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Choking in Adults
with low muscle tone HELP!!


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#1 trebambinibelli

Posted 13 February 2013 - 08:21 PM

Posting here for traffic....

I have a variety of health issues, one being that I have hypotonia (low muscle tone).  Over the last decade or so, I have had increasing problems with dysphagia (difficulty swallowing).  This sometimes leads to choking.  Majority of the time I can quickly cough or swallow but sometimes, like tonight, I try to clear the throat and the food just stays there.  I have to quickly get myself over a desk or table and bang myself on the back while trying to cough.  This time it only lasted about 10 sec.  A few weeks ago, it lasted at least 30 seconds or maybe more, the most terrifying 30 seconds of my life.  sad.gif

I'm so scared of this happening again but possibly losing consciousness if I can't dislodge the food in time. I've seen a speech path who said I had really weak swallowing muscles, so she gave me some exercises on a trial.  The exercises only tired out the muscles more and the choking increased so she said that is all I can do.  

I've googled but most info relates to babies choking but not adults.  I'm a single Mum so have no adult present if can't recover from the choking.  I'm at the very beginning of my dietetic studies so I'm still yet to learn about diet modifications relating to this but maybe I should ask one of my lecturers for their advice? But in the meantime, is there anyone out there that experiences the same problem - or even has older children with it?  If so, what or who helped you or your child?

Thanks for reading original.gif

#2 Mumma3

Posted 13 February 2013 - 08:27 PM

A friends husband has something similar, which last year resulted in a trip to the ED.
I can't remember the name of what he has, but he ended up seeing a dietician after also having an endoscopy (is that the one they do through the throat?) which showed scarring to his food pipe. He had had symptoms since a child, but it has got worse the last few years.
He had to go through an elimination diet, and has managed to control it by avoiding gluten and nuts. It seems to be a variation of an anaphylaxis for him, but had the potential to continue getting worse if he doesn't avoid those triggers.
HTH

#3 TillyTake2

Posted 13 February 2013 - 08:27 PM

Could you see a gastroenterologist?

#4 TillyTake2

Posted 13 February 2013 - 08:31 PM

QUOTE (Mumma3 @ 13/02/2013, 09:27 PM) <{POST_SNAPBACK}>
A friends husband has something similar, which last year resulted in a trip to the ED.
I can't remember the name of what he has, but he ended up seeing a dietician after also having an endoscopy (is that the one they do through the throat?) which showed scarring to his food pipe. He had had symptoms since a child, but it has got worse the last few years.
He had to go through an elimination diet, and has managed to control it by avoiding gluten and nuts. It seems to be a variation of an anaphylaxis for him, but had the potential to continue getting worse if he doesn't avoid those triggers.
HTH


This sounds like eosinophilic esophagitis. A gastroenterologist would be my point of call, this is what came to mind for me too. There are sometimes also surgical options if it is a muscle tone issue.

#5 trebambinibelli

Posted 13 February 2013 - 08:44 PM

Ironically I do have eosinophilic oesophagitis which was diagnosed a year ago but that causes food to become impacted in the oesophagus whereas I choke at the point where it could go either way.  The Speech path said that my throat closes over in order to prevent food going down the trachea but that doesn't help if it won't go down my oesophagus either.  The choking was thought initially to be related to EO but now the Drs, speech path etc think my choking stems from low muscle tone.

Thanks for your replies thus far original.gif

#6 Feral Nicety

Posted 13 February 2013 - 08:44 PM

You need to see a gastro ASAP.

#7 jmaz86

Posted 13 February 2013 - 08:47 PM

I agree go and see a gastro, did the speechy say anything about pureed foods and thickened fluids?

#8 Fossy

Posted 13 February 2013 - 08:55 PM

No advice on the choking, but it might be worth investing in something like a medic alert button. You push it in a medical emergency and an ambulance is dispatched. If you're the only adult present it may truly be a life saver.

#9 trebambinibelli

Posted 13 February 2013 - 09:04 PM

Thanks for replying.

QUOTE (Fossy @ 13/02/2013, 08:55 PM) <{POST_SNAPBACK}>
No advice on the choking, but it might be worth investing in something like a medic alert button. You push it in a medical emergency and an ambulance is dispatched. If you're the only adult present it may truly be a life saver.


