Just had the NG tube

The NG tube is almost always inserted when the patient is conscious and unsedated. It is not unusual to have it after surgery due to ileus or blockages/obstructions, which are common complications of gastrointestinal surgery.

See this thread:

http://j-pouch.org/eve/forums/...1071921/m/5177093526

I have had NG tubes many times...they are never pleasant...how ever they definately speed up and relieve pain due to the obstructions I have had. I always insist a doctor or swat nurse inserts them. I'm always sore for a few days afterwards...it feels like they poked a hole in my stomach...

I agree with Cataja,
Never been put to sleep to have one put in or to have it taken out...But it does the trick...I just hate it while it is in.
It does irritate the linning though and takes a few days to feel 'normal'...and the distention of the abdomen can cause a lot of residual pain too.
Sharon

I've only had the NG tube inserted once and the nurse was a real pro. She told me my surgeon had requested she do it because she was so good! I don't care if she was bragging. She gave me all the confidence I needed to make the procedure not all that bad. I didn't mind having it in as long as I remembered to hold onto it when I repositioned myself. No fun having it pull unnecessarily! I hope I never need one again.

quote:

She told me my surgeon had requested she do it because she was so good!

This reminds me of when I was in Mount Sinai Hospital and had to have my urinary catheter removed. Mount Sinai is a teaching hospital and they have medical students who make the rounds and perform these kinds of tasks. On that day a very pretty young medical student came into my room. She addressed me in a very serious and formal manner and asked me if I would give her permission to remove the catheter. Actually what she said was: "do you have any objection to me removing your catheter?" What was unstated but implied was: "would you rather have me get one of the male students to do the job?"

She was an adorable looking girl who was obviously trying to do her best. I said to her in an equally grave voice, "my only objection would be if you tell me that this is the 1st time you have ever removed a urinary catheter."

She then laughed and confidently told me she had done hundreds of catheter insertions and removals and was an expert at removals, so I granted her permission and she did the job.

I think in hospitals everyone is an expert at whatever menial task they have been assigned to perform. Inserting NG tubes probably requires much more skill than pulling a urinary catheter out of a penis, but in either case you want to be comforted to know that the person to whom the task is assigned is an "expert" at the dirty job at hand.

quote:

the nurse was a real pro

In my opinion, to be a real pro at insertion of NG tubes requires equal parts of skill and brutality/aggression. The one and only time I had it done (also at Mount Sinai Hospital) it was by a middle aged Russian doctor who had fled Russia after the fall of the Iron Curtain and in 1992 found himself in an American hospital forced to do his residency all over again with 20 somethings. He had an obvious chip on his shoulder. However that chip combined nicely with his skill and experience. I could almost feel his anger as he forced that NG tube down on me. I really don't think you can be a good NG inserter and a kind, gentle person. You have to be brutal and very aggressive.

I think Nurse Ratchet from the movie One Flew Over The Cuckoos Nest would have been a good NG tube inserter.

Oh, I disagree. No need for brutality and aggression. I have inserted countless NG tubes, and have never had any complaints from my patients, other than "I'd rather not have this." Some weren't even for medical necessity, but for collecting stomach contents for gastric sectretion tests. I always got the full cooperation from my patients.

The key was in expressing confidence, knowing exactly how to proceed, and knowing how to get cooperation from the patient. Naturally, different skills are needed for children.

Jan

Jan,

You never had me as a patient! Brutality and aggression were required. I physically resisted. It was not a particularly sane moment in my life, but different people react differently in this situation, in which what looks like a physical torture device is about to be inflicted on one's person.

As a kid I cried my eyes out every single time...they didn't freeze the back of my throat but held my head back in one hand and pushed it up with the other...the only thing that they told me to do was swallow repeatedly. I cooperated but cried through the whole procedure. (did not help matters)...not my best memory.
sharon

quote:

they didn't freeze the back of my throat but held my head back in one hand and pushed it up with the other.

Sounds like the brutal/aggressive approach that I had done to me.

Shannah -
I had the NG tube and it was not pleasant at all. When they removed it, I had to take a deep breath afterwards because I couldn't believe what I had felt. The stomach was sore as well for a few days. I felt as though I had been beaten up internally.

As they say, this too shall pass! Be patient!

Roberta

And Jan inserts her own.... Now that's one tough woman!

kathy

I may qualify for one of the worst NG tube experiences (but there is humor in it too). I was at a teaching hospital so I had a very young, inexperienced doctor place mine. I was extremely nervous to begin with, but he assured me that he had placed lots of them successfully and that he had never missed (the stomach). So I got up the courage and did exactly as told and chugged my glass of water with the straw while he placed it. I thought, wow, I did it! Then he says "uh, oh...I didn't get it." He pulled it all the way out and we had to do it again! So at this point, we are waiting to see the stomach stuff come back up the tube, but nothing was happening. Then all of a sudden, I start throwing up again (with the tube in!). He can't figure out whey the tube isn't working. As I sit in agony, throwing up and gagging with the NG tube, they decide to do a chest x-ray to check the position. After 90 minutes waiting for them to come to the room, I am cursing my doctor and telling him I hate him. I got him back though. While he was trying to figure out what was going on, he pulled the canister off the end to check the tube, and I coughed at the same time. That was the highlight of my day watching my vomit shoot up the tube right into his face :-) I told him I didn't hate him anymore after that. Long story, but ended up with the x-ray showing that it wasn't down far enough. They slid it down and then instantly I felt amazing as it started working. Then I told him I loved him :-)

Along the same line....when I first received my temp ileostomy I asked who had the most experience with these on a daily basis and was told the assistants did....formerly known as orderlies, I think. So whenever I needed to empty my new baggie, I'd ask for one of these angels to be present and to give me tips. What a difference that made! By the time I left the hospital, I was a pro.

