Suctioning

[BarryG]

Hello friends, I am having increased difficulty doing my own throat suctioning because of failing arms and hands and want to ask anyone who is doing suctioning on their PALS, how do you do it and how well does it work? When I do my suctioning I am going quite deep to find the gagging bit of goo and I have no idea how anyone else would do this for me. I am getting worried about this and although I'm going to see an ENT about larygnectomy/trache soon I would like to know if others have dealt with this.

 

[laurel]

Just a comment on suctioning Barry--from my nursing days we were instructed to not be too vigorous with the suctioning as it can easily traumatize the throat tissue which then can cause more secretion of muscous i.e. you start up a cycle of increasing the mucous if you are too heavy handed.
Laurel

 

[joelc]

I have been there for several years now. My wife and caregivers do it and it seems to work okay. It was a transition having to let them do it because I can't. It has worked out okay.

 

[LizT]

When we suction out my PALS mouth, we can usually stick the wand just to the back of his throat- then the gag reflex kicks in.
It is so much easier to get the stuff out when there is a trache to suck out instead of just the mouth.
Im sorry youre going thru all of this. Can I ask what you are worried about when it comes to someone else doing it?

 

[Jellycat]

Hi Barry,
I do this for my mum several times a day. At the beginning we were both nervous & took it gently. I got her to signal to me how deep to go & we worked out a sign for stop. As we got more familiar we didn't need that any more. Obviously I can't feel the goo in the way she can but as I move the yankeur to the back of the throat I can feel and hear a difference in sound when I'm nearing the goo. That helps me know where to go. I've also noticed there are spots where stuff tends to build up.

I'm sorry this is a worry for you. Would it help any to tell the person who will be suctioning of your worries?

 

[BarryG]

The stuff that causes me so much trouble is way down, much farther than the back of the mouth. Doing it myself I can feel around with the suction wand and can feel if something is gagging or not. I have a cough assist and it does work but I still need to do the deep suctioning to get the goo out and I'm just not sure how well someone else will be able to do it when it sometimes takes me almost an hour to clear my throat.

 

[LizT]

I think it also helps to tell them to keep moving the yankeur while its in your mouth, almost like rolling it back and forth. Ive noticed that with my PALS, since his tongue is comepletely "dead", like i would assume yours is, that sometimes the tongue will get "sucked" and stuck on the end of the yankeur.
I actually prefer to use the trache suctioning catheters in my PALS mouth. Its alot thinner and more flexible. Plus, when his jaw clamps down, its less likely to hurt his teeth or to break off into his mouth.
Barry, it sounds to me like you could really benefit from a trache. Even if you dont plan to vent. You could use your time and energy on so much more than suctioning! Why not use those hands on Beth instead of spending an hour suctioning yourself!
Do you gag and throw up at all when you have to suction so far back?

 

[BarryG]

Thanks Avril, I use the sound of the suction to help figure out where to go too. I can see a problem in my current home care helper situation where I have a dozen different (wonderful) women looking after me. I can't teach them all and have no control over who comes to help me. Such fun

 

[Jellycat]

I believe there is also a soft attachment for the suction machine which can go down the throat. I haven't seen it but hospice used it on my pals & told me about it.

Barry, maybe you could try the suctioning out with another person while you can guide them in what helps you?

 

[Jellycat]

Oh yes Barry, I do see the problem. We have helpers coming in here too but few would go near the suction machine. mostly too frightened. Though I think the regs here suggest they should be trained by a nurse before doing it so that's a factor in our situation too. Is there one more regular helper or a member of the family you'd feel comfy with and who's there at times you might need the suction? Sending hugs (goo free).

 

[BarryG]

Well, this morning I could barely raise my arms (they are always weakest first thing in the morning) up to do my suctioning. I am hoping that once I have a feed I will have more energy and can do a proper mouth cleaning. I had an awful half hour last night of gagging and choking but finally got ahold of the offending goo and sucked it out.

So tired....

 

[joelc]

I am starting to be able to relate to the problem you are having. Sorry it is happening to you as I now know what a bother that is!

The stage you are reaching is the hardest adjustment you will make as you have to start relying on others to do that for you. It can be frustrating trying to teach someone else how to do it. It takes a lot of patience and time! I am thinking of you buddy! Try to not get discouraged. This too shal pass.

I understand ........

 

[Jellycat]

Oh Barry, just thinking of you and sending love. Sooo hard making this new adjustment. I cried buckets over the loss of Mum's hands & arms and I am only the cals. It's exhausting....but there is life & laughter after this hard patch, promise.

 

[BarryG]

Thanks Joel and Avril, I am feeling a bit better now. My helper came and fed me and I did get a bit more arm strength back so was able to do a good cleaning but I know that it's only a matter of time. Time to get a full time care person, I love all my lady friends but I do need one person to be able to help me. What a life!