Tales of the NG Tube

Ah, tales of the NG tube.  These are even scarier than Tales from the Crypt, trust me. Now, gather around the campfire, bring your blanket, and try not to get too spooked. Let's begin.

The NG tube is not my friend. 

Our first encounter was not a direct meeting -- doctors, including Dr. Ramos, had made mention of this NG tube (its official name is "nasogastric tube" -- think about that unpleasant name for a second) during the first few days of my hospital stay when I was all stopped up (due to the mass in my colon, but nobody knew that at the time). "You might need an NG tube," the docs would say. They'd add, "It's not a pleasant thing." Nothing materialized pre-surgery, but once we knew that I had a mass and we were getting it out on Sunday, September 19th, Dr. Ramos asked that I attempt to get this tube in and ready for surgery on the prior day.

September 18th, 2010. My first face-to-face encounter with the NG tube. A very enthusiastic and kind nurse, Michael, was on shift the night before my surgery. He seemed to relish the dubious task of assisting the NG tube placement process, which consisted of shoving the tube up my nasal passage, down my throat, and all the way down to my stomach. Of all the things I've encountered during this little cancer adventure, including surgery, post-op pain, scans, portacath placement (post on that coming soon), and the pre-diagnosis vomiting, nothing -- NOTHING -- compares to the pure evil of the NG tube.

Back to the story. So Michael walks in my room, admits that the process will be "gnarly" but I'll "get through it," and sends my parents, Will, and my best friend Tim out of the room. I wish they would've walked down the street to avoid the terrible guttural sounds I emitted during this whole fiasco.

I closed my eyes. Michael started to feed the tube up my nose. So far, it feels like I'm underwater -- I can handle this. Then, a crack. More like a CRACK. What the hell? "Ohh, you've got some crystalline boogers up there," Michael observes. "Your nose is bleeding. Take a break." 

I open my eyes. Why, yes, my left nostril is bleeding. I tried to gather myself but Michael's definition of a break consisted of about three seconds. Before I could even realize my eyes were watering, the tube was back up the left nostril and -- BOOM! -- ran into the same crystal palace. We had made progress, though, so I was thinking maybe I'd have one more 3 second break and we'd make a literal breakthrough by the next go-round. But no. "Let's just do your right nostril," Michael declared, as I was busily sopping up the increasing blood flow from my nose.

My right nostril?! Noooo! It's the only good nostril I have left! "Oh...ok," I replied. I was trying to be a good sport, and honestly, if Michael is saying that people routinely get through this and this whole thing is merely "gnarly," I should be able to do this. Before I could even finish the thought, the tube was up my right nostril, breezed through the sheath of dried snot, and was down my throat. Holy cow. Gross.

I kept my eyes shut, trying to be as zen as possible. I can do this, I can do this, I can do this. Then I tried to inhale. I felt like my throat was about 90% NG tube and 10% not constricted normal windpipe. Eyes still closed, I told Michael, "Get it out, get it out, get it out." Michael, almost surprised, responded, "Oh yeah? You can't handle it? You want me to take it out?" Had I not been choking, crying, and bleeding, I would've punched him in the face. "Yes, get it out, get it out, get it out," I respectfully repeated.

He started pulling it out and I finally opened my eyes. Stomach juice and blood everywhere. At least I held out long enough for him to get it down to my stomach, and at least the blood was only coming from my nose, but wow. Worst thing ever. "Do you want to try again?" he asked. You can guess what I told him.

And when I gathered my loved ones from the hallway, blood on my hospital gown, blotting the tears that automatically sprouted to my eyes as a result of this terrible tussle, Michael admitted to all of us, wide-eyed and with stomach juice-soiled linens in hand, "Yeah, usually people are totally sedated for the NG tube placement." This kid was really lucky I didn't smack him. It would've been gnarly.

My third encounter with the NG tube came when I was fully sedated during surgery. Not a bad time.

The fourth encounter was post-op. I had anticipated this fourth encounter, and told Dr. Ramos how much I hated the tube and couldn't live with it and would be so unhappy if I woke up from surgery and it was down my throat. He explained that it was incredibly important because it prevented me from getting backed up while my digestive system was remembering how to do its thing. We negotiated (of course, I'm a lawyer), and he said that I needed it in at least 24 hours post-op. Alright. I could manage that. The first 24 hours after surgery with the dreaded NG tube were fine. I hated it, but I also had a delicious painkiller, wonderful family and friends visiting me, and the eye of the tiger about beating this cancer, so I wasn't thinking about it too much.

I count post-op hours 25-36 as the fifth encounter, because relations between me and the tube started to turn sour at this point. I want you to imagine a dry, plastic tube in a dry throat, and that dry throat trying to swallow and necessarily rubbing against that dry, plastic tube. Not cool. I've also failed to mention up until now that the NG tubes are ONE SIZE FITS ALL. If you've seen the size of my hands, feet, or ears, you can imagine how petite my nasal passage and throat must be. And yet, I had this ONE SIZE FITS ALL thing lodged in my throat (and shoved up my nose without any pain meds or sedation courtesy of gnarly Michael).

When I realized that I had held up my part of the bargain (living with the tube for 24 hours post-op), I started paging the nurses and begging them to page Dr. Ramos. "Tell him I need this *bleeping* tube out of my body," I'd request. Will started texting Dr. Ramos (yes, Dr. Ramos texts -- he's so cool) about removing the NG tube. I started asking doctors who were not my doctors to take out the NG tube. Desperation and an elevated use of curse words ensued. 

Finally, after what seemed like a lifetime, dear Dr. Ramos entered my room. "OH MY GOD, YES! THERE YOU ARE!" I screamed from my bed. "GET THIS THING OUT OF ME, DAMMIT! GET IT OUT!"

Dr. Ramos looked at what the NG tube had sucked out of my stomach -- a serious amount of brownish green liquid. During those hours where desperation bled into delirium, I named the liquid. Stomach iced tea. I even gave it a flavor: Summer Breeze.

"Gloria, this NG tube is doing its job and I'm just not sure we should take it out." Dr. Ramos tried to reason with me, but I was as unbending as the plastic monstrosity in my throat. "You're going to vomit," he warned, "and I'm taking out this tube against my better judgment." I told him I didn't care and that I'd vomit 400 times with a smile on my face if that was my fate without the tube. He relented.

"Do it fast," I instructed, as he started to pull the tube from my nose. "No, I can't do it fast," he said, as he pulled it out in an impressively deft manner. I gagged a couple times as it came out -- this thing was LONG -- but it was over in mere seconds. I was FREE! With tears in my eyes, partly because of the gagging and partly because of pure joy, I grabbed Dr. Ramos. THANK YOU. I LOVE YOU. YOU'RE MY HERO. THIS IS AMAZING. He smiled, laughed, and said I was cool. I don't know if I was anything remotely resembling cool in that moment, but I appreciated his kindness. I've been a new woman ever since.

There are a few morals to this story.

1) Do not let nurse Michael convince you that shoving the NG tube in your body is merely "gnarly" -- it is far, far worse than that.

2) Negotiate about post-op time with the NG tube. You're going to need 200 ice chips per swallow by Day 2 post-op because your throat will feel like a desert. A sore, bloody, desert littered with large pieces of plastic.

3) Name your stomach iced tea. For fun.

4) Be glad that, at this moment, you don't have an NG tube in -- I know I am.