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  1. #1

    Gastric tube for underweight para?

    This procedure has been recommended for my 18 yr old son, a T10 para. He was injured at age 15 (2004) and quickly lost 25 lbs. Since then he has lost another 15 lbs. Now 6' 4" and 112 lbs. He continues to struggle with weight loss, and skin breakdown. He eats well, and uses supplements. Pre-albumen levels remain low. We have consulted gastroenterologist, he has been tested for all sorts of things like celiac and chrons, sees a dietician. He tried a nasal feeding tube, but it was too uncomfortable. In addition, he has severe scoliosis in lumbar (56 degree) but can't have it corrected until the nutritional issues are resolved. I would appreciate any suggestions or personal experiences! is the gastric tube the way to go?
    Hawknest

  2. #2
    My son had a g-tube from almost 1 yr to 9 years of age. If you PM me, I would be happy to share my thoughts and opinions. He had one placed for a GI and swallowing disorder due to prematurity. This resulted in severe malnutrition and failure to grow/thrive.
    Every day I wake up is a good one

  3. #3
    Moderator Obieone's Avatar
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    Hawknest ..... my husband Bill is a T5 para and had to have supplemental feeding while in hosp when he had gall bladder surgery a few years ago! He too had lost a lot of weight (6'2 130 or so lbs. used to be 185/190) and at the same time was trying to heal pressure sores and an incision .... so they did TPN http://en.wikipedia.org/wiki/Total_parenteral_nutrition which was delievered via his PICC line! He began eating again slowly while still on the supplement, in addition to drinking Ensure, to help build up his strength as well as his weight! He stayed on the TPN for quite awhile and he finally started to put weight back on!



    Obieone
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  4. #4
    Like your son I experienced significant weight loss following my accident and further crisis-level weight loss continued to be a problem even as moved into the recovery phase. I had a g-tube placed and had hoped to have it removed, and even went off it for a few months. But when my weight loss issues continued and I was unable to maintain a healthy body weight even after working closely with a dietician, the decision was made to keep the tube for a while longer.

    Psychologically it can be a tough thing to deal with, but I think it was the best thing for me. It has taken away a lot of the stress around my weight and eating in general. My energy levels and health are much more stable than when I briefly went off the G-tube last year. I have some swallowing issues related to my injury and the stress of continually changing my diet to try and pack on the pounds was making them worse. I think that is one of the biggest advantages is that it has significantly lowered the anxiety surrounding my weight for me and my caregivers.

    I do eat three meals a day most of the time, the G-tube really just acts as a supplement to them. My weight has finally begun to stabilize and I am now putting on about two pounds a month, while steadily decreasing how much of my daily nutrition is coming through the tube. More importantly, I haven't been losing any more weight. I am planning on having it removed once I get back to a healthy weight again, so it definately does not have to be something permanent for your son. I might just give him the boost his current diet needs to become more effective.

    There are a number of different options for the type of tube and the feeding process, and I had to try several before I found one that worked the best for me.

    I don't know if that helps any.
    Last edited by orangejello; 06-22-2007 at 03:58 PM.

  5. #5

    Smile Thank you for the input!

    Your responses gave me good questions to ask the doctor and an idea of what to expect. Phil has decided to have the G-tube put in, the procedure will be done next week at Children's Hospital in Philadelphia.

    SCI nurse, you are so right about good nutrition! My son eats, but it is a typical teenage diet-pizza and burgers-I'm sick of nagging him to eat something "healthy"

    He has been taking a supplement called JUVEN which his wound care dr. gave him. It is for chemo or aids patients, but it has really helped Phil's wound heal and his levels were up.

    Thanks again, I'm feeling a bit more optimistic.
    Hawknest

  6. #6
    Hi,

    Your description of your sons situation points to a severe weight loss and
    poor nutrition. Especially with regards to trying to heal the pressure sores, good nutrition with adequate pre and albumin levels really facilitates healing.

    Its been my experience that g tube feedings can often "jumpstart" a clients feeling better, improve their general health status, lab values and improve wound healing.

    It may be helpful to focus on the g tube being temporary. It is a fairly minor procedure to place as well as remove if his nutrition improves where he can be maintained adequately through oral feedings. And, it is not an overnight improvement but often you can see a rise in pre and albumin levels fairly quickly with the feedings.

    Most clinicians strive to remove these tubes as early as possible because it is well known that oral feedings are better overall in terms of digestion, absorption, side effects,etc.

    You are right to ask these questions and getting feedback before consenting to this procedure and I would encourage you to discuss them with your doctor.

    Good luck and keep us posted.

    AAD

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