Implanted port (Portacath): This is a completely subcutaneous port which, when accessed by a (very large!) needle, serves as my feeding line for TPN. After numerous failed PICC lines, we decided to try a more long-term approach with this kind of central line (this one was placed December 21st, 2006). Currently I run the TPN for 12 hours at night, which seems to work fairly well for me.

J-tube (jejunostomy, feeding jejunostomy): This is the tube I had surgically placed on February 7, 2006. It is implanted directly into the small intestine, well past the exit from the stomach, through the abdominal wall. It is used to provide nutrition for people whose stomachs are problematic (as is mine) or who suffer from untreatable acid reflux (causing them to choke and aspirate the fluid into their lungs). J-tubes are much narrower than g-tubes (see below), and the liquid nutrition must be pumped very slowly, as the small intestine is used to small amounts being released by the stomach at regular intervals (something my stomach, apparently, has completely forgotten how to do, unless 16 hours is considered an acceptable interval). So while I was on tube feeding for those five short months, all my nutrition came through the j-tube—the “entrance only” tube. Now I use it for medications, but that’s all.

G-tube (gastrostomy, PEG, percutaneous endoscopic gastrostomy): This is a tube that is implanted in the stomach itself, through the abdominal wall. Usually it is used to feed people who for various reasons cannot take food orally. However, as in my case, it can also be used to decompress the stomach—releasing gas, air, and liquid that is not effectively exiting the stomach via the pyloric valve. I will not be receiving any nutrition through the g-tube—it is strictly an “exit only” tube.

So what happens to the stuff I let out of the g-tube? Well, it’s kind of like burping and vomiting through my abdomen, without the muscle contractions, salivary overload, acidic nostrils, and other various and sundry experiences of a really good barf, so it goes, well, where that sort of stuff goes. I measure how much fluid I let out, and make sure I replenish it by drinking Gatorade-type drinks. I won’t be able to eat solid foods like hamburgers or pizza or anything like that—but things that turn liquid (like ICE CREAM!) and won’t clog the g-tube should I need to release them will be fun to have again. And not everything I eat will need to be let out that way. On good days, I may not need to use the g-tube at all. And sometimes some ice cream (or pudding, or mashed potatoes) may actually make it through the stomach. But those are merely bonuses—I am dependent on TPN for all my nutritional needs.

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