Choking

My mom has been coughing a lot lately. She says it feels like she’s choking on her own spit. Does this sound familiar to anyone? Advice?

[february]

Dear Scrumdidlly, Yes, I've had ataxia (due to Niemann Pick C disease, found out 'why' in 2017) for 20+ years and I cough A LOT. Sometimes I choke on my own spit (goes down the wrong way). And drinking liquids, like water, causes me to cough! I've tried thickening additive for water, although I really don't like it! I think it's a hazard of ataxia (at least fo me)...,ha! If chew gum, that seems to help some, but I only chew it if I start having a coughing fit. I also chew antacids (like Tums) a few times a day, although my doctor would like me to take a Prilosec tablet daily, as I have acid reflux. Can't figure out if my acid reflux has anything to do with my coughing/chocking. Over the years, I've tried a nasal spray (for post-nasal drip), had a chest X-ray and saw an ENT doctor & Pulmonologist, to no avail. ;o)

[LuisRodicioRodicio]

Hi scrumdidlly!

After 7,5 years with PSP these are our experiences about:

•Phlegm and choking: The first thing is to remain calm during episodes of truly shocking coughs. The second is that a physician rules out an infection in the respiratory tract. Get a pulse oximeter to control. (Fever is an indication usually either pneumonia or urinay tract infection (UTI) in PSP patients).

•It is not a big problem that the patient swallows his phlegm. For phlegm to be fluid, it is important to drink liquids. Steam inhalation from boiling water in a bowl with a few drops of some floral essence (avoid mint plants and eucalyptus) that is pleasant to the patient, a small spoonful of marine salt and some pieces of lemon, with a towel covering head and bowl helps. (One to three times a day.) Medications like "Mucosan" (Ambroxol hydrochloride) twice a day or “Fluimicil Forte-600” (Acetilcisteine) one by day, help. Ask physician.

•In case of choking, raise both arms at shoulder height, breathe only through the nose intensely if posible. I not, inhale air intensely but not very fast through the mouth. Retain air a couple of seconds and then force the cough.

•Also here, to avoid in the diet drinks that can be irritating helps: coffee, carbonated beverages as pop or soda (or eliminate the gas by agitation before giving it to the patient), chocolate, orange or grapefruit juice, etc..

Note.- It has been described that: pineapple juice breaks down the protein very well and fluidifies the mucus (phlegms). It will have to be tested if the patient tolerates pineapple juice without coughing or choking.

There are some foods to avoid…. things like grapes, rice, couscous, lentils, peas etc anything small was problematic as were spicy foods. Foods that crumble easily, cookies, crackers, stringy foods, sticky foods, etc.

•There is a suction machine which helped a lot with the very sticky phlegm. We have NOT used it yet.

•A steam atomizer to keep the air in the room moist helped, too. (40% - 52% moist advisable.)

(In our case "a lot": every afternoon and some times on the morning)

•The physiotherapists have exercises reinforcing trunk muscles to improve the cough response to choking. Engage a good speech/swallow therapist to learn swallowing techniques.

•Avoid dairy products, especially before bedtime, this seems to prevent the increase in phlegm viscosity.

•Raising around 15º a 35º (9” to 12”) the head of the bed also helps.

Hugs and luck.

Luis

[TinkerbellHughes]

I can totally relate to this. I have thickening fluid and first I thought it was disgusting, but came up with strategies eg: squeezing in lemon or lime juice and adding ice makes it much more palatable and no choking Result!

[FFNick]

I too have choking problems. A speech Therapist is the health professional you need. When I gag I relax by sitting down in order to breath through my nose. The gag occurs when something tickles the back of my throat.

[HazelCarr123]

My sister had the same and has just had a tube fitted in her tummy as she went to 4 half stone as she was choking on everything, it must be an ataxia thing as I do sometimes sorry.

[Jessie70]

Oh yes. So annoying! I know it disgusts some people but I chew gum. I’m constantly swallowing so I don’t get that “down the wrong pipe” feeling.