QOL

Question 0

If they ask what re my chances?

Answer 0

Say, “Honestly I don’t know yet, but I can give a prognosis after gathering information; most people survive this.”

Question 1

Medical Concerns?

Answer 1

A. Have client tell you what they know about the surgery.
B. Fear of death.
C. High cure rate.
D. Describe the surgery
E. Pre-op visit by laryngectomee?

Question 2

More about medical concerns

Answer 2

Reassure them as much as possible. Let them know: there may be more treatment after surgery, they will wake up in the intensive care unit, and they will stay in the hospital for about 5 days.

Question 3

Tracheal Stoma

Answer 3

Suture made in the neck to have air go directly into the lungs.

Question 4

Communication.

Answer 4

A. NO POST-OP VOICE!!!
B. Describe different forms of a laryngeal speech.
C. How long does therapy take?
D. How much does it cost? 
E. Hearing evaluation.
F. Should they practice pre-surgically?

Question 5

What are the 3 forms of a laryngeal speech?

Answer 5

1. Artificial speech
2. Esophageal speech
3. Tracheoesophageal speech

Question 6

What is artificial speech?

Answer 6

Speech produced with an external device.

Question 7

What is esophageal speech?

Answer 7

Traditionally, air taken in through the mouth is used to vibrate from the esophagus and produce speech.

Question 8

What is tracheoesophageal speech?

Answer 8

Communication established through a fistula connecting the trachea and the esophagus.

Question 9

How long does therapy take?

Answer 9

Variable; 12 sessions for artificial & t-e, 24 for esophageal. May be more or less.

Question 10

General Orientation

Answer 10

A. Return to employment.
B. Activities: swimming, fishing
C. Taste and smell
D. Eating/swallowing
E. Hearing.

Question 11

Employment

Answer 11

Most are employed, may are old enough to retire.

Question 12

Activities

Answer 12

Not recommended because of the open airway.

Question 13

Taste, smell, eating and swallowing.

Answer 13

Some use a device to smell.
Food does not taste as good due to the loss of smell.
Some accommodations may be necessary.

Question 14

Hearing

Answer 14

Have trouble receiving feedback such as from therapy. Spouses may not hear which gives negative feedback to the laryngectomee.

Question 15

General Care

Answer 15

A. Cleaning the Stoma tube
B. Cleaning Stoma
C. Stoma covers
D. Humidity
E. Shaving
F. Sleeping.

Question 16

Stoma tube

Answer 16

Metal/plastic short term tube attached to the Stoma. It prevents stenosis and allows healing.

Question 17

Stoma covers

Answer 17

Wash cloth or tissue. Also have ones for purchase. Cover prevents material from getting in or out of the trachea. It also keeps humidity within the trachea and hides the Stoma for social reasons.

Question 18

Cleaning the Stoma.

Answer 18

Inner and outer cannula. Remove entire apparatus once a day to clean with soap, water, and a brush.

Question 19

How are eating habits affected by laryngectomy?

Answer 19

Most reported no change. Several reported a decrease in the amount of food eaten and hunger sensations. 50% reported longer lunches and dinners. Many reported decreased enjoyment of food.

Question 20

Is QOL better for patients treated with chemo radiation versus surgery?

Answer 20

Laryngectomy patients reported greater impairment of speech and shoulder function. Chemo radiation patients reported greater pain, problems chewing, and difficulty swallowing. Both reported excellent functional outcomes and health-related quality of life.

Question 21

How is speech intelligibility related to QOL after surgery?

Answer 21

Sentence intelligibility is better than word intelligibility.

Question 22

How does laryngectomy affect the senses of taste and smell?

Answer 22

Due the path of air entering through the Stoma vs the nose. Smell has a huge role in taste.

Question 23

Is pulmonary function compromised in laryngectomees? Why or why not?

Answer 23

Yes due to an open airway, and symptoms including coughing, sputum production, dyspnea, chronic diseases and acute infections. Many also reported airway obstruction.

Question 24

What are important points with regard to management of a tracheostomy tube?

Answer 24

Cleaning