Hi Terese,
It is good to hear from you! BJ IS quire the little trooper. He has come
so far.
I also use the Bivona TTS. I use it only at night when I am on the
ventilator. During the day I use a Shiley cuffless. It is easier in the
day to have in inner cannula that I can clean to keep my airway open. I use
~3cc water in the Bivona cuff. With the cuff inflated you cannot talk as no
air can pass over the vocal cords. I measure the amount of water needed in
the cuff by talking. When I cannot talk anymore, I know there is enough
water in the cuff to make a seal. Too much water can cause pressure sores.
It makes the trachea feel like a sore throat.
I think the reason BJ needs suctioning and has nasal congestion with the
cuff inflated is just a matter of airway dynamics. The cuff may dislodge
some secretions, but also changes the air pressures in the trachea and nose
and mobilizes or blocks secretions.
I pray that he gets well and stays well,
Margaret
I joined the list a few months back and apologize for lurking and not
introducing myself sooner. Some of you may know us from the trachties
list. My son BJ is 7 and is on the vent when sleeping and during the day
if he is sick or very tired.
We have recently switched from an LP10 vent to a Newport HT50 and from
volume ventilation to pressure ventilation. A few months ago we started
using a Bivona TTS trach because he has a significant leak and needs the
smaller diameter during the day so he can wear his PMV. I'm quite sure all
these changes feel very different for him and he has been quite the little
trooper.
BJ is not good at communicating pain or discomfort so I'm hoping you adults
can help me understand what he might be feeling. We inflate his trach with
2½ cc of saline and I know he does not like that. He will not talk with it
inflated and always needs to be suctioned a few times after we inflate. He
has been a bit sick on and off needing nebs and several times after
inflating the trach he has developed significant nasal congestion which has
me totally baffled.
Any input from all you experts would be appreciated.
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