coughing fit

[speedyfell]

My mom is living with us and has occassional coughing fitw where she cant catch her breath and I'm hoping someone will have a quick fix or remedy.  Her history is a little unusual.  She has extensive thyroid cancer which is resolved thanks to an unsuccessful, therefore partial, thyroid resection, radiation and iodine treatments.  After 10 months of living with a treach, she had it removed 3 weeks ago.  At first her breathing was better than ever, but now that the treach hole has healed, her breathing is quite compromised.  She is fine most of the time, relaxing and doing small tasks.  She still has mucus and worries that a plug will block the 30% airway that she has left.  She'd like to have a quick fix that she can reach for when the coughing begins and the panic sets in.  These fits only happen 1-2x a week, but they are petrifying and feel life threatening!  We are in the process of trying several ideas: meat tenderizer/water, Robitussin expectorant, codine, hot black coffee, nebulizer and thankfully Ativan!!  These seem to aid in keeping the mucus thin in the esphagus, but does anyone have a quick fix for when there is a mucus plug trapped in the treachea that she can't cough up due to her weak cough from her one working vocal cord and therefore only 30% of her airway.  I realize that putting the treach back in is the reasonable and easy anwser...however it is a quality of life issue and we are trying whatever we can first and we will succumb to that as her last result.

[National Jewish]

That your Mom's breathing was fine with the tracheostomy and significantly compromised with closure suggests that the problem resides in her proximal airway above the tracheostomy, including a paralyzed vocal cord.  Before looking to a "quick fix" it would be wise for her to have a direct examination of this airway to determine what, if any of the obstruction might be reversible.

In the meantime, steam or warm vapor inhalation for 15 to 20 minutes 4 times a day could help liquefy secretions.  You should also check with her doctor(s) about the use of liquefying agents such as glycerol guaiacolate and potassium iodide.  Breathing through one's nose can humidify inhaled air and reduce the tendency of mucus to clot.