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My dad is 83 and lives with my family and I full time. He has Parkinson's along with other problems, although I know this issue is due to the Parkinson's. He has been having a terrible cough because he gets that phlegm that comes with PD not in his throat and not in his lungs but right in between. When it gets stuck there, he cannot cough it up or swallow it down so he gets this deep honking cough going on which keeps him up half the night. Now he's like a zombie. Sleeping all the time. He has been prescribed tessalon perles and they do thin the mucous, but it's just not enough to get rid of it one way or the other. Anyone have any suggestions?

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My moms doctor suggested Mucinex but because she is older he wrote a prescription for a dose that is 600mg. The over the counter is 1200mg. This has helped a lot.
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I had a chronic cough for several years with excess mucus production that made me feel like I was drowning. No medications helped. I tried everything. Doctors could not diagnose me. Then through diet elimination I learned I was allergic to wheat/gluten (even though blood tests said I wasn't). When I cut the wheat/gluten from my diet, my cough stopped within 24 hours. When I reintroduced it, it started right back up again. My dad also had Parkinson's and loved his bread. He ate it 3 times a day. He had similar issues and looking back I wonder if he too had a wheat or gluten allergy. I believe a lot of our illnesses today are food related, not because the type of food itself is bad, but because of how it is produced and handled (pesticides, GMO, etc.) Read this: livestrong.com/article/530669-gluten-allergy-cough/ Try cutting wheat/gluten from his diet for a week and see if he improves. Then you'll have your answer.
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A few suggestions:
#1 Does he have a pulmonologist that may be able to offer suggestions?
#2 Have him sleep with at least three pillows.
#3 Guaifenesin use should be monitored.
#4 Do not use Guaifenesin/DM.
#5 No dairy products should be consumed.
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Lilacalani has a good point. I don't buy milk in plastic jugs anymore, opting for "real milk" sold in glass jar at Kroger. When I drink the plastic jug milk, or eat alot of cheese products, I get a 'thick' inner ear and/or mucus feeling. Yech!! Incidently, I just read that years ago, milk had a Cassien (?) # of 2. It is now at 4/5. Reason it's higher is the way they feed/medicate the cattle now. Wheat is definitely another problem. You might also make sure the sugar/carb intake is not high.
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On the Dr's TV series it was mentioned that eating grapes would help alleviate mucous. I was coughing up large wads of mucous every morning due to COPD plus numerous medications so I tried it, IT WORKS. I've been eat grapes every night for the few years and very few problems since.
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Hubby has advanced Parkinsons and paralyzed vocal chords, issues swallowing. Speech therapist and otolaryngologist suggested a med slant to raise his upper body while sleeping.
(Amazon or at med slant online)
Has worked
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A cup of hot water with a tablespoon of raw honey, half a teaspoon of cinnamon, 1/4 teaspoon of turmeric, and lemon juice to add will take the phlegm out and stop the cough good luck
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SafetySarah raises a good point about using a nebulizer. A pulmonary doctor could script for it. It's been used repeatedly for my father's bouts of dysphasia and pneumonia.

Annie also makes a good point about positioning. Laying at an angle, with the torso somewhat elevated (30 degrees, per a speech pathologist we saw), helps, as do the incentive spirometer and flutter valve.

Lila doesn't post very often but when she does, her advice is always on point, and naturalistic. I had forgotten that dairy fluids can thicken mucous.

Lots of other good suggestions here. Definitely worth saving for future use.
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I have COPD and a lot of drainage from sinus down back of throat, its normal, alot of people have this post nasal drip. Nasal spray of a saline solution, drys up the cavity reducing the extra phlegm.
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I am 80 and have had a phlegmy cough for about 25 years. Had a balloon sinuplasty to clear sinuses, but it didn't help cough. Last year I had CT scan and discovered I had atypical pneumonia--MD did not treat, and this year CT scan shows the same. Still no treatment! I am used to it now, but have a hard time finding traveling companions!
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Eliminating wheat and dairy (which are mucus-producing) from his diet might help.
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My mother also fights this horrible phlegm build up from the Parkinsons. Constantly. Not for the squeamish. We were told all sorts of things; try drinking more fluids, try more broth, try the humidifier, try nasal spray, try claritin., have tried it all and still have it. Another simple tip which helps us is prop the bed time pillows just a bit higher. Also- if you have one of those small plastic breathing gadgets they give you in the hospital- where you can practice a little deep breathing during the day. If he rests a lot during the day do you notice more phleghm? Its constant in our case and more so with the daytime resting. I go back and forth between wondering if its from the Parkinsons med- carbidopa/levadopa or the disease itself. Which, I am pretty sure its the progression of the disease/swallowing. With the Pd they are at higher risk of the aspirating pneumonia. If he has any trouble with swallowing liquids, you might want to look into the thickening agents for his drinks. I'm new to this group also. Great to get tips from everyone!
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naturade.com/shop-online/naturade-herbal-expectorant-expec-with-guafenesin-8-8-fl-oz/

