My mom is having trouble swallowing. Anyone know what this is about?

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Mom has been having "crashes" (I have written about them in past posts). They last a couple days each time.

But..we have something new. She is having trouble swallowing. Throat seems to have phlegm. She isn't running any temperature. No congestion. No breathing difficulties.

She had a stroke 6 months ago and had a few months getting swallow function fully back. This has gone completely away over the last two months...and she was cleared by speech therapist. I don't know if that even has any relevance.

I can't figure out if I should get her to ER, wait 4 weeks for a doctor appointment, or what.

Anyone dealt with this? Any ideas?

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Apology in advance because I have read about this on other threads, but don't really know about it. Just putting this out there, but you state the throat seems to have phlegm. It makes sense that after a stroke she might have trouble clearing the phlegm on her own. Others have mentioned Mucinex to clear the phlegm, or suctioning the phlegm-maybe after eating? Foods like milk may create more phlegm than she can handle. So ask the doctor, nurse, or someone who may know about it on here. Mucinex is over the counter.
Hope there is a good resolution to your Mother's discomfort.
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Warfarin is Coumadin, so yes, she is on what usually works to prevent strokes. At some point those things may just fail, even if the dose is exactly right. I have to keep reminding myself that Mom had a heart attack and continued losing ground neurologically while on everything she could be on and got moved to hospice because it just was not working any more. Unless the "crashes" could be small seizures or could be brief blips in her heart rhythm that would be amenable to treatment, it is possible they can't do any more. There is a fine line between doing what can be done and recognizing when more will not help, vs just not bothering to try, and it's hard sometimes to know.

For my mom, we went with the Ranexa, an oral med, but not the EECP, a possibly onerous and relatively contraindicated procedure to try to help her heart last longer, and also decided no more hospital trips when what they could do had really maxed out. I absolutely needed to take her for that cardiology consultation where they took the time to assess and explain everything so we understood what we were deciding.
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Katiekate
Your mom is right about the doctors. Many feel once a patient gets a certain age then it's better to let nature take its course
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Katie kate, ask your angel to guide you. I sense that time is getting very short. I hope someone is there with you too.
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Thank you for your responses.

She is not coughing. She is on warfarin so aspirin cannot be take also. Because of her heart damage..she also take diltazem at 240 mg.

The last time I asked about the possibility of seeing if she was having small strokes...the answer I got back was.... "and do what?" There is nothing more to do above and beyond what is already being done. The expenses of knowing if she has had more strokes cannot be justified with the certainty that there is no follow up.

Pneumonia has been ruled out.

The period of time between crashes is getting shorter. Just do not know how to help her...and the doctors seem to take it all in stride. Mom has said to me she thinks they are just waiting for her to die.
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KatieKate, I could not fnd yoru prior post. I would agree ER will not be able to do anything great with this, but I also would not wait 4 weeks. It sounds like she is having additional small strokes and the docs need to help you decide if any preventive can be given. My mom stayed on aspirin plus antiplatelet agents but they did not think Coumadin would be safe; she probably had silent posterior fossa strokes eventually found when she had a bigger one in a rehab facility and it ws found she was resistant to them, unfortunately. A repeat dysphagia eval and a neurology visit would both be in order if the primary care doc can't or won't help, and it sounds like there is a quality of life worth trying to preserve.
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An ER visit is a crap shoot at best. Call the primary for an appointment. Actually, late in life our mom saw her MD monthly. When she could no longer do that, she had a visiting nurse weekly who would call him.
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I also think she should be re-seen and re-evaluated by the speech therapist. A videoscopic swallow study can determine if she's aspirating fluids into her lungs. Aspiration pneumonia could result from what's called "frank" aspiration.

There are other issues as well with what might be dysphagia. Certain foods can cause coughing, especially meats that are hard to chew. Beef and ham can be hard to chew. Fish should be easier.

Food with crumbs, such as the crusts of toast, bread, some cookies can also cause coughing. Chocolates, especially thick gooey ones, can cause coughing.

Dysphagia diets specify which foods can be eaten and which foods should be avoided. If she coughs with fluids, Thik-It can be added; it thickens liquids so they're not aspirated as easily.

But seeing a speech therapist is key to finding help. I'd do that ASAP.
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Can you contact the speech therapist who has already seen and tested her, and would have her records? Explain what is going on and ask how to proceed.
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Katie, does Mom cough a lot after eating? If yes, take her to Urgent Care or Patient's First which would be easier than going to ER [especially during the flu season]. They may be able to check to see if food or drinks are going into her lungs. If yes, got to catch this before it turns into pneumonia.
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