Tube Troubles

The NG tube has continued to complicate things this visit. It's gotten increasingly difficult to get it to drain. At one point on Saturday, our nurse spent over an hour trying to get it going again before Karen asked for a break so she could do a couple laps around the hall. The nurse was able to get it going again after Karen's walk, which made us wonder if it was somehow positional. Once it was going it was good for the rest of the day, but that evening, it starting having trouble again. Everytime it gets blocked Karen feels the pressure starting to build up and eventually pain. The night time nurse wasn't as successful as the previous at getting it going again, and ending up going in and out of her room throughout the night, but without success.

Finally, in the early hours of the morning the nurses got together and decided the tube might not be in far enough and pushed it in another 5 cm. They also contacted the doctor to get an order for an X-ray to check the placement. Pushing the NG tube further was rough on Karen, but it seemed to get it going. The official X-ray review came back a half an hour later and stated there was "a bend in the nasogastric tube towards the fundus of the stomach" and suggested it "be retracted approximately 5 cm to relieve this bend." To Karen's great frustration, they pulled it back to where it was before. It continued to work for roughly another hour before stopping again. They decided they wanted to put in yet a bigger NG tube. It was Sunday morning by now and the nurse from the day before was back; they had given her the task of putting in the larger tube. Karen tearfully declared that that was it, and she was going home. The nurse quickly said, "You shouldn't make a decision after not sleeping." She turned off the lights and both her and her helper left ran out of the room. They were gone so quickly it was like something from a cartoon or bad movie. Finally, Karen slept.

Karen's been having trouble sleeping since she came in. We only recently realized the side effect of stopping of one of her meds, gabapentin, was difficulty sleeping - along with irritability and anxiety. They don't let you take any pills when you have the NG tube in, but they have a liquid form of gabapentin they can put down the NG tube. We just have to wait half an hour for it to absorb. We had only recently started back on it, so I think this finally let Karen sleep restfully. You'd think they would have identified the meds you can't stop abruptly and make sure you get them. If I hadn't thought about it, she would just gone without. They go over all your meds when you're admitted into the hospital, so I'm not sure why there isn't some automated process to flag meds such as these.

Before we had gone into the hospital we had run across an article that stated Coca-Cola helped resolve a particular kind of bowel obstruction caused by food. (Here's the article I ran across, and here's the actual paper.) Sometimes just thinking about something you can't have makes you want it. Karen asked me to bring a Coca-Cola Life in to put in her personal refrigerator, so she could have it once they put her on a liquid diet. She really wanted that coke and told me if I were to open it for myself, she might take a sip. But with the nurses going in and out messing with the tube all the time, I figured we'd only get in trouble when they saw the soda coming out of her stomach, through the NG tube, and into the collection canister.

Karen managed to sleep for roughly 4 hours, and was in a much better mood when she woke. Karen's frustrations had mostly been with the night nurses. She got along well with the day nurse. Occasionally her and Karen would just sit and talk. After Karen mentioned how badly she was looking forward to the Coca-Cola, the nurse let her have it. Even though anything you drink when the NG tube is on suction will come right back out, she could have gotten in a lot of trouble for this small act of kindness. It bubbled up through the NG tube and sat in the canister bubbling. The nurse replaced the collection canister with a new one, but coke colored fluid kept coming up. It had mixed with the other fluids in her stomach and seemed to just keep coming up through the NG tube. In fact, the tube started working perfectly. It worked for a good 24 hours. There was only one more blockage. This time the nurse had found the manual for the NG tube and made notes. She flushed the larger part of the tube with water and the blue pigtail tube with a specific amount of air. (This is what they look like.) And that was the last of the trouble with the NG tube.