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PostPosted: Mar 13, 2006 9:26 pm
by teddi

Yes I'm going on a spree here

PostPosted: Mar 15, 2006 1:40 pm
by JennyK
I've had both PICC lines and NJ tubes, so I thought I would weigh in. Anna gave a very thorough and accurate summary of the pros and cons. I just have a couple things to add.

Be wary of clogging with the NJ tube. Flush it with water frequently and, if you can, dilute your Jevity so it's not as thick. I was on too high of a volume of Jevity to dilute it (it can't run more than 24 hours in a day), but that would have been preferable. I would also avoid putting crushed meds in the tube when other routes are available, i.e., zofran ODT and phenergan suppositories. Crushed meds can contribute to clogging.

Request that you be sedated for insertion. I had several tubes. For the first insertion I was given nothing to numb my nose or throat and it was truly awful. After that I got propofol for insertion. I have no recollection of the insertion, just woke up and the tube was in place. Propofol is category B, so I had no qualms about using it. There are other drugs available for sedation as well.

Take measures not to scare your toddler. My 2yo was scared the first time she saw me with the tube in. We cut up some extra tubing and my daughter, husband and parents all scotch taped it to the tips of their noses. This took the fear away, and after a day she didn't seem to notice the tube was on my nose and face. Sometimes she reattached her tube and pretended she was Lumpy (the baby elephant) from Pooh's Heffalump Movie.

I'm glad I gave the NJ a try and would encourage others to consider it. As Anna said, many people have no complications with a PICC line, but the possibility is out there. I'd prefer to avoid them, which is why I gave the NJ a try.

PostPosted: Jun 16, 2006 1:37 am
by megs4413
we're ttc and i am seriously considering the NJ tube in lieu of a PICC (which I'm almost sure it's going to come down to judging on my last HG experience). I'm wondering if the medicine is as effective coming through the tubing as it would be intravenously. I think the thing that finally stopped the vomiting was having my PICC set up with zofran on a constant drip with a demand dose possibility. I am concerned that if I do go with the NJ tube (I had TONS of complications with my PICC including infection) that the vomiting will continue because I can't get my meds in me the right way. I think i could probably do the NJ tube and have zofran injections or IVs, but that seems like a lot of tubes coming out of my body at once. Any ideas about how much the efficacy of the meds would be affected if I took them essentially orally as opposed to intravenously?

Also, is it a good idea to opt for the NJ tube early on? I know I will at least need regular IV hydration and I think once I hit 8 weeks I was no longer keeping anything down for days at a time. I didn't get help for a long time because of a retarded doc (who has now been exiled to :hgisland: ) I'm wondering how soon the NJ tube becomes necessary/makes sense. Is it when you can't keep hydrated or when you have lost a certain amount of weight? I want to be extremely proactive in my care this time. I will be starting treatment from when I get my BFP (already have the zofran) and I don't know how quickly I should pull the trigger on something like an NJ tube or a PICC line.....

Any advice is appreciated!

PostPosted: Jun 16, 2006 12:08 pm
by JennyK
I had those same questions with my second pregnancy. How soon do I need the tube? Certain amount of weight loss? Dehydration? Number of weeks?

Mine was put in at 7 weeks or so. I thought it was too soon, but my doctor was insistent. He wanted it based on my history, bloodwork, and condition in general. He was right. I felt better once I was getting calories in me, and even if I could have gotten by without it then I would have needed it later.

For me, IV zofran worked a hundred times better than ODT. When I switched from the NJ to the PICC I started a zofran pump through the PICC. Without a PICC, I think your choices would be SQ, which a lot of people do, or a peripheral. I've never heard of anyone using a zofran pump with a peripheral, but I don't know of a reason it couldn't be done.

PostPosted: Jun 19, 2006 12:24 am
by MamaLily
I've been thinking the same thing about timing of an NJ tube for my next pregnancy.

With my 1st pregnancy, I got my tube in around 10-11 weeks, which was WAY TOO LONG!!! I was in really bad shape and needed immediate hospitalization and a whole bunch of meds, IVs, steroids, etc.

With my 2nd pregnancy, I got the feeding tube closer to 7 weeks. It made a HUGE difference! I never spiraled down as far as with the first pregnancy, and so my body didn't have to play the "nutritional catch-up" game for so long.

