Money saving “MacGyver” like hacks

One of my pet peeves in the little world of tube feeding and Medicare coverage for expenses, is that due to the fact that I don’t  purchase commercial formula from a Durable Medical Equipment company, Medicare will not cover any of my associated daily costs of living with a feeding tube.

Couple that frustration,  with the short lifespan of an extension set due to the materials manufacturers use to make them, and you can see why what I’m going to demonstrate  (below) brings me such joy.  It really truly does.

For those who are not familiar with extension sets, they are used to connect to low profile “button” type g– tubes when putting  anything at all into the stomach.

The extension sets are designed by the  manufacturer to last about two weeks before discarding.  The tubes are made out of plastic, and gradually harden with use, making them more difficult to manage as time passes by, as they have to be clamped before removing from the port, as well as clamped during use when changing out a syringe of food etc.  Not only are they very difficult to clamp after the plastic hardens, but the stiffness causes more movement of the g-tube in stoma during feeding time, and can contribute to irritation and inflammation at the site.

The out of pocket cost for someone purchasing an extension set  without insurance coverage –that would be me (see first paragraph)  is about $12 each and upward, depending on where they are purchased.  And, that does not include charges for shipping.  Sometimes they can be found on eBay for less than this, but its hit or miss.

In a perfect tube feeding world, a tubie would use a new extension set every two weeks as a bare minimum.

A very helpful member of the Oley Support Forum, Sanford Flach,  shared with me how to create my own extension sets, using the connectors from old worn out ones.  This is just too cool for words! He will make them for you if you send him the connectors. If interested, email him at flachusnret@comcast.net

 

 

DIRECTIONS:

Gather your supplies.  The instructions given here are for a Mic-key bolus connector.

  • You will need medical grade silicone tubing. Inside diameter (denoted as ‘ID’) 0.188″

I purchased mine from Amazon, it cost me less than $20 for ten feet of it!  And, silicone tubing stays soft, it does not harden with use like plastic does.  Silicone is impervious  to bleach, so when my extension sets get stained up, I can pour Clorox through to spiff them up, and they look like new again.  I’ve been using the ones I made for over four months now, and they are as soft and flexible as they were for their first use.

Here is the  link to this item on Amazon:  http://amzn.to/2catD0G

  • You will need cuticle snips. They don’t need to be heavy duty, there is a small ridge that runs around the connector of Mic-Key bolus extension set, and that has to be snipped off, so that the tubing can slide up onto the connector.  If you have a dremel tool, or a more extensive workshop, the ridge can be ground down by this method.  If you are using the AMT extension set, it flares at the one end, and can either be ground down (I use the sanding cylinder attachment on a dremel) or cut off with scissors.
  • as  pure of isopropyl alcohol as you can find.  I use 99%.  Do not know where to buy 100%.  “rubbing alcohol” from the corner drugstore is not strong enough though.  Get the 99%.
  • scissors.  Nothing special, just to cut through tubing
  • an old extension set, either for Mic-key or Mini One.  For other brands, I am not sure of diameter tubing needed, so cannot give specifics here, but the principle would be the same.   This can be done with either the bolus (my preference) or the right angle.
  • small 4″ zip ties 

 

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The photo above shows basic supplies,with the connector already cut off from the old Mic-key extension set.

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cuticle nippers

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99% isopropyl alcohol

 

 

 

 

 

 

 

Cut off the old plastic tube from the mic-key connector.  Trim as close as you can, but not crucial, as you can take the cuticle nippers and get more of it removed next:

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trimming away remainder of old plastic tubing (I’d previously cut off the ridge before trimming the last of old tubing)

When you are satisfied with how much of the old plastic tubing you removed, it is time to move on.  I don’t think its critical to get it all off; I’ve pulled a couple of plastic tubes completely out of the connector, but it was a lot of work for all it did.

 

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note the ridge that will be snipped off

Next, take the cuticle nips, and snip off the ridge that runs around the perimeter of mic-key bolus connector.  The ridge is not difficult to snip off, it seems like it must have been  added onto the connector as a separate piece from the main plastic part during manufacturing process.  Photo below shows the connector after I’ve snipped off the ridge.

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ridge removed

 

 

 

Place one end of the silicone tubing into the bottle of alcohol.  The purpose of the alcohol is to swell/lubricate the silicone a bit, so it will stretch over the connector, and also the funnel at other end of newly created extension set.   Alcohol  will evaporate quickly, and the connection will be very snug.

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Now, push the tubing onto the connector.  Push it up until it is all the way over where the ridge was.

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new tubing attached to bolus connector

For the length:  You can make the tubing as long, or as short as you like. Once you decide, cut the end of the tubing off.

You can either attach to a catheter tip “funnel” from a used right angle set of a Mic-Key, or any funnel end from AMT.  You can also just leave this end open, or slide it  onto a syringe.

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AMT catheter tip from bolus extension set is on top, Mic-Key catheter tip from bolus at bottom. Notice how much larger in diameter the Mic-Key is. I could not get the silicone tubing to fit onto it.

Before you add the end,  if you’re using one, you’ve got to put the clamp onto your new tube! I just use old clamp from the one I’m cannibalizing.

I add a small zip tie to help keep the connection tight.  If you are sliding the tubing onto a syringe tip itself, then the zip tie is not necessary.  Not really that necessary even using the funnel at end  But, better safe than sorry.

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hot pink 4″ zip ties

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catheter tip (“funnel” on end of new silicone tubing, with zip tie in place.

For extra security, you can add a zip tie to the connector too.  I am showing an example of this below, but honestly I don’t use a zip tie on the connector.  I added it to a couple of them, and ended up removing them. I have never had the tube slip off the connector.

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Now, you don’t have to attach a funnel to end.  You can slide the tubing onto a syringe tip itself.

Some, I’ve made with only about a 2″ piece of tubing, and push all the way up onto a syringe catheter tip (after placing that end of the silicone tubing into the alcohol for a few moments).  With this short of a tube, you’re obviously not going to be able to add a shut off clamp,  But, for administering medications, or having on hand for water flushes, they are great.  Not so much for meals.  A meal would have to be pushed, and it gets messy with hooking up and then taking back out with clothing nearby.  Its great to keep with one’s “go bag” supplies though.

The photo below shows a nice length of tubing for the same purpose described above.  I feel it is better, because it is long enough to accommodate  a clamp, but short enough to be efficient in getting meds and water in.

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The next example shows a longish tube, intended for use with  gravity fed meals,  especially when syringe is in a syringe holder stand.

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detail of tubing slid onto the syringe tip

 

 

 

 

 

 

 

 

 

If you like the right angle style, rather than bolus, you can use this connector instead.  However, I don’t feel that the zip tie is optional, for the inside diameter of tubing used in this demonstration, the fit is not secure enough without adding the zip tie onto the connector  too.

right angle connector

 

FYI the fabric shown as backdrop for most photos is the organic bamboo velour I use to make gtube pads.  The link to the Etsy shop that sells this is in the “Shop” tab at top of page.

(and the cat who was determined to lay on the fabric shown, is Phoenix)

This post will eventually be moved to the top of page under a “Tips Tricks and Gadgets” tab.  If you come back looking for it, and its gone, look there instead.

 

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