Once again I'm sitting in a hospital. Not in a big, efficient city hospital but in our small, hometown emergency room. My husband has just arrived via ambulance after coughing up a small,thin tube that was attached to the inside of his nose and is now hanging out of his mouth.
After getting him fed, medicated and situated on the sofa I'm in the middle of preparing his bedtime medications when I hear him start to cough. Walking into the living room I see him doubled over and holding his mouth. One look at him and I know something major is wrong. There is a very small pink tube in his mouth and each time he coughs it pops out - when he stops it slides back in. I grab the phone, hit 9-1-1, grab onto the pink tube when he coughs again and am on the phone with the surgeon when EMS arrives. Poor George is petrified. He's holding onto the tube with his fingers; without teeth he has no other way to keep this thing from disappearing down his esophagus. It's immediately apparent the EMT's have no actual experience with a laryngectomy patient. The first one on the scene tries to give George oxygen by using a face mask. Even after I tell him George is a neck breather the EMT is still attempting to place the make over his nose and mouth. They begin loading him into the ambulance as I am explaining what is needed. The squad members are now asking me what needs to be done. They did not know that he cannot have oxygen without humidification. These guys are wonderful but the one admits this is the first laryngectomee he's dealt with. As we ride towards the hospital I am peppered with questions concerning the multiple surgeries and care requirements. They are genuinely concerned and want to know what to do and how it's done.

Our arrival in the ER resembles a celebrity sighting. Everyone wants to see the patient with the tube sticking out of his mouth. Doctors and nurses surround George and begin firing questions at him. I get the "I'm talking to him" attitude until they realize he cannot speak. Then they all want to see the laryngectomy patient and ask questions. Even the nurse admits they don't see a lot of these. George's surgeon is now on the phone and while he is speaking with the attending ER doctor portable x-rays are take and blood is drawn.

George is coughing again. The nurse is trying to calm him and make him more comfortable but the coughing continues. Before anyone knows what is happening George reaches into his mouth and pulls hard on the tube. He has just pulled out an 8" long, clear, plastic tube (about 2" round)!!! The small pink tube is stitched to this plastic tube. What the Hell is this????? The nurse runs to get the doctor - she has no idea what it is either! Well, at least the coughing has stopped.....

Ahh - the things they don't tell us......the plastic tube is a sheath placed in the esophagus after the surgery so the throat doesn't close up while the new esophagus is healing. The thin, pink tube was stitched to it AND to the inside of his nose to help keep it in place. Ohhhhhhh - George is angry and so am I. We asked about the tube in his nose and were basically told not to worry about it. Ya' think they could've told us what it was and that there was another tube inside his throat?!?!?!? It sure would've made things a lot easier if we knew that the tube hanging out of his mouth wasn't life threatening! Jeez Louise, what a fright! Poor George...coughing unknown tubes out of his body, scared out of his mind believing he was going to die, rushed to the ER by ambulance.... All that could have been avoided if only someone had taken the time to answer our question and to explain what it was and why it was there......