Voice problems and care after intubation

A small plastic breathing tube (called an endotracheal tube) is inserted into your throat to help you breathe during your operation or illness.

The small, plastic breathing tube passes through the vocal cords within your windpipe. For some patients this can cause the windpipe to become inflamed and the healthy mucus, that coats the vocal cords to keep them mobile, can thicken.

You may be experiencing one or more of the following problems following your intubation:

• weak or no voice,
• breathy voice,
• hoarse voice,
• sore throat – particularly when talking and/or swallowing,
• dryness,
• regular throat clearing,
• difficulty projecting your voice.

In the very early hours after extubation, particularly if you have been intubated for a long time you may feel generally very weak and not be able to hold a pen and paper. If you have limited or no voice too you may need to use a white board and pen to write down what you are saying. You could also spell words out on an alphabet board or point to set phrases on a phrase chart. Please ask you nurse for one of these.

To prevent damaging your voice and to aid faster recovery, try and do the following:

• Use your voice without straining, even if it means it is quiet and breathy.
• Avoid talking against background noise.
• Encourage others to come closer to you so that they can hear you.
• Do not shout or whisper.
• Avoid long telephone calls.
• Take regular breaths to avoid straining at the end of sentences.
• If you feel sore from using your voice, give it a rest for 30 minutes to an hour.
• Avoid throat clearing. Instead, try clearing your throat by swallowing.
• If you use an inhaler, rinse your mouth after use.
• Keep your vocal cords well hydrated: Aim to drink two litres of water a day, although check this with your nurse first.

Try to avoid caffeinated drinks, spicy foods that may cause acid reflux (acid that comes up from your stomach and irritates your throat).

The damage to your vocal cords should get better without treatment as you get stronger after your operation or illness and once the inflammation settles. On rare occasions the voice does not improve without treatment and a referral to the ear, nose and throat (ENT) team may be necessary to rule out structural damage to the voice box. This will be arranged by your medical team or by your GP if you are back at home.