Hi doctor,
My sister is tracheostomized and bedridden after undergoing her fourth surgery for foramen magnum meningioma. She has drooling of saliva and it comes out under the tracheostomy plate. She asks for frequent suctioning as she has difficulty in breathing. Her saturation is above 90 after suctioning. Is this an emergency?
Hi,
Welcome to icliniq.com.
If the patient is tracheostomized, there is a possibility of developing fistula between the food pipe and trachea. It is called a tracheoesophageal fistula. In such a condition, we need to heal the fistula and it can be done by following the advice. She needs to have a cuff inflater pipe through which the air is inflated and deflated in and out from the cuff. Even though the inflated cuff prevents faulty aspiration of fluids from the mouth while swallowing, it can also create necrosis around the trachea and thus causing the esophagus to get connected to it.
You need to suction the tube and deflate the cuff every 2 hrs for 15 minutes and so that this raw surface connecting the two heals and saliva from the tube stops coming from it. For few days, patients cannot food orally and they need to be fed using Ryles tube. Repeated swallowing can infect the area and it may lead to leakage of food through the tube.
Thank you doctor,
She is fed through PEG and only homeopathy medicines are given orally. Saliva is also coming from her tracheostomy flank. Her body has a lot of jerks. What to do?
Hi,
Welcome back to icliniq.com.
To give homeopathy medicine through PEG (percutaneous endoscopic gastrostomy), keep her nill orally as much as possible other than giving few sips of water to keep her mouth and throat moist. Jerks can occur due to brain surgery. Nothing happens to a stoma while you maintain its hygiene. Keep it dry. I suggest you give tablet Augmentin 625 mg (Amoxicillin with Clavulanic acid) twice daily three times a day for a week to heal the leakage of saliva from the tube. Continue deflating the tube.
Thank you doctor,
Thanks for helping me.
Hi,
Welcome back to icliniq.com.
You are welcome.
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