Tuesday, October 11, 2011

Up Your Nose with a Rubber Hose

I don't know if any others will remember that common play yard threat which we threw around in my youth. I never expected for it to actually happen to me by someone I love, or that I would perform the same upon another.

But happen it did! My husband and I were receiving our Missionary Medical Intensive training and as it would be, we were often one another's lab partners. We had lab work most of the afternoons and would practice the procedures we had been taught.

It started out lame enough, taking histories, blood pressure and such. Then we began injections and stitches and other procedures.

One morning we were taught how to make our own NG feeding tubes out of IV tubing. OK cool! This procedures is needed to be able to feed patients who are unable to self feed. Or to give meds without an IV. It involves plastic IV tube about a meter long which is placed in the nostril, fed down the throat, carefully avoiding the lungs, and on into the stomach. Then one can begin feeding with a syringe through the tube, directly into the stomach.

It is not that complicated and many parents learn to put them in for their children, but one does need practice and to learn how to avoid the lungs. So...

Yeah, there I was, head tilted back as my loving husband held a long plastic tube which he intended to place 'up my nose'. And I was going to allow him to do so. I began to practice my Lamaze breathing which I remembered from labor! You girls know, pick a focal point, breath slowly ...basically, zone out!

It was not so bad. He did it quickly and correctly as he does most things. He is a quick study and very confident and unafraid to try new things. My husband can do just about anything he sets his mind to. Later, in the jungle, this would be invaluable in our small dispensary. He has delivered over 50 babies, placed many stitches, removed arrows from people, placed feeding tubes, catheters, pulled teeth, done biopsies, and even helped with an amputation.

After he inserted and removed the tube a few times, it was now my turn. I needed to do this as well because I might be alone one day and be required to place a feeding tube in a patient. Or perhaps I would need to place one in my husband, so...

Now he was the one with his head tilted back, great fear in his eyes, as I held the tube and fully intended to place it 'up his nose'. I just wanted to get it over with! Later, in the jungle I did have to do many things, like deliver babies, put in stitches and other medical procedures, I never enjoyed it.

I carefully measured the tubing I would need, cut it off, put in the holes, melt down the sharp edges of the tubing, sterilize, and began to feed the tube up my husbands nostril. He began to gag which is common as one reaches a certain spot. This is helped by having the patient swallow water if able. I offered the water, my husband, pushed my hands aside and continued gagging. Loudly!

Everyone was soon watching us because he was gagging and squirming. So I continued to feed the tube, until...he opened his mouth! The tube was going up the nostril, down the back of his throat and now out of his mouth! Not knowing what else to do, I quickly hauled back on the tube and pulled mightily! It came ripping out. Along with a fair amount of blood and a murderous glare from my husband.

That maneuver became known as the 'Briggs and Stratton' maneuver! You know, how you haul back and pull the rip cord to start a motor? Or lawn mower? It really should not be used to remove an NG tube. The patient would much prefer a calmer removal as there will be less blood involved.

Of course, I still needed to successfully place the NG tube. So we did it again, and again, until it was done properly and I could do it easily. That was not my husband's favorite day of our marriage. Although he had been taught many things in the Marine Corps, Lamaze was not one of them, making it difficult for him to do the 'zoning out' part. All the males seemed to find the procedure much easier to give than to receive.

I am very glad we did learn the procedure as we were able to use it in the jungle for patients who could not eat. I never did need to put another tube up my husbands nose, though, for which I am sure he is most grateful!


Speedy G said...

I think that I would have passed after the first failure... kudo's to Yekwana Man for toughing it out!

Robin said...

What a brave husband to let you practice again after the first try! This made me laugh at the end of long day! Thanks!