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If you want to know if your loved one still needs a feeding tube when they are close to having a tracheostomy removed, stay tuned. I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

Currently, we are working with a client who has their sister in intensive care. The sister sustained a cardiac arrest and had encephalitis. When she first got admitted into intensive care, the doctors, the intensive care team told the family that she won’t survive, and if she will survive, she will never live independently and would always be dependent on other people. The family didn’t buy into the negativity and the negative narrative, the doom-and-gloom. They said, “We want to give our sister the best chance, and we will do whatever it takes.”

Weeks later, after not giving up, the sister is awake. She’s off the ventilator. Yes, she had a tracheostomy along the way, and she had a nasogastric tube. They never consented to a PEG (Percutaneous Endoscopic Gastrostomy) tube, as per our advice, because there’s enough research out there that a PEG tube is more harmful than a nasogastric tube. 

She’s now off the ventilator. She’s getting much closer to decannulation. She is lucid, i.e., she is talking now with a speaking valve. She’s even having small amounts of pureed food, even though she has a tracheostomy. She’s passing all the swallowing tests, that means she’s getting much closer to having the tracheostomy removed.

For anyone who has a loved one critically ill in intensive care who’s getting told, “Your loved is not going to survive, and if they do survive, they’ll be disabled forever and a day, and will never live independently,” well, here’s another example that you don’t have to believe the doom and gloom. You can make up your own narrative and you can stick with it. So, it’s all up to you on how you present your case and whether you get the consulting and advocacy that we were certainly be able to serve this family with to get the results they wanted, needed, and deserved for their sister.

Now, the client sends an email, and the plot, to a degree, thickens but we got to move forward here. Even though the sister is eating and drinking now, even though she’s got a tracheostomy, the ICU team still wants to push for a PEG tube to send her out as quickly as possible. They don’t want to deal with it, out of sight, out of mind sort of thing. 

Let me read out the email coming from the client. So, they’re saying, 

“The harassment continues concerning the PEG tube. This ICU doctor had her nasogastric tube pulled out, and he explained it in his progress notes. He called me the day before yesterday pushing for the PEG tube once again if my sister’s unable to meet her nourishment needs on her own. So now he thinks he can give me a choice of comfort measures versus PEG! Please see the progress notes here. I’ve circled pertinent areas.”

I’ve seen the progress notes. He’s basically saying she should have PEG tube or comfort care. She’s making a lot of progress and that is blackmail. I can’t imagine how many families in intensive care are getting blackmailed. They didn’t have the support that we’ve been able to give this family. 

The email continues.

“The last two nights I’ve seen my sister, she was in pretty good spirits and even flirting with her new male nursing assistant. She’s talking pretty clearly now and is coherent. She refused to eat anything last night. They didn’t bring her food until 6pm, and she was exhausted as she didn’t sleep well the night before. When I tried to coax her to eat, she got upset. She has no appetite. I’m wondering how to handle this. I’m wondering if medications could be affecting her appetite or something else? Today, I’m very upset to be threatened this way by this doctor. I’m going to meet with Patrik soon.” We did. I did talk to the client yesterday. 

So, here’s the way forward. Number one, do not let anyone blackmail you. Him, taking out the nasogastric tube is pure evil. In the notes, he was saying that she needs the nasogastric tube out so she can pass the swallow assessment that is not true. Plenty of patients in ICU that pass the swallow test have a nasogastric tube, that sheer and utter nonsense. Unless, once again, you have the insights that you need when you have a loved one critically ill in intensive care, you’d be making all the wrong decisions most likely. So, do not let them dissuade you to do the right things. Just because a patient is passing some swallowing assessments doesn’t mean they no longer need nasogastric tube.

This is a client in the U.S. and obviously the ICUs in the U.S. have an interest in sending out patients as quickly as possible and they don’t care how they do it as long as they can do it. With all of this said, in this situation, the client does need the nasogastric tube back, she really does. Because otherwise she’d be losing all the strength that she has gained in recent weeks. This is really pure negligence and it’s pure evil. We’re working on it to get the nasogastric tube back in again, so that she doesn’t need a PEG tube.

I’ve made countless videos over the years that patients in intensive care do not need a PEG tube, no need for it, with very few exceptions. In this situation, the patient went from the ICU saying, “She’s not going to survive. If she does survive, she will always need people and she’s always dependent on people.” Nothing could be further from the truth. That is why you need to challenge and question clinical judgement from intensive care teams. Sometimes they’re right, sometimes they’re wrong. It’s very difficult for anyone to have a crystal ball.

I have worked in critical care nursing for 25 years in three different countries, where I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 all over the world. We have saved many lives with our consulting and advocacy that you can verify on our testimonial section where you can see what our clients are saying. You can also listen to what our clients are saying on our intensivecarehotline.com podcast section. You can verify that we’ve saved many lives with our consulting.  That’s why we have helped hundreds of members and clients over the years to improve their lives instantly when they have a loved one critically ill in intensive care, including saving their lives. 

That’s why we created a membership for families of critically ill patients in intensive care. You can become a member by going to intensivecarehotline.com, if you click on the membership link, or going to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. You also have exclusive access to 21 eBooks and 21 videos that I’ve personally written and recorded. All of that will help you make informed decisions, have peace of mind, control, power, and influence making sure your loved one gets the best care and treatment always.

I also do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I talk to doctors and nurses directly, asking all the questions that you haven’t even considered asking but must be asked when you have a loved one in intensive care. I also represent you in family meetings with intensive care teams. I handhold you through this once-in-a-lifetime situation that you simply can’t afford to get wrong.

We also do medical record reviews in real time so you can get a second opinion in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence. 

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send me an email at [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, and comment below about what you want to see next or what questions and insights you have from this video.

I also do a weekly YouTube live where I answer your questions live on the show. You will get a notification for the YouTube live if you are a subscriber to my YouTube channel or if you are a subscriber to my intensivecarehotline.com email newsletter.

Thank you so much for watching. 

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.

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