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NG Tube and Catheter - Pain for LAR? Advice please

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NG Tube and Catheter - Pain for LAR? Advice please

Postby greens » Tue Nov 01, 2011 6:40 pm

Hello Colon Clubbers


For those of you that had NG tube for LAR CRC how uncomfortable was it and how painful was removal? Dont much fancy having a tube in my nose through to my stomach - is it always necessary?

And more for the men, how did you find bladder catheter, was it painful to pass urine and eventually remove?

Are local anaesthics ever used for removal of these or vacuum / JP drain removal from operation site?

Probably sounding a bit un macho but want to get my head round what may becoming next...

Many thanks


Charlie
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby beth568 » Tue Nov 01, 2011 6:57 pm

I was quite worried that I would have a NG tube, but I didn't. I think many docs will try to avoid them if possible.

I can also tell you that the removal of the JP drain was no big deal. No pain at all, just a really odd sensation as it was pulled. It was over within 5 seconds.

Can't speak to catheter issues for you, as I'm not male. ;). I had no trouble with mine.
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dx @age 42, Jan '11 RC, T2or3NxM0 (stage IIIA/IIIB)
6 wks chemorad Feb - Mar '11
LAR 5/23/11, staged T2N1bM0 (2 of 15 nodes positive)
8 rounds FOLFOX, June-Oct. 2011
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby SkiFletch » Tue Nov 01, 2011 7:52 pm

I've had all 3, although not for a LAR :). USUALLY when laparoscopic procedures are done, NG tubes are not necessary. Even if they are, you have them for a couple days which isn't that bad. I had one for my HIPEC procedure for 10 days :shock:. It started sucking after day 3 and REALLY started sucking after day 6. When it came out it wasn't pleasant at all, but it was pretty momentary pain. The resulting coughing fit was fun :). Probably would have been MUCH easier if it was only in for 1-2 days though.

As for the urine catheter, you will have that usually for just 24 hours post-op. It's no big deal so long as you don't go around grabbing yourself if you know what I mean ;). You do have to be careful adjusting the twins. Removal again isn't something I'd want to do all the time, but again, only momentary pain. The first time you pee normally, you won't feel residual pain, fear not.

And as for the drain, it's kind of a luck of the draw thing. If they manage to place it not near any nerves, removal is a piece of cake. If they get a nerve like they did with mine from the HIPEC, well lets just say it's a good thing the pain doesn't linger :shock:. You won't know till they remove it if you're lucky or not as it doesn't feel like anything when it's in.

Of all the pains you'll deal with, removal of any of these tubes will be trivial by comparison, so don't loose sleep over them ;)
11/13/09 5cm Stage IV 9/25 lymph nodes w/2cm peritoneal met at 29 YoA
12/15/09 LA right hemi-colectomy
6/16/10 Folfox FINISHED
8/10/10 Prophylactic HIPEC
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby Peloton » Tue Nov 01, 2011 7:57 pm

Hi Charlie:

I had both after my LAR. Regarding the NG tube, my understanding is that it's not needed for most patients (my colorectal surgeon told me about 10% of male patients need it). For me, my guts refused to wake up and, as a result, fluids were building up in my stomach causing really bad nausea. So the tube was inserted to drain my stomach.

Unfortunately, it was very uncomfortable though, thankfully not very painful. Inserting it took about 2 minutes and was extremely uncomfortable (though again, not really painful). Once inserted, it felt like I constantly had something stuck in the back of my throat (that's probably because I did have something stuck in the back of my throat) combined with a bad sore throat. I coughed a lot, too. I had to have it for three days. The hardest part was trying to sleep with it, but the pain meds helped with that. Thankfully, removing it was a breeze. I literally closed my eyes and it was gone 30 seconds later.

On balance, and in retrospect, having the NG tube was better than having nausea and a bloated stomach all the time. Hopefully it won't be necessary for you.

With respect to the catheter, well, those things are never fun. Urinating with it was not a problem and you probably won't even notice you're doing it. I was terrified - for obvious reasons - of having the catheter removed. Thankfully, it wasn't painful. It was naturally uncomfortable, but that lasted about five seconds or so. I was surprised at how easy the removal was.

