Some
of you may remember last August when I was eating and then suddenly
could not breathe (again) and Marc had to jump up and give me the
heimlich and my granddaughter was sitting there witness to the whole
pissy mess, if not you can read about it here, and I promised
everyone I would go to the doctor about it.
Well, I had my annual last week and I mentioned to my primary care
doc in an oh-by-the-way manner about the freaky spasms and the
choking thing and before I was finished talking she was writing down
orders for a barium swallow test, a modified upper GI test, a chest
x-ray, and a referral to an ENT. So there was plenty of fun to be
had in my immediate future.
I
got the x-ray right away and they scheduled the other two tests for
last Monday and they had to be on an empty stomach, so nothing to eat
or drink past midnight. First I talked with a speech therapist
trying to tease out exactly what happens and when and how often and for how long, if there is any
unifying element. There’s two issues here, one the whole spasm
thing where when I swallow, the food scrapes or scratches (or something but it's always a sensation so I know what's coming even if I'm powerless to stop it) the inside
of my throat and I start coughing and then sneezing forcefully and
more coughing and eyes tearing and my vocal cords freeze up and I
can’t talk but I can breathe fine throughout the whole event. And
then there are the three times when I couldn't breathe and I think
I’m choking and Marc does the heimlich on me which opens my airway
barely but enough air to work through it myself, inhaling with that
horrible sound and exhaling as hard as I can until I can gradually
breathe completely again. And then there's the times when I aspirate
tiny amounts of liquid, a few drops getting past before the glottis
or larynx closes off the airway. Or when food starts to fall into my
esophagus before I'm ready to swallow. Eating, it's all fun and
games kids.
The
speech therapist isn't convinced I'm choking in the literal sense, in
that she doesn't think I've aspirated liquid or food since there is
no food being expelled when Marc heimlichs me and also because if I
was choking in the literal sense, once the obstruction was expelled
then the airway is immediately cleared and that's not what happens
with me. It's more like I'm suffocating because my airway has been
closed off. She says it's a possibility that my vocal cords (larynx)
are responding to some sort of stimuli which causes them to flatten
out and obstruct my airway. Turns out two things happen when you
swallow...the glottis closes and the larynx flattens out, both of
which act to protect the airway.
So
the first test was to swallow this thin barium liquid while she and
the radiologist watched and conferred on the x-ray. I was turned to
the screen so I could watch too. The first thing I did when they
turned the screen on and I could see my skull and jaw and teeth was
laugh. I mean we all know there's a skeleton inside us but to see it
in real time and watch myself swallow was weird. The point of this
test was to see if whatever it is that happens that causes either the
spasm or suffocation happens while they can watch but of course, it
never does. There were four thicknesses of this stuff but she passed
over the middle two and went straight to the thick 'pudding' of barium, then with a bit
of graham cracker mixed in but still no cigar.
Then
they had me drink a bit of fizzy stuff to get air in my stomach and
then this other medium thickness barium stuff a few swallows at a
time while they watched further down the esophagus and from different
positions. I couldn’t see that part. Then I had to drink a whole
cup of the thick barium which was about the consistency of a milk
shake but it didn’t taste nearly as bad as I had feared and they
took x-rays every 30 minutes or so until it reached where the upper
and lower intestines came together. They said everything looked good
and I could go. They’ll send the test results to both my doctor and
the ENT I went to see the following Thursday. The speech therapist also gave me a lot
of printed info on swallowing disorders and strategies for coping
with it. I went home and finally got to eat around 3 PM.
TMI?
Not yet.
It
would have been nice had they given me a little warning about what
to expect when it all came out the other end. Seriously ooky.
Gross!!!
ReplyDeleteOK, if you can do that, I'm gonna tell my snot story.
Yes, this definitely deserves the "scary shit" label.
ReplyDeleteMy husband and I both have swallowing disorders, but my husband's is much worse. His epiglottis and glottis have paralysis and he aspirates often and gets pneumonia. Been through so many tests. Go here go there. ENT says he stops after the vocal cords and gastro goes from there all the way down. My husband is having his throat stretched Friday and new feeding tube (Mickey) put in. Hope yours all goes well. They do those swallowing tests with different things. Hubby needs crisp things.
ReplyDeleteI'm not worried about the wacky spasms because I can breathe just fine through those plus I've learned how to minimize it...thoughtful eating, swallow while looking down. it usually happens when I'm socializing and eating but not always and it can be set off by crisp things but also cooked oatmeal did it once and spicy stuff can do it too. it's the not being able to breathe spasm that I would like to understand. the ENT did say, when I asked, that in 90% of the times if I passed out whatever muscle would relax and I would be able to breathe again. maybe next time I'll just pass out instead of fighting through it to get back to full breathing. I've never aspirated enough (or at all?) to get pneumonia, one of the reason the speech therapist doesn't think I'm actually aspirating/choking.
DeleteSpeech language person has exercises you can do. My husband won't do them. The breathing spasm thing is a mystery. That must be a scary time.
DeleteHow bizarre. And it just goes to show once again that we are all so different and that sometimes there are just no real answers.
ReplyDeleteYou've been very brave. You really have.
There are things about the human body that simply aren't understood -- or are only partially understood, at best. It does sound as though you're getting the good going-over you deserve, and I hope some answers come. It must be distressing to have to pay such close attention to things that we mostly take for granted. Who sits around and thinks about swallowing? Well, you do. I hope the day comes sooner than later that you can stop having to pay such close attention. It has to be anxiety producing.
ReplyDeleteSounds like quite an ordeal. i hope they find out what's wrong and can provide an easy solution.
ReplyDeleteI'm so glad you're getting this checked out! I periodically have trouble swallowing food - it just seems to get stuck partway down & I can feel it slowly, painfully, making it's way down my esophagus. SUPER annoying! Mostly happens with chicken or beef. I'm thinking of becoming a vegetarian.
ReplyDeleteI sure hope you can get to the bottom of this and put an end to whatever is happening. It must be so distressing for you and your family. Our bodies deceive us in the weirdest ways.
ReplyDeletebeen there done that, fun to watch.hope they decide a fix
ReplyDelete