Parkinson’s Phlegm At Night

Anyone Know How To Successfully Treat A Bad Cough Due To Phlegm

My dad is 83 and lives with my family and I full time. He has Parkinson’s along with other problems, although I know this issue is due to the Parkinson’s. He has been having a terrible cough because he gets that phlegm that comes with PD not in his throat and not in his lungs but right in between. When it gets stuck there, he cannot cough it up or swallow it down so he gets this deep honking cough going on which keeps him up half the night. Now he’s like a zombie. Sleeping all the time. He has been prescribed tessalon perles and they do thin the mucous, but it’s just not enough to get rid of it one way or the other. Anyone have any suggestions?

If You Have Swallowing Difficulty What Can Be Done

In some cases, swallowing function varies in response to dopamine medication doses, much like other aspects of motor function. Therefore, if swallowing becomes problematic, an increase in dopaminergic medications can be tried. In addition, make sure you undergo a swallow evaluation when you are in the ON state.

Even before a formal swallow study, you can take steps to increase the efficiency of your swallow. These include:

• Sit upright during all eating and drinking, even when taking pills
• Tilt the head slightly forward, not backward, as you swallow
• Take small bites of food, chew thoroughly, and do not add any more food until everything from the first bite has been swallowed
• Take small sips of liquid
• Concentrate while moving the food backward in the mouth with the tongue
• Double swallow if the food did not go down completely with the first swallow
• Sometimes taking a sip of liquid between bites of food can help to wash the food down
• If eating is very tiring, try several smaller meals spaced out during the day instead of three large meals.

Considering Gi And Non

GI symptoms have a significant influence on the quality of life of those living with Parkinsons, and can reduce the effectiveness of medications such as levodopa. As an example, drooling and difficulty swallowing can result in difficulty taking oral prescriptions. Similarly, gastroparesis can result in changes in response to levodopa treatment by affecting absorption of the drug into the blood stream, and, therefore, into the brain.20,29,39-41 The result of this can be more severe motor-fluctuations in patients, as is also seen in those with other GI conditions that can decrease levodopa absorption, such as small intestinal bacterial overgrowth, or infection with Helicobacter pylori.42 The significance of this is that through appropriate treatment of non-motor and GI symptoms of Parkinsons disease, there is potential for patients to also experience improvement in their response to treatment for motor-symptoms, for a broad improvement in quality of life.

Daniel Levy, PhD, Health Researcher & Writer

First published in the Inside Tract® newsletter issue 211 2019

We thank Maria Marano, Information and Referral Associate, and Julie Wysocki, Director, Research Program, with Parkinson Canada for reviewing this article.

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More Research Is Needed

Based on a review of medical literature, there is no clear thought on the underlying mechanisms that cause shortness of breath in Parkinsons disease.

There are no records of how common it is or the effect of medicationspecifically levodopaon respiration. Limited clinical research is available relating to this often-ignored non-motor symptom.

Additional clinical studies may provide improved understanding and potential treatments.3

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How Are Speech Problems Treated

There are many options to help improve your speech. A speech-language pathologist can help you pick the right approaches for you. Speech-language pathologists are trained health care professionals who specialize in evaluating and treating people with speech, swallowing, voice, and language problems.

Ask your doctor for a referral to a speech-language pathologist. It is also important to contact your health insurance company to find out what therapy and procedures are eligible for reimbursement and to find a list of SLPs covered by your plan. Finally, visit a SLP who has experience treating people with PD.

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How Is Parkinsons Managed

There is currently no cure for Parkinsons but there are medications and therapies that can help to manage Parkinsons symptoms.

Medicines that increase the level of dopamine in the brain are the main treatment used to manage the symptoms of Parkinsons. Medicines are tailored to each individuals needs.

Symptoms will get worse when someones Parkinsons medicines are wearing off and improve again after Parkinsons medicines are taken. If people with Parkinsons dont get their medication at the right time, it leads to their motor symptoms becoming uncontrolled. It can take some time to get their symptoms under control again. If you work in a hospital or care home, it is important to be aware that medicine timings will vary from person to person and may be different to ward medicine rounds.

As well as medicines, surgical options are available for some people with Parkinsons, depending on their symptoms.

Treatments can help to manage the symptoms, but may become less effective in the later stages of the condition.

Parkinsons UK has more information on how Parkinsons affects people and how it can be managed.

What Can You Do If You Have Pd

• Work with your doctor to create a plan to stay healthy. This might include the following:
• A referral to a neurologist, a doctor who specializes in the brain
• Care from an occupational therapist, physical therapist or speech therapist
• Meeting with a medical social worker to talk about how Parkinsons will affect your life

For more information, visit our Treatment page.

Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.

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What Are The Symptoms Of End

Stage four for Parkinsons disease is often called advanced Parkinsons disease because people in this stage experience severe and incapacitating symptoms. This is when medication doesnt help as much and serious disabilities set in.

