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Tuesday, March 15, 2011

The J Tube

The day before we left for San Diego, Charlotte had her G-tube changed to a G-J-Tube. Her feedings now go directly into her intestines, bypassing not just her mouth, but her stomach as well.

The theory behind this is that if there is nothing in her stomach, there will be nothing to create a sensation of being full. The lack of that sensation is supposed to decrease the amount of gagging. The decrease in gagging is supposed to decrease the oral aversion. The decreased oral aversion is supposed to make it easier to feed by mouth.

Phew. That's a lot of supposed to's.

So far, we've noticed days that are much, much better. But then, we have days that are just about the same. The plan is to trial it for a month and make a decision from there whether or not to leave it in or go back to the G-Tube.

Why go back?

Well, for starters, Charlotte cannot have the button GJ tube. Why does that matter? Here's the difference:

GJ Tube (Current)
G-tube Button (Placed Sept 2010)
The button is much smaller, and has a much lower profile, as you can see. The extension tubing that allows access into the button is removable, which causes less tugging on the belly. Charlotte would be eligible for a GJ Button once she hits 25 pounds. She's currently around 18.5 pounds, {which is *huge* for a 12 month old micropreemie. So large in fact, that they are a little concerned that her weight might be holding her back in some developmental aspects (ie, she can't learn to crawl or pull herself up because she weighs too much for her body to handle).} So even though 25 pounds is relatively close, it would be at least  8-10 months before she would be large enough to have the GJ button. Basically, they don't manufacture a GJ button for kids smaller than 25 pounds.

Another reason to go back to the G-tube is that the food would be going into the stomach and then naturally going into the intestines, instead of bypassing the stomach and being pumped directly into the intestines. It's bad enough we're by passing her mouth, we'd like to include as many of her organs in the feeding process as possible.

Also, there's no hope of condensing feeds with J feedings. Formula must be pumped into the intestines at a pretty regular rate (she is "on the pump" for 10 hours and off for 2, repeat over and over and over again).

But if the J feedings get her healthier and help develop a desire to eat by mouth, then, shoot, bring them on! So that's the deal. We're approximately 2 weeks into the trial, and we should have another 2 weeks to go. Hopefully we'll know for sure what we want to do.

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