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Thursday, June 26, 2014

Pump drama. To go along with our G tube drama.

We have had some feeding pump drama the past few weeks. It wasn't totally the pump's fault but the Reader's Digest version is that since we started using the new glow-in-the-dark extensions, we have had major issues with pump accuracy. This is the same thing that happened last summer/fall when one of the AMT reps that I had met at the Oley conference last summer sent us one of the GITD extensions to try out. Initially, the glow factor was cool and the kids and I were all a bit excited about it. Let's face it, glowing in the dark is about the most exciting thing that's ever happened to enteral feeding supplies. It wasn't long though before my love for the improved design of the medicine port far surpassed my excitement about the novelty of the glowing pieces. We had long since stopped using Y port extensions completely because the benefit of having a med port there was not worth the trouble of trying to keep it closed. After a few days of using it, I noticed that her pump was running longer than it should have been and was reading as if it had fed her anywhere from 200-400mls more than what I knew I had put in the pump. There were nights when it should have been empty at 2 or 3 in the morning and didn't beep until 7. At the time, I blamed it on our pump but still kind of wondered if that was the cause or not because we tried 2 different pumps and they both did it.

Fast forward to the past few weeks, and we FINALLY convinced our home health supplier to send us some of the new extensions. It's been SO nice to have a good, solid med port and I had started to get used to having a med port again when we started having problems with pump accuracy again. At first, it was the same thing that happened last summer where the feed wasn't ending until 2-3 hours after it should have, or the pump was beeping "DOSE DONE" but there was still formula left in the bag and shouldn't have been. Then what happened on Monday this week was the straw that broke the camel's back for me.

I had started her pump at about 9:00 that morning. Right now, she gets 2 continuous feeds of 625ml each at 75ml/hour, so she runs most of the day and then I unplug her for a couple hours in the late afternoon, and then start her again at dinner time. I normally start around 8 am but the pump had still been running until about 6, which it shouldn't have been, so I let her stay off for an extra hour just to make sure she was empty & comfortable. I turned everything on and sent her off on her way to play just like we do every day. At 4:45, I went to unplug her for swimming lessons and the pump bag was still very full. By that time of day, it should have been close to empty. It turned out that the extension tube was clamped and had been clamped for most of the day. Nobody knows how it got clamped, of course. But yeah, the pump ran all day long with the tube clamped and never beeped once to tell us there was a problem. THAT is a problem!! Especially when it's late June in AZ and 105+ outside!

On the positive side, I called the after-hours number for our supplier and they had a new pump out to us in about 2 hours, so that was great service. AND it's a brand spankin' new pump, which we've never had the pleasure of having before so that was nice too. It still had the protective film on the screen. The next day, I kept using the GITD Y port extension just to see if it would work normally with the new pump. Long story short, it did not. We still ended up WAY off that day. The next day I switched back to a right angle straight port extension like we usually use and everything went almost perfectly. Almost, but not quite.

We also realized that part of the problem is that for whatever reason, the formula has been settling really badly lately. I don't know if maybe it has to do with the weather being so hot and it being a little more difficult to keep the formula cold or what, but it is definitely part of the pump accuracy problem. If we don't shake the bag every so often, sediment settles down to the bottom of the bag and partially obstructs the opening into the tubing. It seems to prevent the pump from feeding at the programmed rate but must not create enough negative pressure to trigger the NO FLOW IN alarm like it should. It is a frustrating problem but hopefully now that we know the extensions don't seem to work well for us and that the bag has to be shaken a few times a day, we'll be able to avoid the problem.

4 comments:

  1. Except that when they change to all the new connectors, the will only have GITD. At least according to that AMT rep I was talking to. So I wonder what about the GITD would make this work so poorly??

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    1. My guess is that it has something to do with the diameter of the tubing. The glowing Y port extensions have a much smaller diameter tube than the right angle single ports that we normally use. The clamp isn't as tight on the glowing ones either so that may have been part of the reason why the pump was able to run for 7 hours with the extension clamped.

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  2. Last week, when we were in Az, the same thing happened to us! For some reason there was still formula in the bag after a feeding when there usually isn't! Interesting! But now back at home in Cali, the bag is empty after a feeding like it should be. Maybe it is the weather!? :)

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    Replies
    1. Weird!! I really think it has to have SOMETHING to do with the heat. It can't be a total coincidence that we were having this exact same problem almost exactly a year ago, right?

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