Talking Again

 

 

 

hands-free devices

 

 

WHAT IS HANDS FREE?

The Tracheostoma Valve, when used in conjunction with a voice prosthesis, enables hands-free, conversational speech. After proper fitting, the diaphragm portion of the valve rests in an open position and may be adjusted by rotating the diaphragm/faceplate for relaxed, quiet breathing, or routine physical activity. During speech, a slight increase in exhalation causes the diaphragm to close and divert air through the prosthesis. At the completion of speech, the diaphragm automatically reopens as exhalation decreases. (InHealth Technologies)

 

USING THE BLOM-SINGER HANDS-FREE

VALVE & VALVE HOLDER

I have found that the edges of the valve holder for the Blom-Singer valve assembly often cut into the skin of my throat. This is particularly true because my reconstruction included placing a flap in place of skin and muscle taken from the throat. (O.K. the fact that I am overweight doesn't help either.). The skin above the valve holder pushes down on the holder. As the holder material ages, it gets harder and eventually irritates the skin. I have found that if I rotate among two or three holders, using a different one each day, I have less irritation because the different holders stiffen at a different rate and at different places. Therefore, the pressure areas change each day with each different holder. This doesn't completely eliminate the problem, but it eases it significantly (or, I believe it does, which is much the same thing for me). (Terry G. Duga)

 

SHOWER GUARD TO GO WITH THE HANDS-FREE DEVICE

Imagine my chagrin when I nearly drowned while taking that long awaited first post-laryngectomy shower. I had failed to take into account that my breathing hole was now oriented in the wrong direction relative to the shower stream and the high concentration of soap reduced the water surface tension allowing it to go places it was never intended to go. This was extremely disagreeable and I would suspect that many of you might have experienced a similar event. There are a number of products on the market designed to provide relief, but unfortunately some simply just don’t work very well. For those of us that utilize a tracheoesophageal prosthetic device to produce speech, there is a very effective little gadget available for our use. It is merely a small, upside down snorkel and all you have to do is remove your filter or "hands-free" device from the plastic collar and snap this thing in while you shower. I’ve been using one for two years and have yet to suffer the first leak. It works so well that you don’t even have to take any special precautions and may shower just as you did prior to the surgery.

 

 

I use the one designed and produced by ATOS (the blue one) and distributed by Bivona Medical Technologies. It has a clever little internal baffle that may make it slightly more effective. INHEALTH also markets a similar device (the clear one) that should work equally well. These things only cost a couple of bucks and should last forever so you really ought to give one a tryout. (Marvin Whitley)

 

MUCUS REMOVAL HINT

For you "hands-free" and HME TEP users, this is a tip that you will want to try. The collar that attaches your hands-free or HME device also makes it difficult to remove mucus from the margin of your stoma and the inside edge of the collar. To the best of my knowledge, nobody makes a product for that purpose and if you don't keep that area clean, the mucus will eventually cause the collar adhesive to loosen resulting in a leak or loss of seal defeating the purpose of both devices. Indiscriminately poking around in there exposes you to the possibility of injury or accidental aspiration. Fear not - There is an extremely inexpensive, safe, readily available product that will do a great job of cleaning that area. Try using a small (one-inch) disposable foam paintbrush. That's right - Paintbrush! The thing is made of mucus grabbing, open-cell foam (just like HMEs) so you can actually breathe right through it. Most importantly, it's sized and shaped exactly right to get in there and do the job. You can buy a package of them for about a buck at most hardware or craft stores - fifty cents is the most I've every seen a single one sell for. The technique is extraordinarily simple. Just go to a sink with a mirror, moisten the foam slightly, remove your "hands-free or HME, cover your stoma with the foam brush, cough right into it, rinse the mucus from the brush (recommend you get a black one to make that task easier), and then while exhaling slightly to maintain positive air pressure just insert the clean, moist (not wet) brush into the collar and rotate it with light pressure so as to scrub the pesky remaining mucus free from your stoma area. There are other foam brushes available which are apparently designed for special purposes such as stenciling, but I would recommend that you stay with a paintbrush as they have an internal plastic stiffener that will afford some degree of support while scrubbing. (Marvin Whitley)

