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Crohn's Disease Forum » Parents of Kids with IBD » NG Tube insertion questions


04-09-2013, 04:51 PM   #1
LJS
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NG Tube insertion questions

My son (9) will be taught how to insert his NG tube every day and remove it every morning on Friday.. any suggestions on how to prepare him ahead of time? There are many videos on YouTube but they look kind of scary to me..

thanks!
04-09-2013, 04:59 PM   #2
CarolinAlaska
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there is one particular video of a little girl who shows how to put it in very easily and matter of factly...made it look easy-peasy! I think the link is on the EEN thread on the therapy stickies at the top of the Parents of IBD section. Let him know that he can be in control and he can go as quickly or slowly as he needs. Tell him that if someone is trying to pressure him to hurry that he can tell them to back off. Tell him not to give up until he has got it down. It may take a few tries, but once he learns how, it's like riding a bicycle, he will get good at it. Don't be afraid of it - it's like eating a fat piece of spaghetti whole, only he's threading it down his nose instead of through his mouth. He may want to try swallowing a piece of spaghetti whole while holding one end in his fingers - it can be done. The nose part just helps him not to have to have something hanging out of his mouth all the time.
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J's story: http://apathnotchosen.blogspot.com
*J, 18, Crohn's diagnosis 1-2013 (age13), controlled with 6MP.
Osteoporosis, Scoliosis, EDS, Asthma, Lymphedema, Epilepsy, Hla B-27 positive, gluten intolerant, thrombophlebitis, c.diff, depression, anxiety postural tachycardia/POTS and multiple food allergies.
04-09-2013, 05:04 PM   #3
LJS
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thanks. I think I saw the video you are referring to, it's a 10 year old girl, just feeding it through very matter of factly..takes her just a few seconds..
04-09-2013, 06:54 PM   #4
Twiggy930
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My son had no problems learning to insert his NG tube and he was 10 years old at the time. My son is a pretty calm kid and he had bought into the whole EN treatment plan prior to starting, which I think helped. He also approached the whole thing with a bit of 10 year old boy goofiness and was a bit excited to learn how to do it so he could gross out his friends. I think that attitude really benefited him.

The GI nurses that did the teaching were excellent and had him do everything right from the start, with a lot of guidance of course. They explained everything and just walked him through it very calmly and they did not hurry him at all. I think that it is way better for the person getting the NG tube to do the inserting themselves since they can feel what is going on and know when to stop pushing etc.

My son also used some Lidocaine gel (numbing gel that you might use for teething babies) on the end of the tube to numb his nose a little. He kind of sorted some of the gel off the tube and up his nose just prior to doing the insertion. He only had to use the gel for the first couple of days and after that it was no problem and he didn't need it.

The hardest part is when the tube gets to the back of the nose and needs to make a turn down the back of the nose into the back of the throat. This is the part that needs to be done gently and may require some patience as it is a bit tricky the first couple of times.

When he is inserting the tube and it gets to the back of the throat get him to sip water through a straw. This lessens the gagging and ensures the tube goes down the esophagus. Actually I say it lessens the gagging but in reality the only time my son really gagged with it all was when he wanted to play a trick on me and got the tube to go up is nose and come out his mouth!!! (10 year old boy goofiness...)

Finally make sure they use an unweighted small tube. The size we used was a 6 Fr and it was very flexible. It was literally the size of a piece of spaghetti and about as flexible.

I hope it goes well.
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Son (age 13) diagnosed with Crohn's Feb. 2012.
Currently on Imuran and Sulfasalazine.

Also taking: TuZen probiotic and following a low FODMAP diet (not very strictly).

Past Treatments: Prednisone, Flagyl, Cipro, Pentasa, exclusive EN via NG tube (6 weeks), Prevacid, Iberogast (20 drops twice a day) and high doses of vitamin B2.
04-09-2013, 06:59 PM   #5
LJS
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thanks Twiggy! Appreciate all the advice.. my son will be doing the insertion himself.. he will first practice on a doll and then on himself..he's also a really calm kid BUT has a huge gag reflex, so that worries me.. but he's totally onboard for the entire program and wants to gain weight, get healthy and grow so I am hoping it will be smooth sailing..
04-09-2013, 07:54 PM   #6
Farmwife
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Twiggy gave great advice already. I will say the gel is important. I also read where a teen drank a glass of the coldest ice water he could before he put it in. He said it numbed it a bit.

I hope all goes well.
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I'm mom to............... Little Farm Girl 8 yr old
Ibd (microscopic)
(12/28/12),
dx Juvenile Arthritis
(12/13/13)
dx Erthema Nodosum
(8/13/14)
Bladder and Bowel Dysfunction
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Ehlers-Danlos Syndrome dx (1/26/17)
Remicade started on (9/8/14)Every 4 wks
Azathroprine started on 10/9/15
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Past Meds- LDN, Humira, Pred, MTX, Sulfasalazine
04-09-2013, 09:09 PM   #7
LJS
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i use lidocaine when he gets blood draws.. should I bring that with me, do you think?
04-09-2013, 09:21 PM   #8
Tesscorm
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My son's experience was much like Twiggy's.

Just want to emphasize that he should try to do it on his own (with guidance), I think it may be more difficult to have someone else try to insert it.

Also tube size is important, we also have 6FR.

Good luck!
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Tess, mom to S, 22
Diagnosed May 2011

Treatment:
May-July 2011 - 6 wks Exclusive EN via NG tube - 2000 ml/night, 1 wk IV Flagyl
July 2011-July 2013 - Supplemental EN via NG, 1000 ml/night, 5 nites/wk, Nexium, 40 mg
Feb. 2013-present - Remicade, 5 mg/kg every 6 wks
Supplements: 1-2 Boost shakes, D3 - 2000 IUs, Krill Oil
04-10-2013, 08:35 AM   #9
LJS
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thanks - I already ordered 6FR!! so all should be good!
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