Old 04-20-2017, 09:25 PM #1 (permalink)
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Default Barium swallow test

Greetings all,

Swallowing difficulties, and a swallow test has been ordered. What to expect? They aren't going to let me choke, are they? I'm scared they are going to give me something I know I can't handle. Food getting stuck in my esophagus. I need to wash down about every bite with water ( with Thickit). Even puréed foods, I can only take so many bites without water.

Deb
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Old 04-20-2017, 11:17 PM #2 (permalink)
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Default Re: Barium swallow test

Deb they test with a whole range of things and they will know what to use for you.

My Chris had 2 barium swallows some months apart and his swallowing had changed a lot in between. I expected the tests to be the same but they gave him very different textures to swallow the second time, so they were very aware of what his limitation definitely were.

They will not allow you to choke - tell them you may need a liquid to help get foods down. Usually they do barium liquids to swallow as well as barium solids/semi solids.

I hope that helps alleviate your fears
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Old 04-20-2017, 11:34 PM #3 (permalink)
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Default Re: Barium swallow test

I am curious: did anyone's swallowing test give them useful info they didn't already have? Never got the rationale in MND.
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Old 04-20-2017, 11:36 PM #4 (permalink)
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Default Re: Barium swallow test

Sure did for us - eg it showed how far down the back of his throat his palate had dropped and explained a lot of his early symptoms.

We were seeing ENT and facio-maxilliary specialists at the time and Chris would say, when I swallow it is like my palate just flaps over and cuts everything off and out it all comes. They would look at him like, yeah mate whatever you think. Well there it was shown as plain as day and we could work with it as a fact.

The speechie then used what she watched on the swallow test to advise Chris on the strategies we should use.

There was a marked difference in how his swallow was being affected between the 2 swallow tests he had.
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Old 04-21-2017, 12:16 AM #5 (permalink)
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Default Re: Barium swallow test

Glad it was helpful for you guys, Tillie, but esp. in the States, I'd caution that interventional procedures are highly prized in the reimbursement game, but not necessarily actionable. If there isn't a clear indication (by doing the test, we will know X vs. Y, which will tell us we should do A vs. B), I wouldn't buy in.
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Old 04-21-2017, 08:51 AM #6 (permalink)
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Default Re: Barium swallow test

Quote:
Originally Posted by lgelb View Post
I am curious: did anyone's swallowing test give them useful info they didn't already have? Never got the rationale in MND.
I felt like mine was somewhat pointless, as it seemed the only objective was to prove that what I was already telling them was truly happening. I told them I was aspirating a lot on liquids. They did the test, and I aspirated on the very first swallow with thin liquids. They then did thickened liquid, and several of solids, and those were ok. So they had the speech therapist teach me safe swallow techniques and advise using thickened liquids as needed. We could have skipped the tets and gone straight to those recommendations based on my own report that I was aspirating.
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Old 04-21-2017, 01:21 PM #7 (permalink)
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Default Re: Barium swallow test

In my case, Laurie, my ability to eat has declined swiftly. I've had to make a swift transition from eating normally to pureeing all my food and I'm still struggling. Part of the problem is with my mouth( separate thread on that one), but briefly, my mouth is always gummy and thick, (although my lips are dry) and I'm having a had time even getting the food past my mouth.

So the swallow study is to confirm the likelihood that I need a Peg. I totally buy into your theory that tests need an actionable result, and I think this qualifies.

Thanks to all - you've put my mind at ease that this shouldn't be a horrible, scary experience.

Deb
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Old 04-21-2017, 01:31 PM #8 (permalink)
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Default Re: Barium swallow test

Deb, best wishes with regards to your swallow test. I hope it provides some solid clues about what can be done.
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Old 04-21-2017, 02:48 PM #9 (permalink)
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Default Re: Barium swallow test

Good luck with the swallowing test. They should certainly tailor what you are tested with to your particular situation. That is what they did for me.

Laurie, I found the test to be beneficial. It revealed some surprises and the information was very helpful for the swallowing therapist. I hate tests, but am glad I had that one. I am not knowledgeable enough to know whether or not that information could have been obtained without the test, though.

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Old 04-21-2017, 03:30 PM #10 (permalink)
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Default Re: Barium swallow test

The test can be very helpful. There are patients who have episodes of silent aspiration, with no coughing when aspirating and this will be detected on the modified barium swallow. I was a radiologist before I had to retire to care for Frank and I performed many modified barium swallow exams. I diagnosed many cases of silent aspiration, usually in patients who had a history of multiple episodes of pneumonia but no history of coughing when eating or drinking.

The actual act of swallowing is complex and involves multiple specific phases and the radiologist, in conjunction with the speech therapist, can pinpoint exactly where the problem is and whether there is improvement or worsening using specific liquids (thin, thick) and solids. The speech therapist can then advise specific maneuvers and specific food consistencies to try to prevent aspiration.

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Old 04-21-2017, 03:44 PM #11 (permalink)
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Default Re: Barium swallow test

No matter what country, speech therapists are specialists that use this test for specialist reasons. Yep tests and procedures are done in all countries at times without a true beneficial reason, but I'd hate to see people being made cynical about what their speech pathologists use as strategies.

Speechies are one of the most important members of your teams!
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Old 04-21-2017, 03:51 PM #12 (permalink)
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Default Re: Barium swallow test

Sharon, multiple pneumonia eps would certainly be a good indication for the study. My comment was only that it's sometimes ordered when results are ipso facto not going to be actionable [a headline we could run for many tests, no doubt].

Deb, hope it goes well and the gummy coating in your other thread is resolved soon!
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Old 04-21-2017, 03:54 PM #13 (permalink)
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Default Re: Barium swallow test

I had mine done at Mayo after the ENT told me I had partial paralysis of my right vocal chord. When I had it done there was a radiologist and two technicians present. At that time the swallowing test was perfect even though I experienced hoarseness. They concluded the hoarseness was from silent reflux but they wanted to follow it.

I'm scheduled to have another one next week (my first one was done in December 2014 which was before my diagnosis.)

After I had the first one done, I immediately met with a speech pathologist who did other tests and gave me some pointers for my voice.
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