How long for a tracheostomy stoma to heal over? & PALS?

[JDiz]

Hi, Getting fed up of this now, and was wondering how long these normally take to heal?

I went into hospital on 29/09 for minor surgery on my eardrum, it all went tits up after they put me under general anaesthetic and the paralysing drugs, and they could not intubate me, (possibly use of a different type of anaesthetic) they then did an emergency tracheostomy.
The tube was removed on monday 2/10 and left to heal on its own.

Any ideas how long these normally take to fully heal?

I was told by my surgeon they will investigate and send a report to me, but it has been mentioned I should get the PALS service involved so that it doesn't get swept under the carpet? any suggestions/help?

Not due back to ENT til 16/11.

[JDiz]

Thanks for that informative reply, i'll get onto pals in the morning, the district nurses are watching for infection. I did get pneumonia while i was in there too though.

[JDiz]

SantaBarbara said:

Make sure that it is logged as a Critical Incident or whatever the terminology is.

Not sure if it has already been? I was also moved to post op critical care

this is from my discharge:

[JDiz]

I did speak to a senior surgeon (my ent surgeon)and senior anaesthetist, they were having a meeting a couple of weeks ago to discuss, I haven’t heard since. As I still need the ear surgery so need to avoid it happening again obviously.

Side note, I have had two prev generals this year with no issues.

Unsure about the cuffed trachy as when I was in CCU I definitely had a cuffed one. They deflated it and fitted a passy-Muir valve for a day before removing the trachy. Maybe they changed it in recovery. I don’t remember.


The doc, yes they told me I was lucky I was in ENT and saved my life.

Edited by JDiz on Wednesday 18th October 07:11

[JDiz]

FlyingMeeces said:

fk a duck, that's about as close to the pearly gates as you can get and still manage the return journey.

If the rest of you is well, your trachy site should heal really quickly - there are always exceptions to this (just normal human variation not problems) but I've had a couple of vaguely similar holes in me (suprapubic catheter, twice, and gastrostomy - in each case it's a large puncture wound through multiple layers of stuff and only held open by the tube) and when the tube comes out before the stoma has really healed the body usually seems to crack on with it VERY fast, hours to days for it to close-ish such that you wouldn't be able to get the tube back in and days to weeks for it to not really need the dressing or anything.

A mate was looked after at St George's which has a long term ventilator unit or something of that ilk, based on which I suspect their post decannulation info sheet is likely to be good quality and trustworthy.

Wishing you fast mending!

Was it really that bad? coming from someone with no medical knowledge.

No answer at PALS today.

Thanks for the st georges link.

[JDiz]

Quick update, pals weren't great, they just passed a message on to ENT for them to call me, in the mean time the anaesthetist report arrived this morning. ENT surgeon is bringing my appt forward by a couple of weeks.

The medical staff here may make more sense of the report than me.

Edited by JDiz on Friday 20th October 14:03

[JDiz]

The_Doc said:

Are you looking for

a) blame
b) explanation
c) future safety
d) money
e) sense of it all...

or just How long for a tracheostomy stoma to heal over?

b
c
e

I have no intention of suing, as far as I can see there was no negligence, as I understand it was part the new anaesthetic and part my body being awkward?

Obviously I an worried about c. as I am due to retry the ear op in the near future.

and just iooking to vent, I was asking about the stoma, as tbh I fancy shooting off to the bahamas to relax before the retry, but pointless going when i cant get sea or sand near it.

[JDiz]

Thanks for that, explains it much better.

I have actually just received a pm from an anaesthetist who wishes to remain anonymous, which has come as a bit of a shock. Does the below seem correct?

anonymous said:

TBH there are a number of points in the anaesthetic statement that I take issue with and despite being no fan of litigation culture I would advise you to get some legal representation.

You received a very large dose of Propofol (dose usually 2-3mg/kg) which could be for a number of reasons but it was the Remifentanil which is unusual. Its been established for almost 20 years and most people would use it with an infusion pump not as a bolus and would also more conventionally use it as part of a different anaesthetic technique than the one I think had been planned for you. We use computer controlled infusion pumps now but back in the day had to give a manual bolus of 0.5mcg/kg over 30 seconds.

So unless you're 200kg you received a very big bolus and I would have to ask if it was given manually not in a controlled manner by pump.

My other point is that you were given a muscle relaxant after the tracheostomy was performed and not before which goes against the national guidelines referred to by another poster on the thread. It is by no means certain it would have made a difference however in theory it can and most experienced anaesthetists would have done so. Theoretically this could have brought control to the situation and given enough time for things to have been done differently avoiding the trace completely. Obviously this is conjecture though.

[JDiz]

Actually yes, I have found a solicitor who has requested medical records. Still waiting.

I have had some issues with my throat, coughing and soreness and voice dropping, they have found a lesion on my left vocal chord.

It is being removed on friday, they are getting prepared to hopefully avoid the same issues this time. and are doing a hi flow oxygen anaesthetic to avoid having to try and tube.

[JDiz]

numtumfutunch said:

Hoping you're well and wondering what news you have, if any??

Thanks, Forgot about this.

Had a biopsy on the vocal chord removed, wasn't cancerous luckily.

Still been left with a chronic cough after speaking or eating, just finished speech therapy today, not really helped, back to consultant in two weeks to see if wants to fully remove the lump or try meds.

Solicitors said it wasn't worth pursuing as the cost of the medical expert would be about the same as the award.