A Tubie Goes Backpacking

Steve Larson

I am a seventy-year-old highly active man. I travel both domestically and internationally, have done Ironman races, and am a long-time avid backpacker. I had neck cancer about twelve years ago and the radiation finally caught up with me last summer … I needed a feeding tube!

It was certainly not a happy occasion, but I did need it. I was fighting to eat every meal, coughing and aspirating all the time. I was losing weightand things were not going to improve. My doctors concurred: it was time for a feeding tube. Backpacking, cont. on pg. 12

At first, I was in shock (and I still am), but I tried my best not to let the feeding tube change my life—well, as much as possible. I have learned quite a bit in the last few months, and I am sure I still have quite a bit more to learn. There are so many little tricks on feeding!

I wanted to go backpacking and see how the feeding tube would work during the trip. For this first trip, I went with three friends who know me well and are aware of my transition to becoming a tubie. The plan was a three-day hike. The trail was about seven miles to base camp, at 9,000 feet. It was late fall so it would be cold at night, about 40 degrees.

This was a real experiment for me! I would see how tube feeding by syringe would work in the backcountry, but also experiment with nutrition, hydration, and stoma care. I had much to learn. At home, I have an extremely comfortable setup. I use four syringes at a time, enough for 8 ounces of formula. I have a chair, a bathroom, a sink, plenty of room, and it is warm. The hike was not like this!

One of the first lessons was the pack weight. I use commercial formula and it is HEAVY! I take seven cartons a day at 8 ounces per carton, which is 3.5 pounds a day. It was simply too much. As an experiment, I brought two days of liquid formula and one day of powdered formulas. I packaged the powdered formula into one-serving ziplock bags. Even the 7 pounds was just too much weight. So, lesson #1: no more food cartons, only powdered food in my backpack. The added benefit of this is less garbage! Fourteen empty formula cartons are a mess and take up space.

Lesson #2: nutrition and hydration. I like being prepared, so for this trip I brought extra syringes and an extra extension set for feeding. (I also should have brought a spare replacement button [a low-profile type of feeding tube].) This is quite important. If a syringe or tube failed, I would have a backup. I could live a couple of days without nutrition, but we must have hydration.

I will break down this lesson into two parts: Tube feeding in camp and tube feeding during the hike. Honestly, in camp it was not too difficult. I carry a backpacking chair, so I can be nice and comfortable. I brought a dish and a cup. I would put the syringe and towel in the dish and pour the formula into the cup. While camping I just brought one syringe, saving weight and space. Feeding myself was a bit more complex as I had to refill the syringe four times each feeding. Three arms would make this easier! Afterwards, I washed the syringe with water, then dried and stowed it. Pretty relaxing! I give myself a B+ for camp feeding. One last note, it was COLD at night! Raising my shirt to get access to the feeding tube

The hiking part was different. It is close to impossible for me to drink by mouth. So, I would stop on the trail, sit on a rock or log, break out the gear, and get a few ounces of fluid down. I did not do it often enough. I just did not want to take the time, even though it only took ten minutes. On the trip out, about five hours, I only stopped once to hydrate. At the end of the day, I was dehydrated. I get a D- for hydration!

I now use a low-profile extension set that lies flat on my stomach. I keep it attached all day during the hike. I keep a syringe in my pocket. To hydrate, I just stop, and, with my pack still on, grab the syringe, get some water, and squirt it in! I can easily get 4 or 6 ounces in quickly.

My last lesson is stoma cleanliness. As we know, there is a difference between sterile and clean. We do not need to be sterile with a feeding tube, but we should be clean. I was good with my feeding gear but really ignored my stoma…. A mistake! It was pretty crusty at the end of the trip. It would have been so simple to heat up water and nicely wash my stoma area. I just did not do it. Next time I will not forget.

In conclusion, it was a great trip. It went mostly well; a couple of things need improvement. I plan to work on the powdered food. This is necessary. This will save several pounds per day in pack weight and volume in the pack. In camp I will try to even take more time to feed. I will try to make feeding more relaxing, as opposed to a quick feed. I will heat up water and clean my stoma every morning and night. It’s easy to do and so important. Finally, I will make scheduled stops while hiking to hydrate.

I plan on going camping in the winter, another experiment. And I look forward to many more days of backpacking with my newfound skills!