Treating a floppy airway

This post is going to throw you back to the days of GCSE Biology, yep I’m gonna talk about osmosis.

So… treatment.

At the moment, there’s no ‘fix’ for my floppy airway. It’s more of a case of dealing with the symptoms of tracheomalacia and managing them in the best way possible.

I’ve mentioned in a previous post that my airway collapses a bit when I breathe out and a lot when I cough. This means that it’s really difficult to get mucus out of my airway, not just when I’m poorly but on a day to day basis.

With mucus hanging around there’s more chance of infections taking hold so it’s important to try to clear as much as possible to give me the best chance of feeling well.

Salt, salt and more salt

At the moment my main treatment is salty water, 7% saline. This is inhaled daily through a Pari-PEP nebuliser. Honestly, it’s pretty salty and it pretty much works through osmosis. It draws fluid in to the lungs, loosening mucus and making it easier to get off my chest.

The best way to explain how this works is to imagine what happens when you cry really hard with lots of salty tears everywhere. Do you notice that you also get a little bit snotty at the same time? This is essentially what happens in my airway. Lots of salty vapour is blasted down my trachea through the Pari-PEP (Positive Expiratory Pressure). Having positive pressure when I breathe out causes resistance so it keeps my airway open when using the nebuliser, allowing more air to get behind my mucus so that I can get it out…by osmosis!

It’s not a glamorous treatment but hopefully it’ll help reduce the number of infections I get.

The plan at the moment is for me to take an antibiotic called Azithromycin from September to March as a preventative measure. The reason this starts in September is because that’s a time when infections are rife with schools and universities going back and the temperature getting cooler after summer. I’ll take this daily alongside my nebuliser.

What’s going to happen in an emergency?

If I start to feel unwell, I’ll be adding in a second antibiotic to tackle infections and I’ll be taking my salty nebuliser a couple more times a day.

If this doesn’t work, I’ll have to go to hospital where I’ll probably be treated with steroids and more nebulisers for a few hours. Then, the plan is to test my blood to check whether or not I am responding to steroid treatment by monitoring my eosinophil levels. These are a type of white blood cell. This is because it might not be clear as to whether there’ll be asthma and inflammation making the tracheomalacia worse. The next step would then be for me to have emergency CPAP which stands for Continuous Positive Airway Pressure which is much stronger than Pari-PEP and will act to artificially stent my airway open, hopefully helping to alleviate my symptoms.

This will be the first winter of having a plan for dealing with tracheomalacia flare ups and it’s very much going to be a ‘wait and see’ type of approach that will be adjusted and refined over future years.

Fingers crossed it means that my December birthday won’t be quite as miserable this year!

Wondering “What the hell tracheomalacia is?” – give my first post a read.