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The peg tube my wife had went directly into her stomach thru an incision.
No risk of aspiration whatsoever !
I am an RN. There is still risk of aspiration. Again, what doesn't go down, comes up. There is a flow if the process is working correctly, but if it does not, it will overflow into the trachea.
I am an RN. There is still risk of aspiration. Again, what doesn't go down, comes up. There is a flow if the process is working correctly, but if it does not, it will overflow into the trachea.
"overflow into the trachea"
How is that possible when the peg goes directly into the stomach ?
Not if the tube is clamped. Which it generally is if not giving a bolus. And if on a continuous feed from a pump, the pump will not allow back flow into its device, so it will go up the esophagus into the trachea. In a perfect environment, the peg is checked for residual before any feeding. If > 60 cc, you give no bolus. Head of the bed should be kept > 30 degrees.
Look, there are risks with all medical interventions. You have to weigh these options critically and with the knowledge that you need to put aside your own needs, wants and desires. It is difficult when it is a sudden and unexpected illness or trauma. Hopefully you have physicians or other clinicians that are able to explain the issues clearly. Some medical issues are simply not reversible. Sometimes medical staff is wrong. Certainly ask for a second opinion if you are concerned. I'd stand by anyone who demanded it, and in many cases it is warranted.
But in the meantime, understand that wasting illness in dying patients (re: cachexia) happen often because the desire for food becomes less important. Our food and drink impulse drive is different that that of the dying.
My wife had a feeding peg for her last two years.
It started with her eating 1/2 of her nutrients and me giving her liquids for 1/2
As the ALS started paralyzing her throat I was giving 100% via feeding peg 3 times a day.
Never any problem whatsoever!
And I commend you on your diligence. It is possible, but again, not without risks, as the links I posted report. There are risks. They cannot be disregarded.
If and when they transfer him to hospice, they will only provide comfort care, meaning they will withdraw all medications, except for pain and to relax breathing. He has a feeding tube and they will stop nutrition/hydration and that's where I'm having a real problem.
I don't want them to stop the nutrition/hydration unless it appears that his body is breaking down and will no longer tolerate it. Also, doesn't a person have to be terminally ill in order to qualify for hospice? My husband's condition would be stable if it weren't for the pressure ulcers and gangrene.
I had the opposite problem with my mother. She was on hospice for 10 months with metastatic uterine cancer and she was demented. When she said she was thirsty, the gave her Ensure, thus prolonging her life. With my rabbi's advice I finally demanded a meeting with the ethics board of the hospice. At the meeting they gave me the stiff upper lip, but a few days later they suggested morphine, which I approved. She was dead 1 1/2 days later.
Quote:
Originally Posted by Ms. Anony Mous
Nobody knows whether he would eventually come out of the PVS or not. His family is saying just go ahead and "pull the plug" and "take him out of his misery."
I know I may be having false hope, but I would just like some advice from someone who may have gone through something similar.
Thank you.
I am not a doctor. You should let your instinct guide you as to whether he has a real shot of getting better or not. And also to what ccondition he could recover. My instinct is that his family is right, unless they have a financial interest in hastening death.
PLEASE, before you make any final decision, watch (and/or read) The Diving-Bell and the Butterfly.
What sometimes appears to be a persistent vegetative state could possibly be "Locked in Syndrome".
(Those severe bedsores concern me that your husband is not receiving the best of care. Even if it turns out he is at the end of his life, he should not have those damn bedsores!)
PLEASE, before you make any final decision, watch (and/or read) The Diving-Bell and the Butterfly.
What sometimes appears to be a persistent vegetative state could possibly be "Locked in Syndrome".
(Those severe bedsores concern me that your husband is not receiving the best of care. Even if it turns out he is at the end of his life, he should not have those damn bedsores!)
Many insurance companies will only pay for hospice if someone is terminally ill and has 90 days or so to live.
From what I understand,gangrene and pressure sores are not a terminal illness.
They can go away with proper care.
Maybe you can look into if insurance will pay for skilled nursing care either at home or in a Skilled Nursing facility.
Does your husband also have a trach?
Is he vented 24/7,or does he have a mist collar?
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