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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, today’s tip is, again, about a question that we had from a reader, Tracy, who says, “My brother was diagnosed with multiple myeloma. They found a mass on his voice box and his air supply got threatened. They did a tracheostomy and today, we found out from the doctor that the tracheostomy can’t be reversed because apparently, there’s a damaged cartilage in his voice box. Would you get a second opinion? From Tracy.” 100%. Would I get a second opinion? I would almost always get a second opinion because if the voice box is damaged, you need someone from ENT (Ear, Nose, and Throat). You need an ENT specialist (Ear, nose, and throat) to make an assessment here, whether the voice box is irreversibly damaged.

I actually think that’s the most important point here if the voice box is damaged, is it irreversibly damaged? That’s the sort of thing I can’t ascertain from here, but I 100% would say that you need a second opinion here one way or another because having a tracheostomy or not having a tracheostomy, in the long run, makes a big difference in people’s quality of life.

A tracheostomy should be a temporary device, it should not be a permanent device. The goal of a tracheostomy should always be that it’s temporary. There are exceptions to the rule of course. When you look at our Intensive Care at Home service, you can find out more at intensivecareathome.com.

Some of our clients, they are C1, C2 spinal injuries, and there might be MND (Motor Neurone Disease) clients. There might be cerebral palsy clients with tracheostomy. For our clients there, the tracheostomy is irreversible because they have complex medical conditions. But for the vast majority of patients in intensive care, a tracheostomy should be a temporary thing, it should be reversible.

The goal should always be to wean or to take away the tracheostomy as soon as the ventilator has been weaned. The steps, generally speaking, are, you do a tracheostomy in ICU because you can’t wean a patient of mechanical ventilation and the breathing tube. The next step then is to remove the breathing tube and put a tracheostomy, the surgical procedure. Then, the next step is to wean the ventilator once that’s done, try and move towards decannulation, i.e., the removal of a tracheostomy as quickly as possible.

So, if there is damage in the cartilage in the voice box, you 100% need a second opinion. I’m not even going to speculate here why the cartilage is damaged, could be from the mass, it could be from the tracheostomy. That is why you 100% need a second opinion from an ENT surgeon.

Most likely you might also get some input from the speech therapist, especially when it comes to the voice box and see the reversibility of the tracheostomy.

So, that is my quick tip for today. I hope that helps.

If you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, in a membership area and via email and we answer all questions, intensive care and Intensive Care at Home related.

I also offer one-to-one consulting and advocacy with families directly. I talk to doctors and nurses directly. I can participate and represent you in family meetings like we’ve done many, many times successfully, turning situations around very, very quickly. As soon as the intensive care team knows you have someone on your team who knows intensive care just as well as they do, the dynamics, generally speaking, change in your favor.

If you feel like you have no control, no peace of mind, you can’t make informed decisions and you have no power, I can turn this around for you very, very quickly. I will post a link to a podcast that I’ve done recently with the client where I can verify from the client that we’ve turned a life-or-death situation around quite literally where the ICU team was ready to withdraw treatment without family consent and we turned that around successfully and the actual patient is on the podcast talking about their experience in us.

That was someone that was “doomed to die” or labeled by the intensive him as “doomed to die” is now sitting on a podcast and talking about how grateful they are of being alive, that the intensive care team should never label a patient that they’re “doomed to die”, and that they need to be given every chance to live.

So, that’s my quick tip for today.

We also offer medical record reviews, and we provide a second opinion in real time. We offer medical record reviews after intensive care, especially if you are suspecting medical negligence, if you are having unanswered questions, or if you simply need closure. Please contact us as well.

Subscribe to my YouTube channel for regular updates for families in intensive care, share the video with your friends and families, click the like button, click the notification bell, and comment below what you want to see next or what questions and insights you have from this video.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.

Take care for now.