Use it on my da...found it at the health food store.
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My father had serious problems with mucus because he had limited lung capacity (sarcoidosis) + bronchiectasis, which meant that the mucus had a place to accumulate. The doctors had him take large amounts of guaifenesin - purchased in generic form from the drugstore - and albuterol with a nebulizer. If they thought he was headed for pneumonia, they gave him antibiotics and steroids. The guaifenesin is the easiest place to start.
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Guaifenisin is OTC--in various doses. No doubt a scad more expensive than a prescription would be, but very easily obtained. That, with increased liquids and the humidifier or vaporizer should help a lot.

He should be coughing SOME, just not all the time.
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With the progression of his PD he may be losing his ability to swallow the saliva in the back of his throat. Can you ask his primary doctor for a speach therapist evaluation to rule this out? If he has this affliction, they can recommend steps to try to reduce the cough.
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Thanks for the tip Dorianne, I'll take the Jager, but Dad is severely allergic to alcohol, so no dice. I bought him a humidifier and some lemon and honey cough drops, took him off the perles and since I don't have any Guaifenesin pills left from his prescription, I'm just giving him some otc liquid I have left from Walgreens that I bought when my daughter was sick a few weeks ago with flu. So far, it seems like he's not coughing as much, and when he does, I can hear stuff coming up. Guess Guaifenesin must be more potent than Tessalon. Poor guy, now his throat is hurting though.
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Guaifenesin will loosen the phlegm and makes it easier to expectorate. Maybe get him an incentive spirometer.
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This isn't for everyone, and it's no good if he can't have any alcohol. But as a singer, when I'm sick, I find Jagermeister cuts right through the guck in my esphogus like nothing else. It even cured me of laryngitis once.  Keep it in the freezer, give just one ounce at night, and have the person sip it, not shoot it.
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Just thought of something else I used to do. I heated water and crumbled organically grown dry sage from my garden, then inhaled the vapors. That helped clear my nose and throat. Again, this was just more or less sinus congestion, which used to cause a lot of headaches but hasn't bothered me as much as I've grown older.

Good luck; please let us know what works.
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He was on guaifenisen before the tessalon perles. I cannot remember why they switched him. I have some guaifenisen liquid so I gave him some this morning and removed the perles from his normal meds for the day. Haven't heard as much coughing. I will try the honey lemon drops and I think I might go ahead and get him a humidifier when I go grocery shopping today! Thank you all so much! Just joined yesterday, what an amazing group!
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I've found that honey lemon cough drops, either sucked on or melted in hot water and drunk as an alternative to honey lemon tea (when I don't have lemons or lemon juice), cuts through mucus, although it's not as thick as the mucus associated with swallowing or similar issues.

There was a time when I couldn't afford health care insurance and unfortunately contracted a very painful sore throat, from the patient in the same semi-private room where my mother was at the time (SNF). It was scary, but the lemon and honey helped ease the pain, and eventually it was resolved.

I've also used a humidifier for my father, who has more serious issues with mucus and dysphagia and compromised swallowing.

Goddess, your comment that it can't be coughed up or swallowed worries me, b/c of the issue of blockage. Have you asked any of his physicians, such as a pulmonologist who treats respiratory issues, if you can get a suction machine through a DME supplier, for home use?
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Often, older folks don't drink enough fluids daily. That will help "thin" the mucous to make it easier to cough up or swallow.

However, better to cough it up, as mucous is irritating to the stomach.
(Ever seen little kids with a runny nose and coughing that throw up? That's why, they swallowed too much mucous and the stomach "revolts" and gets rid of it.

Have him drink more water or other low sugar, non-caffeinated drink.
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Have you tried a humidifier? I kept one running year round and seemed to help stepdad with the chronic mucus buildup that he had though not related though to PD.
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Have they tried Guaifenisen? It's an expectorant and you can take pretty big doses of this. My FIL has serious lung damage due to being first an miner, then a firefighter. His lungs were a mess in his old age. HE took huge doses of this and it did help him cough up the gunk. Tessalon perles are supposed to take away the "tickle" of a cough, not suppress it.
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