Making Swallowing Safer for those who have trouble swallowing
physics.aps.org
physics.aps.org
At first they thought it was from the intubation but since it continued for several days they referred her to a speech therapist which is who handles this sort of thing. Her neurosurgeon gave her actively dangerous advice that both the nurses and speech therapist told her to ignore ("just chew the food more, then everything turns to oatmeal")
It turns out swallowing is really complicated. After neurological damage you get mobility back much more quickly than sensation and since swallowing is very sensation-intensive there was the real possibility that it may never go back to normal. I'm not a doctor so I'm probably getting some details wrong but there's a semi-voluntary component that kicks off the process, then the involuntary actions kick in. The involuntary bit is a delicate ballet of neighbouring semicircles in your throat contracting simultaneously, then one after the other. In her case, some of those semicircles were not firing or were firing at the wrong time, but only on one side. That made food that breaks into particles or is too thin get pushed around instead of down, so it would get stuck in her throat. If you inhale food particles this way, particularly with a weakened immune system, you're at risk for pneumonia so they take it very seriously
The food she could and couldn't have was pretty surprising. She could have shredded chicken, but not ground beef. She couldn't drink regular water, but could have jello (she could handle jello or augur both, though many people with dysphagia can't handle jello because it melts at body temperature and then runs down your throat). She had to have thickened water which I'd never heard of but was in every drug store I checked. She could have soups that were viscous enough, and vegetables that form fibrous strands when you chew them (like celery), as long as they didn't also form tiny leaves (like broccoli). She could have peanuts but not walnuts.
A good friend saw the weird puzzle of which foods she could have as a fun challenge and flew across the country to stay with us for a couple of weeks and experiment. We went through dozens of dishes a day, mostly in small quantity and then scaling it up if she didn't have trouble with it. I've never washed so many dishes in my life
She's fully recovered now but a challenge definitely helps you definitely learn to appreciate the little stuff :)
Many SLPs work in medical and rehabilitation settings, often with older patients. (And indeed, this work generally pays better than school settings.) Swallowing is a major topic, since not being able to do this competently can have fatal consequences.
Beyond that, SLPs deal with a number of practical cognitive issues. Some of these are related to language specifically, others with related processes. If you've had a stroke, you might have severe problems generating spoken language, even though you can still generate written language without trouble. Or, you might have difficulty with basic planning tasks that we usually take for granted (e.g., what exactly do you need to do to mail a letter?).
Additionally, speech therapists are used to working with patients with neurological disorders.
If you have trouble swallowing sometimes, or it feels like food or pills get stuck, you may want to go see an allergist to get tested for food allergies. Don't procrastinate it thinking it will go away or is just in your head. If you do that, you'll get be at huge risk for Dysphagia, which is Hell. If you distrust the medical establishment, want concrete results (medical tests have false positives/negatives all the time) or would rather save the money, check out the book "The Elimination Diet" by Tom Malterre and Alissa Segersten.
Now that I think about it, I did Keto for about a year and don’t remember it ever happening during that time. My sleep apnea also cleared up.
I got tested for allergies and nothing came up, then the doctor told me to stop the low carb diet and start taking Prilosec. Really stupid, I haven’t seen a doctor since. I’m kinda worried now though, thanks for sharing this.
https://www.webmd.com/allergies/mold-allergy-basics (Note: The list of foods here is pretty good, but some of the foods only need to be avoided if they've been dried/aged/preserved, such as meat, in my experience.)
I later felt that same itch eating pre-cubed grocery store cheddar. They add cellulose to those packages, which I'm guessing could be too blame.
Only fresh cheese don't, such as cream cheese, mozzarella, and queso fresco.
One last tip that might help you if mold is your problem: I find that I have to scrub my faucets clean about once a week with an old toothbrush. I'm sensitive enough that a bit of mold in my drinking water can cause a coughing fit. (But I also live in a pretty humid place where mold grows easily.)
Unfortunately the Elimination Diet is the only way to prove it if the test isn't working. If you have a food you suspect, you can try cutting it out for a couple of weeks and then abruptly adding it back in and see how you feel.
If you are willing to spend the money, an endoscopy can provide some valuable clues. They can take a biopsy of any inflammation and can analyze it to look for clues about what is causing the problem.