After 2 months of trying to find where we could buy Carnation Instant Breakfast VHC,[we live in the Arkansas Ozarks] I finally talked to a Home Health Care company in Little Rock, Ar. today. Here is what I learned. CIB VHC is NOT recommended for tube feeding because it is too dense and may clog the tube.It is for people who can swallow. However, Nestle makes a product called Nutren 2.o that has 500 calories per can and is made specifically for tube feeding. We are going to order a case and try it. {John is presently on 2CAL-HN @ 450 cal. per can] If he tolerates this, he will pick up an extra 200 cals per day. Amy

Amy,

I had the tube through the nose thing for 10 days and I never had a problem with Carnation VHC. I don't know if the nose tube is comparable to the Peg because I've never had one or even seen one.

My guess is that it must be different. The Intral person I discussed this with told me that the VHC was too dense to go through a peg and would cause problems. She also said we should NOT thin it with water-don't know why, but their nutritionist is supposed to call me tomorrow. There is so much info AND mis-info out there, it takes alot of trial and error in my experience. I will post what I find out tomorrow. But extra calories would be great for us, so we are following through. Amy

Hi Amy,
Mike was on a Nestle Nutran product as well. His was called Pro Balance. It was only 300 calories a can. His tube has been out a while now, and he still drinks a can or two a day. Along with eating a normal diet. It tastes ok. A nutrionist precribed it from the dozens of formulations Nestle offers.
The point I would like to make is our insurance covered this product while he had the feeding tube. I got the impression from some posts that people were buying it out of pocket.
Insurance also paid for all the dressing and tape required for maintanence on both the feeding tube and picc line.
We went through a home health company that is national, called Apria. They did the billing to insurance too.
Perhaps some insurance companies do not pay, but it is worth a try!
I hope the new product works well for John.
Ginny (Mike's wife)

Hi David,
The nasal feeding tube passes through the nose, down the throat and esophagus then on to the stomach.
The Peg tube is inserted into the stomach through the outside of the stomach wall. They can be short and flush against the stomach or long or really long like that garden hose Mike had.
I am surprised that you got a Nasal tube. You might have liked the Peg. The Peg is concealed when you are out in public. The nasal one runs through the area you got radiated.

I don't want to get in peg this war again but if you are only going to need a tube for a few days or weeks, the nasal tube is much less invasive. Ugly yes, but it works. I found Ensure Plus worked perfectly fine with the nasal tube I had after surgery in 2001. I also think Ensure Plus which is 360 calories works through the PEG.

Eileen

Hi Amy,
They could be right. Jack was on the neutron 1.5 with his PEG tube and at times he was on the 2.0 formula. He is now using the Carnation VHC by mouth so we have both. He poured out a can of the VHC to compare it to the neutron and it's definitely thicker. It will be interesting to see what the nutritionist says.
Regards JoAnne

Small world, Ginny- the people I talked to today were Apria in LIttle Rock, Ar.! Interesting that your Ins. will cover the ancillary supplies, tape, dressings for the tube-our won't. But we think they will cover the Neutron because they cover the 2Cal. We'll see. Getting 2000 cals. a day through a peg is really a challange when you have no appitite and your stomach has shrunk. Amy

JAM, I live in Texarkana,ARkansas. I was on PEG tube about 6 weeks, I have two cases of 2-CAL left, if u want it send me your mailing address and I will send it to you. Sandra

Amy, I had a peg for ten months and used Carnation Instant Breakfast and had no problems. Afterwards I followed with about 4 oz. of water.
I am curious that you live in Arkansas and in the Ozarks. Last year I purchased a home in Berryville and my husband and I spend time there as well as Arizona. Send me a e-mail and maybe we can meet?

Hacklene

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

Yeah, I have had nutritionists tell me I shouldn't be pouring juice smoothies down my tube because it could clog it. All I can say is I know what the right consistency is and I'm careful and I'm NOT going abandon the veg and fruit juices every day because I feel better when I have them (maybe it's a placebo effect but if so I don't care)

I took some of that docusate sodium stuff when I got out of the hospital last summer after the ruptured esophagus surgery. I had been on pretty serious painkillers for a week and was still on them and they prescribed it because the milder laxatives weren't working and I was constipated. Just as a warning, it does work but it is NOT a mild effect in the way it works (ie: John should be sure he's near a bathroom at all times after taking it ebfore it does it's stuff because when it hits there's no waiting and, at least in my case, it gave me mild diarhhea for a while after).

I have been using carnation VHC for 5 weeks now in my feeding tube.I havn't had any problems so far. I also flush the tube immediately after use. I make sure the can of VHC is at room temp.


Paul-SCC left tonsil, stage 2.Five wks of rad x 2 a day along with chemo.10 week session with a week of treatments and a week off.

Thanks, Nelie and Paul for the advice. I am still leaning on having John try the VHC.He does need the calories. And I will caution him about the effects of the laxative. Amy