Wish I could help you Eric, but my K-pouch knowledge is pretty limited. If you are not feeling faint or weak, the blood loss is not serious. But, still, if you have brisk bleeding each time you intubate, I'd be concerned about your clotting times. Have you had Pro-times done lately? Are you on any nticoagants or anemic? Significant anemia would mae you more prone to bleeding because your clotting factors would be down too.

If it were me I'd put a call into Dr. Cohen's office in he morning, and ask for whoever is on call to get back to you. Anything to avoid sitting inthat dang ER if ou can help it.

Jan

Hi Eric,
Take a deep breath and answer the following question....is it every single time you intubate or only the times that you have difficulty getting the tube in (like in the morning...the first intubation when you wake up with an overfull pouch)? (or the couple of hours afterwards?)
Generally speaking our pouches (or stomas) bleed more than j pouches because we have to introduce a tube into them (kind of like a j poucher when he/she has a scope and bleeds afterwards) 4-8xs daily and even though it isn't supposed to hurt or damage anything when going in, if you have a rough intubation or difficulty pushing the tube in (like you mentioned in another post) then you will bleed...And possibly a lot...you are causing micro damage each time that you force the tube in...my personal experience is that Yes, when I force it, I do bleed a bit...Even, as you say, the tube streaked with blood but it has rarely been anything serious...The pain after a forced intubation can be mild to severe and yes, it hurts like the dickens...but it is not necessarily dangerous... I do not like the fact that you are forcing the tube in so frequently and with so much force...you are damaging the canal, the valve or the stoma while doing this and it is not a good thing for you or your pouch...
So, first off, you can no longer allow your pouch to overfill to the point of having to force the valve open (and pushing/sticking/forcing etc the tube in)...you must either eat lighter at night or wake up at 3am for a quick empty...(also try taking either beano or gasX to reduce the quantity of gas in your pouch)...next, take it slow when you intubate especially in the morning and if need be, do it laying down in the tub...makes for an easier intubation...just keep a cup or jug beside you to empty into...use enough lube but not so much that the tube gets too slippery or you will hurt yourself...you are also clenching your muscles when you get frustrated and force the tube in and that is causing additional pain and stress...so slow it all down...if after 5 minutes you can not put the tube in properly then change positions and try again...But do not push hard or for the tube in...change tube too..try using a strait one or a curved or a bullit tip or a stiffer one that can better navigate the twists...but stop poking!!!
PM me if you need more help or send me your phone number and I will call and walk you through it all...
hugs
Sharon