September 21st was the anniversary of Joshua's gastrostomy tube surgery, g-tube. HE also had a nissen fundoplication (Bethany loves that word!). In a sense it is a procedure to tighten the top part of the stomach so that Josh won't be able to regurgitate or aspirate any food. (So no throwing up!) Every surgery is a big deal, but to me this one wasn't as scary as the trach partly because I was already very used to seeing and working with people with g-tubes as a dietitian. An n-g (naso-gastic) tube is a short term solution, but for people that will need tube feedings longer term like Josh they require a more permanent placement like a g-tube. It is not only more comfortable, but also a whole lot more convenient. When Josh wasn't having a feeding he could be free of lines, and while getting a feeding it would go directly to his tummy and the only tubing in the way was the milk that was going directly to his tummy instead of annoying him by putting tubes up his nose and taping his face.
The surgery went well, and was rather quick (a few hours). We went through our same morning pre-op procedures of prayer and holding Josh as long as we could until it was time for the OR and time for us to camp out with Joey in our corner of the world in Peds. Josh came back from surgery with that same bloated, stoned looking face that we learned quite well and called "Post-op Josh". He was hooked up to the ventilator again just to allow him to breath without working, and he was weaned off of it within hours. We saw his g-tube site right away, and it wasn't long before he was warmed up and moving around. Surgery days were always very taxing, long, nervous waits, calling friends and family with updates, and being with Josh as much as we could. We learned quickly how to start, stop, connect, disconnect, clean, flush, and vent all of Josh's feedings. Between our assertiveness and want to care for Joshua in every aspect we could we were getting good at suctioning, changing trachs, and now in charge of his tube feedings. The nurses often commented on how they didn't have much of a job anymore!