As for local anesthetic, I did not have any and I'm not sure if they are used. But my surgeon and nurses told me to not be shy with the pain meds (they're some good stuff) during the days after surgery. So, while not technically an anesthetic, they helped relieve my overall feeling of being uncomfortable.

Good luck with the LAR. It's not an easy procedure, and you'll be sore for a while afterwards. But I'm sure you'll do great.
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby raym » Tue Nov 01, 2011 8:26 pm

The catheters were a pain..literally..walking the next day!. They placed 2 metal stents up to the kidneys to avoid cutting the ureters during lap surgery. Once was left in...ugh! So the metal wire was uncomfortable when pulled. The only issue I had was my catheter drain bag got full at night and had to wait for nurse to empty. Removal of the catheters was not very painful for me, just weird feeling.

The JP drain removal was strange too, pulling it out. no pain though.
3/11 IIIC 4/5 nd+/FOLFOX
4/12 HIPEC
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9/12 XELIRI+Avast/Zltra
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1/14 Cardiac Issues no more Xeloda/5FU
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby seva » Tue Nov 01, 2011 8:32 pm

I had my ng for 3 days, very uncomfortable. Removing it was horrible but fortunately it only lasted a few minutes. I think my husband hated it more than I did, gratefully he was not in the room when I had it removed, I think he would have passed out. Be tough!!!!!
RC 10/09
Stage IIA
Chemorad 6 weeks, 5fu 24/7
LAR 2/10
Reversal 4/10
Chemo 5fu 2 rounds -1 week on 3 weeks off
ct scans 9/10 , 3/11,9/11, 9/12 NED!!!
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby tammylayne » Tue Nov 01, 2011 8:36 pm

NG tube wasn't great, but not painful. I had trouble swallowing pills with it in, felt like I was choking. After a few doses they told me they could just give it to me through my iv :? Came out after 2 days, took seconds, felt wierd, but not painful. If you are really worried, ask them to give you a dose of pain meds and wait for them to kick in...numb you a bit (mentally)

As for the drain tube, same thing, not painful, just a wierd sensation.

Tip...hold a pillow over your incision when coughing or trying to get upright. Use your upper body strength whenever possible....NOT you stomach muscles....

good luck,,,

Tammylayne
51 F
'06 Stage 1 CC,
'10 Stage 3 Rectal

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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby BrownBagger » Tue Nov 01, 2011 9:05 pm

I don't think an NG tube is common for LAR surgery. I had the open procedure, and didn't have one. I did have a catheter, and you can pretty much count on that. It's not painful at all. In fact, it's very convenient if, like me, you tend to have small bladder capacity. The last thing you need when laid up after abdominal surgery is having to get up (or, for the first few days, move) to pee. So I Ioved mine. I did have a problem after they removed it, however. I had chemo/rad for rectal cancer pre-op, and when they pulled the catheter out, it must have aggravated my radiation-damaged urethral tissue, because it really hurt to urinate for about 3 months after I got home. That was no fun. At one point, I thought I had a urinary tract infection, but that test came out negative. After about 6 months, I was back to normal. No biggie in the big scheme of things, but I asked my surgeon not to place one when I had my reversal surgery, and he was able to make that happen. The only disadvantage of that is that I got dehydrated and while that wasn't uncomfortable at all, the nurses were worried that I wasn't putting out enough urine. My surgeon explained what was really going on: "You're body is busy absorbing all that liquid that it lost." He was right.
Eric, 56
Dx: 3/09, Stage 4 RC
Recurrences: (3/lung)
Major Ops: 5
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby Future_Med » Tue Nov 01, 2011 9:16 pm

I had a non-laproscopic procedure, but did have the NG tube and can speak to that. I was having severe nausea the day after surgery, and finally the doctors insisted we put an NG tube in. It wasn't pleasant going in, but the worst for me was feeling it sitting right against the back of my throat, it wasn't comfortable and kept making me gag. Got to the point later that day where I was begging my parents to get them to take it out. One of the surgery residents offered to spray my throat with lidocaine to freeze it, and I didn't take em up on it until I had gotten so frustrated with the thing that I was begging them to take it out. When I finally allowed them to spray my throat, it was difficult while the freezing was in effect because my mouth would get very dry and they didn't want me sucking on many ice chips because with my throat frozen there was the possibility of to ice accidentally going into my lungs. But once the freezing wore off I found the NG tube all of a sudden was a lot more bearable, and I kicked myself for not asking for the freezing sooner.

