Is anyone working on a less painful intubation tube?

Try and break the problem down with systems thinking. Here's an example of this:

  ━━1=> The output effect you're trying to eliminate/reduce is pain and swelling in respiratory tract.
    ┗━━2=> Hypothesis (needs testing): This is caused by physical irritation of the tube
       ┗━━3=> Hypothesis (needs testing): That irritation is caused by A) friction and B) physical pressure
          ┣━━4a=> How can we reduce friction?
          ┃  ┗━━5a=> Would a lubricant on the tube meet engineering constraints and reduce friction?
          ┃     ┗━━6a=> Would the use of lubricant in practice create added risks or difficulties in the operating room?
          ┃         ┗━━7a=> Hypothesis: Yes, due to the application of lubricant necessitating a glove-change afterwards.
          ┃           ┗━━8a=> How can we overcome problems with lubricant application to the intubation tube?
          ┃              ┗━━9a=> Would passing the intubation tube through a no-mess, easy-to-use "self lubricating ring" mitigate added risks or difficulties in the operating room?
          ┗━━4b=> How can we reduce physical pressure?
             ┗━━5b=> Would reducing the diameter meet engineering constraints and reduce pressure?
                ┗━━6b=> If there is a minimum diameter requirement needed to deliver oxygen, would dynamically changing the diameter of the tube (e.g. inflating it) after insertion create a reduction in pressure?

So that's a very simplified example of how to solve problems with systems thinking (although in reality it would be WAY more detailed and actually test each hypothesis).

The problem is very rarely "money" in medical fields, the problem is someone actually identifying the root problem/s, i.e. the "problem behind the problem behind the problem", and applying engineering to solve that, which solves the problem one level above it, etc.

If you're interested in this, read up on things like "the five whys", a systems approach to problem solving invented at Toyota.

My normal deep voice now sounds like Mickey Mouse's and it hurts to swallow.

Perhaps a more "low hanging fruit" solution for this problem space would be better procedures for helping people recover.

Doctors routinely prescribe antibiotics. I never had any of them tell me to eat yogurt afterwards to repair what they do to your gut biome. I learned that elsewhere.

No doctor ever told me I needed to taper off of steroids. I learned that from a friend.

There are a lot of ways modern follow-up care for medicine seems to be pretty bad and this is probably a much easier thing to improve upon than innovating on intubation tubes (which I'm not trying to discourage -- I see no reason we can't do both).

I don't have much relevant info directly related to your question, but have some second hand experience with recovering from intubations that I would just like to share.

My mom went through this when she was having health issues over a few years before her passing. I think it varies based on how good the person performing the intubation is and how long it is in.

The first time her voice ended up like minnie mouse, and it was like that for a long, long time. Probably a year before it became "normal", but definitely not like how she used to sound. It kept slowly getting better.

A few years later her voice was mostly back to how she sounded before hand and had been for while, then she had more health issues and was intubated again. This time she was fine - no voice change and no pain that she reported. A few months later, intubation, but this time her voice was pretty bad and it never got better before her passing.

It may have been a technique issue as well - the RT or pulmonolgist or anesthesiologist (whoever put your tube in- it varies between hospitals) may have made multiple attempts and/or scratched your larynx. Every second they spend placing the tube in your throat is a second you're not getting ventilation, so they prioritize speed (and accuracy!) over comfort. Also tubes come in different sizes so perhaps they used a large one for your anatomy.

You say you "just" had surgery- you probably still have a lot of inflammation on your palatine tonsils and vocal fold area, making your throat scratchy. It should go back to normal in a few days.

It's not really the "tube" that hurts- what hurts is the removal. While it's in during surgery your anatomy gets used to the tube there and kind of all settles in place around it, getting comfy. When it's pulled out, it feels like it's being ripped out and it's kind of a shock to your system. Imagine if you hiked the Appalachian Trail for a few months and never changed your boots or your socks and the skin kind of melded into the socks and then at the end of your hike I quickly whipped your socks off. Your throat right now is like how your feet would feel.

The thing with the tubes is they have to be rigid enough to stand up to the insertion which while a delicate process actually takes more force than you'd think so they need to have a pretty solid structure and also can't collapse on themselves while keeping the airway open. There's a lot of "stuff" that can come up in the tube or goes down through them - phlegm, sticky sputum, tonsil stones, "gunk," blood, lasers, cutting tools, biopsy tissue, etc. Can't have risk of the tube having divets or anything where something could get caught on or stuck to and block the airway. They also will have plastic and metal suction tubes and cameras and things inserted down inside the tube, so the sometimes the width of the tube depends on the procedure they're doing and what how big it is based on the things going through it.

I'm not a doctor, just a former respiratory therapist but I'd recommend taking ibuprofen and if it's still bothering your sending a message or calling your doctor tomorrow for their input.

As far as making a more comfortable tube - they already use water and gel based lubrication to make the insertion and extubation process more comfortable on the airway. Your idea of a lab-grown natural membrane is interesting, but imo too much medical liability around having the tube be comfortable- would way rather have the patient have a stable airway and uncomfortable throat for a week than the airway collapse mid procedure and have brain damage or worse from an occluded airway.

Maybe a longer lasting lubricant so it could last through and still be lubed up for the extubation, however maybe they don't do that because of risk of it dripping down the tube into the lungs. Generally anything fluid in the lungs is bad and that's why your cilia along your bronchioles bring up all that gunk we cough up on a daily basis.

Anyways- hope you feel better soon! Fwiw, pain on extubation was a very common complaint- it's one of the reasons patients who frequently or need long term ventilation will have a temporary or permanent tracheostomy which goes in through the throat directly and skips the delicate tissue around the vocal anatomy.

Edit- here are two good papers I found googling about this that you might want to read for more info:

Larger review of 9 studies/775 pts: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219530/

Voice loss following intubation: https://www.arwy.org/article.asp?issn=2665-9425;year=2019;vo... <-- what I found interesting from this one is it references between 5-90% of patients have some postop symptoms! Oof.

> The incidence of laryngopharyngeal symptoms after endotracheal intubation varies between 5.7% and 90%. These are usually mild and transient requiring minimal active intervention or none at all. Most resolve in 12-72 h, with an exception in cases of injury to vocal folds or arytenoids.[2]

My father is an expert in this field. He is a pediatric anesthesiologist who has done much work on development of entubation systems. I think he has at least six entubation patents, and was also the developer of the light tube entubation method. Back in the early covid days we were discussing possible lung lavage tubing methods, but neither of us had time to work on that. I can put you in touch with him if you are interested.

It's probably the actual physical metal laryngoscope that is the cause of the throat pain, and not the tube itself. The laryngoscope is used to pry open the throat so the vocal chords can be clearly sen. It's not violent but there is significant force involved and a slight mistake can get a tooth knicked. This visibility is needed so that an air tube can be inserted between the vocal chords to secure the airway.

https://en.wikipedia.org/wiki/Laryngoscopy#/media/File:Macin...

I'm really sorry you are experiencing this. How did they perform the procedure? I'd love to hear more about your experiences, because I have first-hand experience on how surgical procedures can feel really overwhelming.

I suspect other materials wouldn’t help much - that the main pain and irritation is having anything shoved in there.

Just checking: do you know for sure what type of tube was used?

There are two broad types used for general anaesthesia - the endotracheal tube and the laryngeal masked airway, which are very different in design and function.