Eating and Breathing

[Sammantha]

I have been gone awhile, trying to get my finances and home in order..... I had to put all appointments on hold, i will now have my follow up for EMG and thymoma on the 30th. The doctor already said that he did not think i have Myasthenia and that i do have EMG recorded muscle weakness.

I do have a question, when i eat i have to hold my breathe... I have noticed for awhile when I chew food starts going in the back of my throat and i almost choke. Its like i am breathing and chewing my food at the same time. So now when i chew i hold my breathe or sometimes eat with my head down. I guess my question is, is this caused by my possible condition????? Sam

[rose]

Sam,
Would you believe I was just thinking about you?! I'd just checked earlier this week to see when the last time you posted was.

About holding your breath when you eat, everyone holds their breath when they swallow. I guess to be more accurate, we don't breathe when we swallow, and additionally the epiglottis covers the opening to the lungs The epiglottis is a thin lid-like flap of cartilage tissue that is attached to the root of the tongue. It is situated behind the tongue and in front of the entrance to the larynx .

When we are not swallowing, the epiglottis allows air to pass through the larynx and into the rest of the respiratory system. When swallowing, it covers the entrance to the larynx to prevent food and drink from entering the windpipe.

If both the air passage and the food passage were open when someone swallowed, air could enter the stomach and food could enter the lungs. The epiglottis is the way that this is prevented from happening, basically acting like a lid every time we swallow.

By you describing that food moves to the back of your throat when you chew, I'm not sure if you're saying its not being swallowed down when you swallow it (residue left in your mouth after swallowing) or if it gets there too soon, before you're ready to swallow. It seems (to me) if your problem was due to weakness of the epiglottis, then you consciously holding your breath would not help.

However, if it is due to a miscoordination when you swallow, in that the food is getting to the back of your mouth too soon before you're ready for it, then you intentionally holding your breath would have an impact on how well you're able to swallow. I'd had advise from a SLP, saying to hold my breath when I swallowed, and when I questioned that (Re: what I just wrote above) I was given the answer that this would make me more aware of swallowing carefully.. They always advise to pay attention and to not talk and eat at the same time.

How do consistencies such as yogurt and pudding work for you? These are the easiest thicknesses for the muscles of the larynx to move down, also easiest for the esophagus.

Perhaps you can contact your doctor and see if a modified swallow test could be set up for you to have, coinciding with your other appointment so you can get it all done at once. The modified swallow is done with a speech pathologist, it is not a bad test to do at all, actually very easy, and it would give your doctors a lot of information as far as the mechanics of your swallowing.

I still don't understand why you have a thymoma, but your doctors do not think it is tied into your other problems, or that it could be MG. Didn't you have a single fiber EMG? Did you find out the results of it?

It was good to see you post. Maybe someone else can answer your questions better than I can. Let us know how your appt on the 30th goes.

[Sammantha]

Thanks Rose.............. What happens, is when i chew the food flies down my throat.. So i have to clear it before i choke. So, i thought it was due to breathing and eating at the same time because if i chew and hold my breathe the food does not fly down my throat. The only problem with this, is that i dont get my food chewed as well as it should! My thymoma was found purely on accident. My pulmonologist wanted to make sure i did not have a pulmonary embolism because even the lung function test showed it was muscle resp weakness, i also get chest pain. Thats when the ct scan showed a small thymoma. I do not think the doc at UNC is too worried about it, he is more concentrated on my muscles/spasticity/clonus.. He is the best Myasthenia Gravis doc in the area.... I should have went along time ago, i just have not had the chance. Thank you for explaining though.. Sam

I should also say, when i saw him last he said he did not think i had MG