Full v Partial Laryngectomy - the verdict so far

Four months ago I had a partial laryngectomy. At the time I was debating having a full laryngectomy and two different consultants effectively talked me out of the procedure. Four months on I am struggling with the decision I made. Here's how it went and how I thought it could have gone had my decision been different.
Had I have chosen to have a full laryngectomy I would have been eating within two to four weeks of the operation. I would have been talking within six weeks. In order to talk I would have had to had a value fitted which would need changing regularly. This procedure is done by popping in to see your local speech and language therapists and takes about 20 minutes. It is not known how often the valve needs changing but it can be as often as once a month or as seldom as once a year, everyone is different. This valve would have enable me to have had a stronger, but deeper, voice and it could have been adjusted until I got something I liked.  The main disadvantage was that I would have had a stoma in my throat for the rest of my life and would have had to insert a filter each day. This procedure would have been similar to what I have been doing every morning for the last seven months while looking after my tracheostomy.
But I didn't chose the full laryngectomy because, to quote one consultant, 'there would be no going back and with a partial laryngectomy within a year it would be as if all this never happened'.
So four months into my 'intense' rehab here is the reality of the situation.
After the operation I couldn't speak for six weeks. Now I can speak my voice is very quiet and weak. I get breathless and can only talk in short sentences and for short periods of time. As I only have one vocal chord it has got inflamed and swollen, This has caused a blockage in my airway and is making it difficult to breathe. This possibility was never discussed with me when I had to make my original decision.
I often get breathless and struggle to walk any distance. I can't walk up stairs and travel at about half the speed that I did before the operation. Apparently this is because my airway is narrow, again this was not discussed with me. Apparently this could be because there is some swelling from the operation. As I mentioned earlier the operation was four months ago and when I started this there was a chance that my rehab could have been finished in three months. With that knowledge I find it difficult to imagine that there is still swelling from the operation. And if there is could someone please tell me when it is likely to go down so I can start breathing again.
I can't swallow my own spit so I have to have a receptacle with me at all time to spit into. This means I can't leave the house other than to go to the hospital or work. Retail shops tend to frown on their customers spitting as there wander around the cashmere jumpers or fresh veg. I have been very lucky that the people at work have put up with me spitting into a cup all day. Without that release I would have gone stir crazy by now.
I am carrying out swallow exercises in order to restore my swallowing function but it is hardly the 'intense' rehab I was led to expect. I have to try to swallow five teaspoons of water every two hours. It is horrible as most of it hits my lungs and leaves me coughing like a 80 year old who's smoked forty a day all her life but it is not what I would  call intense.
Finally the rehab was supposed to take three to six months with no mention of it running past that. There was even talk of pushing me harder to get me through it in three months. Well four months in and my next swallow X-ray has been pushed back two weeks. Hardly any time at all you may think, but when you don't leave the house because you can't function and you have been fed via a tube for nine months, two weeks feels like a life time. It is also another sign that things aren't as good as they should be.
So was the decision to have a partial laryngectomy the right one? At the moment I doubt it but hopefully I will be proved wrong.

HME's - Swedish Nose v Bib - A Patient's view

When you have a tracheostomy you intake all your air through a tube inserted into your throat. One of the problems with this is that the air goes in dry and cold and doesn't have the benefit of the warming and filtering effects of you nose. In order to replace your nose's function a HME (heat and moisture exchange) is required.
Up until a week ago I have always used a Buchanan bib but at my last hospital visit it was suggested I should try a Swedish nose.
After my first week here is what I see as the pros and cons of the two systems.

Buchanan bib
Pros

• The bib covers the trachi and gives the patient some privacy when out in public. A stranger would not know what was under the bid and not necessarily know the patient had an illness or disability.
• The bib can be washed and is easy to keep clean.
• A bib lasts three days.
• The bib catches projectile spit/mucus that can be ejected from the trachi when coughing.

Cons

• Unfiltered air can still enter the trachi around the sides and the bottom of the bib.
• Although in hides the trachi the bib is fairly obvious and doesn't match most outfits so can look out of place.
• In high winds the bib can be sucked against the trachi and cause some breathing problems.

Swedish nose
Pros

• The Swedish nose fits snug on the end of the Trachi and therefore all the air is filtered.
• There is a flanged opening so suction can still be carried out even with the HME in place.
• I have found if you wear the Swedish nose under your shower protector in stops the shower protector from occluding the trachi and makes breathing much easier.
• It stops mucus from escaping when you cough and staining or being absorbed into your clothes. 

Cons

• The Swedish nose attaches onto the end of the trachi and therefore the whole of the trachi is visible when you go out.
• It only lasts 24 hours and then you need a new one.
• If you cough and produce a lot of mucus and don't suction as you cough, it can gather in the Swedish nose. This causes moisture build up which means the HME loses efficiency. This can also make breathing feel more laboured which means changing the HME more regularly.
• If you have a strong cough, as I do, you can cough the HME off. So make sure you always carry a spare.
• More pressure is needed to occlude the trachi to talk. If you have a sensitive trachi this can lead to more coughing.

I have had a few teething problems getting used to the Swedish Nose but if it is protecting my airways and giving me less chance of getting a chest infection then that can only be a good thing.