What is a tracheostomy? Don't be afraid, let's talk about it!

Sometimes we can have difficulty breathing in ways we never imagined. At times like these, you've probably heard of a procedure that involves putting a small tube through your neck to help you breathe. That's called a tracheostomy. The name may sound a little scary, but it's a very important life-saving procedure. So let's talk about it simply, without any fear.

Simply put, what is a tracheostomy?

A tracheostomy is when a surgeon makes an opening in the front of your neck, directly into your windpipe (trachea), or what we call your bronchi . Then, a tracheostomy tube , or 'trach' for short, is inserted through this opening. This is done by sending air directly into your lungs through the tube when you have difficulty breathing through your mouth or nose.

The surgery to create this opening is actually called a tracheotomy. But in common parlance, our doctors use both terms interchangeably. So don't get confused about it.

Why would someone need a tracheostomy?

There are many reasons why someone might need a tracheostomy. Sometimes it can be temporary, and other times it can be permanent. It depends on your medical condition.

How should I prepare for this surgery?

If this is a planned surgery, your doctor will explain how to prepare for it. If you are having general anesthesia , you may need to stop eating and drinking for a few hours before the surgery and may need to stop taking certain medications.

Also, since you will be staying in the hospital for a few days or weeks, you will need to pack a few things in a bag and prepare them.

• Clothing and personal hygiene items: Comfortable clothes, things like a toothbrush.
• Medications you use: What medications or nutritional supplements you usually take, if any.
• Something fun: It's a good idea to bring something to read, like a book, while you're in the hospital.
• Things to help you communicate: This is very important. After surgery, you will not be able to talk right away. So, carrying a pen and paper, or a smartphone or tablet, will be very helpful in communicating with the doctors and your loved ones.

How is the surgery done?

This surgery is usually done in an operating room. First, you are anesthetized so that you are completely asleep. Then, the surgeon makes a small incision in the front of your neck, just below your Adam's apple. This incision goes straight through the wall of your windpipe. Next, the opening is carefully widened enough to allow the tracheostomy tube to be inserted.

After the tube is inserted, it is secured with a strap around your neck (tracheostomy collar) to prevent it from moving around. You may also need to have a few temporary stitches to hold the tube in place until it heals. If you are unable to breathe on your own, this tube will be connected to a ventilator.

What are the benefits and risks of this?

The main advantage of a tracheostomy is that it provides life-saving ventilation when breathing through the mouth or nose is no longer possible. It is much easier for the patient than intubation, which is done through the mouth. It also helps many people who are starting to breathe on their own after being removed from a ventilator.

However, like any surgery, there are some potential risks.

• Bleeding and infection.
• Damage to your esophagus or windpipe.
• Narrowing of the airway due to inflammation or scar tissue.
• Damage to the nerve that moves your vocal cords (recurrent laryngeal nerve).
• Tracheostomy tube blockage due to mucus or blood clots.
• Air trapping under the skin around the lungs, chest, or tracheostomy.

What happens after the surgery and how to care for it at home?

After the surgery, the medical team will closely monitor your condition. You will need to communicate in writing until you are able to speak. Before you go home from the hospital, you and your family will be given detailed instructions on how to care for your tracheostomy tube at home.

It usually takes about two weeks for the tracheostomy tube to fully heal. It is normal to feel some neck pain during this time. It also takes a day or two to get used to breathing through the tube.

Keeping the tube clean

At home, you will need to clean your tracheostomy tube at least twice a day. You will also need to see your doctor again on the days when the tube is due for change.

Talking

After you recover, you can speak with a tracheostomy, but it takes practice. You can speak by covering the tracheostomy opening with a finger and blowing air through your mouth. A speech-language pathologist (SLP) will show you how to do this. There are also special types of speaking valves that help you speak without covering it with a finger.

Eating

It will take some time to get used to swallowing. In the beginning, you may need to be fed through an IV or feeding tube. Your speech therapist will also help you with exercises to make swallowing easier.

When should I see a doctor urgently?

If you experience any of the following symptoms, call your doctor immediately or go to the nearest hospital Emergency Department (ETU) .

It's normal to feel scared and uncertain when you hear that you need a tracheostomy. But remember, with the help of a medical team, most people can breathe, eat, drink, and talk well after this. Whether it's temporary or permanent, you can enjoy your life.