Emergent G-Tube Change

It is interesting how the same process taken to do something looks – feels – so different when the circumstances change.  Performing a routine g-tube placement and performing an “oh crap, I just accidentally yanked his tube out”  g-tube placement are incredibly different experiences.

For those who have followed our story all along (and seriously, if you haven’t started at the beginning and read all the way through, I think you ought to – our story is a good read), you know this is the second time the tube has been yanked out unexpectedly.  The first time it happened, it was literally the night after we had learned how to perform the placement that morning – so three months after it was surgically placed.  Annnnnd it happened with a sitter.  Needless to say, we ended up in the emergency room with the need to dilate – Worst. Thing. Ever.  It still ranks up there as one of the hardest experiences I’ve watched him go through.

Now, almost two years in, with several successful routine placements under my belt, I at least could approach the situation with far more confidence than I did the first time (when I basically stood back and let his dad attempt, called the home health nurse, went to ER).  So – here’s what happened, in a nutshell (And yes, it was 100% my fault).

Kiran was super sleepy in the car coming home from therapy this afternoon.  Since I gave him his water before we left Childserve, all I needed to do was his g-tube meal when we got home.  I opted to take it all outside on the deck (SUCH a great day!) and just feed him on my lap.  I forgot to take water outside with me, so when I finished with his snack, my intention was to go in and flush his extension and tube with water before putting him down for a nap.

However, once I got inside, my brain went into autopilot, and my focus shifted completely to putting him down for a nap.  I completely forgot his extension was in, completely forgot I hadn’t flushed it out yet, completely forgot that I have been a tubie mom for practically 2 1/2 years and I should not be a newbie at any of this….

So I went to put him in his crib with the extension still attached (This is exactly how it happened the first time, too, only the sitter knew the extension was still in; I wasn’t even being careful because my brain forgot).  Sure enough, the extension caught between me and the crib, and as I laid him down, I heard that dreaded POP!

I knew immediately.  I looked down and one of the things I have feared the most (silly, but true) was reality: There was the extension, his tubie pad, and the Mickey button with the balloon still full of water.  Ouch.

Kiran didn’t even fuss.  He kinda made a noise and rolled to his side when it happened.  Then, as I ran upstairs to grab my emergency tube kit (it lives in the diaper bag so it’s always with us), he started “talking” to me about it, but not in an upset way.  I took the water out of the balloon, lubed the tube up, and made my attempt.  It didn’t go in.

Fun fact I learned today: When the button pops out with the water still in the balloon (It takes some good force; it’s quite a bit bigger than the hole it comes out of), the stoma (the hole) immediately starts swelling.  I’m still kinda amazed Kiran didn’t fuss, because it hurts me thinking about it popping out like it did.  So.  It takes more force to push it back in (It is also why you have to get it done quickly or you end up dilating in the ER).

I learned something about how far I’ve come today.  I stopped, I took a deep breath, I gave myself a quick pep talk, and I tried again, applying more pressure even though I was completely panicked about the whole thing.

And it went back in.  And it didn’t hurt him – at least he gave no indication that it did.  And then I just hugged him.  Put him down for a nap without any additional drama.  And shook for the next hour.

That may be an exaggeration, but it is definitely not a fun experience.  I do feel it is one that will be repeated, only with Kiran as the culprit – He has been pulling and yanking at his tube so much lately, I’m surprised it was my fault the first (second – I don’t always count the first since it was with the sitter and I missed out on the oh crap moment) time this happened!

Still, another experience under my belt.  Now I fear it far less.

 

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