Shiley tube OUT! Montgomery IN!
Question:
Tony and rest of the Trach Gang, I’m glad I don’t have a trach but if I did I would be so happy to have a support group like you folks. You are terrific. All of you are wonderful. How lonesome it would be not to have a friend in the same position. Love, Em
Response:
On Fri, 11 Jun 1999 03:47:31 GMT, hosp…@fullnet.net wrote: >Good news, Tony. You sound great! I use to think the idea of having >a trach would be horrible, but your dignity and grace through this >whole episode have changed my mind. You’ve enlightened me, and I’m >sure others, too.
I suspect the human spirit finds it can do a lot more than it thinks it can do when it has "opportunities to excel." Ten months ago, the term "CPAP" was getting in my vocabulary in a big way. (Not on it at that time.) I personally find it less of a hassle than glasses (which I’ve worn for most of my life). — IMPORTANT: Remove the edible part of the E-mail address before replying.
Response:
Tony Polson provided a wonderful recount of his new Montgomery tube and noted: > My wife, Jan, has noticed a huge improvement in > my mood (although I was completely oblivious!) with > less irritability and a more relaxed demeanour. So > has my son, Michael, who’s pleased I shout less > frequently than before. > [It's funny how your kids make you feel humble, isn't it? > He's only 6, nearly 40 years behind me, yet I learn > something from him every day. He has a wise head > on his young shoulders.]
Sometimes the heart of wisdom is to see and express things as clearly as a child, Often being adult is not the correct way to see and act. We’ve noticed the change, Tony. You are now participating in the newsgroup much more enthusiastically than prior to your surgery. Your messages are more detailed. So, hopefully your life will improve even more. Enjoy your family and your new life. Regards, =jbf= John B. Fisher
Response:
In article <375d926d.133…@news.freeserve.co.uk>, Tony Polson <n…@scalby.freeserve.co.uk> writes >Yesterday the ENT department at York District Hospital asked me to go in >today to have my Montgomery long term tracheostomy tube fitted.
[...] Great news Tony! All the best. Steph & Paul — Paul Kemp anti – spam/UCE measures follow:- :@: E mail :@: Home Page: http://www.kemp.demon.co.uk/ :@: :@: paul@kemp. :@: ICQ Pager: http://wwp.mirabilis.com/1914266 :@: :@: demon.co.uk :@: This is *NOT* my Email address: ab…@demon.net :@:
Response:
Great hope it is more comfortable and easier to deal with for you. = = = = = For information and humor re: A Tracheostomy and the treatment of Obstructive Sleep Apnea please visit http://members.aol.com/citylinc/osa/index.htm = = = = = A great sleep forum http://www.sleepedu.net/forums/apnea/apneainf.html
Response:
Good news, Tony. You sound great! I use to think the idea of having a trach would be horrible, but your dignity and grace through this whole episode have changed my mind. You’ve enlightened me, and I’m sure others, too. Now it is going to be fun to watch your progress. I know when you’re completely healed and rested up, your life is going to be so much better. You are an inspiration. Thanks for sharing with us the way you have. Mary Lee On Wed, 09 Jun 1999 00:11:37 +0100, n…@scalby.freeserve.co.uk (Tony – Hide quoted text — Show quoted text -Polson) wrote: >Yesterday the ENT department at York District Hospital asked me to go in >today to have my Montgomery long term tracheostomy tube fitted. >The hospital had ordered three Montgomery trache tubes of different >lengths. We’ll call them small, medium and large; all were size 8 >diameter, which means an outside diameter of 12mm or 1/2 inch. >Removal of the Shiley tube and insertion of the Montgomery replacement >was a little uncomfortable, but was otherwise quick and (for me) easy. >The doc chose the medium size after some animated but friendly >discussion when I suggested the small size! The doctor was right, and >I’m relieved he didn’t listen to my earnest argument! It took no more >than 10 seconds to remove the Shiley and replace it with the Montgomery. >Immediately I felt very much better. >The Montgomery tube is secured inside the trachea by a soft plastic >flange and two springy plastic lugs, and outside by a soft plastic >’O ring’ to which is attached the plastic bung that’s used to close the >trache tube during the day. After fitting the excess tube is cut away, >leaving a neat installation. However, as it’s early days for me, the >tube is left just a little longer in case my healing changes the >thickness of my skin and tracheal wall. >Four weeks with the Shiley tube has not been a pleasant experience; the >’fenestration’ (an opening in the tube allowing – in theory – normal >breathing through nose and mouth and normal speech) was in entirely the >wrong position for me and so did not do its job. Instead of lying >within the trachea (windpipe) it lay entirely against the rear wall of >the trachea. The lining of my trachea hung into the tube, and every >insertion or removal of the inner tube for cleaning caused acute >discomfort and trauma which took up to 2 hours to subside. I won’t go >into the details, all I