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Necessity and the Art of Invention
Dr. Robert “Flute” Snyder
My story with enteral feeding started with a G-tube. The hospital dietitian taught me to inject my liquid diet of formula using a two-ounce syringe.
The syringe worked fine as long as I had complete control of my mental faculties, the solution was warm, and I had three hands. My first hand held the Bard Tube™ and my other hand grasped the syringe. I don’t know if my hand is too small, but I couldn’t hold the syringe comfortably and reach the fully opened plunger with my thumb. The length of the syringe stroke exceeded my thumb stroke by about an ounce.
After a few months of experimentation, I learned to hold the G-tube in my left hand, hold the syringe in my right hand, and using the wall as my third hand, push the plunger mightily. Success! I could inject two ounces in just a flash, then remove the syringe from the G-tube to refill it. While holding a kink in the G-tube, I had to suck the food into the syringe and keep from slipping.
My experience as a flutist and keyboard player gave me what I considered to be superior control over my dexterity, but still problems persisted.
Sometimes I’d set up the feeding operation in the bathroom so if I dribbled, it would fall in the sink. Right? Usually. However once in awhile, the G-tube would suffer a kink, the syringe would stop, and the food would stop flowing. So I’d push just a little harder to unplug the stoppage. What would happen then? The syringe popped out of the G-tube and formula hit the wall, flitted up to the ceiling and generally messed up the bathroom. Quickly, I’d seal off the tube, wet a washcloth, and clean the room. I got away with my accidents a couple of times and then my wife Ann caught me. She said, “If you’re going to have these accidents, you’re going to use the downstairs bathroom.” And so down I went, never to paint the walls of the lady’s room with chocolate-flavored formula again.
After six or seven months, I got the impression that my digestive system would never settle down if I continued to consume the so-called “lactose-free formula”. My family’s always been lactose intolerant so I read the ingredient label. Among the long list of nutrients, I found this entry: “milk protein concentrate’? That sounded like milk to me. What to do? I had two problems now: ingestion system and diet.
Since my ingestions go directly to my stomach, there was no reason why I shouldn’t use ordinary food as long as it would flow through my syringe tip and G-tube. And so I started on a campaign to puree ordinary food and inject it. Of course, this produced more work in the form of preparing food, blending into a fine puree and finally straining it. I had a lot of fun choosing foods that would puree easily and still strain. Needless to say, I found foods that wouldn’t puree: rice and peas for instance. I found other foods that wouldn’t go through the strainer, like oatmeal.
And so I cooked, prepared raw vegetables, blended, strained, syringed, blocked the tube, squirted food over the wall in the downstairs bathroom, and caused accidents in the car where the ceiling and dashboard suffered several indecencies. What do you use to wash the inside upholstery of the car when you’re 50 miles from home with no towels, cloths or fresh water? Figure it out. OK. It’s time to figure out a way to ingest food in a quart at a time. This two-ounce syringe business couldn’t go on. That was 16 perfect injections per meal, more if some of it hit the wall! Whenever I had time to be creative, I’d design a prospective pump: a hand pump or an electrical pump, a converted oil pump, a cylindrical pump, and so on. They had one-way valves, two-way valves and other complications that I might be able to machine in my basement workshop, but didn’t want to invest the time because they might not work or they’d be too cumbersome to carry in my briefcase, not to mention their need for electricity.
One night, while I waited for Ann to exit from choir practice, I designed a pump in my mind that uses a blood pressure bulb, some chainsaw fuel line, and a one-quart plastic bottle from the thrift store. Back home, I put the pump together and it has served me almost continuously ever since. I mean I’ve pumped six pounds of pureed food daily now for over a year. That’s a little over a ton of puree!
Did I tell you that I couldn’t maintain my body weight until I started using this pump? Yep, I lost weight continually. I weighed about 137 pounds at the lightest. Now I’m up to 157 pounds and still climbing. I think that works out to about 75 molecules a day, but hey, who’s complaining? I’ve had lots of friends say I should patent my pump, but my family’s full of inventors who’ve never made a dime off their inventions. Why should I break an old family “habit”?
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Oley exhibit at A.S.P.E.N.'s Clinical Nutrition Week