Re: Chewing food/ painful trach change

Gail A. Anderson (beadgander(AT)juno.com)
Sat, 2 May 1998 01:00:13 -0400

Michael,
My first question would be what kind of trach tube does your father use?
I use a Shiley , fenestrated with a low pressure cuff. For the first
seven years of trach changes does by a nurse from the VNA, I experienced
major problems, pain and bleeding from each trach change. The nurse
noticed that some of the cuffs were thicker than others. I talked to the
engineers at Shiley and they told me that there were 4 or 5 different
acceptable thicknesses of the cuffs. I asked for the thinnest. After
that I was able to get away from the pain and bleeding but change the
tubes myself without any nurse coming. Now I get what is called the PRV
cuff. Supposedly it is the thin cuff. I still get nervous before each
trach change but I rarely have a problem.

When I began to have to be on the vent full time in the past 2 years, it
was even more important that I get that tube in quickly to get back on
the vent. I came up with the idea of putting the swivel adapter at the
end of the vent tubing in my mouth before I removed the trach tube.
Everyone said that it would not work, that the alarms would go on, that I
would lose too much air through the stoma. I did not care about the
alarms and I was not planning on leaving the stoma wide open for long.
It works perfectly. I am still ventilated through my mouth. Once the
new tube is in and the inner cannula inserted, I reconnect to my trach.
It takes away some of the fear, although I did go back to having a
visiting nurse come and watch in case something goes wrong.

I have gotten terrible pain and swelling around the stoma separate from
trach changes. Sometimes the swelling increases until something bursts
and I find some blood on the trach dressing. Once that happens, the pain
is gone. During these times I use Neosporin or Bacitracin salve around
the area, but I'm not sure they really help.

Gail ........The BEAD goes on!!!!!!!!!!!!!!

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