Sometimes I get asked why I still have a trach even though I'm not dependent on a ventilator anymore now that I have my diaphragm pacer. There are several important reasons:
Even though I'm no longer on the ventilator, sometimes I still need to have my airway suctioned out when I get a buildup of secretions that make it difficult to breathe. On average I need suction a few times a day; sometimes more, sometimes not at all. It just depends on how much gunk I get in my throat/airway, or how bad the allergens are in the air. (I've needed to be suctioned a little more often this spring than I usually do because there must be more pollen and stuff like that in the air.)
When I get suctioned, we stick a thin suction catheter down my trach and suck out any secretions with a special machine. Maintaining access to my airway is a must because it would be difficult to suction without it.
One of the other main reasons I still have my trach is just in case I need to go back on a ventilator. This has only happened a couple of times since I got the diaphragm pacer back in 2006. (I think both of these times were when I was hospitalized and my body was too sick/too weak to just rely on my pacer alone to breathe for me. I temporarily needed a little extra breathing support until I regained my strength and could go back on the pacer.)
Keeping the trach is basically a backup or a precaution just in case something were to go wrong with the pacer. That's highly unlikely, but you never know, and it would be much easier to maintain an existing trach rather than having to do another tracheostomy down the road if I were to ever to need it.
I know the trach is another thing that kind of emphasizes my limitations and I wish it wasn't necessary since it is something people frequently comment on/ask about (especially kids) but at least I'm no longer on a ventilator because that was even more noticeable. I hope this all makes sense and explains why I still have a trach.