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#114954 04-03-2010 03:05 PM
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Rett Offline OP
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Are there any medications that have been used by anyone to reduce the phlegm problem? My dad had to be re-trached (sp?) after an infection because he is very weak and unable to cough anything up. The phlegm seems to be worse than ever and I was wondering if anyone ever used meds to reduce this. The constant suctioning leaves his trach very raw at times.


Rett
Father 80 y/o with BOT Stage IV/ SCC, laser surgery to remove tumor 8/08, Hemi glossectomy, reconstructed tongue, right side neck dissection, RT began 10-8-08, chemo not recommended because of age, Peg tube, non smoker/drinker.
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Someone one this forum recommend Robitussin DM.
I bought it and dumped the recommend dose down my PEG.

Also I slept in a recliner to keep my head elevated and frequently gargled with a glass of warm water + a half teaspoon of baking soda and half teaspoon of salt


Don
TXN2bM0 Stage IVa SCC-Occult Primary
FNA 6/6/08-SCC in node<2cm
PET/CT 6/19/08-SCC in 2nd node<1cm
HiRes CT 6/21/08
Exploratory,Tonsillectomy(benign),Right SND 6/23/08
PEG 7/3/08-11/6/08
35 TomoTherapy 7/16/08-9/04/08 No Chemo
Clear PET/CT 11/15/08, 5/15/09, 5/28/10, 7/8/11

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Rett Offline OP
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Thanks Don, did the Robitussin seem to help at all?


Rett
Father 80 y/o with BOT Stage IV/ SCC, laser surgery to remove tumor 8/08, Hemi glossectomy, reconstructed tongue, right side neck dissection, RT began 10-8-08, chemo not recommended because of age, Peg tube, non smoker/drinker.
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My nurse practitioner prescribed Glycopyrrolate to reduce secretions.

http://en.wikipedia.org/wiki/Glycopyrrolate

It works and works pretty fast! Drastically reduces the amounts of slime that come out the trach. I use 1/2 of the little pills for about six hours. If I am going out to movie, etc., I take one just before so I'm not constantly mopping my trach tube.


Age 67 1/2
Ventral Tongue SCC T2N0M0G1 10/05
Anterior Tongue SCC T2N0M0G2 6/08
Base of Tongue SCC T2N0M0G2 12/08
Three partial glossectomy (10/05,11/05,6/08), PEG, 37 XRT 66.6 Gy 1/06
Neck dissection, trach, PEG & forearm free flap (6/08)
Total glossectomy, trach, PEG & thigh free flap (12/08)
On August 21, 2010 at 9:20 am, Pete went off to play with the ratties in the sky.
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This stuff works good, but has some side effects that may cause other issues. It significantly makes xerostomia worse. To the extreme. I tried it since I produce mucus in amounts that you can't even imagine, and that stuff is cause sleep apnea issues. But this stuff made my mouth dryer than a pop corn fart.


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Since my last surgery, my problem has been too much fluid, not too little. Even so, I only take it when I need it and only take a half-tablet at a time, otherwise my throat and trachea dry out too fast.


Age 67 1/2
Ventral Tongue SCC T2N0M0G1 10/05
Anterior Tongue SCC T2N0M0G2 6/08
Base of Tongue SCC T2N0M0G2 12/08
Three partial glossectomy (10/05,11/05,6/08), PEG, 37 XRT 66.6 Gy 1/06
Neck dissection, trach, PEG & forearm free flap (6/08)
Total glossectomy, trach, PEG & thigh free flap (12/08)
On August 21, 2010 at 9:20 am, Pete went off to play with the ratties in the sky.
Joined: Aug 2008
Posts: 30
Rett Offline OP
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Pete, do you still have your trach in? My dad got sick in February and they had to put the trach in again. He keeps getting infections in the nursing home/rehab he is in, so we want to bring him home, with some help of course. They are trying to talk us out of it b/c they say to care for someone at home with the trach is too difficult. We really want to get him home. We are afraid if he stays in the nursing home it will kill him. He's gotten MRSA, C-Diff, VRE, and something else that I can't remember the name. He is also afraid to swish his mouth now that he has the trach because he thinks he is going to choke. Meanwhile, this leaves his mouth so terribly dry that I'm afraid he is going to develop a mouth infection soon


Rett
Father 80 y/o with BOT Stage IV/ SCC, laser surgery to remove tumor 8/08, Hemi glossectomy, reconstructed tongue, right side neck dissection, RT began 10-8-08, chemo not recommended because of age, Peg tube, non smoker/drinker.
Joined: Nov 2005
Posts: 1,128
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Because the radiation surgery scarring apparently have closed off the wrong pipes, my trach is a permanent part of me. With a very few minor exceptions, no air moves in or out except through that stoma.

It's surprising what one can't do without pressurizing the mouth, like speak, whistle, spit, etc.

I would think he'd be able to rinse his mouth without swallowing (and risking aspiration). Another way to clean the inside of the mouth is with those little green sponges on a stick. They can be moistened. In fact, with my trismus that's about the only way I can clean my mouth of the thick mucous that builds up.

If he is unable to heavily participate in trach clearing and cleaning, then he will need someone there to help at all times. It's not rocket science, but is potentially fatal.


Age 67 1/2
Ventral Tongue SCC T2N0M0G1 10/05
Anterior Tongue SCC T2N0M0G2 6/08
Base of Tongue SCC T2N0M0G2 12/08
Three partial glossectomy (10/05,11/05,6/08), PEG, 37 XRT 66.6 Gy 1/06
Neck dissection, trach, PEG & forearm free flap (6/08)
Total glossectomy, trach, PEG & thigh free flap (12/08)
On August 21, 2010 at 9:20 am, Pete went off to play with the ratties in the sky.
Joined: Jan 2010
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Rhett - My husband is in his last week of radiation - in week 2 the mucus started getting bad and his doctor prescribed caphosol. It's a liquid that comes in 2 vials and he mixes them together and swished it around his mouth and gargles. The mucus has been nominal since he started using this. I have the drug fact sheet scanned as well as pics of the medicine. I'll email you the info. Not sure if this is the right stuff if someone has a trach but worth a look into.


Lisaj, caregiver to Ken age 45 at DX, non smoker, social drinker, athlete
Stage IV SCC BOT, bilateral lymph involvement
DX 01/08/2010
Taxol, Cisplatin, IFEX
Treatment completed 6/2010 - all clear
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Good Morning Rhett:

I was also prescribed glycolprrate by my RO. When the mucous becomes unbarable I give myself an injection that provides relief for approx 4-5 hours. Needless to say for about 3 weeks I took alot of injections. I'm now 6 weeks post treatment and still dealing with the mucous issue, but am only taking an injection once every few days

Last edited by phanmed; 09-30-2010 08:24 AM.

SCC, BOT. Diagnosed May 19, 2010. TX 3 chemo and 35 RT. TX finished on Aug 17, 2010

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