Brody is having surgery to remove NJ and NG tubes and replace his nephrostomy tube

Brody is in surgery right now to remove his NG and NJ tubes and also to replace his nephrostomy tube.   The nephrostomy tube has to be changed out every 3 months.   He happened to be due for this at the same time we are dealing with other tube issues.  

The NJ and NG tubes have been causing Brody a lot of pain and irritation.   He will be glad to have these out and let his throat and nasal cavity start to recover.  

We decided against placing the J tube through the G tube today (converting the G tube to a Gj tube).    We are just too nervous placing the J tube through the G Tube will decrease the diameter of the G tube too much.   We are afraid it would prohibit sufficient drainage of the gastrointestinal secretions that accumulate in his stomach.   He has been draining about a liter a day out of his NG.   Being able to get these accumulated secretions out of his stomach is critical to preventing vomiting.  He starts vomiting once he reaches a critical volume of secretions. 

His G tube cannot be put to suction (at least not yet... it would need to be at least 4 weeks before that could be a possibility and it would be very low suction if we did it).   The tract created for the G tube needs to heal before any possibility of suctioning the G Tube.  

We are very nervous about whether the G tube with gravity drain bag will be enough.   Putting the J tube through will make it even more difficult to get enough drainage to keep Brody from vomiting. 

Brody is not able to tolerate feedings through a J tube.  The primary purpose of the J tube for him is administration of medications that we cannot do via IV.   His nutrition needs are all provided by IV.   He has one medication right now that we had been putting into his NJ tube that is critical for us to give for Brody's nerve pain relief.   It had to be given three times a day.   We have decided to  switch it to a very similar medication that only needs to be given once daily instead of three times a day.   It will be given via the G Tube and then the G Tube will be clamped for a couple hours after administration.   The medication is absorbed quickly and so it's hoped he will do okay with this instead.   Other meds we had been given through the Nj tube will be converted to IV instead.  

The interventional radiologist just let me know Brody is done and is being taken to recovery room.  

I am gonna head to that waiting room now.  

More later....