For my next pregnancy, I'm seriously considering finding a doctor who will insert the tube as soon as I have bad nausea. I considered asking for the tube as soon as conception had taken place, but I'm sure that would be an uphill battle!! :D Do you think it's possible to get a feeding tube before actually vomiting? Well, I'm going to try for it! I honestly think that I would have a much better time of things if I had the tube even earlier than 7 weeks. I'm going to fight for it. (We're not ttc quite yet, by the way, so it may be a while before I test all of my plans.)

Also, the next time around I am going to insist on regular tests to determine my levels of potassium - and maybe other levels as well. I have never felt better during HG than the night I started on the feeding tube and received potassium supplements as well. I honestly could have done almost anything that night. The combination worked better than any drugs have ever done. I almost felt "normal."

Oh, and when I was on the tube I mostly took zofran by mouth. I did the dissolving kind when I was too sick to swallow even a pill. And I did get IVs occasionally to use for IV zofran.

Hope this helps and I wish you luck! I wish everyone could have the tube...even though HG still stinks, it is much easier getting all the nutrition you need every day. The nutrition nurses at my hospital said that HGers who get NJ tubes feel much more relief from nausea/vomiting than the women who get nutrition through PICC lines. Good luck!

- Anna

NG tube syndrome?

PostPosted: Aug 04, 2006 7:21 pm
by tlm5999
I was doing some research on NG because I've had 2prior HG preg. and only was given phen suppositories. I ended up losing 25 lbs with my first and 17 with my second. I came across something called NG tube syndrome it can damage the vocal cords. I sing for a living. Has anyone else heard of this? Or know the risk factor of it?
NG was sounding like my best option so far. Also does anyone have a picture of what it looks like? I couldn't find anything but diagrams?

PostPosted: Aug 04, 2006 8:02 pm
by JennyK
I haven't heard of it, but I haven't researched it either. I've had more than my share of PICC complications and am back to another NJ at 33 1/2 weeks. Here is a picture of me from just a couple days ago. There some from about 6 months ago in this thread:


PostPosted: Aug 22, 2006 2:26 am
by MamaLily
I know I'm late with this one, but I haven't noticed any problem since having feeding tubes with both of my pregnancies. You could talk with your doctor or a vocal coach about it. I'm a singer as well (although I definitely don't sing for money, lol) and I honestly can't tell a difference in my voice (speaking or singing) after having the tubes. I had a voice teacher in college tell me that if a doctor ever needs to stick something down your throat, you should tell the doc that you are a vocalist and you need him to be careful. Seems like common sense to me, but I guess doctors will take special precautions with your vocal cords...

Good luck! I highly recommend the feeding tube...with my next pregnancy, I'd like to have the tube in place as soon as I know I'm pregnant! It would save a lot of grief, vomiting, weight loss, etc.!

PostPosted: Jan 05, 2007 6:24 pm
by mommy2wyatt
Wow! Thanks for the info, I had no idea there was another option besides the picc! I had a picc placed when I was 10 weeks pregnant and it got infected while I was hospitalized at 20 weeks. Due to the infection in my blood it got in my eye and I now have permanent damage as in a scar on my retina. Basically I have a blind spot on my left eye. The Drs say there is nothing to fix it and I should be grateful not o be blind in that eye. I wish someone would have told me there was another option instead of the picc, also that someone would have told me about the rick of infection with the picc.
My little boy was just born on Dec 23rd so I'm not thinking about another one anytime soon, but it's good to know theres another option to the picc.

PostPosted: Aug 14, 2007 8:36 pm
by Buffy
I know I am very late to this topic but I though I would add my experiences with NG. I am Australian and I'm not sure what a picc is or whether it is offered here.

I had the NG inserted finally at 22 weeks and it was the turning point of my pregnancy. I felt the nausea ease almost immediately. Within three days I was able to consume some solids and liquids. I had severe reflux and the doctors believed that my stomach and oesophagus were ulcerated. The NG bypassed this and gave my stomach a chance to heal. I gained weight very quickly. After 4 weeks the tube was removed and i didn't vomit again after that. I did feel quesy and continue with meds up until my baby was born but it seemed to give me a chance to catch up and recover a little.