Mechanical ventilation and Speech

[moonrise]

Anyone out there who is on a ventilator continuously? If so, may I know what kind of tracheostomy tube are you using? Is speech permitted?

 

[joelc]

I have a cuffless tube so talking is possible because air can get past the voice box. If you could talk before getting a trache there is no reason you can't after.

Content Index

There is some information here and if you click on "What Brand" you will see the one I use.

 

[moonrise]

Thank you for your reply, joelc. My grandmother was however prescribed a cuffed trache tube. She's currently on a fenestrated trache tube. However as she is on vent continuously, she has no use for the fenestrated inner cannula. Speech is permitted as long as the cuff is slightly deflated, even if she is using the non-fenestrated inner cannula. As she has no use for the fenestrated inner cannula, we are considering switching to a non-fenestrated trache tube. However, we are concerned about her ability of speech after the switch. Would a non-fenestrated cuffed trache tube with a slightly deflated cuff still allow speech? Anyone has any experience with this?

 

[pudge44]

I think my hubby will need one of those eventually does your medical insurance cover this kind of thing?

 

[moonrise]

pudge44: I think you might like to check with the medical services whether your husband qualify for any financial and home care services aid.

 

[sadiemae]

Home This is very interesting. Subject is a laryngectomy

 

[trfogey]

Home This is very interesting. Subject is a laryngectomy

If I recall correctly from the story as originally told at Patients Like Me, Ken (the subject of your link) had already lost his ability to speak and to eat by mouth due to advanced bulbar symptoms when the decision to ventilate was carried out. The tracheostomy with laryngectomy was done to protect Ken's airway from saliva, mucus, etc. coming down his throat and causing lung infections. The trachea (windpipe) coming up from the lungs and below the larynx was connected to and terminated by the stoma in the front of the neck. The rest of the throat (above the larynx). was reconnected to the esophagus, I think.

Ken's procedure was a good bit more extensive and invasive than a normal tracheostomy. Think of it as a type of reconstruction rather than just improving ventilation and breathing.

 

[sadiemae]

The post said he can still eat by mouth. Interesting if he regained that ability after the surgery.

 

[trfogey]

The post said he can still eat by mouth. Interesting if he regained that ability after the surgery.

Once again, working from memory, Ken was having serious choking episodes prior to the procedure, so eating by mouth was exhausting and dangerous. After the procedure, there was no possible route between his mouth and his lungs, so the choking hazard is gone -- why not try some kinds of food by mouth again? No more risk of aspiration. Swallow what you can and suction out the rest.

Apparently, their experiments have been successful.

If you are a member of Patients Like Me, you can find more of the details I'm vainly trying to dredge up from memory by finding posts by the user named Glenda (Ken's wife -- Ken's user ID there is KenSr). I think Ken's surgery was sometime in the spring of 2010. I think that there was also a thread where Glenda was asking for advice about the procedure after the surgeon offered it as an option to them.

 

[sadiemae]

Thanks. I am talking to her on Facebook

 

[BarryG]

The larygectomy is something that greatly interests me because of the time and energy that I spend each day suctioning mucous out of my throat. As my hands and arms are failing it is getting more difficult for me to do it and as it would be very difficult for anyone else to do it for me I am going to need to do something like this soon. It seems to me that this procedure where no saliva or nasal drip could get into the airway would be more suitable for someone like me than a straight trache. Like Ken I am breathing well without assistance during the day so would only need the vent at night.

I have an appointment in Feb to talk about this, not sure if it is something that has ever been done around here before but we'll find out.

And OMG, if I could eat or even just put food in my mouth again after over a year it would be worth it even just for that!

 

[sadiemae]

Barry, I will send you a friend request on Facebook for Glenda. HUGS Lori