Out with the Old, In with the New (Part II)

Out with the Old, In with the New (Part II)

I had my trach (tracheostomy) tube changed last night. Unlike my g-tube changes (see post from 10/5/06), trach changes can be done at home, as I lay in bed. Typically, I have it changed every other week. It is easiest to do with two people, usually my mother and a nurse. One person pulls out the old trach and the other person inserts the new one. I have had my tracheostomy (hole in my trachea) for four years, so there is less of a rush to get the new tube in before the hole starts to close, but the tube should be inserted quickly.

Once the new tube is in, the velcro ties are attached and a gauze pad is placed around the trach. (above, right). An adapter (the blue piece seen in the picture) is also connected; my ventilator tubing is hooked to the bottom, while the top (clear part)can be opened for suctioning.

The curved tube (above, left)is 6.5 mm in diameter and about 9 cm long and has a "cuff" or balloon that can be inflated with water by connecting a syringe to the piece with the thin tube attached to the trach, to ensure the maximum amount of air reaches my lungs without escaping through my nose and mouth.

However, I never fully inflate the cuff because if I do, air cannot reach my vocal cords and I am unable to speak. (Imagine me speechless!)

During the day, I keep the cuff fully deflated. At night, I inflate it partially so I am still able to call my nurse when I need assistance.

Changing the trach doesn't hurt as long as the new tube has enough lubricant on it (a little K-Y jelly does the trick). However, changing it tends to stimulate the trachea to produce more secretions (mucus), so I usually need more suctioning afterward.