You never know just when and where you will have to do a trach change.
Usually we change A's trach every 9 days. It's a two-person job. Usually I do it with my husband, although more often these days I do it with A's nurse (who works for us three days a week). I COULD do it by myself, if I need to, but it really takes two people: one to hold the old trach in while the ties are cut off, and the other person to quickly take the old one out of her throat and insert the new one. Actually, a third person would be lovely to help hold down her wiggly arms!
There have been four times--in the three and a half years that A has had her trach---that her trach has come out accidentally. The first time was a few years ago. We were at physical therapy and all of a sudden I noticed that while the tie was still around her neck, the actual trach was not in her stoma (the hole in her throat). Uh-oh. After a quick moment of panic, I remembered all the training I had received while she was in the hospital after receiving her trach, and I deftly changed it. It happened two more times over the past few years, both times at home.
The fourth time was today.
I went into A's preschool class to pick her up, and there she was, with a huge smile on her face, ready to come home. I quickly noticed that her trach was not in her throat! I scooped her up, ran to the car, and laid her on the empty third row of my minivan, where I cut it off, and put a new one in, all by myself (well, to be fair, my nurse was in the second row of my minivan and she handed me the necessary supplies [trach, scissors, saline, tie, etc] but I did all the work myself).
Her teacher ran out and told me that it must have just happened. They had recently come in from playing outside, and they always put an artifical nose on her (it's a protective covering that goes over the trach) because there is sand outside and this protects sand from getting in her lungs. Apparently she has been taking this artificial nose off herself, and this time must have pulled to hard and --oops!---pulled the whole thing out. I'm just glad that school ended soon after; if a longer period of time had gone by, the stoma might have closed a bit and that would have been very, very bad.
Life is never boring in my house, that's for sure! I look forward to the day (maybe this summer, fingers and toes crossed!) when she is decannulated and the trach comes out.