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swalker

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Joined
Dec 11, 2014
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1,576
Reason
DX MND
Diagnosis
07/2014
Country
US
State
CO
City
Vail
As my swallowing continues to degrade, I find that food particles make their way up into the base of my sinuses. This causes me to have an unusual pattern of sneezing.

I don't sneeze well due to respiratory issues. When this happens, I sneeze 10 or more times in quick succession. The are small, ineffective sneezes, but they cause what almost feels like spasms at the base of my sinuses. My breathing is also interrupted, which is unpleasant.

I have worked with my swallowing therapist on this, but have not yet found techniques that reduce the impact of this.

Does anyone have any ideas?

Thanks for your help.

Steve
 
The first thing that occurs to me, after adequate humidification in your dry winters, is a nasal steroid, if you haven't tried one.
 
Laurie, thanks for the suggestion. I have not tried a nasal steroid yet.

I think I described things incorrectly in my original post, so will try again.

When I eat, food particles make their way into a part of my nasal passage that seems to be the nasopharynx (from looking at an anatomy diagram). When this happens, sneezing seems to be appropriate, because I need to clear out those food particles.

While getting food particles up there is abnormal, my swallowing therapist says it is expected because of the way I swallow.

I am wondering if there are swallowing techniques that will reduce the incidence of food making up there so that the sneezing is minimized.

Thanks for the help with this.

Steve
 
Steve do you tuck your chin in when swallowing?
I haven't heard of using this technique to prevent things going up the nose, but does help stop things from pooling in the throat, so I'm wondering if it would therefore help you swallow in general and therefore help prevent what is happening.
 
I would ask your clinic speech pathologist
 
Sounds like time for a G-tube ... 8^|
 
Well Greg makes a good point.

If anything is going up into the nasal passage and your sneeze is too weak to clear it, your risk of aspiration will be increasing.

What kind of diet are you eating? It may also be time to consider modifying this - are there certain types of foods or textures that causes this more commonly?

Has your swallowing therapist advised that a peg placement now may be a good strategy?
 
In answer to some questions:

1. I have been working with the swallowing therapist on this.
2. I do tuck my chin when swallowing
3. The doctors do want me to get the feeding tube soon, but primarily due to my degrading respiratory status making surgery increasingly risky.
4. I eat a slightly modified diet. Softer foods. Fewer crumbs. Cut things up into very small pieces. I coat everything I can with lubricating substances, such as mayonnaise, bbq sauce, cream sauce, etc. Yum!

An additional note is that this occurs more often when I lose focus when eating. Maintaining discipline when eating is hard when others are around.

I do aspirate, but can control it when I pay really close attention. This is perhaps the thing I need to focus on. That and getting the feeding tube.

I will look for a pattern of reduced sneezing when following all the swallowing techniques I have been taught.

Thanks for all the input!

Steve
 
Damn, dude.
That's way too much work.

Get the tube ASAP. Then you can easily get the bulk of your nutrition and hydration via the tube and only have to eat for pleasure.
 
Steve,
After reading all the posts, I agree with Greg. The eating for pleasure while we still can is a huge motivator for getting the tube while you're in a less risky position, getting used to the various formulas that agree with you and saving your swallowing function for a nice vanilla milkshake.
 
I do aspirate, but can control it when I pay really close attention.

Hi Steve,
Do not underestimate this mate.
Aspiration is when food or fluids is inhaled into the airways. Now you know this already. But with your breathing issues, your ability to just cough it out is poor and weakening more all the time. The problem with PALS saying - I can control it when I pay really close attention is - it only takes one moment of losing that attention. It could be any outside influence. So you are taking high risks, and you could look at these risks as being like the risk of falling. You were inspiring how you dealt with this and got your wheelchair and opened up your life. Now you are the wheelchair king!

You could look at the swallowing issues in the same way. Aspiration pneumonia is something you truly want to avoid. What if this happened and your days of living at high altitude were suddenly called to a close?

With a peg you can still eat or drink, but you are not relying on getting every morsel and drop of fluid in by mouth and increasing your risk all the time.

Yes there are swallowing strategies, but they only help for a while. Just my 2c
 
Steve, I get it. My Steve has been choking and coughing more when eating. He does not want to use the peg for nutrition because he feels he has made a big step in decline. Not sure that is the case. If you can use the peg and have good quality of life it must be better than aspiration and infections....and hospitals. Just my opinion.
 
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