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Monday, June 20, 2011

Trying something new

One of the things that I have always hated about the feeding tube is having to use tape on Raya's skin. I was glad when we moved from the NG tube to the G tube because we didn't have to put adhesives on her poor little cheeks anymore. The skin on her stomach isn't as sensitive to the adhesives as her face was but it still gets sore. I don't know how other people do it, but we tape the extension tubes down really well so the tube doesn't accidentally get pulled out of her stomach. This is how we normally do it (including her crying:)
The top tube is the G port (connected to the drainage bag) and the bottom tube is the J port (connected to the feeding pump). We use 2" wide Hypafix tape, which is a fabric tape that holds pretty well but is still fairly gentle on the skin. It's the best solution we've found so far but still not without flaws. It starts to tear out around the extension tubes and since it does hold pretty strongly, we don't take the extension tubes off when they're not in use. Like, ever. So the valves in the GJ tube wear out faster than they should and I would venture to say that I probably don't clean them as thoroughly as they should be cleaned. I've been looking for something that I could use to attach the tubes to her stomach securely but also detach the tubes when they're not in use without having to rip the tape off every time. Enter the Hollister Tube Attachment Device:
The white ring around the outside is a paper adhesive and the inside is a thick soft adhesive like the Duoderm that we used to use on her cheeks with the NG tube. There's a slit cut in it for if you're using it for something like a chest tube so that the tube can come up through the slit. The long tab sticking out to the right is a zip-tie that goes back through the plastic part on the left.
I went online to Hollister's website and ordered 2 samples. They were really quick and I got them in just over a week. To be perfectly honest, when I pulled it out of the package, my first thought was how big & bulky it seemed. (it's huge!) It sticks out almost as far as a mic-key button sticks out. Since the G extension is the one that tears through the tape more often (due to the drainage bag hanging from it), I decided to try it out on the G port first. I trimmed it down so it's about the same size as the piece of tape we usually use:

I probably could have trimmed it smaller and next time I will. To secure the tube, you clean the skin and let it dry and make sure you know exactly where you're going to put it. Take off the paper backing and smooth it into place. Then lay the extension tube across the plastic part, pull the zip-tie up around the tube, slide it through the opening, and zip it until it's tight a little bit snug but not compressing the tube. (not too tight or it will block the tube) We clipped off most of the extra zip tie so that it wouldn't be in the way, but we wanted to leave enough that we can unhook the tube when we want to. Here's what it looks like up close:

 This gives a little bit better picture of its size. Never mind the bile coming out of her stomach. :)

Speaking of bile, the port where the drainage bag plugs in to the extension tube broke off while she was sleeping this morning so at 5:30, she woke up crying because she was laying in a giant puddle of bile. It was gross.
Anyway, we will see how this Hollister device works out. I still have questions about how well this will work, but I like the concept so we'll give it a try. I'm hoping to try out a couple of other similar products from other companies too.

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