Well perhaps not in Mudville but in the hallowed halls of the Swallow Clinic and our abode. “Swallow Clinic?” says my faithful reader with a cock of the head and a raised eyebrow that suggests incredulity? Yes. A Swallow Clinic! A largely unknown but an important unit in most hospitals of any size.
“So what do they do there?” asks FR with a barely surpressed smirk. “Watch you swallow? Teach you to swallow?” Yes they actually watch you swallow and if there are problems they teach you techniques and workarounds to help overcome them.
As simple as we may think it swallowing is a complex involuntary reflex which involves the coordination of various organs, muscles, and nerves. (It is explained in some detail here.) It is also a reflex that we can forget if it has not been used in a while as in my case because very little feeding has been done by mouth. Before returning to normal eating a check is done to verify that the reflex is still there and that the pharynx is still protecting the airways during the process. Serious problems with aspiration can occur if that little pouch isn’t performing it’s function.
The process is a simple one. You are seated in profile to an x-ray machine and given a series of drinks to swallow. The technician – in my case the very charming Jo – watches the process on a screen and judges it. All the samples are mixed or treated with barium – not an element I’ll be adding to my spice rack. They start out with the most viscous – custards, mashed banana, yogourt etc and work their way down to fruit juices and water. I thought that a rather odd progression but Jo explained that the more viscous something is the easier it is to swallow. Water is the most difficult as it spreads and can cause aspiration. The final item is a real challenge: a dry digestive biscuit.
So why was there joy at the end of this little exercise yesterday? On everything but the dry biscuit my pharynx did what it was suppose to do and things went where they were supposed to go. I honestly don’t know who was the most excited: Jo, Brenda the x-ray technician, or me. I can start taking food by mouth and have done so today. Not a steak or even that order of fish and chips I crave* but several custards and a broth with puréed carrots. I have to be mindful that my system has not processed solid food since mid-October and introduce things slowly. Things such as dairy has to be approached cautiously again because the system has not processed any in a long time. But I have been assured that in a short time I will soon be able to enjoy (?) some of the things I’ve been cooking! I can’t throw off the chain that is the feeding tube just yet but that too will come.
To end the way I started the post. There is cause for joy: unlike Casey I didn’t strike out, I hit a home run!
*The things you crave in these situations can be quite bizarre and mundane.
The word for January 12th is:
Aspiration ăs″pə-rā′shən: [noun]
1.1 a will to succeed.
1.2 a cherished desire or goal.
1.3 a manner of articulation involving an audible release of breath.
1.4 the act of inhaling; the drawing in of air or other gases.
1..5 Inhaling foreign matter into the lungs.
1530s as “action of breathing into,” from Latin aspirationem (nominative aspiratio) “a breathing on, a blowing upon; rough breathing; influence,” noun of action from past-participle stem of aspirare “strive for, seek to reach,” literally “breathe at, blow upon”. The meaning “steadfast longing for a higher goal, earnest desire for something above one” is recorded from c. 1600.
Willy Or Won't He 