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Edward E

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CALS
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Hello to all
Is choking part of PLS? Although my wife has been recently diagnosed as having Upper Motor Neuron Disease, it seems like she is "coughing" every time she eats.
I tried searching to save repeating a question, but I can't search on my phone for some reason.
Thanks to all
 
Yes, it can be. There is a way to help swallowing and it's called chin tucking. I'm explaining this off the top of my head... the worse thing a person with PLS can do, for example, when swallowing a pill is to throw their head back like most do. When eating swallow slowly with the chin down towards the chest. And of course... smaller portions than before. Hope it is of some help.
 
Edward you may need to think carefully also about the way food is prepared and served.

Usually with bulbar issues choking happens most on foods with 2 consistencies, like a fruit with skin on so you have the soft flesh and the tougher skin.

Also mouthful size is important and how much chewing will be needed.

Cooking food more than you may normally and using creams and butter to mash up cooked vegetables into a really smooth texture can help a lot.

The chin tucking as well as taking her time and concentrating are good strategies too.

It may be worth having a barium swallow study done to ascertain just what is happening and then a speech pathologist can give you more detailed assistance from exactly where your wife's swallowing issues are at now. The barium swallow can also be good to give a baseline that they can use to monitor changes in her swallow ability down the track.
 
>The chin tucking as well as taking her time and concentrating are good strategies too.

Ditto that! #1!
 
Great info. Thank you all so much.
 
Welcome Edward, my first symptom was getting choked, I thought I had some kind of throat issue.Two years later I'm still trying to eat, I get choked more on drink than food. I am into pudding and mashed potatoes and the chin tuck is always the way to go, I can't eat unless I really concentrate on what I'm doing and don't try to watch TV or computer. They make a thickening for drink but it's gross to me.

Janie
 
Janie, Chris resisted the thickeners too and I have to admit I never tried anything with them in myself...

He did end up using it in coffee as that was the only drink he kept taking by mouth.

Smoothies would be a way better idea to still enjoy drinks in my opinion, you can even through some gin or something in a good smoothie ;)
 
The clinic has given me four cases of tube formula, I can put it in the blender with a banana and some strawberry syrup, it's great!.

Janie
 
Comparatively speaking, I choke now more than I used to -- I'm just not sure it's related to PLS. But is sure does seem that way -- I never choked before. And I sure as hades don't see anybody else around me doing it as often as I do (if it walks like a duck....). Fortunately, it's more of an annoyance to me than it is a real threat. I choke mostly on liquids (why, I don't know).

At times, my jaw muscles really tire when eating or talking (footnote **) - and this at times to the point where I actually have to stop eating for a minute or two. The feeling in my jaws is pretty much the same as that unpleasant sensation of "overworked fatigue" that I have so often in my arms and legs. And it's akin to the feeling you get after you've lifted several sets of bicep curls -- heavy, but without the burning of a post-lactic acid build-up.

Related, over a year ago, my neuro noted some weird "hitch" in my jaw -- called a masseter reflex, or a jaw jerk reflex. It's seen in MND, and I suppose is related to "choking" above.

** You know, like when you tried to chew 50 pieces of gum at one time when you were a kid?
 
Edward,
I also have UMN Dom. ALS and have trouble with chocking while eating, have found that going slow, taking smaller bites and knowing what foods I have trouble with helps. For me it is most meats and breads.

Mike
 
I was choking for months before diagnosis with bulbar onset ALS. Even with thickened water, I became prone to choking. Second barium test at VA resulted in a stern warning to start using my peg tube most of the time, or have the high risk of dying of pneumonia from aspirating. I finally got the message after dehydration grew a kidney stone.

Eating and drinking are highly overrated.
 
We have the barium swallow study scheduled for Feb. 27th.
Thank you all for the information!
 
That's great Edward, please let us know the results!

Our speechie would actually sit us down on our next appointment and let us watch the swallow video through at least once.

It really helped me to see the inside story (pun intended) of what I was watching happen from the outside as he progressed along.
 
About the jaw jerk reflex I mention above, I guess the excerpt below explains my jaw spasticity. What I did not know is that jaw jerk reflex is associated with hyperreflexia, and thus, with UMND.

From: Neuroexam.com - Facial Sensation and Muscles of Mastication (CN V)

"Weakness of the muscles of mastication can be due to lesions in the upper motor neuron (UMN) pathways synapsing onto the trigeminal (CN V) motor nucleus, in the lower motor neurons (LMNs) of the trigeminal motor nucleus in the pons or as they exit the brainstem to reach the muscles of mastication, in the neuromuscular junction, or in the muscles themselves.

Presence of a jaw jerk reflex is abnormal, especially if it is prominent. It is a sign of hyperreflexia associated with lesions of UMN pathways projecting to the trigeminal motor nucleus."
 
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