This time around I am not having much trouble taking the food at a higher rate -- However, when I first set up with the company providing the food and accessories, the dietitian made it clear that medicare would have to have a reason for the pump in order to provide and supply one (I already have my own because I bought it on EBay, but the bags with tubes [aka pump sets] are supposed to be changed daily (although in a pinch I would recycle them by rinsing well with a saline solution as soon as I was done feeding) so I said that I had been having problems that were only fixed by a steady slow feed which I couldn't accomplish with a 60cc syringe and needed the sets for the pump (The sets can also be used for gravity feed because they have the little roller clamp adjustment gizmo on them) -- I don't know what they cost, but I doubt they are giving them away.

Since the pump is a Kangaroo brand, the sets could also be called 'Roo Pouches!

I did find, during my post-radiation recovery, that one reason for my anorexia and weight loss was that I was avoiding and short-cutting the food intake because it was such a fuss -- I was putting the 60cc syringe on the PEG and then pouring the food (I was using both the Safeway and WalMart versions of Ensure as my food -- I was paying for it myself) -- If my concentration slipped, so would the syringe and then there'd be a small mess to clean up.

Note: Cleanup of the food should NOT be put off, esp on fabric or carpet -- Best thing seems to be a thick paste of powdered laundry detergent with enzymes and water to actually eat the food.

Also, I was getting bored -- At the urging of a friend, I had moved out of my small RV trailer (didn't have a full toilet, just a porta-pottie which I would have to drag to a marina for emptying) into a small rental house -- It had basic cable TV, so I would stand or sit and watch while gravity did its thing.

It wasn't until near the end of my stay there that I realized I could adjust the PEG for better flow by both turning it and also by pushing it in more -- Prior to that, I had just been alternating sitting and standing, where sitting actually flowed better.

After my first free flap (BTW, friend and I were looking at the shark-bite site on my wrist and he remarked, not having seen it in a while, that it was really blending in with the rest of my arm and not as noticeable as it had been; I wasn't noticing it because I saw it everyday, so it always seemed the same), the feeding was not going well in part because the second PEG was so much smaller that I couldn't get free or gravity flow and had to actually pump the food with the plunger, which was getting hard to do as the plunger would gradually start to bind up and my relatively new shark-bite wasn't helping any. That's when I decided to get the pump.

I kept the second PEG after I removed it for the final time (no balloon, it just slid out) and after I got my gastro-Doc to install PEG number three (He said he has had to replace quite a few of the smaller kind installed at UW), I pulled some of the port 'hardware' (silicone and plastic) off the tube and, as I suspected, I was able to push the smaller one inside the larger one (I.D. on large slightly greater than O.D. on small)!!

Quite a difference when it comes to flow and no contest when it comes to washing crushed pills down inside -- The small PEG would clog INSIDE me at the exit ports, whereas the smallest points on the large one were on the outside and easily removed for cleaning if needed (which so far it hasn't been!) -- To make things worse, the small PEG has a small cord running down the inside, for some kind of adjustment, which cut the usable capacity even more. Wish I'd saved the first PEG so I could post comparative photos of each! I will do that when I remove my current trusty one!

The only saving grace about the small one is the ease of installation by the radiology dept doc -- I was in hospital when they decided to install one (I was getting food by naso-gastric tube, the one that goes in through the nose and down the back of the throat and fluids via IV) -- I walked down with aide down to rad dept where they put me on a contrast or reflective slab of some kind, gave me a local and proceeded with the installation using perhaps a fluoroscope to view the process (I could see part of the screen as he worked).

By comparison, the gastro-Doc had to give me one of the 'roofie' drugs and then shove an endoscope down my throat to mark and observe the placement. When the time comes to remove it, he will just give it a good yank and out it will come (Am seriously considering doing that myself when the time comes -- We will see). Having the PEG installed before the surgery meant that they didn't have to mess around with the NG tube (I REALLY didn't like my first one of those because the Doc secured it with a couple of stitches through my septum, so anytime anyone touched it, pain followed).