Abby, one thing I was told was to BE sure to take a pill BEFORE bed so that I could swallow saliva in my sleep. Apparently, this is something that we just "do". I just take a 60 mg -- haven't needed a timespan so far -- knock wood.

Now, as for the trouble swallowing -- I can only tell you about food and drink. If I am having trouble swallowing, the food feels like it gets stuck in the upper part of my throat -- and this gives me a panicky feeling -- like I'm not going to be able to catch my breath. I start coughing and spitting and gasping --- it is HORRIBLE. And it LOOKS horrible to whoever is around to see it. They think I am DYING!!

If I am having trouble swallowing water or another liquid, it just comes out my nose -- like a runny nose. It is the MOST peculiar thing I have ever seen. I could swallow green Kool-aid and green liquid would drip out of my nose. EEEK!!!

Even with choking, I wouldn't rush to the doc -- UNLESS I aspirated or passed out or something like that. I would only rush with breathing difficulties. With choking -- just don't eat or drink until your muscles have had a chance to rest or until the Mestinon has kicked in.

Maurice had a good point in another thread -- if you want to eat in a few minutes, don't talk -- the same muscles are used. If you fatigue the muscles by talking, you are gonna have trouble eating.