My dysphagia from MS shows up during a difficult swallowing study
On my second sip of juice, I choked and inhaled a mouthful of barium-laced liquid
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In the not-too-distant past, when my hands were still deft enough to use tools, I really enjoyed working on vehicles. The fact that they weren’t vehicles I depended on every day helped make it a hobby I enjoyed, rather than a chore.
Like any hobby, it had its dull moments, but the only time it ever really frustrated me was when a vehicle made a suspicious sound and then refused to make it again in front of anyone else who might be able to help me identify it.
Fast-forward a decade and a half, and thanks to both multiple sclerosis (MS) and middle age, I’m the only thing in my life that ever makes strange noises. Unfortunately, I often have the same issue as a cantankerous engine. Whatever symptom sent me to a provider absolutely refuses to show up when I need an expert to detect it. Except, that is, at my most recent visit.
A common problem
As my MS has progressed, so have my swallowing issues, and I recently completed another study. Just like last time, I had to eat and drink a number of items of different consistencies that were treated with barium so they could be observed through fluoroscopy.
At the start of the test, I joked that, even though my choking and aspiration had increased, I probably wouldn’t do either with the provider watching. If there’s a name for the phenomenon that I just poked fun at, I managed to do whatever the opposite of it is. On my second sip of juice, I choked and inhaled a small mouthful of barium-laced liquid. I don’t recommend the experience, if you’re wondering.
The incident was fully caught on video and provided some great data, a plus. That was actually the first thing I wanted to know once I’d finished coughing white spots onto a pant leg. “Please tell me you got that, because I don’t plan on ever doing it again.”
Difficulty with swallowing, or dysphagia, is an all too common problem for people with MS, with studies suggesting it affects about half of patients to some degree. It may seem obvious, but it’s also been known to cause a lower quality of life. After a recent bout of pneumonia — most likely caused by aspiration — I’d have to agree. Fortunately, there are some precautions that can be taken.
I’m usually a great example of what not to do, so let me set a good example: See your healthcare provider if you start having difficulty swallowing. A speech therapist, or similar expert, can assess any challenges you might have and recommend things to help overcome them. After my last swallowing study, about half the recommendations focused on what I swallowed and how I swallowed. I was advised to continue avoiding foods that were part solid and liquid, not to talk when I eat, and to tuck my chin in when I swallow.
I was also told to continue strengthening the muscles used in swallowing, along with the ones that help expel anything that enters the airway. As my muscles continue to weaken, I use mechanical devices. One assists me in coughing, and the other is a suction machine to remove anything I can’t cough up. I don’t particularly care for either one, but they really are in my best interest.
At the end of the study, the therapist asked me something that was also probably in my best interest, and I didn’t like it, either. She wanted to know whether I had considered a feeding tube. I have mulled that over, but there’s a big difference between thinking about it and having a medical professional ask about it.
Not even a year ago, I would have said that I had considered the possibility of aspiration pneumonia in my future, too, but that it was most likely years away. I hope I’m right this time because I’m not ready to turn a feeding tube from a possibility into a reality. Come to think of it, though, my life with MS could easily be defined by my adjusting to a series of uncomfortable realities. When and if that one comes, I’m confident that I’ll adjust to it, too.
Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.
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