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  #1  
Old 03-29-2005, 06:17 PM
Blalron Blalron is offline
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What kind of food do they give patients with feeding tubes?

What stuff actually goes into the tubes?
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  #2  
Old 03-29-2005, 06:24 PM
spingears spingears is offline
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Quote:
Originally Posted by Blalron
What stuff actually goes into the tubes?
A liquid food/food suplement similar to "Ensure."
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  #3  
Old 03-29-2005, 06:31 PM
chaoticbear chaoticbear is offline
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Liquid People Chow. patent pending
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  #4  
Old 03-29-2005, 06:31 PM
Blalron Blalron is offline
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Quote:
Originally Posted by spingears
A liquid food/food suplement similar to "Ensure."
So does that mean I could survive purely off of "Ensure"?
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  #5  
Old 03-29-2005, 06:35 PM
don't ask don't ask is offline
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In my nursing days it was a vitamised (pureed) diet. The same stuff everyone else got turned to mush with a bit of added fluid so that it was easier to give..
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  #6  
Old 03-29-2005, 07:54 PM
Stillwell Angel Stillwell Angel is offline
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Part my job at the nursing home I work in is to fill in for the supply person when she's gone. I deliver the "tube food" & supplies (bags, piston pumps) that go with it to the patients rooms. Ive never sat down & looked at the ingriedients of this stuff but I know it looks like a grainy chocolate milkshake. Yum.
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  #7  
Old 03-29-2005, 08:05 PM
Smeghead Smeghead is offline
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Well, when I was on a feeding tube due to a seriously fucked-up pancreas, I lived for six months off this stuff called Peptamin. Made by Nestle. It's like Ensure, as has been said. So, yes, you can live off it and nothing else, though I don't recommend it.
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  #8  
Old 03-29-2005, 08:14 PM
Kiminy Kiminy is offline
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Our son was on a feeding tube for about a month when he was paralyzed with Guillain-Barré Syndrome. He was fed basically a kid version of Pediasure/Ensure. The can was poured into a bag, the bag was hooked to a pump, and the pump pushed the liquid through a tube that went up through his nose, down his esophagus, and emptied just on the other side of the stomach, into the large intestine.

The "food" was a prescription-only formula, that had more nutrients than the standard OTC stuff, and it was designed specifically to be the only food the child needed to eat. (I did a side-by-side comparison of one of his food cans and a can of Pediasure.)

Taste aside, the nutrition supplements like Ensure are not generally designed to be the person's only source of nutrition, and most of them clearly state this somewhere on the can.
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  #9  
Old 03-29-2005, 09:19 PM
Triskadecamus Triskadecamus is offline
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The tube feeding formulas available include Promote, Jevity and a number of others with varying dietary profiles. They are also different from Ensure in that they are isotonic, and somewhat more dilute, so as to assure proper hydration. I believe those particular ones are prescription only, but I could be wrong.

They are infused with a pump, generally, at a rate and on a schedule that is tolerated by the patient, and keeps them in a comfortable state with regards to hunger, and hydration. Generally, you would not give any fluids by mouth, but would use swabs to clean and hydrate the tissues of the mouth.

Tris
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  #10  
Old 03-29-2005, 09:29 PM
Stillwell Angel Stillwell Angel is offline
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Quote:
Originally Posted by Triskadecamus
I believe those particular ones are prescription only, but I could be wrong.

That is correct, at least under our policy. We require a doctors order for all of these foods, and usually the doc is pretty specific on what brand and content. For instance we carry the Jevity line among others, but you can't give Jevity 1.0 to a patient if the doctor ordered Jevity 1.2

There are also certain brands made especially for diabetics. So yes they are prescribed.
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  #11  
Old 03-29-2005, 09:41 PM
Waterman Waterman is offline
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My first wife had ALS and had a feeding tube inserted about 9 months before she died. While most of what she had was ensure and jevity she also wanted real food which I prepared by pureeing all sorts of stuff (fruits, milk shakes, etc.) in a blender. As long as you get it through the tube without plugging you could feed it. Her doctor wanted her to have as much food in her as she could tolerate. She had a hard time accepting the feeding tube and she said that at least knowing that she could get "regular" food partially made up for not being able to actually taste it.
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  #12  
Old 03-29-2005, 09:55 PM
ice1000 ice1000 is offline
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Several years ago I had a car accident and as a result of my injuries, I lost the ability to eat. I was on a feeding tube until I learned to swallow. Then they simply gave me the cans they used to fill the tubes with...Sustacal.

The original flavor is horrible but the vanilla flavored one tastes just like a milkshake!


PS. In a morphine induced rage, I tore out my feeding tube once. Being conscious as the tube is reinserted is NOT FUN. The tube hurts like hell when they jam it up your nose so it can turn downwards. After that, you can actually feel the tube crash against your epligottis as they get it in the esophagus vs trachea.
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  #13  
Old 03-29-2005, 10:41 PM
brossa brossa is offline
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There are a lot of different tube feeding formulas, tailored for different needs. Patients who are fed into the stomach can tolerate a higher osmotic load than those fed into the small intestine; people with pancreatitis or absorptive problems can require a sort of 'predigested' formula or one with extra branched chain fatty acids; there are formulas with substances that help to boost immune function; some are restricted in particular compounds (eg lower protein) for those with kidney or other organ failure; patients with pulmonary failure get fewer carbohydrates. The formulas also differ in calorie count per cc - things like 2Cal have double the calories, usually by having more fat.

These specialized formulas come in cans and are not intended for drinking, like Ensure is - they can taste and smell pretty vile. For people without special nutritional needs, Ensure, Boost, Jevity, or whatever brand the hospital has a deal with are frequently used. Patients with nasogastric tubes require a more watery formula because the tube is much longer and has a much smaller diameter; folks with gastrostomy tubes like T. Schiavo can basically get blenderized regular food through the tube, which is a lot cheaper in the long run. Gastrostomy patients can also tolerate plain water in the tube better than folks with jejunal or ileal feeding tubes.

