Symptoms of chest infection?

[Orangezebragirl]

My dad has psp. He chokes a lot. A lot. He seems so extra ill all the time at the moment.... stuff like always being too hot, being so tired all the time, feeling dizzy and weak. I'm worried he might have some kind of infection from aspiration of food particles. What would be the symptoms of this be? He has a mouth full of rotten teeth ( he has always refused to see a dentist his whole life long ) so always has bad breath so how can we tell if he has a chest infection? I'm concerned the teeth themselves would be an infection risk? I'm unsure he even has the motor control to brush his teeth now if he were so inclined.

[laroux]

Hi orangezebragirl,

If you are suspicious of an infection, I would definately get it checked out. I don't think those symptoms should be overlooked. I am a dental assistant, so I do know bad teeth, or an infected tooth can cause all kinds of problems. I think having PSP does compromise the immune system. As far as dexterity for brushing, he likely does require help, my husband has dentures and has a hard time with those. And the mouth is the window to the rest of the body. Keep us posted, let us know what you find out.

Joan

[SharonAB]

Dear Orangezebragirl,

My understanding now is that infection in all areas can easily occur with someone with PSP - right from the early stages... (Yes - I wish I knew more in the beginning..)

For when my husband first became unwell - dentist appointments and how John was brushing his teeth were overlooked. (It was simply forgotten & didn't occur to me to check)

Then my husband went through a stage you are describing - With investigation (Yes I went round in circles for a while) it turned out some symptoms - were due to the nature of PSP, some food swallowing/aspiration, some skin infection (a 1/2 cm fine cut can cause major issues!) and some dental....

Anyway one part that could be fixed was dental related -

Turned out one tooth had decayed and even with the nerve well exposed my husband did not truly feel the pain. (I think loss of sensitively to pain maybe a symptom to PSP that is not that well documented?)

So as well as having the tooth removed (considered too traumatic to crown - John couldn't handle being in the dental chair too long), we had to get back to back to the basics.

In addition to assistance with showering, dressing, skincare etc extra dental care was required. Initially a dental nurse gave instructions on how to brush teeth (John lost a concept of time and effort required) an electric tooth brush was purchased (I was surprised how it made such a huge difference!) and my husband started to use the shower chair in front of the wash basin to brush his teeth.

Regards,

Alana - Western Australia

[Hidden in reply to SharonAB]

Yes absolutely a raised pain threshold -mum had shingles develop after getting burnt on her forehead from a hairdryer as she didn't feel what was happening and only felt the odd twinge from the shingles despite it being around her eye, a potentially very painful place to get it!

[aliciamq in reply to SharonAB]

I have observed a diminished pain awareness with my husband from early on. No matter how horrible the cuts and bruises from falling, he would always say he was OK and they didn't hurt🤔

[Lisen]

Same happened to my dad. Had to put him under and pull out 7 teeth because of infection. They have miss treated his mouth hygiene at respite over a long time. My mum is so careful and always clean the way the dental hygenist tought her. The infection had already gone to the lunges and was admitted for 2 weeks. Very week couldn't eat or walk.

Get on top of it is my advice

Cheers

[aliciamq in reply to Lisen]

😬

[Hidden]

I never knew with mum and she constantly had high temperatures towards the end of psp. I got the hospice involved who arranged painrelief patches and I also asked the GP for prophylactic antibiotics for peace of mind and so we could minimise her suffering. Bad enough having this disease without feeling wretched on a daily basis! Best wishes. Dianne x

[Orangezebragirl]

Thanks. He is seeing the consultant in April.....so I think he will have to say some thing about the teeth. We have all tried. He has NEVER gone to the dentist. Even whilst healthy. He would not do it. We tried making him appointments, begging him, reasoning with him. Maybe if they would agree to put him under they could take the lot out? I can't imagine this would help his eating ability though. I don't think he'd agree either. I might try to get him to go to the gp before the consultant. Would a blood test show up an infection?

Ozg x

[Kathy in reply to Orangezebragirl]

Yes, a blood test would show a raised white cell count as the body increases the number of white cells to fight off the infection.

