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-   -   Swallowing (https://www.neurotalk.org/parkinson-s-disease/56000-swallowing.html)

paula_w 10-10-2008 02:55 PM

Swallowing
 
I 've been scoped and bariumed this week. This morning I had barium water, barium milkshake, barium pudding, cookies dipped in barium. So far so good. Scope showed gastric polyps which I was told are very common. One sent off for biopsy. Swallowing test shows nothing, esophagus does not need to be stretched - normal size.

And yet I can't eat bread or meat or sometimes cake, without it getting stuck in my throat. I often have to stand up to get it down. One more P thing that doesn't show up in any visible form on tests. So all we can do is be careful.....nervously reassuring, but resulting in much weight loss.

careful out there, and it would be helpful if we had been granted 3 sets of teeth!

paula

Ibken 10-10-2008 07:52 PM

Paula
 
Quote:

Originally Posted by paula_w (Post 385927)
I 've been scoped and bariumed this week. This morning I had barium water, barium milkshake, barium pudding, cookies dipped in barium. So far so goodg principles and the digestion of. Scope showed gastric polyps which I was told are very common. One sent off for biopsy. Swallowing test shows nothing, esophagus does not need to be stretched - normal size.

And yet I can't eat bread or meat or sometimes cake, without it getting stuck in my throat. I often have to stand up to get it down. One more P thing that doesn't show up in any visible form on tests. So all we can do is be careful.....nervously reassuring, but resulting in much weight loss.

careful out there, and it would be helpful if we had been granted 3 sets of teeth!

paula

the same thing happens to me sometimes when earting. i think it has to do with food combining principles to do w/ protein and carbohydrate digestion...so i try to eat carbs 1st, then protein. if i eat the protein 1st, the carbs won't go down. and i am fighting to keep weight on. too. 100 lbs clothed! i think the stuck in throat sensation is kind of a gag reflex - from the stomach saying it can't digest that now. usually after i wait awhile i can get it down. as i recall once protein digestion begins, there is an enzymatic slow-down for carbs....but speaking of enzymes, supplements can be helpful here. if you find this useful, let me know. it's only a half-educated guess. :p time to go eat something!

ibby

paula_w 10-10-2008 09:09 PM

Just sent you a pm about this - thanks, i will try it! and let you know....would it offend you if i asked what your "normal" weight was? or how tall you are? do you drink Boost or anything like that? I try to remember one time a day but don't always.

thanks!
paula

Quote:

Originally Posted by Ibken (Post 386094)
the same thing happens to me sometimes when earting. i think it has to do with food combining principles to do w/ protein and carbohydrate digestion...so i try to eat carbs 1st, then protein. if i eat the protein 1st, the carbs won't go down. and i am fighting to keep weight on. too. 100 lbs clothed! i think the stuck in throat sensation is kind of a gag reflex - from the stomach saying it can't digest that now. usually after i wait awhile i can get it down. as i recall once protein digestion begins, there is an enzymatic slow-down for carbs....but speaking of enzymes, supplements can be helpful here. if you find this useful, let me know. it's only a half-educated guess. :p time to go eat something!

ibby


dbiker2 10-11-2008 03:09 AM

It's PD.....
 
My MDS had me see an occupational therapist for a swallowing evaluation. PD affects the muscles and since their are muscles involved in swallowing.....we have trouble swallowing. Some foods go down easier than others. the texture and consistency even temperature makes a difference. We really do have to be careful though, if we choke on something and it goes into the lungs causing pnemonia, it could be life threatening.

lou_lou 10-11-2008 03:30 AM

dear all - swallowing therapy for Parkies?
 
I chew gum as therapy for speech and swallowing?


heres the article -
Swallowing Therapy :
How can it help?

By overcoming swallowing problems, you can help your body get the energy, vitamins, minerals and fluids that it needs. Swallowing therapy may also make your mealtimes safer and more enjoyable.1


Why should it work?

The muscles in your jaw and face can become weak if you have Parkinson's. You may have less control over your teeth and not be able to close your lips tightly. This makes it hard to chew your food and swallow. Food and saliva may collect in your mouth and in the back of your throat, causing you to choke or dribble.

Although the drug levodopa can improve your swallowing speed, drugs don't help much with these swallowing problems.2 So therapy is used to improve how you swallow and to strengthen the muscles you need for swallowing. Other advice, such as changing the texture of your food, may also make swallowing easier and safer for you.

For some people, though, swallowing therapy may not be enough. They may need another way to nourish their body, such as a feeding tube through their nose or directly into their stomach.


Can it be harmful?

Probably not. But we can't say for certain since there's no good research on swallowing therapy for people with Parkinson's.


What's the evidence?

What's the evidence for swallowing therapy?

