Choking/gagging w/ Bipap

[brooksea]

My husband is constantly gagging and choking, using Kleenex all the time to catch secretions!

Lately with the Bipap, he tries to go to sleep and then - BAM - he starts choking and "spitting up" into the mask and hose!

Anyone have any suggestions?

He now has the scop patch to limit saliva, but he still has a problem with drooling. Is it all related?

 

[Patsy]

Does he have a warm mist humidifier?
Is because the air air is dry or is he swallowing air?

 

[rose]

CJ,

There seems to be a connection with the mouth being open and salivation trigger. I don't understand the connection, but it has to do with the position of the jaw.

Is his mouth starting to fall open a little when he relaxes now? And if so, if you could find a strap that keeps jaws all the way shut it might cut back of the saliva.

I have dry mouth (my own special version of ALS I guess) but if I have to have my mouth held open a little, it will make me drool. Its not like I'm drooling because my mouth is open and hence my lips don't stop it; but rather it causes the saliva to actually be produced (does that make sense?)

 

[brooksea]

Thanks y'all.

He does have the warm mist humidifier.

He has the full facial mask.

Maybe he shouldn't drink the Boost before bed.

How do you handle the choking when it obviously is saliva? I really know the answer.

 

[Patsy]

I can't do without my chinstrap, try that and see if it makes a difference!

 

[Ronelle]

Jimercat,

Can you please give me the correct spelling of "scop patch" that helps with saliva. I went through forums to find information on that but found 3 different spellings and not much about it. I wonder why do we have to much saliva? Nothing is supposed to happen to glands. This is a disease of nerves and muscles?

 

[BarryG]

Ronelle, it's not so much having more saliva as it is the inability to swallow what you have and that your lips don't close to keep it in your mouth. And because the mouth hangs open the saliva tends to be thick and gooey. Gag!

 

[brooksea]

Ronelle-

Scopolamine patch. It is also apparently available in pill form. It is mainly used for motion sickness.

Barry hit the nail on the head! The tongue becomes weak and cannot handle the saliva. The tongue is a very long muscle. You don't realize how many times you swallow during the day as it is second nature.

Patsy- Thank you for your suggestion, but he tried the chin strap and hated it.

 

[hopingforthebest]

Hi CJ

I would definitely call the ALS nurse tomorrow and she can maybe order a R.T. visit to check things out on his bipap. Does not sould bipap related but would like the experts at ALS clinic give you their thoughts.

Will be thinking about you both.

Patty

 

[Ronelle]

My swallowing is still fairly good but the saliva............ I make an effort to swallow and seconds after, my mouth is full again. But is does not matter why, as long as I can make it less with medication. I am getting frustrated with "say it don't spray it!

 

[sharonca]

Jimercat - have you seen the pics of the new nose pillow bi-pap device? I think Alley posted pics on PLM. Looked very interesting. It allows one to keep their glasses on and have their mouth free. My case (I have the nose mask) is that I drool out one side and am dry as sandpaper on the other. If I cannot keep my mouth closed the air goes in my nose and out my mouth - no breathing. Makes for an interesting night of waking - closing my mouth - trying to get my mouth all moist by moving saliva around with my finger - and trying to get back to sleep. I'm thinking of seeing if I can get what Alley got.
Sharonca

 

[Jeannie]

Thinking of you, My MIL has a horrible drooling problem that nothing seems to be solving, with her though I think it is different at night as the drooling subsides a little.

 

[GlenBrittle]

Hello Everyone , my name is Glen and I drool . I can put enough into a full-face mask that it gets cold and Eeeewwwwww. {{I have never been to AA - no truly}}

My Pulmo doctor gave me a script for Atropine 1% drops. 2 of those under the tongue before bed seems to do the trick. Yes, those are eye drops. But it works for me.

As for the mouth open, I use a full face mask. Even when my mouth falls open , I still get the air pressure needed.

Hope this info helps
Glen

 

[topsfan]

Hi Everyone, My mother has ALS, uses a Bipap and was doing well with it. Her major complaint is the bridge of her nose hurting and about a month ago she had us take the humidifier off as she got a bad choking spell and blamed the moisture in the humidifier on it. She wakes up with the thickened mucus, etc. I'm also wondering how we can tell if the settings on the bipap need changed as she seems to be more fatigued and yawning more, etc. throughout the day now. She's being stubborn and refuses to rest with the bipap during the day for an hour or so, reserving it for night use only. Any suggestions?

 

[brooksea]

topsfan,

When my husband was having difficulty sleeping and using the Bipap, I emailed the ALS Clinic he goes to and asked them about increasing medication dosage and upping the Bipap settings. They simply asked the following:

1. Difficulty getting to sleep or staying asleep?
2. Is he having any pain that is keeping him awake?
3. Is this new since starting Celexa?
4. What time does he go to sleep?
5. How long does he sleep?
6. Is he napping during the day and if yes, for how long?

This will help us to decide what to do next re: Sleep.

Increasing his IPAP pressure may also help with the sleep.

I answered the questions and they called the RT at the DME company. He came out and adjusted the settings.

My husband felt the adjustments helped, however, he is still having difficulty using the thing! He complains of dry mouth and pulls the mask off and shuts down the machine.

You need to get with the clinic your mom attends and talk to them about the symptoms you have described.

Good luck!

PS-

As far as the redness on her nose, you probably need to address that problem right away. This could be the beginning of a nasty pressure wound. I searched the forum and found what others have used to combat this situation. The pads and patches, such as Duoderm and Granuflex are rather expensive, but maybe they can be prescribed and covered by insurance, I don't know. Also, have you tried vaseline or chapstick on the gel part of the mask that touches the skin?