Theres an increased severity in:

• How you speak a softer voice that trails off.
• Falling and trouble with balance and coordination.
• Freezing a sudden, but temporary inability to move, when you start to walk or change direction.
• Moving without assistance or a wheelchair.
• Other symptoms such as constipation, depression, loss of smell, low blood pressure when going to stand up, pain, and sleep issues.

Many times someone with advanced PD cant live on their own and needs help with daily tasks.

Stage five is the final stage of Parkinsons, and assistance will be needed in all areas of daily life as motor skills are seriously impaired. You may:

• Experience stiffness in your legs. It may make it impossible to walk or stand without help.
• Need a wheelchair at all times or are bedridden.
• Need round-the-clock nursing care for all activities.
• Experience hallucinations and delusions.

As Parkinsons disease progresses into these advanced stages, its symptoms can often become increasingly difficult to manage. Whether you or your loved one with end-stage Parkinsons lives at home, in an assisted living facility or a nursing home, hospice services can optimize your quality of life and that of your family members as well.

The Real Cause Of A Constant Phlegmy Throat

Learn about the root cause of chronic phlegm and the best ways to address it.

1:15 What causes chronic phlegm?

3:26 A deeper look at treatments

5:07 The root cause of chronic phlegm

6:00 Why you need hydrochloric acid

10:05 How to increase stomach acid

14:13 Check out my video on hydrochloric acid

Lets look at what really causes chronic phlegm and what you can do about it.

Chronic mucus production in your throat can worsen at night, and you may notice other symptoms such as:

Postnasal drip

A sensation of a lump in your throat

A sore throat without an infection

An allergy or virus could cause chronic mucus production. However, there is a more likely cause thats related to two other symptoms, GERD and LPR. Both of these conditions are typically treated with antacids or other medications that suppress stomach acid.

If you have chronic mucus in your throat, you want to ask yourself if you have any symptoms related to GERD or LPR. But, the big problem is that some of the treatments for these conditions can come with many side effectsthey may even aggravate the condition. The optimum solution should not give you a bigger problem than you started with.

Its my view that low hydrochloric acid is the most likely cause of GERD or LPR, which can lead to chronic phlegm. Hydrochloric acid is a very important fluid for many different bodily functions.

Instead of suppressing the symptom , we need to look at what we can do for the root cause .

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Sleep Disorder Breathing And Daytime Somnolence For Parkinsons Disease Patients

Non-motor symptoms are prevalent in Parkinsons disease patients and it has also been recognized that non-motor symptoms play an important negative role in the overall functioning and quality of life of Parkinsons disease patients. The most representative symptoms for this category are sleep disturbances, daytime sleepiness, cognitive dysfunction, and mood disturbances .

Sleep disturbances are non-motor symptoms of patients with Parkinsons disease and include sleep fragmentation, insomnia, restless legs syndrome, acute respiratory failure, and REM sleep behavior disorder.

The main treatment for preventing all the abovementioned symptoms is standard positive airway pressure therapy however, it results in a variable and incomplete response in obstructive sleep apnea patients . In addition, it has been reported in the literature that Parkinsons disease is correlated with obstructive sleep apnea, increased sleepiness, and decreased global cognitive function . In a 12-month study by Kaminska et al., standard positive airway pressure therapy in Parkinsons disease patients with obstructive sleep apnea showed beneficial results in non-motor symptoms globally, subjective sleep quality, cognitive function, and anxiety .

Breathing Problems And Parkinsons Disease

Usually, trouble breathing is not thought of as a symptom of PD. Those with PD who complain of this will typically have testing of their heart and lung function. This is necessary since, as we continue to emphasize, a person with PD can develop medical problems unrelated to PD and needs every new symptom evaluated like someone without PD. However, often the testing does not reveal a cardiac or pulmonary abnormality. Could difficulty breathing be a symptom of PD itself?

There are a number of ways in which difficulty breathing may be a symptom of PD:

Shortness of breath can be a wearing-OFF phenomenon

Some non-motor symptoms can fluctuate with brain dopamine levels, which means that they change as a function of time from the last levodopa dose. For some people, shortness of breath can be one of the non-motor symptoms that appears when medication levels are low. However, shortness of breath can be due to anxiety which can also be a wearing-OFF phenomenon. Sometimes it is not possible to determine whether the key symptom is anxiety or shortness of breath. Treatment involves changing medication dosing and timing so that OFF time is minimized. You can view this webinar which discusses the concept of wearing OFF and potential treatments.

Abnormal breathing can be a type of dyskinesia

Restrictive lung disease

Aspiration pneumonia

Sleep apnea

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What Are The Causes

People with Parkinsons may experience varied respiratory symptoms, ranging from shortness of breath without exertion to acute stridor, the sudden onset of high-pitched breathing sounds when taking a breath.1,3

Dysfunction can be caused by a variety of factors including physiological restrictive changes in the lungs, upper airway obstruction, and response to medications.1,3

Combine Exercise With Diet

Dr. Gostkowski says if you want to feel your best, combine a healthy diet with exercise. Research has shown that regular exercise can improve PD symptoms.

