Drip

[Nomad]

Got on Pilcarpine. Got some improvement. But I have now periodic "drip" of some kind. Very similar to post nasal drip...but not really. Front of mouth only. Like front two teeth. Maybe front four teeth. Coming down from that area into mouth. Usually watery. Sometimes thick. It's driving me nuts. Thoughts? Experience? I'm miserable. Thank you.

[meirish]

Just curious if you have tried cutting back some on the dose? It might cut down on that drip. Interesting that the drip is there. Wonder which glands the drip is coming from. I can't think of anything right now that would help. This is a rather unusual experience when one has Sjogrens. Also am wondering if you took the dose a little earlier before eating if it would change things. Like maybe not so much drip before eating and less after. Im thinking that possibly the most dripping would be when one is eating. Anything you think of will be worth a try. Take care and good luck. meirish

[Nomad]

Can you explain a little more specifically about your idea when to take the Pilcarpine? I could take 1/2 tabs 45 -60 minutes before each meal?

Awhile back I saw someone with sjs used this term "teeth sucking" I wish I had wrote down their name. I suppose this could describe what is almost involuntarily happening to me. Saliva falling down  in the front part of my mouth only. I'm so afraid of it drooling, I sort of suck on my front teeth and make weird noise. This  saliva in the front doesn't help my dry mouth. I've tried lowering my dosage of Pilcarpine and it is unclear if it is helping. At first I thought so, now I'm unsure.

 When I wake up, it's not happening. This might be an important clue. No drip  in the front. The second I eat or drink something it starts. Worsens badly with the second item digested.  Weird drip in the front starting with food intake. And my cough drops now seem to make it a little worse. It's almost like an over reaction. Yet my mouth remains very dry.

 My gp, dentist and oral surgeon have not heard of this before. I see rheumatologist in February. Any experience like this? Thank you.

[meirish]

This is a really interesting plus bothersome issue that you have. If you go online and search for phrase images of face/salivary glands you should eventually see a picture of a persons face and the position of the salivary glands. There are two salivary glands that lie beneath the tongue and are called the sublingual glands. They would drain more at the front of the mouth. I would bet that these are the glands that are being so busy secreting saliva.

Also, there are two glands tucked in sort of up next to your jaw bones but slightly lower down in the tissues  These are the submaxillary glands. I had to have one of these surgically removed due to strange issues. Also the glands on each side in front of the ear. These two glands in front of the ear are often the ones that will give people pain.  It is sort of like the ducts are trying to stretch open to secrete saliva. Causes spasms and hurts.

This can be bloody miserable. Generally what needs to be done when that happens is to apply some heat to the area and then do some gentle massage. Often the saliva gets so thick that it can hardly slide through the ducts. Plus there are times that one can have gravelly mucus as stones can form in the saliva. It also can help to apply heat and do some massage just to help keep these ducts open. You can tell when things back up in the ducts as the glands will swell. Some people have little swelling and some discomfort and other people will have very enlarged glands and lots of pain. This usually means a stone needs to be removed.

I am wondering if it would help to elevate your pillow some when you sleep. When you lie back the saliva may not move through the ducts well and then when you get up and around it could just gush out. I wonder if an assessment by an ENT doctor or another doctor would help.  It could be helpful to do some scans that might pin point something causing this to occur.  What happens when you stop taking the pilocarpine I wonder. Just some info and some thoughts. Hope you can get this resolved. Good luck and Merry Christmas. meirish

[Nomad]

Stopping the Pilcarpine ended up being horrible. Super dry. Yet the drip in front was still there. It's maddening.

[meirish]

Nomad, This is very interesting and not very comfortable. I sat here and thought about this and I wonder if it would help to see an ENT doctor. Sometimes these docs have been exposed to some of the strangest health issues and they do see a lot of Sjogrens patients.

One of these docs might have a theory or idea on how to deal with this. My one thought was that -- is it possible that you have a duct that is not draining correctly so that saliva backs up in the duct and doesn't drain properly.

Sort of like a pail of water with a slow leak. Or maybe you have a gland that is full of "sludge" or small gravel that is impeding the natural drainage. Sometimes it is just worth it to wait until you have several issues that you need to discuss with a specialist and take your list  and see what they say. There is no stupid question that is for sure.

Don't want you to think that every problem is solvable, but, there have been some weird physical issues over the years that have been solved by doctors who can take a step back and think outside the box. Good luck and let  us know it you find an answer. meirish