Trach stoma not closing.

Posted by karlm @karlm, Apr 23, 2023

I had a tracheostomy due to stage four larynx cancer. I completed chemoradiation without surgery. The trach was removed in March 2022 but has not closed. I am not able to swallow anything. I have had a feeding tube since 2021. I am concerned about having a procedure to close the stoma. I am extracting mucous via stoma. If it is closed surgically, I fear lung infections. On the other hand, the speech therapist thinks that not having a hole in my neck would improve my swallowing. Has anyone experienced this?

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My trach also did not close. Getting soap and water from the shower was really the edge for me. I had mine stitched closed after three months as it would not heal itself. I also worried about the mucus but that was because of the trach. However my swallowing was pretty good at that point.
I would see what your doctor or oncologist says as each case is unique. Speech therapist probably shouldn’t make that call.
Give this post a few days as others might have opinions as well. I hope it all works out eventually.

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@hrhwilliam

My trach also did not close. Getting soap and water from the shower was really the edge for me. I had mine stitched closed after three months as it would not heal itself. I also worried about the mucus but that was because of the trach. However my swallowing was pretty good at that point.
I would see what your doctor or oncologist says as each case is unique. Speech therapist probably shouldn’t make that call.
Give this post a few days as others might have opinions as well. I hope it all works out eventually.

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Thank you so much for your reply. I appreciate it. My ENT thinks it’s time for the procedure. But when I had asked about the mucus, he said it may go to the lungs but it should come out of the mouth. He is not sure if swallowing will improve.

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Hi, I am Kerri from Canada and I am new here. I have obstructive sleep apnea for which I received a Tracheostomy in 1986 at aged 11. I had the Tracheostomy removed on jly 7, 2023 but the stoma will not close. If i undergo the skin flap procedure, I am informed i cannot use my BIPAP machine which is set to pressure of 21 over 11. If I do not use it, severe apnea ensues. what can I do?

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Hello, kerrig0707.
Although the answer to your question eludes me, it drives me to ask you a few questions! I have had a tracheostomy for a few years. Why can't you put a "plug" over the opening when using your machine for CPAP?
Don't they make a certain plug to see if a person is able to breathe through their nose and mouth without the help from the stoma-opening? Doctors do this to see if the person is capable of having the tracheostomy removed. Will the skin-flap procedure eventually heal, but you need use of the machine immediately?
My ENT told me that many people decide to receive a tracheostomy, rather than live with a CPAP machine the rest of their lives. Although that is hard for me to fathom, my tracheostomy has been a lifesaver in terms of mucus removal and being able to breathe freely. Would you go back to the tracheostomy, and why did you decide to remove it?

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@thomason

Hello, kerrig0707.
Although the answer to your question eludes me, it drives me to ask you a few questions! I have had a tracheostomy for a few years. Why can't you put a "plug" over the opening when using your machine for CPAP?
Don't they make a certain plug to see if a person is able to breathe through their nose and mouth without the help from the stoma-opening? Doctors do this to see if the person is capable of having the tracheostomy removed. Will the skin-flap procedure eventually heal, but you need use of the machine immediately?
My ENT told me that many people decide to receive a tracheostomy, rather than live with a CPAP machine the rest of their lives. Although that is hard for me to fathom, my tracheostomy has been a lifesaver in terms of mucus removal and being able to breathe freely. Would you go back to the tracheostomy, and why did you decide to remove it?

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Hello, @thomasan. thaks for your response. I have undergone almost a year of trials in which i had polysomnigrams (sleep tests) with my tracheostomy pluged and my apnea hypopnia index is low. now, the doctor who is the only one in this limited area of BC, states that if I do not breathe well, she will put in another tracheostomy I opted for BIPAP because the tracheostomy i had been using which was a #4 shyley, was discontinued and the replacement did not work, it restricted my breathing, it protruded too far. I only ever used the tracheostomy for sleep apnea, it was capped all day. we haven't found a sufficient plug strong enough to plug it while using my machine. honestly, htough i do think if your tracheostomy helps you reliee mucus plugs, it's great and a major advantage but i do not need this any longer. ps, i don't understand why ayone would chose a tracheostomy over BIPAP though BIPAP does take getting accustomed too.

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I forgot to mention that I do not ever wish to return to using a Tracheostomy because it's a lot of care and cleaning for a device I only used while sleeping.

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@kerrig0707

I forgot to mention that I do not ever wish to return to using a Tracheostomy because it's a lot of care and cleaning for a device I only used while sleeping.

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How are doing, Kerri? Have you found a BiPAP that works?

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@colleenyoung

How are doing, Kerri? Have you found a BiPAP that works?

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hi, i'm doing great and yes, i do have a BIPAP that works but i cannot use it until the stoma is closed.

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