Having a Laryngectomy

Back on the ward you will be made comfortable and a nurse will probably stay with you for most of the time. You will be nursed in a fairly upright position, in your bed, supported by several pillows. This will help reduce swelling in the neck area and make breathing easier.

You will have your blood pressure, pulse and oxygen levels checked. This will be monitored by a machine which has a blood pressure cuff and a rubber attachment to fit on your finger.

There will be a fluid drip going into a vein probably in the back of hand which will is to help to keep up your fluid levels as you will not be able to eat and drink for about 7 days after your operation. You may have a long feeding tube going into your stomach through your nose or through the opening made at the back of your windpipe (if you have had a primary voice restoration procedure). This will be used to give you water and liquid feeds a day or so after your operation.

Pain relief may be given through a fluid drip, by injections/liquid medication or by a pump which you may be able to operate yourself (PCA).

You will have a tube in your throat in the stoma and some stitches around the operation area. There will be a mask around your neck to give you oxygen and moisture in your lungs. There may be metal clips on either side of your neck if you have also had a neck dissection. You will have a small tube on either side of the neck. These tubes are quite long and attach to drainage bottles and remove excess fluid from around the neck area. It is normal for there to be some generalized swelling in the neck and around the jaw line after surgery. As the drainage reduces the tubes will be removed, usually 2-4 days after surgery.

Because you are now breathing through the tube in your stoma you will have more mucus to cough up and you may find this tiresome at first. The nurses will help you with this. A small narrow tube connected to a suction machine will be inserted into your stoma to remove this mucus and this will make breathing feel easier. This is called suctioning. You will learn, with help from the physiotherapist and the nursing staff how to cough this mucus out through your stoma by yourself. The mucus may be blood-stained at first – do not worry as this is normal.

You will be given a mist to breathe in and out through a mask over your stoma and this will help to loosen mucus so that you can cough it out. This is called a nebuliser.

The tube through which you breathe, in your neck, will be removed after a couple of days and the stoma will be cleaned regularly. The nurses will begin to show you this. You may or may not have to wear a laryngectomy tube in your stoma but your nurse will explain all this to you. After a few days as your wounds removed and gradually some of the clips and stitches taken out on the ward.

Now as you breathe air does not pass through the nose, which previously moistened and filtered the air before it reaches your lungs. Instead air goes straight through your stoma to your lungs. To replace moisture needed you will have moistened oxygen given through a mask into your neck stoma – this can be quite noisy! After a days you will progress to wearing a humidification cover (bib) or filters which help warm and moisten the air that you breathe.

At first when you need to use the toilet the ward staff will bring you a commode or bedpan. However soon you will be able to walk to the bathroom yourself. For the first couple of days you may have a urinary catheter to make recovery from the anaesthetic easier for you.

You will have a call bell by which you can contact the ward staff for assistance as needed. As you will have no voice initially you can communicate by writing, picture cards and by others lip-reading.

Following your operation you may not feel very sociable so it is wise to only have a couple of visitors. The visiting hours vary in the different hospitals and you will be advised about this.

You will receive liquid food through a tube which will be place in your nose or through the back of the stoma. This will continue for about a week. You may have a swallow test (called a barium swallow or a gastrograffin) in the X-ray department to determine if all the internal wounds have healed.

Your doctors will let you know when you can start to drink. You will then gradually increase drinks and food by mouth and the liquid food will be reduced and stopped.

Most people when first told they need a laryngectomy say they feel all sorts of mixed emotions, while others feel numb, some feel they knew all the time that they would need surgery. We are all individuals and cope in different ways and need different lengths of time to get used to the changes we face. Support and help is available from all the Head and Neck Unit Staff.

When you go home you will be able to have some help arranged for you if this is needed. This may include visits from the District Nurses, Home Helps, Social Services and your GP for example. District Nurses are often invited to meet you in hospital before you go home to assess your needs and see what is required of them at home. The specialist nurses who have looked after you in the hospital may be able to visit you at home if this is needed.

You will be given contact numbers for the ward so that if you have any immediate problems then you can get advice as to what to do. There is always somebody there 24 hours a day.