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Thread: Mucus plug

  1. #1
    Forum Member Jeannie's Avatar
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    Mucus plug

    I would like to bring to your attention about mucus plugs. It appears that in ALS the most common cause of sudden breathing difficulty is airway blockage due to mucus plug.

    I have recently heard of several people dying due to sudden breathing difficulties caused by mucus plug blocking their airways. Sadly the cause (mucus plug ) had gone undetected and was not detected until after death. If it had been detected and treated they would still be alive today.

    Weakened abdominal and throat muscles in ALS diminish the ability to cough. When a person with ALS can’t cough up mucus and inhaled particles, these can fall back into the lungs, where they can cause irritation and infection.

    For those with a weak cough:

    Assisted Coughing

    The simplest method is to place your hands or arms over the person’s stomach, just below the ribs and under the diaphragm, while he or she is lying down or sitting. After they take one or two deep breaths, firmly push in and upward toward the ribs as they cough. This will force air from the lungs more quickly and help push any secretions out through the mouth. Have a tissue or portable suction device available to collect any mucus coughed up.

    This is best done on an empty stomach. If the person with ALS gets nauseous or throws up during the process, try gentler pushing. An increase or other change in mucus may indicate a respiratory infection needing medical attention.

    NOTE: Let a respiratory therapist demonstrate these techniques so you’ll be sure to perform them correctly. If the person with ALS has any discomfort or bad reaction, consult the therapist or physician.

    For mechanical assistance, the CoughAssist from Respironics, also called an insufflator-exsufflator, is a very handy, effective device. A mask is put over the mouth, and the machine blows air into the lungs, then reverses the flow, simulating a cough.

    After either a manual or mechanical assisted cough, you may need to use a portable suction device to remove secretions from the mouth through a small tube. You can rent or buy a suction device (similar to those dentists use) from a medical equipment vendor or borrow one from the MDA loan closet.

    Doctors also may suggest these cough assist methods:

    Expectorants — prescription medications that thin secretions, making it easier to cough and clear the secretions
    Breath stacking — closing the throat after each breath taken in through a mouthpiece and then coughing
    Oscillation vests or airway clearance systems to “shake up” mucus in the chest

    If you have sudden breathing problems seek medical attention asap, inform the Dr about possible mucus plug.
    Best wishes

    Jeannie
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  2. #2
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    Good info as always, Jeannie. Glad to see you back here.

    Best wishes,

    Mike.

  3. #3
    Forum Member MattJ's Avatar
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    Hi Jeannie,

    Brilliant article! Good timing as well as my mum is currently suffering from excess saliva and mucas. I'll print it off and pass onto my Dad.
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  4. #4
    Batty
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    Hi Jeannie,
    I am currently on a clinical trial using a cough assist machine, this is to prove to the NHS that we benefit from this expensive equipment the trial is sponsered by the MNDA and you are correct with the facts in your post.
    Regards Mark
    I have had two experiences of mucus plugs before I stated on the cough assist, both ended in 999 but there was nothing they could do - not even suction!
    Last edited by Batty; 17th January 2012 at 11:37.

  5. #5
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    Before his trache, Mark ended up in A & E with a mucus plus which was sooo frightening for all of us. We were then taught how to do what the A & E doctor did. We were taught how to put an airway tube into Marks mouth and feed a fine catheter suction tube down to clear this. This method does take a bit of practice and control. Mark had lost his gag reflex so could quite calmly cope with the airway tube and as his hands were still working could put the airway in himself so giving him complete control. We were shown how to do this by a specialist neuro chest physio. This problem was solved once a cough assist machine was delivered. I think cough assist is an essential piece of equipment for every PAL and should be a standard issue bit of equipment. I also think Mucodyne (Carbosisteine) shouldl be standard prescription to ensure the mucus is kept thinner. Mark also uses a nebuliser which helps to break down the gunk.

  6. #6
    Forum Member Jeannie's Avatar
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    Thank you guys ;-)

    Hi Mark,

    That is great news re cough assist trial. Where are these trials being held? How are you getting on with it?

    Scary shit that they couldn't do anything when you had your mucus plug...was it the fact they couldn't or didn't know how? did they try any treatment at all? It's alarming they couldn't help eek!

    Just did a quick search on treatment for mucus plug and found the following:

    Treatment
    Depending on the cause, treatment will be directed toward thinning the lung secretions, eliminating or minimizing any airway obstruction or lung compression, or re-establishing surfactant production.

    When collapse is caused by an accumulation of mucus, treatment may include deep breathing, coughing, chest clapping, and postural drainage (a technique using gravity to assist in drainage of lung secretions). Treatment may also include antibiotics, increased fluid intake, and the use of humidifiers or bronchodilators. If mechanical obstruction is suspected, the first measures are forced coughing, suctioning, and respiratory or physical therapy. If there is no relief, then fiberoptic bronchoscopy (a lighted viewing instrument passed down the trachea into the bronchi) helps identify and remove the obstruction. Heavy secretions can be suctioned at the time of bronchoscopy. If a foreign body is present, it can be removed at this time as well. It is rare that surgery is required to extract foreign objects. http://www.mdguidelines.com/lung-collapse
    Best wishes

    Jeannie
    ______________________________________

    GAGGED - MND ISN'T THE ONLY THING TAKING AWAY MY SPEECH


    FREEDOM OF SPEECH

    MND forum http://www.magimedia.co.uk/buildforum/ please feel free to come join me and other members.


    ALS onset June 2000, dxed July 2001, I am 34 yrs old.
    Living and loving everyday regardless of ALS although I do have my down days.
    I'm singing and dancing inside!

  7. #7
    Batty
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    Hi Jeannie,
    The trial is through the Royal Hallamshire Hospital in Sheffield, so far it is working for me and no more plugs or infections, Rachelg mentions a nebuliser which I also use but is not part of the trial, hopefully in the future this equipment will be available to all PALS.
    Regards Mark

  8. #8
    Forum Member Jeannie's Avatar
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    Good advice, Rach...I also use a nebuliser when I have a cold.

    Thanks Mark.
    Best wishes

    Jeannie
    ______________________________________

    GAGGED - MND ISN'T THE ONLY THING TAKING AWAY MY SPEECH


    FREEDOM OF SPEECH

    MND forum http://www.magimedia.co.uk/buildforum/ please feel free to come join me and other members.


    ALS onset June 2000, dxed July 2001, I am 34 yrs old.
    Living and loving everyday regardless of ALS although I do have my down days.
    I'm singing and dancing inside!

  9. #9
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    Thanks for this thread. Really helpful to us.

    Jenny

  10. #10
    My Dad's lung collapsed last night from a mucus plug. I didn't know coughing assist machines were in existence, will have to let my mum know. Although not entirely sure the NHS in wales would have access to such a machine...

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