Nasogastric tube

What a day.  This was one of the most difficult days in this whole year. 

I knew that it was time for Boeta to get a NGT.  He started eating again but too little and too much junk (only junk, actually).  Wouter and I talked it over weeks ago already and we weren’t shocked when Cristina declared it Time For The Tube.  I also wasn’t surprised when she wrote it up in Boeta’s file and then made a quick escape. 

S:  Let me guess.  You wrote it up but YOU aren’t going to do it, right?

C: (utterly horrified) Of course not.  Wouter and I are friends.

Then Gerrit arrived and prescribed pre-meds for Boeta to keep him from remembering the trauma.  Apparently it is very traumatic having the tube inserted.

S:  Let me guess.  You wrote up the meds but YOU aren’t going to do it, right?

G: (utterly horrified)  Of course not.  Wouter and I are friends.

Then Debbie arrived with the chlorol hydrate that Boeta had to drink.  He drank it, then he vomited it.  So Debbie phoned Gerrit and Gerrit prescribed 1.5mg Dormicum.  More than enough to keep a normal 15kg child high for quite some time.

Except that, as previously ascertained, Boeta isn’t a normal 15kg child.  The anaethetist could barely keep him under when he had his recent scan because his liver function is off the charts as it constantly tries to clear the chemo drugs from his system. 

My cousin Lizbé (aka Zippy) was visiting at that time and she stayed with Boeta while I relocated to the patients’ lounge.  I could hear exacly when Gerrit (who did in fact insert the tube) and Debbie started.  Boeta was screaming for 15 minutes.  During that time they inserted the tube 5 times and he ripped it out 5 times.  I could hear him screaming for me.  I should’ve gone a lot further.  It was very upsetting to me, Lizbé, Gerrit and Debbie, who burst into tears.  Debbie is such a mother to every child in her care and seeing Woutertjie that upset broke her heart.  On paper it is easy to insert the tube:  stick it down the nose and down the oesophagus and into the stomach before you tape it down on the cheek to keep it in place.  But Boeta is like an octopus – holding him down is impossible and he can wriggle out of any grip.

When I heard Boeta calm down I went to the room and found him sitting on Lizbé’s lap, fast asleep.  I took my leave again.  They tried one more time but again Boeta ripped it out.

It was time to call in the big guns.  Meanwhile Boeta woke up from his drug-induced state and couldn’t remember a thing.  That is the beauty of Dormicum.  While you are apparently awake and fully functioning you will have no memory of the time.  Gerrit then prescribed 3mg of Dormicum and they tied Boeta’s hands into fists so that he couldn’t get a finger near his nose and hook the tube out. 

This time they got the tube down and it stayed down.  Wouter and I went to buy coffee at the cafeteria to make sure that we don’t hear anything.  We were barely there when Gerrit phoned to say that they were done and we could come back.

It is amazing how quickly Boeta made peace with the tube.  During the first attempts to insert the tube he was screaming that he didn’t want to look like Enrico (who already has a NGT).  When he was properly awake he wanted to look in the mirror to see what he looked like and that was it.  Children are so amazingly adaptable while the adults are all traumatised.  Eish.

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2 Responses

  1. Eish is right 😦 Sorry you all had to go through that.
    Hope that he gets the nutrition he needs now 😦

  2. Oh Suzanne 😦
    Biggest hugs to you, I’m so glad he has adapted well!!!

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