This is the first of a series, titled Life Lessons; although perhaps it should be titled "things my patients taught me never to do".
Number 1: Never, ever let your dog chew on your tracheostomy tube. If by some chance your dog does, please discard it immediately. Do not, and I repeat; DO NOT continue to use the tube anyway. Especially do not continue to allow your dog to chew on it, and continue to use it.
This patient came in with a tracheostomy tube that was approx 1/3 the length it had been, the end of it was jagged and sharp. She had a tracheoesphageal fistula from continuing to use the sharp tube. That fistula was discovered when the patient attempted to drink liquid potassium supplement, and then coughed it all over the night shift nurse! Now, you really don't want anything down in your lungs, but especially not liquid potassium!
The patient had been living with a family member who made no attempts to help her, get her medications, or even feed her properly. She was diagnosed with aspiration pneumonia (no surprise!) and eventually sent to a nursing home, under care of Adult Protective Services.