Well all I know is that Ron came home with his trach and that suction machine, it was a portable one he took everywhere with him while he had the trach in and they delivered the sucky part with the medical supplies to stick down the tube that I was shown how to do it and did it a couple times for him to help clear him out, but he actually did it himself...but he didn't have it that long. I hated that thing as did he, he is still scared of getting that this week, he says he can't breath with it in and got mad that he says he couldn't breath but his sats were fine in the hospital. Good Luck!