New g tube pt-have questions

[PedsNP2007]

Hey Dawn,

In our peds ICU, we have a protocol to clean around the GJ tube site with soap and warm water. No need for hydrogen peroxide... that might irritate the site more.

We don't reuse bags in the ICU (change every 24 hours), but when the kids go home, the parents reuse the bags and even syringes that GT meds are given with. Just do warm/hot water and soap to rinse out the bags and syringes. Too hot of water may ruin the bag. I'm not sure how long the bags do last...

Oh, so you are doing Jtube feeds... just make sure you aren't being told to run fast feeds. What percentage of your calories are you giving in your feeds? If you are giving 50% of calorie needs for tube feeds and then doing 50% feeds during the day orally, then 12 hours is good at night. But 100% calories through the Jtube, 12 hours seems a bit too fast. Some people may be able to tolerate it, but it is rare to tolerate that amount of volume (and osmotic load) in that time period.

For kids who are only fed Jtube (and no feeds orally), we start their new Jtube feeds at 24 hrs per day. The lowest continuous feeds we do is 16 hours/day. Too high of input can lead to dumping syndrome, where you will not feed good at all.

As far as your Gtube... are you giving any meds through it? If so, just the flushing after the med will be ok as long as you are giving meds at least 2x/day. I'd flush it 2x a day to make sure it is still patent, so before starting and ending Jtube feeds just to make it easy for you.

Feel free to PM if you have any other questions.

Jenn
30 yo cf, peds nurse practitioner in the peds ICU

 

[PedsNP2007]

Hey Dawn,

In our peds ICU, we have a protocol to clean around the GJ tube site with soap and warm water. No need for hydrogen peroxide... that might irritate the site more.

We don't reuse bags in the ICU (change every 24 hours), but when the kids go home, the parents reuse the bags and even syringes that GT meds are given with. Just do warm/hot water and soap to rinse out the bags and syringes. Too hot of water may ruin the bag. I'm not sure how long the bags do last...

Oh, so you are doing Jtube feeds... just make sure you aren't being told to run fast feeds. What percentage of your calories are you giving in your feeds? If you are giving 50% of calorie needs for tube feeds and then doing 50% feeds during the day orally, then 12 hours is good at night. But 100% calories through the Jtube, 12 hours seems a bit too fast. Some people may be able to tolerate it, but it is rare to tolerate that amount of volume (and osmotic load) in that time period.

For kids who are only fed Jtube (and no feeds orally), we start their new Jtube feeds at 24 hrs per day. The lowest continuous feeds we do is 16 hours/day. Too high of input can lead to dumping syndrome, where you will not feed good at all.

As far as your Gtube... are you giving any meds through it? If so, just the flushing after the med will be ok as long as you are giving meds at least 2x/day. I'd flush it 2x a day to make sure it is still patent, so before starting and ending Jtube feeds just to make it easy for you.

Feel free to PM if you have any other questions.

Jenn
30 yo cf, peds nurse practitioner in the peds ICU

 

[PedsNP2007]

Hey Dawn,

In our peds ICU, we have a protocol to clean around the GJ tube site with soap and warm water. No need for hydrogen peroxide... that might irritate the site more.

We don't reuse bags in the ICU (change every 24 hours), but when the kids go home, the parents reuse the bags and even syringes that GT meds are given with. Just do warm/hot water and soap to rinse out the bags and syringes. Too hot of water may ruin the bag. I'm not sure how long the bags do last...

Oh, so you are doing Jtube feeds... just make sure you aren't being told to run fast feeds. What percentage of your calories are you giving in your feeds? If you are giving 50% of calorie needs for tube feeds and then doing 50% feeds during the day orally, then 12 hours is good at night. But 100% calories through the Jtube, 12 hours seems a bit too fast. Some people may be able to tolerate it, but it is rare to tolerate that amount of volume (and osmotic load) in that time period.

For kids who are only fed Jtube (and no feeds orally), we start their new Jtube feeds at 24 hrs per day. The lowest continuous feeds we do is 16 hours/day. Too high of input can lead to dumping syndrome, where you will not feed good at all.

As far as your Gtube... are you giving any meds through it? If so, just the flushing after the med will be ok as long as you are giving meds at least 2x/day. I'd flush it 2x a day to make sure it is still patent, so before starting and ending Jtube feeds just to make it easy for you.

