What does my cough indicate?

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blitzc

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In another recent thread, an observation was made that a cough could indicate aspiration. I cough, and have for some time, often. When exerting myself and taking a deep breath but also when eating. Breathing while eating is difficult and makes the process of eating exhausting. I don't choke too often but it does happen once in a while. So how do you know if the cough is breathing related or swallowing completly related?
 

KarenNWendyn

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It can be hard to tell. With ALS, cough due to food going down the wrong way or coming up from the stomach (reflux) are legitimate concerns. A barium swallowing study would be diagnostic. If the cough predated ALS, it may be something else. Coughing from allergies, asthma, or post nasal drip are other common causes.

I’m finding that use of BiPAP right after eating for at least 30 minutes is helpful. You could try it before eating too.
 

lgelb

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The more you choke when eating, the more likely the issue is swallowing than breathing. But, poor respiratory function can sap energy and make any swallowing issue worse. So it's chicken/egg.

Coughing when you take a deep breath could relate to allergies or reflux but again weakness of one or more muscles in the breathing process likely contributes, because if everything along the passageway is not opening and closing as it should, that can cause spasms that trigger coughs. And the ability to cough out or swallow mucus or saliva is weaker so it all can get stuck.
 

Jimi

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I am using NIV 24/7 for the past 2 years. Prior to ALS, coughing was not an issue. As things progressed and I required assistance for breathing 24/7, I had several things that caused me to cough:

1) Using the humidifier on my bipap caused congestion. Adjustments to the humidifier did not help. Finally I removed the humidifier completely and have never gone back. 1.5 years now. Sinuses are not dry. Southern California climate. Drink plenty of water. Really helped.
2) I use a cough assist machine every day. Six sets of six. I don't really need to cough up anything. It's more of a way to completely open my lungs. This has kept everything very clear and really helps. I think of it as my daily exercise. Takes 5-10 minutes.
3) When eating it is very clear when it goes down the wrong pipe.... But because my lungs are expanded fully everyday, and not all gummed up , clearing some errant food or liquid is easier
I have found that things in my lungs will build up if I use the humidifier or don't regularly expand my airways. But a little bit of preventative maintenance is all it takes
Hope this helps
 

blitzc

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I use a cough assist machine every day. Six sets of six. I don't really need to cough up anything. It's more of a way to completely open my lungs. This has kept everything very clear and really helps. I think of it as my daily exercise. Takes 5-10 minutes.
I think this is one of the most interesting pieces of advice I have heard. Thank you! I appreciate all your detailed information.
I have been waiting for a cough assist since January... 😤 Medicare hangup I guess. I keep trying to get both pulmonologist and neuro to work on it....waiting.
 

nona

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Cathy, what kind of cough are you experiencing? Dry? Productive?
 

blitzc

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what kind of cough are you experiencing? Dry? Productive?
it differs, dry(chest) generally, sometimes a tickle/irritant, while eating a loose/productive cough. It changes.
 
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