Swallowing issue & what if it won't go down?

A friend of mine who has diabetes and an attack this past weekend. He thought it was one of those insulin attacks so he started to eat an apple he carries around with him. He had is injection kit too. Too late for the apple though, he went into, I guess a diabetic shock. Friends got the rangers there quick and they started CPR. Pulse was ok, but his lips started to turn blue. When the paramedics arrived they put something in his throat and that was how they found the partially chewed apple slice blocking his air. He survived. His memory is a bit off today but should come back I hope. He is alive though!!

I mention this because some of us on this list has that "hard to swallow" issue. It happened to me the other day again. This time it was quite painful when the stuff got just past my windpipe. I didn' t know if it was going to make it down or not. You ever have that feeling?

I got to thinking today while visiting my buddy in the hospital, what if that food/liquid stays hung up and the breathing is cut off? I know the outcome of that if one doesn't get help. I live alone so I guess that is why i was thinking about that.

For us with demyelinating disease, i wonder what causes this hard to swallow sensation that at times can be painful and unnerving?

[essdipity]

Swallowing seems simple to us--we just do it. But in reality, it requires a complex series of nerve and muscle activity in the brain and the throat. This not only has to work correctly, but it also has to work in the right order.

If the signals get fouled up because of demyelination, a 'short circuit' can result. Activity can just stop, or it can go the wrong way, or some combination. Depending on what goes haywire, food can seem to get stuck, or it can come out the nose (yuck, this has happened to me), or a worse situation is that it can get breathed in. That can cause choking, and it also can cause pneumonia.

From what I've read, people with severe swallowing difficulties often become malnourished. Many MSers have learned to take small bites and to chew with more thoroughness than otherwise thought necessary. Fortunately, swallowing problems in MS are often intermittent rather than constant.

ess

[saveone]

Everything Ess said is true.  What I would add is the muscles in the throat can become weak and contribute to the difficulty with swallowing.  

I recently had a modified barium swallow and 2 different scopings for my speech.  Both showed my throat muscles are weak.  This in combination with the mixed or no signals my brain sends cause me difficulty in swallowing and makes my speech sound strangled, horse or intermittent.  I am supposed to start speech therapy to strengthen my throat muscles.  I am just waiting to hear when it has been approved and scheduled.

terry

[Weakandfalling]

I've had similar swallowing problems with things getting stuck halfway down.  It's very uncomfortable, but is not usually life-threatening as you can still breathe because it is stuck in your esophagus, not your trachea.  As essdipity said, when aspiration results with some of the food going down your trachea into the lungs, pneumonia can result.  

I was informed by a speech therapist that If you are having frequent swallowing problems, it's best to avoid foods that are a combination of liquids mixed with solids - like soups with chunks of veggies or meats in them since they increase the likelihood of aspiration because it is harder for you to deal with swallowing both liquid and solids at the same time.  Also avoid drinking with straws because that increases the chance of aspiration since you are sucking and could suck food into the trachea.  Sometimes I have had to switch to softer easier foods when I have my sluggish esophagus syndrome.  

A couple of times I absolutely could not swallow anything at all even though I was very hungry.  I was very fatigued at the time and after going to bed and having a long long rest, I was able to swallow again, as usual, the next day.

About your living alone:  If you have a cell phone, I suggest carrying it in your pocket at all times - that way if you fall or need help, it will be where you can reach it.  When you bathe, have it nearby in the bathroom - within reach.  At night keep it (turned off) in your bed or on your bedside table.  Don't just leave it in your purse.

Also, if your finances permit, I suggest getting some emergency contact system such as a Life Alert button worn around the neck or as a wristband.  I was amazed when I read their literature!!  They protect for medical, home intrusion, fire, CO2 gas etc.  Amazing - they provide great peace of mind.  I am considering it for the future when (or if) my 18-year-old ever moves out.

Parkinsons and ALS also involve swallowing issues with ALS having eventually total inability to swallow requiring a PEG tube (a tube in stomach that food is put into).

[Ufrustrated2]

thanks ess, fortunately as you mention, my swallowing problems are intermittent.

weakandfalling, i'll leave it on my night stand as there is no purse here. ;-) thanks for the tips.

[BOK2Bjan]

This is something I know a lot about unfortunately.  I aspirate almost every other night.  And the gastric reflux goes all the way up into my nose and sinus cavities and then drains out my nose + I blow it out.  The rest goes into my lungs - and yes, they're very damaged.  Blowing out grapes, beans, and other assorted things is a mess!  I have Scleroderma Esophagus with no motility and MS, but when I first started having the problem, my doctor said there must be a neurological component to cause my gastric contents to go past my throat and up and out my nose, rather than my mouth.  Cause, I never have any in my mouth when this happens.  It never was followed up on as a neuro problem though - test after test, swallowing tests of every kind and scopes and such - but although each doctor mentioned neuro involvement, I wasn't ever actually tested for it.  Needless to say, my MS dx was slow.  But, as I've mentioned many times - already having serious dx, docs don't look for more.

However, I did ask my doctor what I should do, if I ever was choking or unable to breath and on my own.  I made him show me how to do a trach on myself.  He kept saying I wouldn't be able to do it - but if you're going to die - you'll do things you never thought you would. I would try anyway.  I'm hard headed that way!  Don't tell me I can't do something!  lol  I WOULD be hard, though.  Let's hope none of us have this problem - yes?

[Ufrustrated2]

intersting post. i have quite a strong will to survive so a trach on oneself would be possible. i've seen some folks in the mil do some strange things to survive.

self preservation is more powerful than some think.

indeed, let us hope no one has to be presented with that situation ...