A lecture about life challenges after laryngectomy including preventive care can be viewed on YouTube.
Continual medical follow-up by specialists, including the otolaryngologist, radiation oncologist (those who got radiation treatment), and oncologist (for those who received chemotherapy), is very important. As time passes from the initial diagnosis and surgery, followup occurs with less frequency. Most otolaryngologists recommend monthly follow-up examinations in the first year after diagnosis, and less often afterwards, depending on the patient’s condition. Patients should be encouraged to contact their physician whenever new symptoms arise.
They also recommend a thyroid checkup if the neck has been irradiated or the thyroid has been removed, smoking cessation and alcohol counseling if needed, dental evaluation, a nutritional evaluation and treatment until nutritional status is stabilized, speech/hearing evaluation and swallowing evaluation if needed, and ongoing surveillance for depression.
tumor. Continued smoking, either during or after radiation therapy, can increase the severity and duration of mucosal reactions, worsen dry mouth (xerostomia), and compromise patient outcome.
Counseling services are available to help one stop smoking and/or alcohol consumption. There also are medications approved by the United States Food and Drug Administration (FDA) that can help stop smoking.
- Reduce the consumption of sugars in food and drinks, brush your teeth well after consuming sugary food and/or drinks.
- Brush your teeth well after every meal and especially before going to sleep.
- Diabetic should maintain adequate blood sugar levels.
- Take antibiotics or corticosteroids only if they are needed
- If one uses an oral suspension of an antifungal agent,, one should
- Wait for 30 minutes to let it work and then brush your teeth. This is because some of these suspensions contain sugar.
- Consume probiotics by eating active-culture yogurt and/or a probiotic preparation.
- Gently brush the tongue if it is coated with yeast (white plaques). Brushing should be avoided in those who have irradiation mucositis
- Replace the toothbrush after overcoming a yeast problem to prevent re colonization with yeasts.
There are two types of influenza vaccine: an injection that is adequate for all ages and an inhalation (live virus) only given to individuals younger than 50 years who are not immuno-compromised.
A new vaccine for influenza is prepared for every new season. While the exact strains that cause influenza are unpredictable, it is likely that strains that caused the illness at other parts of the world will also cause illness in the U.S. It is best to consult one's physician prior to vaccination to ensure that there is no reason why one should not be vaccinated (such as egg allergy). Information of the current recommendations about vaccination can be found in the Center of Disease Control Website.
The best way to diagnose Influenza is a rapid test of nasal secretions by one of the diagnostic kits. Because laryngectomees have no connection between the nose and the lungs, it is advisable to test nasal secretions in addition to tracheal sputum (using a kit that was approved for sputum testing).
Information about these tests can be found in the Center of Disease Control website.
One "advantage" of being a laryngecomee is that one generally gets fewer infections caused by respiratory tract viruses. This is because “cold” viruses generally first infect the nose and throat; from there they travel to the rest of the body, including the lungs. Because laryngectomees do not breathe through their nose; cold viruses are less likely to infect them.
It is still important for laryngectomees to receive yearly immunization for influenza viruses, to wear a Heat and Moisture Exchanger (HME) device to filter the air that gets into the lungs, and to wash their hands well before touching the stoma or the HME, or before eating. The Atos (Provox) Micron HME with electrostatic filter is designed to filtrate potential pathogens and to reduce susceptibility to respiratory infections.
The influenza virus is capable of spreading by touching objects. Laryngectomees who use a voice prosthesis and need to press their HME to speak may be at increased risk of introducing the virus directly to their lungs. Washing hands or using a skin cleanser can prevent the spread of the virus.
It is advisable that laryngectomees and other neck breathers get vaccinated against the pneumococcus bacterium which is one of the major causes of pneumonia. In the United States there are two types of vaccines against the pneumococcal bacteria: the pneumococcal conjugate vaccine (Prevnar 13 or PCV13) and the pneumococcal polysaccharaide vaccine - a 23-valent pneumococcal polysaccharide vaccine (Pneumovax or PPV23).
One should check with their physician to make sure they can be vaccinated.