A tracheostomy is a procedure where the surgeon makes a small incision in the neck into the trachea (windpipe). Then a small tube is inserted into the stoma (hole). The tube, refereed to as the trach, has a small balloon that is inflated to block the airway. This stops saliva and food from getting into the lungs and helps to hold the trach in place. (There is also a strap that goes around the neck to help secure it.)

The balloon is called a cuff. For most, the cuff can be partially deflated which allows for enough air to pass the vocal cords to let the user speak. Because of my weakened throat muscles I have to keep mine full.

This immediately changed my ability to communicate. While I had been using my eyegaze computer for going online, now it is the main way I communicate. This works when I am lying in bed and nothing is being done to me. Unfortunately having the trach means I must be suctioned, both mouth and lungs (via the trach). This happens several times day and night, and the computer gets in the way.

So my backup lo-tech solution is a clipboard with a sheet that has the alphabet printed out in frequency of use order. I use my toe to point to letters and spell out words., obviously limiting and often a challenge for the reader if words are long. This is why it was important for me to have an advocate with me throughout my 3 week recovery stay at the VA. This was fulfilled by an army of friends and family, for which I am incredibly blessed and eternally grateful. During my entire stay there was someone at my side, helping me to communicate with the nurses. The staff at the VA were amazed at how many people came to help.