Tracheostomy

Tracheostomy (tray-key-OS-tuh-me) is a hole that surgeons make through the front of the neck and into the windpipe (trachea). A tracheostomy tube is placed into the hole to keep it open for breathing. The term for the surgical procedure to create this opening is tracheotomy.

Where do I begin? Yes it’s a lifesaving device to enable one to breathe but apart from that it’s a real challenge.  

First of all you can’t talk. No sound comes out of your mouth. So only sign language or handwriting enables you to communicate. 

You could use text to speech on your phone but I couldn’t use my phone much at all in my doped state. The hospital did supply a chart of signs but no one I met seemed to use it. I thought it was good.

Doctors, nurses, even my support person forgot I couldn’t speak or watched me hand-write and then read out the words out while I was writing them! I was so doped I kept doubling up on letters and then crossing them out. 

This time there were lots of thumbs up or thumbs down. Yes or no. Binary. Nothing in between. 

There were little whiteboards but even they were problematic for me because the marker dust was a bit annoying.  I would advise these though with a small marker.

I didn’t have my trache in long this time and when it was partly opened up and I could speak, I was amazed at how much more agency I had, how I could build some sort of bond with the nurses

(When they open up the airway during the staged removal of the device there is an amazing sensation, not only the return of voice but of senses. There’s a woosh and a zing and hey presto you can smell again too. It’s a fabulous sensation.)

Breathing through your neck means there’s no nose to moisten and humidify the air and the breathing passages don’t like it with lots of mucous secretions which have to be suctioned with a sort of metal wand. Not as unpleasant as last time but some people find it painful and scary.  However, everything that is done to keep the trache clean so secretions don’t affect your lungs adds to the heat in the hot hospital room with the overheated (in my case) patient. There’s the nebuliser and the humidifier, both of which make various sucking and gurgling and humming sounds. To me that is an added torment to the already troubled mind! Totally understand why they have to be used though.

The tracheostomy enables head and neck surgeons to operate in the mouth or throat without worrying about later swelling threatening the airway. Useful things but better out than in for the patient.