I am new to this forum but I did go through the topics with PEG in their titles to see if this has already been covered and I did not find it. I had my PEG inserted in Sept. 2004 before the start of my throat cancer treatment. Neither my wife nor I were given any instructions on the care and use of the PEG. A chemotherapy nurse provided a little instruction, but mostly I learned on my own. But since I had no instructions on proper care, the tube became encrusted with deposits - no one had told us about flushing the line. I asked about replacing it and they said the tube should last about a year. A little after a year of ue had passed, I was feedinf myself at the hospital one day and the tube sprung a leak. It was near the connection end so I was able to use a clamp I had installed and went up to GI for them to repair it. They replaced the tube with a different style and they left off my clamp (and the new style does not have a removable connection piece like the old one so I have no way of putting it back on unless they replace the tube). The new tube is firmer than the old tube so shutting it off by finger pressure does not work. Since the tube is shorter than my old tube, it can frequently spew out material when I open it. If anyone knows a good clamp I can use I would appreciate it.

But the clamp is not my real question. Since the new install I have a frequent problem that I never had with the old install. Every now and then the tube appears to do a flip-flop! This can be very disconcerting. Sometimes I don't see it happen for some time and at other times it will happen several times in a short period. I stopped back at GI one day to ask about it and they said to just adjust the length and tighten the flange. This does not seem to help much as the issue will come back again. Has anyone else had this problem? And if so, do you know a solution?

Thanks!

I am in the same boat. My PEG was replaced with a G-tube, which is basically like a foley catheter, a tube within a tube. It has an inflatable balloon on the end that is in your stomach, this little bulb/balloon holds approximately 17cc of liquid like water or saline solution. I dislike the G-tube as much as you. With my old PEG, installed surgically, I had a clamp on the tube between my stomach and the atmosphere. With the replacement G-tube, no clamp. It sucks, I spill stuff all the time. I keep my G-tube in a vertical position with (believe it or not) with a small velcro strip, looped around a shirt button. If I don't keep it vertical, it leaks around the CHEAP little closure thingy..... The plus side to this is the G-Tube is cheap ($45.00) you can purchase one on the web and replace it yourself or have a nurse or doctor friend. Very easy to replace.....

I keep mine up with a lanyard used for name badges that I run through one of the loops and around my neck. I actually have three so I can change them out when I shower.

Instead of a clamp, have you considered a lopez valve? Similar to a stopcock device, it allows you to close off the tube between syringe-fulls of liquid, and your hands are free, and you don't get any leaking back or spilling from the tube while you are manipulating the syringe. Most hospitals/E.R.'s/etc will have them, they may also be available in hospital supply stores. It is what we use in the ICU when the patients have "foley"-type G-tubes, and they sure save a lot of time and hassle.
Andrea

Many of us who live with Peg type tubes, have adapted some simple techniques to help. Many of the tubes with attached whips - the whip can be folded and held, pinched over, with a rubber band. It keeps them from leaking and doesn't seem to weaken the tubing at the fold. Those with really long whips can be folded over a couple of times and 'stored' that way between meals - without the velcro or the lanyard.

I gave up trying to the use the plunger of the syringe. I insert the tube of a 60cc syringe in the end of my tube, and pour the liquids into it, gravity feed, using it like a funnel, no plunger.

Eat sitting down, reclined a bit if possible, belly relaxed. Pour the meal in the tube and let it slowly drain in. Finish every meal with lots of water. Your body needs it and the water rinses out the syringe and the tube. Whenever the tube doesn't look super clean, pour in some ginger ale, or fizzy soda water - it cleans the tubes out very well.

Go to the pet supply store and buy some long skinny aquarium brushes. They will keep your syringes and tubes sparkly clean. Pour warm water into your peg at the end of each meal - the warm water melts away the residues from the food.

When you have a choice, get a 'button' type tube installed. It has no attached tube, only a plastic button, near your skin, with a vinyl flip valve to cover it. The button contains a one-way valve that prohibits leaking. The feeding tube hooks on with a twist lock motion and the syringe attaches to the tube. This type of tube is SO much easier to wear, easier to use and keep clean. The tube is held in place with a small bladder of saline inside the stomach.

