This is important, because it means that I now have to set Nicholas up for his 5 p.m. feed at the studio. Not a big deal, I just take the pump with me in his tiny little backpack and hook him up right before Zach is done with his class. I put the kids in the car and hit start on the pump so Nicholas can eat while I drive home. We usually are sitting right next to Nicholas when he's feeding, but since he was eating in the car, I obviously couldn't watch him eat.
Wednesday evening when I got home, I carried the babies up the stairs to our condo, got inside, got Zach situated playing in the living room with some water to rehydrate and took the babies out of the car seat. As I took Nicholas in to the nursery to change his diaper, I noticed that his onesie around his g-tube was wet. Thought this was unusual so took a look. His diaper was very full, so I just figured he had overfilled his diaper and felt bad that his diaper had gotten so full that he had peed out of it. I also noticed that his g-tube pad was soaked, so I unsnapped it. It didn't look like urine on the pad, so I smelled it (the things parents do, huh?) and it was not urine. It was milk. I tried to remember why milk would be leaking from the g-tube site. Called Mike, he wasn't available so he didn't answer. Google led me to the Mic-key button website where I found a handy troubleshooting guide. Troubleshooting guide said the balloon may be loose (explanation in one moment) or there may be a large amount of gas build up in the stomach and the person may need to be vented.
I think I've explained before, but basically the Mic-key button is the tool through which we feed Nicholas. It is a tube that goes through the hole in Nicholas's stomach and abdomen. On the top it is flat and pretty much flush against his skin. There's a hole on one side to stick a slip tip syringe in and control the amount of water in the balloon and there's a hole that we attach the Mic-key extender to which then connects to the bag which is hooked to the pump and holds the milk. On the inside of Nicholas's stomach is the balloon. This is filled with water and basically holds the button so that it doesn't come out of Nicholas's stomach. It fails. It is made of latex and basically spends all day sitting in stomach acid and rubbing against the inside of the stomach. We are authorized one Mic-key button per month from insurance (I think...) but our surgeon told us we don't need to replace them until the balloon fails or something else goes wrong with the button.
I think I've explained before, but basically the Mic-key button is the tool through which we feed Nicholas. It is a tube that goes through the hole in Nicholas's stomach and abdomen. On the top it is flat and pretty much flush against his skin. There's a hole on one side to stick a slip tip syringe in and control the amount of water in the balloon and there's a hole that we attach the Mic-key extender to which then connects to the bag which is hooked to the pump and holds the milk. On the inside of Nicholas's stomach is the balloon. This is filled with water and basically holds the button so that it doesn't come out of Nicholas's stomach. It fails. It is made of latex and basically spends all day sitting in stomach acid and rubbing against the inside of the stomach. We are authorized one Mic-key button per month from insurance (I think...) but our surgeon told us we don't need to replace them until the balloon fails or something else goes wrong with the button.
When you "vent" the g-tube, you put in the extension (above against the green background) and attach a 60 ml syringe to the extension. You let the milk and gas come out of the tummy into the syringe and then you use gravity to push the milk back into the belly. I figured this was a likely place to start, so I got Nicholas situated on his pillow and started to attach the extension to the button. It was precisely that moment that the button fell out of Nicholas's stomach onto the pillow. We've been told several times by several doctors that fluid will take the path of least resistance. Know what the path of least resistance is when you've just put 4 oz into a baby's belly and then a hole appears? Yep...through that hole. Milk began shooting out of the hole that was now in Nicholas's stomach. I grabbed the button (noting that the balloon was basically empty) and shoved it back through the hole. Zach noticed something was happening and wandered over. I told him I needed some water and then realized that I can't ask my three year old to grab a slip tip syringe because well...he's three. I couldn't probably ask an adult to grab one unless they're in the medical field or had some experience with needing slip tip syringes, much less a three year old. Zach heard I needed water and ran away before I could amend my request. He came running back into the living room with the entire gallon of purified water, incredibly proud of himself.
I told him he did a great job and asked him if he could stand there and hold the button in Nicholas's stomach while I grabbed what I needed. He said "Sure!" and put his finger on the button. He turned to watch something on the TV and his finger slipped off. Milk began shooting out of Nicholas's belly again (and I'm talking like the arterial spurts you see on TV - this was no slow dribble) and soaked poor Zach. He screamed and I shoved the button back into Nicholas's stomach and told Zach he had to hold it tight. I run to the kitchen to get a slip tip syringe (and a smaller bottle of water) and then to the nursery to grab a new button. Come back into the living room and not only is Zach still holding the Mic-key button in Nicholas's stomach but he's also holding Nicholas's hand and saying "It's okay Nicholas, Mommy will fix you." He saw me and said, "Nicholas was trying to grab his g-tube so I held his hand." This kid. I swear. He was meant to be Nicholas's big brother. He was not paying any mind to the fact that he was physically holding a button in his brother's stomach, or to the fact that he's currently covered in milk that had shot out of his brother's stomach. He was just doing what I asked and trying to calm his brother down while he did it.
I test the balloon of the new button (works yay!) and tell Zach thanks for his help. I pull the old button out and very quickly (milk shooting everywhere again!!!!) put the new button in. Take the slip tip syringe included in the new Mic-key button kit and fill the new balloon with water. The new button is sitting perfectly. It was at this precise moment that Mike calls me back. Tell him that Nicholas's button failed and a new button had been installed and oh by the way, his toddler is a rock star. Thank goodness I was still on maternity leave when we had the appointment with the surgeon to learn how to replace the button!
Next order of business? Lots and lots of laundry (clothes, the pillow Nicholas was sitting on, the couch cushion the pillow was on...) and bathing two kids covered in milk. Yuck. Phew.
Never a dull moment around these parts. It was a little stressful on Wednesday, but now I'm laughing. And still totally impressed with Zachary.
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