Barrett, it's great to hear you are doing well. Welcome back to the living.
I don't think you should try forcing anything larger than 6 unless your ENT is in agreement. Later when you are well healed it might be possible to get an 8 to go, but I wouldn't try it without passing it by your ENT first. Besides, I don't believe you can get a larger stent, or anything for that matter from Boston Med, without a prescription. Don't forget that over time there will be some natural in-growth of the skin lining the opening which may help tighten to seal. After you've well healed and you still have bothersome air leak when talking, then I would see your ENT and ask him about an 8 for daytime use. I like the slightly smaller stent at night to allow for some in-growth.
The permanent plug is a minor nuisance if you nap during the day. I just switch it with my open stent, it's quick and easy. You can always cut your open stent shorter if you wish, but extra length is not a big issue for night time use. You don't want to cut it so short that it can be inhaled. That's a no-no. Mine protrudes about an inch and a half.
The mucous outside is good. That means it's not inside where you don't want it. Keeping your trach clear is essential. I do a check and cleanse, if necessary, during a regular bathroom visit. It's never been a problem for me.
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