Excess phlegm from paralyzed vocal cord...

I had a brain tumor removed 8 months ago...it affected cranial nerves 5 thru 12...have a paralyzed vocal cord and epiglottis so have not been able to swallow since surgery...have a j tube and use Jevity...I tolerate the Jevity but have excess phlegm that I spit up constantly...only break I get from it is at least when I sleep I dont do it. Anyone else have this?

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Wow! Cool! Another person with a paralyzed vocal chord! Me too!

It's my left vocal chord that's paralyzed, and apparently it's been that way since 1976, after my initial repairs of a tracheoesophageal fistula (no esophagus).

I have been doing pretty well with it my whole life, up until the past 4 years though. Now, like you, I have had a lot of phlegm and also have to spit it out.

I am j-tube fed and am on Osmolite 1.0 since I wasn't able to tolerate the Jevity at all.

To deal with all the congestion, i take a Benedryl at night. That seems to help with the phlegm. But also I found I have underlying allergies to dust and mold.

Recently, I've taken a break from my formula and have been doing more natural nutrition such as broths and carrot juice. I am so surprised to find how much my phlegm has lessened! I've been so excited to not have to deal with all that gunk this week.

It's hard to say what might be the cause of the excess phlegm for you, but keep trying new things and listening to yourself. If it doesn't improve or lessen to your liking, perhaps ask your dietician if you can try a lactose-free formula as milk products can tend to be congestion forming. Just a thought.

Nice to see your post!

All the best,
ChristanQ

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Well...I dont really have a dietician...I was in a rehab and had one there but not now. Dr. ordered my formula and my PcP signed it but he doesnt really get involved with me. Im on speech therapy but thats ending...my voice was real raspy but is a little better...but not like it was. My rt vocal cord and rt side of my face is paralyzed...walk slowly with a cane. I just get so tired of the phlegm...I have no pain but I take 1/2 Hydrocodone pill before social functions and it helps with my cough and plegm...I flunked my swallow test...Thanks for responding.

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Hello Rozelle,

Do you use a suction machine?
Jo (Duvie's sister) & I, take care of Duvie's med. needs such as meds., bandages, feedings, lung suctioning, appointments, etc.
Duvie's swallowing doesn't work either. He also has a lot of saliva that collects or pools by the voice box. He does at times fight to try to cough and spit it out. We have two suction pumps that we use. One uses electricity only and stays in his room. The other is a portable suction pump which is ran by a rechargable battery. It can be recharged by electricity or cigarette lighter. That one stays in the vehicle. We take care of the lungs once the saliva goes into the lungs, but Duvie catches most of the saliva himself by using what is called a " YANKER." It is a hard plastic curved piece that is used through the mouth down into the throat to retrieve the saliva before it continues on down into the lungs. The yanker helps control his fluids in the throat and he likes it.

If you have never tried a yanker, then perhaps you could try one and see if it makes life a little easier.

RESPECTFULLY
Errol & Jo
caregivers

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I have to spit all day long, and I'm able to keep my vocal chords clear(according to the ENT doc)
Sleeping is hit or miss. Some nights, no drool; other nights my pillow is a massive mess. My doc prescribed Amitriptylene, to work as mild sedative and to dry out the mouth. It seems to work. I usually sleep pretty soundly(except this night) And I always sleep on my side because of fear of aspiration. I could tell a difference in the thickness of phlegm when I have a cold. I never realized how much mucus I swallowed when was able!!! Good luck!

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I also can not swallow and the phlem and mucus are a problem, seems like I am spitting every other minute.Any help would be very helpfull.

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Thanks for posting your problem with mucus/phlegm. My husband also has a problem with it, and I thought that he was the only one with the problem. He has Alzheimer's and requires total care in our home. We use the suction machine in the morning, and if needed before bed. He, too, does not take anything by mouth. I give him one can of 2calHN in the morning, and the other two meals are blenderized. Due to protein and calorie needs, I'm hesitant to eliminate milk products. I have not tried the "Yanker" and would like to know where to obtain it. He would not be able to use it on his own. It would be something that I would need to do for him. Does it require a prescription from the doctor? Since he sleeps with his mouth open and has a tendency toward dry mouth, the previously described medication would not work for him. And yes, we, too, are constantly on guard for aspiration pneumonia which he is currently fighting.

Thanks, and please keep the ideas coming!

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Hello The Tinkie,

Duvie sleeps with his mouth open also and constantly has dry mouth. I believe patients develop sleeping with their mouth open from being on a ventilator. I also believe some patients swallowing mechanism stops working properly due to the swallowing mechanism hitting the tube of the ventilator if the patient is in that situation for several mos. It seems to me that the swallowing mechanism gets used to only being able to travel so far and the subconscious mind, which controls most swallowing thinks it is only suppose to move that distance. Why hospitals are so slow at starting swallowing therapy, is beyond my understanding.

You said your husband is currently fighting asperation pneumonia. Is he in the hospital? If so, ask respitory to bring a yanker and show you how to use it properly.

We get all Duvie's medical supplies from one provider including suction catheters and yankers.
It's hard to get anything without a perscription if insurance is paying for it. I can't even get paper tape.
However if I am willing to pay for it myself then I can purchase some of the supplies without a perscription.

Duvie handles the yanker own his own. He apparently feels when the yanker is far enough to get the saliva without going too far.

RESPECTFULLY
Errol & Jo
caregivers

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I, too, have a paralyzed vocal cord. The right RLN was damaged or cut during the second of three surgeries through the same incision on my neck in the past four months. I also have phlegm after I eat/drink through the tube or orally and will choke if I don't spit it out (which I am good at).

I did have a Radiesse injection done which helped immensely. That along with therapy returned my speaking voice and my singing voice until the Dec 19 surgery to repair the esophageal tear where they cut the neck muscles. I can speak normally but cannot raise my voice, project, and can only sing softly. This they believe will improve as the muscles heal.

During the last scope the greatest thing happened... Amidst the phlegm when I 'aahed' the right vocal cord started quivering. Not full movement but something and I was told a sign the cord is healing which was doubted before the injection.

I share this with you because if anyone reading this has suffered a recent injury to their vocal cords I urge them to inquire about Radiess Injection for the Voice. I had to go to a Voice Center - ins did cover. I do not know the effiacy for someone with an old injury but you could ask.

As for the phlegm I gargle a lot and now that I can be PO I squirt chloraseptic in my throat at night which helps break up the phlegm.
Also, if you can drink at all warm chammomile tea is my favorite 'phlegm breaker'. I also eat no dairy, either oral or in my tube as this increases phlegm.

So interesting to note this is from the vocal cord. They told me it was acid reflux.
Hmmm. Do any of you have AR?

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Rozelle...........

Your condition is almost a close match with mine. I started 7 months ago while in the hospital for another reason after complaining of difficulty swallowing and speech. They thought I had a mini-stroke after many, many tests but settled for dysphagia (non-swallowing) and a paralyzed vocal cord, left side. Went for a PEG and an implant for the vocal cord. Speech is okay but excess saliva and phlegm drives me nuts. ENT says we make about a pint of saliva a day. Prescribed Allegra to dry things up which seems to work a little but I still do my share of "spitting". While sleeping there is no problem. My epiglottis is "lazy" as swallow test showed. It's been a wait and heal process but I'm looking for something more aggressive. On Jevity 1.5, 7 cans ,4 times a day, 2400 calories. Had some therapy but insurance cut me off. Let's hope 2013 is good for both of us. Thanks for sharing.
85 yr. old male, happily remarried 9/10/11.

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