Stuck cough on the throat

[Candor8]

Hi Everyone,

My mum had her meal this evening and looks like the food went the wrong way, she has been coughing, she feels like there is cough around her throat that she can’t seem to cough, Has anyone experienced this?

[Eaton7]

if your Mum is still not comfortable by now then do get her checked by a doctor as she may have food on her lungs which will quickly lead to a fever and then Aspiration Pneumonia.

If she is now comfortable with no fever then you are OK for now but please get in touch with Speech & Language team to discuss her correct food consistency level.

Best wishes.

[Candor8 in reply to Eaton7]

Thank you, she is better now.

[Bergenser]

I'm sorry to hear your mum is encountering this problem. Unfortunately most PSP patients will experience increasing difficulty with swallowing food and drink. Choking/coughing episodes can get frequent and distressing. As Eaton7 pointed out, there are risks of severe complications and it is important to get professional advice. I wish you and your mother the best 🌻🫂

[Candor8 in reply to Bergenser]

Thank you, getting a speech therapist to check her out next week

[Hopeanywhere]

yes, as others commented difficulty swallowing is common. So too is controlling the diaphragm to push air out of lungs with force, and probably any muscle movements to close throat to cough rather than just pant. My mom was able to sometimes do little throat clearing if I helped gently push in a quick staccato fashion on her upper tummy on the diaphragm, timed with a breath out she was doing (so watch her rhythm of breathing and try to help amplify). Coordinating the breath and the throat mechanics at the same time is as too tricky for her, but she was able to do one aspect and then I could help with other.

This was very useful for immediately clearing food when something seemed to have started to cause some coughing. We were already doing various puree mixtures and thicker liquids like half and half (great for calories if it’s getting harder to eat enough for energy)

Make sure when she’s eating she is sitting upright but with chin tucked a little bit down. Try swallowing yourself in all different positions, as well as really noticing how exactly you cough and clear throat, all the different parts of body that are working together to better understand how to assist and what can go wrong and how to position her in different scenarios.

[Hopeanywhere in reply to Hopeanywhere]

I should say try pushing on your own diaphragm first a bit, see the pressure and also notice how it feels if you do or do not tense your abdominal muscles beforehand. The right pressure is crucial, as well as timing and position. Talk through it with her, even if she can’t speak back. Work on the timing with the breath. It’s useful to get a full breath in that is slow (faster sometimes sets off a cough response too soon) so that you have enough air to push out a cough. One will naturally do a rather quick breath in after a cough or pushing air out, so making sure she’s upright even leaning a little forward will ensure saliva doesn’t get sucked right back. I found it helpful to think of the anatomy of the mouth and throat and neck, assess my mom in profile often, to make sure gravity would assist not hinder. Drooling will eventually occur if it hasn’t already as that swallow ability slows down.

I was able to never once have severe aspiration, even though mom lost complete ability to swallow, even saliva at the end. But I know that it’s fairly common for a lot of people, depending on how long they have the disease.

[Candor8]

this is so helpful, thank you so much

[Hopeanywhere in reply to Candor8]

Check out my other replies to other posts. I was my mom’s sole caretaker for 4 years and I tried a few times to write some advice here in response to questions - I think if you click my profile you can see all the replies I wrote. I never got around to my own posts, was too busy while caretaking, and too melancholy after :/ but I am happy to help others through this hideous disease.

[SimonandMaria]

With PSP, over time, one loses the capability of caughing, be it a necessity because of food aspiration or simply because of a virus/flu. We were prescibed a very good machine called "Caogh Assist" We used it quite often and i beleive it gave my wife a lot of relief specially due to the fact she had difficulty in coughing herself.

[Dosco]

As PSP advances, swallowing food becomes increasingly difficult and aspiration can occur leading to pneumonia. My wife who recently exhibited these symptoms was examined and slowly pureed food was provided by a dietician while she was in care, Ultimately, she had to be fed slowly as she no longer had the swallow reflex and gravity was how some nutrition got into her stomach, Protein beverages etc. were also given and she was hydrated often. Please contact a dietician familiar with PSP to develop her meal plan.

[Candor8 in reply to Dosco]

Thank you for your reply, we really do not have much knowledge about this disease in Nigeria, most of her food have been puréed, i am making more research and it has better, just cases of sudden cough while eating puréed food.

[45purple]

I would have mum checked out just incase of aspiration. Peace of mind for you and maybe ask for speech & language to access her swallow 💜

[Candor8 in reply to 45purple]

Nigeria is such a weird place to have this disease, I was given a contact of a speech therapist and she is not responding to her calls for a week. But I will keep trying, thank you for your reply

[SunriseLegend]

This is a really helpful discussion. My husband has swallowing difficulty which is under examination by the SALT team so it is helpful to know about others experiences

[search4support]

Also ask the GP or Speech Pathologist about a post nasal drip treatment. It may help a little to reduce the amount of mucus that is running down the back of the throat that causes a lot of throat clearing. We use Dymista Allergy nasal spray to help alleviate. It’s a very challenging condition. So sorry to hear you have had difficulty accessing health specialists. This site has been like a source of truth for me for the last 18months.