🗣️ My Story: What I Thought I Knew About Trachs
When I was first told I needed a trach, the ENT described it as a quick, routine procedure — about 20 minutes, done under local anesthetic. It sounded simple enough.
But maybe because of my own medical background, something about that conversation didn’t sit right. So I got a second opinion from another ENT at a local clinic.
He was great — no pressure, just a thoughtful chat in his office. At one point, he said,
“If you were my dad, I’d send you to Dr. XYZ.”
Then and there, he picked up the phone, called Dr. XYZ, and I had an appointment a couple of days later.
After a quick exam and a careful review of my medical history, Dr. XYZ looked at me and said:
“You’re going to need a permanent trach.”
Until that moment, I had no idea there was even a difference between a temporary and permanent trach — or why that distinction mattered.
If you’re facing the same kind of decision, here’s what I’ve learned. I hope it helps you feel more informed, and maybe even a little more prepared.
🧠 What’s the Difference Between a Temporary and Permanent Trach?
Most people think a trach is just a hole in the neck to help you breathe. But there are actually two main types, and they’re quite different — not just in how they’re done, but in how they feel, heal, and function day to day.
🔹 Temporary Tracheostomy
A temporary trach is often used for people who need short-term breathing support — maybe due to surgery, illness, or trauma.
How it’s placed:
Usually with a trocar — a sharp instrument that punches through the skin into the trachea. It’s quick and doesn’t involve stitching the skin to the airway. This can be done at the bedside under local anesthetic and by somewhat less experienced providers.
Healing and removal:
Once the tube is no longer needed, the trach site typically closes up on its own.
Things to know:
- Can be uncomfortable, especially around the raw edges
- Often causes granulomas (little overgrowths of tissue)
- More prone to leaking, crusting, and skin irritation
- The stoma (hole) can close quickly if the tube is removed
🔹 Permanent Tracheostomy
A permanent trach is done when you’ll need airway support for the long haul — whether that’s due to structural issues, vocal cord problems, or something else long-term.
How it’s placed:
Done surgically in the operating room under general anesthesia. The skin and tissue are sewn to the trachea, creating a clean, stable opening called a mature stoma.
Healing and long-term care:
The stoma doesn’t close, even if you don’t wear a tube for a while. It becomes a permanent feature — but a manageable one.
Things to know:
- Heals cleanly, often with minimal complications
- Fewer granulomas and less irritation
- Easier to clean and care for daily
- The opening stays stable over time — no collapsing or sudden closure
💬 What I Experienced
When I got my permanent trach, it healed quickly. The stoma was stable, the skin wasn’t irritated, and I honestly needed very little support after the first few weeks. It’s now been over three years, and I rarely think about it unless I’m doing routine care.
Looking back, I’m grateful I got that second opinion. If I hadn’t, I probably would’ve ended up with a temporary trach that didn’t suit my long-term needs.
🟰 Pros and Cons Summary
| Feature | Temporary Trach | Permanent Trach |
|---|---|---|
| Placement | Quick, via trocar | Surgical, with skin flap |
| Healing | Closes when tube is removed | Stoma stays open |
| Skin irritation | Common | Rare |
| Granulomas | More likely | Less likely |
| Long-term use | Not ideal | Designed for it |
| Maintenance | Higher | Lower |
🙋 Final Thoughts
If you’ve been told you need a trach — or already have one — it’s okay to ask questions. In fact, it’s essential. The choice between temporary and permanent isn’t just medical; it affects your quality of life in real ways.
In my case, the permanent trach was the right move. It’s not glamorous, but it works — and it works well.
If you’re going through this, I hope this post gives you some clarity. And if you need someone to say it out loud:
It’s okay to ask for a second opinion. It might just change your outcome.