Feeding Tube

[Cherise77]

My Dad is scheduled for his feeding tube on January 12. He is very nervous and is thinking of not getting it.
His breathing is 48% when he’s standing and 20% when he’s laying down. He can’t lay down flat without his biPap but he doesn’t use it in the day time only for sleep.

Because of his low breathing scores he thinks that being intubated for surgery could result in his lungs becoming worse after.

Is this true? Does anyone have experience getting a feeding tube with lower FVC?

Thank you.

 

[Nikki J]

He shouldn’t be intubated for this. The usual procedure is a rig ( radiology) and he should be able to have his bipap during the procedure But a PEG shouldn’t be general either
they like to have feeding tube done by about 50 svc but plenty of people had lower. My sister was more like 25% I think ( she refused to tell me her numbers)

 

[affected]

Definitely this should be a RIG procedure to put the tube in and he can be on his bipap while they do the procedure.

 

[Mary2]

The anesthesiologist insisted on having the right to intubate my PALS for the procedure which was done PEG. My husband tried to resist this but it was pretty apparent the anesthesiologist wasn't going to do the procedure without having permission to do so if he needed to. We are a couple of hours out from Atlanta. I am sure if we had gone to Atlanta the procedure would have been different.

 

[Nikki J]

Mary that sounds like he wanted consent to intubate if things went unexpectedly wrong not that it was part of the plan. Was he intubated? My sister was not in spite of horrible breathing going in

it used to be common in hospitals that anyone having surgery had to be a full code during the procedure. they could have their dnr reinstated after. This sounds like the anesthesiologist was essentially saying this

 

[affected]

It sounds like 'if he needed to' means if something went wrong.
A PEG is inserted endoscopically, which means a scope goes into the mouth and down into the stomach.
They can't be intubated for the anaesthetic as well.
It isn't a full anaesthetic that is required either, it is more like what is given for any endoscopic procedure.
A RIG is done radiographically which is why the PALS can wear their bipap mask.

 

[Mary2]

You know I haven't any idea whether he was intubated or not. My husband was so sensitive about the subject, I dared not raise the subject again. He was back real quick though..30 minutes or 40 minutes maybe. And he was alert and awake and never had any pain or complaints from the procedure.

 

[affected]

Sounds like a RIG Mary. If he was awake he was not intubated in any way.

 

[MupstateNY]

Maybe this thing they call "twilight sedation"? (Wild guess.)

If I have a feeding tube put in with PEG, will I be aware of the tube going down my throat? I haven't had my resp capacity or whatever you call it measured yet, but I will in early Jan. I think it's well above 50% though. I do breathe more often now but breathing is kind of the least of my problems.

 

[lgelb]

The idea with a RIG for a PALS is as little/brief sedation as possible. What that consists of depends on the procedure and the patient. In most cases, you are a little sleepy but not knocked out.

As mentioned, a PEG is usually not recommended ahead of the RIG for ALS unless someone has certain GI issues.

The actual tube is placed in the stomach from the outside. The tube down the throat (after the throat is numbed by a spray) is for inflating the stomach with air beforehand to make the area easier to see. If you had a PEG, the tube down your throat would be to see inside the stomach (endoscopy).

 

[affected]

My Chris had it inserted via PEG and he was sedated enough that he did not feel a thing and was still lightly sleeping when they brought him out of the procedure room to me. Back in 2014, in Australia, RIG was not an option. It is widely used for PALS now.

 

[Tomswife]

As described in my other thread. TOM had his Peg done "inside out". We met with the surgeon and anesthesiologist b4 and they were confident and upbeat. The procedure went very well. He was able to walk an hour later. It was a very good decision and it has enabled us to keep him hydrated. I do all of the PEG care. It was easy to learn. He still eats by mouth.
I was nervous, but no one else was.

 

[lisa g]

I too had my peg done from the inside out.I was given twilight anesthesia and the procedure took about 20 minutes. I was fully alert afterwards and went home. The procedure sounds scarier then it actually is. No need to stress over it.

 

[Bestfriends14]

I wonder if a feeding tube can be placed with an FVC of high single digits to low double digits? Wayne doesn't have one, and a couple of pulmonologists have said it's too risky now

 

[affected]

Bestfriends it can, it is placed via RIG rather than PEG (which is done from the inside out).
However, sometimes a PEG is needed because of structural issues. You could discuss this as soon as you get back home so you can present the options to Wayne.