27. Difficult to Swallow

A health question to The ME Association's most recent ME Essentials magazine caught my interest for two reasons; the first, the question was about swallowing difficulties, which I have experienced myself and secondly because I am a speech and language therapist (SLT) with a post grad training in Dysphagia (swallowing difficulties).

Swallowing difficulties are terrifying. Everyone chokes from time to time on notorious foods such as grapes, dry crumbly scones, rice crispies so most people will remember how alarming it is to  try to cough a bit of food out of the back of your throat in order to regain the ability to breath. And how embarrassing it is if you take a bite of scone or cake in a busy cafe and end up gasping, coughing, spluttering not actually sure if your breath is going to return.  You feel that you're trying not to choke to death while equally fearing soul-destroying embarrassment, and in some ways when composure returns, the fact you have your dignity intact means more to you than your breath returning!

I've made my own assessment of my swallowing difficulties and try to avoid offending items of food: taking a bite of a dry scone then breathing in ready to speak or laugh is a danger zone; eating food that has two different textures, especially salad with a liquid salad dressing often results in me chewing the salad items while unnoticed the acidic salad dressing slips down to the back of my throat; I can sometimes feel icy cold drinks at the back of my mouth going up into my nose and down towards my lungs instead of my stomach.

In addition to choking episodes, I had over a year of non food related coughing that occasionally took my breath away and left me unable to breath in. A diagnosis of Asthma and a prescription of inhalers helped this instantly but even with the inhalers it is creeping back again and will be reviewed.

In my work as a SLT I often assessed clients who choked on food or drinks and advised about types of food that were best to eat and which to avoid. If assessment face-to-face was difficult and it wasn't completely clear what was physically happening inside someone's mouth and throat I could make a referral to the local hospital for a Video Fluoroscopy (VF) appointment which involved having a video xray taken while the client was swallowing food and drink with what nowadays is done using the most modern computerised technology.

Having your swallow assessed is a wise thing to do if you have choked repeatedly on food or drink, especially as the lady who wrote the the ME Assoc said that she'd needed the Heimlich Manoeuvre three times. There is the risk of choking but also the irritation to the lungs of food or liquid finding their way in.

I've written to the ME Association saying that the lady who wrote the question for ME Essentials should ask her GP for a referral to SLT.

I will return to this topic again.




I'd be interested to hear other ME sufferers' experiences of choking either in a comment below or a tweet on Twitter and I will follow up by discussing ME and Dysphagia with SLT colleagues in the VF dept.