Choking

[Robbo1]

Has anyone any advice as to what to do when a PSP patient chokes? I have managed to get my husband to swallow some wet bread which seems to have forced whatever food was stuck, down, but I am concerned about his choking in the night when he hasn't had anything to eat or drink.

[Heady]

Hi, I don't know about serious choking episodes. But small ones, sit him up and try putting his arms above his head. Make him do some breathing exercises. Deep breathes in and out, hold for a couple of seconds, then cough, using the stomach. S will only ever use his throat to cough, if he can manage that! This really helps. Got it from the physio. Suggest you make an appointment. They can give exercises that may help. Or else see the speech therapist.

Lots of love

Heady

[NannaB]

It's horrible listening and seeing our loved ones choke isn't it? If mine chokes while eating, I pull him forward and slap him on the back like you would anyone who chokes but it is the saliva and mucus that causes the worst problem. I still have the suction pump we were given, sitting here unable to be used because a part is missing. I'll let you all know how we get on if we ever get it working.

At night, I always make sure C is on his side with his head raised, easy in his hospital bed but if he was in an ordinary bed, I'd use pillows. If he does choke in the night, me, or our night carer sit him right up, lean him forward and again bang his back. It can take a long time for him to bring anything up but once he does, he quietens down and relaxes.

X

[formercarer]

I'm not sure about wet bread. In my mums case, swallowing became involuntary. Her natural swallow reflex worked, so she would swallow eventually, but she could not swallow at will. Despite not having swallowed, she would look for another mouthful, and that would lead to choking.On the rare occasion that she did choke, I would stand her up, support her, pat her back, empty her mouth. Once or twice it was scary. As the illness progressed mealtimes took longer and longer. I would watch very carefully for each swallow before offering the next mouthful. I found verbal prompting to be worse than useless, as I said, her swallow, like her blinking, was not within her conscious control. The more they "try" the more they fail. Relaxation is key. Rely on those involuntary reflexes. Warm wishes to you both.

[Amilazy]

Loss of swallow or involuntary swallowing is part of PSP. it often sounds worse than it is, my SALT team told me to let it happen and not to worry unless it was prolonged. But as it got worse and eating took more effort M started to lose weight we had to have a PEG fitted to allow M to be fed. If you think your husband is losing weight (which can be dangerous for neurological patients) get him seen by a dietician through your GP.

PEG had a beneficial effect of reducing choke for some time, but now her saliva is getting thicker and causing the choke to reappear but only early evening at present. I do the sit up and head forward (that can be difficult) to relieve the choke. I am looking into a suction machine but at present not found a suitable one.

Best wishes Tim

[Kelly55]

Hey Robbo, a lot of the choking issues with my mum are due to a build up of watery saliva or the thick sticky mucus saliva that blocks her throat. She uses a saline nebuliser to break down the catarrhy stuff, atropine drops to reduce excess saliva and as she also has suspected copd she can get very breathless and so then lorazepam to calm is given and asthma inhaler and a new hard fought by pump called seebri breezhaler. The MND website has lots of helpful info :

mndassociation.org/wp-conte...

[Robbo1]

Many thanks for replies and helpful suggestions. It's good to know that I am not alone .x

[mthteach]

Have you had a Barium Swallow done to see if he is aspiration problems. That would be the 1st thing that I would do.

Secound, there is a thickener you can buy online that is not as bad as the powder kind.

bettymills.com/shop/product...

My spouse was put on a puree diet. He lost 75 pounds in 18 months before he started to stabilize out on the puree foods. He now has a little more strength and we have started taking him to the gym a little.

Good Luck.

[Robbo1 in reply to mthteach]

. He has thickener but hates anything with that texture so it has not been used. I had not heard of a barium swallow so might follow that up. Thank you.

[mthteach in reply to Robbo1]

This thickener is a honey type liquid. My husband hates the powder, cheep, kind of thickener. The Barium Swallow is where they take a ex-ray while he is eating and drinking. It will show if a little or lot is escaping down the wrong way. They say aspiration pneumonia is the leading cause of death with PSP patients.