Do exercise that raises your heart rate, Dr. Gostkowski says. Aim for about 30 minutes a day, five days a week. Dont worry about specific exercises. Do an activity you enjoy, as long as it gets your heart rate up. Try brisk walking or biking or more advanced exercise for veteran athletes. I recommend seeing an occupational therapist. They can tailor an exercise program to your needs.

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Catarrh Mucus Excess Saliva

Hi my hubby recovering from major Bowel surgery Ben in icu for 2weeks was recovering well but now got this problem with not being able to cough to clear his throat as his muscles are too weak you can hear the crackling and gurgling coming from his throat but cant seem to shift it he is on medication to break up any mucous and he has had dr listen to chest and lungs are clear any one else on medication for this or any help please

I see that this conversation is 2 yrs old, but wonder if anyone has anything to add. I get an attack of catarrh almost every evening and sometimes during the night and first thing in the morning. The feeling of breathlessness briefly gave me panic attacks but Ive learned to control them with breathing exercises. Getting rid of the catarrh is more difficult, Benylyn and hot tea and steam are the only remedies that work. When they dont , it often means a sleepless night sitting upright in bed and only being able to breathe through my mouth.

Constipation And Parkinsons Disease

Constipation is one of the most commonly reported GI symptoms of Parkinsons disease, affecting 60-80% of patients.17,18 Constipation occurs when movement of material through the GI system slows down. This slowing can result from the direct effects of Parkinsons disease upon the action of intestinal muscles that would normally act to massage material through the intestines in a wave-like action , or indirectly through side-effects of some medications.19 In severe cases, accounting for approximately 7% of those with a parkinsonism, compromised peristalsis can lead to complete gut blockage resulting in further symptoms such as cramping, abdominal pain, vomiting, and bloating.16

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What Are Some Of The Disorders That Cause Hoarseness And How Are They Treated

Your doctor will ask you about your health history and how long youve been hoarse. Depending on your symptoms and general health, your doctor may send you to an otolaryngologist . An otolaryngologist will usually use an endoscope to get a better view of the vocal folds. In some cases, your doctor might recommend special tests to evaluate voice irregularities or vocal airflow.

Hoarseness can have several possible causes and treatments, as described below:

Laryngitis. Laryngitis is one of the most common causes of hoarseness. It can be due to temporary swelling of the vocal folds from a cold, an upper respiratory infection, or allergies. Your doctor will treat laryngitis according to its cause. If its due to a cold or upper respiratory infection, your doctor might recommend rest, fluids, and nonprescription pain relievers. Allergies might be treated similarly, with the addition of over-the-counter allergy medicines.

Vocal fold hemorrhage. Vocal fold hemorrhage occurs when a blood vessel on the surface of the vocal fold ruptures and the tissues fill with blood. If you lose your voice suddenly during strenuous vocal use , you may have a vocal fold hemorrhage. Sometimes a vocal fold hemorrhage will cause hoarseness to develop quickly over a short amount of time and only affect your singing but not your speaking voice. Vocal fold hemorrhage must be treated immediately with total voice rest and a trip to the doctor.

Nausea Vomiting And Gastroparesis

Nausea and vomiting are reported by many Parkinsons patients, and may be the result of dopamine-based treatments aimed at alleviating motor symptoms.32 These symptoms can occur as the enteric nervous system of the GI tract, like the central nervous system, makes use of dopamine as a means of communication between neurons.33 Identical receptors for dopamine can be found in the GI tract as in the brain, and these play an important role in the movement of material through the intestinal tract.34 Nausea and vomiting can result from dopamine receptors within the gut interacting with Parkinsons treatments, such as levodopa, that are intended to act upon dopamine receptors in the brain. These symptoms can alleviate over time however, in cases of severe reaction to levodopa therapy, adjustments to treatment made in conjunction with a physician may be necessary. Such adjustments can include changes to dosage, or simply how such medication is taken, for example, by taking medication with a meal.21

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How Do I Know If I Have A Speech Or Voice Problem

• My voice makes it difficult for people to hear me.
• People have difficulty understanding me in a noisy room.
• My voice issues limit my personal and social life.
• I feel left out of conversations because of my voice.
• I cannot participate in telephone calls because of my voice.
• My voice problem causes me to lose income.
• I have to strain to project my voice.
• My voice clarity is unpredictable.
• My voice problem upsets me.
• My voice makes me feel handicapped.
• People ask, “What’s wrong with your voice?”

What Does This Mean

This study showed that Ambroxol is safe to use as a treatment in people with Parkinsons. Ambroxol may slow the progression of Parkinsons disease. How? Taking Ambroxol as a medication can prevent the negative effects of the GBA mutation including possibly reducing the formation Lewy bodies at the source. Ambroxol shows promise, and warrants further investigation including conducting larger, placebo-controlled trials.

Of note, while Ambroxol has been used as a safe and effective over the counter expectorant for adults and children in more than 50 countries for 30-plusyears, the administered dose in this trial was approximately 10 times the specified dosage. Additionally, Ambroxol is currently not approved for prescription or over the counter use by the U.S. Food and Drug Administration for any indication, at this time.

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