When I had my surgeries (6 in 10 months because of complications), the NG tube was so painful, typically because the nurse did not push it down far enough and so I felt like I had something stuck in my upper chest, as well as the pain in the throat. It was so annoying. If they don't get it right on that one big push, then it has to be done all over again. So, the last the surgery was "scheduled" (not er surgery) and I refused to have the surgery if my doctor wouldn't agree to have it put it while I was heavily medicated. Somehow they did! My memories are pretty vivid and they all about that darn tube!!! That too, does pass (as Jan would say).
Sally

My beloved Dr C put in a gastric tube when I had my k pouch done...directly into the stomach without having to torture me up the nose (did it in O.R.)...I kept it for 30days...the day that they decided to discharge me, I showered for the 1st time, got dressed and pretty and awaited the intern to remove the gastic tube...he cut it in the middle...and it went balistic like a fire hose spuuing green bile all over me, him and the room..(smells really nasty)...I couldn't stop laughing and the more I laughed the more it squirt...
My French surgeon put in an NG tube and hooked it up to the noisiest vacume cleaner that I have ever heard...1 week of hoover up my nose and in my head....I cried all week and prayed for Dr C to find and rescue me!
Sharon

Here is a 2 minute 25 second video demonstration of how to insert an NG tube:

http://www.youtube.com/watch?v=en5ctZInOyA

The NG tube being inserted in this video is done under ideal conditions with the patient being asked to swallow. In the post-surgical ileus situation, if the patient has to have the tube inserted you can forget that portion of this demonstration because the patient is likely vomiting and/or severely nauseous.

The reality of it is much worse than what is portrayed in this video. The actor or patient they used in this video is a very serene looking guy who actually thanks the inserter at the end. However, it does seem like an overall good technique to use if in fact the patient is not vomiting and is as serene as this guy in the video.

I think the NG tube experience would be much easier for people if they are told early on that there is a reasonable chance it may be necessary following surgery. A clear explanation of what is involved, how it works and what to expect should be part of the protocol for all those susceptible to an ileus or related problem.

My first tube experience occurred following my colectomy. I developed an ileus - resulting in the usual massive abdominal pain and vomiting. The resident came by one morning and said I needed an NG tube. I said "A what?" I had no idea what she was talking about. She gave me the Cliff's Notes version of the procedure just prior to it being done. Fortunately, everything went smoothly and relief was instantaneous.

It didn't start bugging me until I was told it had to remain in place for a few days. It was at that moment I became resentful and didn't want to have anything to do with the NG tube anymore. I naively assumed it was going to be removed as soon as my stomach was emptied. Had I been prepared, I think I could have saved myself all lot of negative energy.

My moment of truth occurred a few days later after I had pulled the tube out during my sleep. The nurse said I was the only non-demented patient to do that. Hmmm...

In any event, the doctors thought they would leave it out to see if I had regained (or would regain) normal bowel function. I didn't. After a couple of days the intense pain and projectile vomiting returned (I got pretty good at hitting the bucket from distance). I then begged for the NG tube.

My second insertion was a completely different experience. I knew exactly what to expect. I knew exactly why it was necessary and how it functioned. I also knew that relief was to be found at the end of a vacuum pump connected to my stomach via my nose. I was so well prepared I no issue with one of the residents learning how to perform the procedure on me. It took her a few times to get it right (not succeeding until after I suggested she try the other nostril instead). Life was good again.

I had it for an additional four days and it became just another tube sticking out of my body. After a while I was shown how to connect and disconnect it myself, allowing me to go to the bathroom or walk about the halls much less encumbered. In some ways it was kind of fun to wander the halls with my "that's right ya'll, I have a tube sticking out of my nose" shuffle.

I never experienced any problems with the tube while it was in place other than a mild sore throat at the end of the fourth day. My stomach was not irritated. In fact, I overheard a discussion among the doctors (mostly residents) about how the tube is designed in such a way that it can't irritate or harm the stomach. Just relating what they said. I know I didn't have a problem.

The bottom line is that knowledge is power. Knowing what the whole NG thing is all about should make the experience much less stressful.

quote:

My moment of truth occurred a few days later after I had pulled the tube out during my sleep.

Tin Can,

Your post very much hit home with me.

I pulled the NG tube out while awake after it was in for 24 hours. I guess that makes me a demented patient. Like you, I became resentful of the NG tube and for some reason, it just started to creep me out after a while. The only way I can describe it is like a feeling of intense claustrophobia or agoraphobia. One time before the World Trade Center towers were destroyed I was at the very top and looked down and my knees felt weak and I thought I was going to pass out. I had the same feeling of sudden revulsion with the NG Tube after 24 hours. All of a sudden I was overwhelmed with anxiety over it, it was like a live snake in my nose and down my throat.

I pulled it out and when the nurse came in and saw what I had done, she freaked out and read me the riot act. But they did not try to reinsert it because by then, the ileus had passed and my bag was filling up.

It was the only time I ever had the NG tube. My throat also felt irritated after it came out, like a mild sore throat one has with a cold. I think if I had to have the NG tube again I would be better prepared intellectually, if not emotionally, for what to expect.