Aa
Inhaling Juice
Hi Guys-- has this happened to anyone else? Yesterday I took a sip of juice and all of a sudden it was as though I was literally inhaling it-- I felt myself breathing liquid, choking, and of course automatically bent over and began to cough like mad and gasp for air. I wasn't talking at the time, and I certainly wasn't laughing. I wasn't breathing fast or "gulping"-- I was just standing in the kitchen, waiting for my daughter. It just felt so "out of nowhere." This is the second time in a few weeks I've had this while drinking something. I've never had it before. I just figured the first time was a fluke, so of course last week I said "None" when the MS specialist asked about possible swallowing problems. Good times...
Sadie
Sadie
I, too, occasionally have drinks and sometimes dry foods (like crackers) go down the wrong way, resulting in choking fits. I also periodically managed to choke on my own saliva like tjbk. In fact, it happened earlier this week.That's scarier since it's hard to see what I could do to head it off. Since this only happens occasionally, I have just been ignoring it.
Thanks, Beachcomber, for all the helpful info.
sho
Thanks, Beachcomber, for all the helpful info.
sho
I get the bread hiccups, too! For years. But when I googled it, there were tons of people who have the same problem, so I do not think it is related to our MS. :) But who knows, maybe we are more likely to get it, since it involves the vagus nerve--nerves sometimes do the wrong thing in our bodies, hm? I find that taking drinks often while eating bread helps. And smaller bites. I hate getting the hiccups, because I always have them for the rest of the day.
Wow the coffee one is interesting! From your description, that sounds like an esophageal problem. Almost like vomiting but instead of stomach contents, it was what you had just tried to send to the stomach. My money is on a quick spasm of the esophagus.
The previous posters described problems with the first two phases of the swallow. The coffee thing and the slow swallow thing seem to be problems with the third phase: the esophageal phase.
Feeling foods go down slowly or get stuck in the esophagus. Although there could be a blockage of some kind, more likely it has to do with motility.
The esophagus contracts and relaxes in waves. So one little part contracts, then it relaxes while another part contracts, and so on. It is highly coordinated. Picture a worm moving along the sidewalk--that is the idea with the esophagus.
Tone problems such as spasticity can cause this process to be disrupted. It can happen "randomly" in normal people every now and then, which would not be a cause for concern.
Food, especially hot food, is not meant to hang out in the esophagus for any length of time. If this happens to you frequently, you might want to see a specialist. Swallowing problems in the esophagus are shared (disputed?) SLP and GI territory.
So whom to see? Your copay is probably better for GI visits, but check with your insurance company. An SLP is going to be more likely to give you strategies, and a GI doc is going to be more likely to give you medicine/surgery. This has to do with their training and where their minds go. SLPs are like PTs of the head and neck: rehab specialists. If the SLP believes you need medicine or surgery, she would refer you to the GI. Whether a GI will refer to an SLP for swallowing strategies... Hm, what's that old saying? "If you can't say something nice..."
Wow the coffee one is interesting! From your description, that sounds like an esophageal problem. Almost like vomiting but instead of stomach contents, it was what you had just tried to send to the stomach. My money is on a quick spasm of the esophagus.
The previous posters described problems with the first two phases of the swallow. The coffee thing and the slow swallow thing seem to be problems with the third phase: the esophageal phase.
Feeling foods go down slowly or get stuck in the esophagus. Although there could be a blockage of some kind, more likely it has to do with motility.
The esophagus contracts and relaxes in waves. So one little part contracts, then it relaxes while another part contracts, and so on. It is highly coordinated. Picture a worm moving along the sidewalk--that is the idea with the esophagus.
Tone problems such as spasticity can cause this process to be disrupted. It can happen "randomly" in normal people every now and then, which would not be a cause for concern.
Food, especially hot food, is not meant to hang out in the esophagus for any length of time. If this happens to you frequently, you might want to see a specialist. Swallowing problems in the esophagus are shared (disputed?) SLP and GI territory.
So whom to see? Your copay is probably better for GI visits, but check with your insurance company. An SLP is going to be more likely to give you strategies, and a GI doc is going to be more likely to give you medicine/surgery. This has to do with their training and where their minds go. SLPs are like PTs of the head and neck: rehab specialists. If the SLP believes you need medicine or surgery, she would refer you to the GI. Whether a GI will refer to an SLP for swallowing strategies... Hm, what's that old saying? "If you can't say something nice..."
Yes this does happen to me occasionally. Last week immediately upon swallowing a sip of coffee, it shot out of my mouth and all over my laptop! No warning at all that this would happen. I'm glad my laptop was the only victim, in private in my livingroom; I would've been mortified had this happened in public and worse if anyone had been in the line of fire.
Sometimes food and drink seems to move very slowly, it's like I can feel it going down; I"ve had pain when swallowing something hot (temp, not spicy) when it seemed to get stuck halfway down.
