Who will I need to talk to before I leave the hospital?
A dietitian will discuss your diet. A social worker will help arrange for a visiting nurse and any equipment you will need at home. If you have your medication prescriptions filled at the hospital, a pharmacist will discuss your medications with you. A physical therapist will review your home exercise program. A nurse will explain instructions for your care at home.
What will I need to have at home when I am discharged from the hospital?
Each patient will have a plan specific for his/her needs. You and your family members will discuss your needs with the nurse, doctor, dietitian and social worker. The usual issues/concerns that need to be arranged for before you go home are:
Tube feedings require formula, a machine to keep the feeding at the right rate, bags and tubing to give the feeding and medicines. You and your caregiver will be instructed on how to give your tube feedings.
Incision care and the supplies you need will be explained if incision care is necessary.
6" concrete blocks will need to be placed under the legs at the top of your bed. Raising the top of your bed will help to prevent slumping, acid reflux and aspiration.
Outpatient rehabilitation will be needed to help you gain back as much lung function and physical strength as possible.
Home issues such as:
- General safety issues in the home — going up and down steps, non-skid rugs, a chair to sit on in the shower, getting in and out of the shower/tub, etc.
- Help with daily needs — laundry, preparing meals, shopping, housekeeping, etc.
What kind of care do I need to do with a jejunostomy tube at home?
You will need to learn how to take care of your jejunostomy tube while you are here so you can take care of it at home.
Skin care around the J-tube
The skin around the tube needs to be cared for. It should be washed daily with soap and water. You may shower. Hydrogen peroxide may be used if there is crusting or thick drainage to remove. Rinse thoroughly with soap and water. You may use a light dressing if there is still drainage. It should be left open to air if it is not draining.
Night-time tube feedings
Patients will need liquid feeding through the tube at home for a short period of time. The nurses and the social worker will help arrange for your feedings, feeding pump and instruction on the use of the pump at home. We also will arrange for a visiting nurse to help until you are comfortable with using the equipment. We will teach you as much as we can while you are in the hospital. The company that supplies the pump will instruct you at home and be available for assistance. The visiting nurse will also be available to assist you in caring for your tube at home.
Medications through the J-tube
If you are giving medications through the J-tube, it is very important to flush the tube with 30 cc water between each medication and after the last medication. You do not want the medications to mix with each other or mix with the feeding in the tube. This may cause your tube to become clogged.
J-tube that is not being used
If you are not using your tube, it will be left in place (for about a month) until the doctor and dietitian are sure you are eating enough by mouth. During that time, your tube will need to be flushed once a day with 30 cc of water to keep the tube open if it is needed in the future.
What type of problems with the J-tube should I report to my doctor?
Notify your doctor if at any time if you:
- are unable to flush the tube or
- notice signs of infection at the jejunostomy tube site.
When I am at home, is there anytime I should call back to my doctors at the University of Iowa Hospitals and Clinics?
Call before going to see your local doctor unless it is an emergency. Keep your University of Iowa doctor updated with any problems or concerns you have. Call the Cancer Center Clinic, Monday- Friday (8:00 a.m. - 5:00 p.m.) at 319-356-4422 and ask to speak with the Thoracic Care Coordinator. Weekends and evenings call the hospital operator at 319-356-1616 and ask to speak with the Cardiothoracic Fellow on-call.
Call immediately if you have the following:
- Temperature greater than 100.4° F or 38° C
- Shortness of breath that continues after activity is stopped or while at rest
- Increased shortness of breath
- Blue fingernails or lips
- Coughing when you eat or drink
- Difficulty swallowing
- Nausea, vomiting, diarrhea or constipation
- Weight loss or inability to eat
- Signs or symptoms of wound infection:
- Redness, swelling, pain, increased tenderness, drainage that is different than while you were in the hospital or creamy drainage.
- Heart rate greater than 120 beats in one minute
- J-tube becomes clogged
How do you keep my local doctor updated on what is happening with me?
Letters are sent to local doctors: 1) after clinic appointments, 2) after surgical procedures, 3) after discharge from the hospital, and 4) as needed. Be sure to tell us the names of ALL doctors you want to receive information.
Your doctor may call the hospital at anytime to speak with your staff doctor. UI Consult (800-322-8442) is available to connect your local doctor with your UI doctor.
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