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Thank you so much, Laurie!

We were talking about a hospital bed, and I think there is a way: I'll talk to my family and convince them to get it.

Gosh... I already know what he'll tell me about suction: he has to put it down his throat because that's where the stuff is that won't let him breathe... What can I tell him then? I could sometimes hear this stuff gargling deep in his throat... He hates his cough assist and tells me it only upset his throat even more..

My sisters are looking for pineapple juice - even that may be a problem...

He does have a BiPAP, with settings decided once by his doctor. That was last September, I think. I know nothing about those settings. I could ask what model the machine is, and I could talk to his doctor, too.

What needs to be cleaned in the BiPAP machine other than the mask?
 
Laurie;

You mentioned automatic setting of moisture in a humidifier if air is too dry.

We have several ways of moistening the air:

a humidifier in our heating system, a separate room humidifier, and the humidifier on the Trilogy.

I have two humidistats throughout the house so I can know the relative humidity.

Is there a range of relative humidity that Is recommended for PALS?

My wife sets the Trilogy to her level of comfort but when not using the Triliogy we rely on the other ways of controlling humidity.
 
Combining thoughts for NMD and Chinco:

1) Only distilled water should be used in a Trilogy/other BiPAP -- I'm not sure if pts are told this in every country. If distilled water is not available, cleaning frequency for the hose and humidification chamber should be increased.

2) But even assuming distilled water, besides the mask, hoses should be changed out every few months and the humidifier chamber should be rinsed out/cleaned of residue -- calcification often produces a white dust

3) For someone who is not using the Trilogy all the time, humidification of the home air however makes it most consistent from room to room is desirable. It won't match the Trilogy's environment because having air blown in requires more humidity, which is why the machine has a humidifier. There's no set percentage -- it should be based on the results (less discomfort, coughing).

4) Also, home furnace filters should be changed regularly, along with BiPAP filters.

5) As many PALS here could testify, BiPAP settings need adjustment as things change and progress, and even from minute to minute if someone is choking or coughing. So yes, knowing the machine type and settings so you can tell someone in Poland how to adjust them, and trying some adjustments that might help the saliva situation are good ideas. When he began using the PEG, that changed the secretions his body produced, as you might expect.

6) If pineapple juice is not on offer, lemonade is another option. Or tea with lemon, or lemon water if sugar is an issue.

7) I can understand going after what's "stuck" in the throat short-term, and he's already doing it anyway, but longer-term would really focus on making that unnecessary. Or at least using an olive-tip or similar attachment on the suction catheter to make the edge less intrusive.
 
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This is so super useful, Laurie, thank you so much!
I'll be following your suggestions as much as I can from the far.

I tried to do research about those olive-tips for the suction machine and I don't know how to find them. Would you know where I could look?

And one more question from my dad.
Today he had a very bad choking episode in the evening - he hasn't had those at all, only at night. It was so bad he couldn't breathe at all, and suction machine didn't help at all. Finally, my sister tried to push on his stomach from the back, and somehow that helped.

And he'd like to know if he can die choking on his saliva. Does this ever happen?

Kids won't let me write more here - pretty hectic with two little ones here...

Thank you once again for being an angel and so much help!!
 
Laurie;

Adjusting settings on the Trilogy. I assume your suggesting CALS make these adjustments. The pulminary nurse comes Tomorrow so I also assume she is the "go to" person for this question. I certainly am not knowledgeable enough although I have activated the menu and adjusted display settings.

For clearing mouth secretions (not yet a serious problem) and food debris my wife prefers Coke. Probably not the best option but effective. I think it is the effervescents. She is not thrilled abou trying pineapple or other juices.
 
Ernie, nothing wrong with Coke!

If you email me (I'll PM you), it's easy to learn how to change the settings, no more difficult than your phone, and something I believe every CALS should be able to do.

NMD, I got ahead of myself -- I don't know what kind of tip your dad actually has. Taking it down to what's commonly available, he should have something in a Yankhauer tip, like this. I chose this site to link because it has other products that may be helpful, but as always, price-shop for what's available generically and in similar form. In the case of the tip nearing the throat, soft is obviously better.

Side note -- for those who are doing nasal suction, the olive tip seems less available than it used to be, possibly related to the fact that one of the mfrs had a recall. We also used a baby aspirator -- the one with the longer tip.
 
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I haven't even started to solve one problem (what to do so that my family can change my dad's BiPap settings), and now a serious new problem shows up.

My dad stopped eating any food by mouth about 3-4 weeks ago. And now his jaw becomes more and more tight. This causes serious problems with tooth brushing - he still does it by himself, but says it becomes almost impossible, even just to open his mouth enough to brush it, and even worse to rince it.

I now freak out thinking what will happen if he won't be able to open it enough to do all the suctioning he still does by himself.

What can he do with those two issues? Is there anything that can be done?

Please help. I feel so terrified and helpless and depressed, and being far away is just killing me....
 
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