phlegm and nausea

[ECpara]

My husband is still having bouts of nausea. We are certain it is caused by phlegm in his stomach, he has so much of it and he is unable to cough it up. He throws up globs of it. He uses a cough assist machine and suction machine and he's been using pineapple juice to thin the phlegm, but of course the production of phlegm won't subside. I'll be calling his ALS doctor tomorrow. How do I go about getting a prescription for a non-dairy based nutrition supplement like Compleat or Liquid Hope? We're thinking the milk base in his current supplements (Ensure and Boost) are the problem. Do we have it shipped to our home or is it picked up at a drug store like a normal prescription? He has Medicare (primary) and Blue Cross (secondary), how much would they cover? Any thoughts, suggestions? Geesh, after 3+ years of this disease you would think I'd know the answer, but this is new territory. Thank goodness all this phlegm hasn't caused pneumonia, knock on wood. Thanks!

 

[Atsugi]

One of the causes of thick phlegm is dehydration. When it becomes difficult for a PALS to pee, they restrict their liquid intake.

 

[affected]

Good point from Mike - when phlegm is thick the first thing is to hydrate really well. Often people feel they want to restrict fluids thinking it may settle the phlegm, when it fact it will only make it thicker and harder to deal with.

Most people don't realise that we produce an average of 2 litres of saliva each day. Often PALS believe they are producing excess saliva, when the issue is that they are not clearing it from their mouth.

Phlegm is not actually saliva however as it comes from the back of the throat, but the issues dealing with all that saliva can cause irritation in the back of the throat and produce more phlegm too.

Sorry I digress as I can't answer how you get your nutrition on prescription there ...

 

[ECpara]

Atsugi, he takes in plenty of fluids with his supplements and clear water flushes. It's his stomach that's really giving him a problem.

 

[lgelb]

From the ingredients lists, only Liquid Hope would qualify as a non-milk base. They have a list of DMEs by state who stock their product on the functional formularies Web site, and are also contracted w/ one who drop ships nationally (looks like that is the only one that serves GA). They state that it is Medicare-approved but your doc will need to write it, obviously, for reimbursement to be possible. A sample letter of necessity that s/he can use is also on the Web site. Meanwhile, you might just switch over to blended real food in the interim using non-dairy liquids as bases, since he is obviously uncomfortable and at risk. I know other threads have recipe links.

I agree that intolerance to traditional tube formulas (which I would avoid for nutritional reasons anyway) is a possible reason for phlegm and hydration is important but would also look at things like allergies and room environment (humidity, chemicals, dust, etc.) Some phlegm is unavoidable, of course.