On a somewhat related note, I often get hiccups immediately upon swallowing, usually bread does this to me. ???? Very odd.
Sometimes food and drink seems to move very slowly, it's like I can feel it going down; I"ve had pain when swallowing something hot (temp, not spicy) when it seemed to get stuck halfway down.
On a somewhat related note, I often get hiccups immediately upon swallowing, usually bread does this to me. ???? Very odd.
Hm, sorry to say that you seem to have a bit of dysphagia. Even if you aren't as bad off as old granny yet.
If you are choking on your own saliva, that may be due to reduced sensation in your mouth.
Normally you are aware of what is in your mouth because you feel it--subconsciously, perhaps. You feel it, you gather the liquid with your tongue, you push it back, and the swallowing reflex takes over.
If you do not accurately feel what is in your mouth, you will not gather it into an organized bolus. It may trickle or spill down the back of your tongue, where it runs straight into your lungs.
You know how you have the two "tubes?" The esophagus is where the food and liquids are supposed to go. The trachea ("windpipe") is for the air. Guess which one is in front. Right, the trachea--it's a straight shot in there from the throat. In order to send things to the stomach, you have to close off the trachea and open up the esophagus (which is naturally closed--or your breath would be unnaturally nasty).
Uh, am I nerding out again?
There are other reasons you might choke on saliva. If you are actively swallowing saliva and it happens to go the wrong way (or partly the wrong way--it is possible to have some liquid go to the esophagus and some to the trachea), that could be due to a problem with a variety of nerves. Swallowing is complicated.
I do not want to send anyone into a panic. Again, coughing is good. It says: Congratulations, you have sensation at the level of the larynx (aka voicebox--guardian of the trachea). That is a very good thing. And a tiny bit of liquid can cause a major laryngeal spasm--that's why we tend to feel like we can't breathe when things go the wrong way.
The other good news is that "down the wrong pipe" is a bit of an exaggeration. Usually things don't even get into the wrong pipe. The larynx freaks out and you cough before it gets that far. But with an impaired swallow, you never know--the larynx might be a bit slow to respond.
Yes, I would mention this to your neuro. And you should see an SLP to make sure things aren't trickling down unnoticed. Choking on saliva is a bigger deal than choking when you drink.
If you are choking on your own saliva, that may be due to reduced sensation in your mouth.
Normally you are aware of what is in your mouth because you feel it--subconsciously, perhaps. You feel it, you gather the liquid with your tongue, you push it back, and the swallowing reflex takes over.
If you do not accurately feel what is in your mouth, you will not gather it into an organized bolus. It may trickle or spill down the back of your tongue, where it runs straight into your lungs.
You know how you have the two "tubes?" The esophagus is where the food and liquids are supposed to go. The trachea ("windpipe") is for the air. Guess which one is in front. Right, the trachea--it's a straight shot in there from the throat. In order to send things to the stomach, you have to close off the trachea and open up the esophagus (which is naturally closed--or your breath would be unnaturally nasty).
Uh, am I nerding out again?
There are other reasons you might choke on saliva. If you are actively swallowing saliva and it happens to go the wrong way (or partly the wrong way--it is possible to have some liquid go to the esophagus and some to the trachea), that could be due to a problem with a variety of nerves. Swallowing is complicated.
I do not want to send anyone into a panic. Again, coughing is good. It says: Congratulations, you have sensation at the level of the larynx (aka voicebox--guardian of the trachea). That is a very good thing. And a tiny bit of liquid can cause a major laryngeal spasm--that's why we tend to feel like we can't breathe when things go the wrong way.
The other good news is that "down the wrong pipe" is a bit of an exaggeration. Usually things don't even get into the wrong pipe. The larynx freaks out and you cough before it gets that far. But with an impaired swallow, you never know--the larynx might be a bit slow to respond.
Yes, I would mention this to your neuro. And you should see an SLP to make sure things aren't trickling down unnoticed. Choking on saliva is a bigger deal than choking when you drink.
This happens to me quite a bit. I have even inhaled food- and did get the aforementioned pneumonia. It was great to read all the tips from the other folks who commented ;-) Thanks!
Tammy
Tammy
WOW! When my neuro asked if I had trouble swallowing I answered "no" also. I immediately thought about my 90+ year old grandmother who could no longer eat solid food because she would choke, it never dawned on me that he could be talking about "the wrong pipe thing". At least once a week I choke on water, or my own saliva. The saliva thing is really embarrassing when it happens at work (or out in public in general)...out of no where you start coughing and gasping for air while co-workers just stare at you. I don't see my neuro again until January but I'll definitely mention this to him.
Yes, I have had this twice for two or so week bouts at a time. My tongue just wasn't coordinated so I had to S L O W down and really think about what I was eating or drinking. It luckily went away.
Thanks so much for the responses and great info. I really appreciate it-- it helps a lot!
I forgot to mention a couple of other strategies you can use, in addition to or as an alternative to chin tuck and thickened liquids.
