Food Tube Farewell

The removal of my PEG food tube certainly wasn't what I was expecting -- even though the surgeon had informed me twice as to what was going to happen:

I went into the examination room -- and invited Deb to come along. She seemed a little reluctant. (Shortly afterwards, I understood why.)

The nurse escorted us into the room, thanked us for getting the blood test results from my chemo doc, and told me to take off my shirt. That the surgeon doc would be in shortly.

And shortly afterwards, the nurse returned with the doc in tow. He shook my hand and we exchanged a few pleasantries ("Are you keeping your weight up?" "Does Dr. Chemo [not his real name] agree that the tube can be removed?" You know, some lighthearted banter to put me at ease.) Meanwhile, the nurse was putting on a surgical gown and getting one ready for the doc.

The nurse suggested that Deb might want to leave around this time, and she (Deb) beat a hasty retreat. The nurse and doc pulled on surgical gloves as the doc told me to lie back on the examination table.

Now the doc had told me, on previous visits, that when it was time for the tube removal, he would simply pull it out. But I knew that there had to be more than that to the procedure. I mean, I might have accidentally pulled the thing out when showering or something. Right?

Besides that, just pulling the tube out would almost inevitably lead to leakage of food particles and digestive juices from the stomach into the rest of the body cavity. And you can't allow that now, can you?

But the doc had told me there would be no stitches. Hmmm...

So I'm lying back on the table, shirtless, while the doc and nurse get themselves ready. And then the doc, who's a tall, lanky guy, comes shambling over to the examination table and puts one hand on the food tube and the other on my abdomen.

And I'm thinking, okay, he's examining the tube and its environs, preparing for the next interesting step in the process. The one that doesn't involve him just pulling the tube out. I was absolutely sure this was what was going on.

But then wham! Without the slightest warning, the doc pulls the tube out. With a movement reminiscent of starting a lawn mower, he turns his shoulders slightly, grabs the tube firmly and yanks it out. Big guy. Probably started a lot of lawn mowers in his day. Good shoulder rotation on the yanking.

Now he's standing there, holding my food tube up in the air like it was a freshly caught trout or something. And then, giving the tube to the nurse for disposal, he grabs a wad of gauze and presses it down over the hole in my tummy. And he asks me how I'm feeling.

Dazed? Astonished? Puzzled? In pain? All of this and more? How do I answer such a question?

The pain (which wasn't that bad anyway) recedes pretty quickly, and the nurse hands the doc 4 or 5 strips of tape to hold the gauze in place.

There. Done.

And I'm very glad that Deb isn't here to see all this.

After the doc has helped me up to an upright sitting position, I press him for some details. Like, why isn't my tummy currently emptying itself into my abdomen?

He explains, with the help of a nicely drawn sketch that, when the tube was initially installed, it pulled the front of my stomach right up against my abdominal wall. And, over the last several months, my body had created "fibrous connective tissue" (I think that was his phrase) to connect the hole in my stomach to the hole in my abdominal skin. Kind of a tube-outside-the-tube, if that makes sense.

And his sketch showed that the thing that held the tube in place for all those months was a mushroom-shaped widening of the tube itself. Just at the end of the tube, with the hole of the tube extending all the way through the "mushroom."

So, thanks to that "fibrous connective tissue," any leakage from the stomach could only drain directly to outside the body (but it wouldn't drain at all, thanks to the wadded gauze over the hole). But, over the course of the next two weeks, scar tissue would form to close the hole completely.

(It took me several hours to figure out that the surprise yanking of the tube was probably part of the procedure. He wouldn't want to say something like, "Okay, I'm going to pull the tube now," because that would likely cause me to tense up, which might make the pulling either harder or completely unsuccessful. At least that's what I want to think.)

After the medical team left, I went over to the trash receptacle -- the red one that says "Caution! Biohazard Waste Material!" or somesuch. And I pushed the foot treadle that opened the container, and there -- on top of God-only-knows-what-else -- was my food tube. And I briefly thought about retrieving it from the trash. Briefly.

It was my first opportunity to see the "mushroom" that the doc had sketched up. And it did, indeed, look like a mushroom.

And I thought about what an important part in my healing that the tube had played. And I was grateful. And then I thought about what a pain in the neck the tube had been recently. And I was relieved to see it totally outside my body and sitting in the trash. And after all, it was only a plastic tube, wasn't it?

After putting my shirt back on, I went out to the waiting room and motioned to Deb to come with me back to the exam room. I wanted her to see the tube in its entirety, as she had spent so many hours carefully filling it with Jevity. Again and again.

I feel quite different without the tube. I feel slimmer. Streamlined. More organic, now that I'm not fitted with and dependent on a plastic tube.

We live in a wonderful time. That is to say, a time of wonders.