Feel free to PM if you have any other questions.

Jenn
30 yo cf, peds nurse practitioner in the peds ICU

 

[PedsNP2007]

Hey Dawn,

In our peds ICU, we have a protocol to clean around the GJ tube site with soap and warm water. No need for hydrogen peroxide... that might irritate the site more.

We don't reuse bags in the ICU (change every 24 hours), but when the kids go home, the parents reuse the bags and even syringes that GT meds are given with. Just do warm/hot water and soap to rinse out the bags and syringes. Too hot of water may ruin the bag. I'm not sure how long the bags do last...

Oh, so you are doing Jtube feeds... just make sure you aren't being told to run fast feeds. What percentage of your calories are you giving in your feeds? If you are giving 50% of calorie needs for tube feeds and then doing 50% feeds during the day orally, then 12 hours is good at night. But 100% calories through the Jtube, 12 hours seems a bit too fast. Some people may be able to tolerate it, but it is rare to tolerate that amount of volume (and osmotic load) in that time period.

For kids who are only fed Jtube (and no feeds orally), we start their new Jtube feeds at 24 hrs per day. The lowest continuous feeds we do is 16 hours/day. Too high of input can lead to dumping syndrome, where you will not feed good at all.

As far as your Gtube... are you giving any meds through it? If so, just the flushing after the med will be ok as long as you are giving meds at least 2x/day. I'd flush it 2x a day to make sure it is still patent, so before starting and ending Jtube feeds just to make it easy for you.

Feel free to PM if you have any other questions.

Jenn
30 yo cf, peds nurse practitioner in the peds ICU

 

[PedsNP2007]

Hey Dawn,
<br />
<br />In our peds ICU, we have a protocol to clean around the GJ tube site with soap and warm water. No need for hydrogen peroxide... that might irritate the site more.
<br />
<br />We don't reuse bags in the ICU (change every 24 hours), but when the kids go home, the parents reuse the bags and even syringes that GT meds are given with. Just do warm/hot water and soap to rinse out the bags and syringes. Too hot of water may ruin the bag. I'm not sure how long the bags do last...
<br />
<br />Oh, so you are doing Jtube feeds... just make sure you aren't being told to run fast feeds. What percentage of your calories are you giving in your feeds? If you are giving 50% of calorie needs for tube feeds and then doing 50% feeds during the day orally, then 12 hours is good at night. But 100% calories through the Jtube, 12 hours seems a bit too fast. Some people may be able to tolerate it, but it is rare to tolerate that amount of volume (and osmotic load) in that time period.
<br />
<br />For kids who are only fed Jtube (and no feeds orally), we start their new Jtube feeds at 24 hrs per day. The lowest continuous feeds we do is 16 hours/day. Too high of input can lead to dumping syndrome, where you will not feed good at all.
<br />
<br />As far as your Gtube... are you giving any meds through it? If so, just the flushing after the med will be ok as long as you are giving meds at least 2x/day. I'd flush it 2x a day to make sure it is still patent, so before starting and ending Jtube feeds just to make it easy for you.
<br />
<br />Feel free to PM if you have any other questions.
<br />
<br />Jenn
<br />30 yo cf, peds nurse practitioner in the peds ICU

 

[jfarel]

My gtube site hurt very bad for about 3 or 4 days after a week it felt much better. I didn't gain weight for a couple months. I have gained about 10 pounds and kept it on.

 

[jfarel]

My gtube site hurt very bad for about 3 or 4 days after a week it felt much better. I didn't gain weight for a couple months. I have gained about 10 pounds and kept it on.

 

[jfarel]

My gtube site hurt very bad for about 3 or 4 days after a week it felt much better. I didn't gain weight for a couple months. I have gained about 10 pounds and kept it on.

 

[jfarel]

My gtube site hurt very bad for about 3 or 4 days after a week it felt much better. I didn't gain weight for a couple months. I have gained about 10 pounds and kept it on.

 

[jfarel]

My gtube site hurt very bad for about 3 or 4 days after a week it felt much better. I didn't gain weight for a couple months. I have gained about 10 pounds and kept it on.

