air travel for adults with trachs

[viking]

I am sixty-nine years old and have had a trach since November of 2008 due to paralysed vocal cords. I would like to resume travelling by air including trips overseas, but I need to know how can I maintain my trach under the conditons of dry air on the plane. I need to clear out my trach quite a few times a day due to mucous and some times clotted blood. Normally I clear it out with running water in the sink. If I'm out, I "dry" clean it with a brush and a paper towel to wipe off the brush. I moisturize my throat several times a day as needed with the compressor or the nebulizer. How best can this be done on a plane? Would a squeeze bottle spray be good enough?

Is it normal to have so much mucous? And how about the blood clots that clog up the tube? My paralysis of the vocal cords came from numerous insertions and removals of the ventilator tube over nine days after open-heart surgery. Will the vocal cords come back on their own after 18 months of inactivity? Tom Beverly Hills, MI

[kadiera]

Hi Tom - we're in Troy MI

I don't think blood sounds normal, but almost all my trach experience is with my son, Alexander - and little guys like him don't get trachs with the removable cannula. We use a suction machine to suck the mucous out of his trach.

Do you wear something over your trach, like an HME? We use that to help keep Alexander's trach moisturized, without using the compressor or a nebulizer. We flew to Florida over the holidays with Alexander, and the dry air wasn't too much of an issue this way.

[bryantem]

I would suggest an HME too. I would use sterile saline over a spray bottle. I have also heard of adults that use a product called simply saline. It is a spray that people use to clean out their sinuses. Saline is naturally ocurring in your body, so the saline is absorbed better- too much water could cause pneumonia. You can also get portable nebulizers as well. A lot of mucous is normal, however we only ever see blood if she has been sick or if she has been exposed to extreme temp changes.

[CCHSMOM]

I would ask you doctor about the blood - it concerns me as well since my daughter only has bleeding with infections since she was switched to the Bivona TTS trach.

What type/size of trach are you using and is it cuffed? If you have an inner cannula, is it disposable (the disposable ones aren't meant to be washed)? My daughter used to have bleeding with every trach change when we were using either the Tracoe or Shiley cuffed trach tubes b/c the deflated cuff caused trauma to her stoma during removals/insertions. Also, how often do you change your trach? Do you suction at all, and if so, do you put saline down the trach before you do?

An HME (heat and moisture exchange) over your trach should help as well, as mentioned above.

[viking]

Thanks, guys. You gave me some good ideas. I'll look into using a HME and saline solution in a spray. I have a No. 6 Shiley Trach with a reuseable cannula. I haven't changed it much, twice in eighteen months. I have a portable suction machine and a portable nebulizer as well as the compressor. I haven't used the suction machine after the couple of days when I came home from the hospital. I have a good strong cough now and I moisturize with the compressor or nebulizer to loosen up whatever's in my trach and throat. This is essential in the morning and some other times. Tom













Adult

[CCHSMOM]

Tom, I've never heard of going that long between trach changes. My daughter's ENT says to change the trach at least every two weeks for cuffed and at least monthly for uncuffed. It may be different with adult ENT docs, but Shiley's own package insert says not to use the tube longer than 28 days. Is your Shiley cuffed or uncuffed?

Also, did you know shiley makes trach tubes that use disposable inner cannulas? You just switch them out daily when you do your trach site care. I would check with your doctor about the bleeding, daily trach care, type of tube, and frequency of change, etc.

[trainmanj]

I also use a Shiley, size 8 though, uncuffed. I've used a trach since I was young, but have always changed it every other week. For me, going longer tends to result in plugs getting stuck the outside of the trach.

You should ask your doctor about the blood. As others have said, this is very rare unless something is going on. For myself and others I know, bleeding is uncommon and should be checked into. Getting that cleared up may help with traveling as well.

[lauramchayle]

Hello from Nurse Laura, I also have never heard of leaving a trach in so long. A month at most. Perhaps you are developing small abcessess that bleed because trach is in so long and rubbing same areas over and over? But definitely let your MD know.. has been going on too long! Also I remember hearing years ago that when flying...because of the air pressure changes, that the cuffed trach may need air inserted or let out. So if problems when flying, keep this in mind. Also I remember MedFlight Adding water to the cuff.
They may have info.
Does anyone know about any special rules about trach's and flying. Not o2 or vent questions, my girl is on a HME. But she has + MRSA and secretions, and Angel's Flights and National Patient Travel Helpline won't fly her.
I can't find any rules in the CDC site or FAA site.
Is it a Don't Ask,,, Don't Tell issue?
Thanx so much all you lovely people.

[destinyandmiracles]

Why won't they fly her??? Because of the trach?

[destinyandmiracles]

Oh and I agree that I think something could be going on because of not changing the trach. We change Ashton's every Monday.