Problems with My Tracheostomy

The above picture is not of me, but it is a good picture of what kind of Tracheostomy I have.

I’m Home at last!

Home feels a little strange at first. Kinda like I don’t know what to expect. I’m not sure what I thought it was going to be like, after having been in the hospital over two months. The last several weeks of my hospital stay was while I was the most aware of what was going on around me. I became familiar with many of the nurses and other members of the hospital staff, and they came to know me. With the way Insurance Companies put pressure on doctors to get patients out of the hospital as quickly as possible, I became quite a novelty. Diane and I saw so many people be admitted into the rooms around us, then transferred or discharged out only to have someone new coming in. This coming and going along with some of the more regular hospital employees became my world. This is what I was accustomed to, all very structured and organized. But now all that has changed.

At home I will make my own schedule. I will decide when things are going to happen. As long as my body agrees with my plans, I will be in charge.

When I had the problems with my Trach in the hospital, Dr. Cowan changed me from a #8 Trach to a #7 Trach. What that means is that the tube going down my trachea is now smaller. He also cut the cuff, expanding balloon, off so if the tube clogged up I would be able to breath around it. In essence this was to prevent another situation like the one I had the night before. Well the doctor did tell me that there was a disadvantage to this smaller tube, it does clog up easier. A foreboding of things to come.

I got out of the hospital on Tuesday and by Friday I was in trouble. I awakened Friday morning gasping for air. Again just like the time in the hospital no air in and no air out, my heart beating so fast I thought it was going to come out of my chest. I awoke suddenly with a violent jerk and sat straight up in bed. Then as I became more awake and aware of what was happening there was a loud gasping sound and my chest filled with fresh air. I was breathing again. My Trach was completely blocked and no air passing through. But since this Trach had no cuff and was smaller I was able to breath past it even though it was blocked, just like Dr. Cowan had promised.

But what happened? It was due to my Sleep Apnea that I awoke in such a state. The whole reason for the Trach is so I don’t have to use my CPAP machine to maintain an open airway. The Trach is located below the part of my airway that closes off due to the Sleep Apnea. That’s so when I go to sleep and my airway closes off I continue to breath through the Trach. But this time the secretions or phlegm in my airway clogged the Trach and put me in danger. Thank God in all his wisdom I awoke. When I was first diagnosed with Sleep Apnea in 1992 the doctor told me without intervention I would one night wake in terrible pain as my heart went from rapid beating to not beating at all, and I would be gasping for air but it would be too late I would be dead.

But now I was awake and everything was okay. I knew that even though breathing was slightly difficult, all I needed to do is clear the clog in my Trach and continue as normal. I worked on myself for more than 45 minutes without success. I tried doing suction on the tube with a catheter. I tried squirting saline solution into the tube to loosen the clog. But nothing worked. I finally decided that since this Trach does not have an inner canula that is removable for cleaning that the clog was either going to be sucked out or pushed through. If in trying to push the catheter into the clog it dropped down into my lungs I would be in trouble for sure. At this point I decided to call for professional help.

I called my doctor’s office and told them what was happening. Dr. Cowan was in surgery so the nurse told me to go to the hospital emergency room and be treated there. This I did. After a long wait in the emergency room waiting area I was finally taken into triage and the nurse went to get the doctor on duty. When he saw the type of Trach I had he instructed the nurse to page my doctor and let him confer. By now Dr. Cowan was out of surgery and did call back quickly, but instead of talking with the doctor on duty he ask for me. The nurse put me on the phone and he said that since I was able to talk I mustn’t be in any real present danger and to come to his office to see him.

In Dr. Cowan’s office I was taken to a room and he had me lie back and lift my chin. As I thought he was just looking at the Trach, in one swift motion he just pulled it out! He then took a little stick like thing and pushed the clog out of the tube. It was like watching toothpaste come out of a tube. Then just as quickly he pushed the Trach tube back into the hole in my throat. "All done, you can go home now." he exclaimed. He told me he would call me back into the office in a couple of days when he would change me from a plastic tube type of Trach to a stainless steel one. This new Trach would have a removable inner canula and I would be able to care for myself easier.

By now it was late in the afternoon and I was plum wore out. My home is about thirty minutes from the hospital where I waited a very long time. Then another thirty minutes to my doctor’s office and some normal wait there too. And of course the drive home in rush hour traffic, over an hour. Now I see that I am not as much in control of my own schedule as I thought I was.

Yes I’m home now but I’m not really King of the castle yet!

Below on the Left is a picture of me in my easy chair before surgery, then on the Right is my New "At Home" picture with all my tubes and food bags, IV pumps and other equipment.

Before Surgery, Nov. 1998.................After Surgery, Jan. 1999