Suddenly swallowing is an important issue

Again and again I make the experience that things that used to run so incidentally and unconsciously, now become a use of force and conscious action. So walking and not even a meaningless turning around in bed remains unspectacular. This is how it has now become with swallowing. I notice that some things do not work as well as before, doctors and therapists also ask about possible disturbances when swallowing. Swallowing problems are also part of the clinical picture and are called dysphagia.

What should not happen first of all, of course, that disorders destroy the desire to eat and feast. Because we already do without a lot of things, so the food should remain with us for a while, as long as possible. The first contact person for all questions and matters is the speech therapist. If someone does not have one yet, a prescription for a logopedic care should be written down immediately by the family doctor or neurologist. Specific exercises and techniques can be used to avoid any complications that may arise.

What I was thinking, that one can choke and suffocate. Well, it is more complicated than I thought…

Firstly, one also chokes on one’s own spit, so it doesn’t have to be a proper bite roast. Big bites or a too full mouth is of course unfavorable. Much more important is the fact that besides the danger of choking, the mouth contents or parts of it, can get into the windpipe instead of the esophagus. Once in the lungs, it can cause an inflammation there. Lung inflammation is the most common cause of death in MSA and other neurological diseases.

The accidentally wrong substance (food, drink or it`s own spit) is instinctively coughed free by the body – so as long as I have the strength to cough, that’s fine. The problems start when I cannot. It is well known that a patient in an advanced stage does not have the strength for it and swallowing is almost inevitable. Certain head positions, strengthening of the muscles, a relaxed neck, small bites, sitting upright and no sudden head movements are of course helpful.

The real problem begins with so-called “silent aspiration”. This means that minimal amounts of unwanted substances get into the windpipe unnoticed and the person affected, does not cough it up. Concerns and fear can also lead to malnutrition and dehydration. In advanced stages, the deficiency is remedied with a tube. The patient gets food and drink through an access through the abdominal wall. For me this is of course a horror. What I didn’t know is that you can continue to eat “normally” in addition to this artificial access and actually everyone realizes that it is not as bad as they imagine it to be. Patients who have lost a lot of weight gain weight again and dehydration does not happen anymore. Nevertheless I do not want to have that…

Therefore caution is advisable at an early stage. Avoid sticky and crumbly food. Be careful when drinking. Simple liquids like water get “too fast” into the throat. Swallow carefully and in small quantities. Drinking straws or the well-known sippy cup are rather unfavorable. Always drink from full glasses, the sippa cup is recommended, the givings can be prescribed.

My surprise effect was when I swallowed my own spit for the first time, because I did not expect this. I am C, so MSA-C, so more ataxia-plagued, swallowing is also more affected. It happened while lying down. It is better for blood pressure and also for reflux, so it is better to lie with the head/upper body higher. It is also easier to swallow lying flat. 

At least I can still fart in any pose even under distraction…

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