K

[jillannf6]

Can he try an electric toothbrush ?

Loljill

[quickgel]

Hi Orangezebragirl,

Cleaning someone else's teeth with their co-operation can be awkward but someone with PSP may not always be able to co-operate. It was the one aspect of my wife's care that I took back from the care assistants following an episode when Margaret clamped her mouth tight shut when the care assistant was attempting to remove a small denture, narrowly missing her hand. Clamping was completely unpredictable and eventually stopped as suddenly as it started (after a couple of months). I found an electric toothbrush helped a lot.

Like SharonB I too wish I had known a lot more of what to expect, aspirational pneumonia is certainly an ever present risk and well worth checking with the GP. Kind regards, Jerry.

[jimandsharynp in reply to quickgel]

I use an electric toothbrush on my wife. She's such a sweetheart and never complained when I took over brushing. We also use a dental rinse after brushing. Hugs. Jimbo

[quickgel in reply to jimandsharynp]

You're quite right I forgot to mention the dental rinse which was a big help. I also gave Margaret thin slices of fresh Pineapple, I was told this would freshen the palate as it had antiseptic properties - whether or not it did I have no idea but it was worth a try, did no harm and seemed to be enjoyed. Cheers, Jerry.

[jimandsharynp in reply to quickgel]

Jerry, Thanks for the pineapple tip. I'll give that a try.

[Greenbee]

He also could have pneumonia. My husband has pneumonia now and is in the hospital for the second time this month. The doctor keeps talking feeding tube but he doesn't want one.

[groovychick in reply to Greenbee]

Greenbee, doctors did the same with dad when he was initially admitted with aspiration pneumonia. Kept talking about peg feeding tube, but dad refused it so they had to adhere to his wishes. They can't force him.

[Sharon637]

I had to brush my Dad's teeth for him too as he didn't have the motor skills to do it either. Also made him rinse with a mouthwash too. When he couldn't do that any more, I used to use a diluted mouthwash solution to rub around the inside of his mouth. Yes the clamping is an issue and I got bitten a few times but I used to just try and make him laugh and he would open his mouth to do so. I would certainly get bloods and urine tested and if possible, a doctor to listen to his chest. Our neurologist said to watch for an extreme spike in temp as sign of pneumonia. Often he would look really flushed, be sweating a lot but on actually taking his temp (armpit, mouth too risky with the clamping) it was often below normal. I think one of the problems is that in some cases, the part of the brain that can regulate body temp gets damaged so you have to do more of the regulating manually. They can be hot one minute and cold the next so we were constantly having jumpers and cardi's on and off all throughout the day. We would check Dad's temp, blood pressure and pulse twice a day every day to watch for any irregularities. The one time he did have a spike in temp and his breathing sounded a bit laboured, we got the doc out but his lungs were clear and blood oxygen fine. I just sponged him down with a cold washcloth every hour and let him air dry and by morning, the fever had broken and his temp was back down. He never got pneumonia. But any type of infection should raise temp a bit so best to get it all checked out. Good luck and I hope he feels better soon. xx

[groovychick]

For the best part of dads last year, I had to brush his teeth for him. He just didn't have the motor function to do the job properly anymore. Definitely get the chest checked. Is his chest making bubbly/cracklings noises and rapid breathing?Constantly trying to clear phlegm and secretions can also take its toll on him.

[Rockfly]

My Mother in law, who I care for has the same problems with coughing and choking, very big part of psp sufferers. I have consult with the salt (speech and language therapists) a lot as it is often to do with too much saliva and parts of their throat not working so well and not being able to swallow properly. This means food often goes into their lungs which is why many people with psp get pneumonia. I have changed her diet alot, ahe doesnt want to eat just pureed foods but I make things that are more glupey, like currys, fish pie, spag bol etc. We have cut out cakes and bread and anything crumbly although when her coughing is good she has treats. If she fancys sweet things i mix them with custard or ice cream. I also try and remind her to swallow twice after every mouthful as this was something the SALT suggested. I would get your dad checked out as chest infections can be a big problem.