Methods Of Eliminating Mucus for EN tube feeders

[rucknchoy]

My partner is doing fine on a feeding tube since October. His nutrition intake is Jevity 1.5.
He is gaining a pound or two each week and regaining his strength.
His only problem is the mucus buildup in his throat. He has difficulty getting this out. Have read others with similar delayed radiation dysphagia conditions but no one mentions suffering with this mucus problem that affects breathing also. He has tried several remedies like inhaling sea salt and hot water, sipping hot tea and coughing it up. Would like to hear from anyone with a similar problem and possible remedy to effectively ease this mucus.

[Art]

Hi. This seems like an all to common issue. I’m a head and neck cancer survivor and have trouble managing my saliva. I use a portable suction machine made by Roscoe that I found on eBay for $140. I tried different dental aspiration suction tips and the one that works best for me is pointed. I use it with a mirror and light to help guide the tip to the right spot. Here are links to the Roscoe machine and dental tips. BTW – my dentist gave me the suction tips; it seemed wasteful to buy a whole bag of them.

Roscoe suction machine on eBay

Sample dental tips

It would be great to hear how others are handling the mucus build-up. I hope this helps.

Art

[rucknchoy]

Hi Art,
Thanks for your response. Not being familiar with the potable suction machine I assume you connect the aspiration suction tips to the machine and then direct the tip to the mucus location. Can you determine if the mucus is below the vocal chords? I was advised not to attempt to suction the mucus if below the vocal chords.
My partners mucus is very thick surrounded by a thinner coating of saliva. This mucus does affect his ability to speak and affects his breathing. He is willing to try the portible suction if no other options arise.
rucknchoy (Chuck)

[Art]

Hi,

Yes, the tip fits within the plastic tubing at one end; the vacuum cup of the suction machine is at the other end of the plastic tubing.

This mucus issue is so foreign to those who don’t have to live with this condition. In some ways it is like being water-boarded. I use my machine frequently, once or twice a day. I have seen others actually take it with them and use it as needed in public. When I use the machine, I do it very carefully using the right lighting and a mirror. I only suction what I can see and I have to be careful about not triggering my gag reflex.

If mucus is building up below your partner’s vocal cords, I agree with the advice you have been given. Having someone other than a skilled professional use a suction machine close to one’s vocal cords feels dangerous and could damage the cords. Not a good thing.

Here’s two words you may hear in conjunction with a swallow, penetration and aspiration. Neither are good, but one is worse than the other. Penetration is material (food, saliva, liquid, mucus) entering the airway, but staying above the vocal cords. Aspiration is material going past the vocal cords where the next stop is the lungs. People with head and neck cancer treatment are at high risk of aspiration which can lead to life threatening conditions such as aspiration pneumonia. Not everyone who aspirates gets pneumonia, but it is more common in this cancer population than the general population. The vocal cords are our body’s last defense against aspiration. The primary natural defense in a working swallow is the epiglottis.

One way to help stay healthy is to continue to exercise the lungs through aerobic exercise and even walking. If it feels like liquid (or mucus) is entering the airway, cough it up. This isn’t always pretty in a public setting, but it may make the difference between staying healthy and becoming ill.

Good question by the way. I hope this helps. Take care.

Art

[Rocco]

Hi Art and Rucknchoy –

Here’s what I’ve heard from a dietitian who works with head and neck cancer survivors that she says can sometimes be helpful. She says that the thick mucus can be caused from radiation damage to the salivary glands.

1. Making sure to stay hydrated – 6-8 cups of fluids a day (even through a tube)
2. Here’s a new one I hadn’t heard: gargle diet ginger ale
3. Using a humidifier
4. Trying mucus-thinning medications, like Tussinex (check with your doctor first)

I think number one is probably the most helpful from the list above, but the others might be worth a shot. Suction is another good idea.

Glad to hear your partner is gaining strength!

-Rocco

[rucknchoy]

Hi Rocco,
Thanks for your suggestions. My partner said its worth giving it a shot.
He started with number one and has added more water to his four tube feedings.
Other than the tube feeding this mucus seems to be his major discomfort next to the neuropathy in his fingers and neck area.
Wishing all the Best for the New Year,
Chuck and Roy

[cologirl1]

I am a speech pathologist and want to thank you all for the suggestions to help Roy with thick mucus in the throat. It is a terrible problem that afflicts many who have had oral pharyngeal cancer that are treated with radiation. I wish there was a single great solution. The body is amazing, and who would guess what an important role the production of saliva (thin, watery, not too much, not too little) can play in terms of mouth comfort. I think the suggestions above are good ones. If Roy has just recently finished radiation therapy, the condition should improve as time goes by. Using a humidifier at night, with the mist facing the head has helped some people I have worked with. Keep us posted on how Roy is doing!

Best
Jan

[rucknchoy]

Hi Jan,
Thanks for your comments. Roy is lucky to have much saliva. Others experiencing the same treatment I have
heard were not so lucky. Roy had his treatment (chemo & radiation) in 2008. He was fine eating and drinking
for five years after cancer remission. Two years ago swallowing difficulties resorted to eating soft foods only, which led to purees and then complex aspiration and weight loss. At weight 105 we welcomed the return of the peg tube at this stage as difficult as it was for us both to accept. His weight went from 105 to the present 121. Although we don’t feel the therapy treatments are helping much as long as he has all this mucus in his throat. He has posponed therapy until he can get control of the mucus problem. He is finding comfort and able to eliminate much mucus with the addition of water to his diet as was suggested. Also gargling with ginger ale is also helpful. We are grateful for all suggestions.
Regards
Chuck & Roy

[Author]

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