|
[Date Prev][Date Next]
[Chronological]
[Thread]
[Top]
[Dysphagia] burning in tongue, inner cheeks, lower neck and left ribcage?
- Subject: [Dysphagia] burning in tongue, inner cheeks, lower neck and left ribcage?
- From: bonnieh4455 at sbcglobal.net (Bonnie Heintskill)
- Date: Mon, 19 Feb 2007 18:21:20 -0600
I have a new patient, Parkinson's Patient (17 years since Dx). Recently hospitalized for weakness due to possible infection post teeth extractions and/or slight stroke (not officially diagnosed but shows some asymmetry to facial features). Alert and oriented x3. Also says she cannot produce tears to cry, although her oral cavity was moist and so were her eyes. Says she has too much saliva and spits it out frequently into a Kleenex. Suggested she try to do more swallowing of her saliva to keep muscles in shape.
Mod to severe oral dysphagia (poor mastication, lateralization of tongue during bolus prep), tongue pumping, c/o food feeling like it gets stuck in her throat (possibly poor epiglottic inversion with food/pills sticking in vallaculae. Fair laryngeal excursion. Currently on soft solids and thin liquids by straw and taking nutritional drink 3x/day via straw. No change in vocal quality after swallows and no overt signs/symptoms of aspiration or silent aspiration.
looked at the side effects of the meds on Medscape. (significant side effects in parentheses)
Medications include:
Pepcid 20 mg daily
Fosamax 70 mg 1x/wk
Remeron 15 mg at bedtime (can cause paresthesia, back pain, flu like symptoms)
Namenda 10 mg BID (Back pain, fatigue, arthralgia, flu like symptoms)
Sinement 50/200 1 at bedtime (akathisia, tremors,
Aricept 10 mg at bedtime (diskinesia)
Lexapro 10 mg daily (serotonin syndrome, extrapyramidal disease)
Sinement 25/100 1 tab 3x/day
ProAmatine 5 mg (for hypotension) (not to be taken with tricyclic compounds or methyldopa; head sensation disturbance, back pain,
Calcium 250 mg 2 tabs daily for osteoporsis
Amoxicillin for infection
Xanax .25 mg 3 times daily (arthralgia, dysarthria, fatigue, paresthesia, limb pain, extrapyramidal disease, hypesthesia, myalgia, increase bronchial secretions, sialorrhea (excessive drooling),
Other than talking to her doctor about all the medications and side effects and obvious treatment for compensatory strategies for swallowing, any other ideas? thanks
|
|