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#119040 07-05-2010 05:24 PM
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mom had a peg tube inserted into her stomach about 3 weeks ago they have tried several foods etc... but she is still only pumping at 40ml/hr (apparantly should be at 80ml/hr?) and is vomiting almost every day?? any suggestions, is this normal? for how long?


mom just dianosised with sequamous cell CA hypopharynx - would be cured with radiation -however she does not qualify as she already had radiation in same area years ago.... now has feeding tube
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Sunshine,

sorry to hear your mom's having difficulties with her tube feedings. I never used a pump, and had no real problems with my tube feedings. I'm sure others on this site will be able to provide some info.

Good luck


44 at 10-26-2009 Dx; SCC, T2N2b, St.IV BOT; Rt. Tonsil out; PET 11-12-09 (3 spots); 3 rds Cisplatin, Taxotere and 5-FU started 11-19-09; PEG 12-24-09; 7 wks chemo-rads done 03-16-10. 06-28 CT/PET watching 1 node; PEG out; 11-15 CT - larger; 11-23 PET activity up; mrdc 12-21; 04-01-11 CLEAN SCANS! ; March 2018 new SCC - Meet with surgeon 4-4-18
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There is a product called Carnation VHC. It can be ordered from a pharmacy or the company that is supplying her cans now. It has 560 calories per can and my husband tolerated it quite well. Her doctor may know about it and may be able to advise you. I'm sorry she is having difficulty. We had some problems in the beginning as well but as he got used to it, it got better.


cg to husband, 48 Stage 1V head and neck SCC. First surgery 9/07. Radiation and several rounds of chemo followed. Mets to chest and lungs. "Life isn't about waiting for the storm to pass, it's about learning to dance in the rain." Went home to God on February 22, 2009.
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Add an extra can or 2 of water and it will help her tolorate it.

Dont worry so much about the speed, it will be able to get increased when she stops getting sick from the feedings.

Some formulas arent easy for some to digest. Talk to the nutritionist or whoever prescribed the formula. There are many different types out there. Some are easier on the stomach.

What is the formula that she is on?

I went thru several formulas before I had one that didnt make me sick.

I use the Carnation VHC also. I order it thru the Amazon link on the forum pages so OCF gets a small kick back. The Carnation VHC is very thick so you must add a can of water to it. I mix one can of VHC with one can of my regular formula and one can of a health food hi protein liquid. Do not do this unless the doctor oks it and she is able to tolerate it.



Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Vomiting "almost every day" three weeks after getting a PEG is NOT NORMAL and its' almost unbelievable that the doctors have not addressed this more seriously. I used "almost" because unfortunately it is very very believable based on my experiences of how cavalierly PEG problems are handled. It's as though the default medical assumption is that the patient is doing something wrong.
Have anyone considered any anti-nausea medication?
I can't add anything else except sympathy here as Christine is the resident OCF expert based on her hard earned knowledge especially on pump rates etc.


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
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Carol couldn't tolerate a couple of formulas then switched to Jevity 1.2 and tolerates that just fine. She started with bolus feedings then had to graduate to gravity feedings. Too much formula too fast made her nauseous and vomiting. The anti-nausea pills didn't work.

Just recently she wasn't able to do her feedings. She would vomit every time afterwords. She woke up one morning with her peg sucked into her abdomen. If it wasn't for the ports (Ross 18FR) it would have been totally gone! Come to find out the balloon had entered her bowel. Has anyone heard of such a thing? One of the nurses tried to blame it on us, "because it just doesn't happen". Needless to say, him and I got into a heated argument.....he's an arrogant SOB and doesn't play well with others. Carol now has a new PEG and doing wonderfully. We also fired her Primary Care Doctor, finally, and her new Doctor is great.

Charm is absolutely correct that the medical world doesn't provide much help or support when it comes to the PEG as in Carol's case. We learned everything about the PEG from this forum and googling. And, unfortunately, the patient has to do their own experimenting to get their nutrition intake.

Linda


CG/Carol 57;SCC Stage IV L Tonsil T4N2bM0 12/2009
Recur 7/2010 - 2cm mass Invasive SCC L Floor Lower Jaw
Surgery 8/10 - Trach,ND,p. mandibulectomy,pec flap
ypT4aN0 HG Mucoepidermoid carcinoma
2nd Recur 1/18/11 - Tumor lower left lip
Surgery 2/9/11 - Canceled - Inoperable
3/29/11 - Died




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While no Internet web site can hold a candle to OCF in terms of relevance and excellence for oral cancer patients, "PEG" issues are a special subset. I thought I would share a site that specializes in feeding tubes that was recommended to me by my home care medical supply company's nurse.
Here is a pdf chart that breaks down all the potential complications for Home Enteral Feeding - a more generic term that encompasses all feeding tubes - G & J & NG. Although technically a PEG is only a G tube inserted a certain way and while all PEGs are G tubes but all G tubes are not PEGs, once the G tube is in, this chart applies even though it does not use the term PEG.
PEG complication chart
Charm


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
Joined: Dec 2009
Posts: 108
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The "PEG" complication chart is an excellent guide which every person having a feeding tube should download. As in Carol's case her tube ended up going into her bowel. Her 1st Primary Care Dr. likened the tube to a straw....it goes in and out. Well, it isn't suppose to go "in and out"! So, that was the last straw with that Dr. Carol's new Primary Dr. immediately took action hence the new tube. There was never any pulling or pushing on the tube as that nurse had implied.

There is another web site from our friends down under that provides a tube feeding guide PEG only. It is a guide for Aussie direct support workers but is invaluable for people who are having a tube placed and for their caregivers.

http://www.goforyourlife.vic.gov.au..._a_guide_for_direct_support_workers?open


Linda




Last edited by ElCee; 07-08-2010 04:56 AM. Reason: spelling

CG/Carol 57;SCC Stage IV L Tonsil T4N2bM0 12/2009
Recur 7/2010 - 2cm mass Invasive SCC L Floor Lower Jaw
Surgery 8/10 - Trach,ND,p. mandibulectomy,pec flap
ypT4aN0 HG Mucoepidermoid carcinoma
2nd Recur 1/18/11 - Tumor lower left lip
Surgery 2/9/11 - Canceled - Inoperable
3/29/11 - Died




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Linda, yep the PEG issue happened to me too. I know of 2 others on here who also had it dislodged. Mine happened while I was bedridden in the hospital. An overzealous doctor for some odd reason was checking my stomach area and pushing really hard until I told her to watch out for my PEG. Dont ya know a couple days later I was in agony as it became embedded in my abdomin wall.

Your link is a good one!!!!!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
Joined: Jun 2007
Posts: 10,507
Likes: 7
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Patient Advocate (old timer, 2000 posts)
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Charm....that chart is amazing!!!!! This info every single person who has any type of tube should have at hand. Excellent link smile smile


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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