I did have another NG tube in early September while in hospital for a blockage (Actually asked the nurse for it as soon as I got to an observation bed, surprised her to have someone asking for one ;) ) With that one they had me breath gas through a mask to freeze my throat first, I don't know if it was this new approach, or the fact that I had had one before or a combination of both things, but this one I tolerated a heck of a lot better.

Aideen
Diagnosed colon cancer Stage 1 November 30, 2010 Age: 27
Collectomy December 24th, 2010
Genetic Testing back December 19th 2011. Familial Adenomatous Polyposis confirmed
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby StarGirl » Wed Nov 02, 2011 6:10 pm

Did not have LAR--but open abdominal surgery. The catheter was no problem. The JP drain came out quickly and the nurse who removed it was great--when I had my gallbladder removed (back in April) and the surgeon took out my JP drain I thought I was going to scream--so this was a much happier experience--having a great nurse really makes a difference. The NG tube was no fun--I was lucky in the fact that they put the NG tube in after surgery and before I woke up. When the NG tube was removed, it was a strange feeling--not sure if I needed to cough or gag--the feeling is short lived though.

Best of luck to you!
DX 03/31/2011
Stage IV Rectal Cancer with mets to liver
6 rounds of 5FU, Oxaliplatin
3 rounds of Avastin
PET scan 07/15/2011 shows liver mass inactive
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby penguin » Wed Nov 02, 2011 8:46 pm

greens wrote:Hello Colon Clubbers
I had open ab surgery. I got very sick and could not even keep water down for 2 weeks. They put an NG tube in and I can tell you that will never happen to me again. That was the most uncomfortable thing I have ever experienced. I felt like I was going to choke to death. Horrible, horrible experience...I would rather vomit. It didn't hurt to take it out thought...it was very quick and a relief. The cath does not hurt...just feels a little weird. They just yanked by drains out...it hurt a little.

For those of you that had NG tube for LAR CRC how uncomfortable was it and how painful was removal? Dont much fancy having a tube in my nose through to my stomach - is it always necessary?

And more for the men, how did you find bladder catheter, was it painful to pass urine and eventually remove?

Are local anaesthics ever used for removal of these or vacuum / JP drain removal from operation site?

Probably sounding a bit un macho but want to get my head round what may becoming next...

Many thanks


Charlie
Metastatic CRC 2008
colon resection, partial hysterectomy
mets to liver, pelvis, lungs
been on all available chemo regimens
currently on Avastin and Folfox round 3
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby PGLGreg » Thu Nov 03, 2011 11:14 am

I had catheter and NG tube for 9 days. I woke up after the open LAR surgery with them in place, so I don't know about pain going in. They were not painful to remove -- no anaesthetic -- the nurse just pulled them right out. The NG tube made it difficult to brush my teeth, and eventually gave me a sore throat, but it was never painful. Likewise, no pain from the catheter. When it was time to walk around for exercise, a nurse would disconnect the NG tube from the suction device temporarily, hang the urine bag onto the hangar-with-wheels (don't know the term for it) which also held my IV pouches connected to a port at my jugular. I got used to it. It took my bowel a relatively long time to wake up after the surgery, but once it did and I could go home, I had essentially no recovery problems at all.
Greg
stage 2a rectal cancer 11/05 at age 63
LAR 12/05 with adjuvant radiation+5FU,leucovorin 1-2/06
NED for 8 years, cured
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby nicola smith » Thu Nov 03, 2011 11:31 am

greens wrote:For those of you that had NG tube for LAR CRC how uncomfortable was it and how painful was removal? Dont much fancy having a tube in my nose through to my stomach - is it always necessary?

