Proper adjustment of the cough-relief valve

Adjustment of the cough-relief valve should be optimized for both coughing and voicing (see video clip). Insert the valve in the housing and ask the patient to cough. The cough-relief valve should open easily and with the least possible noise. When the valve is adjusted stronger the noise resembles more of a clicking sound caused by the magnets and when the valve is adjusted lighter that sound is softer. In between those extremes the noise resembles more of a ‘fluttering’ sound that is usually not liked very much by the patient. Obviously, the weaker the adjustment of the cough-relief valve the lower the pressure exerted on the seal when coughing and consequently, the longer the seal of the adhesive. After adjustment of the cough-relief valve it might appear that the valve is adjusted too weak for voicing. In that case the patient experiences that the valve opens when attempting to speak or when attempting to speak louder. Depending on the wishes of the patient the strength of the cough-relief valve could be increased slightly to avoid this problem. However, in some patients it might be advantageous to have the cough-relief valve opening at lower pressures in order to prolong the seal of the adhesive. For speaking louder or shouting the patient can support the cough-relief valve with his finger.