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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Tracheostomy Advisable For Pneumonia?

Hi. My brother had a left-brain ischemic stroke 5 months ago today and developed pneumonia. He was at the hospital for over 2 months. The pulmonologist suggested tracheostomy but did not fully discuss the pros & cons. We declined on account of this, plus we were told chest x-rays were clear. He is on NGT and sent home on a number of meds, only a mucolytic being prescribed by the lung doctor. My brother continues to secrete phlegm; we were told to use a suction machine and a nebulizer to aid with getting the secretions out. My question is: As it looks like the mucus producion is not stopping; what else can we do to make my brother be more comfortable? Thank you.
Tue, 5 Mar 2019
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General Surgeon,  's  Response
Hi,

Noted the history about your brother having left brain stroke, pneumonia, excessive mucus production and your query about tracheostomy.
Tracheostomy is advised for specific reasons like easy removal of mucus if it is not possible by the patient to expel it out aided by oral and pharyngeal suction; it also helps to improve oxygenation as the dead-space as we call it reduced so that the patient can have less exertion.
Please see if your brother can expel the mucus nicely then there may not be any need to do tracheostomy as it is already so late and it will be difficult to manage tracheostomy care at home if you all are not trained well.
I hope your brother might have improved well. Make him ambulatory and moving around, get the chest physiotherapy done so that the mucus is expelled well, breathing exercises help a lot.
Also see for any causes that the mucus is produced more nd nullify then like dust and other allergens around. Use air filters in the room to reduce the pollen load.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. T Chandrakant,
General Surgeon
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Is Tracheostomy Advisable For Pneumonia?

Hi, Noted the history about your brother having left brain stroke, pneumonia, excessive mucus production and your query about tracheostomy. Tracheostomy is advised for specific reasons like easy removal of mucus if it is not possible by the patient to expel it out aided by oral and pharyngeal suction; it also helps to improve oxygenation as the dead-space as we call it reduced so that the patient can have less exertion. Please see if your brother can expel the mucus nicely then there may not be any need to do tracheostomy as it is already so late and it will be difficult to manage tracheostomy care at home if you all are not trained well. I hope your brother might have improved well. Make him ambulatory and moving around, get the chest physiotherapy done so that the mucus is expelled well, breathing exercises help a lot. Also see for any causes that the mucus is produced more nd nullify then like dust and other allergens around. Use air filters in the room to reduce the pollen load. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant, General Surgeon