 

[juliepie]

my site hurt for a good two weeks because I coughed so much. My surgeon told me to use a 50% hydrogen peroxide, 50% saline mix to clean around the site daily, and then after a few months to use it a few times a week. It helps build up scar tissue around the hole (I was slack with this and mine is pretty leaky and gross). As far as the bags/tubing go, I think it depends on the type. It should say right on the package what the recommended use time is. The bags I use with my pump have the tubing attached and are single use. Besides, the formula smells so disgusting I would hate to have to wash out bags in the morning! I've done it before when I forget to bring enough to the dorm or to my mom or dads house. I just wouldn't do it more than once with the same bag set.

Good luck!! It's been a life-saver for me!

 

[juliepie]

my site hurt for a good two weeks because I coughed so much. My surgeon told me to use a 50% hydrogen peroxide, 50% saline mix to clean around the site daily, and then after a few months to use it a few times a week. It helps build up scar tissue around the hole (I was slack with this and mine is pretty leaky and gross). As far as the bags/tubing go, I think it depends on the type. It should say right on the package what the recommended use time is. The bags I use with my pump have the tubing attached and are single use. Besides, the formula smells so disgusting I would hate to have to wash out bags in the morning! I've done it before when I forget to bring enough to the dorm or to my mom or dads house. I just wouldn't do it more than once with the same bag set.

Good luck!! It's been a life-saver for me!

 

[juliepie]

my site hurt for a good two weeks because I coughed so much. My surgeon told me to use a 50% hydrogen peroxide, 50% saline mix to clean around the site daily, and then after a few months to use it a few times a week. It helps build up scar tissue around the hole (I was slack with this and mine is pretty leaky and gross). As far as the bags/tubing go, I think it depends on the type. It should say right on the package what the recommended use time is. The bags I use with my pump have the tubing attached and are single use. Besides, the formula smells so disgusting I would hate to have to wash out bags in the morning! I've done it before when I forget to bring enough to the dorm or to my mom or dads house. I just wouldn't do it more than once with the same bag set.

Good luck!! It's been a life-saver for me!

 

[juliepie]

my site hurt for a good two weeks because I coughed so much. My surgeon told me to use a 50% hydrogen peroxide, 50% saline mix to clean around the site daily, and then after a few months to use it a few times a week. It helps build up scar tissue around the hole (I was slack with this and mine is pretty leaky and gross). As far as the bags/tubing go, I think it depends on the type. It should say right on the package what the recommended use time is. The bags I use with my pump have the tubing attached and are single use. Besides, the formula smells so disgusting I would hate to have to wash out bags in the morning! I've done it before when I forget to bring enough to the dorm or to my mom or dads house. I just wouldn't do it more than once with the same bag set.

Good luck!! It's been a life-saver for me!

 

[juliepie]

my site hurt for a good two weeks because I coughed so much. My surgeon told me to use a 50% hydrogen peroxide, 50% saline mix to clean around the site daily, and then after a few months to use it a few times a week. It helps build up scar tissue around the hole (I was slack with this and mine is pretty leaky and gross). As far as the bags/tubing go, I think it depends on the type. It should say right on the package what the recommended use time is. The bags I use with my pump have the tubing attached and are single use. Besides, the formula smells so disgusting I would hate to have to wash out bags in the morning! I've done it before when I forget to bring enough to the dorm or to my mom or dads house. I just wouldn't do it more than once with the same bag set.
<br />
<br />Good luck!! It's been a life-saver for me!

 

[Ready2Dance]

I just got my tube in April, so my knowledge is still limited, but let me give this a shot.

Before I got my button (when it was still the PEG) I would flush the line daily after my feed. Once a week my surgeon said it would be a good idea to flush the line with Coke to avoid the formula building up and to clean it. I was told just to was the area around the skin with soap and water. He told me to treat it like another part of my body, not to baby it. Basically, think of it as an extra appendage. It took about 2 weeks before I could get a good cough going since the area was so tender. I had to go through the tenderness again when I got my button, but this was minor and only for a few days.

When they started the feeds, they started me at ta slow rate and had me increase the rate and amount each night. Unfortunately for me, they increased the rate too quickly and I got sick in the mornings alot. That's been fixed now, but it took me a while to find a good rate for me. I now run my pump at 75mL/hr and I take 700mL of my formula (Nutren 2.0 - 2 calories per mL) during the night and have started a bolus feed during the day with just one can (250mL) at 240mL/hr. This is a preference for people and changes for me depending on how I feel. If I'm getting sick and coughing alot, I slow the rate down in case I cough too hard and get sick.

