From my experiences, I would advise getting it changed at least every 6 months. I had mine for 3 years (Feb 04). I had some infection in Nov. 06 and saw a GI doctor. It cleared up with antibiotics but I decided to have it changed. I went to the hospital and he tried to take it out by "pulling" on it. It hurt like "hell". After several tries, we told him to quit (good thing I took some pain killer before going in). I called the hospital where it was installed and I aranged to go there. They tried once to pull again which hurt the same way (felt like my guts were coming out). They decided to put me under and went in through my throat. I was told later that it was in so long it became enbedded and they had to go in with a device to break it up. They said it should be changed every 6 months. Spent one night in the hospital as there was some bleeding and pain. I was put on pain med. I'm OK now. No one told me about having it changed despite regular visits to my ENT. Live and learn! Good luck with yours.

Jim
-------------------------------------------------- SCC Rt lateral tongue Dx 9/03, Surg 11/03 (T2/N0M0);recur SCC BOT and anterior tongue Dx 1/04; surg 2/04 (T4/N0M0) subtotal glossectomy, forearm free flap, floor of mouth reconstruction,pharyngoplasty;trach until 3/04;PEG still have; 36 rad (3/04-5/04)therapy 12/04-12/05; 2 esophagus endoscopies