Sinjz,
Sorry, took me a while to look up this thread again...hadn't found your updates in your first post.
As for the paranoia, I think Oddjob put it well: a few days in Intensive Care can have a spectacular effect on someone's mind, and (mild) paranoia and delusions are quite common. It is usually temporary. Is this still a problem? I don't know your father's age, but if he had only the slightest beginnings of dementia pre-op, the effects may have been more severe. Hope he has recovered from this. If it is a real problem, I surely hope the nurses and/or doctors will have taken action. A very mild dose of antipsychotic medication will often help. But by the sound of it, your father is past this stage; the first few days are mostly the worse.
As for the bleeding: he may have had a vein or even artery that was afflicted either by the surgery, or by the trach. It can take a while to start leaking. Internal bleeding can put recovery back severely in that it can create tissue damage and even a fistula. And since it is in or near his airway, there is usually a greater risk, and it needs immediate action. I think that, after a crisis like that, and all has gone well, you may find that most hospital personell (especially docters) will have the tendency to play down what happened, so as not to scare the patient or family in hindsight. I think this is understandable, but questionable. A social worker looks at this from a very different angle and possibly does not have all the information. If the doctor has said it was a close shave to the social worker, and says different to you, that's not good. But the fact that people were running about does not necessarily mean that his life was acutely at risk, either.
I share Oddjobs view on this: a family meeting with (at least) the doctor (specialist who performed the surgery), nurse and social worker in which all your questions and fears must be adressed. Ask the nurse to set it up. It is important that you utter your feelings of disbelief as a result of the different kinds of information you received. My feeling is that there are different perceptions of how great the danger was, and different views on what should be told (see above). If you want to go further, your father is always entiteled to look into or have copies of his medical file. If he should do this, I think he will mostly find a very neutral description of events, hopefully complete and accurate, with no direct indication of what might have happened. But it can serve as a subject for an evaluation. But I suggest you do this towards the end of treatment, or when these things still bother you after, say, six weeks.
Good news about the lymph nodes, though. And it seems that the swelling has gone down far enough for him to use the original airway. He can get rid of the tube if the swallowing function allows it. If the problems with this are still severe, and he should swallow the wrong way regularly, pneumonia is a big risk. For his longues to be kept clean, he will then be better off with the tracheostomy, for as long as is necessary. With the extra surgery (and sedation), he will in any case have some more work to do on his general recovery.
As for the future: your father will in the near future still have some swallowing problems. My guess is that the radiotherapy will start within two or three weeks after he is dismissed from hospital. The thing is, radiation will certainly make swallowing more difficult, because the mucous membrane and salivary glands will take a beating. And during the five to seven weeks the radiation will take, he will need all the nutrition he can get, because it can be very exhausting (differs from person to person), and all the affected tissues need nutrition. So it may be advisable to leave in the feeding tube for that time (and till some weeks after radiation has stopped) to guarantee his intake. Sometimes they will give someone a feeding tube that goes directly into the stomach through the abdominal wall, if the swallowing problems will be severe enough or last longer. You could adress this question. Probably the best person to answer this, apart from the nurse and doctor, is the speech-trainer and/or dietician.
I hope it all works out well for you all!
My thoughts are with you.
Kees