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---------------------------------------------------------------------------- -- >In several letters to the list lately I've seen reference to a >gastronomy, or feeding tube. Could anyone tell me what is involved with >using one? How is it put in? Is it permanent, or inserted at each >meal? How much expertise is needed to feed a patient using one? Can the >patient eat in any other way once a tube is used? My mother does more >choking than swallowing, and is losing weight. It takes her so long to >even eat a little, that she is quickly too tired to finish taking in the >amount she needs. She tries to eat often, but we should know about what >may be yet to come. Thanks. Well, we are not experts on the subject, but here goes! My dad, like your Mom, used to sometimes spend the better part of the day choking, and the embarrassment forced us to avoid social situations, and it made my Mom ANGRY at him! She knew that he didn't choke on purpose, I think it was a milestone progression of the PD that none of us wanted to take place, and that we were ignorant about what to do next. Our situation is another example of making sure that we all demand the medical care and advice that we all deserve! No one explained to us that moving to a G tube is sometimes inevitable. We has a gastroenterologist that performed an esophogial balloon procedure that would help Dad swallow for a period of time. Meanwhile, he was getting dangerously thin, and like you said - just too tired to eat. To top it off, our dentist indicated that after 30 years of medication, his teeth began cracking apart. We though that new chompers would fix him up - because he could chew properly. WRONG. I would suggest aggressively pursuing the subject with your doctors. YOU make sure that they understand your concerns and your Mom's eating habits. It seemed to us that the neurologist felt that this was a gastro problem and that the gastro didn't understand how PD effects eating. The procedure initially required an overnight surgery, and subsequent home nursing care until the area around the incision "healed". (It never really heals, b/c it is a hole in your gut.) The home nursing staff instructed my Mom on the proper usage and care. It includes cleaning the area and applying cross-cut gauze around the tube regularly. The feeding procedure uses a big plastic syringe that attaches to the end of the tube. The pressure of the tube splooshes the food into his stomach. Most of us have easily learned how to feed Dad. The youngest was a 14 year old grand daughter. When we visit Mom we try to relieve her, because dad has an ulcer that requires medicine an hour before eating, so with meds Mom has 8 feedings a day. The tube has a shut off valve that keeps stomach stuff in and prevents big messes. ( My sister messed up this summer and squirted an entire tube of food into Dad's ear and across the sofa and up the wall - so it isn't always great.) Squirting the food in takes some practice. If it goes in too fast, then it comes right out the bottom end - and it is messy. Too cold food can cause some cramping. Most of it is common sense. Meds have to be crushed and dissolved before they can go through the tube. This is a pain in the butt for Mom and her arthritic hands. Don't forget that food has to be ground up, and mixed with liquid - and sometimes it is just easier to feed him full of "Ensure". (He doesn't know the difference except hot and cold) The first tube lasted almost a year - and then an outpatient procedure replaced it. We have since gone through about 4 tubes. There is some kind of balloon that is inflated inside the stomach that keeps the tube in place. My Dad's extremely acid stomach destroys the balloon and the tube occasionally comes out. All we need to do is put the tube back in, and call the home health nurse to replace it properly. We always keep spares in the he house. My summary - Dad feels better b/c he has nourishment, has put on weight and gets his meds regularly. The adequate food allows his meds to work better. He says the tube doesn't hurt. Occasionally, he HAS to eat - and we give him ice cream, but it makes his drooling much worse. (but that is another topic) I wish that we had done this earlier. Sara Byron