would say is I found it quite humiliating and >demeaning to have to undergo such pain and discomfort due to the >problems caused by the poor fit (in my case) of the Shiley tube. I >would never wish to inflict such pain and discomfort on any living >creature. >The Shiley needed cleaning every 2-3 hours during the day, and it was >rare for me to sleep more than 5-6 hours except for a couple of days >when I managed 8-10 hours. I suspect that, even when I was asleep, the >uncomfortable Shiley tube was doing less than it should to help me get >good sleep. >In my humble opinion (IMHO), the main reasons for the poor performance >of the Shiley tube in my case were the "one length fits all" philosophy >adopted by its manufacturer and the basic crudeness of the overall shape >and form of the device. Contrast this with the Montgomery tube; this is >available in six lengths (and four diameters) and each length is >adjustable in small increments to obtain a snug fit. >What is clear about the Montgomery (made by Boston Medical Products) is >a very high level of attention to detail that is probably rarely seen in >such items. This attention to detail leads to *far* superior comfort >for the patient; one is not aware of the Montgomery tube except when >cleaning it or opening/closing it respectively at the start/end of a >night’s sleep or a nap. The Shiley tube is forever reminding you it’s >there, whether by its bulk, its poor fit (in my case, but others’ >mileage may vary) or its (IMHO) inferior design. >The attention to detail extends to the material of which the Montgomery >tube is made, the high gloss finish to encourage a good seal with the >patient’s soft tissue, and the optimised shape, size and flexibility of >every element. Overall, there is a minimalist and miniaturist approach >to design leading to a product which is small and light but works >intrinsically better than something bigger and bulkier. In design terms >I would compare the Montgomery tube to a pair of Leitz binoculars, an >Olympus OM1 SLR camera, a portable Sony MiniDisk recorder or a Nokia >cellular phone with integral email and web browsing on its LCD display. >Yes, it really is that good. >I was enthusiastic about the Montgomery when I heard about it on this >newsgroup, and even more so when I received the catalog from Boston >Medical Products. But I was completely unprepared for how I feel about >this tube right now, now it’s been fitted. It’s already an old friend, >and now I’m looking forward to some much improved sleep! >The irritations of wearing a Shiley tube have somewhat taken my >attention away from the improvements in my mood and alertness. My wife, >Jan, has noticed a huge improvement in my mood (although I was >completely oblivious!) with less irritability and a more relaxed >demeanour. So has my son, Michael, who’s pleased I shout less >frequently than before. >[It's funny how your kids make you feel humble, isn't it? He's only 6, >nearly 40 years behind me, yet I learn something from him every day. He >has a wise head on his young shoulders.] >For those actively considering a tracheostomy as a treatment for sleep >apnea, I would strongly advise that you insist on the Montgomery tube. >It is a hugely better design than the Shiley IMHO, although I know that >metal tubes also have their own fan club. For me, if I was told I had >to use a Shiley for the next X years, I’d ask the surgeon – without any >hesitation – to sew up the trache and try something else instead. >I’ll post reports about my progress in due course. Until I’ve had a >sleep study I cannot be conclusive, but I do seem to have made some real >progress in spite of the fundamental unsuitability (in my case) of the >Shiley tube. I’m looking forward to greater things with Monty! >Once again may I thank the newsgroup for the massive support I’ve had >during the last couple of months. Apart from the many old friends I’ve >been lucky enough to get to know over the last four years, I’ve also >made friends of people who lurk but rarely or never post messages but >have been kind enough to send me messages of support by private email. >I cannot thank you enough. >Particular thanks are due to the "trache gang" who have patiently >answered all my damn fool questions about tracheostomy surgery and >hardware and sent me many private emails as well as newsgroup messages >Without you people I would not have had the courage to do this, but >together you gave me the courage I so desperately needed. >Bless you, all of you. >– >Tony Polson, North Yorkshire, UK
Response:
Hi Tony! I am so excited at the news! It is so encouraging not only to hear that the Monty is so much more comfortable, but also that you are feeling more upbeat. I feel everyone’s small triumphs, but this is particularly important after all of the trials that you have had prior to the trache operation. You have been such a help to everyone and also have provided so much research to us all. I am curious about why it took so long to get the Monty. Is that a common delay everywhere or is it that you are in the UK and it has to come from the US? I join the many others who wish you continued improvement in both your physical health and your spirit. And thanks so much for your informative posts. Your posts and the posts of the others in the trache gang have made me much less fearful of getting a trache if that ever becomes a necessity for me. (As long as a CPAP continues to work for me, I’ll stick with it, however.) Best wishes, Kent Taylor
