Thanks to Joan for the reminder to keep the humor happening and to Tony for the nudge to actually note tips (!). They may be in somewhat random order, but here goes.
Here's a start:
PEG TUBE INFO AND TIPS (Part 1)
~For PEG tube (or "G-tube") care, hydrogen peroxide on gauze pads works very nicely for daily cleaning around the stoma site. (Best after a shower.)
~Just after having the tube inserted, it's not unusual to have a bit of drainage as your body adjusts to having the tube. After Stephen had a PEG tube inserted (just before beginning chemo and radiation), we didn't receive much instruction at the hospital, and we were worried about the healing, taking a shower too soon, etc. We were fortunate to have quick access to advice from a doctor (my dad, a retired surgeon) who assured us that it's almost impossible to screw it up.
~When using a 60ml syringe for taking medications through the tube that are more granular in consistency and which can be taken with food (such as sulfasalazine, for colon issues) it works best to have a thicker liquid in which to suspend the medication. Otherwise, the tube can get blocked unexpectedly, causing explosive spillage and possibly creating interesting designs of food-sprays on the wall, or surprisingly very far across the room. We finally learned to laugh at these occurrences, but it's preferable to avoid the clean-up. (Especially with sulfasalazine, which becomes a stubborn bright orange sand after being crushed.)
~When crushing medications, hold crusher with fingers while turning crusher rather than holding in the palm of one hand and turning with fingers of only one hand. This can result in an sensitivity to pressure on the palm opposite the first knuckle, I believe due to a displacement of a tendon. (As the assistant pill-crusher for Stephen, I ran into this problem in my left hadd, which was alarming to me as a musician, since that part of my hand presses against my bassoon as I play. After adjusting my pill-crushing technique, the injury gradually healed itself over the course of a couple of months.)
~If you have a long PEG tube, the NexCare sensitive-skin tape is worth the higher price for less irritation of the skin in taping up the extra tubing so it doesn't hang down. If you hold the tubing to the side of the stoma (leaving a bit of a loop so as not to pull at the base of it), and place two pieces of tape in an X just above the clamp, the end of the tube can be looped through and stays in place pretty well. (My husband liked wearing a t-shirt under his shirt to help keep a "tube bump" from showing.)
~The low-profile button tube is a wonderful change from the long PEG tube. (After a year and a half of the longer tube, Stephen had a mic-key button tube inserted several weeks ago during an EGD procedure.) We're making plans to go swimming. We've been advised by our doctor that there's no concern about the tube site being exposed to the pool water, but Stephen plans to wear a t-shirt to avoid stares (and, as he put it, to not freak out any kids!)
SWALLOWING ISSUES (Part 1)
~To help address swallowing problems, noted below is an exercise from Dr. Reza Shaker (Milwaukee College of Medicine) for the suprahyoid muscles (critical for swallowing) to strengthen them or to help keep them strong while going through treatment.
~Check with your doctor to see if the Shaker Exercise is appropriate for you. If you're just beginning treatment, find out from your doctor if you can start doing this exercise right away to help prevent swallowing problems later.
<Beginning of Shaker Exercise Info>
Dr. Reza Shaker (pronounced “shah-care”) developed the Shaker Exercise as an exercise to improve swallowing. It is specifically designed to exercise the muscles under the chin, or the suprahyoid muscles.
These muscles help to open the top of the esophagus, allowing food to pass completely downward through the esophagus, leaving no residue in the throat after the swallow.
This exercise is a simple two-step exercise, to be done three times per day for six weeks
• Lay flat on your back, on floor or bed.
[Per Dr. Shaker: “Tighten your teeth.”]
• Hold head up, looking at feet, for one minute. Relax for one minute
• Repeat this sequence two more times. Do not raise your shoulders while lifting head.
[Per Dr. Shaker: “The more your forehead is pushed toward your toes, the better.”]
• Remember, do not raise your shoulders while lifting your head.
• Raise your head thirty more times and look at your feet. Do not hold these head-lifts.
• Again, don’t raise your shoulders off the bed or floor, and remember to breathe.
Breathe normally while performing both steps of the Shaker Exercise.
Please perform the Shaker Exercise three times per day for the next six weeks.
For more information, contact:
Reza Shaker, M.D.
Chief, Gastroenterology & Hepatology
Medical College of Wisconsin at Froedtert Hospital
Video link available on Medical College of Wisconsin Web site :http://www.mcw.edu/display/docid26360.htm
(Click on “Shaker Exercise video” to view)
Approved by Dr. Shaker for distribution, 9/17/08
<End of Shaker Exercise Info>
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More to come in future installments...