Great difficulties to open the mouth. - PSP Association

PSP Association

9,255 members11,352 posts

Great difficulties to open the mouth.

LuisRodicioRodicio profile image

After 8 years living with PSP and for about 1 month we have observed increasing difficulties in providing food (in pure form or in a very soft texture) due to the fact that the jaw hardly moves to open the mouth. With much difficulty and care, we force the food into the mouth with the teaspoon. So little by little and with a lot of time (we can take around an hour or more) we can feed her.

We try to avoid PEG.

Has anyone positive experience with this problem and managed to improve the situation with a trick?

Thank you.

Luis

Written by
LuisRodicioRodicio profile image
LuisRodicioRodicio
To view profiles and participate in discussions please or .
16 Replies
wear1947 profile image
wear1947

Dear Luis, try with Botox!

Inject Botox in the muscles that control the movement.

The amount of Botox and the site of application is a matter of experiment.

We use Botox with my sister for the eye's lids .

The neurologist has had to change the inoculation site.

Big hug!

Elena

LuisRodicioRodicio profile image
LuisRodicioRodicio in reply to wear1947

Thank you.

Luis

NannaB profile image
NannaB

Sorry I couldn’t find any tricks to help my husband eat. We avoided the PEG until 2 years after it was first recommended by the Hospice. My husband changed his mind (using thumbs up when asked if he thought it time) when a pressure sore would not heal and he was losing lots of weight as he wasn’t eating or drinking enough. He was also suffering from constipation. Once the PEG was fitted everything improved, the sore healed quickly and he even put on weight. For months it had taken him nearly 2 hours to eat a liquidised meal. With a PEG we could go out several times a week and even go into restaurants with friends as my darling had a pump in a back pack on his wheelchair so I no longer had to feed him. At home I gave him the feed with a syringe. Right up until the end he could still enjoy ice cream by mouth and loved Bailey’s poured over it. A bit messy but he loved it.

Best wishes

XxxX

Karynleitner profile image
Karynleitner in reply to NannaB

Can you tell me how long he lived with the peg and how difficult it was to care for? My husband can eat and swallow soft foods and thickened liquids. He does get upper chest congestion and an awful gurgling. He does not clear his throat or cough with any strength.

He eats, but not enough. Some days liquid intake is good, some days not. Everyday I spend half of each day trying to get him to drink. A peg may be in our future.

NannaB profile image
NannaB in reply to Karynleitner

It’s so hard isn’t it. Colin lived for 10 months after having the PEG fitted but could have gone on for much longer. He decided he had had enough and wanted to me to let him go. He did this by pulling on the PEG tube with one finger while I was feeding him, making it difficult. It was a few minutes before I asked him if he was asking me to stop and his thumb went up. I called the GP who came and asked if he’d had enough of life as it was and again his thumb went up. He asked several more questions and then told me it was Colin’s decision and I could stop feeding him. Two days later he indicated he didn’t want liquid so I just did mouth care, spraying a little water to keep it moist. It was the most peaceful 11 days we had had for 6 years. All our friends and family came to see him and he was able to squeeze all of their hands. When he died he wasn’t on any medication at all. There was morphine ready here but he indicated he didn’t need it. He had no chest infections, pressure sores etc and was able to communicate with thumbs up until 2 days before. That evening he went to sleep and didn’t wake again. 2 days later I told him I loved him, thanked him for the happy 44 years we had been married and said I would be OK and it was time to go. He left me within 2 hours..

Fitting the PEG in hospital only took 20 minutes under local anaesthetic. I found it very easy to use. The district nurse gave me a training session. The food goes via a syringe into the stomach and it’s just a case of flushing through with water to keep the tube clear. I also had a pump which did the feeding for me but Colin liked the contact of me next to him so I often used the syringe at home. It was great going out though as the pump fitted into a rucksack on his wheelchair. I saw a photo of him yesterday exactly 3 weeks before he died, taken on Hastings beach where we spent the day with my brother and his wife.

It was his decision to have it fitted and when asked weeks later if he was pleased he had made the decision, thumbs went up.

Best wishes.

XxxX

LuisRodicioRodicio profile image
LuisRodicioRodicio in reply to NannaB

Hi NannaB!

Thank you for sharing these hard experiences that I think help those of us who have to go through there.

A big hug.

Luis

Megabrew88 profile image
Megabrew88

Hi Luis,

What about using a syringe to feed her.

Sorry not much help here as we didn’t encounter this problem until the last week when my B refuses to open to eat and would bite or clamped on the spoon to express his unwillingness to eat.

Best of luck and stay strong.

Mx

LuisRodicioRodicio profile image
LuisRodicioRodicio in reply to Megabrew88

Thank you

Luis

ncgardener799 profile image
ncgardener799

Our neurologist has discussed Botox for several problems associated with PSP. So far we have not needed to initiate using Botox, but it is an option our Dr has offered if needed at a later time.

LuisRodicioRodicio profile image
LuisRodicioRodicio in reply to ncgardener799

Thank you ncgardener799.

Luis

Nanny857 profile image
Nanny857

Fortunately we didn't encounter this difficulty as W had indicated he didn't want peg fed.

I was going to suggest feeding by syringe and I see others have too, so maybe worth a try. I hope you find a solution.

Thinking of you.

Lots of love, Nanny857xx

Thank you Nanny.

Hug.

Luis

Caninedoc profile image
Caninedoc

Same situation here. My wife started about 9 months ago with a progressive inability to open her mouth. Is receiving Botox now every three months. Haven’t found correct dose yet but does help for a few weeks. Only able to open mouth about 5 mm. Past two years tube feeding. Started with peg tube then after six months we place a mickee tube which I would recommend instead of peg. Two yrs ago severe dysphasia and weight loss. Even with puréed food would take me at least 2 hours each feeding. I asked my wife that she has two options either we place a tube or continue as we are and you won’t be here within 6 months. She chose the tube. She is doing well on her nutrition now and has gained her weight back

Hi Caninedoc!

Thank you for sharing your experiences that I will keep in mind.

Hug and luck.

Luis

raincitygirl profile image
raincitygirl

Luis, I have no advice but wanted to send empathy. Sorry things are getting worse.

Hugs,

Anne G.

LuisRodicioRodicio profile image
LuisRodicioRodicio in reply to raincitygirl

Thank you Anne.

Big hug.

Luis

You may also like...

Not opening mouth for food.

it with a spoon. At one point she stopped opening her mouth and when I did get her to take some she...

Open Mouth with PSP

woke up Sunday morning his mouth forced open, we waited all day for his mouth to return to normal...

Swallowing difficulty in PSP

diagnosed with PSP 6 years ago. He is findings huge difficulty in swallowing food & liquid. Can...

Communication difficulties

mother. She has very advanced PSP and can no longer speak or write or even indicate yes and no...

Opened the curtains...