Ideally, the choice of tube feed is made in consultation with a hospital nutritionist.
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  #14  
Old 03-29-2005, 10:55 PM
picunurse picunurse is offline
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What they said. Here's a site that explains it medically (I don't know why its an orthopedic site, but the information is good.)
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  #15  
Old 03-29-2005, 11:39 PM
danceswithcats danceswithcats is offline
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I'm soo glad that feeding tubes were used while I was comatose. The shite I was handed to swallow after the tube came out was turble! DEE-skusting.
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  #16  
Old 03-30-2005, 02:42 AM
Mac Guffin Mac Guffin is offline
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The hospital I work at in supply uses Ross products, IE. Jevity, Jevity Plus, Osmolite, Osmolite plus, Glucerna, Nepro, Pulmacare, Oxepa, Promote, and Promote with fiber. They all have a rather beige appearance. Each one is special for whatever problem the patient has. I beleve Pulmacare is specificly designed for patients on a vent. Glucerna is for diabetics.

Here is the Ross Website that lists the adult feeding solutions. There are a whole bunch listed.

http://www.ross.com/productHandbook/adultNut.asp

I haven't tasted these, but I am told they are pretty vile. Kinda like drinking an oily milkshake with a bunch of vitamins ground up into it.

Up until about two years ago, the feeding tubing we used contained a blue dye capsule. The feeding solution was dyed blue to help the nurses tell if the patient was asperating the stuff, as opposed to mere mucus since there isn't much difference in appearance between the two. They stopped using the blue dye when they discovered that it was turning the patients blue from the insides out. I heard that patents on long term feeding, when autopsied, were entirely blue inside.

Or was that more than you wanted to know?
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  #17  
Old 03-30-2005, 06:05 AM
spingears spingears is offline
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[QUOTE=Blalron]So does that mean I could survive purely off of "Ensure"? Much longer than only water or nothing at all.
Quote:
Originally Posted by spingears
A liquid food/food suplement similar to "Ensure."
All About Tube Feeding
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  #18  
Old 03-30-2005, 07:32 AM
a pirahna brother a pirahna brother is offline
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Quote:
Originally Posted by Triskadecamus
<snip>
Generally, you would not give any fluids by mouth, but would use swabs to clean and hydrate the tissues of the mouth.
Tris
I have a question regarding this part of your response, do you not give oral fluids at all to someone with a feeding tube, or is it only for people who are in a PVS, comatose, or otherwise incapacitated?

I can see the latter for obvious reasons, but if I was conscious with a tube and couldn't have anything to drink, I think I would go mad in a very short period of time.

D. Pirahna
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  #19  
Old 03-30-2005, 08:45 AM
butler1850 butler1850 is offline
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I can't believe that nobody has said the obvious!

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  #20  
Old 03-30-2005, 09:19 AM
WhyNot WhyNot is online now
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Just to make the answer fully complete, I have to add that infants in intensive care are tube fed a special infant formula or breastmilk, if mom is willing to pump it. For premies, a special premie powder (our hospital uses Enfamil) is added to the breastmilk to increase the calories and some nutrients.
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  #21  
Old 03-31-2005, 01:06 AM
Triskadecamus Triskadecamus is offline
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Quote:
Originally Posted by a pirahna brother
I have a question regarding this part of your response, do you not give oral fluids at all to someone with a feeding tube, or is it only for people who are in a PVS, comatose, or otherwise incapacitated?
In some cases, yes. In most cases, no. The level of incapacity doesn't have to be as severe as a coma, or persistent vegetative state. I have regular contact with people who have a condition called disphagia. It means that their oral neuromuscular control has been compromised. With some, soft, or even pureed foods are the only foods that can be eaten, and liquids have to be thickened to a honey consistency. If that regimen is not followed, they are very likely to aspirate their food or drink, and can become infected with pneumonia. It is a very common cause of death in the elderly, and the infirm.

In the extreme case, tube feeding is the only safe way for them to ingest food and fluids. The tissues of the mouth are treated with swabs, often flavored with liquid food flavors, but never so saturated to present a swallowing hazard. The person may be conscious, and entirely rational. The problem is not always related to the same neural regions that control the conscious mind. In some cases it is entirely related to trauma or infection of the oral motor nerves.

Comatose patients cannot ever be given liquids by mouth, for the same reason. They are simply not able to reliably swallow without high risk of aspiration, although a swallow reflex may still be present. But the use of feeding tubes for extended periods also presents a set of risks. Atrophy of the same neuromuscular skills, and the possibility of infection in the stomach from the site of the gastrostomy (hole into the stomach). Nasopharengeal (up the nose, and down the throat) tube are generally only used in very short term cases, because of the trauma involved in the inevitable removal, and reinsertion that would occur with long term use.

One case I know of involves using the tube only for medications. The person has such a profound gag reflex, and such a strong emotional aversion to taking pills that she cannot (and will not) take her needed eleven different doses of drugs without the tube. The medications are essential to her continuing health. The tube was originally placed while she was unconscious. (recovering from an acute episode of the very problems her medication are meant to alleviate) The decision was to leave the tube in place, even after she had recovered enough to eat and drink normally, so it could allow her to stay on the appropriate doses of her medication. So far, it has been working quite well.

Most of the time, though, you don't use tube feeding on a person unless it is necessary to avoid serious medical consequences. In those cases, just taking a sip of ordinary water is a very risky thing. A very capable, responsible person might be physically able to rinse their mouth, and spit, but for most people with serious disphagia, that's pretty tough, too.

Tris
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