I have posted a few times on here now about my mum and her ICU stay. She seems to be improving, got her tracky out on Wednesday and no longer requires any additional oxygen help. She is sitting up in a chair for a few hours a day and has sat at the edge of the bed.
One problem she is having is with secretions, she seems to be able to cough it up to the tracky wound but does not have a strong enough cough to get it into her mouth. She seems to have a lot, all the time.
The doctor spoke to me today and said the nursing staff are currently putting the suction tube down her throat to help clear the secretions but because she is not gagging etc like you normally would they think the muscles are very weak and this could lead to further problems like it going back down and into her lungs. They said palliative care are coming to speak with me and my mum - not because she is getting put on end of life care but in case something was to happen there is a plan in place.
Sounds odd to me - has anyone had this whilst they were in icu? also any advise / experiences with the sectretion would be great to hear.
Thanks
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Westbeginners1
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My Dad had so much trouble with secretions during his prolonged trachi weaning, they would suction so much from him and then when he could talk he would even ask them for the suction because as horrible as it was it felt better for him to get it off and would force a cough.
He came home last week as COVID outbreak on the ward, but still uses a nebuliser twice a day to loosen the secretions and help bring them up. Have they tried using the nebuliser to help loosen the secretions to make easier to bring up?
The SALT team also gave some good physio for his lungs which helped him open the base of his lungs to bring it up- it involved lots of deep breathing in and then a ‘huffing’ (like the breathing out rapidly as if fogging up a mirror). It helped strengthen his throat muscles. I’m sure they are already doing this but we would do this physio of breathing all through visit too as it’s not much physical exertion for Dad but was really beneficial. We also did a lot of mouth movements with Dad- like even things like tongue up and down and fake yawns (fake yawn activated some of muscles used to swallow). Physio and time I hope will make a difference- it did with Dad.
Hope everything goes well and I would ask for what SALT based physio your Mum can be doing during the long days of ICU.
Hi. I had lung failure after sepsis (ICU for one month, on tracheostomy) so had a bad time with secretions as well. The only thing that really helped me was the nebuliser, even having one near me that I could breathe in was great. It cleared up the phlegm attacks that I would get. There was a handheld device that I called The Bubbler that I would breathe in and that would help to break up the phlegm. Before this I too had what I called extreme suction - that was pretty nasty but I was lucky in having a strong enough cough to bring it up. What I didn't get were breathing exercises by physio (the physio in my hospital were just ok, although physio in critical care was awesome) therefore if your mum is not getting that through physio, then that's something to push for. We weren't aware that we could get that help.
As with others here, I also remember having my secretions cleared for a little while after the trachy was removed.
I also had a nebuliser with Salamol (I think, it was that or some other bronchial inhaler chemical) added into the air-stream.
And I was also given the lung clearing exercises by SALT, including the "huff" one, where you breathe in and out deeply and regularly, then do a short breath huff blast as though you are cleaning a pair of spectacles.
Finally, even after being home for 6 months, I was still doing my morning breathing exercises, and each time it would cause a coughing fit and bring something out of my lungs.
Hi Westbeginners1 i hope there continues to be good news with your mum, and that seems like a huge milestone getting the tracky out! We’re not there yet with my mum. Did you end up speaking with palliative and find out why they organised that meeting despite her progress.
Great to see your mum got her Tracheotomy and she seems to be doing very well sitting in a chair that’s amazing seeing where she was a short time ago. 🤞. I had a tracheotomy after 4weeks on a ventilator. I remember the days when physio used to come around and ask my to cough and cough, it is so hard to do as you’re totally worn out and if you can imagine being asked to cough when it feels like someone is standing on you’re chest and you can’t draw enough breath to do it. I did managed to get it into my mouth but I sympathise with how difficult that really is
All I can say is try and see if she can with you’re help keep clam and do some slow breathing exercises everyday if she can , medical advice obviously but it might help build a stronger cough reflex 🤷♂️ see what they say
Hopefully she and they can work this out and get you’re mum to the next stage if recovery
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