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Wednesday, July 27, 2011

Clogged Peg Tube, ER & Hot Coffee

On Monday, after I posted on my blog, I went to prepare Bob's morning meds. I crushed his pills and dissolved them in water and then, the first thing you do before giving him his meds is flush his feeding tube with water. So, I've got the syringe full of water in his peg tube and lo and behold, nothing happens. The tube is clogged. First, I check the clamp, because sometimes his clamp sticks, but it's not the clamp. Then I get another syringe, because weird as it seems, syringes do wear out and get stuck, but a new syringe doesn't work either. So I get out the Coca Cola, which is trick shown to me by one of the nurses in the hospital. Coca Cola never fails to unclog Bob's tube, at least it never failed before, but this time the Coke gets part way down the tube and then back blows--causing the second port on his tube to blow open and I end up with a face full of soda. So, then I massage the tube, trying to squeeze out whatever is clogging it and try again and end up with another face full of Coke. I try this three more times and by then, I am drenched and the bed is drenched and poor Bob is drenched with soda. So I figure we need an expert and maybe a tube replacement, so I get Bob dressed and in the wheelchair and off we go to the emergency ward.

We get to the hospital and there's only one other person in the ER waiting room, so I'm thinking it shouldn't take too long to see a doctor. As we wait, three other people come in, two of which I overhear their ailments (a guy with a spider bite he's had since last Thursday and a woman who was having break-through menstrual bleeding for over a month) and everyone is called in before Bob. And I ask the receptionist when Bob will get to see the doctor, and she tells me they take in patients based on triage--so the more serious cases get in first. So we sit. For two hours. Then, we finally get into a room. Where we sit for another hour and 45 minutes before a doctor comes in.

I don't know what's with doctors these days, but it seems darn hard to find a doctor with compassion. Of all the countless doctors that Bob has seen, I can count the compassionate ones on one hand. This one's no different. The first thing she does is tell me that I should have not brought Bob to emergency, that a clogged tube is not an emergency and I should have made an appointment to see his regular doctor about this because I am wasting her precious time. And I'm thinking that Bob's regular doctor is only in on Tuesday and Thursday afternoons and there's no way in hell I was going to let him go 24 hours or more with no food, water or medications and I tell her as much, but she huffs off and says the nurse will take care this because she doesn't have the time....

So the nurse comes in (she's OK, she's cool) and asks if I've tried Coca Cola? And if I've massaged his tube? And did I check the clamp? (Yes to all of those.) She's not sure what to do other than that, so goes to consult "an expert".  She comes back and asks if I've tried hot coffee? Hot coffee? Never thought of that one. So, she goes and gets a cup of hot coffee and a syringe. She syringes the hot coffee into Bob's tube and it blows back in her face. I nearly laugh out loud because it's the same thing that happened to me, but at least Coke is isn't hot. So, then she tries pouring the coffee directly into the tube and actually manages to get a bit in there and caps it off and says, "let's let it sit for awhile."

And do you know? That actually worked. Learn something new every day. Although it took three tries, then the coffee got cold so the nurse tried just hot water. She massaged the tube and the end cap came right off at which she said oh shit, then laughed because she thought she broke the thing but realized it does indeed come off (which I didn't know either). We finally got home around 3:00 p.m. but Bob's tube is clear now and I learned a few new tricks, although it was a rather expensive way to learn.

But I still don't understand why a five-day-old spider bite and a messed up menstrual cycle are "emergencies" and a clogged peg tube is not. I suppose I should've taken him to a Walk-In Clinic instead, but that would've meant a trip in the car (wheelchair transport requires a 24-hour advance reservation) and that's difficult enough without Bob being in pain without his morning medications and the hospital is only three blocks away and we walked there. On our way out of the ER, the nurse gave us discharge papers which informed me to "come back to our facility if tube clogs again" and here I thought I wasn't supposed to bring him there....

On a better note, Bob was much more motivated yesterday and I managed to get him up and walk the rail six times. Pretty soon, I'll have this at-home therapy thing figured out. Although I still have a couple pieces of furniture to move out of the way.....

3 comments:

barbpolan said...

I'm glad you have another trick in your home-health-care arsenal. Watch out for that hot coffee, though.

Nikki said...

Geez, makes me think of the time I was waiting in Urgent Care or something and I thought because I was visibly in pain and was moaning a bit even that I'd get in sooner but nope. I have no idea how triage /actually/ works, but I'm convinced it's not that the worst gets in first. At least you got a useful tip outta that!

Anonymous said...

Im a new nurse and recently an older nurse taught me about the coffee trick!! I spent 3 hours off and on trying to unclog this tube! It's helpful to intermittently flush the tube with cranberry juice throughout the day to keep it clear...granted he isn't diabetic. There are also prescription strength enzymes u can purchase that are effective and marketed for clogged pegs... I commend you for taking care of your husband... We all can only hope we end up with someone who loves us that deeply. God bless you