I am seeking information pertaining to a friend of mine with multiple sclerosis. He was diagnosed with MS at age 19 and is now 49 , he is in bed most of the time and unable to swallow causing drainage from his sinus to go into his lungs. His Mother is a registered nurse and is concerned about vacuuming the secretions from his lungs, she places his bed on an incline and has to vibrate his chest to remove the secretions. The problem she having is that the secretions are very thick and wondered if there may be any way to thin the secretions, she said he recieves plenty of liquid.
I am sorry to hear about your friend. This is a difficult problem with MS patients at this stage in the disease. His mother is doing the correct things, plenty of what we call pulmonary toilet-vibration, clapping, and suction. There is a cystic fibrosis medication that has been developed to decrease the viscousity of secretions that might help. I would seek out a pulmonary expert and see if this might help in your friend's case. Depending on the quantity of secretions, if they are in large amounts then there are medications available to cut down on the quantity of secretions. Your friend's neurologist should know about these. See if one of these suggestions might help.
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I have MS and I was diagnosed in 1988 at the age of 30. While I am ambulatory right now, I too have been in bed for extended periods and on the vent. Your respitory therapist is right in not using a catheter tube to suction secretions. Such deep suctioning only causes greater secretions. You should check with a pulomonologist about this issue, but perhaps the patient needs to have breathing treatments with ventolin (albuterol) to help thin the secretions. A treatment machine is easily rented, and covered by insurance with a doc's orders. Further, if he is on a vent now, it has a setting for treatments, too. In addition to using the treatments, RT's often will add saline directly into the trach tub (several drops or even large squirts) to help thin secretions. Saline is normally in pink viles to distinguish it from distilled water (blue viles). For secretions that do not respond to the above, and to induce coughs, RT's often do use the blue viles (sterile distilled water). This solution produces heavy coughing, but it may be necessary. Also, make sure that if he has a regular trach that is open all the time (not secured to a vent with moisture), that he has what is called a "nose" on it. Shiley and other companies make these devices that do not plug the trach but cover it with a moisture inducing filter. Whether the trach is fenestrated or non-fenestrated, if it is open all the time (not plugged), the patient may benefit from this humidifyer. PLEASE CONTACT A PULMONOLOGIST ABOUT THIS. USING A TRACH AND BEING BED RIDDEN DOES NOT MEAN THAT YOU HAVE TO HAVE UNHEALTHY LUNGS. I am happy that you are there to help him. Thank you, on his behalf, and on behalf of others who must rely on family.
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