Life with a breathing stoma
A stoma is a hole (opening) made in the skin in front of your neck to allow you to breathe. It is at the base of your neck. Through this hole, air enters and leaves your windpipe (trachea) and lungs.
You can see when and how you might have a breathing stoma in our surgery section.
Coping with a runny nose or cold
It’s quite common to have a runny nose for the first few weeks after your laryngectomy. The lining of your nose has to get used to the lack of air passing through it. Over time this gradually stops.
When you have a cold, you have to cough up any mucus you have through the stoma. You can no longer blow or sniff through your nose. This might be very hard to get used to at first. In time it becomes easier for you to put your tissue up to your neck and not to your nose.
Risk of infection
If you get a cold, your doctor may say that you have tracheitis. This is inflammation of the
. You are more at risk of developing a chest infection. Infections can sometimes be life threatening. A fever may be the first or only sign of an infection. But with some infections, you may have other symptoms without a fever.
It is important that you contact your doctor, your specialist nurse or the hospital advice line straight away if you have any symptoms.
If you get a bacterial infection, you might need to take antibiotics. Symptoms of an infection can include:
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feeling generally unwell – not able to get out of bed
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an increase in phlegm
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thick phlegm
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a change in the colour of your phlegm (brown or green)
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a cough that doesn't go away
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phlegm that has a bad smell
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bleeding from your stoma
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a change in your temperature – 37.5°C or higher or below 36°C
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flu-like symptoms – feeling cold and shivery, headaches, and aching muscles
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a sore throat or sore mouth
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a fast heartbeat
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feeling dizzy or faint
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skin changes – redness, feeling hot, swelling or pain
Contact your doctor or call the hospital 24 hour advice line immediately if you think you might have an infection. You may need treatment straight away.
Your sense of smell and taste
After a laryngectomy, your sense of taste and smell will not be as good as it used to be. To smell things, you need air to flow through your nose. Because your mouth and nose are now cut off from your breathing, this no longer happens automatically.
For some people, their taste may improve quite quickly. The sense of smell can take longer or not fully return. Some people may have long term problems with both.
Speak to your dietician or speech therapist for tips. For example, adding more flavouring to your food, such as spices and herbs may help. You might also be able to learn a technique to improve your smell. This is called the polite yawn or nasal airflow inducing manoeuvre. To do this, you yawn with your mouth closed. This draws air into your nose, so that you can smell. Your speech therapist is the best person to help you with this.
It is important to maintain your weight. Let your dietician or nurse know if you find that you are not eating well or off your food. They can offer help and advice.
Showering and shaving
You can still shower with a stoma. But you must be careful not to get water into it and wear a shower cover. Various types of shower covers are available. Ask your specialist nurse or speech therapist about these.
Speak to your nurse about shaving after your surgery. Remember that your neck might be numb for a few months after surgery. To avoid cutting yourself, it might help to use an electric razor.
Swimming
You must speak with your speech and language therapist for advice about swimming. You might be able to swim in some situations, but special equipment is needed to stop water going into your lungs.
Lifting heavy things
Usually, when you lift something heavy, you breathe in and hold your breath. This gives you extra strength.
But if you have a breathing stoma, you are not able to hold your breath. Not being able to do this makes it difficult for you to lift heavy things.
Constipation
As you can't hold your breath, it is difficult to strain when you go to the toilet to pass a bowel movement. So it's important that you avoid getting .
It is easier to sort out constipation if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor if you think you are constipated. They can give you treatment if needed.
Smoking
It is important to try to give up smoking before your laryngectomy operation if possible.
This isn’t always easy, especially if you have smoked for many years. But if you continue smoking, you are at risk of another head and neck cancer or lung cancer. Or developing an infection.
Coping with a breathing stoma
Getting used to having a permanent breathing stoma can be difficult. It can take time to get used to the changes you need to make. Feeling sad and very low in mood is part of the recovery for many people but there is help available.
Contact your healthcare team or specialist nurse to let them know how you feel. They can help you and explain what support is available in your area.
