Tracheostomy - Living with a tracheostomy

It's possible to enjoy a good lifestyle with a permanent tracheostomy tube. However, some people may find it takes some time to adapt to breathing and communication.

Physical activity

You should be able to resume everyday activities, but you should avoid vigorous activities for about six weeks after the procedure.

When you're outside, it's very important that your tracheostomy opening is kept clean and dry. The opening will usually be covered with a dressing, but a loose piece of clothing, such as a scarf, can also be worn over the top. This will stop substances such as water, sand or dust from entering the opening and causing breathing problems.

Speech

It is usually difficult to speak after having a tracheostomy. Normally, speech is generated when air passes over the vocal cords at the back of the throat. After a tracheostomy, most of the air that you breathe out will pass through your tracheostomy tube rather than over your vocal cords, which means you will be unable to speak normally.

One solution is to use a speaking valve, which is a plastic attachment that sits at the end of the tube and is designed to temporarily close over every time you breathe out. This prevents the air leaking out of the tube and allows you to speak. However, it can take a while to get used to speaking with the valve.

After having a tracheostomy, you may be referred to a speech and language therapist. They will be able to give you further advice and training in speaking while the tracheostomy tube is in place so that you can improve your ability to communicate.

Cleaning the tracheostomy tube

A tracheostomy tube needs to be cleaned whenever it gets blocked with mucus or fluid. The tube may need to be cleaned several times a day.

If the tube is permanent or if you are allowed to return home with the tube still in place, a specialist tracheostomy nurse will teach you how to take care of the tube. They will show you how to suction fluid from your windpipe (trachea) and how to clean and change your tracheostomy tube.

Removing the tracheostomy tube

If you have a temporary tracheostomy, the tube should be able to be removed when you are able to breathe, protect your airway and clear fluids unaided.

After the tracheostomy tube has been removed, the opening in your neck will be covered with a dressing. The opening will usually take one to two weeks to heal, and afterwards you may have a small scar where the opening was. If the opening does not close on its own, stitches may be needed to close it.

Over time, a tracheostomy opening tends to narrow, so if you have a long-term or permanent tracheostomy tube, you may need to have further surgery to widen it.