December 14, 2010

Let's Do Lunch!

A few people have put out for some pics of how tube feeding works - so I've invited you all for lunch at my place today to have a look see.  Come on in...

(pics from my 1MP iPhone camera, sorry, but the upload speeds here would make anything bigger take........for........ever.......)

This is our kitchen table where I do most of my feeds - I call them feeds, but many people prefer to call them meals.  That's OK too.  If my wife is using it, I will often just stand by the kitchen bench.  Let's get set up.

What you see here is my little kit, which comes out a few times a day whenever there's medicines etc involved (otherwise it's just syringe, water, feed, tea towel).  So in the foreground, from left, is a 1/2 cup measuring cup that I use to dissolve crushed meds and liquid meds in, a 200ml glass of water, a pill crusher and some pills, and just under 400mls of yummy blend.  The kit in the middle ground is just where all the medicines, herb tinctures, syringe equipment and so on live together in peaceable harmony between feeding sessions.  What you'll notice in the background is important too.  It's good to make the place you have your food a nice place to be, especially if you're not getting the usual tantalising visuals and textures of having a meal the traditional oral way.  I like to have flowers around if there's some from the garden but today I have Special Birthday Flowers also (thanks Meeta xo) so it's a bonus.

Also, music can be good.  Today for example I have been listening to the indescribable Geoffery Gurrumul Yunupingu.  If you haven't, then I strongly suggest you do yourself a favour.

OK, getting hungry now so let's get it on...

That's herb tincture and medicine soup, that is.  The eagle-eyed amongst you may have detected the water level going down in the glass - as well as making the medicine soup, I added just a teensy dribble (that's the technical term) into my blend container and gave it a shake (remembering to put the lid back on - I haven't done that one, yet :-) to turn it from a 'needs pushing' blend to a 'gravity is my best friend' blend.  The ridiculously eagle-eyed will wonder why the folded paper towel has moved from right to left also.  Well, I don't know either.

Today's lunch comprises:
Leftover vege pasta bake with rice+corn pasta, wholewheat tortillas, and lots and lots of different veges in a tomato-based sauce.  Smelled great.
Olive oil
Homemade applesauce (it's just apples, some spices, agave nectar and lemon juice)
Digestive spices and herbs (cardamom, ginger, dill)
Organic oat milk
Pomegranate and cranberry juice.

OK, this next bit is what has proved hard to describe adequately and in part inspired this post - so here's a picture:

This is The Grip. Thumb and forefinger are holding the syringe barrel down into the feed port while the other fingers help by supporting it.  The Very Important Part of The Grip is the part of my palm (yes, that's my hand, I couldn't afford a professional Hand Model for the shoot) , under the first finger knuckle, that's sitting firmly on top of the pesky med port cap.  If you do not hold this cap down, and you are using the syringe plunger to push a thick blend - and this even happens sometimes just with gravity feeding - IT CAN BURST OPEN SUDDENLY AND HAVE YOU AND THE SURROUNDINGS WEARING THE CONTENTS OF THE SYRINGE IN POSSIBLY ALARMING, OFTEN HUMOUROUS, BUT DEFINITELY MESSY FASHION.  Note also I am wearing light-coloured trousers today, which dramatically increases the chances of a spillage event.  This applies to any PEG-end or extension that uses a cath-tip port.

Oh, and the colour of the tube itself?  Over its life to date (about 16 months now) it's gone from a nice clear non-colour to the deep burnished mahogany you see here.  This is just staining and is not a problem in the least.

Finally, the money shot:

It's just as easy as that; I have poured in a syringe-worth of feed, and it is slowly running through the tube, whilst I maintain The Grip, under gravity.  If I were doing a thicker bolus (that just means feed without a pump, for non-tubetalkers) with the plunger, then that little white med-soup cup would be serving also as a rest for when I put the plunger down during the plug in-pour-insert plunger-push-unplug-take out plunger (rest in little cup)-plug in (repeat all) routine.  If it's a rubber-tip like this one then I'd be dipping it in the blend too every second or third syringeful for a bit of lubricatory action.  When all the feed has gone from container into me, I just tip the rest of the water in to flush the tube.  Then....

Do, please do, always just have a little double-check that YOU'VE ACTUALLY CAPPED THE TUBE if you have a PEG and not one of those high-tech one-way valve low-profile button doovers.  Because sometimes, I've not quite closed the cap all the way and, well, let's just say I'd never win a wet t-shirt contest, so I don't want to wear one.

Now, let's go wash up.

Note here the pristine paper towel - it can be saved for next time, as I was dribble-free today.  Yay for no mess!  All this'll just be given a good rinse in very-hot water.  If things are starting to look a bit too grimy I'll break out the dish liquid and get serious, but really, it's a cosmetic and psychological thing, cleanliness, as much as a common-sense thing.  Air-drying means no contamination from dish towels etc too.

So, thanks for dropping bye!  I hope this was of some use to some of you.  As you may know, I have an on-again-off-again issue with motility and reflux so for the next hour after feeding time I need to stay pretty upright, but just like all us creatures after a lovely feed's a good time for a little siesta:

Tell me Cisco here doesn't have it all worked out.



  1. Great write up on "how it works" daughter was tube-fed for nine years and then learned to swallow enough to become oral. Now she eats everything. It was actually no big deal to make all her food and tube-feed her, and actually quite convenient at times! Here's a video you might enjoy of her taking over her tube feedings back in 2007, she had a few *interesting* techniques...

    Thanks for sharing!

  2. Haha @Lisa.W, I've done the 'chin thing' too! Cool video there, thanks.

  3. Hi!
    Lovely description, and I am so happy I have found your blog. I just thought it worth saying that we avoid the need for "the grip" by having luer lock extensions and syringes. Tom (my little boy) has a cool button thing, and the company (AMT) make luer lock extensions.... I no longer feed the bed either!