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Tracheostomy: What to Expect at Home

Your Recovery

After surgery, your neck may be sore, and you may have trouble swallowing for a few days. It may take 2 to 3 days to get used to breathing through the tracheostomy (trach) tube. You can expect to feel better each day. But it may take at least 2 weeks to adjust to living with your trach (say "trayk").

At first, it may be hard to make sounds or to speak. Your doctor, nurses, respiratory therapists, and speech therapists can help you learn to talk with your trach tube or with other speaking devices. When you speak, your voice may sound deeper and scratchier than normal.

Your trach tube may be sewn or tied to your skin. If you have stitches, the doctor will remove them about 1 week after your surgery. The doctor may also take out your original tube and put in a new tube 5 to 10 days after surgery.

Taking good care of your trach is very important. It can prevent infections and help keep you breathing easily.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start out by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid strenuous activities, such as biking, jogging, weight lifting, and aerobic exercise, for 6 weeks.
  • You may take a bath in shallow water. Do not splash water into your trach.
  • You may take a shower. Aim the showerhead at your lower body or back. Cover the tube so that no water gets in but you can still breathe.
  • Do not swim.
  • The doctor will help you decide how much time you will need to request off work. Once you are ready to return to work, the doctor will complete any paperwork to ensure your return. It can also depend on the type of work you do, your employer, your ability to speak, how you feel, and other health problems you may have.

Diet

  • Eating and speaking may require the use of a special valve.
  • If food or liquid gets into your tracheostomy tube, suction it out right away. Sit up while you eat.
  • If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
  • If you take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do.
  • Be safe with medicines. Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, take an over-the-counter medicine such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
    • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines contain acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor tells you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision, stoma, and tube care

Your doctor or nurse will give you instructions on how to take care of your trach. This will include knowing the size of your trach, how to suction your trach, how to clean the opening in your neck (stoma), and how to clean and replace your trach's inner tube (inner cannula). Be sure to follow all of your doctor's instructions closely. And remember to have your emergency supplies such as your obturator ready and available wherever you are.

  • Suctioning Always have suction supplies ready, including a fully charged suction machine. Suction as often as needed, but at least 3 or 4 times a day. For example, two of the times could be before you go to bed and when you wake up in the morning. You will need suction catheters, a suction machine, and a mirror. These should be delivered to your home before you arrive there. Here are the steps to take:
    • Wash your hands with soap and water for at least 30 seconds.
    • Connect to oxygen for 30 to 60 seconds before suctioning.
    • Connect a catheter to the suction machine tubing. Insert the catheter into the trach. Push the tube in gently to the premeasured length.
    • Slowly pull the catheter out of the trach, rolling it back and forth between your fingers, with your thumb over the control valve (this turns the suction on). Do not keep the suction on for more than 10 seconds at a time.
    • Wait about 30 seconds, and repeat inserting and pulling out the tube until all the mucus has been removed.
    • Catheters can be used again if you clean them properly. Ask your doctor how to do this. Throw away used catheters if your doctor tells you to. Connect to oxygen after suctioning. Wash your hands again.
  • Stoma care Clean and dry the stoma 2 times a day, and as needed. Apply ointment to keep the skin healthy. Do not let crust form on the skin at the stoma. You will need saline fluid or sterile water, 8 or 10 cotton-tipped swabs, gauze pads, a small cup, a dry cloth, a mirror, presplit gauze, and ointment for the skin. Follow these steps:
    • Wash your hands with soap and water for at least 30 seconds.
    • Fill the cup with the saline fluid or sterile water. Dampen a gauze pad or cotton-tipped swab and squeeze out any excess liquid from the gauze.
    • Clean and remove dried mucus around the stoma with the damp gauze pad or cotton-tipped swabs. To prevent spreading an infection, wipe the gauze or swab only once and then throw it away. Repeat with new, sterile material until the skin is clean. Be sure to look for any changes to the area, such as changes in colour or swelling.
    • Dry your skin with a clean gauze pad. If your doctor tells you to use skin ointment for your stoma, apply it with the remaining cotton-tipped swabs. If needed, use a new, presplit gauze to protect the skin.
    • Wash your hands again.
  • Cleaning the inner cannula If you are not using the disposable type of cannula, clean and replace the inner cannula 2 times each day and as needed. You will need 2 small bowls, a small cannula pipe brush, sterile water or saline fluid, and a mirror. To clean the inner cannula:
    • Wash your hands with soap and water for at least 30 seconds.
    • Pour a small amount of sterile water or saline fluid into both bowls.
    • Unlock the inner cannula from the trach and remove it by gently turning it counterclockwise then pulling it out and down. Put the reusable inner cannula into the first bowl. (If the inner cannula is disposable, throw it away and replace it with a new inner cannula.) Clean the inside and outside of the reusable inner cannula with the brush.
    • Rinse the cannula in the second bowl. Shake the cannula out, and slide it gently back into the outer cannula. Make sure the cannula is locked in place and you cannot pull it out.
    • Wash your hands again.

Other instructions

  • Wear clothes that are loose around your neck.
  • If you are outside, wear a loose covering over your trach, such as a scarf or other cloth, but avoid clothing with loose fibres. Covering your trach prevents dust, dirt, and bacteria from getting into it. You can also use special trach "bibs" to cover your trach and to protect your clothing from mucus when you cough. You can buy trach bibs at a medical supply store.
  • Try not to breathe in anything that might irritate your trach. This includes small bits of food, smoke, powders, aerosol sprays, and dust.
  • Keep the air in your home moist with a room vaporizer or humidifier.
  • Carry an extra cannula and obturator with you at all times, in case your tube becomes blocked.

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 or nurse call line 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.

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.