How I handle dysphagia, common among people with multiple sclerosis
by Benjamin Hofmeister | July 11, 2024
I have been betrayed by my Breakfast cereal
Other than eating it, I’m not sure what I did to deserve this. I always liked cereal and thought we had a good relationship. The only disagreement we’ve had was when I tried mixing two high-fiber cereals. The result was a bowl of something that looked like it should’ve been raked up into neat piles in the yard. It also made me a bit too, um, regular.
That wasn’t the cereal’s fault, and I never blamed it, so I’m not sure why we’re at odds now. I’m as cordial to it as I ever was, but it keeps trying to choke me.
Come to think of it, a lot of foods and liquids have it in for me these days, but it really isn’t their fault. Even though I can do things to make the situation better (or worse), it isn’t my fault, either. As usual, the real enemy is my multiple sclerosis (MS).
Silly rabbit …
According to a recent study, nearly 50% of MS patients reported having difficulties with swallowing, a condition known as dysphagia. It’s not just annoying; dysphagia can also lead to choking or aspiration, which, in turn, can cause serious complications like pneumonia.
The remedy that has helped me greatly is seeing a speech-language pathologist, also known as a speech therapist. Before I was referred to one, I thought speech therapists just helped with pronunciation or enunciation issues. I quickly learned, though, that they’re the experts to see when you’re having problems swallowing.
I performed a swallow test, which unfortunately had me consuming a variety of substances laced with barium. Then a diagnosis was given and several therapies suggested.
The first was simple positioning. I tend to eat while I’m in my wheelchair and have a bad habit of wanting to be slightly reclined. That’s a recipe for choking, so it was recommended that I try to eat more upright.
A second recommendation had to do with the consistency of the foods I was trying to swallow at once. Having both solids and liquids in your mouth at the same time isn’t recommended. Foods that have a dual consistency of both a solid and a liquid, like cereal, for example, are especially dangerous, my therapist said. These risky foods might include soups, stews, and even juicy fruits.
Swallowing difficulties, including choking, can’t be entirely eliminated, so a large part of speech therapy is focused on strengthening the muscles associated with swallowing and coughing. For coughing, it’s important to be able to expel anything that gets aspirated into the lungs. A number of exercises can help strengthen these muscles.
If you’re in a wheelchair like me, you might want to study techniques for performing the Heimlich maneuver on a person in a wheelchair. You might also want to make sure that family members or caregivers know the maneuver as well.
I’m almost never completely alone, but I’ve had times by myself while eating when I’ve had a slight swallowing problem. I started thinking about what I could run into with my wheelchair to expel an inhaled object. Since a lot of my time has been spent eliminating objects that I might run into, this thinking can be an exercise in creativity.
I’m not quite ready to give up on cereal. I still eat it. I just make sure that I eat it in a way that eliminates the dual-consistency problem as best I can. For me, that means not having a spoonful of both cereal and milk at the same time. It’s slow and not how nature intended, but it’s another one of my MS workarounds — a technique, rather than a tool in my MS toolbox.
MS may try to choke me from time to time, but with certain precautions, I can still be a cereal killer.
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Source of article found here