Response:
Yesterday the ENT department at York District Hospital asked me to go in today to have my Montgomery long term tracheostomy tube fitted. The hospital had ordered three Montgomery trache tubes of different lengths. We’ll call them small, medium and large; all were size 8 diameter, which means an outside diameter of 12mm or 1/2 inch. Removal of the Shiley tube and insertion of the Montgomery replacement was a little uncomfortable, but was otherwise quick and (for me) easy. The doc chose the medium size after some animated but friendly discussion when I suggested the small size! The doctor was right, and I’m relieved he didn’t listen to my earnest argument! It took no more than 10 seconds to remove the Shiley and replace it with the Montgomery. Immediately I felt very much better. The Montgomery tube is secured inside the trachea by a soft plastic flange and two springy plastic lugs, and outside by a soft plastic ‘O ring’ to which is attached the plastic bung that’s used to close the trache tube during the day. After fitting the excess tube is cut away, leaving a neat installation. However, as it’s early days for me, the tube is left just a little longer in case my healing changes the thickness of my skin and tracheal wall. Four weeks with the Shiley tube has not been a pleasant experience; the ‘fenestration’ (an opening in the tube allowing – in theory – normal breathing through nose and mouth and normal speech) was in entirely the wrong position for me and so did not do its job. Instead of lying within the trachea (windpipe) it lay entirely against the rear wall of the trachea. The lining of my trachea hung into the tube, and every insertion or removal of the inner tube for cleaning caused acute discomfort and trauma which took up to 2 hours to subside. I won’t go into the details, all I would say is I found it quite humiliating and demeaning to have to undergo such pain and discomfort due to the problems caused by the poor fit (in my case) of the Shiley tube. I would never wish to inflict such pain and discomfort on any living creature. The Shiley needed cleaning every 2-3 hours during the day, and it was rare for me to sleep more than 5-6 hours except for a couple of days when I managed 8-10 hours. I suspect that, even when I was asleep, the uncomfortable Shiley tube was doing less than it should to help me get good sleep. In my humble opinion (IMHO), the main reasons for the poor performance of the Shiley tube in my case were the "one length fits all" philosophy adopted by its manufacturer and the basic crudeness of the overall shape and form of the device. Contrast this with the Montgomery tube; this is available in six lengths (and four diameters) and each length is adjustable in small increments to obtain a snug fit. What is clear about the Montgomery (made by Boston Medical Products) is a very high level of attention to detail that is probably rarely seen in such items. This attention to detail leads to *far* superior comfort for the patient; one is not aware of the Montgomery tube except when cleaning it or opening/closing it respectively at the start/end of a night’s sleep or a nap. The Shiley tube is forever reminding you it’s there, whether by its bulk, its poor fit (in my case, but others’ mileage may vary) or its (IMHO) inferior design. The attention to detail extends to the material of which the Montgomery tube is made, the high gloss finish to encourage a good seal with the patient’s soft tissue, and the optimised shape, size and flexibility of every element. Overall, there is a minimalist and miniaturist approach to design leading to a product which is small and light but works intrinsically better than something bigger and bulkier. In design terms I would compare the Montgomery tube to a pair of Leitz binoculars, an Olympus OM1 SLR camera, a portable Sony MiniDisk recorder or a Nokia cellular phone with integral email and web browsing on its LCD display. Yes, it really is that good. I was enthusiastic about the Montgomery when I heard about it on this newsgroup, and even more so when I received the catalog from Boston Medical Products. But I was completely unprepared for how I feel about this tube right now, now it’s been fitted. It’s already an old friend, and now I’m looking forward to some much improved sleep! The irritations of wearing a Shiley tube have somewhat taken my attention away from the improvements in my mood and alertness. My wife, Jan, has noticed a huge improvement in my mood (although I was completely oblivious!) with less irritability and a more relaxed demeanour. So has my son, Michael, who’s pleased I shout less frequently than before. [It's funny how your kids make you feel humble, isn't it? He's only 6, nearly 40 years behind me, yet I learn something from him every day. He has a wise head on his young