I have no use for a tracheostomy now, but for the first five years of my life, it was vital to my survival. I was born 30 years ago, nine weeks premature, with a dangerously narrow airway.
A tracheostomy - or a trach as my family called it - is a small incision through the neck and into the trachea. A tube is placed there to, primarily, keep the airway open. My trach also had other functions: if I was sick, it secreted mucous like a second nose. Also, it was just plain reassuring to have an extra opening to breathe through. In fact, more than twenty-five years after I had the hole surgically closed, it still feels a little bit wrong not to be able to breathe through my neck.
When my sister, Tara, and I went to bed at home, the first night without my extra airway, our dad came in and had a serious talk with us (after we said our prayers, and I reprimanded Tara, as always, for saying "Lord Jesus." I was of the firm opinion that the pray-er could only say "Lord" or "Jesus", not both.) Actually, the talk was more a series of directions for Tara. I just happened to be there, listening.
As an LPN in his early twenties, our dad lived in a world of medical crises - and had likely heard the harrowing story of me as a tiny three-month-old being rushed back to the hospital as my airway started to close the first time they attempted to take out my trach. The second time, no chances were taken. I had my trach, with a very narrow tube - so it would have less chance of affecting my vocal cords - until I was five. The small hole was left to close on its own, but never quite managed to do so. I was around seven years old when it was finally stitched closed and I experienced breathing like most everyone else.
"Now, if she starts making any noises, I want you to come and get me. Or if she starts to turn blue. Do you understand?"
Tara nodded seriously, always my protector. Always playing the "big sister" though in reality, she is just 15 minutes older than I am.
It was an odd conversation to be present for, and I don't remember being particularly anxious about things going wrong. But something must have seeped into my seven-year-old consciousness. That evening, like most others, Tara and I prepared to stay up "late" and play pretend, where she was always the hero. I was the one in peril, who needed saving. I wanted her to promise me that she would wake me up if I fell asleep. I made her promise to come climb down from the top bunk above me to shake me awake. To tell me if I talked too much. Or wasn't talking. Or said something wrong.
"Okay," Tara answered dutifully. Again and again. Until she sounded less devoted to my well-being and more irritated at my irrational demands. Finally, she fell asleep.
I had no problems that night or any other, though I still have an airway so narrow that it often sounds as if I am sucking all the oxygen out of a room when I yawn suddenly.
I still have the scar - a couple inches long in the center of my neck - and shaped like a smile. It's an identifying characteristic for two little girls who dressed and looked so alike that in certain pictures even we can't tell each other apart.
I don't need the trach today, but I'm grateful to have had it. Of course no one wants a tube protruding from their neck for their first five years. No one wants to wear hankies like a cowboy to catch their neck snot, but considering the alternative, I know it was worth it.
I don’t remember traumatic trach changes, when the tube had to be suctioned and changed. I still have my voice.
What was needed, I kept, and what I had to let go of, I lost.