Aspiration?

[SandraD]

Hi,

I have a question about aspiration. For a long time, I have had a chronic cough. this preceded the muscle weakness and twitching. it has progressed, however, from mostly in the morning to throughout the day.

I have also had off-and-on again excessive saliva. Today has been a particularly "wet" day for me and I have been coughing/throat clearing a lot.

I also had a scary episode today where I choked on iced tea. I couldn't get it down and I couldn't breathe for a few seconds and then it went down, but it created this weird, cold sensation spreading across my chest area. like it went down the wrong "pipe" so to speak. does this sound like the iced tea got into my lungs? is this aspiration?

I have had some episodes of coughing and slight choking (on soup and water) before, but never this sensation involving the chest. is this something I need to see the doctor about soon? I did mention this to the second neuro in Sept. (I was seeking a second opinion) and he said everyone chokes on things now and again. Personally, I have never had recurring episodes of coughing/choking until all this stuff started. they are not happening a lot, but are frightening and disturbing when they do occur.

for those who may not have read my earlier posts, I have had an 8-month or so history of muscle pain, fatigue, muscle weakness, stiffness, and some twitching that comes and goes. it was around one side of my mouth and chin for most the summer and now is happening off and on in my upper torso. I have seen two neurologists specializing in ALS. one said he does not think I have ALS "at this time," the other said "unlikely." I had a normal EMG on both legs and one arm in June, conducted by the first neurologist. I do not have any other signs, such as Babinski or Hoffman's, but have brisk deep tendon reflexes of 3+. I have also developed weakness and pain of my right hand, arm, shoulder, which has been diagnosed as tendonitis. It is also happening in the right ankle now.

both neuros they could not completely and definitively rule out the possibility of a neuro condition, however. question is: what it might be. the first neuro asked to follow me at 6-month intervals or if things worsened, before then. the second suggested every three months.

I am supposed to go back to the first neuro in mid-December. I sought a second opinion at a larger hospital and could also see that neuro again, but it is a few hours away. The first is an ALS specialist at a university hospital located near my home.

anyway, just looking for some advice on what to do. I guess I am worried about what the results are of food or liquid getting into the lungs-- does it automatically result in pneumonia? should I request a swallowing study be done in advance of my next neuro visit?

sorry this is so long.

Hope you all had a nice day. it is beautiful in New England today.

thanks,

Sandra

[joelc]

Sounds like it is time for a barium swallowing test to see if you are indeed aspirating.

[marywest45]

joel, Please tell how often the swallow test should be done. I had one done in July (demonstrated some mild problems). Since October I'm aspirating on water; my next clinic visit is not until January. Is it OK to wait until then?
God bless, Mary

[rose]

Sandra,
I've experienced the cold sensation you describe, and have become sick afterward. To answer your question, no, getting something in your lungs does not automatically mean you will develop pneumonia. The body has several lines of defense set up to protect the lungs, and there are scavenger cells inside the lungs and passages that also clean up any foreign substances. From what you describe with the iced tea, perhaps the sphincter muscle at the top of the esophagus did not open when you swallowed, and the delay allowed the tea to build up and then spill into your airway.

Most people run a fever right away if an infection is brewing. If you start to run a fever over 101° get to a doctor right away.


Mary,

Definitely get re-evaluated. I was told the general schedule for swallow studies is every 6 months unless something changes. It sounds like you've had changes since October. I would not wait until January. Are you seen at Hopkins? Donna Tippet is an excellent SLP there.

[joelc]

Originally Posted by marywest45

joel, Please tell how often the swallow test should be done. I had one done in July (demonstrated some mild problems). Since October I'm aspirating on water; my next clinic visit is not until January. Is it OK to wait until then?
God bless, Mary

I agree with what has been said above. Get reevaluated right away to be safe. Don't wait until something happens and you start running a temperature, at this point it is too late to ward off problems.