I was asked a question today by PM, and answered it, but decided the info also belongs here on the open forum.

QUOTE
My PEG has been clogging in the outer part and I have been able to unplug it, but since it has been in for almost a year they want to replace it Monday. When they replace the PEG will they have to totally sedate me? My airway is very constricted now and they can not get the tubes down it anymore which would mean a trach. I have a call in to the doc also - but I like to be as informed as possible. I thought that you might know since you have had one switched before.
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I've never had one switched (I took one out several times to clean it, but that was 'unofficial', of course!). I've had three, but they were all new from the start.

I am considering having mine switched to the Mic-Key low profile one, so I was thinking about that myself. Looking at the YouTube video, putting a Mic-Key into an existing hole seems easy, with the balloon being inflated after it's in with a syringe and water (In fact, I'll probably ask to do it myself). A lot might depend on what you have now, that is, does it have a balloon (The skinny one I had didn't; it just slid out, depending on length and some curves for retention) and whether the balloon is inflatable/deflatable (My other two have non-deflatable 'donuts' on the end and are the 'just yank it out' kind.

The Doc is going to be your best bet for that info.

If they are going to sedate you, they will have to tell you beforehand so you can arrange for someone to drive you home afterwards. In my case, the sedation was something like Rohypnol (aka Roofie) by injection by the Doc, not a full-bore anesthesiologist undertaking, however, a new placement involved an endoscope down my throat.

Hi Pete

Hope you are going well and you have not had any additional problems with the flap.

My airway has been severely damaged from radiotherapy so it was decided by the anethestists prior to my last surgery to debulk my tongue flap that they would put some sort of a tube thing via my nose and down my throat that way.(I can't remember the name of it)

One nostril was numbed with lots of spray before they actually put me out to it and then stuck the tube in my nose - just in case there were any difficulties with my breathing during the procedure.

Karen

Karen, thats the same way as I am knocked out for surgeries. I have severe trismus and cant open my mouth wide enough for anestesia. Here I think they call it something like twilight sedation but not sure.

I am glad that you decided to post this on the open forum. I don't think as clearly right now with the pain meds and the fever and should have probably put it out there myself.

Christine I hope that you are correct about the twighlight method. I found some info on another site about PEG replacement that would indicate that the twightlight sleep is what they will do. Right now my fever is up to 101 so I don't know if they will do the switch or not.

I would welcome any one else's experience with having their PEG replaced. I was hoping that I would be at the point in my life where I would be having the PEG removed now, not replaced so that I can use it longer.

Patty

Patty, I really dont know how they replace the PEG. I just know about being sedated for operations with restricted airways. I had 2 operations using that method. My teeth being removed and another one where the port was removed and tubes put into my ears for HBO. If you ask me, I wouldnt know the difference between the "twilight" and any other method. All I know was it knocked me out and I got the procedures done.

Good luck tomorrow and I sure hope your fever goes away so you feel better.

Christine

I had a heart procedure once using the twighlight procedure. It was a catheter procedure and it was interesting to be awake and watching them move a catheter around inside my heart. I will know tomorrow - I was just hoping that someone had already had their tube switched and I would feel a little more confident about the procedure tonight. I'm not the most patient person sometimes. LOL

Patty

I think the big thing with the twilight is that the PEG doc can administer it and doesn't need services of a full-bore anesthesiologist to do the procedure.

Patty

IV in hand with fenatyl drip is likely for switching out a PEG even if it has to be done the hard non edoscopic way like mine. After all my fussing about never getting a PEG, when I finally did get one, it only lasted four weeks as it turned out to be defective and leaked. I was conscious during the operation but felt no pain. Relax and it will be over before you know it
Best wishes
Charm

Charm and Pete that is exactly what I wanted to hear!! I just know that they can't get a tube in my airway anymore and with all of this other swelling becuase of the lovely infection it would be a real mess.

I just would like a tube that worked more reliably again since it would appear that I will have it for a little while longer.

I am very lucky to have you guys on my team. Thank you.

Patty