I had a long talk today with an Apria nutritionist. She said they do not recommend the Carnation Instant Breafast VHC for peg tube feedings because of the viscosity of the product and the chance of it plugging the tube. She recommended Nutren 2.0 instead [60 fewer cals per 8 oz can.] When I told her tht John was putting buttermilk down the tube she sputtered. Also not recommended because of potential bacteria build up in the tube itself. Then I told her that John's Oncologist said he could grind up anything he wanted to pour down his tube and she said "well, there is no controlling what Doctors will tell a patient". This lady is a purist- her training has taught her that only certain things should go in a peg. I got totally lost in her calculations of cc's to nutrients and liquids to patient body weight per day and that John should quit using grape juice, tea, etc. because they filled his stomach and caused him not to want regular feedings of 2 Cal or Nutren. I told her I would be happy for her to come explain that to John, but I wasn't "going there". We settled on trying a case of the Nutren 2.0 to see how John tolerates it. One tidbit of good information [I think] is that John should try Docusate Sodium or Bisacodye for constipation because the amount of pain killers he is one is causing his GI tract to "go to sleep" and powdered fiber or laxitives will not help[and she's right, they have not been helping thus far] so we will try this with a nod from his Doc. Here we are, learing more everyday. Amy