stroke victim won't get well

[Kunda]

My mom has been in and out of the hospital every few days since initially leaving the hospital from a stroke.  She has a trach and feeding tube but almost regularly has mucous building up in her lungs.  White blood count is super high but she has no fever!  This has happened a few times and I am trying to figure out how to stop the cycle and get her lungs clear for more than a couple of days.  

[caregiver222]

There is another suggestion I am reluctant to make. It requires consultation with your physician. On ocasion, when a lung becomes "inflamed" the inflamatiuon process must be stopped and the lung de-sensitized. At one time this meant a short-term regiman of two - three days of 10mg prednisone. Then, after a number of bad experiences with systemic prednisone,  the pharmaceutical companies  developed aerosolized steroidal sprays that delivered a much smaller dose, usually provided to asthmatics. The danger from these medications is real and is serious.These steroids destroy the ability of the lung to defend itself against infection, and the danger of death through infection is significant.I suggest you purchase an ultraviolet bulb disinfection unit in the room to kill airborne bacterial. Someone won the nobel prize in 1905 for discovering that the wavelengths of ultraviolet light destroy bacteria. There is also apossibility the mucus comes from GERDS. Yes,you can have GERDS even with an enteralfeeding tube, especially when the aides feed and allow the patient tolieflat. The acidic reflux goesup the esophagus, down the trachea, and guess what - massive mucus forms as a protective reaction.In some cases the surguryprevents this from happening, but in many cases it dows not.

[caregiver222]

You can learn to clear the mucus yourself, althouggh the health professions discourage this. I did this for my mother, why had a stroke and died a horrible death and was trached. Nebulized oxygen is contraindicated. Also be aware that the throat and nasal passageways clear much dust from the air before it reaches the lungs. She needs an electrostatic dust eliminator with HEPA filter in the room and should not be covered in blankets that shed. Anyone with a trach is much more susceptible to asthmatic attack. The suctioning itself. iof not done properly can be sensed by the lung as an antigen and produce mucus.  There are medications that can reduce the mucus. Ask your physician. Think about a new mattress and eliminating a rug from the room and repainting. It only takes a minute amount of antigen to stimulate a phenomenal amount of mucus. I have worked in many nursing homes and visited patients in others and have yet to find one worth the powder to blow it to hell. Talk to your doctor to getting her off the enteral feeding tube and trach. That may not be possible. But don't give up hope!

[Kunda]

Thanks for your reply, interesting perspective.  Her gag reflex was not that good and her ability to cough up mucus on her own had been almost non-existent direc tly after the stroke and in fact has changed only a little.  She did not have the ability to solely clear her pathways so they put the trach in.  Yes, its true that a few days later she was out of ICU but she was in the hospital (first time around) for 3 weeks.  Nursing homes seem to be weak in the area of keeping her lungs clean because everytime she leaves the hospital her lungs are clear and within a few days one lung is full of mucos again!  

[caregiver222]

Sometimes the trach is sensed as an antigen, particuliarly if it is placed down too far, and in itself produces thr mucus. I am not prepared to state the trach was inappropriate, because sometimes they are in fact necessary to prolong life. In most cases they are installed for the convenience of the staff in removing thre patient from the ICU. You are literally at the mercy of your physicians at this point unfortunately. The trach requires regular suctioning and there are medications to reduce the production of mucus, all with side effects. Don't give up hope but petester your physician with phone calls, letters, e-mails, and all means at your disposal.