Dear Doctors, I Have Been Asking For Helpful Information For

Question: Dear Doctors,
I have been asking for helpful information for my 59-yr old male friend, who lives in a Social Services-controlled group home. He has had a problem with too much mucus in his throat and is in the habit of spitting every few minutes to get it out. By his report, this has been going on for a couple years. We have received some suggestions already, but my question is, "what can we do to evaluate my friend?" And how will it get paid for? The group home is not too anxious to find a solution for him, but I AM, although I'm not rolling in dough. But I am quite ignorant on how to solve this. I have never met anyone who "needs" to spit every few minutes.
Does anyone know someone who used to spit all the time and, after finding a solution, has been relieved of this? If so, how?
My friend is very discouraged and wants to just give up and die. He believes that there is no solution to his problem that can be found and paid for by Social Services.
I believe that there is a solution out there which will help my friend to overcome this habit/problem and return to living in a useful way.
Again, thank you to those who have already responded. I printed out your answers and took them to him today. I just need more understanding of what can be done to help him find a solution.

Dear Doctors,
I have been asking for helpful information for my 59-yr old male friend, who lives in a Social Services-controlled group home. He has had a problem with too much mucus in his throat and is in the habit of spitting every few minutes to get it out. By his report, this has been going on for a couple years. We have received some suggestions already, but my question is, "what can we do to evaluate my friend?" And how will it get paid for? The group home is not too anxious to find a solution for him, but I AM, although I'm not rolling in dough. But I am quite ignorant on how to solve this. I have never met anyone who "needs" to spit every few minutes.
Does anyone know someone who used to spit all the time and, after finding a solution, has been relieved of this? If so, how?
My friend is very discouraged and wants to just give up and die. He believes that there is no solution to his problem that can be found and paid for by Social Services.
I believe that there is a solution out there which will help my friend to overcome this habit/problem and return to living in a useful way.
Again, thank you to those who have already responded. I printed out your answers and took them to him today. I just need more understanding of what can be done to help him find a solution.

I am very thankful for your explanation and questions, Dr. Bhagyesh. As soon as I get the answers I will forward them to you. My friend might be asleep already, so it may be in the morning.

I am very thankful for your explanation and questions, Dr. Bhagyesh. As soon as I get the answers I will forward them to you. My friend might be asleep already, so it may be in the morning.

Dear Dr. XXXXXXX

I finally spoke with my friend today by bringing him a printout of your answer and list of questions. Here are the answers to your questions, as best I could get from my friend.

1. Details of progress of the condition since the beginning: My friend told me that this condition has gotten worse since he first noticed it, about 10 years ago, while he was riding on his motorcycle. He told me that at that time he was spitting, while riding the motorcycle, about once every hour. This HAS gotten worse. He was noticing that in the last 2 years it has worsened to needing to spit about every few minutes.
When he is asleep, he is in deep sleep, because of medication he gets from those in charge where he lives, but about 6 months ago he started waking up suddenly with a fit of coughing and spitting and he has to spit on the floor. He says that his condition of spitting is about 10 times as bad now as when he first noticed it.
FYI, While we were sitting in my parked car discussing these questions, for example, my friend brought up mucus with the sound of bringing up phlem by clearing one's lungs, would open the door and spit about every 4-5 minutes. Now the spitting is too often for him to be comfortable.
He has some acid reflux. He takes TUMS.


2. Associated cough, fever, breathlessness if any: He does not have an associated cough before spitting, other than the bringing up phlem, probably from his lungs. There is no fever associated with it. Sometimes he feels breathlessness, but not all the time.

3. Alteration in weight, limitation of daily activities: NO (But as an observer I might say that his spitting problem affects his social life and self-confidence.)

4. Associated high BP, diabetes, heart or kidney problems. NO

5. Can swallow food, chew properly or not: Some mild problems in swallowing once in a while.

6. Level of stress, sleep pattern details: Stress is definitely increased with the excessive spitting, due to his inability to control it, although when he is with me in church, he quietly and swallows what comes up, so as not to disturb others. When I watch him, I can tell that he is struggling to keep it quiet.

