Fact Sheet Looking after your stoma following a laryngectomy

Transcription

1 Fact Sheet Looking after your stoma following a laryngectomy

2 THE NAME YOU CAN TRUST Your national specialist service provider It is our aim to be the best we possibly can and never to let a customer down. We want to surpass your expectations and be the name you can trust for your laryngectomy, tracheostomy or jaw rehabilitation needs. We understand how essential your supplies are to maintaining a good quality of life and that s why we hold the largest inventory of laryngectomy and tracheostomy devices anywhere in the UK, ensuring we have the items you need, when you need them. Unlike chemists we hold prescription items in stock meaning that we can dispatch your goods as soon as we receive your prescription. As part of our service we can write to your GP (once we have received your order) to collect your prescription for you, so you don t have the stress of doing it yourself. We also operate an electronic prescription service to further speed up the process. At Countrywide Supplies we endeavor to give you everything that you need from a home dispensing service. We have dedicated Customer Care Representatives who are trained and ready to help you, ensuring you have unconditional support and one point of contact. Our friendly staff are happy to contact you to check your supplies and services as well as informing you of any relevant updates. We continue to liaise and collaborate with Healthcare Professionals (Speech and Language Therapists and ENT nurses) allowing us to make sure you re getting the most suitable product or service for your different requirements. That s why we are best placed to offer you an effective and personal service which is designed to meet your individual needs in a discreet and efficient manner.

3 Introduction It is very common to have lots of questions after a laryngectomy. This information is a guide to looking after your stoma following a laryngectomy. It contains general information to help you, but does not replace the information or advice given to you by your own hospital. If you have any queries on the day-to-day management of your laryngectomy stoma please contact your local hospital team. Information on laryngectomy support groups is provided at the end of this booklet. We at Countrywide Supplies have been working with the laryngectomee community for over 15 years. Through our prescription home delivery service we support the community and help laryngectomees obtain their necessary devices quickly and direct to their door. This booklet has been prepared in conjunction with leading Pulmonary Physiotherapists and Speech and Language Therapists in the UK.

4 Looking after your stoma Wearing a humidification device day and night will help keep secretions (mucus) down, but it is important to keep your stoma area clean as well. Before leaving hospital you will be shown and have practised caring for your stoma. As with all things this will become easier with practice and thus less time consuming. It is important to get into a routine of checking your stoma at least three times a day. Many laryngectomees do this as part of their morning, lunchtime and bedtime routines. You should not allow any mucus to build up either in or around your stoma or in your airway (windpipe). This could lead to lots of coughing and may affect your breathing. To clear mucus from your stoma, hold some clean tissue or gauze near to your stoma, take some deep breaths and cough any mucus to the top of your airway and wipe away. The amount of mucus produced will vary from person to person.

5 Cleaning your stoma Before cleaning around your stoma you will need to remove your laryngectomy tube or stoma button or your adhesive baseplate and HME (heat and moisture exchanger) cassette. If you use a foam cover or a laryngectomy protector this would also need to be removed. Equipment needed: A freestanding mirror A good light or pen torch Gauze swabs Cleaning solution (this may be saline solution or freshly cooled boiled water. You should use the solution recommended by your hospital team.)

6 How to clean your stoma Removing your baseplate Use an adhesive remover wipe over baseplate Gently push off the baseplate with remover wipe 1. Once the tube/stoma button/baseplate is removed, clean around the stoma with a cleaning towel or gauze dampened in the cleaning solution, wiping away any mucus. You may need to do this on the inside of your stoma also take care with this as it may cause you to cough. Do this in the manner your local hospital team have taught you and if in doubt ask for help! Special adhesive removers are available to help remove any adhesive residue for baseplate users. Check your stoma is clear Clean your stoma Pat dry your stoma 2. Moisten any dried secretions with damp gauze and gently wipe away to remove. You may need to use your (clean) fingers or Tilley Forceps (angled tweezers) may be provided by the hospital. Some hospitals recommend moistening the area with an aqueous lubricant gel (e.g. Aquagel) to help soften stubborn dry mucus (crusts). Pat dry the outside of your stoma with gauze or tissue. Using a good light or pen torch, check that the inside of your stoma is clear. If this is difficult you may need a friend, relative or district nurse to help you with this at first.

7 Apply a new baseplate Peel away the liner of the adhesive Apply the ring of the adhesive as closely as possible to the stoma 3. When your stoma is clean and dry reinsert your tube / stoma button or affix a new baseplate as you have been taught in your local hospital. Make sure you insert a a clean HME cassette. If in doubt look at the manufacturers instructions as a refresher. Your laryngectomy tube or stoma button should be cleaned according to the manufacturers guidelines supplied with the product. Sponge tipped tube cleaners can be used to remove stubborn crusts. Rinse it well and ensure it is completely dry before replacing in your stoma. Care tips Occasionally the skin around the stoma may become sore. Barrier wipes and films can be used to protect the skin. These are available on prescription via your GP. Gauze swabs should never be cut up as small fibres could fall into your stoma causing irritation to your airway, which can be difficult to relieve. For the same reason cotton wool should not be used as the small fibres could also be inhaled. You can feel if your airway is clear by placing your hand near your stoma. You will feel warmth and air moving as you breathe in and out. In the first six months after your laryngectomy the stoma may shrink a little as it heals. It is very important to report any changes in your stoma, such as size, redness, swelling or sores to your Healthcare Professional.

