Nausea while speaking

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KarenNWendyn

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Reason
PALS
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07/2017
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US
State
OR
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Southern Oregon
I’m wondering if anyone else has or has had this problem.

For about the past 3 weeks, I’ve intermittently noticed a wave of nausea coming on when I try to speak. At first it would be only with standing and talking. ( I can only stand for a few seconds using the wheelchair and the walker). Today it also happened while sitting. After it happens, I sometimes have a couple of dry heaves and then involuntary yawning with jaw snapping shut.

I’m guessing this might be respiratory with more diaphragm weakness, but I don’t know. The other thing I’ve considered is delayed gastric emptying as I often feel very lethargic for about 20 minutes after a tube feeding (Kate Farms, given by gravity feed). I have severely affected speech, and respiratory status is on the decline. I’m going to try using BiPAP a bit more during the day to see if that helps but also wonder what others think.
 
I thought respiratory too though I have no experience with this.

if bipap doesn’t make a difference consider trying a pump rather than doing gravity feeds. My sister did a pump intermittently during the day, asking for it to be connected and saying how many containers she wanted. She was in her chair so we just hooked her up wherever and it would run for whatever time
 
The fact you’re yawning at the end leads me to think it’s something respiratory. When you’re talking your exchange of air is being impacted. Maybe when you’re talking you need to stop and breathe deeply. I’m sure you already do that. That’s kind of miserable.
 
Mobilizing the vocal cords may be running up against incomplete glottis closure? So the snapping may be a spasm that is coming with that.
 
I'd be thinking a combination of slowing down feeds, maybe a pump as suggested, with more bipap.
A fuller stomach can put pressure on the diaphragm, and when it is compromised it doesn't take much pressure to affect a PALS.
Sorry it's such a cruel disease, too many surprise changes.
You can also try a pump feeding you overnight so that you need very little during the day which could help stop the nausea and free up what stuff has to be done during the day.
 
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