Newly diagnosed: a new tracheostomy
New tracheostomy? How to communicate, starting today.
New tracheostomy, how to communicate when the mind is sharp and the voice is gone for a while: the gap between the two is exhausting for the patient and frightening for the family. ExpressAgain's Head, Neck and Throat mode was written for exactly this, short first-person phrases for the airway and the trach, swallowing, pain and talking again, spoken out loud with one tap, with an alphabet board for everything the library does not have.
What to do this week
Choose the Head, Neck and Throat mode
Its phrases open first: I can't breathe, please suction my trach, my trach tube feels loose, I need humidity; I can't swallow, please thicken my drink, can I eat by mouth yet?; pain from 0 to 10 and where it hurts; I'm trying to talk, please give me time; please read my lips; I can hear you, I just can't talk right now.
Where it lives: Phrase Library · Read how it works
Letters, for everything else
On the Communicate page, Letters is an on-screen alphabet board: the patient spells a word or a sentence letter by letter, the board speaks it, and Share sends it as the patient's note to family and to the care team. Type lets a family member type anything and have it spoken.
Where it lives: Communicate page, Letters · Read how it works
If surgery is still ahead, record the voice first
From Settings, record the patient speaking before treatment where that is possible, and the app builds a personal voice from it; the phrase I want to record my voice before surgery is in the talking-again group. Until it is ready, a clear built-in voice speaks.
Where it lives: Settings, Voice and Accessibility · Read how it works
Put every doctor on the Care Team page
One card per person: a name, a role and a phone number to tap and call. A card has no login; when a clinician should read the record, Give access turns the card into a login with a single-use code for that discipline, and the person joins at the IDC Team sign-in.
Where it lives: Care Team page · Read how it works
Today: the trach phrases first, Letters for everything else, the voice recorded if surgery is ahead, and the care team on one record.
How to start
Create a free account: your name, email, a password and who the app is for, with the patient's name. Communicating is never behind a paywall, so nothing on this page waits on a card.
The first time you sign in, choose Set up the patient's care or Start talking now: a few questions, one per screen, saved as you answer, that open the right pages first and become the patient's plan.
From My People, tap Invite family and friends: each person gets a personal link that works once and a role (full access, family, or extended). On the Care Team page, add every doctor as a card to tap and call.
Read next
- Just got the diagnosis? Here's what to do next.
- Home care, home health, hospice or palliative care? What each one means, and when you need it.
- Do you really need a caregiver, or do you need a nurse?
- How to choose the right care provider for your loved one.
- How to build a care schedule for your parent or loved one.
- The tools and equipment you'll actually need to care for someone at home.
- How to coordinate family visits without overwhelming anyone.
- Caregiver burnout is real. Here's how to protect yourself.
Questions people ask
Does the app work at the bedside in the hospital?
Yes. It runs in the browser on a phone or tablet, nothing to install, so it works on the hospital's tablet and the family's phone alike. The ICU and Ventilated mode covers a breathing tube; the Head, Neck and Throat mode covers the trach, the stoma and talking again.
What if the patient's hands are weak too?
The accessibility settings make the buttons and the text bigger, raise the contrast and reduce motion, and a 3 at a time switch shows fewer choices at once.
Can the speech therapist and the nurses see what the patient is saying?
A clinician who joins with a code reads the day plan, the readings and the notes, and a note the patient spells on Letters and shares goes to the care team as the patient's note. Typed text itself is never shown to the care team; only phrases and counts are.
Is it free to start?
Yes. Free is where everyone starts, and communicating is never behind a paywall: tap to speak, the phrase boards, the sentence builder, Letters, the Phrase Library, lessons, Games and Play, the emergency screen, the Emergency Plan Card and the built-in voice. Free also invites 2 family members to the Family and Friends Feed. The Pricing page shows the plans side by side.
What happens after I sign up?
Sign up asks for your name, email and a password, and who the app is for. Then the guided setup takes four short steps: who the app is for and the condition mode, text and button sizes, a voice and the first people, then a review. Entering the patient's name and date of birth pins the two phrases hospitals ask for constantly.