Wednesday, November 22, 2006

Introduction to tube feeding..

Puan2x dan tuan2x, hari ini saya akan sediakan bahan2x yang harus digunakan untuk feed anak anda yang ada g-tube atau nama panjangnya gastrostomy tube...hehee..macam ajar masak2x lak yea...

Today I thought of showing everyone what exactly is a g-tube for short or a gastrostomy tube is...Ridhwan had undergone a gastrostomy tube on 5th July this year and alhamdulillah thanks to the tube, Ridhwan's weight at last is at par with his height and the best news of all is his fits/seizures are finally gone..yes gone for good...gone are the days that I keep worrying when he'd wake up from his sleep with eyes flickering and hands twitching...yes, do watch out for these my friends if your toddler may show signs like these when he is more than 6 months, no, babies after 6 months should show no twitching behaviour anymore as their system should be stable by that age.

Anyway, I've taken images of feeding ridhwan through the tube. And decided to explain a bit how I've been feeding Ridhwan through this tube since July. Initally it was painful, not to Ridhwan that is but to me as it hurst to put a tube through his stomach and also wondering how long is this going to go on, feeding my son through the tube and straight to the stomach. However, after awhile, I get use to it and even the nurses were amaze with my skill when Ridhwan had to go to day surgery to to cotorization or getting rid of his granulation tissues around his g-tube. Yes, such bombastic words me, after awhile, when you're a mother to a cerebral palsy child with a g-tube, you tend to memorize by heart all these medical terms and meaning. Even when you visit GPs, they will be amaze with your knowledge...heck, I have too, who else is going to know about my son's condition but myself right?

And so, our lessons starts, what is this gastrostomy tube all about?

Gastrostomy tubes are feeding tubes placed through the abdomen into the stomach. Gastrostomy tubes are used to give children formula, liquids, and medicines. These tubes are placed by a Pediatric Gastroenterologist or by a Pediatric Surgeon. A gastrostomy tube is placed one of two ways, 1) percutaneously (this is called a PEG) and 2) surgically.

A PEG Tube, or Percutaneous Endoscopic Gastrostomy tube, is placed by a Pediatric Gastroenterologist in the operating room. The PEG tube is inserted using a telescopic instrument, called an endoscope. The endoscope is a small tube with a light and camera on the end that lets the Gastroenterologist see into the esophagus (food tube) and stomach. The endoscope allows the doctor to choose the best location in the stomach to place the PEG tube. Once the location is chosen, a small opening is made on the outside of abdomen into the stomach. After the opening is made, the top part of the PEG tube is pulled up out of the stomach through this opening. The top of the tube rests on the skin and the bottom part of the PEG, which is shaped like bulb, remains inside the stomach. This bulb shape anchors the tube in the stomach and prevents it from coming out.

After the PEG tube is placed your child will be admitted to the hospital for observation and care. The hospital stay is usually three days. Prior to the procedure, an IV (intravenous line) will be placed in the operating room. This will be used to give fluids, antibiotics and pain medication, for one to two days, as your child is recovering. Feedings will be started through the PEG tube within one or two days.

PEG tube

Who needs a gastrostomy?

Children require gastrostomy feeding tubes for a variety of reasons. The primary indication for gastrostomy is the child's inability to take adequate nutrition or liquids by mouth for growth and development. The reasons why the child is unable to take proper nutrition can be developmental, mechanical, or secondary to other health problems.

A small, flexible, hollow tube (catheter) with a balloon or flared tip is inserted into the stomach. The stomach is stitched closed around the tube and the incision is closed.

So, there you have it, a little summary of g-tube and who needs them. The above picture shows how the tube really looks like in the stomach. Yes, my dear friends, this is what Ridhwan has in his stomach, and now that he's learning to grab things slowly, I am so afraid that he may pull it out of his stomach cause many times he has tried to pull it lightly...nauzubillah, this is how the milk will go directly in his stomach as he does not want to drink milk in his mouth like other normal children should...

Ridhwan getting ready for feeding..tembamnya anak mama nie...hehee

The g-button in ridhwan's stomach..its purple in colour as I had to put gentian violet(pronounced like "gen" in "gentoo" not gentian as in "gen" in "genting" in malay, ridhwan paed laughed at me when i pronounced it as in gentian..cet sabor aje") to prevent the granulation tissue from growing more. Oh, the straight cut scar in the middle of ridhwan's abdomen is the surgery for fundoplication of his ..umm..darn, was it esofagus or of it lah, will get back to that later....hehee...ridhwan's paed said that ridhwan's scar will not heal fast and tends to look like that, tertimbul, so if ridhwan needs to be operated(nauzubillah) , we need to tell them that he scars this way to the surgeon or whomever related.

next, we have one bottle of milk..usually around 6 ounces or 5

Air masak is also a must for the tube feeding

next, the kidney pan to put the tubes and sryinge after use

then, of course one of the most important apparatus in feeding is the syringe, the 60 ml syringe by terumo..good brand

then last but not least is the tube, there are 3 different types of tube..can't remember what's the name if this one, but each has its function, like decompression, feeding for liquid only and feeing for solids, well not really solid, like fine cereal with milk that is

oh, i forgot, and a box of tissues, yes, it can get quite wet and messy sometimes...

Okay, time to nite2x now and also ridhwan's feeding time, yup, through the button and tube. Will continue more soon...


Izan said...

Sayu hati aku mengenangkan nak beri makan kat Ridhwan macam tu. Teringat pula time Abg Iko kena pasang tube kat jantung dan masuk segala ubat chemo dari situ. Ya Allah berilah kesihatan kepada diri kita dan semua orang yang kita sayang...amin.

izreen fara said...

Hi Reenaz... thanks for visiting my blog! It's been great to finally meet up (albeit virtually) with old acquaintances and such. I really admire your strength and resilience in getting through your masters and taking care of Ridhwan - I feel huge bursts of love in every sentence you compose! Take care and insyallah, we shall meet up one of these days, Allah permitting.

drewreeny said...

chiya..semoga Allah sentiasa beri kita kekuatan untuk mengharungi setiap hari dengan hati yang tabah..insya-Allah..all the best in your PhD. dear... nice to hear from you dear! yes, I'd love to see again one day and your precious little one..she's so adorable..thanks for wishes...