Oh, Erin! I'm sorry you are worse right now!

Swallowing issues are rough. Do you talk or socialize a lot? That will make swallowing muscles worse.

A cold washcloth on the jaw/neck muscles can help. Using a soft yet firm neck brace can help relax those muscles, if it is the right kind. You don't want anything pushing up into any muscles either. Do you tense up when you sleep? That can make those muscles worse.

If you haven't been evaluated for sleep apnea, you should. Choking while sleeping, as Mike mentioned, can make those muscles worse. A APAP (a new kind of machine with alternating pressure) or BiPAP can help, even if you don't have apnea.

I can choke on saliva too. When the choking/coughing is really bad, like when I aspirate food, I nearly cough up a lung! Scary.

I always keep cold ice water around, which helps me. For some people, drinking through a straw makes things worse. For me, drinking through a straw for all liquids uses less of the bulbar muscle groups. I eat slower than practically everyone. Sipping water between bites helps. I also don't eat tough to chew food, or anything thick such as peanut butter. Citric foods can make someone choke more easily.

Watch what you do during a 24-hour period. At what times do you tense up those muscles or use them more? Really think of anything that could make those muscles weaker and then try to mitigate them.

Even while on drugs, MG can still cause weakness after activity to varying degrees.

There's only so much doctors can do. I think that pinpointing what exacerbates the situation can help. I haven't found anything to avoid choking altogether. But I have alleviated it. Good luck!


Annie