choking

[blackcat]

over the last several months i am having problems with swallowing and i choke easily doesn't matter what i am eating i also am losing my ablity of being heard apparently my vocal cords are not working properly they had me go thru speech therapy a few years ago to work on my swallowing and ability to get my loudness back when i speak. it seemed to work for a while but now is not being offered to me as an option

is anyone else experiencing this and what are u doing for it or is there a med u are taking for it i find my self eating and talking less

blackcat

[wifeofparky]

Have you tried doing the exercises you tried in Speech Therapy? Why can't you get it again? If you are experiencing a change, it should be provided to you. Speak to your Movement Disorder Specialist now.

[isis6361]

It's common in pwp. You need a speech and language therapist to carry out a swallow assessment . This will give you the cause. A dietician will advice on a soft diet but only once a salt has given a diagnosis. Sometimes it's fluids that cause this other times it's diet.

[munnings in reply to isis6361]

I also suffer with swallowing issues. Last year I was on a liquid diet only for some months. It started with getting a tablet stuck, after this incident I went into panic mode every time I ate. Am much improved now after doing the exercises given to me by the speech and language therapist. When speaking, I try to project my voice (shout) as much as possible. This's seems to make it come out as normal! I rarely now eat meat and I crush tablets or have dispersable ones. Despite all of this, I have a very healthy diet and am not concerned with the new adjustments, just grateful I am back on solids. Sorry to go on about myself but sometimes it is interesting to get someone else's history. Are you still practising the exercises for speech and swallowing? Also, make a note of what makes you choke and avoid. I find a smoothly lolly helps move small bits that are stuck in my throat.. Swallow water with your chin tucked into your neck and chew your food well! Hope this helps. Oh and also concentrate on eating when you are eating.

[Coblrman]

My speech is better now than it has been in a long time. I do sing a lot each day very loud (I work from home). Don't know exactly why its better but I hope it is at least encouraging to you.

[PatV]

Project. Ask someone if they can hear you.

[michaela13]

I have a swallowing problem and i noticed its mostly after i take my sinemet. In the morning and at night i have no problem. I just make site i have liquids at all times.

[isis6361 in reply to michaela13]

That is known as early morning off periods. Soluble Madopar might help

[quirkyme]

in USA, we do Lee Silver's Voice Training or LSVT-LOUD. In improving speech loudness, PwPD also/often get help with swallowing. My husband will do LOUD in January. He had a swallow evaluation when he was first diagnosed in 2007. He has some coughing and a little trouble but tends to eat slowly anyway which helps him. Have you had a swallow evaluation?

[blackcat]

thank you for all your input that is why i love this sight because i know the support is always there. i do still do the exercises that were given to me and try to remember to talk using my muscles and push the air from my stomach, but forget and get lazy too. i have never hear of the LVT Lout. would like to know more about it. i do plan to ask my doctor to write a new Rx for more therapy, but he will have to write it for a different type so my insurance will cover it. i have had a swallow eval done twice it showed the muscle obviously are losing their strength. i do take seniment i will need to see if it is worse after that . i do a lot of liquid but bottom line i am starting to hate to eat. food and eating has become a bother to me thank u so much for the support God Bless u all

blackcat

[margie]

I told my movement specialist and she ordered a test to see if I had problems swallowing. It was not an evasive test.I went into a seated booth and was given different textures of food and I was filmed while swallowing the food. It is to see what is causing the problem. Is it muscle spasms, or etc? Fortunate for me it was due to sinus problems and that was resolved.

You may ask to be tested. I hope this helps.

