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    choking/ cough

    Susan
    Maybe you can help me. My husband has PPMS and is paralyzed from the neck down. We move him with Hoyer lift, feed him , cath him ect. My concern is this. As his MS progresses his breathing is getting shallow. He coughs when he talks for any amount of time. What do I do if he chokes on food or drink. If he gets a bad cold how do I get mucus out of his throat? He can't blow his nose anymore and gets so frustrated when I can't clean it. I have a little blub syringe, (for babies) it does nothing. I have a RX for respiratory therapy eval but have not found anyone that will help teach me. They are saying he needs to go to nursing home....not on my watch. Any ideas would be greatly appreciated

    #2
    When he has a cold, you can do some chest PT. if possible you want his head lower than his chest. Gravity will help the drainage. You can percuss anywhere the lungs are protected by bone. Your hands must be cupped. Use a firm touch, cover with a towel if you think he will bruise. You want a good rthym. About a minute and a half for each lobe of the lung.

    You can buy a suction machine. It can be used in the nose, throat, etc.
    If no one will teach you, google.
    Good luck.

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      #3
      Nana:

      Please go to the Wellspouse website, for caregivers of spouses who are disabled. There are many people there who care for paralyzed spouses with ms and other diseases and they are very experienced in all aspects of care. I know they can point you in the right direction. I am a member there and it has certainly helped me!

      Good Luck!!

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        #4
        Can you get Home Health?--the nurses should be able to teach you and maybe connect you to some other services that can help you deal with this.
        Remember to take care of yourself as a caregiver you can get burned out and that does not help him -- it is fantastic that he has someone like you.

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          #5
          A speech therapist would be the person to see about swallowing problems. Your husband obviously has complex issues.

          I'd definitely discuss his issues with his doctor or a nurse in his/her office. They SHOULD be able to give you some ideas re: help in your area.

          Much good luck, and please do keep us posted!
          “The world breaks everyone, and afterward, some are strong at the broken places.” Ernest Hemingway
          Diagnosed 1979

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            #6
            Sorry to hear about your situation.

            The biggest concern is aspiration- when a liquid or an object is inhaled into the lungs.
            Having food, drink, or even saliva from the mouth go into the lungs can cause aspiration pneumonia. His coughing and mucus may be indication of such.

            I would get him checked out as soon as possible.

            Medically he should be checked out as he may need medications along with the respiratory therapy prescription (I don't know how long ago you received the Rx)

            Another aspect of care is assessment from a speech and language therapist (SLP) as they perform swallow tests to assess different foods and liquids.
            They check to see how well he can move the muscles of his mouth and how clearly he talk.

            They may need more information about his swallowing and may use another swallowing test - using x-ray with barium to swallow.
            You may hear different names for this test.
            Some names are:
            videofluoroscopic swallowing study (or videofluoroscopy),
            modified barium swallow (MBS),
            esophagram, or cookie swallow

            These assessments will show if food is going into his airway instead of the stomach (aspiration),
            which parts of his mouth and throat may not be working well,
            what kinds of food are safest for him to swallow,
            and if certain positions or strategies can help swallow better

            The SLP assessment requires a prescription from his physician.
            I strongly suggest getting one and doing it as soon as possible.
            Be Well,
            Susan

            Comment


              #7
              I just had a swallow test, and it's an easy test...but would be harder for your husband because it has to be done in the radiology department and it sounds like in his condition that would be a task in itself.

              They position you beside an x-Ray machine, and then while a speech pathologist, and a radiologist watch the x-Ray, they feed you different consistency foods.

              It's very informative as far as aspiration, they can also even tell you if your tongue is working right or is sluggish. Then the speech pathologist makes recommendations as to foods you should avoid.

              Comment


                #8
                This is one area i have extensive experience is as i care for my wife 24/7.

                For nasal passage I clean every day with cotton buds. Usually dip into water first then squeeze out any excess. This is to reduce trauma in the nasal passage.

                I also have a suction machine to take care of the flem that she can’t cough all the way up. They cost around $700-$800.
                Secretion plugs will also develop.

                With PT therapy and going from side to side in bed usually brings it up. A towel across the chest with hand cupping PT and or both also across the back over the lung area.

                Silent aspiration and pneumonia is almost unpreventable.

                However HERBS of tea like Dandelion root tea, and other lung related teas will help with speedy recovery together with antibiotics.

                My wife can recover from full blown pneumonia in under 7 days these days.

                She has had pneumonia more than25 times in the last ten years. But these days it’s under control at around once a year now.

                At the first sign of green or discoloured mucus always seek medical advice ASAP. At the very least an x-ray can be taken to identify any lung issues. Things can turn nasty very fast if not seen to quickly.

                Moving side to side every 1 ½ hrs is what is really needed especially overnight. I have been doing that for my wife since late 90’s.

                If you haven’t already you will need to consider an air pressure mattress to prevent bed sores and they are around $2,000 plus. Hopefully you are covered by some subsidy medical scheme in your area. I have seen cheaper ones like this http://www.medicalairmattress.com/excel5.html

                I hope this advice helps

                Comment


                  #9
                  P.S nana5406,

                  I just noted at the end of your post you were told he needs a nursing home but not on your watch, so good on you!

                  My wife will never see a nursing home either. It has been a long hard road of learning to care for my wife 24/7 when she was dx with end stage MS late 90's. everyone gave up including doctors.

                  you can see some of my posts regarding this.

                  I feed my wife via a PEG tube now. She had a NGT (nasal gastric tune for 8 1/2 years).

                  The PEG is much better by far.

                  It's an extremely hard and very difficult and challenging path you are going down. You must love him very deeply as i do my wife. Don't give up as Love will conquer all and get you and your husband through this!

                  any questions you want to fire at me on 24/7 home care please do so anytime or email me in my profile.
                  Good luck!

                  russ

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