This is just a quick post to say that we did pass the clamping test. They take a large plastic syringe and try to pull anything they can up through the tube just to see how much comes up. They've always gotten something back in the past, even when we've passed the test, so I'm not sure what the threshold is. But this time they got absolutely nothing.
They had previously told Karen even though she couldn't have any food or water by mouth, lozenges were ok. So I brought in some Ricola - the original and the honey herb - but I also snuck a Lemonhead into the bag since Karen really likes those. She worked on that during the second half of the clamping trial. If something is going to get your digestion going it's one of those. I credit the Lemonhead with the overwhelmingness of our success.
Karen's now allowed to have clear liquids. So she's had water, tea, broth, some strange but delicious off brand jello, cranberry juice, and Italian ice. She hasn't even had a hint of nausea, which she's typically gotten in the past just as a hint that we need to slow down. Hopefully we start soft foods tomorrow morning. No one has given us a time frame, but in our past experience they will keep us until she has another bowel movement. Assuming she's empty now that means the new food is working it's way through just fine. We hope to be heading home by at least Sunday.
Friday, January 13, 2017
Clamping Trial
Karen started to get real hungry last night around 1am. To her this meant her body was ready to eat again, and she wanted to be proactive about it. They have to unhook you temporarily from the suction if you want to go for a walk, sit in a chair outside of your hospital bed, or go to the bathroom. So after they clamped Karen for a bathroom break we went walking around for a while and came back to the room to rest in a chair, and then started the cycle over. Karen managed to stay unclamped for about two and half hours before she felt exhausted enough to get back into bed. A clamping trial is usually 3 hours, so she was ready with this news when the doctors came in to see us. They were happy, but told us we should still consider having a PEG tube inserted through Karen's neck for future occurances. Karen said, "not this time" and they agreed to a formal clamping trial.
They ordered an extended clamping trial, which is 6 hours long. We have only done this once before after a false start earlier in the year after her ostomy reversal, which was very traumatic on her intestines. Since the nurse had only reconnected Karen for a couple minutes before the doctors came around she decided to quickly disconnect Karen from the suction and count the earlier time towards the trial. So if everything goes well we'll be on clear liquids in a few hours. We're pretty confident it'll happen.
They ordered an extended clamping trial, which is 6 hours long. We have only done this once before after a false start earlier in the year after her ostomy reversal, which was very traumatic on her intestines. Since the nurse had only reconnected Karen for a couple minutes before the doctors came around she decided to quickly disconnect Karen from the suction and count the earlier time towards the trial. So if everything goes well we'll be on clear liquids in a few hours. We're pretty confident it'll happen.
You Little Piece of...
Karen passed a very small amount of stool earlier. In the past this has been enough to get us on a clamping trial. That's where they clamp your NG tube and see if you get nauseous. If you do, then it's due to the pressure of your own digestive fluids building up again and this tells them things still aren't moving like they should be. This time it's not enough. It was suggested a clamping trial could still be a day or two off.
Our favorite doctor, the one who did the original surgery and watched over us in the hospital in the past, wasn't able to take us on this time for one reason or another. He did stop by "just socially" to say hi and offer some words of encouragement, which means a lot coming from him because he's one of the few doctors that's always given it to us straight and has never been one to dance around bad news. We have a different doctor who has taken the lead in Karen's care this time. So perhaps this doctor is just more conservative in her treatment of bowel obstructions compared to him.
The only other thing that comes to mind is the output from the NG tube. The output they are getting seems to be more than I remember in the past. There's no shortage of doctors around and I've asked what output volume would be a healthy amount, but no one seems to have a set amount. They just seem to be expecting "less." And the output doesn't seem to have changed much since the previous day. I'm not sure if the depth of tube placement matters in the amount of output, or if certain locations are more likely to catch more of her digestive/gastric fluids even when things are moving. But that is a possible issue.
Since this was a mid to high grade blockage maybe there's just more progress that needs to be made before the clamping trial. I'm just not sure how they are gauging progress. I'm a little surprised they haven't used more imaging to check on the obstruction. I guess we'll just have to wait and see what tomorrow brings.
Our favorite doctor, the one who did the original surgery and watched over us in the hospital in the past, wasn't able to take us on this time for one reason or another. He did stop by "just socially" to say hi and offer some words of encouragement, which means a lot coming from him because he's one of the few doctors that's always given it to us straight and has never been one to dance around bad news. We have a different doctor who has taken the lead in Karen's care this time. So perhaps this doctor is just more conservative in her treatment of bowel obstructions compared to him.
The only other thing that comes to mind is the output from the NG tube. The output they are getting seems to be more than I remember in the past. There's no shortage of doctors around and I've asked what output volume would be a healthy amount, but no one seems to have a set amount. They just seem to be expecting "less." And the output doesn't seem to have changed much since the previous day. I'm not sure if the depth of tube placement matters in the amount of output, or if certain locations are more likely to catch more of her digestive/gastric fluids even when things are moving. But that is a possible issue.
Since this was a mid to high grade blockage maybe there's just more progress that needs to be made before the clamping trial. I'm just not sure how they are gauging progress. I'm a little surprised they haven't used more imaging to check on the obstruction. I guess we'll just have to wait and see what tomorrow brings.
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