Sources for the information on this page:
Parkinson's Disease Society. Eating, swallowing and saliva control in Parkinson's. Information sheet FS22, 2006. Available at http://www.parkinsons.org.uk/pdf/is_swallowing_06.pdf (accessed on 18 September 2007).
Deane KHO, Whurr R, Clarke CE, et al. Non-pharmacological therapies for dysphagia in Parkinson's disease (Cochrane review). In: The Cochrane Library. Issue 1, 2005. Wiley, Chichester, UK.

http://besttreatments.bmj.com/btuk/c...ons/16813.html

gaykir 10-11-2008 09:44 AM

one swallowing tale.....
 
It is interesting to us that this topic should come up now. Kevin has had periodic swallowing problems for several years. In fact, two choking epidodes are what finally forced us to get a diagnosis. He has always been extremely active spyically so the disease was masked for many years.

He recently failed a bariactric swallow test - in fact it was so bad, they were unable to complete the test. He has been on a prureed diet since then but even that is becoming an issue. We've had many lenghy discussions about the situation and his decision is to refuse a feeding tube. We have been through all the speech & occupational therapy and even used a "power lung" to help but in the end there is no recourse at this point other than a tube which brings it own set of issues.

He is currently under the care of Hospice Plus and he has had his body accepted for parkinsons' research at UT Southwestern med school. It is his desire to "make sure it was all worth something". He is completely aware and keeping a sense of humor. He is now telling folks who ask how he is doing that he is getting ready to go back to school.

The saddest part of this is that he is just 60 years old. He was diagnosed in Feb 2000 and had DBS Feb 2007. I don't mean to scare you. Not everyone with PD experiences these swallowing issues. Just thought I'd share where we are on the swallowing road. :(

paula_w 10-11-2008 09:54 AM

thank you gaykir
 
Although I hate hearing it, I'm not sorry that you posted. This is a PD forum, and PD is a monster. It's open to anyone, anywhere, along any road. Your husband is too young for this, but obviously wise to keep his spirits up and I'm glad you have help. My thoughts and prayers are with you both. I hate this disease.

paula

Quote:

Originally Posted by gaykir (Post 386325)
It is interesting to us that this topic should come up now. Kevin has had periodic swallowing problems for several years. In fact, two choking epidodes are what finally forced us to get a diagnosis. He has always been extremely active spyically so the disease was masked for many years.

He recently failed a bariactric swallow test - in fact it was so bad, they were unable to complete the test. He has been on a prureed diet since then but even that is becoming an issue. We've had many lenghy discussions about the situation and his decision is to refuse a feeding tube. We have been through all the speech & occupational therapy and even used a "power lung" to help but in the end there is no recourse at this point other than a tube which brings it own set of issues.

He is currently under the care of Hospice Plus and he has had his body accepted for parkinsons' research at UT Southwestern med school. It is his desire to "make sure it was all worth something". He is completely aware and keeping a sense of humor. He is now telling folks who ask how he is doing that he is getting ready to go back to school.

The saddest part of this is that he is just 60 years old. He was diagnosed in Feb 2000 and had DBS Feb 2007. I don't mean to scare you. Not everyone with PD experiences these swallowing issues. Just thought I'd share where we are on the swallowing road. :(


chasmo 10-11-2008 10:05 AM

thoughts on swallowing
 
for some reason egg Mcmuffins cause me to choke,. I avoid these like the plague. AVoid things that you choke on frequently.

take small bites and chew them completely up. Its amazing to me how many people do NOT do this!! (including me at times!)

have a beverage close at hand to wash things down with.

lastly and most importantly, put your chin to your chest before swallowing. this will help your swallowing mechanism.

Charlie

bandido1 10-11-2008 10:47 AM

Good advice Charlie! I think I will try the "chin down" technique vs. "chin up" for morale. My danger foods are shelled peanuts and popcorn. Bob C

Wiix 10-11-2008 11:23 AM

I have had some swallowing problems in the past myself. It happened after I had some of my front upper teeth extracted. Then when I had the others in the front extracted. It has to do with the position of the tongue when you try to swallow. Usually with front upper teeth you press your tongue tip up against them to give the food a sort of push backwards. Without this push the food sort of gets to a place it didn't before, not far enough back in your throat. I had to relearn how to swallow. This also happened to my Dad after he lost his front upper teeth. It's a mechanical problem and doesn't have anything to do with your esophagus. You have to be concious of where your tongue is when you are trying to swallow.

I have also heard this from other people who JUST lost their front uppers. Wearing your flipper or upper partial or full plate helps. I also had a friend when I was a teen who lost her front teeth in an skateboarding accident. She told me this way back then, that she was having trouble swallowing. All our physical structures work together in our bodies and if we lose one or part of one we have to learn how to do things we used to do before without thinking. Tilting your head slightly back while trying to swallow also helps.


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