I only use the bags once but for the button adapter tubing, I use that for about a week. I can sometimes get more out of it if I wash it well.

I didn't gain weight well at first, but that was due to my blood sugars jumping around. Took a while to get that under control. Also, the feeds caused my oral intake to almost cut in half for a while. The formula filled me up and kept me full for a good amount of the day, so it was just hard to eat more. When I had my tube placed I weighed about 97 lbs. I was sick at the time though and usually weighed around 103. I couldn't seem to break through that weight! I now weigh about 110 and am steadily gaining now. I still don't eat a ton but it's all getting easier.

I too got mine because I was considering transplant. In fact, it's the one thing that my docs at Cleveland have repeated "You have to gain more weight for this surgery", so I've been trying!! Best of luck with everything and if you have more questions feel free to PM me!!!

 

[Ready2Dance]

I just got my tube in April, so my knowledge is still limited, but let me give this a shot.

Before I got my button (when it was still the PEG) I would flush the line daily after my feed. Once a week my surgeon said it would be a good idea to flush the line with Coke to avoid the formula building up and to clean it. I was told just to was the area around the skin with soap and water. He told me to treat it like another part of my body, not to baby it. Basically, think of it as an extra appendage. It took about 2 weeks before I could get a good cough going since the area was so tender. I had to go through the tenderness again when I got my button, but this was minor and only for a few days.

When they started the feeds, they started me at ta slow rate and had me increase the rate and amount each night. Unfortunately for me, they increased the rate too quickly and I got sick in the mornings alot. That's been fixed now, but it took me a while to find a good rate for me. I now run my pump at 75mL/hr and I take 700mL of my formula (Nutren 2.0 - 2 calories per mL) during the night and have started a bolus feed during the day with just one can (250mL) at 240mL/hr. This is a preference for people and changes for me depending on how I feel. If I'm getting sick and coughing alot, I slow the rate down in case I cough too hard and get sick.

I only use the bags once but for the button adapter tubing, I use that for about a week. I can sometimes get more out of it if I wash it well.

I didn't gain weight well at first, but that was due to my blood sugars jumping around. Took a while to get that under control. Also, the feeds caused my oral intake to almost cut in half for a while. The formula filled me up and kept me full for a good amount of the day, so it was just hard to eat more. When I had my tube placed I weighed about 97 lbs. I was sick at the time though and usually weighed around 103. I couldn't seem to break through that weight! I now weigh about 110 and am steadily gaining now. I still don't eat a ton but it's all getting easier.

I too got mine because I was considering transplant. In fact, it's the one thing that my docs at Cleveland have repeated "You have to gain more weight for this surgery", so I've been trying!! Best of luck with everything and if you have more questions feel free to PM me!!!

 

[Ready2Dance]

I just got my tube in April, so my knowledge is still limited, but let me give this a shot.

Before I got my button (when it was still the PEG) I would flush the line daily after my feed. Once a week my surgeon said it would be a good idea to flush the line with Coke to avoid the formula building up and to clean it. I was told just to was the area around the skin with soap and water. He told me to treat it like another part of my body, not to baby it. Basically, think of it as an extra appendage. It took about 2 weeks before I could get a good cough going since the area was so tender. I had to go through the tenderness again when I got my button, but this was minor and only for a few days.

When they started the feeds, they started me at ta slow rate and had me increase the rate and amount each night. Unfortunately for me, they increased the rate too quickly and I got sick in the mornings alot. That's been fixed now, but it took me a while to find a good rate for me. I now run my pump at 75mL/hr and I take 700mL of my formula (Nutren 2.0 - 2 calories per mL) during the night and have started a bolus feed during the day with just one can (250mL) at 240mL/hr. This is a preference for people and changes for me depending on how I feel. If I'm getting sick and coughing alot, I slow the rate down in case I cough too hard and get sick.

I only use the bags once but for the button adapter tubing, I use that for about a week. I can sometimes get more out of it if I wash it well.

I didn't gain weight well at first, but that was due to my blood sugars jumping around. Took a while to get that under control. Also, the feeds caused my oral intake to almost cut in half for a while. The formula filled me up and kept me full for a good amount of the day, so it was just hard to eat more. When I had my tube placed I weighed about 97 lbs. I was sick at the time though and usually weighed around 103. I couldn't seem to break through that weight! I now weigh about 110 and am steadily gaining now. I still don't eat a ton but it's all getting easier.

