A moment of tenderness between mother and son…..a look passes between them, a gentle touch on the cheek and a kiss, as light as a feather and the baby breaks out into a big smile. A closer look and there is a bandage around the neck of the baby. The baby, the mother and the [...]

The Sundaytimes Sri Lanka

A breath between life and death

LRH’s ‘Home Tracheostomy Care Day’ shows how advances in technology allow children and their families to lead a normal life even after life-changing surgery
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A moment of tenderness between mother and son…..a look passes between them, a gentle touch on the cheek and a kiss, as light as a feather and the baby breaks out into a big smile.

A child sings at the eighth Home Tracheostomy Care Day. Pix by Hasitha Kulasekera

A closer look and there is a bandage around the neck of the baby. The baby, the mother and the grandfather are among a large number of people gathered at the auditorium of the Lady Ridgeway Hospital (LRH) for Children to take part in the Home Tracheostomy Care Day being celebrated for the 8th consecutive year.

The celebrations which follow soon after World Children’s Day are organised by the dedicated staff of Ward 12 under the guidance of Consultant Paediatric Ear, Nose and Throat (ENT) Surgeon Dr. A.D.K.S.N. Yasawardene. This year it was on October 4 and the nurses also took the opportunity to train parents on how to care for these children.

How many of us give a thought to the actual act of breathing which is essential to keep us alive? Not many, according to Dr. Yasawardene, for we take it for granted.

But for some, this is a life and death issue. They may include babies with birth defects that affect breathing, have noisy (stridor) breathing caused by a soft or weak breathing tube, have bronchopulmonary dysplasia or have been on a ventilator or respirator (a mechanical breathing machine) for a long time, having had a plastic breathing tube from the nose or the mouth connected to the ventilator and may have had their mouth and throat, including the voice box damaged.
These babies may need a tracheostomy or simply put a hole in the neck that will allow them to breathe. The hole goes directly into the trachea (windpipe) and connects to the lungs.

In this procedure which is performed under an hour, a small cut is made in the neck and the trachea of the child and a plastic tracheostomy tube, the size depending on the child, is inserted. The opening of the tube juts out of the neck, allowing the child to breathe through the tube instead of the nose and mouth. 

A flexible strap around the neck holds the tube in place. Although a tracheostomy prevents the child from talking, there are caps and valves that can cover the opening of the tube to enable speech. The hole can be short or long term, with surgery once again being done to close it if it is not needed.

What has changed over the years is the lifestyle of not only children who undergo tracheostomies but also their families. Until recently, these children had to be in hospital for months and years, disrupting the families’ schedules and routines. 
Now they go home after the surgery and get back into the life of the family. The older children also go to school and are part of most activities.

Their home stay has been made possible because all the expensive equipment including a suction (vacuum) machine — to remove secretions that get collected in the throat — for needy children has been provided by the LRH staff, well-wishers and Belvoir College International. For families without electricity, which powers the suction machine, foot-operated substitutes have been provided.

Among the eminent guests who took time off their busy schedules to share the happiness of these parents and children were LRH Director Dr. Rathnasiri Hewage and Consultant ENT Surgeon Dr. Chandra Jayasuriya of the National Hospital.

Donating ‘essential gifts’

A Belvoir student hands over the donations to LRH Director Dr. Rantnasiri Hewage

They come every year in their blue uniforms, having worked round the year to collect funds to help the families with children who have had a tracheostomy.

These are the students of Belvoir College International, Milagiriya, under the guidance of Principal Chitra Weerasekera who don’t forget their “brothers and sisters” in need on World Children’s Day and come bearing essential gifts for them.

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