Tracheostomy help

Hello 

My dad has been undergoing chemo and radiotherapy treatment for a number of weeks now. The only help he has is from me and my sister, we are both in our early twenties and I work mon - fri 8-530 and my sister 8-730 so he is pretty much home alone most the time by himself - no district nurses. 

He has been in and out of hospital and his first stay of over a month he had a trache put in. He has been readmitted for dehydration after his second lot of chemo and when he was still peg feeding (no drinks). Also been in for picking up cdiff and also he was rushed  to A&E with an infection which put him in ICU. He has no immune system (can't spell the medical term). Therefore this is why I am super worried about something which may be minor. 

Since his treatment has been intensified he has found it more and more difficult to keep the trache clean.

He had his last lot of treatment on Friday, however his whole neck is so sore from radio, it's really hard to clean all the dried mucus (sorry for tmi). 

Does anyone have suggestions on how to clean especially in the hard to get areas. We have tried wet kitchen roll but without a scrub, which we cannot do we can't remove it. I am just worried about it causing him to get any infections.

He doesn't know when he will next will be seen either, waiting on the letter which we are sent however I guess it will be a few weeks before he is assessed to see if he needs more treatment or not. Sorry not really sure where we go from here! Been 10 months which have just flown by never really asked what happened after treatment.

Thanks in advance for any replies!

xx

  •  Hello, I am one of the enquiry nurses and have been asked to have a read of your post by our by our moderator Lucie. 

    I am sorry to learn about your dad, I imagine this has been a tough time for you all. 

    I think your dad needs the district/community nursing team to come and check his tracheostomy and also take a look at the skin on his neck. Radiotherapy can make the skin very red and sometimes the skin breaks down and weeps. I am not sure if this is the problem or if the mucous is coming from your dad’s chest.

    Radiotherapy skin reactions heal in time, but the skin can get worse for a couple of weeks after the radiotherapy finishes before it starts to get better. I think someone needs to take a look at your dad's neck and decide what needs to be done in terms of cleaning agents and dressings and arrange for a supply of them if needed. The GP can arrange for a district nurse so I would contact them today to get the ball rolling. Another person who may be able to help is the practice nurse if there is one at your surgery. If there is a head and neck specialist nurse at the hospital they would be worth getting in touch with, you might have to leave a message and they will get back to you. You could also phone the radiotherapy outpatient department and ask to speak to the nurses based there. 

    If the skin has broken down, there is a risk of infection so it is important to try and keep it clean. I am not sure if your dad’s immune system is still low, it might not be. This would depend on when he last had the chemo. A low immune system is a temporary side effect of chemotherapy that the body corrects in time. I think it would be worth mentioning this to the GP when you ask for the district nurse referral.

     I am sorry I can’t be more specific, but I do think a health professional needs to assess your dad in person and decide if anything needs to be done. I hope you can sort something out.

    Take care, 

    Julia