Trach/PEG info

[prttynpnk]

My husband is being prepared for discharge from rehab and he is having trouble with swallowing- the doctors want to leave in the trach and PEG indefinitley. He is unvented (3 weeks now) and the trach size has been reduced, but they don't want to remove it. Does anybody out there still have these in place and what complications are we looking at in a home setting?

[Carl R]

I am approximately four years post injury (C3 sensory, C5 motor) and still have a trach in place. I get conflicting information from doctors on whether or not I will ever be able to get rid of the trach. I still have to be suctioned roughly two to three times daily using an assisted cough method and we still do breathing treatments once per day on average to keep everything loose and easier to get up. I was on a ventilator for six months after injury and had a feeding tube for about six months as well. I was able to get rid of the feeding tube before coming home. I have a #6 trach which we change roughly once a month and clean once every other day around the site unless more is needed. I can tell that my breathing has become stronger over the last year and have been on theophylin for about six months which has also helped in strengthening my cough, but still not strong enough to cough up secretions yet.

I am sure everyone wants to pull the trach as soon as possible, but you need to make sure that his lungs are stable before pulling it to quickly. You Would not want to have to put it back in at a later date should problems arise.

[prttynpnk]

Today they capped the trach to see how well he does.
I really appreciate your input on this!

[SCI-Nurse]

The dilemma your husband poses to the health care team is a difficult one. If they remove the trach he could have serious lung problems that would be difficult to treat. But the trach itself could be part of what is bothering his swallow--when you have a trach in the trachea is immobilized in the throat--when you or I swallow the trachea moves up and down during the maneuver. It would probably be best to leave it in a while longer, continue with the PEG and then when he's been stable a bit longer to take it out and reevaluate his swallowing.

Good luck!

(RAB)

I'm a C5 complete and I was on a vent for about 6 weeks. After that period of time I still had a trach and went to Craig in Denver for rehab. They kept it in for a month longer while I was there because they told me I would always have to have it due to sleep apnea. After they told me that, I demanded they take it out. I was convinced that the elevation affected my breathing and I'd be fine once I was back at sea level. Fortunately, I was right. I've been home for almost fifteen months without any problems. I was lucky - the only reason I was on a vent was aspirated pneumonia. Once that healed up, I was able to bring up secretions on my own and developed a pretty strong cough. That respiratory doctor and me had several heated arguments, but I won. It all depends on your husband's motor level and his ability to bring up secretions. Being capped will be a good test. Good luck and I hope his doc is better than mine was!