photo comparison of mic-key versus mini one button

[rose]

Hi, I changed out my peg tube yesterday, and, if you're curious as to how the MIC-KEY and AMT Mini One compare with each other, before I put the new peg in, I took a few photos of it alongside the other model button.

When my long dangler tube was first switched out to a low profile type peg, my doctor put in the AMT Mini. This was right before AMT introduced the Mini One. The type I got then, is now called the "Mini Classic" (AMT stands for Applied Medical Technology).

The best known type of button (peg) is the MIC-KEY, originally manufactured by Kimberly Clark. Kimberly Clark is now Halyard.

After almost 17 months, that first button needed replaced, and what was available in my size at that time in that particular hospital radiology department was a MIC-KEY button, so that was what I got. In retrospect, the AMT button lasted a heck of a lot longer than any of the MIC-KEYs did.

From there on out, with one exception. I've had all MIC-KEY buttons, just due to availability, as I opted to change them out at home, rather than having my doctor do it at a hospital.

I also had a Corflo cuBBy, that I loved, as it is much more stable, and got rid of the problems I'd had with overgranulation tissue (but that is not what this post is about).

The AMT Mini classic is not compatible with feeding extension sets for the MIC-KEY button, but, the Mini One is. However, I found you really have to push, to get the Mic-key extension set to go into the Mini One.

So, when I found that the balloon on my MIC-KEY (placed about five months ago) was starting to fail, I decided to try the AMT brand again, and got the Mini One, which can use the same feeding extension sets as I already had in my possession.

Before I did the switch, I took some photos of the new guy before I put it in. The other peg in the photos is exactly like the peg I was removing. It was just an old one I'd hung onto.

I'm adding the link to my blog, but not sure if it will show up, as the rules may have changed since I was active here.

If the link does not appear, you can go to tubechic . com (no spaces) and click on the MIC-KEY versus Mini One tab.
Mic-key versus Mini One size comparison | Tube Chic

Have a great day everyone!

 

[pittsburghgal]

My PALS has a MIC-KEY placed last Oct. How do you know when this needs to be replaced?

He is starting to have leakage of a small amount of the Jevity liquid from around the base of the tube after feedings. This is causing the skin to become very red adjacent to the button on the skin. I am cleaning and drying the area twice a day and changing the gauze. I applied Bacitracin ointment to the red skin for 10 days with no real improvement and then switched to antifungal ointment for the past week with minor improvement. Does the MIC-KEY need to be replaced?

Sharon

 

[rose]

Sharon, Mic-keys have a life span of less than a year. Usually about six months.

Have you checked the water in the balloon? If it is losing water, there will be leakage. To check the fill, you insert a small 5 ml syringe into the end of balloon port, and draw out the contents. He most likely started out with 5ml fill, (and you can find out from whoever handled his feeding tube placement. Even without an actual leak, the balloons tend to lose volume over time. So, if its low, top it off, and check it again in day or so. If its empty, the balloon has busted.

If he has lost weight, that could also be a factor.

The short answer is that there should be no stomach contents coming out around the tube onto the skin.

Stomahesive powder can help keep leakage from reaching his skin until you can get a replacement. There are several brands out on the market, most pharmacies would have at least one brand to try. The powder turns into a gel when liquid comes in contact with it, and that is how the skin is protected.

I hope this helps answer your question.

 

[bkite]

I had a MIC-KEY implanted one year ago and have needed it replaced three times .This due to balloon failure and on one Occasion I looked down and found the MIC-KEY laying on my lap. Is there actually formula leaking, or is it inflammatory exudate? Regardless, it is no big deal to replace it. You are fortunate to have received this much use from the current one.

 

[affected]

Rose, this is a little aside, but it's the very reason we chose a BARD instead of mic-key. We knew my Chris was rapid progression and so we wouldn't need to replace.

It was inserted in the January, and as it happened he was gone by the end of that April, but in January all we knew was he wasn't likely to last another full year, so it was one less thing. I am so glad as his last month or so was very rough and if his peg had fallen out and it had meant yet another race to a hospital (they don't give us spare ones for at home) it would have been really awful for him.

Have you had any experience with the BARD? It's pretty much the same but with a plate at the back which is easily collapsed with a tool so changing it is no harder. It just doesn't have the issue of a balloon that degrades. They do still change them as they still deteriorate of course being immersed in acid, but I think they last more like 12 - 18 months.

Thanks for your site, it's wonderful!

 

[rose]

Tillie, I'm very sorry for your loss, and appreciate that you still give of your time here. It surely is appreciated by many!

I've wondered about the Bard button, I see references to it frequently - just recently in fact - but never pursued as it does not have a balloon, and anesthesia is a very bad idea for me. It looks like it has a nice flat profile (i.e. lightweight so not as much pulling and stress where it enters the body) I will ask my doctor about it.