I've lived with my peg for nearly three years now. Hope these ideas are of some use. Tom

Andrea:
I googled Lopez Valve and downloaded a PDF file on it's uses and applications.
It sounds like it is exactly what is needed to prevent spills.
Tom:
The button tube sounds like a good alternative as well. Is it easy to clean around the entrance area?
Darrell

I did some checking around today on the Lopez Valve as I had never heard of it. I found a description of it on the internet but I was not sure if it would work for me since my new unit does not seperate at the end like my old unit did. This one is one peace for all the external section. I don't have any idea what is on the inside. While I was out doing some other things we checked at a local pharmacy. They had not heard of it so they looked it up on the web and found it where I did. The price we saw was over $300 but he thought that might be a case price although it didn't tell us on that page. No way could I afford $300! When I got home I checked some more and eventually found out that they sell in a case of 50 so that would bring it down to around $6 each. If I can find someone that sells them individually and not at too large a markup I may try one. I have some appointments on 1/10 at the VA Hospital so I will try and ask around then. I am a charity case so I depend a lot on what I can get from the VA.

Darrell: Belly tubes all share the messy problem of the body constantly trying to 'heal' the tube incision. A variety of body chemistries accumulate on the skin around the tube's exit from the body. Under relatively healthy conditions (not infected) these secretions form a kind of gummy scab that eventually dries into a crusty accumulation around the opening.

Regular application of anti-biotic cream or other soothing creams around the site keeps the secretions from forming a ridgid surface, but the whole site becomes gooey and sticky. Allowing the secretions to dry out leaves us with the problem of a scab-type formation around the opening, stuck to body hair and uncomfortably hard. Keep this residue from accumulating. Reach into your shirt a few times a day with a tissue and carefully swab away the gathering goo. Don't agonize over every molecule of the goo. Swabbing too close to the tube just irritates the site. The junk immediately around the opening, (1/16 of an inch) and on the emerging tube itself - leave it. It lubricates the wound and helps water proof the opening. You and your belly will be happier.

I worried and fretted for months about getting my peg site wet in the shower, or even too wet with a cloth. I constantly kept fresh 2X2's hung over the tube site, and they constantly dried onto my skin. Then I met up with some veteran peg users and wised up a bit. Within a month or so of tube insertion, the body has pretty well closed that opening around the tube - and fairly tight. We can't swim or submerge, but the shower poses no real threat. Warm water running over the site will rehydrate the residue on the skin and allow it to be brushed away easily. The site will always be tender, so don't flood it, scrub it, scrape it, staple spindle or mutilate it

The wonderful nurse who instructed me about my peg did a good job, but she has never had one. Many of the things I initally learned about pegs turned out to be only a little useful. Get good advice from knowledgeable people about your peg. And ask several different folks for their perspectives.

Safety tip: If you feel a sneeze coming on while pouring into your tube.... either pinch the tube off for a second, or learn a messy lesson in fluid dynamics. (Though strawberry Ensure does make a very colorful geyser.) And remember, peg tubes are ONLY inserted into people of fine character. We are the few, the proud, the punctured. Be strong. Tom

LOL! Boy I have sneezed my way into a mess more than once. It's reassuiring to know everyone with a PEG deals with that. I ALWAYS have a towel over my lap when I use my PEG--I've learned there is no way to be sure something like a sneeze won't mess up everything otherwise.......

Nelie.

Tom: Thanks for the good info on your two posts. I wish I had known some of it long ago as it might have saved me some trouble. I did use the plunger at first to feed but then the chemo nurse suggested I try gravity and I use that most of the time. Sometimes I get a clog and I have to use the plunger to get it going. I am going to see if I can get an aquarium brush. That would have helped a lot on my first tube. But by the time I found out anything about even flushing the tube there was a heavy accumulation that would not come off. I wish I still had that tube because it was softer which made it easier to use and especially to close off. My new tube is of a firmer material. Might that me why I have the problem of it flip-flopping?

Yes, I also have learned the hard way about sneezing when feeding through the tube. But a mess caused by an issue from the other end surprised me the first time it happened. I have long had an issue with flatulence but it seems to be worse now. I suspect it comes from too much air when I tube feed and too much air with all the liquid I drink (mostly water) when I eat solid food.