Too much mucus or phlegm in 102-yr old LO, interferes with swallowing. What doc for her to see: ENT? Pulmonologist? Other?

Update: we decided to give my aunt a higher dose of Mucinex (or generic) because nothing bad could result if it didn't work. I got the one without an additional drug in it called dextromethorphan, which is a cough suppressant and was making her jittery and that's why she was pushing back on taking it. So, doubled the guaifenesin. She now takes it 2x a day and hasn't had any more problems with excess saliva/secretions and swallowing food. If this wouldn't have worked we would have moved on to a specialist. I hope this info helps others on the forum. Thank you to everyone who responded with their insights!

My memory jogged itself and after posting, I began to do some research and found this, a thread I created when Scopolomine was recommended for my father.  He was 99.5 at the time.

https://www.agingcare.com/Questions/does-anyone-have-experience-with-scopolamine-patches-for-someone-with-dysphagia-437151.htm

Others offered good insights, and I think that other than the complaints about the sports med practice that became involved w/o my knowledge or consent, there are some on topic suggestions.   Others also addressed how their loved ones' oral accumulations were handled.

In retrospect, I do believe the Scopolomine helped (as did the suction machine) to clear some of the mucus; it wasn't as bad as when I first brought him to the rehab center.    But he also was less capable of drinking anything as time went on.

Geaton, I apologize but I don't recall if your aunt is living at home, with you, or in a facility.   My father experienced this, after several years of dealing with progressive dysphagia.   Then one day the mucus and if I recall correctly an infection created such volume that he was really choking and gasping for breath.  I called EMS and we were back in the ER.

He was suctioned there, but the mucus kept accumulating.    No D/X had been made yet, and when I asked an ER nurse to suction him, she told me to do it myself.   She was not responsive to my statement that I wasn't a trained medical personnel and wasn't comfortable suctioning; I could easily injure something since I wouldn't know what I was doing.    I can't recall now if another nurse came, or if I went above her (which I probably did) to get help.

I believe that Dad was later diagnosed with a throat infection, but I don't recall for sure.  

I think if I were you I'd try to get a speech pathologist to determine what the accumulation is, i.e., just mucus or a throat infection.  That would determine what treatment would be appropriate.  

From your experience, I'm assuming you're familiar with dysphagia and escalation from the basic level to a higher one in which inability to swallow is more dangerous.    If she's in a facility, I'd try to get an immediate exam by a speech pathologist.  If not, I'd arrange for an ER visit.  

Later on that night, I was so glad I went to the ER.  And if I don't have my dates confused, that was the night that I received a 1 am call from one of the treating physicians telling me that Dad had become cyanotic .  I was soooo glad I took him to the ER with experts; I was already terrified at his house when I saw the volume of white "stuff" in his mouth earlier.

He did have aspiration pneumonia, was repeatedly suctioned in the hospital as well as in the follow-up rehab placement, during which suctioning still needed to be done, while he also segued into palliative care.  

A med was considered and used (after I investigated and researched) to help control the mucus accumulation.  A lot of what happened about that time isn't clear, as we both knew he was dying and our thoughts were heavy with emotion and concern, but I believe the drug was Scopolomine.  

(I remember b/c in one Alistair MacLean espionage movie I watched several times, that was the drug used to interrogate someone, to  "relax" his mind enough to reveal confidential issues.    So I initially didn't understand why a doctor or nurse would recommend Scopolomine.)

As to your aunt, I'd act and call EMS, now.   I don't like to scare people, but the thought of turning blue might be enough to encourage her to agree to an EMS visit.   I'm sure if I hadn't called EMS, my father would have died shortly after I arrived at his house.  At least he had some more time to say goodbye to his family and friends.

When my husband started having mucus or phlegm when eating, and he had to continuously spit it out, was when I called 911 and had him taken to the hospital, where it was discovered that he had aspiration pneumonia, and almost died.
Hopefully that's not what your aunt has, but it might be worth having it checked.

Also when my husband was in his 6 week dying process and he started to build up a lot of mucus, and phlegm, hospice provided patches to put behind his ears(the same patches they use for nausea, as they supposedly help with phlegm as well)and provided some kind of drops for me to give him for the problem as well. Sorry I don't recall the names of either, but a Dr. or pharmacist will know. Best wishes.

Her GP or PCP is the best person to advise on which specialty to consult and will probably also know the key personnel in your area.

How is your aunt's health otherwise? I'm not sure what is going on because what you describe seems contradictory, she is bothered by thick mucous blocking her throat as well as an excess of saliva that runs "so much she can't swallow it", but my first instinct is that this is all related to swallowing dysfunction (dysphagia).

I know with my Husband there was an increase in secretions (he had dementia as well as allergies)
I had tried Benadryl at one point then I tired it myself one night and woke with a "foggy brain" and I figured if it did that to me I can imagine how my Husband with dementia felt having an even foggier brain so I stopped giving it to him.
When he started on Hospice he was prescribed an off label use product. Atropine Eye drops to be given orally to dry or lessen secretions. That did work to some degree.
When he was in bed I would roll him on his side to allow the secretions to drain out.
I know there are other medications that can help dry secretions it might be worth talking to the PCP first rather than subjecting her to a lot of testing.
If the PCP will not prescribe anything I think the first appointment I would make would be with an ENT.
Are there any other problems with swallowing? It might be possible that the reflex that closes the esophagus from the trachea is "confused" and does not know what to close off. There is a possibility of aspiration even small amounts.