Advice please

[lindsey48]

Hi. Mum has recently been in hospital due to falling and breaking her collar bone. She is now really wheezy and choking when drinking, and has a cough. She is already on thickened fluids. I have called the GP out twice, but apparently it is not on her chest, so I wondered if she has aspirated in hospital ( don't know if they always thickened fluids when we weren't there). The GP prescribed Gaviscon, which I thought was for indigestion/heartburn?.

Any ideas please.

Mum is sleeping much more now and seems much more fatigued and distressed.

Kind regards

Lindsey

[Hidden]

Try to get speech therapist out if possible. GPs could easily miss deterioration of swallowing/cough reflex

best wishes

jmbb

[lindsey48 in reply to Hidden]

Yes, she's coming on Friday.

[lindsey48 in reply to lindsey48]

Thanks

[denmob]

Suggest getting in a speech and language therapist who should arrange a "swallowing" video to see if she is aspirating. Depending on results they will advise you on what to do. However all final decisions are up to your Mum but at least you will be more informed about what is happening. Good luck.

[Hidden]

Hi lindsey48

Sorry to hear about your mum. Firstly, if the GP has checked her lungs (twice after the hospital stay?) and not found any " crackling or gurgling noise signs" of aspiration, then it may not be aspiration at this stage. Secondly, coughing (especially with a wheeze like a bronchospasm) is often a symptom of acid reflux (GERD) so I assume he suspects this fact by prescribing Gaviscon. Thirdly, after falls, especially bone breakages with hospitalisation, there can be (for a short or more permanent time) some faster progression of the PSP. This is quite a common occurrence. This will often be seen as "more fatigue", along with extended sleeping in some sufferers. It can also exacerbate eating/swallowing habits. (The distress will probably be a consequence of all these "events" taking place in a person who has a progressive neurological disease).

The idea of seeing a Speech and Swallowing Therapist is always advisable in order to monitor the progression of dysphagia and dysarthria.

It is possible to aspirate small amounts of fluid/small food particles where the lungs can "cope and resolve" the problem, but if the bodies defence mechanisms fail (both for infectious or non-infectious conditions) it is very serious and needs immediate medical treatment. (The signs of coughing, wheezing and fatigue can be symptoms of aspiration pneumonia, but Drs will look for other symptoms and often perform appropriate tests to identify the condition).

Take care and hope you'll find some answers and be able to help and comfort your mum. It must be a vey worrying time for you and family.

T.

[peterjones]

HI LINDSEY SORRY TO HEAR ABOUT YOUR MUM MATE I WAS IN HOSPITAL RECENTLY AND I HAD TROUBHLE WITH MY LUNGS AND BREATHING I HAD PNUEMONIA FROM ASPIRATING BUT THEY BROUGHT ME AROUND JUST NORMAL FLUIDS EVEN AFTER I TOLD THEM THAT I HAD PSP AND WOULD ASPERATE ON THE FLUID THEN IT SUNK IN AND THEREAFTER I GOT THICKENED DRINKS AND NO MORE SANDWICHES I HAD MY FOOD ALL MINCED UP \\ SO MAKE SURE THEY KNOW ABOUT MUM S CONDITION FOR SURE BECAUSE SOME OF THE DIFFERENT STA[FF THAT COME ON DUTY MAY NOT KNOW ABOUT HER CONDITION GOOD LUCK HOPE IT ALL GETS SORTED OUT FOR YOU AND YOUR MUM MATE PETER JONES QUEENDSLAND AUSTRALIA PSP SUFFERER\\\\\ BY THE WAY NOT ONE OF THE STAFF HAD HEARD OF PSP THAT I ASKED

[Tz2388]

You may find in a couple of months that gets a little better. When my husband had a severe collar bone break, he went through that, but as swelling subsided so did the problem. I was sure the PSP was the problem, but all the internal swelling restricted throat and airways. Jill

[Hidden in reply to Tz2388]

This is a good observation, because depending on where and how the collar bone is broken it can cause airway compression or nerve injury affecting the voice and swallowing. However, it would be medical neglect for a hospital not to identify these issues (even if symptoms are due to inflammation and swelling alone) and inform the patient and carer(s) of these problems, and also, having identified them, to treat them before leaving the hospital (since airways compression etc is serious).

Perhaps I'm being too optimistic about hospitals !

Cheers

T.

[lindsey48]

Thanks for your replies. Speech therapist came today and reviewed mum. Said her swallowing hasn't deteriorated too much but said to take a sip of drink and then put her chin down before she swallows as this gets her in a better position. She's coming back on Monday