[Forgetmenot]

Background : My husband has been recently diagnosed with PD, at age 50 He doesn't have much of a tremor but his symptoms are: shuffling gait, lack of arm swing in both arms but more so in right arm, rigidity and bradykinesia. The symptoms are all very mild --he still works full time, he can play sports, just a little slower. Sometimes I think he runs better than he walks. But he doesn't run like he used to either (of course he is 50 now he tells me So NEUro #1 says this is very early PD. We have noticed these symptoms progressing ever so slowly for about a year. He has had a reduced sense of smell for about 6-8 years. He has had lots of testing to rule other things out - and an abnormal DAT scan consistent with PD.

Over the years my husband has had various issues with clearing his throat and coughing when drinking or eating, mostly drinking. I would sometimes hear him say that he thinks he has a very narrow passageway in his throat because he thinks he chokes easily. But it was never really serious. Well about 4 months ago he had a pretty severe choking episode. But I still didn't think too much of it. I have esophageal dysmotility from a chronic illness of my own, so I know what it is like to have difficulty swallowing. But my husbands episodes seem much, different. I wondered for a while if the throat clearing was simply reflux -- but the choking scares me. Today I came home and my daughter my husband had a severe choking episode while eating watermelon, I asked her if he was talking while he ate, or laughing or anything that might have caused him to choke. She said no she wasn't in the room with him, he was alone and then she came in and found him choking. She said it was pretty scary, but he was able to work it out, and he hasn't told me about it yet.
Now, I have read that PD can cause problems with swallowing and choking, but my understanding is that this comes late in the disease. My husband has no problems with his voice -- does not speak softly either. I don't want to worry him or make this into anything that it isn't. Lots of people choke once in a while-- it can happen to anyone and I don't want to be paranoid. I just remember when the neuro asked us if he had any trouble swallowing, I was tempted to say something, but didn't because I'm just not sure. Now we will be seeing an MDS and I'm wondering whether it is something to bring up or not. My husband does not know that swallowing issues can be a problem with PD and my kids think I shouldn't tell him because it will just scare him--worrying about the future.
Does anyone have any thoughts for me? Can swallowing problems come earlier in the PD picture?

[lurkingforacure]

I wish I had an answer, but if I've learned anything about PD, it is that it affects everyone differently. I have read that same thing, that choking happens really late in progression, but I think that is a very generalized statement. If you go on PD forums, you'll find symptoms all over the place as well as the point at which they manifested.

And I don't think you can read anything into the fact that your husband may be choking earlier than you expected him to be. He may just need a med adjustment to help get him over a rough patch If it were me, I would ask his doctor and get his input.

[aquario]

I had swallowing difficulties as an early, relatively mild, symptom before I was even diagnosed 8 years ago. It was what prompted my primary physician to refer me to a neurologist. The difficulties have increased slowly over the years. But since the beginning of January when my neurologist put me on a small dose of agonists (Requip XL) to go along with my minimal sinemet intake, I have had much less a problem with choking and swallowing. Very little else has changed, but the lessening of swallowing issues has been a considerable relief.

Jon

[Forgetmenot]

Thanks to both of you for your insights. My husband is not on any meds at all yet.
Aquario -- along with the swallowing issues early on, did you have any trouble with speech or voice? I had read the 2 often go together and I have not noticed any trouble with my husband's speech, I don't think his voice has softened noticeably. It is only the choking and swallowing issues. I am wondering if there can be swallowing problems without having obvious speech or voice issues. Thanks for your help!

[slashman48]

I also had chocking & swallowing problems early. Seems like tremors were one of the later symptoms that I had. Shuffling gait, balance issues, loss of smell, fatigue, loss of fine motor skills, slow weak achy muscles, soft low voice, masked
face, bizarre & vivid dreams every night. Seems like I had all of those before tremors set in. I was opening & closing my right hand all the time before it turned into tremors though. I had trouble swallowing, choking & drooling. I did have a swallow test done where they X-ray you swallowing different food textures. I take smaller bites now, chew more and have to time when I swallow so I don't choke. It's like the muscles used to swallow are not coordinated now.

[Aunt Bean]

I had choking issues for about several months early on during a very stressful time in my life. I learned to not drink when I eat, not to try to talk during a meal and to breathe in and start breathing out before swallowing. When you are young...it is easier to adapt to difficulties (along with deciding a course of action that will help and follow thru) You aspirate when breathing in while trying to swallow . May God Bless and guide you thru this

[aquario]

Originally Posted by Forgetmenot

Thanks to both of you for your insights. My husband is not on any meds at all yet.
Aquario -- along with the swallowing issues early on, did you have any trouble with speech or voice? I had read the 2 often go together and I have not noticed any trouble with my husband's speech, I don't think his voice has softened noticeably. It is only the choking and swallowing issues. I am wondering if there can be swallowing problems without having obvious speech or voice issues. Thanks for your help!

For the most part I haven't had any speech problems. Occasionally my voice gets a little softer and flatter. But not over any longer period. I sometimes get a little tongue-tied when I call kittykittykitty to try to persuade our two cats to come inside when night starts to fall and the coyotes start to prowl. But the swallowing is not currently the problem it was increaasingly during the first seven years.