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Suggest Remedies For Discomfort Caused By Tracheotomy In An Elderly Person

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Posted on Sat, 25 Jun 2016
Question: my name is XXXXXXX i am 54 years old , C5 spinal injury since 1980 . In 2006, 2007 and 2008 i had 3 serious urine infection which lead to septisimia. I was in ITU each time requiring tracheostomy and ventilation . The first two times i recovered and had the trcheostomy removed. The third time i recovered but i was told i had to keep the tracheostomy all the time. For the first two years the tracheostomy gave me no problems . But for the last five years i have increased problems with secrections. I now use PEG Feeding because of increased secrections during eating and drinking. The problem has become so bad even without eating or drinking that i have tried hyocinth patches and now im taking GLYCOPYRROLATE 1MG four times a day.
The hyocinth patches and now the GLYCOPYRROLATE cause me to have a very dry mouth but i seem to be producing too much secretions in my throat about the level of my vocal cords or below causing me to require almost continuos suctioning and nebilisation. The worst part is the secretions drible down from the top of my throat down pass the tracheostomy outer wall and the inner back wall of my throat. It is not until the secretions pass the bottom of the tracheostomy tube then we can suction off these secretions but always leaving secretions trapped above the tracheostomy tube and the secretions trapped between the tracheostomy the back wall of my throat. The problem also increases when iturn from side to side in bed for pressure relief. I dont know if i can inrease the dose of GLYCOPYRROLATE or stop it as the secretions are very sticky and difficult to suction.
I am greatiful for any possible help you can give me. I have been to three ENT departments and they say that taking GLYCOPYRROLATE should stop the secretions but it gives me very thick secretions its difficult to suction.
doctor
Answered by Dr. Sumit Bhatti (2 hours later)
Brief Answer:
Speaking valve, Suction Aid TT, Botox.

Detailed Answer:
Hi,

Thank you for your query.

1. A trial with a Passy Muir speaking valve should help create back pressure to prevent the secretions entering the airway. In adoption, the cough reflex will be more efficient in clearing out the secretions.

2. A Portex Bivona Suction-Aid Tracheostomy Tube will help clear secretions above the tube.

3. USG ( Ultrasound ) guided Botox A injections into the salivary glands will help reduce the salivary secretions. Your current medications have many side effects, especially thickening the secretions.

4. Certain details are requested, such as the contraindications for decannulation, aspiration, lung function, current tube and so on.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Suggest Remedies For Discomfort Caused By Tracheotomy In An Elderly Person

Brief Answer: Speaking valve, Suction Aid TT, Botox. Detailed Answer: Hi, Thank you for your query. 1. A trial with a Passy Muir speaking valve should help create back pressure to prevent the secretions entering the airway. In adoption, the cough reflex will be more efficient in clearing out the secretions. 2. A Portex Bivona Suction-Aid Tracheostomy Tube will help clear secretions above the tube. 3. USG ( Ultrasound ) guided Botox A injections into the salivary glands will help reduce the salivary secretions. Your current medications have many side effects, especially thickening the secretions. 4. Certain details are requested, such as the contraindications for decannulation, aspiration, lung function, current tube and so on. I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.