From the trach tubes I have seen (worn, or touched) the Tracoe Twist tube seems to be the best tube made today. It is the only tube with a great neckplate swivel. This is important for turning your head, lying down, driving, etc. They can customize them to a degree. Get your doctor to order the tube way before surgery and do NOT accept a we will change it after.
Also have your doctor order you 2-3 extra inner cannulas per trach tube.
Trust me it will make your life easier especially when you are out of the house away from all your cleaning supplies.
I am not connected with the company so I gain nothing for passing you this information.
About trach tubes:
The inner diameter of trach tubes need to be larger than most doctors realize. Remember then haven't had to wear one. (remind them of this too!)
The choice of cannula diameter can be made on practical considerations like ease of breathing thru the tube. A 10mm cannula has 277% more of an area to breath through that a 6mm does. (Pause and think about this a minute, this means it only takes about 1/3 the energy to take air in through a 10mm as opposed to a 6mm cannula.) The difference in these numbers is even greater when you get 1 or 2 mm of sludge/mucus in the trach tube. Have your doctor get a cocktail straw, plug his nose and try to breath only through the cocktail straw, that will give him an idea of what you will go through if the hole is too small.
Also many doctors (and patients) don't realize that if you are going to use your normal voice and not use assisted voice, then you need to have a fenestrated trach tube so the air passes over your vocal cords and not damage them by "breathing around the tube" They have to make sure and get the fenestration in the correct place, or you will end up damaging things.
Excessive Phlegm is part of trach life....the more you are on a humidifier the better off you are in keeping the thickness down. Using the humidifier is something you should be on 24 hours a day for the first 6 months, then you can cut to using HME's during the day and humidification at night. You get a machine that you connect with approx 2 inch diameter tubing connected to a mask that you wear around your throat.
You have to remember you have an object in your windpipe that is not normal to your windpipe. Movement of tube can cause pain, coughing, scrapping (if not correct fitting tube).
Alternative to trach tubes that seem to work for OSA trach patients:
Be sure and click on Blom-Singer Laryngectomy Tubes (what Jill uses)
The BE 6301 (or any Clean and Ready to Use Laryngectomy Tube)
This is a soft silicone tube usually used for laryngectomy but can be used as trach tube. Because of its flexibly it fits comfortably. You will need your doctor to tell you where to put the fenestration. Don't buy their fenestration punch it is just a regular hole punch you can buy at an office supply store much cheaper.
How do I talk-
Well if they don't damage your vocal cords when the do the surgery for the trach you will plug your trach to talk with your finger. Be aware that changes the trach position and it presses slightly against the back of your windpipe and can cause secretions and at times coughing.
So people use a speaking valve, but success is person to person. Be aware some speaking valves make talking and breathing harder.