GI follow up

I finally took Liam in to the GI for his post op check up.

They didn't harass me for being almost 2 weeks behind. =)

I actually got some really good information.

Liam is having major granulation tissue problems. It originally started at the one spot I showed you guys before and has spread all the way around the stoma. It makes his tube leaky and ugly looking. It definitely isn't the pretty one you see in the take home g-tube video!

I realized, after watching the Dr, that I do not use enough silver nitrate to head off the tissue. I was following Dr. Kid's example and just putting a bit on the edge of the tissue, being a bit too conservative. Dr. Gut slathered the entire stoma with the nitrate, numbing the skin in advance and sealing it to prevent any damage to healthy tissue. By the time we got home over half the tissue had sloughed off. Once we get the tissue down to a small size, I can keep it away with some steroid creme.

I also got to meet with our amazing nurse practitioner and the nutritionist who shared my concerns about Liam's continued use of Boost Kid Essentials for all of his caloric needs. I hate to admit that I only recently looked at the formula and noticed that the first two ingredients are water and sugar! I couldn't believe it! I've been feeding him this stuff for over a year!

They also set up a feeding schedule that will hopefully help him with not only his reflux but will help me take away the night time feeds. As it stands, I am feeding him 16 ounces while he sleeps! I am not fond of that idea at all, reflux can continue unabated through the night and feeding him stuff to reflux is not the greatest of ideas.

So, we are switching him to Nestle Compleat which is REAL food (real chicken stock, cranberries, etc) in a drinkable formula and we are going to take an hour to feed him 125 ml 6-7 times a day.

We are also upping his reflux meds for now and adding in some probiotics.

Hopefully these steps will keep him from vomiting so much.

Tissue

Liam had a small ring of dark blood the other day around his g-tube. I thought it very odd but when I looked at the site it all looked well and there were no tears or bleeding anywhere. The next day when I checked it out and was cleaning the site, I noticed what I can only describe as a large loose flap of skin under the top side of the tube. I racked my brain training to figure out how that had happened and the only thing I could think of was that somehow while he had been in his car seat he had hurt it (I know, I'm new to this g-tube thing). Anyway, I kept an eye through the week and the flap wouldn't adhere or heal to the rest of his tummy.
I figured if it was still bad next week I would take him in.

Liam had PT today and I had Cathy take a look at it. She said it looked like granulation tissue.

I called the ped, took him in and yup...it's granulation tissue.

Good thing I know what I'm doing, right?

This was one of my biggest concerns with this tube. I had heard horror stories and I have had numerous people reassure me that it's not a big deal and many people who have never had that problem. But here we are 3 weeks in and he is getting granulation tissue already.

Dr. Kid said that granulation tissue isn't worrisome unless it starts to look wet. Liam's was saturated.

She took some silver nitrate, assured me it doesn't bother Liam, and applied some to the area.

Any and all advice is welcomed on what to do to keep this from becoming a problem.

I have two tips so far- use the 2x2 pads and use Eucalyptus oil to clean it.

Anything else I should know?