Actually that has been mentioned for another condition I have (I said I had multiple issues lol!).  I'm starting to think that maybe I need to investigate this further.  The GP dissuaded me at the time saying that it is way too expensive.

Tilly take2, Balzac, jmaz86 - I am under a gastro because of my EO.  I am on a (very long!) waiting list for a repeat endoscopy.  He knows about my chronic choking but said it's not to do with EO as someone with EO only does not choke, just feels food trapped in their throat.  At the time I was diagnosed with EO I had an extremely elevated eosino count but no strictures.  And the speech path did not recommend texture modification for me.  She said to avoid some foods which seem to trigger the choking but it is getting to the point where I choke on something pretty much every day.

#10 Kafkaesque

Posted 13 February 2013 - 09:20 PM

On adult patients at work with dysphasia they would be on a soft diet. Has this been suggested to you?

#11 trebambinibelli

Posted 13 February 2013 - 09:32 PM

QUOTE (Kafkaesque @ 13/02/2013, 09:20 PM) <{POST_SNAPBACK}>
On adult patients at work with dysphasia they would be on a soft diet. Has this been suggested to you?


No.  No diet modifications recommended at all (apart from avoidance of those foods that mostly cause the problem, pretty much everything now!).

#12 ednaboo

Posted 14 February 2013 - 09:49 AM

The Australian Resuscitation Council Management of Airway Obstruction guidelines are to adminster 5 back blows to the upper middle of the back, then if needed, follow by 5 chest thrusts.  See here for how to do it:
ARC - Airway pgs 4 - 7
It would probably be easier to do chest thrusts to yourself than back blows.  But I agree with the PP - some sort of Medic alert system would be sensible.

#13 Therese

Posted 14 February 2013 - 10:03 AM

You do really need to discuss this with your gastro again.

Please also remember that although it is great to get people's thoughts on EB, that nothing replaces proper medical advice.

#14 trebambinibelli

Posted 14 February 2013 - 10:07 AM

QUOTE (ednaboo @ 14/02/2013, 09:49 AM) <{POST_SNAPBACK}>
The Australian Resuscitation Council Management of Airway Obstruction guidelines are to adminster 5 back blows to the upper middle of the back, then if needed, follow by 5 chest thrusts.  See here for how to do it:
ARC - Airway pgs 4 - 7
It would probably be easier to do chest thrusts to yourself than back blows.  But I agree with the PP - some sort of Medic alert system would be sensible.


Thanks ednaboo, I'll have a look at those recommendations original.gif

QUOTE (Therese @ 14/02/2013, 10:03 AM) <{POST_SNAPBACK}>
You do really need to discuss this with your gastro again.

Please also remember that although it is great to get people's thoughts on EB, that nothing replaces proper medical advice.


Yes Therese, I'm aware, hence I asked if anyone else has experienced this and how they handled this issue, not asked specifically for medical advice

#15 trebambinibelli

Posted 21 May 2013 - 10:05 PM

Hi, just thought I'd update if anyone is interested.... This morning I had a video fluoroscopy which showed eosophageal dysphagia due to slow motility.  Sometimes it took several manual swallows to get the food down.  The speech path recommended that I have only soft, nutrient/energy dense food with smaller meals, eat with a certain posture (sitting forward which I was doing anyway) and organise my children to have training in first aid, particularly how to handle someone choking.

The speech path felt that my swallowing problem is mostly related to muscular weakness (I have a genetic condition related to muscular dystrophy) and low muscle tone, and just worsened possibly by the eosinophilic oesophagitis.  At least now I know.....  

Thanks to those who gave me ideas and advice, I appreciate it.  Next step is I'm having an endoscopy in 2 weeks and need to see my GIT specialist to get a management plan.  Right now it is still somewhat 'mild' as there was no aspiration into my lungs so hopefully as long as I stick to soft food and smooth thickened liquids I should be okay.  However, it is worsening so who knows what will happen down the track.

I feel sad for my kids who have to be vigilant in case something untoward happens but it is what it is...  If nothing else, I hope this makes me a better dietitian, what better way to empathise than having to live it yourself




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