to expect my elderly Dad to be able speak after his tracheotomy

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My elderly Dad recently had major stomach surgery and he's still very weak. There's been a breathing tube in place for a week and now he's scheduled for a tracheotomy - a temporary measure to help him breath without having to have a big lump of plastic tube in his mouth and down his throat.

But I thought he'd then be able to talk and so be less frustarated, but medics say not for a while (maybe a few weeks). Why not? Why can't he talk? I don't understand and the medics don't seem to be able to explain it to me without launching into medical jargon I can't understand

Anyone know anything about this or got any tips on how to help my Dad communicate and/or be more comfortable after the tracheotomy?

they should have explained this better at the hospital

you can't talk with a normal tracheostomy because the tube bypasses the vocal cords

he could later be fitted with a special speaking tube if the trache is to be longer than short term though

If he can write he can communicate that way, or flash cards if unable to write do he can point to what he wants

Basically when you speak it is partly contingent on air vibrating on your vocal cords. A trachie takes place below the cords so no air gets up to the vocal cords to help you make sounds.

Sometimes it is possible for you to cover the trachie in order to speak but it is usually a raspy noise and uncomfortable for the patient.

I know that this is incredibly frustrating for you and no doubt your dad, but when the trachie is closed he will speak again. Remember your dad is still there albeit as a somewhat quieter version.

To speak you need to have air going through your vocal cords. With a tracheostomy, the air goes directly into your lungs from an incision made below the vocal cords, so the air bypasses them.

I gather that it's not as uncomfortable as having a breathing tube down your throat but it's still not nice (my father had one when he was seriously ill a few years ago) and it is frustrating not being able to talk.

Pad of paper is the way if he is up to writing. My father was too ill and weak to hold/control a pen so it was just sign language/guess work for a long time.

It depennds on the type of tube they use, if it has a hole in the outer tube and if he needs an inflated cuff. The type of tube they will use will depend upon your dads health. some tracheostomies can have a speaking valve placed on the end.

If you find out which trachie they use i can give you more detail.

if your dad cant write, try typing out some cards with common questions/phrases that he can use

You could use a personalised version of the PECS pictorial communication system which was developed for non-verbal communication with children on the autistic spectrum.
Ask on the SN boards here, someone will know a good site where you could download images, and they'd be able to explain its use far better than me.

If you have access to an ipad or android tablet you can buy a program to speak for him. There are ones where he types and the tablet reads it out or you can get simpler version with pictures so he presses a picture and a sentence or word is read out.
Speech buddy is pretty cheap. It's aimed at children but can be customised.

OP I assume he is in intensive care yes? If he is going from an endotracheal tube (i.e. the tube directly in his mouth) to trache he is presumably going through the process of weaning from mechanical ventilation. Therefore his nurses will need to wean him to an acceptable level so that he is breathing independently before they will even begin to consider speaking valves etc- He will need to be off the mechanical ventilator entirely and having just an oxygen mask and/or room air. Traches are held in place with an inflated cuff initially and as the patient grows stronger they can deflate this cuff for periods of time allowing air to pass over the vocal chords as outlined above and the use of speaking valve. I always liken it to a roller coaster ride for my patient - lots of ups but the inevitable downs, recovery isn't a straight line but a series of peaks and troughs if you see what I mean.

In the meantime ITU nurses usually use a series of communication tools from the simple pad and pen but in my old unit we used to use eych a sketches like the kids have! Also bear in mind that most ITU's will not allow IPADS or other Wi Fi enabled devices due to risk of radio frequency wave inteference.

My stepdad couldn't talk for a while after having his tracheotomy removed, and not at all while it was in. He had it after the tube in throat was removed while he was in intensive care though, it might be different for longer term ones, though not initially I shouldn't think.

Is the tracheotomy still in place or has it been removed?
It took my dad about a week to start talking again (painfully) after it had been removed. It can be very very frustrating for them, must be terrible to be trying to communicate and then just produce a bubbly sound. It's amazing how quick they recover so very quickly and despite other problems he's had to contend with, the only trace of ever having a trache is a scar on his throat.
Good luck :)

Yes, my Dad is in intensive care and due to have his tracheotomy tomorrow or the next day.

Thanks so much for all your very well informed answers.

Its a long road ahead with no certainty that the destination will be worth reaching

all our best wishes, weet x

I had a tracheostomy as an emergency a few years ago.

With some tubes I could have a speaking valve and speak, with some I couldn't.

The most clued up person on the ward re trachys and speaking valves was a specialist speech therapist.

Hope operation goes well for your father tomorrow.

My brother's tracheostomy looks dislodged and is making an awful noise. He's had it since December last year and is still in hospital. We've pointed it out to the nursing staff but they've dismissed our concern and taken no action. He's also been waiting to see a dentist from the Galleries Health centre in Washington since march. He has toothache but they just keep telling us he's on a list for a visit and that painkillers are helping; they aren't! What can we do? I'm sitting with him now feeling desperate.

shielahussain this thread is 5 years old you would be better off starting your own in the health section.

Plus it's doesn't sound like something solvable over the Internet. If your brother's trachy is making an odd noise you should be doing suction or changing the tube.

Speak to his doctors, again and again until they listen.

BTW this thread is 5 years old.