 

[vw-fl]

Hi Rose.

One of the reasons DH chose the MicKey is because we can change it at home. Insurance covers it and sends it to our home. It's also nice to have a spare on hand just in case, especially if you do any traveling.

Unfortunately, to the best of our knowledge, the Bard still has to be changed by the doctor, usually in the hospital. Like you, anesthesia poses major risks for DH (whether it be general or twilight).

So far (knock on wood) he hasn't experienced any problems with his balloons failing. He says if he starts having any problems that he'll most likely go to the mini one.

Thanks for posting all your updates and answering questions.

vw

 

[affected]

I can only talk of course as to how things would be done here in my local area of Australia.

The BARD here could have been changed in the rooms of the gastroenterologist without anaesthetic as that plate does just collapse with a little tool.

It was very low profile indeed.

Thank you Rose, I draw a lot of comfort for myself by continuing to support others

 

[rose]

Thank you for all of your replies. My insurance is original Medicare, and it only covers the cost of the peg if it is placed by my doctor (who is not that closeby)

I tried, and failed, to find a a local, or online supplier that could use the prescription I had for replacements, and only charge me the 20% copay. Therefore, my choices have been to pay out of pocket, or make the drive, going through the whole hospital rigamarole, to have my doctor change it out.

If I used commercial formula, Medicare would cover my supplies, but, I don't, so they don't.

It is helpful to know the Bard has to be changed by doctor, I'm tucking that away for future reference :wink:

I wanted to note (already mentioned in the starting post of this thread) that my first button type peg was the AMT mini (called the classic now, but I think it is the same size as mini one) It was placed earlier than originally planned, due to the huge amount of overgranulation I was having with the long dangling tube.

At first it made a big difference, but the granulation came back. You can read about that saga on my blog.

In retrospect, now that I understand the importance of keeping the peg from all movement, especially during the initial healing process, as friction is frightful (I'm feeling poetic this morning ha ha), and, if I'd been aware of Hy tape, I would have been completely rid of the overgranulation back then, instead of a few years later.

I placed the new mini one a few days ago, and I continue to marvel at how much more lightweight it is! (and I'm not taping it so far either) Seeing as weight is a big factor in how much incidental trauma/friction the stoma is subjected to, just like changing from the dangler to low profile caused an improvement, the weight of the mini one versus the weight of mic-key is measurable. Previously I kind of thought that a button is a button, but, now I feel maybe there's more to it than that.

The "footprint" is less too, and that means less skin covered up by something that doesn't allow air under it.

I'd forgotten how much smaller the mini was than the mic-key. Probably if my first button had been the mic-key, and the next the mini, the contrast between the two would have made more of an impression on me.

Late last winter, when I tried getting the corflo cuBBy as a replacement for the mic-key that I had at the time, THAT was when the overgranulation finally took a hike, and, I made the connection that it was because that cuBBy just does not move :idea: It stands up on little "feet" that keep it very stable. But, I had problems with availability, and went back to the mic-key when that button's antireflux valve failed.

The cuBBy is kind of bulky, and definitely heavier than either the mic-key or mini one, but the feet keep the weight off of the stoma. I did find it more difficult to clean under. The extension sets are not interchangeable with other buttons either.

I'm really loving my new AMT mini one!

 

[affected]

Rose you should check about the BARD where you are and changing it.

Here in Australia they don't give PALS a mic-key to change at home either.

Our doctor did what is called bulk-billing which meant it did not cost us anything to see him as our health system is very different.

By the same token as our peg was placed and changed in the public hospital system there was no charge for that being done.

The skill of the surgeon can be equally important.
When the original tube was first replace he was given a mic-key by mistake. Our surgeon was on holidays and we had a really bad-tempered rough surgeon who was running late.

We had no end of granulation, pain and even spasming of the stoma.

After 6 weeks our original surgeon put in the BARD and ALL issues ceased!

 

[rose]

I will! I've been Googling images of it, and it certainly does look light and thin, I've read before that the spasms, (stomach sucking in and popping back up) are more prevalent with balloon type devices. I had the non balloon, dangler tube for such a short while, I don't remember if it happened with it or not. But I did/do with all of the balloon buttons I've had. For entertainment, I can lay there in the morning and watch my stomach get this deep dimple as the button slowly moves down inward, and then... pop! it punches back up again. When I had the granulation problems, this was painful. Does not hurt now, but would just as soon it didn't happen.

Since switching back to the AMT mini one, I'm not having to tape to secure or anything. I'm totally granulation free, have zero secretions, and am convinced it is the weight factor more than anything else that causes friction. Obviously the long tube weighs the most, and exerts more movement within the stoma, but the Mic-Key is measurably heavier than the AMT, and it looks like to me, that the Bard is even more lightweight than the AMT. Having no balloon port takes away a lot of bulk and weight.