Tonight we changed Henry’s g-tube…
The brand of g-tube that Henry has is called a MIC-KEY Low Profile Gastrostomy Feeding Tube, manufactured by Kimberly-Clark. The “button” portion of the feeding tube needs be changed every 3 months, and this time I took photos as we did it (must mean we’re feeling more confident about changing it!). If you’d like some general information on what a g-tube is, start by clicking here first.
It is actually a very simple process and WAY easier than changing his old ng-tube. But having said this, we were still freaked out the first few times we had to insert a new button. Something about the gaping hole in my baby’s stomach and the stomach juices seeping out is just unnatural. This all sounds very melodramatic, and for me it still is at times, but in reality it is a relatively small hole and only a small amount of fluid may leak out.
To get started, here’s a photo of Henry’s tube:
Sorry for the hand in the way, it’s the only shot where he’s still enough that it is partially in focus! But it gives a good idea of where on his belly the tube is located.
Here’s some photos of the “tools” involved:
This is what the kit looks like that the g-tube comes in. Also included are two syringes (35ml & 12 ml), some gauze, one extension tube (which is what we use) and one bolus extension tube (used primarily for syringe feeding).
Also required is a glass of water and some water-based lubricant.
Each kits also contains a full instruction manual, which – even with all our training at the hospital – was very helpful at the beginning. The manual can also be found online here.
Here’s a photo of the g-tube, prior to being inserted into Henry’s tummy. I know it’s hard to see – I chose the wrong background… but the next one’s are easier. Henry’s tube is a 1.5 cm, number 14 french (that’s the size). As he grows, so will the size of his tube.
Once all the supplies are ready, the next step is to “test” the balloon. The button is held inside Henry’s tummy by a small balloon containing 5 ml of water (as he grows, so will the size of the balloon). This balloon needs to be tested to ensure there are no small leaks in it. We’ve had one tube fall out already – after only being in for 2 weeks – and it was because of a very small pin-point hole in the balloon, so we definitely know the importance of testing!
Here you can see the small syringe inserted into the balloon port of the tube, and the balloon inflated with 5 ml of water. This is exactly how it will look once inside Henry – the balloon is inside his tummy and the rest is outside and can be seen.
This next step is to remove Henry’s current button. To do this, the same syringe is used to remove the water that is inflating the balloon. While the balloon is supposed to have 5 ml in it, it is also slightly porous so water slowly seeps out into Henry’s tummy. This isn’t a big deal, and we check the amount of water in his balloon weekly.
It can pull a little on the way out, but with a little twist the tube comes out easily.
It’s at this point that Henry becomes our little octopus boy, and Shawn’s main task is to keep him lying down – no small feat! It doesn’t hurt to do any of this… slightly uncomfortable when the tube is actually pulled out… Henry just hates being forced to lay down (well actually… he hates being forced to do anything… he certainly has his mama’s stubbornness!).
Here is a photo of Henry’s tummy with the button removed. This is the part that still kind of freaks me out (and it’s ok if it freaks you out a bit too). It doesn’t look bad at all… it’s just a small hole and it’s always slightly red around the edges. The redness is perfectly normal, and Henry’s stoma (that’s the fancy name for the hole) looks better than others we’ve seen. The redness is just because it gets bumped and pulled throughout the day as Henry moves and plays. If he doesn’t have a bath one night, it gets some build up of dried fluid, but so far we’ve been really lucky.
The stoma can get very inflamed and start growing tissue – it’s the body’s natural reaction to the hole. When Henry’s tube was first put in, we had problems with that for about the first 3 month. But that is apparently quite common and it’s been really good ever since.
Here’s a photo of the tube we removed from Henry’s tummy. When compared with the earlier photos, you can see that over the 3 month period it gets quite discoloured. This is normal and is due to all the foods and stomach acids inside Henry’s tummy.
And finally, here’s a photo with the tube inserted. A little bit of water-based lubricant on the end that goes into his tummy and it slips in easily. Fill the balloon with 5 ml water, give it a pull to ensure it’s snug and we’re done. Henry’s trying his darndest to get up… it’s bath time and he wants outta here!
I hope this overview of changing Henry’s tube is helpful as I know it’s not something most people are familiar with. If you have any questions, please do not hesitate to ask!
For more information about the mic-key feeding tube, to read stories of other users, or general information about Enteral Feeding, check out the Kimberly-Clark website… it really is quite good.