These 60mL, "single use", syringes are a piece of sh*t. Even lubing the plunger with olive oil only works so long (and I have some concerns about oil build up on walls of the peg tube- its not you can rinse it with detergent). Once the rubber swells up, its game over. My hydration syringes - I don't wash, just keep refilling them, I do wipe the tip with alcohol. I'm going to eliminate all syringes, except for flushing and meds, by just pouring the food/water down a syringe barrel (I already gravity feed the food but the 300mL of water, I have been using syringes).

There is a tube feeding website with all kind of tips for extending syringe life (for and by "tubies"). I have ordered some O-ring syringes, per their recommendation, to see if they are an improvement - they are expensive though, at $4 a whack (compared to $.90 for a single use one on Amazon). If anyone has any bolus feeding or syringe suggestions, I'd love to hear them. It's been a fun learning curve (based on my manufacturing engineering and efficiency expert background). Pumps aren't really practical, for me, since I sleep with my dogs and they'd be getting tangled up in tubing in the middle of the night. I could probably work that out but bolus is working pretty well for me and it helps to quell my hunger pangs during the day (I dreamt about binging on pizza last night ;-)

On another note I have been taking coffee down the peg right after the bolus feeding and it feels more natural, like I used to do (I can taste the coffee in my mouth!). I have had to cut back the amount of grounds when making the coffee to reduce the strength because, even with decaf, I was OD'ing on caffeine. Hopefully this will offset the effects of the Atenolol because, in the first hour I take my BP meds, it will crash sometimes as low as 64/43 (fricking baro-reflex failure). (The spell check here is relentless!)

That's what I do. I use the syringe and just pour my canned nutrition in it, and don't use the plunger. Takes a minute of two. I pour water first by holding syringe in one hand, other hand the water, then my canned nutrition, and water when I'm finished. I rinse out the syringe in water, refrigerate syringe in a plastic bag. I don't know about single use syringes, but I keep using my two plastic ones over and over for the past 4 years.

I do the nutrition the same way. So, just pouring water down the barrel is your flush? You're not "pushing" it with a syringe?
What about meds (tablets)? Right now I'm pulverizing them in a mortar and pestle, then diluting in a small Pyrex dish and pushing it with a syringe.
Why do you refrigerate the syringe barrel?
How long do your peg tubes last?
Do you use a Mic-Key?

I'm just doing what they showed me in the hospital but there are obviously more efficient ways to do this.

Sorry I have so many questions but I vehemently fought getting a peg during treatment so I'm late to the party.

No. I never use the plunger, even for water. Just pour and go! No back up, no problem. That's what they even did in the hospital. Once in a while I used the plunger, if it backed up, but wasn't frequent, maybe more from meds. I'm also not tube dependent now, but was for several treatments. I used a coffee grinder to crush the meds to dust, then mixed with water, poured into the tube, flushed. Not all meds should be crushed, like pain meds, so check with your pharmacy or ask for liquid medications. I refrigerate mine because that's what my infectious disease doctor said to do for storage, but never asked why, and assume it had to do with bacteria? I've had this peg, button type, since December 2010, although I had one before that, which I had it yanked out after being NED in July, 2010, and a month later had a recurrence, had another one put in, and kept it since, and used it for several treatments. The peg saved my life, initially losing over 110lbs in 2009, and have gained 50lbs back, actually 70, but lost, gained, lost since last summer due to treatmnts, and teeth issues. Some wanted to take the tube out, but my local oncologist understands my reason for keeping it having been with me through my worst tmes, and possibly needing it again.

Thanks Paul,
you've been very helpful. It make sense to ditch the plungers! I'll ask my nurse about refrigeration, right now I'm washing the barrel with soap and water between feedings.

Do you check your residual every feeding?

Soap and water works. Sometimes I do, most times I don't. What residual every feeding? This?

http://www.medscape.com/viewarticle/780771_3

Checking for residual should only be done with a regular PEG tube. Anyone who has a J/G tube should NEVER attempt to check for residual as it could cause serious problems. Im not sure if a button PEG user needs to check for residual or not.

When I had a PEG tube I often forgot to check for residual. My visiting nurse advised if its done once or twice a day thats enough.

I never checked for any gastric residual volume in 4 years nor was I instructed to do so, not while hospitalized at any time or by visiting nurse, unless while unconscious or in ICU. Seems to be many unknowns, done by medical providers, and is new to me. I was only on the pump for several months while hospitalized in 2010, which it may or may not be used for.

http://lifeinthefastlane.com/education/ccc/gastric-residual-volume/

My peg instructions are to check residual every time, before feeding, and if over 100 mL wait an hour before feeding. Some hospital websites don't even mention measuring residual on their peg instructions. I've only had a residual over 60 mL one time (I don't have a syringe that is greater than 60). Its typically between 0 and 30 mL. Another question for the home nurse tomorrow. I typically feed every 4-5 hours so that plenty of the time for the residual to decrease. I have also noticed that when I'm really hungry and my stomach is growling, my residual is usually 0 anyway.

To me, it sounds like you are doing very well with your feeding tube! You are lucky you can tolerate the formula with the bolus method of feeding. Wonder why your residual was 60+? When I had my PEG, my residual was either 0 or very low, less than 10ml. I have had the J/G type for almost 5 years so its hard for me to remember how much a PEG is different.

Please post what your nurse tells you.

Paul,
Thanks for that link -very interesting. I have problems with aspiration pneumonia, but from swallowing problems, not GERD or anything like that. That's probably why the jury is out and there are 2 schools of thought. Probably just precautionary. I was instructed, in the hospital, in a regular ward (not ICU) to do this. That, while I was adjusting to peg feedings and feeling a bit queasy. I have no problems with it now, so I think I'm going to dispense with the residual check. I did the entire gravity process that you did and it was easy and fast. Thank you for that.

The time it exceeded 60mL was the first feeding in the hospital, and they were also giving me a bolus of IV fluids that may have been the reason (and I was on my back). It's never exceeded that at home. I have seen as high as 50 mL residual but typically its between 0-25mL. I also hydrate myself between feedings so that might factor in. I'm getting Nestle fiber sourceHN which is 300 cal/250 mL (same as Jevity).

I've also been diluting the formula, a bit, to speed things up. In the morning I alternate pouring formula with coffee and its quite pleasant actually. I can taste the coffee. Decaf, of course, but thats what I always drink anyway - Pete's no less. Can do breakfast in 9 minutes, including meds and cleanup vs. 20 minutes undiluted. The stitches near the Stoma have fallen out and it looks pretty healthy. I hope they clear me for full body showers soon. Can you believe that these idiots, in this New Yorker link think that they're on to something and WANT to eat formula to make their time more efficient?!?!
http://www.newyorker.com/reporting/2014/05/12/140512fa_fact_widdicombe?mbid=social_tablet_f I'm been having dreams about binging on pizza...

That's what I did, dilute the feeding, goes down faster.