HME Decorations

After being diagnosed with laryngeal cancer in September of 2019, I underwent surgery to remove the cancer. First I was given an emergency tracheotomy to open an airway so that I could breathe. Then, during the following weeks, I had appointments with several doctors who were members of a group of specialists dedicated to head and neck cancers. The group included an Otolaryngologist, a radiologist, a thoracic surgeon, and a psychologist, just to name a few. Together, they prepared me for the next step, a total laryngectomy to remove the cancer, and a partial thyroidectomy in case the cancer had spread.

This left me with a permanent hole in my neck, called a 'stoma' through which I now breathe. The stoma needs to be covered and a filter used to mimic some of the filtration, and the heat and moisture retention that previously had been the function of my nose. This little filter, about the diameter of a US quarter is called a Heat and Moisture Exchange cassette, or HME for short.

In the months that followed, as I recuperated and got used to breathing through my neck, I joined some on-line support groups. It was while on these sites that I met several hundred other laryngectomees, or larys as we like to be called, whose stories mirrored my own. One of the more common complaints that I heard was that when they went out in public, people stared. Specifically, people stared at the quarter-sized button sticking out of their necks where their Adam's apple used to be. I found out that quite a few larys were a little shy about this and wore jewelry or scarves or bibs to cover them up.

I have never been particularly shy. It seemed to me that the HME might be kind of ugly, but that did not mean that I wanted to cover my throat whenever I was in public, especially not in Southern California in the summer! This led to me creating decorations that could be applied directly to the exterior of the HME, effectively disguising it as jewelry to any cursory glance, or drawing attention to it in some way, usually humorous, that actually seemed to help the situation somehow. Eventually, at the request of some of my fellows, I wrote up the following instructions for my lary friends so that they could create their own decorations:

Making HME Decorations.

The usable area on an Atos brand HME is a 22mm diameter circle. For a template, I use the hole in the coated paper that peels off the back of an adhesive plate, which is about the right size. When shopping for decals or cruising yard sales looking through the costume jewelry for anything that I could use, I carry a US quarter as a size comparison: if anything sticks out from under the quarter's edge, it is too big. I use old wrapping paper, mylar balloons. advertisements, the sunday comics, any printed matter really to find images the right size that strike my fancy. I use images from the public domain either from a book I found at a bookstore in Los Angeles or downloaded from a website that I found using my search engine. I type things like "PRESS TO TALK"or"DO NOT REMOVE" into my word processor and can choose the color of the paper I print them on. I often draw my own images using the paper template to draw the circle and draw the image inside it. Once I have an image That I want to use, I prepare it by using a clear piece of packing to cover each side, then I use a good pair of scissors to cut it into a circle. Using a clean new HME, I use 1/2" (13mm) Glue Dots to carefully attach the decoration to the center of the HME.

CAUTION!

Do not attach the HME to your adhesive plate or to your lary tube until you are certain that the decoration is firmly attached and that it does not interfere with the operation of the valve in the HME!

The beginning of a new design, an 'ON' switch pictograph:

Some of my early prototypes:

The decorations turned out to be a big hit! I have a friend who owns a shop where they make stickers and she has turned many of my designs into sheets of stickers that can be peeled off and applied directly to the HME.

I will continue to find new designs and I will continue to answer any questions about how to DYI!