[redread]

My husband has similar issues with the Parkinsons/Parkinsonism. We found swallowing strategies online but the truth is, his diet had to change to adjust to the problem. If one continues to choke, you can aspirate and end up with pneumonia like my husband. He now eats only finely chopped foods and very little of that because it can take an hour to finish a meal. Please don't let yourself lose weight. That can be disastrous unless you need to lose a few pounds. The nutritionist advised my husband to supplement with Ensure Plus or Boost...or, if you're an organic person, make hi protein smoothies with fruits and vegetables. My husband has advanced symptoms so he is eating/drinking all day just to get enough calories. For his 5' 11", he has to eat 2000 calories + to gain, along with 75 grams of protein. I puree soups and add extra fat like avocado or tahini. We waited too long to pay attention and his weight dropped off terribly. Now we're having a huge problem trying to put pounds back on. Supplement with healthy liquids and get some "Thick-It" from Amazon.com to add to liquids. A second swallow test would help pinpoint what thickness you need for fluids. Totally understand how difficult this problem is but there are products that can keep your diet maintained until you can get a plan together for food prep, etc. We also got books from Amazon.com that have recipes, etc. Also explain the problem. One is, "Easy to Swallow, Easy to Chew Cookbook. Good luck!

[JohnPepper]

Hi Blackcat. I would like to add to what others have said. I have found that when I am not concentrating on what and how I am eating, I tend to choke, quite often. My understanding of this is that if I am in company, especially with my family, and we are all talking, I battle to get into the conversation. I am so intent on getting in, and am not paying any attention to the fact that I have food in my mouth and am in the process of swallowing, when I start to talk. Immediately I get food down my windpipe and I choke. I have learned to concentrate on what I am doing and not on what is going on around me. There is something else I have learned how to do, when choking. It is learning NOT TO PANIC. I know it is difficult, but I have had lots of practice at this. When something gets into my windpipe, I immediately hold my breath and then I lean my head forwards and downwards towards the floor and slowly intake air into my lungs, so that I don't bring the food any further down the windpipe. When my lungs have got enough air in them I give one big blast outwards, getting the food to exit the windpipe.

It is natural, when food gets stuck in the windpipe to suck air quickly into the lungs, and at the same time, bringing the food further down the windpipe. That can be fatal. As I feel the food enter the windpipe, I immediately stop breathing. I wait a few seconds to get my mind focused and then carry on with this procedure. Most times, other people don't even notice it. My wife notices immediately, and watches every move. Her late husband had Pd for 22 years, and he choked on a piece of steak and he sucked it firmly down into the windpipe, and in doing so he injured the muscles used to swallow. He survived that episode but he had to be fitted with a PEG into his stomach in order to feed him. She had to feed him every day for the next three years, after that. SO! Now she is married again to another Pd patient and is very wary of this happening again. The secret is not to panic. We can all hold our breath for quite awhile before we become desperate for oxygen. DON'T PANIC!

With the voice volume; I say to patients, "Pretend there is a fire and your children are upstairs and they will burn to death if you don't warn them. Shout as loud as you can, they are in terrible danger." You would be amazed at how loud they can shout. They amaze themselves. The problem is a muscular one. The muscles in the larynx are not guiding enough air over the vocal chords. It is a simple as that! When they learn that they can push more air through the larynx, they are on their way to recovery.

John

[redread]

These are very common forms of the progression of Parkinson's and my husband is experiencing both problems. Vocal exercising is recommended and many hospitals have the "Loud" progams where therapies are taught and practiced. I printed out lyrics for songs we both like and we sing/practice in the car and at home. Every muscle in the body is affected by Parkinson's and needs a workout every day. A "barium swallow test was recommended for my husband and they taught him swallowing strategies to avoid choking. I bought a huge container of Thick-it from Amazon. com and experimented with mixing it in cold liquids. The swallow test determines which foods/liquids are causing problems and how much Thick it to add so choking won't occur. My husband had three bouts of pneumonia requiring trips to the ER and antibiotics, so getting a referral for a swallow test is important. Usually they are conducted by a Speech/Language pathologist and some hospitals have this department. My husband still chokes sometimes, especially is his sinamet is causing involuntary mouth movements, but when he follows the steps the Speech people taught him, the choking id reduced.