Deshae once slept on a rotating mattress overlay (http://www.volkner.com/products.html) that minimized the need to have her turned, but with more recent deterioration she now sleeps on a regular air mattress and is moved when needed. At night her vent rests on a bed-side ventilator stand (http://ventilatordistributor.com/images/standex.jpg). While sleeping she uses an oxygen concentrator and a noise maker: a radio whose power is fed through a wireless control system activated by remote control, then into the standard electrical outlet (http://en.wikipedia.org/wiki/Oxygen_concentrator; http://www.smarthome.com/1162.html). Pressing a button on the remote blares radio music, alerting the person tending her that Deshae has a need; pressing another button deactivates the music.
During nebulized breathing treatments and when Deshae sleeps, the cuff around Deshae’s trach tube must be inflated to prevent the air the vent provides from escaping through her mouth, a situation that would not offer her the oxygen required to sustain life and would cause the ventilator to alarm incessantly (http://www.smiths-medical.com/catalog/bivona-tracheostomy-tubes/adult/fome-cuf/bivona-adult-fome-cuf.html). So far throughout the day Deshae typically can concentrate on her breathing and help pull the air into her lungs; this allows the cuff to remain deflated when she is conscious and not inhaling medicines that would escape through her mouth.
By day Deshae uses a power wheelchair (http://www.sunrisemedical.com/products/product_detail.jsp?FOLDER%3C%3Efolder_id=1408474400871054&PRODUCT%3C%3Eprd_id=845524442338285&ASSORTMENT%3C%3East_id=1408474395285139&bmUID=1171509941867 or http://www.permobil.com/USA/Products/Rehab/C500-VS-/).
At this point Deshae still can speak; to amplify her voice for public speaking and throughout the house as needed, Deshae utilizes a voice amplifier and speakers (https://www.lightspeed-tek.com/delta+x6.aspx).
Three to four times during the day she undergoes pulmonary therapies, a series of machines and processes to help her thin her mucus, dialate her bronchi, and propel mucus from her lungs. Mucus thinner and bronchodialator mediations are administered via a nebulizer (http://www.americanallergysupply.com/compressor-nebulizer/proneb-ultra-patient-guide.htm). Then to make the mucus more mobile, for 20 minutes each round of therapies Deshae is fastened into to a chest vest apparatus (http://www.thevest.com/products/vest.asp?gs=patients). After using the Vest, Deshae’s trach tube is connected to the cough assist device tubing (http://www.jhemerson.com/coughassist.htm). Following the use of the Inexsuffolator or Cough Assist machine, a trained individual suctions Deshae’s lungs using the ballard and the suction pump machine (http://www.northeastcenter.com/equipment_glossary_ballard_style_multiple_use_suction_catheter.htm) (http://www.dhmedical.com/devasupumo73.html).
For sterility and functionality, the ballard, heat-moisture-exchange (HME), and trach collar are exchanged for a new set every other day and as needed (http://www.lifelinedelhi.com/pcat-gifs/products-small/heat-and-moisture-exchange.jpg and http://www.cpap-shack.com/foam-trach-collartie-p-238.html).
In terms of other therapies, every one or two weeks Deshae takes diuretics due to symptoms similar to congestive heart failure but induced from the positive pressure system ventilation creates in the chest cavity. On these days her restroom routine is repeated every 30-45 minutes for six or more hours.
In between diureses days implemented to control her edema from muscle loss, ventilator pressure, and surgeries for port-a-cath implants (http://en.wikipedia.org/wiki/Port_(medical)), Deshae wears 30-40 mmHg support hose thigh highs on her legs and uses both a lymphedema compression arm garment and a lymphedema compression machine with inflatable arm sleeve (http://www.supporthosestore.com/ , http://www.lymphedemaproducts.com/products/cg_arm.html , http://www.ehow.com/how_6047790_lymphedema-compression-machine-home-use.html)