We went through several different methods of communication. We tried charades; we tried going through every letter in the alphabet; and I tried using a list of commonly used phrases. Although these methods were adequate, they sure were maddening. I was intubated for a few days and I wasn't exchanging gases adequately enough. It was decided that a tracheostomy was necessary. It was definitely not what I wanted.

A funny thing happened on the way to surgery, at least if you don't really believe Dr. Welby. I was given a local and, after a few minutes, two doctors came up to the gurney. One of them was a short intern who needed to use a step stool just to reach me, which was bad enough, but then he started to make a horizontal incision as is done for children. Luckily, the other doctor was paying attention and stepped in and did the incision vertically and the tracheostomy was completed smoothly.

A friend, who had been trached a few months before, was kind enough to come by and offer some advice about living with a trach. I left the hospital on a hopeful note. When I got home, however, I became very depressed and angry because I wasn't able to wean myself from the ventilator. I tried to plug my trach, but I just didn't have the strength.

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