One is to change the bolus size. The bolus is the "ball" of food or drink that you swallow. A little sip would be a small bolus. Sometimes a larger bolus is actually easier to swallow. That is certainly true for me. I will almost always sputter if I take a small sip.
It also helps to be very conscious of swallowing. We are typically not aware of what we are doing when we eat, because we have been experts at eating since before we can remember. If you try to increase your awareness of where the food/drink is, it can help you coordinate your swallow. Kind of like the way biofeedback works, but without an external feedback system.
Another thing you can do it consciously hold your breath when you swallow. This will close the airway and make it impossible for stuff to go the wrong way. Well, "impossible" comes with small print: it depends on what is causing your swallowing problem.
I suppose that your swallowing problem (called dysphagia) is not so bad that you need strategies. But for those who do, these are a few things you can try, in consultation with your SLP or neuro.
One is to change the bolus size. The bolus is the "ball" of food or drink that you swallow. A little sip would be a small bolus. Sometimes a larger bolus is actually easier to swallow. That is certainly true for me. I will almost always sputter if I take a small sip.
It also helps to be very conscious of swallowing. We are typically not aware of what we are doing when we eat, because we have been experts at eating since before we can remember. If you try to increase your awareness of where the food/drink is, it can help you coordinate your swallow. Kind of like the way biofeedback works, but without an external feedback system.
Another thing you can do it consciously hold your breath when you swallow. This will close the airway and make it impossible for stuff to go the wrong way. Well, "impossible" comes with small print: it depends on what is causing your swallowing problem.
I suppose that your swallowing problem (called dysphagia) is not so bad that you need strategies. But for those who do, these are a few things you can try, in consultation with your SLP or neuro.
I once calmly ate a spoonful of soup, only to have it all exit one nostril, immediately. No coughing, nothing. Mentioned this on my next Neuro visit, but I haven't had any more accidents of this kind. Thank heavens! Between that and my ever-present trembling hands, I'd be the guest from he'll.
ess
ess
Oh, the "wrong pipe" thing. Hate it! I have had trouble with this liquids sometimes, but the worst is mixed textures. Cereal with milk (solid plus liquid). Soup. Very juicy fruit.
Swallowing is complicated. It involves a variety of cranial nerves, which is why we can have problems with it. Cranial nerves are ones that start at the brain and head outward--like the optic nerve. You need to have all of those nerves working together to swallow normally and safely.
A chin tuck is helpful: tip your head forward a few inches as you drink. It seems counterintuitive to tip your head forward; most people think that tipping it back makes drinking easier. But it really does help.
The good news is that you sputtered and coughed. Your risk of having any liquid actually enter or hang out in your lungs is minimal. The people who let liquid slide into their lungs and don't even notice it are the ones that keep speech pathologists up at night.
Small amounts of liquid can be handled by the lungs. But only small amounts. Food in the lungs is a surefire way to get pneumonia. You might think that you would notice if food were getting in there... well, I once watched on nasendoscopy as a cottage cheese slid into a man's lungs and he didn't notice. "Cough please, Mr. Nice Old Man."
Do mention this episode to your doctor. But I would not worry about it if it happens once. If this begins to happen more often, you should see an SLP for a swallowing eval. Just be aware that there is not much we can do about it, aside from the chin tuck and thickened liquids. And you can do those things on your own... without paying for an evaluation. The main reason for a swallowing evaluation is to catch the silent aspirators, like my friend Mr. Nice Old Man.
Swallowing is complicated. It involves a variety of cranial nerves, which is why we can have problems with it. Cranial nerves are ones that start at the brain and head outward--like the optic nerve. You need to have all of those nerves working together to swallow normally and safely.
A chin tuck is helpful: tip your head forward a few inches as you drink. It seems counterintuitive to tip your head forward; most people think that tipping it back makes drinking easier. But it really does help.
The good news is that you sputtered and coughed. Your risk of having any liquid actually enter or hang out in your lungs is minimal. The people who let liquid slide into their lungs and don't even notice it are the ones that keep speech pathologists up at night.
Small amounts of liquid can be handled by the lungs. But only small amounts. Food in the lungs is a surefire way to get pneumonia. You might think that you would notice if food were getting in there... well, I once watched on nasendoscopy as a cottage cheese slid into a man's lungs and he didn't notice. "Cough please, Mr. Nice Old Man."
Do mention this episode to your doctor. But I would not worry about it if it happens once. If this begins to happen more often, you should see an SLP for a swallowing eval. Just be aware that there is not much we can do about it, aside from the chin tuck and thickened liquids. And you can do those things on your own... without paying for an evaluation. The main reason for a swallowing evaluation is to catch the silent aspirators, like my friend Mr. Nice Old Man.
Learn to always tuck your chin before swallowing. It saves a lot of pain! Also they sell thickeners for liquid. It took a long time before the speech pathologist could talk me into trying it. I am here to tell you, it doesn't change the taste of liquids one bit.
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