Can having cough cause respiratory failure?

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Erika

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Sep 21, 2016
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175
Reason
CALS
Diagnosis
06/2016
Country
US
State
Arizona
City
Mesa
My mom's cough has gotten her so tired. She is loosing her voice and is getting harder to understand her. She's has 3l laryngospasms in the last hour and a half. She is unable to use the Bipap because of her cough.

What is worrying us are her lungs. She is now the one asking my sister to put the Bipap on her when she almost always needs "reminders" to use it. She wants to spend the night on her recliner and says that if she lays down her lung feel like their're being squished.

Can this cough cause her to go into repiratory failure??? Her O2 level is between 92-94% Her blood pressure is 136/82 and pulse between 98-102 I don't know if this means anything. What can we do to help?? The doctor will see her tomorrow, but should my sister be taking her to a hospital??

Can things really go down hill this quick or are we just freaking out?
 
She can't handle the machine now, even though she wants it. Says it's going too fast and makes her feel more fatigued.
 
First, the vitals you mentioned: blood pressure, heart rate and blood oxygen level are all fine. They're better than my usual values and I don't have ALS or any other diseases.

The recliner is a good idea. I hope another member can tell you how set the PAP.

I don't know your mom's history or her condition; can she talk? My impression is that this is a temporary problem because of something making her cough. I hope you have an ALS-qualified doctor following her. I hesitate to go to the ER because ER docs and nurses might treat her too aggressively, knowing nothing of ALS. Personally, the 3 times my PALS had an emergency, I GLUED myself to her, never left her side, and I made sure nobody touched her until I briefed them about ALS paralysis and the need to support every limb in a comfortable position at all times, etc.

Respiratory failure in ALS can happen several ways, but I personally have NOT heard of it happening as you describe. In my wife's case, some of the Coke we fed her by dropper got into her lungs. That irritates the lungs, they must get infected, and in some cases, death occurs. But I don't see anything in your post to tell us that she is in danger of dying.
 
I hope she is ok. Is she seeing the doctor now? I would have said go to the hospital ASAP. I told you about my sister
 
My PALS had a pretty bad cough early on. His PCP gave him some cough medicine that helped but he wasn't using the bipap so your moms situation is different.

I hope she is doing better?
 
Erika,

It sounds like the settings need to be adjusted for the BIPAP machine. Laurie, on this site, is an expert and I am sure she can help you with this.

Sharon
 
I asume that these pO2 values have been measured during daytime ,
values during nightime below 90% should be worried..
When she did get the pCO2 measured from the arterical blood and what was the % ?

Udo
 
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I disagree that changing bipap settings is the answer without being medically evaluated. The bipap was apparently ok until she suddenly became ill. This is not normal progression. She is sick and I think the illness is causing her symptoms. Someone on bipap ( so in respiratory compromise to start with) acute respiratory infection and increasing respiratory distress needs to be evaluated. Add to this she is , I believe, very far from emergency medical services.
 
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Just to clarify-- I certainly agree that she needs to see a doctor for this and Erika states that she is scheduled to see the doctor tomorrow. I was not suggesting adjusting the BIPAP settings instead of seeing the doctor.
 
Yes, respiratory problems can go downhill drastically in a matter of a couple of hours. You are not over reacting. You just cannot take chances with any rapid change in respiratory status with ALS. Her O2 Sat. is a little low and her pulse is fast reflecting her respiratory distress. If a cough suppressant type of cough medicine doesn't stop the constant cough, her remaining respiratory muscles will tire quickly and although unlikely, she could get beyond the ability of BiPAP to help. She needs to be seen in the ER even if it turns out to be a wasted trip because she stops coughing and the laryngospasms stops just as you pull into the hospital drive!
 
Maybe some of you are unfamilar with the situation- though my advice would be the same if she were in downtown Manhattan for the reasons Diane stated. Erica's mom is out of the country visiting family. She left her cough assist at home. She got sick saw a gp who prescribed some cough medicine and is getting worse. She is in a rural area. Rescue will not get there quickly if needed. Even if they could it might be too late if things go badly. It happens. It happened to my family

Erica please update us when you can
 
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Thank you all. I haven't heard from them today, but no Mike. She is able to move her mouth but the voice is gone. At least for now anyway. Might be from the same cough. We have to see if it returns once her throat stops hurting.

Soonerwife, Sharon and Nikki, she was only using the bipap ocationally. Maybe an hour a day. Now she wants it, but can't stand it. Says it makes her feel more fatigued. The fist few breaths r good but then it goes faster and this is when she can't keep it on. I feel her needs have changed in the past days. But she also has not use it enough to tell. Trying to get a hold of the RT that saw her last time. Laurie has been of great help in the past (thank u Laurie!) Breathing through her nose was difficult too and she asked my sister to get her an oxygen tank the next day. She explained that her o2 levels were fine and that she needed to get rid of the co2. She helped her relax and put the bipap on her for as long/often as she could handle and that seemed to help.

She was given cough medicine. The fist day she had iiT she felt worse as we think her secretions were trying to come up, but can't cough them up. The next day she refused to take her meds because her thought was so irritated even eating was painful and lemon with honey was a strong no because it burned. But she was able to rest that day from having to cough all day and had a decent night. Yesterday she gave it a try again and the rest of the day was the same coughing dilema. Still can't find a cough assitant, but not sure she would use it anyway. Still looking for one anyway.


We don't want to take her to any hospital for the exact reasons and fear Mike motions above. But there are two hospitals where the als neuro she saw, works at and have great respiratory specialist. Kind of far andoooo expensive because it's a private one but I think this is our next step.

She couldn't fall asleep last night. She would doze off and wake right up, wider if she was afraid to or just not able to. Her levels were checked around 8pm with one of those things you stick you finger into. It mostly read 94% but went as low as 92%.

I will check to see how her night went and will get back. Thank you all.!!!
-Erika
 
I asume that these pO2 values have been measured during daytime ,
values during nightime below 90% should be worried..
When she did get the pCO2 measured from the arterical blood and what was the % ?

Udo


We don't know her co2 levels
 
Erika, who supplied the BIPAP? They may have an RT on staff who can help answer some of your questions. Some RTs aren't very ALS-literate, but some RTs really know their stuff and like helping people with tough questions.
 
Erika, please check your private messages. I'm going to send you the phone number of a professional who specializes in these issues.
 
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