I also had to go to the ER for one exchange because the balloon broke and the tube was too small. There is an office of General Surgeons nearby connected to my health care (Unity Point). I go to either the surgeon who inserted my first tube or the one who saw me at ER. Now, after reading what Gary wrote - I am going to see if I can make an official appointment in 6 months rather than wait for something to happen. The digestive care unit has been less than helpful and has only seen me twice in two years once was after I had developed an infection (surgical stuff left in during the insertion started to fester) and the other time just a check up.