What does it mean when LO gurgles right after going to sleep but then it stops? - AgingCare.com

What does it mean when LO gurgles right after going to sleep but then it stops?

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When Hubs first lies down & goes to sleep, his breathing sounds terrible. He sounds like he's under water, he tries to clear throat but can't really. Caregivers/hospice has been giving him albuterol breathing treatments, maybe they help a little. He does it less or not at all when he's on his side. He sounds like he's dying! But then it stops after a short while and he sleeps apparently comfortably after that. Every so often it scares me, I call the hospice number, they put a nurse on, last night's nurse told us how to do suction but by the time we got it set up he'd stopped. One caregiver thinks he should have antibiotics but hospice & I see no indication for this. He has run a little fever (1 degree or so) for about a week during the night but after drinking a liter of Pedialyte in the morning his temp is normal. Hospice nurse says it's not infection, but electrolyte imbalance. I just hope we're doing the right things for him. Hospice nurse last night said give him breathing treatment when he's sitting up so he can clear stuff out before we lay him down. We did that today & he did cough & spit some. (FYI, his illnesses are Parkinsons & unspecified severe dementia.)

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The experts have provided all the answers but i will add that with a feeding tube you do need to keep the head of the bed elevated 30 degrees to avoid aspiration.
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I am an RT also and it sounds just as mentioned, saliva is hanging out at the back of the throat. Elevation of the bed can help and albuterol will do nothing unless there is wheezing. You can also just before sleep to try laying him flat, and on his side to let gravity drain the secretions then once he is asleep to elevate the bed. Ask him to cough before he goes to sleep.You would have to remain awake for a little while to elevate the head and slightly turned once he is asleep.
You also have suction and you may not be using it correctly. If he tolerates it, go deep to the back of the throat. It sounds terrible but if he is retaining secretions back there chances are that he also has no gag. So he should tolerate it well
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Thank you for your help. Yes, we have elevated the head of his bed. We also sit him up now for the breathing treatment if he's in the bed. (Frankly I think the sitting up works regardless of whether he has a breathing treatment--he is in his wheelchair most of the day without this problem.) Also we do put him on his side in the bed and he seems to cough it out better. It just sounds so awful when he breathes as if he's under water! But it doesn't seem to disturb him, and it stops. He doesn't have any trouble swallowing and can still cough.
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Thanks Pammzi and Garden Artist! Teamwork!
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Thanks, Pam !
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sorry Superstring,, and everyone.. I was in the wilds for a few days.. no internet.
Sleeping elevated may very well help him sleep, it improves breathing as it allows the lungs to expand better. It does sound like saliva is pooling in the back of his throat. laying on his side allows it drain out more easily( yep that lovely "drool" we all dread!) And being more upright would help it go down. The problem is if it goes into the lungs and not the tummy,, we call it silent aspiration.. and a swallowing or speech therapist can help you get this evaluated. Albuteral is not usually going to do much for this, but it won't hurt either, and it will open his airways so he can breath more easily..If he is not aspirating . Aspiration can lead to pneumonia, so you may want to get this looked into. I see he is on hospice? My father had this toward the end of his life.. good luck and hope I helped a bit
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Thanks, Send. I just P'M'd her.
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P a m z i m m r r t
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I was just reminded of advice given by a speech pathologist during my father's last hospitalization. Durign and after a videoscopic swallow study, we were discussing options, i.e., aspiration, all pureed food vs. a PEG tube. Sometime during the conversation she said that sleeping with head raised at a 30 degree angle would be required.

I took so many notes that they're not clear whether head elevation while sleeping applied only when a PEG tube had been inserted, or if dysphagia required elevation whether a tube was used or not.

Still, I've thought about that and it does make sense.

Superstring, you might try elevating your husband's head by putting a few pillows underneath, and see if that makes a difference. From your description, it sounds as if fluid might be accumulating, is eventually swallowed or expelled, and then the gurgling stops.

PamZimmint is I believe a respiratory therapist. I've tried to access her profile to PM her and ask that she offer her opinion, but I can't seem to get the right spelling of her name. If anyone knows it, maybe you could PM her?

I think a respiratory therapist should be evaluating your husband in addition to the hospice nurses. I'm not sure a recommendation of antibiotics would be appropriate unless an infection has been diagnosed.
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Superstring, I am moving your post back to the front page. Hopefully someone who is familiar with this can answer you.
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