My wife is having increasingly frequent choking episodes even with thickened drinks etc., Are there any devices out there that can be used to suck out ant accumulation of mucus and drinks etc.? I have seen that in the Americas they do have home use vacuum devices, does anyone know whether they are available in the UK?
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Scottoppy
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Scottoppy
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Yes there is Scottopy, I asked the same question here a few years ago and someone recommended a DeVilbiss Medical VacuAide. I printed out the information from the DeVilbiss website and took it to the GP. He said he had never known anyone to have one in a home before so I told him about this group and that others had received one. Very soon after the district nurse brought it round giving me instructions on how to use it. It was a bit noisy but a life saver. There are others on the market.I hope you are successful in getting one.
• 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. (Bazooka111 provides this experience regarding phlegm generation: "Ipratropium Bromide and Albuterol Sulfate inhalation solution twice per day. We have been doing these breathing treatments for several months, and the phlegm has pretty much disappeared." I think interesting to ask the doctor.
• 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. Giving her dinner "before" the "steam inhalation" the results were 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, lemon or grapefruit juice, etc..
• Atomic 55: “I would recommend Hockney or Scolpadeine/Scopoderm patches. They work to reduce the saliva build up. As soon as I started them in him he stopped choking on saliva completely. Patches last 3 days”.
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.
• In stubborn cases some caregivers have mentioned the rental of suction equipment which seems to have helped effectively when the phlegm is very thick and sticky. The vacuum cleaner is called: DeVilbiss Vacuaide (see different types on the Internet). The caregiver “binnyrox” suggest: “Apart from the DeVilbiss suction machine - our respiratory therapist advised choosing a softer catheter - it will be less traumatic while still providing high suctioning efficiency.I use Sz 14 and it generally does the job with thick phlegm. If you aren’t very experienced (I wasn’t ) the RT also recommend placing an airway guide to steer the catheter in. That was a good tip”
• 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.
When my wife got to that stage, I think she mentally checked out and decided she no longer wanted to live like that. Within a matter of a few weeks, she was gone. I am not saying that this is your case, but you do need to prepare yourself for a possible outcome.
Yes I had one at home to use for my husband. It was provided by the local hospice free and was absolutely invaluable - and also easy to use. I would talk to your GP. Wishing you all the best with this.
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