Nutrition After Severe Brain Injury: Kelly Part Nine
In part nine we will talk about nutrition after severe brain injury and while she had the trach she was fed by a PEG tube.
We were beginning to talk about physical limitations, and you had some physical limitations with respect to your breathing issue with the trache. And they took that out and you were able to breathe fine when they removed it; as far as you remember?
Yes.
Do you remember any problems with breathing after they took out the trache?
I do not.
What were they doing for nutrition after severe brain injury when you were in the coma?
Oh, well, that, that was, that’s fun because, because I had the trache they could not feed me the normal way that you would normally eat. They thought that I might have swallowing problems which is typical with people with strokes or brain injury because swallowing is usually affected. When they took the trache out they put a peg tube in and I was fed through a PEG tube.
They put the PEG tube in before, while you had the trache?
I’m sure they did.
The PEG tube is a way in which they get nutrition after severe brain injury into your body and they, and they put it directly I think into your stomach?
Yes; it, it, it’s a, it’s not like a, it’s kind of like an IV but it’s not into your vein like an IV. A peg tube is like a G tube: gastroin, gastroin something.
Yes; but it goes into your digestive system for nutrition after severe brain injury; correct?
Yes; goes straight into your stomach.
Had you lost a lot of weight when you were in the coma?
I couldn’t tell you.
You have a scar from the PEG tube?
Yes; and that is a very vivid memory that, that PEG tube removal. Very vivid.
So they did that while you were awake?
Yes.
Tell us about having it removed.
Okay; I was at Vanderbilt Stallworth. I had been there for… I, we got there early, early October. I know that much and I was getting really hungry. And I didn’t have the trache anymore but I had the peg tube. I said listen I’m really hungry. I had a craving for a corndog. I know that sounds awful, but I said could I please have some food? We’re feeding you through your peg tube. I said no. I need some real food; meat and potatoes that I can chew it, and they said well, we’ll have to see what we can get you.
So it took two or three days to do that, but when I finally got some food and could hold it down. Because they gave me food they also take, made me take a Pepcid just in case there was some gastronomical aversions to my eating. So I had to take Pepcid AC before every meal; one fun thing.
You had no problems with the swallowing for nutrition after severe brain injury?
None.
Next in Part Ten– Relearning to Walk, Use Left Hand after Severe TBI
By Attorney Gordon Johnson
Percutaneous endoscopic gastrostomy is an endoscopic medical procedure in which a tube (PEG tube) is passed into a patient’s stomach through the abdominal wall, most commonly to provide a means of feeding when oral intake is not adequate. The procedure is an alternative to surgical gastrostomy insertion, and does not require a general anesthetic; mild sedation is typically used. PEG tubes may also be extended into the small intestine by passing a jejunal extension tube (PEG-J tube) through the PEG tube and into the jejunum via the pylorus.[1]
PEG administration of enteral feeds is the most commonly used method of nutritional support for patients in the community. Many stroke patients, for example, are at risk of aspiration pneumonia due to poor control over the swallowing muscles; some will benefit from a PEG performed to maintain nutrition. PEGs may also be inserted to decompress the stomach in cases of gastric volvulus.