Bonnie C

It is good to see you professionals supporting each other - especially when
one's been challenged.

Bonnie R
daughter of Jim 77/3

In a message dated 3/19/99 1:17:59 PM Eastern Standard Time,
[log in to unmask] writes:

> Dear Will:
>
>  According to everything that I've read and have heard in conferences, (I've
>  read and heard Dr. Abraham Lieberman, specifically, address this topic),
>  Kathrynne is correct when she stated that Parkinson's does not cause
>  excessive salivation.  As a matter of fact, she is right on target that the
>  saliva does indeed pool under the tongue.  Normally, throughout the day, we
>  all subconsciously swallow at regular intervals.  In those with PD, due to
>  the increased incidence of swallowing difficulties, the tendency is not to
>  swallow as frequently, therefore leading to a build up of saliva.
>
>  When you mentioned post pallidotomy speech and swallowing problems in
>  relation to "excessive saliva" (drooling), it reinforces this concept.
>  With post-operative swallowing difficulties, there may appear to be an
>  increase in saliva, however, once again, it is the decrease in the
>  automatic swallowing.
>
>  The good news is that there are certain 'exercises' that can be done to
>  help this problem and a Speech Pathologist can show you those exercises.
>
>  An excessive secretion of saliva is called 'ptyalism' and according to
>  Taber's medical dictionary there are several conditions in which this can
>  occur.  It also can be caused by some medications (Taber's mentions
>  mercury, iodides and pilocarpine).
>
>  I know that for so many people, drooling is quite a problem.  In Dr.
>  Lieberman's book  (Parkinson's Disease - The Complete Gude for Patients and
>  Caregivers), he suggests that during the day sucking on a hard piece of
>  candy will help as it will force the person to "remember" to swallow.  He
>  also suggests that for those who are in advanced stages of PD with this
>  problem, that their caregivers periodically remove the saliva with a bulb
>  syringe. Also the suggestion is made to have the person sleep on their side
>  so that they will not have a choking episode.
>
>  Warm Regards,
>
>  Bonnie Cunningham
>  NPF
>
>  For once I beg to differ with your esteemed opinion. Since childhood I have
>  experienced periods of increased saliva production. This is usually brought
>  about by some reason, like biting into a delicious piece of food. It used
>  to be so strong that on opening my mouth saliva would come out
>  in a spray. Another occasion would be a visit to the dentist where the
>  saliva production could be awkward and probably was psychosomatically
>  induced. In those cases there was a real cause of increased saliva
>  production and not a sudden cessation of swallowing.
>
>  I have known several PWP's, who had undergone palidotomies and developed
>  excessive saliva production as an aftereffect of the operation, along with
>  speech and swallowing problems. I cannot go along with the explanation that
>  the drooling these people exhibited was just caused by a sudden diminishing
>  of swallowing and I don't understand that so many neuro's and other experts
>  seize on the easy explanation.
>
>  I wonder if there are more people that take issue with this.
>
>  Will A. Kuipers      Dallas, Texas        78 / 71 / 70
>  <[log in to unmask]>
>