Author: Krisi Brackett MS SLP/CCC
Amy is a three year old with a diagnosis of severe laryngomalacia and bronchomalacia (narrow airway making it difficult for her to breathe). She is bright, playful and energetic at times, but her difficulty breathing has caused some problems such as:
* Difficulty sleeping at night when her breathing is interrupted and she wakes up
* Poor weight gain and growth (she expends a lot of extra energy breathing)
* Poor eating because it is difficult for her to coordinate her breathing and eating ( a g-tube or gastric tube in her stomach was placed a year ago to help her gain weight)
* Poor endurance when running and playing (she gets tired easily)
Amy sees an Otolaryngologist (ear, nose and throat doctor) for her breathing issues. He was hoping that Amy would grow out of the problem but as Amy has gotten older her airway has stayed small so a recommendation was made to put in a temporary tracheostomy/trach (small hole in her neck to breath through). After careful consideration her parents felt they had no choice but to go ahead with the surgery.
Because the surgery was planned, Amy and her family were counseled about what having a tracheotomy means. It would make breathing easier which would improve her endurance, sleeping, and growth. However, she would not be able to talk after the surgery because her air would be going in and out of her trach (hole in her neck) and not through her vocal cords. The plan was that Amy would eventually wear a Passy-Muir Trach Speaking Valve (a small valve that goes on the end of her trach that allows air to go in through the trach and then forces it up through her vocal cords allowing speech).
In preparation for being temporarily unable to speak, the speech pathologist met with Amy and her parents to put together a communication system before the surgery. They used a message mate, a small electronic device that can hold up to 40 prerecorded messages. Guided by the therapist, Amy was able to help choose messages. The therapist suggested things such as a way to call for help, ask for suction, ask for a favorite toy, or even to say !?Leave me alone!?. Amy recorded her own voice onto the machine and took it home to practice with it before the surgery.
After the surgery took place, Amy was frustrated with not being able to talk. But she was able to access her message mate to communicate basic things plus a little gesturing. Two weeks later, she was able to successfully wear the Passy-Muir valve on her trach and was able to resume talking.
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