7. History of smoking, if any: My friend told me that he started smoking at 12 years old, but he has never felt addicted. Even now, he is not addicted as are others living at the home where he lives who NEED their cigarettes or they'll die. I would call him a casual smoker, as I have seen him smoke only twice in the two months I have known him.

8. Any other supportive details which may help to understand the issue? Here is MY addition, based on what I have heard him say. He did spend some time, at least a year, as a homeless person. One thing he told me is how often things were stolen from him while living in that condition.

9. List of current medications, if any. Any reports carried out on the issue so far?: My friend knows that he takes gabapentin. He takes other things, but he doesn't remember what they are. The home in which he lives knows what he takes, but THEY were not willing to tell me, because I am not my friend's relative. But I will go talk to another person in authority tomorrow to see if that person will tell my friend and me together.

Anyway, Dr. XXXXXXX thank you so much for your questions. As I am still getting to know my friend, I have done my best to report what I understood him to say.

Dear Dr. XXXXXXX

I finally spoke with my friend today by bringing him a printout of your answer and list of questions. Here are the answers to your questions, as best I could get from my friend.

1. Details of progress of the condition since the beginning: My friend told me that this condition has gotten worse since he first noticed it, about 10 years ago, while he was riding on his motorcycle. He told me that at that time he was spitting, while riding the motorcycle, about once every hour. This HAS gotten worse. He was noticing that in the last 2 years it has worsened to needing to spit about every few minutes.
When he is asleep, he is in deep sleep, because of medication he gets from those in charge where he lives, but about 6 months ago he started waking up suddenly with a fit of coughing and spitting and he has to spit on the floor. He says that his condition of spitting is about 10 times as bad now as when he first noticed it.
FYI, While we were sitting in my parked car discussing these questions, for example, my friend brought up mucus with the sound of bringing up phlem by clearing one's lungs, would open the door and spit about every 4-5 minutes. Now the spitting is too often for him to be comfortable.
He has some acid reflux. He takes TUMS.


2. Associated cough, fever, breathlessness if any: He does not have an associated cough before spitting, other than the bringing up phlem, probably from his lungs. There is no fever associated with it. Sometimes he feels breathlessness, but not all the time.

3. Alteration in weight, limitation of daily activities: NO (But as an observer I might say that his spitting problem affects his social life and self-confidence.)

4. Associated high BP, diabetes, heart or kidney problems. NO

5. Can swallow food, chew properly or not: Some mild problems in swallowing once in a while.

6. Level of stress, sleep pattern details: Stress is definitely increased with the excessive spitting, due to his inability to control it, although when he is with me in church, he quietly and swallows what comes up, so as not to disturb others. When I watch him, I can tell that he is struggling to keep it quiet.

7. History of smoking, if any: My friend told me that he started smoking at 12 years old, but he has never felt addicted. Even now, he is not addicted as are others living at the home where he lives who NEED their cigarettes or they'll die. I would call him a casual smoker, as I have seen him smoke only twice in the two months I have known him.

8. Any other supportive details which may help to understand the issue? Here is MY addition, based on what I have heard him say. He did spend some time, at least a year, as a homeless person. One thing he told me is how often things were stolen from him while living in that condition.

9. List of current medications, if any. Any reports carried out on the issue so far?: My friend knows that he takes gabapentin. He takes other things, but he doesn't remember what they are. The home in which he lives knows what he takes, but THEY were not willing to tell me, because I am not my friend's relative. But I will go talk to another person in authority tomorrow to see if that person will tell my friend and me together.

Anyway, Dr. XXXXXXX thank you so much for your questions. As I am still getting to know my friend, I have done my best to report what I understood him to say.

Thank you so much, Dr. XXXXXXX I will print this out and see him today after my dental appt. Lynda

Thank you so much, Dr. XXXXXXX I will print this out and see him today after my dental appt. Lynda

Dr. XXXXXXX
I am glad to report that my friend took your suggestions about what to do seriously. Apparently he has a doctor of some kind from whom he needs to get permission to have the tests done. He has made an appointment to see her on Monday. We will let you know what happens.

Dr. XXXXXXX
I am glad to report that my friend took your suggestions about what to do seriously. Apparently he has a doctor of some kind from whom he needs to get permission to have the tests done. He has made an appointment to see her on Monday. We will let you know what happens.