NG Tube

Hi All,

I'm wondering if it's absolutely necessary to have an NG tube in after revision surgery and if so, for how long. I had a lap RNY in the past and did have an NG tube in while I was in the recovery room, but it was removed before I was moved to my post-surgical room.

I have a very difficult time having anything forced down my throat due to past sexual abuse trauma. After the RNY procedure, I woke and started having flashbacks and tried to pull the tube out of my throat. They did get me calmed down and let me suck on a few ice chips and told me the tube would be removed soon, which it was.

I've recently had my consult with Dr. Buchwald in Minneapolis for a revision from the RNY to the DS. My understanding is he only performs open procedures. I'm now awaiting insurance approval and a surgery date. I heard from one of his other patients that she had to have an NG tube in for three days post surgery. Honestly, I'm not sure I'll be able to tolerate that unless I'm heavily sedated, i.e., knocked out completely! And I'm not sure that's a possibility.

So I'm wondering about others' experiences with the NG tube. How long did you have to have one in? How did you tolerate it? Can they put you out during the period of time you have one in? I'm very concerned about having a repeat occurrence with the flashbacks and trying to pull it out again in my drug-induced state. Why is it necessary to even have it in afterward and is there some set standard that determines when it can be removed? I'd appreciate any and all input. Thanks!

Warmest wishes,

Lisa

Dagnabbit, I wrote a nice long response and it got eaten. Okay, trying again.

First of all: NG tubes are our friends. There are not a lot of surgeons who go without them, because they prevent a LOT of problems and misery. They get nasty stuff out and therefore reduce MANY possible complications.  Heavy sedation is bad, very very risky for a lot of reasons, not the least of which is the awful strain on your respiratory system. The risk of pneumonia and other bad stuff like that goes up exponentially the longer your system is depressed by that stuff.

However, I too have a trauma history and understand all too well the power of flashbacks. I'd like to suggest some brief therapeutic interventions that can address this particular trauma issue: EMDR (Eye Movement Desensitization and Reprocessing), Thought Field Therapy (or a variation, Evolving Thought Field Therapy or EvTFT) and Heart Assisted Therapy or HAT.

http://www.heartassistedtherapy.net/ This psychologist has some thirty years of experience in working with trauma survivors and a wide network of professional contacts. If you are not able to find someone in your area who does these kinds of interventions, contact him and see if he can help. Feel free to mention my name.

Another way to address this is with a customized hypnosis recording that you would use in surgery and recovery to mobilize your mind's ability to find other ways to move around and beyond this issue. You need a very good therapist with strong experience in the use of trance work in trauma recovery to do this. I am especially partial to the Ericksonian method of doing this, which uses storytelling, metaphor and other subtleties of language rather than direct suggestions in most cases.

Thanks, Elizabeth, for all of the trauma-related resources. I certainly think some of them will be helpful to deal with the psychological discomfort. How did you cope with the actual physical discomfort of the tube though? That seems more distressing to me as it feels like I'm constantly choking. If it is necessary for me to have one post surgery, I was going to ask if they may have a pediatric sized tube they could use instead as that may make it more tolerable. I certainly appreciate your feedback and all of the valuable resources you've provided. I enjoy reading your posts on this site. It sure helps me to get perspectives from those who've already undergone the procedure and are well into their recovery. Thanks again!

Warmest wishes,

Lisa

For me it felt like no more than a slight irritation at the back of my throat, a little more than a tickle or scratch that made me want to clear my throat sometimes. However, I had a very nice pain pump and made liberal use thereof, so my sensation was limited :-D. That was the first two nights postop. I got it pulled on day three (second postop day), once I got moved to a regular room. Got the incisional drains pulled then too.

I had an NG tube for both my RNY and my DS revision, I think this last one was 1 or 2 days. I really don't remember. Excellent pain management.

Thanks for your feedback, Gail! I sure hope if I do have to have the tube in that it's only for a day or so. Was there anything that made it more physically tolerable for you? How did you get around that choking sensation? Thanks again for all of your wonderful posts on this site. I appreciate the insight and wisdom you and the other vets share!

Warmest wishes,

Lisa

I don't remember any choking sensation at all, just a sore throat. I remember it kind of "tickled" when it was removed. I know that sounds weird. Again, I was pretty much dozing/sleeping or up walking. In fact, the whole first week was pretty much a blur.

I wouldn't worry until you heard from the doc you need it. I did not have one?

Thanks for letting me know that, Emily. I haven't heard from anyone yet who didn't have to use one. I certainly hope that will be the case for me as well!

Warmest wishes,

Lisa

Don't get your hopes up. The RNY to DS revision is a HUGE operation and the surgeon will be that much more cautious in covering every possible base.