My wife is three weeks after BOT tumor resection (low grade mucoepidermoid recurrance) w/ flap reconstruction and bilateral neck dissection. Today the doctor capped her trach w/ goal of removing it in two days. She finds her breathing very restricted w/ the trach cap. The nurse told us to alternate between the cap and the inner canula every couple hours until she is used to it. She also gets thicker mucous w/ the cap and continues to use suction for it. Any suggestions for handling the trach cap over the next couple days to make it easier? She thinks it will be easier to breathe once the trach is removed entirely b/c she feels like the trach is taking up half her airway now. Comments/ suggestions?
She is prob 4-5 weeks from a swallow study and can't swallow now. She will visit the speech pathologist next week.
Thanks,
Allen

Oh, you are preaching to the choir! I am on the board researching the same issue. My mom has had a trach since her surgery 6 months ago. She spends a large %age of her time with the cap off as it helps her to breathe. Three pulmonologists have flat out refused to take the trach out as she has a lot of secretions. OF course her surgeon says that the reason for the secretions is that the trach takes up so much room in the trachea!

We "manage" the secretions with Robitusson and a drying agent.

Hey Allen - good to hear your wife is scheduled to see an SLP next week. The sooner the better! I hear of an awful lot of people who are seen by SLP's for consults rather than actual treatment. I think we're missing a big opportunity to progress by not truly treating these problems. Talk with your SLP about a treatment plan rather than a "wait and see" approach - same thing for respiratory therapy.
As an SLP, I've worked with many similar cases. Here's the thing about breathing - if it doesn't come easily then we reflexively freak out a bit which leads to - you guessed it - increased difficulty breathing!!! With treatment, a person can be well monitored for appropriate oxygenation while they work with the therapist to build their tolerance for the cap and learn to relax a bit and better manage their own respirations - leading to increased likelihood of de-cannulation (trach removal)

These things can improve with treatment - same for your Mom, Trish!

Most insurance plans cover speech therapy.

Good luck!