help

Hi Everyone

Does anyone know what could help my wife clear her throat when clogging up with saliva, it is very worrying hearing her struggling, and making chocking noise, especially during the night.

[easterncedar]

We found a suction machine very helpful, until we tried atropine eye drops, which basically have, for the past two months or so, solved the problem entirely. The suction machine hasn't been needed since we got the proper dose of atropine figured out. One drop under the tongue morning and night does it. Everything loses efficacy eventually, I guess, but for now we are happy with this. The choking is very scary and exhausting. I hope you and your wife find something that helps. Good luck!

[Hidden in reply to easterncedar]

many thanks easterncedar for your prompt reply, hope this does the trick.

[easterncedar in reply to Hidden]

Some people have bad reactions to atropine and hyoscine, which is also sometimes recommended. The atropine at first made my guy extremely antsy, if not quite agitated, but that subsided after a few days. And I am very careful with the dropper. Best wishes, ec

[twinies in reply to easterncedar]

By the way I'm Twindles i somehow have two accounts now ha ha. Not very technical sorry

[twinies in reply to easterncedar]

Hi Guys, would you share some of your helpful tips on my Facebook page for Dublin. I find what you say very relevant and helpful for my dad, i know people would appreciate your wisdom and knowledge. Facebook- PSPA Dublin.

[sammy90210]

I would recommend, if possible, if your wife could sleep on the side, with the mouth pointing as downwards as possible - then you can gently suction the phlegm/saliva out - I would recommend trying the drops as recommended by easterncedar as well - my dad hated suctioning and would get very distressed

[richmond1]

Mum was terrible with saliva pooling in her throat she tried hyoscine which gave her confusion/hallucinations she now on a medication called glycopyrolate which has worked. Hope this helps xx

[Tokki]

Hi, sorry I can't add anything much. The atropine seems to help but only if the use is restricted to nights only and also trying to gets Bugs to sleep on her side. For drooling during the night I have found padded cotton pillow protectors from M&S helpful as they are absorbent but also seem to stay dry enough to not be uncomfortable.

The problem we are having is the throat clearing during the day. It is like Bugs is trying to regurgitate her slippers - very loud and long.

Has anyone else had this sort of problem and found a way to help?

[Amilazy]

My wife has had saliva choking problems for over 2 yrs. the seemingly uncontrolled saliva flow is caused by the loss of the swallow reflex so saliva has no where to go.

We found initially too much thin saliva caused choking as pooled at windpipe junction could be relieved by positional change either sitting forward or putting into recovery position. We were then prescribed hyocene patches very bad reaction 2 yrs ago frightened both of us. The patches were retried by the nursing home about 3 weeks ago with much better effect saliva reduced and only a little disorientation, so we are continuing with their use. We tried Glycoperonium 1mg tablets for a year initially very good at reducing saliva and stopping the choke but after a year effectiveness lost. Then in March this year we tried Botox injection to the saliva glands without much effect.

I noted that when saliva production reduced the choking reduced but when it did occur the saliva was very thick and difficult for M to move. Note this saliva mainly white or clear but as soon as coloured was very good indicator for infection. We found the way to relieve M distress from the thick saliva was sit upright lean forward and pat gently on her back. She would either swallow or spit out the saliva.

Suction machines good at clearing mouth but M bites (hard) and so no good at further down also can be dangerous if not used correctly. We do not use a machine now but I have found muslin clothes for baby feeding are great at absorbing the drool and protecting clothing.

I can only suggest get your wife to see the SALT (speech and language therapy) team usually referred by GP or neurologist.

Good luck Tim

[abirke in reply to Amilazy]

DR. Tim! I always like your responses. So M is doing well? How are you doing? Now that you have a little extra time on your hands, have you created a new normal in your life? Sorry if I already asked you this....but you can tell it to me one more time! ahahha

AVB the forgetful....ya , wait , no that's it, the forgetful....I think

[carlam]

If you haven't already done it, try an antacid to lower production of mucus. Zantac 150 mg (generic Ranitidine) cleared up my dad's thick, choking phlegm problem.

[abirke in reply to carlam]

well there's an idea! Does he have acid reflux?

[carlam in reply to abirke]

I don't really know. Never used to need antacids pre-PSP. All I know is I read the solution on a Parkinson's forum, tried it and it worked for us. Previously the doctor had x-rayed my dad twice, thinking the terrible cough and phlegm must be from pneumonia.

[Kelly55]

The choking is very distressing isn't it, especially when you can see how worried your loved one is. Mum has a mixture of watery saliva (reflex to swallow diminished) which gags her or drools out but also has thick tenacious mucus like secretions which she feels block her throat so she makes horrible noises trying to shift it.

We have been using atropine sparingly for the last year and it is relatively effective at drying up saliva but tastes horrendous so make sure drops administered carefully. We also had bit of battle getting it as being used out of recommendation so persevere! Hyoscine patches were awful for my mum, caused bad dreams and skin rashes and she used to keep peeling it off before the 72 hours were up.

We Also have a glycorpyrronium bromide inhaler which is technically for COPD but side effect is it dries secretions, this worked great for first few months and made a big difference to first few hours of sleep. Also a battle to get from GP as allegedly is expensive ! So again persevere! Although mum struggles inhaling now so we are trying to get a solution version currently..

Also thoroughly recommend a saline nebuliser, a simple piece of kit that you put the mark over their mouth and nose and as they breath in the moist salty air it breaks down thick secretions so can be coughed up easier or swallowed. They need to still be able to cough /swallow to use this though. But your OT should be able to get one to you easily.

We also use a suction machine (after nagging our neuro for one!!) which is effective with the excess thin drooly saliva in the mouth. It clears it quickly to pre empt a choking fit and mum is missing her back teeth so it's easier to get the nozzle in. But during a choking fit it seems to make my mum gag more so that doesn't help for us.

They also recommend drinking pineapple juice and I use lemon and ginger tea bags with added honey for taste to try and keep secretions in check too. It thickens okay and can be quite refreshing for their palate (if they like ginger!)

Hope some of this helps but tbh the choking is an ongoing battle even with all these techniques!

[nanonthenet1]

My husband has used Atropine drops for a while and the do work well for him, one drop under the tongue every morning, it does cause him to have a dry throat after a few weeks use but we stop it for a little while and then restart , it seems to do the job, it's really helped with clearing that awful thick fluid, hope you find something that works for your wife.

[abirke in reply to nanonthenet1]

I wonder if he can't use sponges to wet the mouth. If he is unable to swallow ; sponges are dipped in water were recommended for B.

[nanonthenet1 in reply to abirke]

Thank you, I'll try that, giving him sips of water just make him choke so that is certainly a good one to try 😊

[Cuttercat]

Dear Clytie,

I sent an email previously and suggested applesauce in those little squeeze packets. Charles uses them to take his pills, no gagging, and to loosen the phlegm.

Hope it helps, but there are so many different scenarios and it's hard to suggest.

Cuttercat

[Robmatlol]

Hi Clytie, the gp prescribed Carbocisteine tablets for my mother. We found out about them through another psp sufferer. My mum takes one capsule when needed and literally within minutes the phlegm/excess saliva has gone. They really work brilliantly.

Good luck, Michele

[Hidden]

Thank you for your reply, this sounds like the best solution that I have heard of to date. Many thanks will give them a try.

[psplife]

Clytie

We just discussed this with out Neuro and my guy is scheduled in August for Botox injections to the cheeks. He said it will help control the production of saliva. We are looking forward to this because I know that his pillow gets wet from his saliva production and at times has trouble passing all that saliva. I will keep you all posted.

Nikkie