8 The importance of humidification Humidification is the warming and moistening of the air that we breathe. This is normally done by your nose and upper airways. After a Laryngectomy breathing through your stoma means the natural humidification systems are lost. As a result, your lungs start to produce more mucus which can cause coughing and affect sleep. Appropriate humidification is an important part of your rehabilitation will help keep your mucus production down and any that is produced will be thinner which will make it easier to cough up and prevent build up. An HME (humidification device) should be worn both day and night and clinical studies show that doing so can improve people s breathing, voice, sleep and quality of life. While you are in hospital your clinical team will discuss this with you and help teach you how to use them. As well as wearing an HME it is a good idea to drink plenty of water to remain hydrated. Doing so helps to keep the body tissues moist and keep the secretions in your chest thin. However this does not replace the need for a humidification device over your stoma. Practice deep breathing exercises regularly throughout the day as this helps to clear secretions. You may have a nebuliser unit given to you when you leave hospital and your team will show you how to use it. Nebulising saline (salty water) can provide extra moisture to make coughing to clear your mucus easier. Breathing in steam from a bowl of hot water may be helpful if your mucus is becoming thick and difficult to cough up. Make sure the water is not too hot. Remember that your mucus may change according to the time of year. Your mucus may also become thicker during a cold or flu. You may need to check your stoma, do your deep breathing exercises and cough more regularly to keep your airway clear.

9 Additional advice and information Remember that during the summer time there are more flies, wasps, pollen etc. in the air, which may irritate an unprotected stoma. Make sure you wear a humidification device over your stoma. During cold and flu seasons, laryngectomees are more at risk of infections. Make sure you get a flu vaccination and it may be appropriate to ask about special microbial filters (for example, Provox Micron) for added protection. Make sure you discuss this with your local hospital team. You need to take care not to get water into your stoma as it will go straight into your lungs. You can use a plastic shower shield to protect your stoma when showering and shaving etc. These are available on prescription. Shower attachments can be used with HMEs and baseplate systems and your hospital team can advise you on what to use. Things to consider Do not go swimming unless you have the correct breathing equipment and have had lessons in how to use it - your local laryngectomy support group may advise you on this. Take care not to spray aerosols such as furniture polish, deoderant, perfume etc. too near your stoma area as this may irritate your airway causing coughing. During hot weather take care to protect your skin from the sun - a sunburnt stoma is very painful! While on the beach take care not to get sand in your stoma. Remember that it gets windy on the beach so make sure you wear a humidification device over your stoma.

10 Laryngectomee support groups The National Association of Laryngectomy Clubs (NALC) provide a very useful support service for Laryngectomees and their loved ones. They provide an opportunity to socialise, share experiences and coping mechanisms, whilst also hearing about the latest developments in Laryngectomee rehabilitation and care. For more information visit Macmillan provide information on their website and offer online discussions and information exchange forums. They are there for anyone affected by cancer, their family and friends. Find support and advice on their website. For more information visit There are also many excellent local head and neck cancer support groups with information about these local groups being available from your referring hospital. As well as these groups there are a number of useful websites for patients, families and carers. These provide not only helpful online information about laryngectomy care but also can assist in where people may seek support on financial and care issues. Other useful websites Cancer Laryngectomee Trust: The International Association of Laryngectomees:

11 Contact us Phone: Text: Web: Post: Countrywide Supplies Ltd. Freepost RSLR-GTKU-GCER, Cartwright House Tottle Road Nottingham NG2 1RT Office open hours: Monday to Friday 9.00am pm Closed on bank holidays How to order All of the items we supply are available on prescription. We deliver your supplies direct to your door and can also collect your prescription from your GP. To take advantage of our fast, reliable, delivery service Contact us Order Prescription Delivery Via our website, phone, text, or fax Place your order, giving product code and quantity Send in your prescription or let us collect it from your GP We aim to deliver your order the next working day If you do not find what you are looking for in the catalogue, rest assured that you can contact one of our specialist Customer Care Representatives who will be happy to help source your product. Please note: We aim to deliver orders to Northern Ireland within 2 working days. Orders must be placed and prescription recieved before 5pm to quality for next day delivery.

12 The name you can trust for all of your laryngectomy, tracheostomy and jaw rehabilitation prescription supplies. Head office: Countrywide Supplies Freepost RSLR-GTKU-GCER Cartwright House Tottle Road Nottingham NG2 1RT Phone: Text: Web: We are part of the Atos Medical Group