Introduction to nasogastric tube feeding at home

Into our sitting room walks the friendliest chatty lady.  Armed with a Hessian Tesco shopping bag, not filled with shopping, not bearing gifts of food parcels,   And no lovely sweets to munch.  Instead there were items that were unfamiliar to Steve and me.

Steve and I sat together on the sofa like a couple of school kids niavely watching in anticipation.  Gwen, the nurse specialist methodically explained the whole process.  She was very thorough and hands on.  Carefully telling us how to set up the pump, what tube to use, checking the ph level, flushing the feed tube.   After an hour or so of first time training Gwen left.  She gave us an abundance of literature to read through.  We both felt fairly confident in using the pump and setting up the feed.

Thursday morning came.  Steve and I arrived at the hospital early.  Time for a hot chocolate and malt loaf at the hospital cafe.  We toddled up to the ward.  Lovely nurse Stacey was waiting for us.  She took us to a designated room.  She came in with a loaded trolley. Amongst other things on it was the tube  and a cup of water with a straw.    I asked how I should sit on the large comfortable chair.  The nurse was very reassuring and said I was to sit in whatever way I wanted and she would work round me.  I got comfortable the nurse measured the length of the tube against me and then was instructed to rest my chin on my chest.

The procedure was just about to begin.  She lubricated the tube and then inserted it into my right nostril.  I’m not going to lie, I felt nervous.  As the tube was pushed in I felt this pain up my nose.  It was as if a bee had stung me.  I remember saying oh that feels awful, rather sore up my nose.  Simultaneously the nurse said we are in the back of your throat and ready for you to take a sip of water.  As I drank from the straw the tube was fed down.  I knew co-operating would make swallowing the tube much less painful and it would all get done a lot quicker.   Voila – it had now entered my stomach.  Carefully the nurse secured the tube to my face.  A large plaster covering 90% of my nose and a transparent dressing on my right cheek. Now to check the placement – the nurse put the syringe on the end of the tube and started to draw some contents from my tummy.  Nothing.  Oh !  Of we went to X-ray to check where the tube had gone.  Had to make sure it had gone into my stomach and not entered a lung.   The guide wire had to be left in.  This would give an accurate image on the X-ray.  The great thing with modern technology is by the time we were back at the ward the doctor had seen the X-ray on the computer in the ward.  Great news it was in the right place.  Steve got me some orange juice, I drank it.  Fingers crossed we would get some contents now to check the ph level.  As the nurse drew up the syringe some of the orange juice I had just drank was now in it.  Carefully she squirted some fluid onto one of the strips.  Waited for it to change colour then compared it to the chart.  Ph level 4.  Perfect.

My dietician came to the ward to see us.  We had a frank discussion.  She explained all about building up my tube feed.  Gave us lots of good literature, together with do’s and don’t’s.  Also very useful telephone numbers just in case I need help.

I had a constant pressure in the back of my throat and my nose was really hurting by this time.  I was reassured this was all normal and would ease.  We left the hospital and headed home.

The next morning the district nurse arrived, basically to check in on me and give me support, change face dressing.  The plaster on my nose was stuck firmly.  With a bit of gentle tugging and pulling she got the plaster of and checked the measurement.  Good news the tube has not moved.

For the first few days I have to feed through the tube for 10 hours during the day.  Gradually building up the speed of the pump, allowing me to get more feed each time.  The feed is peptamen.  It’s partly digested and appears to be the best formula for my tummy.

Four days later and all is going better than I hoped.  My body is tolerating the formula.  I can confidently set up and use the pump, draw fluid from my tummy and check ph level, and can flush my tube.

My nose is still uncomfortable and my throat is now much less sore than it was even yesterday.   It wasn’t the easiest procedure I’ve had.   However a combination of keeping calm, a good clinician and having my hubby was my biggest asset.
  

Too much ‘happy clappy’ chemicals

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One of the tests to confirm carcinoid syndrome is a 24 hour urine collection.  The test is called 5hiaa.  the level of serotonin excreted into the urine is measured.  From day one my levels have always been elevated.  As my doctor would say results are on the high side.  Serotonin is a feel good chemical.  A doctor was once described it to me as your happy clappy chemicals are very high.  I believe this is why I do not get down in the mouth and my glass is half full and not half empty.  I try my best to keep upbeat and positive.  With a wonderful husband and beautiful family such as mine it makes wanting to be happy relatively easy.

