Tuesday, May 3, 2011

Estelle had some trouble with her feeding tube yesterday and spent the day trying to get an opening at the hospital for replacement. Unfortunately they could not fit her into the schedule so it had to wait until today.

I went to Woodbine this morning and waited for the ambulance to come and then accompanied her to the cardiovascular/GI lab around noon. Once there she was quite agitated. She does not like ambulance trips at all and this one was no exception. The hospital is less than 5 minutes away but it's still an ordeal to get moved from bed to stretcher, stretcher to bed, bed to stretcher, stretcher to bed and I think she knows it.

Once we got signed in (which was an obnoxious ordeal) she was treated promptly and very, very nicely. There was a Physician's Assistant and a fleuroscopy RN with us at all times. They examined her carefully and kindly and found that the small silicone disc which holds the tube flush against the skin was no longer in place, thus causing stomach acid and feeding material to leak back out from underneath of it. The circular disc sits around the tubing and it keeps riding up and away from the skin which allows stomach contents to bubble out of the stoma itself and spill onto the surrounding skin. They put two stitches into it - stitching the tubing to the disc which will prevent the disc from riding up. They also deflated the ballon which is inside of the stomach and re-inflated it with two additional cc's of sterile water in the hopes that it will hold the inner workings in place, as well.

They flushed it several times without any leakage, cleaned the area carefully, medicated the irritated skin and gave me written and verbal care instructions to take back to the nursing home.

Because the tube has been leaking virtually since Day 1 both nursing homes were keeping heavy gauze pads around the entire site in an attempt to collect the drainage and keep it from dripping - the dressing worked wonderful for that, but it also kept the skin underneath the dressing constantly moist and irritated. Now that it's not leaking at all we are hoping that applying an antibiotic salve and leaving it open to the air will heal it quickly.

Estelle does not verbally complain of pain in the area but we've noticed that she does constantly pick in the general vicinity and occasionally becomes agitated and pushs at the tube site quite vigerously. We are assuming it is painful for her and we are praying that this helps heal the area.

She was awake for most of the trip and the procedure. She was talking fairly often but, unfortunately, her speech was totally unintelligible at all times today.

I went back to Woodbine with her and stayed until she fell asleep. I'm sure she was exhausted from all of the moving and from the procedure itself so I hope she sleeps peacefully for the rest of the day and the night. She was quite dry from not having any fluids in over 24 hours and they were starting her feeding when I left. That should help perk her up, too.

Hope all is well with everyone else. We think of all of you often.