Is It Hard to Live With a Stoma After Laryngeal Cancer?
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My husband will need a stoma after his laryngectomy. We’re anxious about the impact that will have on our lives and his ability to enjoy things like going out for dinner, exercise, etc. Is it hard to take care of? Does it limit your life very much?
Laryngectomy is a surgery where the entire voice box (larynx) is removed for advanced cancer. After the reconstruction, the esophagus is still attached to the mouth, so swallowing is unchanged. But the windpipe (trachea) is now brought out through the middle of the neck just above the collar bone and this opening is called a stoma. A very, very rough analogy is a blowhole seen in dolphins. So while you swallow the same, patients with a stoma now breathe directly into the lungs, bypassing the mouth and nose.
Taking care of the stoma is relatively minor after healing is complete. In general, speech, dust, water, and sense of smell are all long-term issues with this surgery.
As you breathe, your nose and mouth warm, humidify and filter the air. So the lack of relative humidity can cause crusting around the opening of the stoma. This needs to be regularly cleaned out. Most patients wear a small ascot that conceals the stoma and filters out dust. Since the stoma is open all the time, in addition to keeping dust and other particulate matter out, showering can require an adjustment in order to keep the water out. Though there are some devices that allow patients to swim and even snorkel, patients with stomas must think twice before boating or other activities where they can fall into the water as this poses a very serious risk.
Your sense of smell and taste are diminished due to the lack of air flowing through your nose and mouth, so smoke detectors and devices that detect natural gas are needed. You will also not be able to blow your nose.
I find most patients adjust very well to life after laryngectomy, especially after speech rehabilitation. Several excellent support groups exist for laryngectomy patients, including and local chapters of the Chatterbox laryngectomy support groups. Several other resources for patients and families are listed in the link below.
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