My Gastroenterologist Appointment

on Nov. 7, 2005 regarding
Tube Feeding by the Stomach
SURGERICAL PROCEDURE

• Valium will be used for relaxation so that the surgeon will be able to pass the scope down the esophagus and into the stomach.


• Local freezing will be used on the left side of the abdomen to enable the surgeon to cut a 1 cm. in diameter hole through the abdominal wall. Pain killers and antibiotics will be administered after the surgery is complete. The cut through the abdominal wall is suppose to be quite painful after the local freezing losses its effect. The whole procedure takes 20 minutes as follows:


• Firstly the surgeon inserts a scope and passes it down orally, through the esophagus and then into the stomach.


• Secondly, the surgeon will make the cut through the abdominal wall.


• Thirdly the surgeon inserts a wire through the hole in the abdominal wall she then with the scope she grabs onto the wire and then pulls the wire back out via the esophagus and mouth.


• Fourthly, the feeding tube is attached to the wire and then she pulls on the wire outside the stomach thereby pulling the feeding tube down the esophagus and through the stomach to the outside of the body.


• The surgical hole through the abdominal wall is located on the left side and above the belly button. My back brace will not interfere with the feeding tube at all and the surgery will be preformed with my back brace on.


• There should me no difficulty to get the scope down my esophagus because my upper sphincter was surgically relaxed.

RISKS AFTER SURGERY

1. The biggest risk is infection for ten days after the surgery. You have to wash the area around the incision three times a day.

HOME CARE

1. You will be monitored by a nurse and dietitian.

FOOD ONE CAN EAT ORALLY AFTER SUGERY

1. Same food that I am eating now.

REPLACEMENT TUBES

1. The original tube has to be replaced once a year and in so doing this the surgeon does not have to place a scope down the esophagus.

BOLOUS FEEDING

1. Will be the type of feeding used

DOCTOR’S RECOMMENDATIONS

1. She did not think that I should be fed by a feeding tube at this point in time because

I am not loosing weight
I am not aspirating
My present health is good
I have never had pueumonia (had walking pneumonia five years ago and
was put on antibiotics)
RESPIROLOGY

1. My respirologist will access if my bonchiectasis and COPD has remained stable or have become worse over the last two years.


2. With his help I should be able to make a more intelligent and more informed decision wether tube feeding is appropriate at this time.


3. I need a new Acapella device as the mouth piece on my existing one is all cracked.


4. What do you think of the flutter device?

THINGS I WILL BE ABLE TO DO AFTER THE INCISION HAS HEALED

1. Take baths and swim in a pool.


2. Will be able to eat orally as I am doing now.


3. Will be able to lie with stomach facing down on my chiropractor’s table for my treatments .