I too got mine because I was considering transplant. In fact, it's the one thing that my docs at Cleveland have repeated "You have to gain more weight for this surgery", so I've been trying!! Best of luck with everything and if you have more questions feel free to PM me!!!

 

[Ready2Dance]

I just got my tube in April, so my knowledge is still limited, but let me give this a shot.

Before I got my button (when it was still the PEG) I would flush the line daily after my feed. Once a week my surgeon said it would be a good idea to flush the line with Coke to avoid the formula building up and to clean it. I was told just to was the area around the skin with soap and water. He told me to treat it like another part of my body, not to baby it. Basically, think of it as an extra appendage. It took about 2 weeks before I could get a good cough going since the area was so tender. I had to go through the tenderness again when I got my button, but this was minor and only for a few days.

When they started the feeds, they started me at ta slow rate and had me increase the rate and amount each night. Unfortunately for me, they increased the rate too quickly and I got sick in the mornings alot. That's been fixed now, but it took me a while to find a good rate for me. I now run my pump at 75mL/hr and I take 700mL of my formula (Nutren 2.0 - 2 calories per mL) during the night and have started a bolus feed during the day with just one can (250mL) at 240mL/hr. This is a preference for people and changes for me depending on how I feel. If I'm getting sick and coughing alot, I slow the rate down in case I cough too hard and get sick.

I only use the bags once but for the button adapter tubing, I use that for about a week. I can sometimes get more out of it if I wash it well.

I didn't gain weight well at first, but that was due to my blood sugars jumping around. Took a while to get that under control. Also, the feeds caused my oral intake to almost cut in half for a while. The formula filled me up and kept me full for a good amount of the day, so it was just hard to eat more. When I had my tube placed I weighed about 97 lbs. I was sick at the time though and usually weighed around 103. I couldn't seem to break through that weight! I now weigh about 110 and am steadily gaining now. I still don't eat a ton but it's all getting easier.

I too got mine because I was considering transplant. In fact, it's the one thing that my docs at Cleveland have repeated "You have to gain more weight for this surgery", so I've been trying!! Best of luck with everything and if you have more questions feel free to PM me!!!

 

[Ready2Dance]

I just got my tube in April, so my knowledge is still limited, but let me give this a shot.
<br />
<br />Before I got my button (when it was still the PEG) I would flush the line daily after my feed. Once a week my surgeon said it would be a good idea to flush the line with Coke to avoid the formula building up and to clean it. I was told just to was the area around the skin with soap and water. He told me to treat it like another part of my body, not to baby it. Basically, think of it as an extra appendage. It took about 2 weeks before I could get a good cough going since the area was so tender. I had to go through the tenderness again when I got my button, but this was minor and only for a few days.
<br />
<br />When they started the feeds, they started me at ta slow rate and had me increase the rate and amount each night. Unfortunately for me, they increased the rate too quickly and I got sick in the mornings alot. That's been fixed now, but it took me a while to find a good rate for me. I now run my pump at 75mL/hr and I take 700mL of my formula (Nutren 2.0 - 2 calories per mL) during the night and have started a bolus feed during the day with just one can (250mL) at 240mL/hr. This is a preference for people and changes for me depending on how I feel. If I'm getting sick and coughing alot, I slow the rate down in case I cough too hard and get sick.
<br />
<br />I only use the bags once but for the button adapter tubing, I use that for about a week. I can sometimes get more out of it if I wash it well.
<br />
<br />I didn't gain weight well at first, but that was due to my blood sugars jumping around. Took a while to get that under control. Also, the feeds caused my oral intake to almost cut in half for a while. The formula filled me up and kept me full for a good amount of the day, so it was just hard to eat more. When I had my tube placed I weighed about 97 lbs. I was sick at the time though and usually weighed around 103. I couldn't seem to break through that weight! I now weigh about 110 and am steadily gaining now. I still don't eat a ton but it's all getting easier.
<br />
<br />I too got mine because I was considering transplant. In fact, it's the one thing that my docs at Cleveland have repeated "You have to gain more weight for this surgery", so I've been trying!! Best of luck with everything and if you have more questions feel free to PM me!!!