Swallowing and Choking Difficulties?

While checking my Facebook page, I ran across a link to the ALS Association’s ‘Living with ALS Manuals’ on the Kennedy’s Disease Team Great Britain page. Since many symptoms with ALS are similar to Kennedy’s Disease, I explored some of the manuals and found some of the information relevant and potentially useful for those of us with SBMA. 

The first manual I want to make you aware of is:

Adjusting to Swallowing and Speaking Difficulties

Swallowing and choking, at some point in the progression of Kennedy’s Disease, can become an issue. This ALS manual tackles many of the concerns in an easy to understand manner. Speech issues are not as prevalent in Kennedy’s Disease, but it can be an issue for some of us living with the condition. This manual also discusses communication devices including aids to use computers.

TABLE OF CONTENTS

·         Swallowing
How does ALS affect swallowing?
What should you do if muscle weakness affects your eating habits?
What can you do to control your saliva?
What should you eat to maintain a balanced diet?
Why should fiber be included in your diet?
How many and what kind of fluids should you drink regularly?
What is the most appropriate weight for you?
How can you increase your intake of protein and calories?
Do you need to change the consistency of the food you eat?
What if you cannot consume enough food, even after changing the consistency and using supplements? 

·         Speaking
What can you do if your speech sounds slurred?
Tips for Speaking Difficulties
Helpful Hands, Helpful Voices
Using the Telephone
What can you do if other people have difficulty understanding your speech?

·         Communication Devices
How do you choose a communication device?
What types of communication devices are available?
What are the low-technology options?
What are the high-technology options?
What types of aids are available to help you access computers?
What are the “Alliance for Technology Access for the Disabled” and “The Rehabilitation Engineering and Assistive Technology Society of North America (RESNA)”?
Where can you find funding for these devices?

A few examples of the information you will find in this manual follows:

WHAT IF MUSCLE WEAKNESS AFFECTS YOUR EATING HABITS?

A good rule to follow is to swallow two or three times with each mouthful in order to make sure that all food is cleared from your throat. Moistening food with sauces and gravy is helpful in preventing the feeling of pieces being stuck. Taking a sip of liquid after each bite also may help move the solids.

Moreover, try tipping your chin downward as if you are looking at your plate, so that you shift the structures into place which protect the airway, as opposed to tilting your head backward.

WHAT CAN YOU DO TO CONTROL YOUR SALIVA?

The body produces about four-to-six cups of saliva every day. Normally, this saliva is being moved in the mouth and swallowed unconsciously. If your swallowing muscles are weakened and your lips and jaw are not in control of the saliva, you may have difficulty keeping it in your mouth (drooling), or experience some occasional coughing or choking.

If your saliva is thick, it is important to take in enough fluid to make your saliva thinner. It is easier to swallow thin rather than thick saliva.

If excessive saliva becomes a problem, you should talk to your doctor about the possibility of using medicine to control it. There are also suction machines available which are used to dispose of excess saliva; you can get more information about these aids from your nurse or doctor.

If you are experiencing swallowing issues or are finding it more difficult to communicate, please check out this resource from the ALS Association.