Are local anaesthics ever used for removal of these or vacuum / JP drain removal from operation site?


I had an NG tube for about 10 days owing to an ileus following my colectomy surgery. Insertion, once they found the right hole :roll:, was uncomfortable. No anaesthetic required. Having the thing was profoundly uncomfortable but better than the non-stop nausea and vomiting I had without it. Removal was not the least bit painful and, again, no anaesthetic required. I had a sore throat for about a week after.

Along with the NG, I had a PICC for fluids and nutrition. The PICC was itchy as hell but it's insertion was painless and done under local anaesthetic.

No anaesthetic was needed to remove the JP drains either.
UC history
11/09: Dx
02/10: colectomy, temp ileo; pT3N1Mx
10/10: 12 Folfox6
03/11: jpouch
03/10,11,12&13; 06/14: CT NED
04/12: PET/CT NED
03/13: port out
CEA ~3 mnths: 2.9@dx,.9,1.7,1.5,1.1,1.3,.8,.9,.9,1,.9,.8,.8, 1.1,1,1.1,1.3,1.2
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby SJC » Thu Nov 03, 2011 11:37 am

My husband had an LAR in January and had the catheter. He ver complained about it even after they removed it. He also had the NG tube and that bothered him quite a bit. They gave him Ativan to help him relax so that helped a great deal with that. He had a sore throat after it came out and a cough that lasted a couple of days.
SJC spouse to Bill
Dx RC 10/10 on his 47th bday
Chemo (5-FU) 11/10
LAR with temp iliostomy 1/11
knee surgery (non cancer related) 6/11
Suspicious CT 11/11
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Re: NG Tube and Catheter - Pain for LAR? Advice please

Postby hannahw » Thu Nov 03, 2011 5:47 pm

My Dad has had an NG tube a couple of times, but not for LAR. All I can say is, if you need it, don't let the fear of it cause you to (try) to decline it. Having it placed isn't the easiest thing, I wanted to cry watching the first time my Dad had one placed. But it's over pretty quickly and once it's in it's more of nuisance than anything. I think sometimes the doc prescribes Ativan, or something else for the anxiety the NG tube can produce. The one thing we learned that I wish we would have known to start is that there's really a skill to placing the NG tube. It takes practice so not all nurses are as capable of placing them. My Dad's first NG tube placement was a miserable experience. We finally had to ask the nurse to stop trying and get someone else to come in and do it. In hindsight, we should have known, the nurse seemed nervous and unsure of herself. Placing an NG tube, amongst other things, takes confidence because if you're certain and quick, it's much less uncomfortable for the patient. NG tubes aren't the most common thing so a lot of nurses don't have many (if any) opportunities to place them. Or your nurse might be new to nursing and inexperienced. Whatever the reason, you don't want to be the guinea pig.

By the time we got to the second nurse I was mad and my Dad was struggling and anxious so it was incredible to watch the second nurse place the tube in one pretty easy shot. It still wasn't comfortable, but the nurse was so sure of herself and her instruction was so clear that it was over with in a flash.

The second time my Dad needed an NG tube I made sure to ask for a nurse who had experience. The nurse assigned to my Dad said she wasn't our best option (thankful she was willing to be honest) so she went and got one of her colleagues. He had been placing NG tubes for 20 years. The first thing he did was stick the tube in ice to make it a little rigid. Then, as he placed it, he used a slight turning motion (hard to explain). Having a tube go down your throat is never going to be fun, but this nurse was amazing.

The third time my Dad needed an NG tube I asked for the nurse by name. They actually went and got him off a different medical floor specifically to place my Dad's NG tube. Once again, he was flawless and the tube made a huge difference to my Dad.

Bottom line - get the tube if it's advised. If you have the chance to sort of interview the nurse who is going to place it, do it. A confident, experienced nurse makes the process SO much better.
Daughter of Dad with Stage IV CC
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