Sunday, July 09, 2006

To cover or Not To Cover

Another subject that I had not planned on writing trach (tracheotomy, trach tube, stoma) all words that 4 months ago were not part of my vocabulary in any way, but are now daily words.

If you are not curious about the subject, please feel free to skip this post completely.

Initially, whenever I went out, I covered it with a scarf so that others would not have to feel embarrassed by staring or trying not to stare but being compelled to look and look again. At home, I did not cover. In general, I have found children to have no problem with it. They ask what happened to my neck, I explain that it is called a trach, and that it helps me breathe, particularly at night. They say Oh, think for a moment then want to go play with Paco. Don't you love the honesty and simplicity of children. If only we could preserve that pure innocence into adulthood, I believe we would not need to spend a lifetime seeking answers. Adults, on the other hand do not deal well with anything that is outside their scope of experience.

After the last trach change a week ago Friday, I decided not to continue to cover it for the benefit of strangers, particularly since it is so hot and humid this season. The scarf was just one more thing to be uncomfortable. My daughter and I had recently taken two of the soft ties that are over half an inch wide and painted vines and flowers on them. I had planned on wearing them when visiting with my grand-daughters by choice. Instead, I took one with me when I went for the exchange. The respiratory techs thought it was a great idea and they used one of the painted ties instead of the plain narrow cotton ribbon, normally used. I put the scarf back in my purse and walked out to meet the world, neck exposed for all to see.

It did not take long to see the results. While I was standing outside a store, a woman nearly ran over another woman with her car, she was so busy "not" looking at my neck that she forgot to look where she was going. All the rest of the time in town, people were staring and trying to pretend they weren't. I would have been happy to answer any questions that anyone had. No one asked. This is small town and most have never seen a trach tube before.

To be fair, many who know me in person and many who only know me on the internet have asked questions and I have been more than happy to answer. Still others, I am sure, have questions that they are afraid to ask in case it hurts my feelings or embarrasses me. So here goes my very own version of FAQ.

The appliance consists of a right angle tube with a base plate near the end that sticks out of my neck, an inner tube that follows the same curve as the outer tube, a "cork" which looks a bit like a bottle cap and fits over the end of the tubes, and two slots in the base plate to feed the ends of a tie through. The tie goes around the neck and prevents the tube from coming out accidentally, as well as prevents me from removing it in my sleep.

The hole in my neck is called a stoma and if the tube were removed, would probably heal over within a very few days. In my case, the trach is permanent as I suffer from sleep apnea caused by nerve damage to my throat and the trach prevents me from stopping breathing in the night. It is nice to wake up in the morning feeling rested and with some color in my face. The sleep apnea was not the reason for the trach in the first place, but is a very good side effect of having it.

Yes, I can talk. There are holes in the bend of the tubes which allow air to flow over my vocal cords and I can speak normally with the cork on the outside of the tube. If the cork is not there, I can make very good obscene phone calls as I run out of air rather quickly, but can still talk.

The modern trach tubes are plastic and are replaced every 4 to 6 weeks. It has taken a few tries to find the most effective and most comfortable brand and style, but I think we have been successful. The regular replacement reduces the chances of infection and allows the doctors to catch any problems in their infancy.

Maintenance is simple and is done twice a day. It consists of cleaning the area and replacing the ties if necessary.

It takes a bit of getting used to as it can be uncomfortable but is not actually painful. The trach does not bother me a bit but I am not really thrilled with having a hole in my neck. Strange what will bother one and not another. It is hard getting used to sleeping with it as I tend to block it in my sleep, then wake up with a start. That is getting better now, but I still have to contend with the cool mist humidifier and the electrostatic air cleaner running all the time and if it is really hot, a fan too. Those nights, I sleep in the morning when things have cooled down some.

The only other thing is to remember to go to the Emergency dept. of the local hospital before I am in serious difficulty breathing. So far so good.

If there are any other questions, please ask as I do not mind answering at all.


Don Iannone said...


We known folks who have gone through this. I admire your courage, will, and love of life, You continue to inspire.



Zareba said...

Thank you Don. While I was writing this piece, I realized that it had a lot more to do with honesty than with a trach. We need to live our lives in honest, naked truth. Again, it is not an easy thing, but the more we do it, the easier it does become....well manybe not easier, but the alternative becomes harder. ...Z

Zareba said...

Hi asgain, Don. I finally was able to visit your blog and really enjoyed reading, but couldn't leave a comment. We say so many of the same things in different ways.


Don Iannone said...

Thanks Z. Sometimes Blogger locks up wih its comments.

I think you're right that we say many of the same things but only in different words. That's nice.

Living in honest naked truth is a challenge... practice cutting the crap in my life. There's less than there used to be. Namaste!

rama said...


Glad to have discovered your blog!

Invite you to visit my blog at:



Zareba said...

Thank you, Rama. I enjoyed my visit to your blog as well. ...Z

samuru999 said...

I also admire the courage have!
And what a great place to be from.
Nova Scotia....paradise to me!
I will be up there on Friday.
I was born in Nova Scotia.
So nice to see a bloger from
Nova Scotia...

Zareba said...

Thanks Samuru. Yes it is a beautiful province. We are transplants, moved here in 1975 and discovered we can not leave again.

samuru999 said...

Oh... transplants.... well, you
sure picked the best place to go.
I will be going to Antigonish...
have a sister there. I hope to get
down to Cape Breton while there.
It is so heavenly there!!!
It is always so hard for me to
leave Nova Scotia... I love it so!

Anonymous said...

I have been making stoma covers for several years & mostly donate them to cancer centers and hospitals but I do have a website and thought you might like to check it out. I would appreciate any ideas or suggestions you might have. e-mail: