What is a g-tube?
A gastric feeding tube, or “g-tube” is the type of feeding tube that Henry currently has. It was inserted February 14, 2011 and replaced the nasal-gastric tube (ng-tube) he had prior (an ng-tube is a more temporary feeding tube that is inserted in the nose and goes down the throat and into the stomach). There are many brands of g-tubes available and Henry has a mic-key. It is a low-profile device, meaning it sits close to his tummy and doesn’t have any long tubes sticking out. Here is a photo of Henry’s g-tube, taken about a month after it was first inserted.
The g-tube is considered a permanent feeding tube, meaning it is surgically inserted under general anesthetic. It is done laparoscopically, so there is only a small scar near his belly button. It can be removed at any time and the wound heals quickly. During the surgery, the stomach is physically moved and stitched to the side of the abdomen wall. This tube is changed every 3 months, and Shawn & I can do it at home.
Henry’s g-tube stays in because of a small water-filled balloon that is on the inside. Here is a diagram of what the g-tube looks like when it’s not inside:
As you can see, the part that you can see in the first photo is only the very top of the “button”. This is attached to small tube that goes inside Henry’s tummy. At the end of this tube is a small balloon filled with 5ml of water (the amount of water depends on the size of tube, which depends on how big the person is). This balloon prevents the tube from falling out. It is semi-porous, so Shawn & I check the amount of water in it every week or so, to ensure it is still full.
We specifically wanted a mic-key brand of g-tube as it is the smallest and less invasive in daily activities. Some other styles have long tubes (like a catheter tube) that stick out. From my understanding, the style of tube you get is largely at the discretion of the surgeon, at least at BC Children’s Hospital. Henry’s mic-key allows him to participate in all his usual activities… swimming, crawling…playing… anything that any other 18 month old would do. If he falls really hard on his tummy we check to make sure it’s ok, but thankfully so far we’ve had no concerns.
If his tube were to ever fall out, it’s no big deal as long as we’re close by and notice right away. If it comes out, and we have a replacement mic-key kit with us, then we’d simply put a new one in. If we don’t have a replacement, then we can insert a catheter tube (we carry some in our diaper bag, just in case). Then put a g-tube when we get home. The problem arises if his tube comes out and we’re not there, or if we don’t notice (like at night). The body heals tremendously fast, and the hole into his tummy would begin to heal immediately. Within a couple of hours, it would have shrunk so much that his regular g-tube would no longer fit. For this scenario, we have smaller sized catheter tubes that we would use. Then off to the hospital we go… they would likely be able to manipulate the hole enough to get the g-tube in. If – worst case scenario – his tube falls out and we don’t notice for many hours, then the hole would like heal over. For example, if his tube fell out at midnight, by morning the hole would be closed. Then he’d have to have surgery again to reopen it – no one’s idea of a good time :(.
When it’s time for Henry to eat, we fill his extension tube with water (see above diagram for pictures of the extension tubes). We put water in it to limit the air going into Henry’s tummy. There are two extensions – a larger one for thicker fluids and a skinner one. This is then attached to the mic-key “button”. Then we “flush” his tube with more water – currently 15 ml water before and after he eats – to help prevent the tube getting clogged with dried food (I’ve clogged his tube twice already!). Then the extension tube is attached to his feeding bag. We use a feeding pump with Henry as it delivers his food at a slow, steady pace which he seems to tolerate better. You can also use a syringe (usually 60ml) to push the food into the tube. I’ve tried this before with limited success.
Henry will likely have his g-tube for quite some time and we are coming to accept this. It’s not what we envisioned our lives would be like, but that’s ok. It’s where we are now, and that’s what matters. :).
Alot of the information contained here can be found in the Tube Feeding At Home manual, from BC Children’s Hospital.