiler’s making!)
Firstly you can see me wetting the end of the tube to lubricate it - this helps to get the end past the two main difficult points: the back of the nose and the top of the throat. Both of these areas are highly sensitive and it’s important that the placement of the tube goes right in the right direction in these areas. When the tube hits the back of the nose you want to make sure that your head and chest are upright and that the tube is at a 90 degree angle to your face, so the tube goes down and not up (into your brainzzz). When the tube hits the back of the throat you need to push it past the epiglottis (the flap in your throat that covers your lungs when you eat and let’s air in/out) and the easiest way to do that is to DRINK. The liquid closes the flap and the swallowing action helps the tube to pass down more quickly. You may have to pull the tube in and out a bit before you slide past the epiglottis as I did, but you get past it soon enough.
Once you’ve hit the hard parts it’s important to keep pushing the tube in. Before it’s inserted a stomach measurement is made - there is a certain point at which it should sit, slightly curled, in your stomach and you can measure this outside the body, using your stomach/ribcage and the numbers on the tube as indicators. I mark my number with tape so I know when to stop. I then remove the tape, pull out the lubricated guide wire (that helps the tube stay stiff as you push it down), tape the tube to my face so it doesn’t slip and KAPOW! Step 1 - done!
It’s really weird reading the ng tube tag stuff. People are seriously scarred by this little yellow fella that goes down their nose and here’s me putting them in at home through choice. I know it’s a different scenario and I’m not recovering from an ED, but it is a disorder to do with eating, of sorts, if you think about it.
Having CF means that you don’t absorb half the nutrients in food that you need to remain at a healthy weight, unless you’re very lucky or take supplements to boost your calorie intake. We’re expected to eat around 3000-4000 cals a day, which is really hard when you quite like vegetables and salads and not feeling sluggish after consuming lots of carbs.
I love fatty foods and sweet foods and all the foods everyone else is told they should eat less of and we should eat more of, but it’s actually a chore when someone tells you you have to eat more more more of everything. And when you get ill you get sicky and not hungry. And then they give you drugs to make you better and you feel nauseous on them too so food doesn’t seem too appealing. And sometimes the meds they put you on fuck with your tastebuds so you don’t want to eat anything that tastes funny. It’s a vicious circle of illness - lose weight - meds - feel sick - more meds - feel better - forced to eat more to gain weight - eat too much - sicky AND IT CONTINUES.
I love food. I love everything about food. Certain foods make me feel a certain way that I can’t describe through any other means (red velvet cupcakes in particular) BUT I hate being forced to do things that other people don’t have to do. It’s always been like this since I was a kid, which is probably why I spent so many years not taking any medication at all. Yep, that’s right, that’s why I’m in this mess now, because I thought I was invincible.
The fact is that no one is invincible and we have to do these things for the good of our health. I hope that these girls (I say girls because the only people on that tag are girls, I think) and other sufferers begin to see their tube as their little bit of salvation. And I hope they find that putting it down isn’t all that bad when they accept why it’s there and why they need it. I hated it to start with, but it helps. It helps take the pressure off of me to eat double the average calorie intake and I can eat normally like everyone else. This feeding tube is a step in the right direction - it’s a positive thing that should be thought of as some kind of friend.
I think both the nurses and I can now argue that, in terms of minor procedures, passing an NG tube when the patient has laryngitis is the most traumatic experience for both parties. We both cried, I had a nose bleed, nearly vomited everywhere and we both want guide wires to burn in hell.
Oxygen on, feed going through - I’ll be fat before you know it!