 

ROUTINE FOR INSTALLING HOUSING

I use the Tru-Seal disposable housings with adhesive (Skin-Tac “H”) and here’s how they work for me. First, I gently clean the area around the stoma with plain soap and water, followed by alcohol. After that dries, I use a protective barrier wipe, either Shield Skin or Skin-Prep. This gives the adhesive a good base and protects the skin from irritation. I then apply a thin coat of adhesive to the area where the baseplate will go and wait about 4-5 minutes. (I use this time to do other grooming things which help the time go faster) I apply a 2nd thin coat and wait another 4-5 minutes. Now, I carefully place the baseplate around the stoma, making sure there are no wrinkles. At this point, I gently but firmly keep pressing the whole baseplate to work the glue in thoroughly. I then pop the hands-free valve in (with HME filter) and it’s done. I’ve also found that waiting about 15 minutes before speaking gives the bonding a better chance. When it’s time to change again, I use adhesive tape remover pads which I pick up at a local medical supply store and that’s that. It should work. Good Luck! (Libby Fitzgerald)

 

SECURING HOUSING FOR VALVE

When I was introduced to the Hands-Free device, I was given a bottle of glue and some disks. This was messy and unreliable as the glue did not keep the housing secure. I finally found Hy Tape, which is waterproof and has a zinc oxide base and created my own method of securing the housing for my tracheostoma valve, which I use on a daily basis. It has worked very well for me during the past 4 years..

These are the products I use, including the brand names:
Hy Tape - available at Bruce Medical or from Hy Tape.
Smith Nephew "Skin Prep" and "Remove"- most health supply stores (in Canada)

My method is as follows:
Place the valve or housing on the tape disk and use a scissor handle to get a good seal.
Apply Skin Prep "only" around the area that will require tape.
Apply the housing over the stoma using fingers to seal.
Cut a 3 inch strip of Hy Tape and apply to the top of the housing under the chin.
Cut another strip a little longer and apply to the bottom .
The sides seem to take the most pressure so I use two strips on each side overlapping each other.

The housing should be secure. Normally it last several hours depending on use. If it breaks the seal, I simply pull it off, clean the area with "Remove" and put a new housing on with a new disk. I normally have three housings or valves, and remove the tape and disk each night. They can be cleaned with "remove" and washed with water to be used until they become brittle.

I find it quite reliable, easy to apply, and have used it successfully.
(Robert Smith)

 

TAPE THAT HOLDS

After many problems with tape that came loose while holding the strap of my Blom-Singer prosthesis against my neck, I have found two 3/4" tapes that I can recommend. They both come in rolls that are probably available in every drugstore.
(1) 3M Nexcare Soft Cloth Premium Tape - Advanced Holding Power (White Tape)
(2) 3M Nexcare Foam Premium Tape - Absolute Waterproof (Flesh-colored Tape)
The Foam Tape seems to work the best for me .. although the cloth tape works almost as well. (Dutch Helms)

 

PREPARING SKIN TO HOLD TAPE

I've used 3M's Transpore tape to hold the strap on my prosthesis with good success for sixteen years. I suggest that you change the tape once or twice daily, and clean off the residual glue with a little alcohol on a Q-tip. You might leave the tape off for an hour now and then to let the skin breathe. Some people might find a thinner strip of tape (3/8" or so) placed alternately high then low on the strap is sufficient to hold the strap, and will give the skin more chance to breathe. (Ron Langseth)

 

GLUE ON YOUR CLOTHING?

When I first started wearing the hands-free valve and seal, it seemed I was having to re-glue all day long. Unfortunately, when using the glue to repair my seal, I ruined a lot of clothing because of the glue drips. I have finally found an adhesive remover that works really well and have removed the glue from the clothing. It is called "Citrus Magic" - Natural Citrus Stain & Adhesive Remover. I buy mine at a Meijer Store but you could probably find it at Target or Walmart. Also I have found an additional product it is made by Carbona. It is called Stain Devils Spot Remover for removing chewing gum and glue especially from fabrics. You can find this usually in any grocery store. (Kay Allison)

 

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