Please don't be afraid of feeding tubes! My spouse has had a G-tube for 3 years now and I wish we had gotten it *years* prior to that - he developed urosepsis on more than 10 occasions due to dehydration. A feeding tube would have let us keep him hydrated and medicated while he still ate for pleasure while he still could.
I don't have too many problems with the physical action of swallowing (so long as eat slowly and carefully) but food and liquid can take a long time to work their way down to my stomach. I remember in the early days of MS first noticing fluid building up in my throat one evening causing me to constantly cough / throat clear. I could even cough back an ibuprofen tablet virtually as swallowed (they are bright pink) 5 mins after taking. Achalasia of the cardia was excluded and, despite my then neurologist firmly stating it was nothing to do with MS, a second and extremely observant neurologist later picked up on my cough in clinic.
Over the years I've learnt to control the throat clearing and re-swallow so not to cough in public. Just as well in the covid era!
Another very insightful article. I was diagnosed in 1992 and have had numerous choking episodes and coughing. It can be very disconcerting and worrying for those witnessing it!! I have dysphagia and must always to remember to chew my food properly and have a drink to hand!
I was diagnosed with MS in 1991. I have had problems with swallowing food and have been admitted to hospital a few times because of it.
However, I have found that if I make sure that I have chewed the food properly, and have a drink after swallowing it, I have had fewer problems.
The staff at the old Lymington hospital A&E suggested that Coca-Cola is a good drink to help with food stuck in the throat as it can dissolve the food.
It’s really frightening when no air is entering either through the mouth or though the nose, rendering me completely silent, so that it’s not obvious I’m totally failing to inhale and can’t utter a sound. Consequently I’m unable to communicate this and am ignored. It’s just a question of quelling any panic until it passes.
Hiccups are more common in people with NMOSD (neuromyelitis optica spectrum disorder) and if it is part of the initial presentation they may have diagnostic utility.
This is not uncommon in pwMS and is due to brainstem disease. Rarely they can last weeks and months, usually as part of a relapse, and can be quite resistant to treatment.
Yes, you can get them from high cervical cord lesions as well. Hiccups are due to spasms of the diaphragm and this is innervated by the phrenic nerve which is from the C3-5 cord level.
Please don't be afraid of feeding tubes! My spouse has had a G-tube for 3 years now and I wish we had gotten it *years* prior to that - he developed urosepsis on more than 10 occasions due to dehydration. A feeding tube would have let us keep him hydrated and medicated while he still ate for pleasure while he still could.
I wish more neuros would bring up this option.
A very informative post thank you.
I don't have too many problems with the physical action of swallowing (so long as eat slowly and carefully) but food and liquid can take a long time to work their way down to my stomach. I remember in the early days of MS first noticing fluid building up in my throat one evening causing me to constantly cough / throat clear. I could even cough back an ibuprofen tablet virtually as swallowed (they are bright pink) 5 mins after taking. Achalasia of the cardia was excluded and, despite my then neurologist firmly stating it was nothing to do with MS, a second and extremely observant neurologist later picked up on my cough in clinic.
Over the years I've learnt to control the throat clearing and re-swallow so not to cough in public. Just as well in the covid era!
Another very insightful article. I was diagnosed in 1992 and have had numerous choking episodes and coughing. It can be very disconcerting and worrying for those witnessing it!! I have dysphagia and must always to remember to chew my food properly and have a drink to hand!
I was diagnosed with MS in 1991. I have had problems with swallowing food and have been admitted to hospital a few times because of it.
However, I have found that if I make sure that I have chewed the food properly, and have a drink after swallowing it, I have had fewer problems.
The staff at the old Lymington hospital A&E suggested that Coca-Cola is a good drink to help with food stuck in the throat as it can dissolve the food.
I have found it useful on a bad day.
Interesting. I would expect the bubbles not to be too helpful, do you stir it first?
It’s really frightening when no air is entering either through the mouth or though the nose, rendering me completely silent, so that it’s not obvious I’m totally failing to inhale and can’t utter a sound. Consequently I’m unable to communicate this and am ignored. It’s just a question of quelling any panic until it passes.
Hiccups are more common in people with NMOSD (neuromyelitis optica spectrum disorder) and if it is part of the initial presentation they may have diagnostic utility.
Re: hiccups or hiccoughs
This is not uncommon in pwMS and is due to brainstem disease. Rarely they can last weeks and months, usually as part of a relapse, and can be quite resistant to treatment.
Yes, you can get them from high cervical cord lesions as well. Hiccups are due to spasms of the diaphragm and this is innervated by the phrenic nerve which is from the C3-5 cord level.