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Stenosis

There are some weird & wonderful happenings in the world of cancers (and non-cancers!) We have a friend, Mabel is her name, who suffered from this somewhat rare form of much reduced breathing – this is her story:-

(Note: this can get very complicated so we’ll try and keep things simple for you)

Here we have a slightly different scenario to a full blown laryngectomy because although the larynx & vocal chords can be affected they are not necessarily removed, snipped, nudged or budged but breathing problems are occurring. Meet ‘Mabel’, our friend in need for this situation:
     Mabel is a normal, happy go lucky girl, early thirties, married with kids and a full time worker. She starts feeling very tired for no apparent reason and feeling breathless for no apparent reason. Now we all know that if we charge around the superstore to get the shopping out of the way or go jogging for a couple of miles we are going to be puffing & panting for a while, whilst we ‘regain our composure’; ie, get our breathing under control and our heart rate steadies as blood pressure reduces from all the activity. OK, so far so good!
     Now imagine that Mabel gets up in the morning, enjoys her little bit of ‘morning cuppa of solitude’ before rousting the kids into action for the day – she’s fine, but, the hustle & bustle of the household coming alive, breakfast for the kids & getting them out of the door with the correct coats on etc leaves her puffing & panting; ie, breathless. Oh dear me, our Mabel needs to sit down and have another cuppa, this time a restorative one before even thinking about household chores or getting herself ready for work. (Now having suffered a similar situation to Mabel where breathing is difficult and ‘panic stations’ are only a heartbeat away I can fully empathise with what this poor girl is going through).
     Mabel gets to work but starts to find that every day, mundane chores in the workplace are causing her to be breathless which in turn causes her to be less effective/efficient in her particular field of expertise. Luckily she has a friend in the medical world to whom she turns to for advice.

How things change!
                                                                 How things change!

     Upon being seen by a consultant/specialist at her local ENT department Mabel goes through various tests and it turns out that her breathing tube (windpipe) is, for some unaccountable reason, narrowing slightly (Airway Stenosis). However, the news is good as this does NOT mean that cancer has planted itself and needs sorting out and all that is needed (“all” says he, wiping the beads of sweat from his brow!) is a bit of ‘dilation’ to ease the windpipe back to its previous size/situation.

     Sadly this didn’t work as planned and after a few attempts/failures Mabel underwent a simple surgical procedure whereby a small, damaged section of the windpipe was removed, everything stitched up & secured and of we went again. All was going well until Mabel noticed that although she had been breathing much more normally for a few months she was starting to labour once more and, unfortunately, another meeting with her consultant/specialist came with the bad news that ‘scarring’ had occurred on the inside of the airway/breathing tube/windpipe just below her vocal chords thus restricting her breathing once more.

     Perhaps you can now see the radical difference between that which a laryngectomy goes through and a Tracheostomy patient suffers as we unfold this miserable & unfortunate tale. Because the scarring causes such a restriction (and don’t forget here that laboured breathing puts tremendous pressure on the heart & lungs) it was decided that a Tracheostomy was the ONLY solution left. To digress slightly, this scarring business which causes the narrowing of the breathing tube is (medically) known as a STENOSIS – A stenosis,  (plural: stenoses,  from Ancient Greek στενός, “narrow”) is an abnormal narrowing in a blood vessel or other tubular organ or structure. It is also sometimes called a stricture.

Tracchy Tubes
                         Tracchy Tubes

     A ‘tracheostomy’ is a bit of a shock when you come out of the anaesthetic as your neck feels numb and it’s difficult to figure out why you feel like you have ‘scaffolding’ sticking out of your neck as your fingers very gingerly feel all around your neck – I felt as if my life was over, not realising that a second life had just begun! It takes a few days to get used to breathing through this weird feeling tube and, believe me on this, you do your utmost NOT to cough as it is very easy to block up the ‘tracchy tube’ with mucous. However, even in this seemingly woeful situation there is good news for the ‘tracchy tube’ has an ‘inner tube’, (just like a bicycle wheel has) so the art of comfort is to get to the stage where you are comfortable whipping the ‘inner tube’ out and rinsing it thoroughly under running water – you don’t even have to touch the mucous if you don’t fancy it as running water soon loosens the muck! Obviously you are going to quickly learn that when you do cough all is not good for the ‘inner tube’ can quickly become restricted in airflow but each day after the operation you will feel a little bit better, a little bit stronger & a whole heap more confident.

     I know that is very easy to say but you must try not to panic through the first few days. You have trained nurses on hand to help you and guide you through the basics and a pretty face always helps any situation along – in Mabel’s case we are dealing with ‘handsome hunks’ for the ‘eye-candy’ stakes .
      When you do first start removing the inner-tube for cleaning purposes you will be amazed at the amount of air that you suddenly inhale – and that is how it was before any of these problems started for Mabel (good job her married name isn’t Thorpe! ). She had suffered on a daily basis, yet the diagnosis was relatively simple. The ‘repairs’ weren’t quite so simple but a bit of re-arrangement of the ‘plumbing’ and our Mabel is back in the world of happy breathers. OK, to some she might appear a bit different but a nice silk scarf hides the ‘trachy-tube’ and speech is conducted either by placing a finger over the open end of the trachy-tube or by using one of the voice valves.
      Thankfully Mabel did not have cancer but she still had to suffer all the ignominies that we larys did/do (excepting the chemo/radiotherapy of course) and now joins the merry band of Daleks – nice to have a pretty face on board and thank you so much for sharing your story ‘Mabel’.