The test is simple enough and can be done at home.  As long as you remember to pee in a urine pot and then pour it in the designated container.  The container has acid in it the last thing you want to do is put your ****** over the containers and have the acid vapours direct themselves at you – most of us have enough problems without adding to them.  My main issue is trying to pee and not poo at the same time.    As well as reducing the flushing the lanreotide injection has cut down the diahrea from 9 times a day to  loose bowels 3 or 4 times per day.  I’ve perfected a stance that allows me just to collect the urine.  I certainly wouldn’t win any prizes for looking cool but it gets the job done 🙂

I start my next 24 hour collection for 5hiaa in 7 hours time.  I’ve been practising my pee positioning all week.

Some happy news

This week was a tiring mixed emotional one.  My hospital admission.  Death of a friend.  Body and brain in overdrive.

Sunday brought happiness and celebration.   Our youngest son, Stuart, arrived at the house on Sunday lunchtime with Christine and Grace.  After the usual blethering and noise for the first five minutes.  Stuart announces he asked Christine to marry him and she said yes.  As parents Steve and I are so pleased that things are going on the right track for the youngsters.   We always worry about our children and I think more so the older they get.  There is something frightening for a parent when a child reaches that independent age and starts heading off in their own direction.  Our philosophy is not to interfere or tell them what to do.  We would rather support our boys and let them know they are loved and we are there for them 24 hours a day.  I can still hear my mother say I worry more about you now you are an adult than when you were in nappies; my boys are 25 & 27 and I can definitely relate to this comment.

 

Stuart, Christine & Grace     Stuart, Christine & Grace

 

Worth breaking the rules

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For the last five years my health has dictated holidays – breaks away abroad had been a thing of the past.  Postcards and tales from family and friends seemed to be the closest we were getting to foreign lands.  Anytime we thought about going away we hit stumbling blocks.  Our general rule is usually stay in UK, go somewhere proven.

  • do I feel up to going away
  • fitting timings in with lanreotide injection every 21 days
  • is it all really worth it
  • takings unusual meds on the trip
  • holiday insurance????
  • the weight of my fortisip drinks
  • carrying tubs of creams, factor 50 sun cream, etc

Im not the easiest person to be with at the best of time.  The spontaneous hypoglycaemia attacks when you least expect it.  Those who know me know I blether a load of rubbish at the best ofdden drop in blood sugar can turn me into a raving lunatic.  This tends to make my hubby slightly nervous, after the episode of us in the centre of Edinburgh and I just sat down in a crowded street – I could go no further and needed some supplies.  I’m sure Steve says in his sleep – “eat something” or “here is ….. Get it down you”. By the way this happens very often. I get grumpier than normal when my tummy aches.  one of the biggest challenges is the thought of leaving home and not knowing where the nearest bathroom is.  We have all had diahrea or loose movements at some time – but when this is an everyday occurrence a great deal of thought goes into leaving the security of your home and the comfort of ones own loo.

This is my 49th year on earth and have been married to Steve for 29 of them.  I want to do cheery happy things with my hubby.  Sitting one evening I thought I’ve had enough of pussy footing around.  I want us to go on a holiday abroad – go somewhere no-one knows us, take in sights and most importantly spend quality time together.   So we struck while the iron was hot and booked 7 days in Ibiza.  Was this too ambitious – a sunny island and me being photosensitive.  Get a grip woman I said to myself – put on plenty of your cream snd smother the factor 50 on.

The month before we were booked to go I was in hospital with pneumonia.  The thought of the trip we had planned together gave me strength and stamina to push myself.  Every breath, step was an effort.  Combination of IV antibiotics, steroids and sheer want to go helped me on the right road.

We got to Ibiza last week and spent 7 days there.  It wasn’t always problem free but having my soulmate with me made everything easier.

  • was it worth it? – most definitely YES
  • it wasn’t always easy
  • some of the hilly streets were a tad ambitious & challenging
  • was I tired? – exhausted – still am
  • would we go back – in a heartbeat

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