What you need to know about tracheostomy: Don't be afraid, let's talk

It's normal to feel a little scared and uncertain when your doctor tells you or someone in your family that you need to have a tracheostomy. It's a little strange to hear that you'll be making a hole in your neck and putting a tube through it to breathe, right? But don't worry. This is a very important medical procedure that can save lives and prevent breathing difficulties. We'll talk about everything in a simple way that you can understand.

Simply put, what is a tracheostomy?

A tracheostomy is a surgical procedure that creates an opening in the front of your neck, directly into your windpipe (trachea). A tracheostomy tube is then inserted through the opening into your windpipe. This allows air to flow directly into your lungs when you have difficulty breathing through your mouth and nose.

Doctors often refer to both this procedure and that opening as 'tracheostomy.' So don't get confused about that.

Why is it necessary to have this kind of surgery?

There are several reasons why someone might need a tracheostomy. Sometimes it's a temporary solution, and other times it can be a permanent solution. Let's look at the main reasons.

How do you prepare for surgery?

If this is a planned surgery, your doctor will give you instructions on how to prepare for it. Since it is usually performed under general anesthesia, you may be asked to avoid eating or drinking for a few hours before the surgery and to stop taking certain medications.

Since you will be in the hospital for a few days or weeks after the surgery, you will need to prepare some necessary things.

• Clothing and personal items: Comfortable bed clothes, toothbrush, and soap.
• Medications you are taking: If you are already taking medication for another medical condition, be sure to bring those medications with you.
• Something to entertain yourself: It's a good idea to bring something to keep you entertained, like a book or newspaper, while you're in the hospital.
• Communication tools: This is very important. You may not be able to talk right away after surgery. So, keep a pen and paper, or your smartphone or tablet nearby to communicate with the doctors, nurses, and your loved ones.

How is the surgery done?

Tracheostomy surgery can be performed in two main ways.

Traditional open surgery (Open Tracheotomy)

This is done in an operating room. First, you will be put to sleep (general anesthesia). Then the surgeon will make a small incision in your neck, just below your Adam's apple. The incision will be made through the wall of your windpipe, creating an opening large enough to insert the tracheostomy tube. Once the tube is inserted, it will be secured with a collar around your neck to keep it from moving. Sometimes, a few temporary stitches may be placed. If you are unable to breathe on your own, this tube will be connected directly to a ventilator.

Percutaneous Tracheostomy

This is a relatively new procedure. It can often be done in the hospital near your bed. There is no large incision. Instead, the doctor uses a needle to make a hole in your neck and into your windpipe. Then, a wire is passed through the hole, and a plastic tube (catheter) is threaded through it, gradually enlarging the hole. Then, the tracheostomy tube is inserted.

What are the benefits and risks of this?

The main advantage is that it can help save lives when other methods of breathing are not possible. It is much easier for the patient than intubation. It is also a great help for patients who are starting to breathe on their own after being weaned off a ventilator.

But like any surgery, there are some risks involved. But remember, doctors do their best to minimize these risks.

• Bleeding and infection.
• Damage to the esophagus or trachea.
• Narrowing of the airway due to scar tissue or swelling.
• Damage to the nerve that controls the vocal cords (recurrent laryngeal nerve).
• Tracheostomy tube blockage due to mucus or blood clots.
• Air trapped under the skin around the tube or in the lungs.
• An abnormal opening (fistula) between the windpipe and esophagus (this can cause food and drink to pass into the lungs).

How do you adjust to life after surgery?

After surgery, your medical team will take good care of you. It usually takes about two weeks for the wound to heal completely. 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.

Tracheostomy care

Before you go home from the hospital, the nursing staff will give you and your caregiver detailed instructions on how to clean the tube at home (usually at least twice a day) and suction it. It is very important that you follow these instructions exactly.

Talking

After a while, you will be able to speak, but it takes practice. This usually involves covering the opening of the tube with your finger and speaking while blowing air out of your mouth. A speech-language pathologist (SLP) will show you how to do this. There are also special speaking valves that help you speak without covering your finger. Be patient, and you will be able to speak better with time.

Eating

At first, it may be difficult to swallow food and drink. During this time, you will be given nutrition through an IV or a feeding tube. The speech therapist will teach you exercises to improve your swallowing skills, and you will gradually be able to eat normally.

When you need to call the doctor immediately

After returning home, if you develop any of the following symptoms , call your doctor immediately or go to the nearest hospital Emergency Department (ETU).

Although hearing that you need a tracheostomy can be scary, it is often a life-saving and safe procedure. With the help of your medical team, you can adjust to this new situation, do the things you love, and live a happy life.

Tracheostomy, Tracheostomy, Trachea, Breathing, Ventilator, Surgery, Tracheotomy, Trach Tube, Breathing Difficulty, Respiratory Disease