Tracheostomy in the Times of the Covid-19 Pandemic

It has been unsettling,to say the least, to have such a virus spreading that would hit me where I am most vulnerable. Truthfully, any respiratory infection could be life threatening for me, due to the risks of respiratory crisis, and would have required an emergency tracheostomy. Since I can’t cough, due to weakness of my respiratory muscles, I could suffocate on the fluid buildup. The social distancing has not been an issue for me since I hardly leave my apartment anyway. Previously it was quite risky to be out and have one of my frequent saliva aspiration episodes, saliva getting into my lungs. It could take hours to get the mucus out of my lungs, and I really needed to be home with all my equipment to manage it.  

I had been thinking a lot about being proactive and getting the tracheostomy sooner than later. So if I do get infected with the virus, I will be able to directly suction out the fluid from my lungs, as many people who get covid, especially those who do not have a strong immune system, develop pneumonia, where part of the lungs fill with fluid. The surgery was recommended by my pulmonologist and neurologist many months ago. I had decided I would get it done at some point, because it can add up to ten years to my life expectancy, but I had no idea how I would actually make the decision to get such a life changing invasive procedure. It is hard for me to put into words how the decision weighed on me. My doctors had informed me about clear markers of when I should get the surgery, like becoming short of breath without the noninvasive ventilation mask, or if my oxygen saturation became chronically depressed, etc., none of which applied to me. I was managing and it left me in the grey area. How would I choose to put a tube into my lungs and become completely dependent on the ventilation machine to breathe, suffocating without it?

The indecision was overwhelming and I went into periods of hibernation, not checking emails or returning any texts. I needed space from the decision. The stories in movies provided the temporary solace I needed. Eventually I started to fill in the gaps of the great unknown surrounding the surgery. I began to research about the common complications from the surgery and the daily maintenance that it would require. I got a list of questions ready for my upcoming phone consult with my pulmonologist. I sought out consul from my most trusted advisors. One who I deeply respect, helped it hit home that it made a lot of sense to get the surgery soon to mitigate the risk of getting infected with the corona virus. Emotions aside, it started to sink in that it was time for the surgery.

I let my pulmonologist know at our next appointment over the phone I was considering getting the surgery. It was a huge step for me to tell him I was considering it, but he raised the ante and added a new layer of complexity. He thought that soon hospitals might be over capacity, and no longer allow elective surgeries. My surgery would be considered elective because I was not in a respiratory crisis. So he recommended that if I want it soon, then I should get the surgery that week. Otherwise I could have to wait months until the corona virus situation improved substantially. So much for just considering the surgery, he said I needed to decide in the next couple days to have it done that Friday. It was impossible for me to shift gears that quickly, but by Friday I called to tell him that I was ready to go ahead with it next week.

 On the day of my surgery it was a ghost town in the hospital. Arriving in the surgery lobby was eerie. There was nobody behind the desks to check me in, and there were no other patients in the huge empty room. The surgery went well. It was challenging to be in the hospital so long afterwards. I had to stay in the ICU eight days. Normally I would have been sent to a different post-operative recovery area of the hospital once I stabilized, but they were keeping that side of the hospital separate for Covid patients. There was a strict policy of only one visitor for my entire stay in the ICU. That way they could limit exposure risks of the corona virus.

So here I am. I've made it to the other side. I'm feeling much better about the corona virus situation. It could still be life threatening if get infected, but I'm much better equipped to deal with it. I got a minor case of pneumonia in the hospital. It was good experience to learn right away how to deal with fluid in my lungs. The direct sectioning of my lungs is a game changer. I'll show you how it works at the end. It is a closed system, therefore less chance of infection. Another bonus with the surgery is that I no longer have to wear a ventilation mask, which opens up my face. Now you can see me smile.