Swallowing

[Carolss]

Recently it has gotten harder for me to swallow and can foresee that shortly I may not be able to swallow at all. Please share with me ur experiences re. Swallowing.

[Hidden]

My son like me has episodic ataxia 1 and goes through that.

[Legs-alive]

You need to ask your gp, your neurologist or whoever it is that your under to be referred to the neuro SALTS team- Speach & language therapists. They can help with swallowing problems & give you advice & techniques to help you.

[LuisRodicioRodicio]

Hi Carolss!

These are our experiences with PSP disease, hoping could be useful for you.

Hugs and luck.

•Phlegm and choking: The first thing is to remain calm during episodes of truly shocking coughs. The second is that a physician rules out an infection in the respiratory tract. Get a pulse oximeter to control. (Fever is an indication usually either pneumonia or urinay tract infection (UTI) in PSP patients).

•It is not a big problem that the patient swallows his phlegm. For phlegm to be fluid, it is important to drink liquids. Steam inhalation from boiling water in a bowl with a few drops of some floral essence (avoid mint plants and eucalyptus) that is pleasant to the patient, a small spoonful of marine salt and some pieces of lemon, with a towel covering head and bowl helps. (One to three times a day.) Medications like "Mucosan" (Ambroxol hydrochloride) twice a day or “Fluimicil Forte-600” (Acetilcisteine) one by day, help. Ask physician.

•In case of choking, raise both arms at shoulder height, breathe only through the nose intensely if posible. I not, inhale air intensely but not very fast through the mouth. Retain air a couple of seconds and then force the cough.

•Also here, to avoid in the diet drinks that can be irritating helps: coffee, carbonated beverages as pop or soda (or eliminate the gas by agitation before giving it to the patient), chocolate, orange or grapefruit juice, etc.. There are some foods to avoid…. things like rice, foods that crumble easily, sticky foods, etc.

•There is a suction machine which helped a lot with the very sticky phlegm. We have NOT used it yet.

•A steam atomizer to keep the air in the room moist helped, too. (40% - 52% moist advisable.)

•The physiotherapists have exercises reinforcing trunk muscles to improve the cough response to choking. Engage a good speech/swallow therapist to learn swallowing techniques.

•Avoid dairy products, especially before bedtime seems to avoid the increase in viscosity of phlegm.

•Raising around 15º a 20º the head of the bed also helps.

Prevent solids or regular liquids from reaching the lungs to avoid eventual “aspiration pneumonia,” (Besides falls, this is another very important risk.)

•Add thickeners (eg, Resource from Nestle, Thick-it, Simply Thick-Easy Mix, CVs) to drinks (soups, water, Aquarius(*) orange or lemon or similar without gas, etc.) till obtain a bit glutinous liquid. To drink, it is advisable to use a special cup (Ornamin 815) with the chin as near as possible to the chest. Some mango and peach juices have an adequate consistency.

(*) Isotonic drinks are interesting to help maintain blood electrolytes at the correct level.

•The food must be moderately doughy and in small pieces if solid.

•The speech therapist has insisted that she should not take meals that "deceive" the mechanism of swallowing that is damaged. The foods that “deceive” are those that have liquids and solids in the same bite (eg, some beans with soup or a soup with pasta).

•Check the patient is sitting fully upright to eat and try not to have distractions around while he is eating.

•Making a puree with a hand blender is always a solution, but it is preferable to crush with a fork until a homogeneous paste without liquid and so as not forget the function of chewing. What is not used is lost!

Foods: Mediterranean diet emphasizing on fruits (peeled fruit avoiding the presence of seeds) and vegetables; high fibre diet... no so much pasta or potatoes (always with a size of each piece of pasta between 1/2"- 3/4"). Fruit compotes in small pieces or better crushed using a hand blender. Dates, avocados, bananas, yoghurt, custard and ice cream are well tolerated. Thick milkshakes from Wendy's (Frostys). Mango juices usually have an adequate consistency. Try jelly. Avocado and dates provide magnesium, avocado and mango fiber and bananas the potassium.

Hugs.

[Carolss in reply to LuisRodicioRodicio]

thanx

[benning]

PERSONALLY I think it's all to do with Posture????

[joecampbell94]

I have experienced this aswell and discovered that it's all about concentrating, taking your time and don't rush with anything, staying relaxed and keeping your posture. I found that swallowing which looking forward is easiest, it also helps sometimes to nod your head as you swallow to help the food down. Oh and have a drink every now and then.

[suzie44na]

I have weak swallow and sometimes food sticks on going down. I think myself in my case it is due to muscle spasms, so the muscles don’t move the food down properly, I feel as if it is slowed up. Hope you can get help from your speech therapist x

[Carolss]

thanx

[Jobbo16]

I have dysphasia I know how hard it is swallow they discovered I have a pocket which closes over my throat

[coat2003]

Carolss, can't partake as waiting for a speech therapy appoint, addressing choking as well, whether it is the muscle that needs exercising or directions how to swallow safely, as scared last night, wrong breathing, dry bread and soup and a frightening choking...it happens with solid food, sporadically, not often, but when it comes...scares me...maybe liquidizing food, just keep an eye on it, as possible weight loss...