Tracheostomy: Before Your Surgery

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What is a tracheostomy?

A tracheostomy is surgery to help you breathe when something is making it difficult or impossible to breathe. For example, it may be done if you have throat cancer, a lung or nerve problem, trouble handling secretions,or something blocking your airway.

The terms tracheostomy, tracheotomy, and "trach" (say "trayk") are all used to talk about the surgery itself and the opening created by the surgery. The opening is also called a stoma.

The doctor makes a small cut (incision) to create an opening in your neck. Then the doctor puts a breathing tube through the opening and into your windpipe (trachea). This tube is called a tracheostomy or trach tube. It makes it easier for air to get to your lungs. It also helps remove mucus and other fluids from your lungs.

After the trach tube is put in, the opening may be made smaller around the tube with stitches or clips. If you no longer need the tube, the doctor will take it out. You will have a small scar on your neck that fades over time.

You may get medicine so you will be asleep during the surgery. Or you may be awake, but you will get medicine so you don't feel pain.

You will stay in the hospital until it is safe to go home. In some cases, the trach tube can be taken out before you go home. If not, you will need to go home with the trach tube. If you go home with a trach tube, your doctor will teach you how to take care of it.

After surgery, it will feel different to breathe and speak. Most people get used to breathing through the tube in a few days. At first, it will be hard to make sounds or to speak. Your doctor or a speech therapist can help you learn to talk. This is done by closing the tube with your finger or by adding a special one-way valve to the trach tube.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines, including natural health products, such as vitamins, supplements, and herbal remedies you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The surgery will take about 30 minutes.
  • You will have a bandage over the surgery area. A nurse will check and clean your trach every few hours.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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