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  • anywhereoutofthisworld
    I was reading an article this evening that I found interesting enough to post here, to read it: Click for Article. I was researching swallowing issues or dysphagia, as it's a symptom of MS I get on occasionally and it's one that I experienced this afternoon while eating a sandwich. I took a bite and tried to swallow as normal and suddenly felt like I was choking and had to cough hard for a bit to clear it out, all the while my nose was running as I gasped for air. I also get the drinking something (and it goes down the wrong pipe) way too often but that's nothing compared to when food is involved of course. This swallowing food issue happened to me before, I was only officially diagnosed with MS, in late July of this year but the swallowing issues every so often have occurred. For the most part food wise it's eating rice (on many occasions wild rice oddly enough) and the best way I can describe it is I feel like I am suffocating, it burns, nose runs and I end of throwing up the rice and some rice would even come back out my nasal passages. My eyes would water too and I wouldn't feel fine until I burped, thats when I would know it was okay and it was over. This only happens on occasion thankfully, but when it happened today with a sandwich and not rice that seemed strange and so this article was interesting to me. I too, on all these occasions felt a genuine panic for my life and I felt like I was gasping for air as the article describes.

    Here's a key part of the article -

    The reasons swallowing problems arise are complex because swallowing itself is complex.

    “There are 17 components that work together during the two-second period in which swallowing occurs,” says Martin B. Brodsky, PhD, assistant professor and speech-language pathologist in the department of physical medicine and rehabilitation at Johns Hopkins University School of Medicine in Baltimore.

    Of the 12 cranial nerves in the brain, Dr. Brodsky says, half are devoted to swallowing, and these 6 cranial nerves control upward of 30 pairs of muscles.

    In a properly executed swallow, the airway is closed tightly before the swallow is initiated and food or liquid enters the throat. Once the swallow is complete, and the food or beverage is gone, the airway opens back up.

    Swallowing issues related to multiple sclerosis are usually due to problems in the timing, or coordination, of a swallow or to weakness in the muscles used to swallow.

    Just curious what others think of this article and if they too have had these kinds of swallowing issues along with the panic that the episodes cause.

  • RQManchester
    This can happen commonly with esophagus problems brought on by acid reflux.  Doesn't seem like it would, but it most definitely can and does cause that.  Just a another possibility to explore!
  • beaurylancambria
    The first time this happened to me, I was in the hospital being diagnosed. I had never had the issue before. For me, it always involves liquids. Never when I am eating, only drinling. Oddly enough, it usually involves water. It is scary.
  • curlyloopa
    Oh my goodness, yes. I was diagnosed in 1986, and I announced to my husband that people didn't die of MS, they died of pneumonia.  Then I got pneumonia in 2002 and actually almost died. I had been on tube feeds for 6 weeks, and as part of recovering from that episode, I had to have a barium swallow test. Now my pneumonia was NOT aspiration pneumonia, it was just ordinary really really horrendous cold with influenza pneumonia. But there I was as an inpatient trying to eat and swallow safely. I had already had plenty of coughing/choking episodes like the one you describe. 

    I have to say, the barium swallow was the single most unpleasant test I have had! And I've had tons of unpleasant tests. So the rest of my life has been devoted to NOT repeating that awful test. In 2012, I went off Medicaid and onto my husband's Blue Cross plan, and I got a whole new team. I finally admitted that I was having trouble swallowing and speaking.

    i  met with a respiratory therapist in 2012, but I told her I was unwilling to repeat the barium swallow. So I learned how to tip my head to swallow more  safely. But hey, I could have figured that out without using up  my Medicare therapy benefit. In short, I found RT for my medium-level dysphagia unimpressive. 

    However, what did help was understanding that most of my unrelated  MS problems could be able considered neurogenic. Years and years before, in 1987, it was explained to me that I had a NEUROGENIC bladder. My brainstem couldn't coordinate contracting the detrusor muscle with relaxing the urinary sphincter. Either EVERYTHING relaxed or nothing relaxed, so I was alternating incontinence with retention. 

    What if I thought of other processes as neurogenic? I couldn't coordinate the closing and opening of my esophagus, so I choke, gag and cough. I couldn't coordinate the tongue and soft palate contracting and relaxing, so I stutter and hesitate. Thinking that way didn't actually help me do anything better, but it helped me make sense of these seemingly unrelated symptoms. They all had  to do with processes that are supposed to work automatically but no longer do.

    I don't bother with RT anymore. I no longer have BC/BS so I am much more careful with my  Medicare therapy benefit. But I am  vigilant about swallowing carefully because I know I can't count on any of that stuff to work correctly automatically any more. And I don't want to get aspiration pneumonia. 

    I don't know if my tale is interesting or helpful. If you want to pursue treatment options, the department is respiratory therapy, which does speech and swallow. Good luck and be careful. 
  • RQManchester
    Curlyloopa,  very good information to share.