Excessive saliva

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Jfmitch38

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My wife has excessive thick saliva, I give her a pill through her PEG tube which kind of thins it. Is this a common thing is there something to help her. She wipes her mouth with wash cloths.
 

jazzdoc007

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How is this for service...a response within 15 minutes of posting? Hopefully....a useful response as well...
In answer to your question, salivary issues of all kinds are very common in PALS, and vary significantly from one PALS to another. Additionally....in an individual PALS, such as your wife, the specific salivary issues often change within the course of the disease. You noted that your wife has a G - tube and it sounds like you gave hean expectorant (a medication that, as you noted, 'thins' salivary excretions). I am the primary caregiver for my mother, who was officially diagnosed in 2/2016. For some time, we have been dealing with somewhat alternating salivary issues. Specifically...at times, her issues are similar to those you describe, thick saliva that is difficult to clear, resulting in 'uncomfortable and scary' choking episodes. At other times, it appears as if a saliva faucet has been turned on, and lacking the facial musculature necessary to form a seal with her mouth - this can lead to embarrassment (from her perspective) in public and in any situation, inconvenience. Fortunately (something that can only be thought of this way in PALS and others with similar issues...) we are headed to the hospital tomorrow, where she will have a G - Tube port placed, and possibly a diaphragmatic pacer as well. I bring all this up to say that, in PALS and everyone else, the degree to which an expectorant 'thins' secretions is directly related to a patients hydration status. Since most work by increasing the water content of the secretions....no H20, no thinning. Finally, in my mom's case, a few different meds have been used at times, to treat salivary issues. For those times when it seems like the faucet has been turned on, she was given 'atropine drops'....which she would use by putting one or two drops under her tongue. This medication is indicated for ocular issues....but 'dry mouth' is one of the side effects....which is taken advantage of in PALS. Besides tasting terrible, it was difficult to gauge how much she was putting under her tongue - and most of the time - the dry mouth was worse then the salivation. She has been on Neudexta for some time. This med is typically used for 'pseudobulbar affect' issues (heightened emotional responses to issues/situations that did not provoke these responses in the past) - but it also helps with excess salivation and drooling.

As usual, I have written much more then I intended to. I hope it was possible to locate my responses to your specific questions within all the other stuff. If not - adequate hydration would have served as an adequate response.... but, oh well...

Paul
 

jazzdoc007

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Well....I started on it within 15 minutes ; )
 

lgelb

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Our standbys for the saliva/mucus/nose/throat complex included a baby nasal aspirator, papaya tablets [obviously, in a tube you would use cut juice], warm liquids, nasal steroids, Nasalcrom, saline drops and sometimes essential oil diffusion. Of course, some of these, for safety, require more bulbar musculature than others.
 

Duker52

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I'm curious about the use of papaya tablets. I was given a prescription that I was supposed to take four times a day. I was hesitant, so I never took them. Papaya tablets, however, intrigues me. How much and how often should one take it? Would papaya juice have the same affect? Bill
 

Bob R

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I have bulbar onset ALS and my saliva, if left alone, is ridiculous. I also have extreme yawning, which I see as a muscle spasm. Left alone, I will yawn every minute or so. And when the yawn is near the end, I grind my teeth mercilessly. Oh and since all the muscles around my mouth are gone, including my tongue, I bite my tongue, lips and cheek very hard.

My high tech solution ? I take a plain white paper towel, fold it in half again and again, until I have a towel about 3" square, which I keep in the corner of my mouth. For some reason, I don't yawn with the towel in place. I still grind my teeth, but the towel is a good cushion. And the saliva is less and the towel soaks it up. And it also cushions my tongue, lips and cheek. Pills are not always the answer.
 

Firefly

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Thank you.
I'm going to try that!
 

lgelb

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Bob, we used the folded paper towel ("select a size" for the half size) but to "spit" into. So it has multiple uses.

Bill, Larry took a Natrol papaya tablet when he felt congested/queasy, usually after meals. You can take 2 but because of his warfarin, we tried to be consistent. He preferred that but others have used papaya, pineapple juice (cousins) and Larry also got pectin from his Luden cough drops, which he was able to suck on. It would be trial and error to find what works best for you.
 

Jfmitch38

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Where do I get the Juice?
 

Jfmitch38

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She is on Glycopyrrolate, 3 times a day? Any feedback on this drug's use? Keeps getting more and more with frequent need to urinate, at night little or no sleep due to up to urinate.
 

tripete

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I had in the past mentioned that Alka-Seltzer had all but removed my Phlegm issues. This continues to be true and I highly recommend it. It was unbearable before I started the daily regiment and now is virtually unnoticeable. A note on this is that it does not work instantly it seems to take a day to work, so take it daily, and during allergy season twice a day and you will see improvements if not elimination of phlegm all together.
 

affected

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Pete are you saying it also stopped saliva issues? I thought it was phlegm?

Most PALS don't actually have excessive saliva, we produce around 2 litres per day and swallow it constantly. When the lip seal goes and swallow is poor that saliva comes out of the mouth.

An important thing to remember is when this happens you also need to give extra fluids as usually you would swallow and recycle all that saliva!
 

affected

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Jfmitch38 your wife seems rapidly progressed with a peg already in and only diagnosed in the last few weeks?
 

tripete

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I had not considered the differences between saliva and mucus. I just saw a lot of the same mucus cures (like papaya) being suggested and did not consider the difference. Is there anything that helps with saliva then?? It must be just that we do not swallow it properly at some point. It seams like gauze or a towel is all that could help that.
 

hjohnson

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is this plain alka-seltzer or the cold remedy?
 
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