Tube Tips

Hi again, everyone!

Here's another detour post, but again, so necessary. For my HG sisters, I am sorry that you are here; I sincerely hope this post helps ease your journey. You are strong. You are loved.

And now, without further ado... Tube Tips!

Tube Tips

Before Placement: 

-request that 2% viscous lidocaine be used. Trust me. Have them squirt 3mL in each nostril and “snort” it back and swallow it. Hold your nostrils shut so it doesn’t drain out. (2% viscous lidocaine contains 20 mg of lidocaine; 5 mg/kg is the maximum safe dose of lidocaine, so if you weigh around 60 kg (132 pounds), your maximum would be 300 mg or 15 mL, so if you want more than 3 mL, go ahead and go for it up to 7.5 mL per nostril.)
-this one is VITAL: allow a FULL 20 MINUTES to elapse for the best anesthesia to occur!
-Make sure your cup of water has a bendy straw.
-request 8 mg of Zofran (ondansetron, it’s an antiemetic) about 60 minutes prior to your procedure (I was taking 64mg/day through my PICC/IV my entire pregnancy)

During Placement:

-tube placement should not be painful! Tell them to STOP if it is
-you will likely gag for about 5 minutes straight as you acclimate- breathe through your mouth and try to concentrate on releasing tension in every single muscle in your body. If you can, try do long slow breaths through your mouth, but for me short, shallow breaths were what felt right once the tube was in.
-they will likely have you hold it while they adjust it and get it in the right place- hold it against your cheek, not your nose.


-Once the tube is properly in place in your gut, ask them to tape it down with Tegaderm.  They can also use TenderGrips right next to the outside of your nostril on your cheek. The nose clips are obnoxious and always triggered gagging for me. Band-Aids actually work nicely too, just cut off the pad part and secure it with Tegaderm.

After Placement:

-this may sound gross, but it may help to spit out your spit rather than swallow it the first day.
-talking may cause you to gag or throw up, but eventually (sometimes even the next day already) you won’t even realize it’s there, unless it gets jostled, which is why tape is your best friend.
-your throat may be sore, this will go away in 1-3 days.
-try to avoid letting your tube get kinked; they have “kink memory” and will continually kink in that spot and cause your pump to alarm.
-if your tube clogs (NJ tubes are more prone to it because they are a smaller diameter, usually an 8 Fr), use a 3 mL or syringe (basically anything 10 mL and under, not the giant 60 mL) and push 1 mL of water with a bit of oomph to clear the clog. (You may have to do a bit of push-pulling, but it should free with patience and persistence.)
-You can also unclog by putting a 10 or 12 mL syringe in your food port (with about 1 mL of water), a 3 mL in your small port, then tilt the tube to be parallel to the floor, push the tubes simultaneously and it should “boop” and come free. I usually suck it out after it frees.
-Use a Neti pot to keep your sinuses clear. You’ll want to use it frequently if you have postnasal drip, otherwise it will build up and irritate your throat. Use distilled water, though!
-Watch your slack! Getting caught is terrible and will jostle your tube.


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