Hope you're doing well despite these worldwide circumstances,
I was wondring if some of you has already witnessed/lived the "Coughing/Choking on nothing (mostly at night ) daily scenarios for PSPs ...
My mom suffers from that ... mostly at night, once laid on bed & wakes up at night choking / coughing ... Is it saliva ? her mouth seems dry, no mucus/Phlegm seen inside...
Thanks for any piece of advice
HAVE A GOOD ONE
Written by
Adamxd
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hi. well of course everyone's different, but currently my husband is experiencing this and I've been told that yes everyone has saliva that they can choke on; it's someone with PD or PSP to choke on it because of weak muscles in throat and maybe inability to cough deep enough to bring it up and rid themselves of it. My husband cannot spit out anything that he might be able to bring up to his mouth. If he does, then he re- swallows it, and is absorbed into the gut which is okay, as I understand it. You just don't want it in the lungs. When my husband has what the respiratory therapist calls a wet cough then there is something that needs to come up and a lot of times with him it is phlegm. He now has, as a result of a recent hospital stay, and swallowing test, a cough assist machine which is basically a suction machine and he's getting positive pressure treatments, which is forced air pressure that helps him to take a deep breath, which he doesn't do anymore and deep breaths help coughing which helps bring up anything and therefore clear the lungs. As it was also explained to me, he is now many times not receiving the nerve signal from the brain to start the cough mechanism ( silent aspiration). I think I have digressed somewhat from ur question. This all may not be what is going on with your loved one, but I think the info is important to know. God Bless her and you. This is THE single hardest thing I have ever had to deal with. My heart goes out to my sweet husband and to anyone in the same situation. You are in my prayers.
My husband used to cough alot when put to bed and during the night. And someone advised me to purchase a humidifier to ease the situation. So far it has been a success. It's only a vicks £20 one from argos with out the vicks. It might be worth a try? Good luck
Hi Adamxd!These are our particular experiences with PSP:
• Persistent cough. Use the syrup recommended by the physician. To avoid in the diet: coffee, carbonated beverages as pop or soda (or eliminate the gas by agitation before giving it to the patient) as well as chocolate, avoiding also orange, lemon or grapefruit juice, helps.
In acute attacks of cough taking some yogurt can help.
We switched to a pine and propolis syrup (ProtectSapin) from the health food store that seemed to help a bit.”
The “easterncedar” chat contributor indicates that: “The medicine in most cough syrups conflicts with the anti anxiety medication”.
• Phlegm and choking: The first thing is to remain calm during episodes of truly shocking coughs. The second is that a physician rules out an infection in the respiratory tract. Get a pulse oximeter to control. (Fever is an indication usually either pneumonia or urinay tract infection (UTI) in PSP patients).
• It is not a big problem that the patient swallows his phlegm. For phlegm to be fluid, it is important to drink liquids. Ten minutes steam inhalation from boiling water in a bowl with a few drops of some floral essence (avoid mint plants and eucalyptus) that is pleasant to the patient, a small spoonful of marine salt and some pieces of lemon, with a towel covering head and bowl helps. (One to three times a day (*))
• Inhalation of the mentioned water steam together with abundant oral hydration are usually sufficient to improve the fluidity of phlegm.
• A steam atomizer to keep the air in the room moist helped, too. (40% - 52% moist advisable.)
• Medications like "Mucosan" (Ambroxol hydrochloride) or “Fluimicil Forte-600” (Acetilcisteine) can help in some cases. Ask physician.
(*) We have observed that a steam inhalation session immediately before dinner can reduce appetite. We are trying to give her dinner "before" the "steam inhalation" and, for now, the results are better.
• In case of choking, raise both arms at shoulder height, breathe only through the nose intensely if posible. If not, inhale air intensely but not very fast through the mouth. Retain air a couple of seconds and then force the cough.
• Also here, to avoid in the diet drinks that can be irritating helps: coffee, carbonated beverages as pop or soda (or eliminate the gas by agitation before giving it to the patient), chocolate, orange or grapefruit juice, etc..
Note.- It has been described that: pineapple juice breaks down the protein very well and fluidifies the mucus (phlegms). It will have to be tested if the patient tolerates pineapple juice without coughing or choking. (Red1990 indicates that: the pineapple juice enzyme complex is available as a supplement called Bromelain. For people taking anticoagulants, bromelain and melatonin have the same risks of gastrointestinal bleeding as aspirin).
There are some foods to avoid…. things like grapes, rice, couscous, lentils, peas etc anything small was problematic as were spicy foods. Foods that crumble easily, cookies, crackers, stringy foods, sticky foods, etc.
• There is a suction machine which helped a lot with the very sticky phlegm. We have NOT used.
• A steam atomizer to keep the air in the room moist helped, too. (40% - 52% moist advisable.)
• The physiotherapists have exercises reinforcing trunk muscles to improve the cough response to choking. Engage a good speech/swallow therapist to learn swallowing techniques.
• Avoid dairy products, especially before bedtime, this seems to prevent the increase in phlegm viscosity.
• Raising around 15º a 35º (9” to 12”) the head of the bed also helps.
My mom was on a pill to dry up her saliva and also received Botox shots in her saliva glands every four months. With this we kept her salvia and chocking almost under complete control for years and years. Even when she passed it was not from aspiration or chocking or phenomena, it was because she could no longer swallow. These things helped us tremendously. Hope it gets better.
Yes. Drooling increases and there may be pocketed food in mouth as chewing and eating in general is more difficult. A hospital bed may help with incline of upper body. My husband has posture issues with head down and back and shoulders bent over so airway is not open.
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