Don still has his trach since they placed it right before surgery on the 12th. He already had rad/chemo. I thought the trach would be a big issue too but turns out not to tough to handle the care. Saline irrigation a few times a day seems to really cut down on the coughing and secretions.( after the initial of coarse) While the canula soaks in peroxide. A good swabbing with saline a few times a day to clean it up and make him more comfortable in "public" and I put a good balm on his chest to keep the skin protection "from the elements" then slide a clean split gauze up snug between the trach and skin. Snug up the tie if the gauze is too loose. Other than that...we can't wait till it's gone,(less maintainance while we have other areas to work on) maybe Thursday. Good luck Sara