Nissen & Gagging?????? - Mothering Forums

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Old 01-16-2008, 02:56 PM - Thread Starter
 
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DD had a nissen fundoplication on Thursday and I am wondering if it is normal for her to gag a bit and if that's okay. I know that was one of the initial problems post surgery that indicated she wasn't emptying. Should I be worried that, when I just gave her 5ml of multivitamin and 2ml of her pain med, she gagged for about a minute? Only a dribble of "vomit" came out. Will she ever be able to vomit? I know I should have asked these questions of the surgeon, so please don't flame me. They just literally pushed us out the door at discharge, so I was pretty discombobulated.

Also, we are just, for the first time, beginning bolus feeds, but she seems to be tolerating me pushing the formula A LOT faster than the doctor indicated. In fact, I don't think she could sit still for 30 minutes while I bolused her. Is there a chance that I'm messing her up by going too fast? :

Wendy ~ mom to VeeGee (6/05), who has PRS, Apraxia, SPD, VPI, a G-Tube, 14q duplication, and is a delightful little pistol! I'm an English professor and a writer.
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Old 01-16-2008, 02:59 PM
 
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this is a very very common side effect of a fundo. Since they can no longer vomit, they retch instead. From what I understand it can calm down with time. Sorry she's having problems.
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Old 01-16-2008, 03:01 PM - Thread Starter
 
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Once again, MotherWhimsey to the rescue! Wish you were on THIS side of the state so I could hug your neck!:

Wendy ~ mom to VeeGee (6/05), who has PRS, Apraxia, SPD, VPI, a G-Tube, 14q duplication, and is a delightful little pistol! I'm an English professor and a writer.
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Old 01-16-2008, 03:21 PM
 
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Very common side effect. Did she gag with you giving the meds through the g-tube? If it was orally then I would give them through the g-tube from now on. If it was through the g-tube, you're out of luck. My daughter has never really had a gagging problem but she has horrible retching. The only time she's ever able to vomit is when her nissen comes undone and needed to be fixed.
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Old 01-16-2008, 03:21 PM
 
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well, we don't have a fundo so I don't know too much about it, but a LOT of the kids I know with one retch. Have you tried venting when she starts retching? I know that helps a lot of kids. Just put an open 60 ml syringe on the extension tube and let all the bubbles and stuff out. eventually it will all go back in.
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Old 01-16-2008, 03:24 PM
 
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I know I am new here but I thought I would share our experience with you. My husband has had 3 nissans done the last one was filled with lots of complications but from what we can tell the nissan has held, and yes he gags a lot, he also coughs a lot and no he can not vomit. My son also has severe reflux and we are trying to avoid him having to also have a nissan.
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Old 01-16-2008, 03:27 PM
 
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And in terms of boluses. I would get a pump. I tried for months to just push the feed and it made the retching worse and in the end I think it loosens the nissen too much. We got a pump and can do her feeds in as little as 10min or spread it out over a more reasonable 30min time frame.
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Old 01-16-2008, 03:54 PM
 
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I second the pump suggestion. zevex are the best pumps. Linden doesn't do well if I push food through with a syringe, but gets a 167ml feed over about 45 minutes with a pump. If I push food through, he leaks out the mouth, lol! If you can't find a home supplier that carries the zevex, call your local zevex sales rep and tell them what insurance you have and they will tell you where to get it. It is soooooo worth it though.
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Old 01-16-2008, 05:04 PM - Thread Starter
 
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Thanks y'all. That's really helpful.

I do have a pump (kangaroo), but was told to try to start with the syringe. I really don't want to loosen the nissen, though, so maybe I'll just go back to the pump. It's just hard for me to have to make her be attached for so long.

We had to do the nissen because she was throwing up six to ten times a day, fully emptying her stomach, and so just could not gain weight. I'm hoping that we'll get on the road to weight gain now. It was definitely becoming life-threatening. I hated doing it, though.

I will definitely try the venting, too. We did that while she was still in the hospital, and LOTS of bubbles came out.

Wendy ~ mom to VeeGee (6/05), who has PRS, Apraxia, SPD, VPI, a G-Tube, 14q duplication, and is a delightful little pistol! I'm an English professor and a writer.
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Old 01-16-2008, 05:16 PM
 
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Quote:
Originally Posted by kalkiwendy View Post
Thanks y'all. That's really helpful.

I do have a pump (kangaroo), but was told to try to start with the syringe. I really don't want to loosen the nissen, though, so maybe I'll just go back to the pump. It's just hard for me to have to make her be attached for so long.

We had to do the nissen because she was throwing up six to ten times a day, fully emptying her stomach, and so just could not gain weight. I'm hoping that we'll get on the road to weight gain now. It was definitely becoming life-threatening. I hated doing it, though.

I will definitely try the venting, too. We did that while she was still in the hospital, and LOTS of bubbles came out.
If she was vomiting before then chances are she's going to continue to retch with the nissen. The kids I know who struggle with vomiting have actually been told a nissen wasn't an option because the retching would just undo the nissen. I really hope that's not the case with you guys but I think your best bet is definitely like you said venting and slowing the feeds. I don't know why someone would tell you to start with the syringe. You have to slowly work up to faster feeds. Also, if you can, get your DME to take back the kangaroo and give you a zevex! The zevex has a very long battery and is portable and does not run based on gravity. It's awesome!
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Old 01-16-2008, 05:32 PM - Thread Starter
 
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Originally Posted by irangel View Post
if you can, get your DME to take back the kangaroo and give you a zevex! The zevex has a very long battery and is portable and does not run based on gravity. It's awesome!
Unfortunately, the kangaroo is paid for. It's not too bad on battery life and portability, though. It's too big for dd to carry or anything, but not too much of a hassle.

Wendy ~ mom to VeeGee (6/05), who has PRS, Apraxia, SPD, VPI, a G-Tube, 14q duplication, and is a delightful little pistol! I'm an English professor and a writer.
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Old 01-16-2008, 07:34 PM
 
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when will they buy you a new one?
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Old 01-16-2008, 07:37 PM
 
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