How was my clickbaity title? I think it was pretty great, personally, because this post is a gold mine!
A friend and fellow GJ user helped me write this post to make it extra thorough!
An important point before we start though: I’m not a doctor. I’m definitely not your doctor. Please take a moment to read the disclaimer if you haven’t already.
On with the tips!
- Immediately following surgery, request heat and ice packs to help with pain around the tube site. Heat under the tube and ice above can be especially useful because it essentially “tricks” the nerves.
- Your tube site will likely be incredibly sore following surgery, and it can be hard to use your abdominal muscles at first without causing more pain. One method to go from lying down to sitting up is to bring your knees halfway to your chest, hook both arms under your knees, and with the weight of your legs and arms, slightly lean forward and roll yourself up.
- Do not attempt to remove pink HY tape without adhesive remover or alcohol swabs. While it adheres well to the skin, it is extremely harsh to remove it by itself.
- Grip loks (REF: 3300M) are great for holding up GJ tube extensions. It keeps both out of the way, but also takes the tension off of the stoma. Another benefit is that it’s very small and you only need to use it, so I’ve found that it greatly reduces irritation. Some other tapes for extensions are medipore, micropore, and hypafix.
- One trick to cleaning around the stoma is to shower with your gauze and tape on. Once you are out of the shower, just remove the gauze and tape. The wet gauze is like a wipe, and will remove a large amount of drainage upon removal. After that, touch it up with a q-tip, dry it well, and dress the site as you normally would.
- If you have a sore tube site, hold the tube in place while attaching the extensions. Also do not ever rotate a GJ because it could flip the J portion into your stomach.
- If gauze is stuck to the stoma, using warm water helps loosen the gauze so it’s easier and less painful to remove. Keep in mind immediately following surgery, you may not be allowed to use water around the stoma.
- There are several ways to dress your tube, though you should always follow your surgeon’s/doctor’s instructions. Methods include leaving it open to air, using split gauze and tape, just using split gauze, just using tape, or using a tubie pad.
- Use a barrier cream/film if leakage is an issue; it helps protect your skin so you avoid acid irritation. Cavilon no sting barrier film (REF: 3344 & REF: 3343) is a great option.
- If you drain your stomach, Farrell bags are the simplest and cleanest solution.
- Request to have all adapters, extensions, and syringes switched to EnFit. They are very hard to accidentally disconnect, meaning that you won’t “feed the bed” at night. If you can’t acquire EnFit, the AMT clamp works well too.
- Mepitac tape is great for securing the tube because it is incredibly soft and sticky, but releases from the skin without residue.
- If you use crushed medications, they can settle and you lose a significant amount of med stuck on the plunger. Super easy trick: pull the medication into the syringe and add 2mL of air. Connect it to a clamped extensions and give it a good shake. Now hold it upside down and let any air settle. Slowly push the med as per normal, stopping when you reach the air.
- A great hypoallergenic adhesive remover is made by Sensi Care – it’s unscented and highly gentle while being effective.
- You can make a stoma salve out of neosporin/mupirocin/Vaseline, triamcinolone acetonide, and hydrocortisone cream – this helps a lot with granulation tissue, itching, and general discomfort. However! You really need to ask your doctor before doing this! Different docs have largely different opinions. Also, even if they say yes, I would recommend only using it once or twice/week.
- Never forget to flush before and after feeds/medicine. The J tube especially has the tendency to clog. Be sure to flush enough water (at least 2-3mL twice/day) to clear the G port of stomach contents, or it could harden and clog your tube. (also, don’t forget to flush with at least 1mL of water between every medication)
- If you have an early morning or late night event, you can predose liquid medications – crushed ones will settle and have high clogging potential though, so they need to be mixed with H2O immediately before taking. However, you can crush the medication in advance easily.
- For crushed medications, a mortar and pestle (stainless steel one specifically for pills) is 1500x easier to use. The plastic twisty one requires a repetitive forceful twisting motion, and doesn’t do as well at crushing the meds. With the M&P, you simply drop the pestle (or the mortar… Hmm… the crushy part, not the bowl part!) onto the pills until the are broken into small chunks. Then you move it left and right until they appear powdery. A trick to ensure that you don’t have any large chunks is to rap to container on the counter – large chunks will come to the top. I also recommend using extremely warm water to dissolve pills, you get a much better solution this way.
- Cleaning extensions: I deep clean my extensions once in their one week lifespan (on Wednesday). Here’s my deep cleaning method: I disconnect the extension completely. Then I make a baking soda warm water solution. I use a syringe to pulse this in and out of the extension a few times, then I leave it to sit for just a couple minutes. Next, I place the end of the extensions in some white vinegar and again pulse the syringe to bring the vinegar in and out of the tubing. The chemical reaction breaks down gunk and kills bacteria wonderfully. After that’s done, I rinse thoroughly with warm water.
- Before connecting the extension, prime it with water so you don’t get any excess air in your body.
- To vent your stomach, take a 60mL syringe. Remove the plunger and connect it to a gastric extension. KEEP THE EXTENSION CLAMPED. Find a comfortable spot that you can sit or (preferably) lay down. Lay a towel underneath you (stomachs, especially angry ones, like to explode). Holding the syringe upright, unclamp the extension. Wait for a moment and then you can roll on your side or move the syringe up and down to let the air vent. DO NOT sharply inhale, or you will likely inhale a significant amount of air into your stomach, which, of course, is not the point! You will know that air is venting when you hear a straw at the bottom of a cup kind of sound from the syringe.
- During a GJ replacement, they will insert a wire through the J port. Then they will deflate the balloon, pull the tube off, and feed a new one over the wire. Then the wire is removed and the new balloon is inflated. It is relatively low discomfort and certainly not something to be especially nervous about.
- Tubie clips (I like the ones from Crafting for a Cure Co) are really convenient for tying up excessive tubing.
- Get a routine! As an example, you can have a flushing routine. After you wash your hands, flush the tube, for example. Or a medicine routine, every time the bag runs out, take your meds.
- Most button tubes have what is called an anti-reflux valve in the extension ports to prevent stomach/intestinal contents from leaking when there is not an extension in place. However, the valves wear out so quickly that they’re practically useless. One way to help prevent messes is to remove and attach extensions while reclined or laying down. Always have gauze ready to catch the mess if it does leak. Finally, keep the ports closed or an extension in at all times.
Please make sure to share this post so that it can reach other new and scared tube users. I sincerely hope that even one of the tricks will help you in a small way during this difficult time 🙂
*make sure to comment which tip is your favorite!