"Timing is Everything"

  1. A Question:

    How soon before a g-tube must be reinserted? Or if it comes out on vacation (balloon breaks) what do you do?
    My personal story to follow..............
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  2. 7 Comments

  3. by   CoffeeRTC
    I'd love to hear your story...
    I would reinsert it ASAP...not sure how quickly it would start to close up.. I quess it would depend on the size of the stoma... How many times have you come across a resident who's tube was pulled out and you didn't know how long. At the most maybe a few hrs?/

    Okay...give details!
  4. by   7nurse
    Quote from michelle126
    I'd love to hear your story...
    I would reinsert it ASAP...not sure how quickly it would start to close up.. I quess it would depend on the size of the stoma... How many times have you come across a resident who's tube was pulled out and you didn't know how long. At the most maybe a few hrs?/

    Okay...give details!

    Last Sunday afternoon my mother who is 88 and lives alone,alert oriented,feeds self by g-tube,npo,post throat
    cancer,radiation,

    She called me and said her tube came out. (has had tube for about 5 years)

    I found she had taken all meds for the day. Had one bolus of 12oz. left to feed for the day.

    I--We decided to call the dr. in Am and have it put back in.

    To make what could have been a short story long.....
    she is still in hospital.had flash pulmonary edema from the g-enterolgist trying to get the scope down her esophages which was to narrow due to the cancer radiation

    took a couple of days to get edema stable(almost went on a vent)

    about day 3 the tube is inserted surgaclly with a small incision (no scope.. local anathesia)

    Ad iv's,x-rays,foleys,blood tests.,,,and the effect of everything on her health and you got me ...one disgusted
    nurse? who would resign today and work anywhere else if the money wasn;t a factor

    The moral of this sad story is... the stoma closes within 6 hours.....I should have,I could have, I would have..

    dc sometime tommorow....8 days of hell and rehab at home for who knows, to get her back to that Sunday afternoon when my asumption that we had until "tommorow" to get the tube back in....
  5. by   Rustyhammer
    I, too, am surprised that the stoma would close so quickly.
    A 5 year old stoma should have been able to last til morning but I have been wrong about things before. Why all the proceedures and trauma for what should be a relative easy thing. What type of g-tube does she have?
    I wish her a speedy recovery.
    -R
  6. by   chris_at_lucas_RN
    Fascinating that she could have the gastrostomy with a tube, no less, for FIVE YEARS and the thing would close in 6 hours?

    Sorry to hear that things went the way they did--hope Mom is home and feeling better!

    And don't beat yourself up! You did the best with what you had--
  7. by   7nurse
    Quote from chris_at_lucas
    Fascinating that she could have the gastrostomy with a tube, no less, for FIVE YEARS and the thing would close in 6 hours?

    Sorry to hear that things went the way they did--hope Mom is home and feeling better!

    And don't beat yourself up! You did the best with what you had--
    Thanks to everyone for the reply's

    I've stopped beating on myself for now and am questioning the Wisdom of The MD.

    Please see my post on gastroenterology forum.(would paste it here but my web tv doesn't do that function)
  8. by   CoffeeRTC
    I did see your thread on the Gastro board... good question... why did they scope her if they knew she had throat Ca? What about a foley type of G tube? Those are easy to replace and you can always have them on hand. I'm taking care of a lady whose tube had been out for almost a year and it still hasn't closed up and drains a ton of stuff.
    Sorry you and mom had to go thru so much.
  9. by   Rnltc
    Sorry to hear of your painful emtional trauma. From what I have picked up over the last couple of years it is not the stoma its self that is the issue it is the the line of the stoma and the stomach lining. The lining of the stomach does close up realitive fast.
    My Uncle had throat CA many years ago and was one of the first radical re-struction of the throat and jaw that Mayo did. After several months he was lucky and was able to return to PO and was to be pureed, but after getting sick of that stuff after a few years he tried normal food and for the most part he could swallow small amounts and most food. He did have to have his throat dilated several times over the years due to the scare tissue from the raidation. I would have thought the MD would have know this if your mom had been NPO for 5 years. The scare tissue from the raidation will close. The dilation should have been done first when he could not get the tube to slide down.
    They do the dilation by starting with the smallest and stretching to the largest they can get which is done all at once.
    I am so sorry your mother had to go through this. I would really question the physicians practice.

    My Uncle had the dilation done 4 times over a period of about 15 years and three of them was done at Mayo. The last one he had done was at our local hospital and was not as sucessful.

    RNLTC

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