I think this choice has to be made on a case by case basis. I am a post
polio quad and I originally used an iron lung (very big and not very
portable). I was weaned from the iron lung and for 8 years I didn't require
the use of any type of vent.
Then, due to sleep apnea, I started using a chest piece while sleeping (for
15 years until it became ineffective due to a severe scoliosis).
At that time I was given a cuffed trach which I hated, as it constantly
irritated my trachea. This made me gag every time I turned my head and
produced a tremendous amount of mucus. I had to be suctioned every fifteen
minutes for one hour when I got into bed for the night and I coughed non
stop for an hour every morning when I got in my chair. I also didn't like
the medical aspects of it; Sterile conditions, suctioning, monthly trach
changes, fear of the cuff rupturing and having to make an unexpected
(usually in the middle of the night) trip to a doctor to have it changed,
and the fear of someone or something accidentally hitting my trach.
After a year of misery, I contacted Dr. Alba at NYU and she suggested a non
invasive type of vent (IPPV with a Benett Lipseal) for sleeping (I can
breathe on my own while awake). I have been using this system since 1981
and it has worked out fine but I am thinking of trying a nasal or face mask
as I've heard good results with them and I'm somewhat uncomfortable having
to continually bite down on the mouth piece of my present system.
Dan, who doesn't like to cough.