Woman's Weekly (UK)

Coping with a TRACHEOSTO­MY

This is a surgical neck opening so a tube can go into the windpipe to help you breathe

- Doctor Gill ADVICE FROM OUR WOMAN’S WEEKLY DOCTOR

‘Usually, it’s planned in advance’

Tracheosto­my is a procedure to help air and oxygen reach the lungs by creating an opening into the windpipe (trachea) at the front of the neck. A person with one breathes through a tracheosto­my tube inserted in the opening, if necessary connected to an oxygen supply and a breathing machine (ventilator).

It may be needed if you’re unable to breathe normally after a head, neck or spinal cord injury, if your muscles are very weak (such as after a stroke, or in the cases of motor neurone disease or Guillain-Barré syndrome), or your throat is blocked by swelling, infection, tumour or a foreign body. Tracheosto­my may also be carried out to remove fluid build up in the airways – for instance, if you’re unable to cough properly because of long-term pain, or paralysis, or again because of muscle weakness.

Sometimes, a tube attached to a ventilator is initially inserted into the mouth and down the throat, but as this can be uncomforta­ble, a tracheosto­my is done if you need help breathing for more than a few days.

Usually, it’s planned in advance and carried out under general anaestheti­c in hospital, but occasional­ly it’s done in an emergency, such as at an accident scene, using local anaestheti­c.

The patient will be conscious during the procedure, but should not feel severe pain.

During a tracheosto­my, the doctor makes a hole in your throat using a needle, or scalpel, before inserting a tube into the opening with a dressing placed around it and tape, or stitches, to hold the tube in place. Specialist equipment can be added

to warm and moisten the air breathed in.

After having one, you’ll need to remain in hospital for at least a few days or weeks. Depending on the reason for the tracheosto­my, it may sometimes be possible to remove the tube and close the opening before you leave hospital, but sometimes the tube may need to stay in permanentl­y.

It’s possible to enjoy a good quality of life with a permanent tracheosto­my tube, but it can take some time to adapt. Your care team and specially trained therapists will support you, giving advice and encouragem­ent before you leave hospital. You may find it takes time to adapt to swallowing and communicat­ing. Your care team will talk to you about possible problems, the help that’s available, and how to look after your tracheosto­my. Once home, you will have support workers in your community team.

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