swallowing difficulties

[MindyR]

Hi, It has been some time since I have been on the forum, but last night I had quite a scare and I'm hoping to get some advice. I have been having increasing difficulty with swallowing in the last few months. At my last doctor visit we discussed a peg and I am scheduled for the procedure on July 19. In the meantime, my swallowing has been getting progressively worse. I am drinking nectars and carbonated drinks, but no water or other thinner liquids. I've been eating softer foods and foods with gravies, sauces, or cream. Last night I was just eating applesauce and began to choke. And then I started to panic and that only made my breathing worse. I am on bipap 24/7. Thank goodness for my calm husband who talked me through it. Today, I have been absolutely terrified to eat. I've drank nectar, had some eggs and sour cream, and some baby food fruits. We plan to call the doctor tomorrow to see if we can move up the date for the peg, but in the meantime any suggestions would be greatly appreciated. Thank you!

 

[affected]

Hi Mandy, it is really scary.

Tucking your chin in while food is in your mouth and when swallowing can help a lot.

I would get the peg moved up if possible as you don't want to have a big weight drop now and become dehydrated.

Maybe your hubby can make some high calorie smoothies?

Staying calm is the real key as you noticed your husband could help you best by staying calm. It's not easy, but tuck your chin, breathe through your nose and try to stay calm. If you have a cough assist that could really help to clear the throat too.

It's rarely a true obstructive choking, but a partial aspiration that is happening (which feels like choking), which is where the cough assist can really help. You are at risk of a pneumonia from this, so possibly sticking to smoothies and thick soups in the meantime will be much safer.

 

[lgelb]

Hi, Mindy, Tillie gave you some good advice. Additionally, you might focus on foods that are all one texture -- applesauce has bits and smooth parts both, if that makes sense. Commercially-made pudding is an example of a single texture.

Also, since blenderizing "real food" has helped many of our tubed members (commercial formulas are not a nutritional bonanza, in most cases), you might want to order a high-power blender now, if you don't have one, and that will help you get a more consistent consistency in your food now and when you tube feed.

Best,
Laurie

 

[GregK]

Smoothies, milkshakes. Yep.

How about Boost Plus or Ensure? If too thin, add some ice and blend.

 

[MindyR]

Thank you all for your advice and suggestions. Tucking my chin in was helpful with breakfast this morning. I was able to eat eggs and drink nectar with no choking! We have a NutriBullet, is that considered a high power blender? My husband went shopping so we can try all your suggestions. I am so lucky to have him. Thanks again and I will keep you posted.

 

[GregK]

We have a NutriBullet, is that considered a high power blender?

yep, but definately not a high capacity one! 8^)

 

[Duker52]

I have a hard time with thin liquids so we went to the drug store and got powdered thickener. I put some in any thin liquid and it thickens it up so I can drink it. Also, check out Boost Very High Calorie drink. I order it from Amazon and each 8 oz has 580 calories. For the most part, I live on the stuff.

 

[MindyR]

I was able to get the date for the feeding tube moved up to the 12th. Thank you for your suggestions. Everything has been very helpful and I'm feeling like we are in a good place right now. Thanks again!!

 

[Paul Wicks]

While it's still early days, there was some evidence presented in Orlando that the drug Nuedexta could potentially help with bulbar symptoms including swallowing. I think a proper Phase III is still warranted but it might be worth a shot.

Paul

 

[GregK]

That was why I pressed for the Neudexta. They seemed pretty sure it helped with the bulbar symptoms.

 

[MindyR]

Thank you for the suggestion. I will talk to my doctor.

 

[Buckhorn]

You've gotten some great advice here. Tillie's suggestion (tuck your chin) when you swallow is actually a technique that speech therapists teach patients with various causes of "dysphagia" (difficulty swallowing). Also, the "double swallow" technique is beneficial: swallow twice for each bite. I am assuming you are drinking liquids out of a straw?