On Friday, May 15th, 2015, Abi had a nasojejunal tube (NJ) inserted. That is a feeding tube that it is threaded down through the nose and stomach, and into the jejunum, the middle section of the small intestine. Doctors decided that an NJ tube was the right option for Abi because it would bypass her stomach and, therefore, help minimise any chance of vomiting. Meanwhile, because her stomach would be empty, she should still feel hungry, so it gives her a chance of regaining her appetite.
Abi had a nasogastric tube (similar to an NJ tube, but it only goes as far as the stomach) to aid her nutrition for about three months at the end of 2014. She had to have that re-inserted many times, due to her vomiting it up regularly. Each time it was tough to put the tube down Abi’s throat, and, this time, was no different. In fact, if anything, it was even more of a drama. The nurse’s first attempt was coughed back up. That led to lots of tears and Abi determinedly preventing the nurse putting the tube down her nose. “I can’t, Daddy!” she insisted. I was equally determined: “Yes you can, Abi. I’ve seen you do it many times before, so I know you can,” I told her, firmly. She sobbed a muffled reply through fingers clamped tightly over her nose and mouth: “No I can’t, Daddy.” I stroked her leg, gently, and tried reassuring her that the tube was a good thing: “It will help get you big and strong, Abi. It will mean we can get you home. Come on Abi, let the nurse put the tube down your nose.” But she was determined: “No!” Abi’s obstinance continued for about 10 minutes more until she finally agreed to let the nurse try again. But only if she was allowed to sit up. Apparently the NJ tube needed to be inserted with Abi lying on her right side, but the nurse agreed that Abi could sit up for the first part of the insertion, down into her stomach. So, somewhat reluctantly, Abi allowed the nurse to have another go, this time with Abi sucking lemonade through a straw. The tube was soon into Abi’s stomach, and the nurse asked her to lay on her right side. A few seconds later and all was done. Success! Not that Abi saw it that way; tears flowed for a good 30 minutes afterwards. She was still feeling somewhat sorry for herself due to the injustice of having to have a tube pushed down her throat. I finally managed to cheer her up by pretending that her fluffy squirrel was a flying squirrel who was dropping kinder egg bombs on Abi’s stretchy-man toy. Even then, with a fierce determination, Abi tried not to laugh. But a snigger betrayed her.
An X-ray later confirmed that the NJ tube was in the correct position. Abi spent the night having Dialyte pumped through it, just to make sure she tolerated having feeds pushed directly into her intestine. That went well, so soon afterwards she started receiving a nutrient supplement at 40ml an hour.
Meanwhile, Abi has improved a good deal. She’s even began eating again (600 calories so far today). Hopefully, that continues and we can start thinking about getting her home.