shoulders.] For those actively considering a tracheostomy as a treatment for sleep apnea, I would strongly advise that you insist on the Montgomery tube. It is a hugely better design than the Shiley IMHO, although I know that metal tubes also have their own fan club. For me, if I was told I had to use a Shiley for the next X years, I’d ask the surgeon – without any hesitation – to sew up the trache and try something else instead. I’ll post reports about my progress in due course. Until I’ve had a sleep study I cannot be conclusive, but I do seem to have made some real progress in spite of the fundamental unsuitability (in my case) of the Shiley tube. I’m looking forward to greater things with Monty! Once again may I thank the newsgroup for the massive support I’ve had during the last couple of months. Apart from the many old friends I’ve been lucky enough to get to know over the last four years, I’ve also made friends of people who lurk but rarely or never post messages but have been kind enough to send me messages of support by private email. I cannot thank you enough. Particular thanks are due to the "trache gang" who have patiently answered all my damn fool questions about tracheostomy surgery and hardware and sent me many private emails as well as newsgroup messages Without you people I would not have had the courage to do this, but together you gave me the courage I so desperately needed. Bless you, all of you. — Tony Polson, North Yorkshire, UK
Response:
> But I was completely unprepared for how I feel about >this tube right now, now it’s been fitted. It’s already an old friend, >and now I’m looking forward to some much improved sleep!
Congratulations Tony, been following your progress with great interest and am very happy to hear the good news. I’m sure your sleep will indeed be improved. I have to point out also….as your "story" has unfolded you have been meticulous in keeping the NG posted with real details, not only around the procedures, but also how you are feeling. This must be a great source of information…and now inspiration….to anyone who is, or may in the future, face the same decision on trache as you and others have done. (it’s the most optimistic message I’ve seen from you too 
). Good luck, fingers crossed that the improvement continues….. Trevor
Response:
Tony, I knew once you were fitted wih the Montgomery tube you would feel much better. I hated that damn Shiley tube too. Your trache woes will soon disappear and you will hardly feel that you have a trache tube at all. Boston Medical Products make the best trache tube on the market and they are always improving their product design. I’m really happy for you Tony, now that you are finally feeling better and ready to enjoy life once again. Best Regards, Ron M.
Response:
Congrats on getting your good tube in now. Yes, without this group I think alot of us would have given up. I know I would have. – Hide quoted text — Show quoted text -Tony Polson wrote: > Yesterday the ENT department at York District Hospital asked me to go in > today to have my Montgomery long term tracheostomy tube fitted. > The hospital had ordered three Montgomery trache tubes of different > lengths. We’ll call them small, medium and large; all were size 8 > diameter, which means an outside diameter of 12mm or 1/2 inch. > Removal of the Shiley tube and insertion of the Montgomery replacement > was a little uncomfortable, but was otherwise quick and (for me) easy. > The doc chose the medium size after some animated but friendly > discussion when I suggested the small size! The doctor was right, and > I’m relieved he didn’t listen to my earnest argument! It took no more > than 10 seconds to remove the Shiley and replace it with the Montgomery. > Immediately I felt very much better. > The Montgomery tube is secured inside the trachea by a soft plastic > flange and two springy plastic lugs, and outside by a soft plastic > ‘O ring’ to which is attached the plastic bung that’s used to close the > trache tube during the day. After fitting the excess tube is cut away, > leaving a neat installation. However, as it’s early days for me, the > tube is left just a little longer in case my healing changes the > thickness of my skin and tracheal wall. > Four weeks with the Shiley tube has not been a pleasant experience; the > ‘fenestration’ (an opening in the tube allowing – in theory – normal > breathing through nose and mouth and normal speech) was in entirely the > wrong position for me and so did not do its job. Instead of lying > within the trachea (windpipe) it lay entirely against the rear wall of > the trachea. The lining of my trachea hung into the tube, and every > insertion or removal of the inner tube for cleaning caused acute > discomfort and trauma which took up to 2 hours to subside. I won’t go > into the details, all I would say is I found it quite humiliating and > demeaning to have to undergo such pain and discomfort due to the > problems caused by the poor fit (in my case) of the Shiley tube. I > would never wish to inflict such pain and discomfort on any living > creature. > The Shiley needed cleaning every 2-3 hours during the day, and it was > rare for me to sleep more than 5-6 hours except for a couple of days > when I managed 8-10 hours. I suspect that, even when I was asleep, the > uncomfortable Shiley tube was doing less than it should to help me get > good sleep. > In my humble opinion (IMHO), the main reasons for the poor performance > of the Shiley tube in my case were the "one length fits all" philosophy > adopted by its manufacturer and the basic crudeness of the overall shape > and form of the device. Contrast this with the Montgomery tube; this is > available in six lengths (and four diameters) and each length is > adjustable in small increments to obtain a snug fit. > What is clear about the Montgomery (made by Boston Medical Products) is > a very high level of attention to detail that is probably rarely seen in > such items. This attention to detail leads to *far* superior comfort > for the patient; one is not aware of the Montgomery tube except when > cleaning it or opening/closing it respectively at the start/end of a > night’s sleep or a nap. The Shiley tube is forever reminding you it’s > there, whether by its bulk, its poor fit (in my case, but others’ > mileage may vary) or its (IMHO) inferior design. > The attention to detail extends to the material of which the Montgomery > tube is made, the high gloss finish to encourage a good seal with the > patient’s soft tissue, and the optimised shape, size and flexibility of > every element. Overall, there is a minimalist and miniaturist approach > to design leading to a product which is small and light but works > intrinsically better than something bigger and bulkier. In design terms > I would compare the Montgomery tube to a pair of Leitz binoculars, an > Olympus OM1 SLR camera, a portable Sony MiniDisk recorder or a Nokia > cellular phone with integral email and web browsing on its LCD display. > Yes, it really is that good. > I was enthusiastic about the Montgomery when I heard about it on this > newsgroup, and even more so when I received the catalog from Boston > Medical Products. But I was completely unprepared for how I feel about > this tube right now, now it’s been fitted. It’s already an old friend, > and now I’m looking forward to some much improved sleep! > The irritations of wearing a Shiley tube have somewhat taken my > attention away from the improvements in my mood and alertness. My wife, > Jan, has noticed a huge improvement in my mood (although I was > completely oblivious!) with less irritability and a more relaxed > demeanour. So has my son, Michael, who’s pleased I shout less > frequently than before. > [It's funny how your kids make you feel humble, isn't it? He's only 6, > nearly 40 years behind me, yet I learn something from him every day. He > has a wise head on his young shoulders.] > For those actively considering a tracheostomy as a treatment for sleep > apnea, I would strongly advise that you insist on the Montgomery tube. > It is a hugely better design than the Shiley IMHO, although I know that > metal tubes also have their own fan club. For me, if I was told I had > to use a Shiley for the next X years, I’d ask the surgeon – without any > hesitation – to sew up the trache and try something else instead. > I’ll post reports about my progress in due course. Until I’ve had a > sleep study I cannot be conclusive, but I do seem to have made some real > progress in spite of the fundamental unsuitability (in my case) of the > Shiley tube. I’m looking forward to greater things with Monty! > Once again may I thank the newsgroup for the massive support I’ve had > during the last couple of months. Apart from the many old friends I’ve > been lucky enough to get to know over the last four years, I’ve also > made friends of people who lurk but rarely or never post messages but > have been kind enough to send me messages of support by private email. > I cannot thank you enough. > Particular thanks are due to the "trache gang" who have patiently > answered all my damn fool questions about tracheostomy surgery and > hardware and sent me many private emails as well as newsgroup messages > Without you people I would not have had the courage to do this, but > together you gave me the courage I so desperately needed. > Bless you, all of you. > — > Tony Polson, North Yorkshire, UK
Response:
Wow, Tony! We’re not talking minor improvement here, from one tube to the next–this sounds like a drastic difference, and thankfully, it’s for the better. Glad to hear the good news. I noticed in the brochure from Boston Medical Products that they make an initial "short-term" Montgomery cannula, and am wondering if that may be the way to go for others considering a trache. It’s apparently for insertion immediately after the operation and is plastic instead of metal. Was there ever any discussion of you starting with that one instead of the Shiley? Maybe there are reasons why the Shiley is best during the initial healing period. Perhaps other members of the "trache gang" can comment on which short-term tube they used. In any case, you’ve survived the worst of it, and here’s hoping for constant improvement in your healing and sleep from here on out! Regards, Tim W.
