Life with a breathing stoma

A stoma is a hole (opening) made in the skin in front of your neck to allow you to breathe. It is at the base of your neck. Through this hole, air enters and leaves your windpipe (trachea) and lungs.

You can see when and how you might have a stoma in our surgery section. 

Coping with a runny nose or cold

It’s quite common to have a runny nose for the first few weeks after your laryngectomy. The tissues lining your nose have to get used to the lack of air passing over them.

This gradually stops. Don't take allergy tablets (antihistamines) as they’re likely to make things worse in the long run.

If you get a cold, your doctor may say that you have tracheitis. This is usually more serious than for someone who doesn't have a breathing stoma because thick mucus could potentially block your stoma. You are also more likely to develop a chest infection (pneumonia). So it is important you see your doctor straight away.

When you have a cold, you have to cough up any mucus you have through the stoma. You can no longer blow or sniff through your nose. This might be very hard to get used to at first. In time it becomes second nature for you to put your tissue or handkerchief up to your neck and not to your nose.

If you get a bacterial infection, you might need to take antibiotics. Symptoms of an infection can be: 

• an increase in phlegm
• thick phlegm
• a change in the colour of your phlegm (brown or green)
• a cough that doesn't go away
• bleeding from your stoma

Your sense of smell and taste

After a laryngectomy, your sense of smell will not be as good as it used to be. To smell things, you need air to flow through your nose. Because your mouth and nose are now cut off from your breathing, this no longer happens automatically.

Your sense of smell might improve in the months following your operation and you can learn a technique to improve it. It's called the polite yawn. To do this, you yawn with your mouth closed. This draws air into your nose, so that you can smell. Your speech therapist is the best person to help you with this.  

Learning this technique can help improve your taste too. Taste depends partly on smell. So if you can't smell, you might find your food doesn't taste quite as much as it did.

You can also add more flavouring to your food, such as spices and herbs. This helps your taste buds along.

Showering and shaving

You can still shower and have a bath with a stoma. But you must be careful not to get water into it. Various types of shower covers are available. Ask your clinical nurse specialist or physiotherapist about these.

Showering can be a concern for you. But try to remember that if you breathe in a little water, it will make you cough a lot, but you can cough it up straight away.

Remember that your neck might be numb for a few months after surgery if you like to clean shave. To avoid cutting yourself, it might be best to use an electric razor.

Swimming

You need special equipment and training if you want to swim. This is so that you don't get water in your stoma. You need the help of your local swimming pool staff. They must have training in helping someone with breathing difficulties who has a tracheostomy or laryngectomy.

The National Association of Laryngectomy Clubs (NALC) can provide training and assistance if you wish to return to swimming.

Other water sports might not be possible. This can be difficult to accept if you were a keen diver, for example.

Other exercise might not seem as enjoyable. But there are plenty of things you can still do. Try to find an alternative exercise to keep yourself fit.

Lifting heavy things

Usually, when you lift something heavy, you breathe in and hold your breath. This gives you extra strength.

But if you have a breathing stoma, you are not able to hold your breath. Not being able to do this makes it difficult for you to lift heavy things.

Constipation

As you can't hold your breath, it is difficult to strain when you go to the toilet to pass a bowel movement. So it's important that you avoid getting constipated. To avoid constipation, you should:

• drink plenty of liquids
• eat fruit and vegetables and other foods that contain fibre
• keep active

If you do get constipated, ask your GP for help early on. You can have suppositories or a micro enema (a very small enema) to start your bowels moving again. Talk to your GP about taking a regular laxative or stool softener if you get constipated a lot.

Smoking

It is important to try to give up smoking before your laryngectomy operation if possible. 

This isn’t always easy, especially if you have smoked for many years. But if you continue smoking, you are at risk of another head and neck cancer or lung cancer.