Another Surgery

This one is so much smaller compared to the last I've had. I guess now that I am on a ventilator the tables have turned. There are some added risks involved and some unknowns I am still figuring out.

Thursday March 4th, I go in to have a G-tube placed. A G-tube is a gastrointestinal tube that is placed directly into the stomach. This will be completely separate to my J-tube. This is done outpatient and is a rather quick procedure.

Why do you need a G-tube if you have a J-tube? So my J-tube is used for medications (not all medications can go through a J!), and my tube feeds.

I have a rare condition called Gastroparesis. While there are varying degrees to this condition ranging from mild to severe, I unfortunately am in the severe category. What this conditions means is, delayed stomach emptying (or stomach paralysis). Your stomach doesn't digest as quickly as it normally should. This is a condition often seen in diabetics, but can be idiopathic as well. Due to this when I eat or drink anything orally my stomach personally does not digest what I consume, and after about 30 minutes to even hours later I will vomit everything up. My doctors believe due to the severity, I've had this for quite some time. Its quite possible my eating disorder was misdiagnosed or Gastroparesis lead to disordered eating behavior which lead to an eating disorder. Whatever it maybe, this condition was missed!

I also have a rare condition called Superior Mesenteric Artery Syndrome or SMAS. What this means is part of my duodenum is compressed between the the aorta and the superior mesenteric artery. This was the deciding factor for my J-tube. Nothing could pass through my duodenum due to the compression. Not only is my stomach paralyzed but I also have a compression to part of my upper intestine.

G-tubes help aid in nausea by releasing trapped air or gas in the stomach. By having a G-tube I will be able to vent my stomach and release this air decompressing it and hopefully relieving the nausea. I have constant nausea, it'll be interesting to see if something so simple as venting will help vs taking rescue medications.

Your stomach is also always making stomach acid. Even though my stomach doesn't work to digest food it does make acid. Apparently a lot of it. I have bad GERD. I have to take two different kinds of prescription medication for reflux. G-tubes do have a function that allows you to drain stomach contents, though this can be very dangerous so obviously do not do this unless discussed with a doctor a head of time!! This can also relieve nausea and bloating. Or if you in take anything orally and to avoid vomiting you can drain the stomach.

I have dysphagia - difficulty swallowing. I have had this for years but it's gotten worse to the point I am now aspirating. I had a swallow study earlier this year which proved this. Although I did exaggerate it quite a bit to get my point across and out of frustration because I had to advocate like hell as to why I was even there. Thats a totally different story!! We think the progression maybe due to the overall muscle weakness happening to my body.

Having a G-tube allows me to take medications I cannot take through my J-tube or that I cannot get in liquid form. There are also medication that generally do better going through the stomach even if it goes through slower.

A big reason for my fighting for a G-tube for now over a year is nutrition reasons! G-tubes and J-tubes usually go hand in hand in aiding each other in tube feeding. J-tube for nutrition and G-tube to help with any nausea and gas build up.

I've never been able to reach my prescribed feed rate, or been able to run my feeds for very long without it becoming uncomfortable. It's not the formula because this happens even with plain water.

I've talked to 3 different nutritionists who all agreed a G-tube would be beneficial and may help in increasing my rate which would hopefully help me run my feeds longer too. Which in turn would allow me to maybe gain weight. I say maybe because gaining is really hard. What's MOST important is getting the nutrition I need.

I was originally supposed to have the G-tube placed on January 15, 2021. My pulmonologist and GI decided there was too much risk involved. My lungs were too weak to undergo anesthesia. The tracheostomy needed to be done first before the tube could be placed.

With me now on a ventilator we now have to make sure the hospital is aware of this and is prepared! I will have to be switched from my home ventilator to the hospital's ventilator. A respiratory therapist will also have to be present during the procedure, so they will need to make sure one is now available during that time.

They will need an anesthesiologist and not an anesthesiology nurse. Usually during endoscopy procedures anesthesiology nurses are used because of the type of sedation used. Because I am on a vent this is not possible as nurses are not equipped or licensed to run ventilators. Again its important the hospital is prepared with the correct staff.

So here we are. This will hopefully be the last surgery for a long long while!

My nephrologist is urging me to come in after seeing my labs from after my trach. I just need a break, like seriously, my body is doing too much at one time. My kidneys have been a long time coming though! A suspicion I've had for a while too. They just aren't doing a very good job.

Just have to keep fighting, keep going, and keep pushing forward!! I got this!! Onward we go!!

Fighting to breathe another day💜 #beccasfight

and keep pushing forward!! I got this!! Onward!!