Parkinson's, speech therapy, and swallowing

In My Humble Opinion
1

I have Parkinson’s Disease, diagnosed in 2019. Some of the effects of PD include quiet, raspy speech and difficulty in swallowing. I got some speech therapy for the speech part, and I asked the speech therapists about the swallowing part. So far, my swallowing problems are only while taking pills. When it goes wrong, I end up coughing a pill or two back up for a second try.

The swallowing advice I got was, first, start when you’re upright, not leaning back. Second, take the pills with something thick, like applesauce. Third, make a conscious effort to swallow forcefully.

The problem, as it was explained to me, is that PD interferes with the “automatic” nerve paths that handle routine tasks such as talking, swallowing, and balance. The PD patient has to relearn these things, making them intentional, rather than automatic.

We’ve all been swallowing, talking and walking straight since we were babies. Most of us don’t forget how to do those things without thinking about them. Parkinson’s patients have to work at it.

My speech therapist works with a program called Speak Out! from parkinsonvoiceproject.org Note that there’s no “s” between the “n” and the “v.”

2

Now that I posted that, in Factual Questions, I realize that I didn’t actually ask a factual question. Maybe I’m in the wrong category.

3

I’m not going to link a company or product but google “swallow solutions”.

4

My husband was diagnosed about the same time. They tell him to Glottal Swallow, he can’t seem to manage that. They want him to thicken his drinks, but he will not drink thickened beverages. Can’t say I blame him. He can’t eat enough to keep his weight up, so he now has a g-tube. He was down to 130 lbs. he’s now back to 163.

For him speech therapy didn’t work very well. He really doesn’t practice the therapy at home. We used to play in a band together. Now he can’t play guitar anymore or sing. He often can’t get out of the lift chair alone.

He does have other issues hip/knee replacement all vertebrae fused, a stroke some years ago with some tingling, but not bad. It came on fast after he fell and was on the floor for 6 hours. However, we’re sure it was coming on and no one recognized it thinking some symptoms were other things. His doc finally noticed “flat affect” and off to the neurologist we went.

It’s been a long difficult trip for both of us. Best wishes to the OP.

5

IMHO is the usual place for real world medical discussions. No biggie. I will move this for you.

Moved from FQ to IMHO.

6

I DuckDuckWent to “glottal swallow”, mentioned by @Sylvanz , and one of the hits brought up Supraglottal Swallowing. Here’s what that site says to do.

This swallow consists of 4 steps:

  1.  Take a sip of liquid into the mouth and hold it on your tongue

  2.  With your mouth closed, take a short breath in though your nose and BEAR DOWN—like you are picking up a heavy weight, or having a bowel movement

  3.  While holding your breath, swallow all at once

  4.  Cough when you let go of the air to clear residual liquid/food from the airway

A modification of this is called simply the “Early Breath hold maneuver” and includes steps 1-3 and omits the post swallow cough.

I’m sorry to hear that Sylvanz’s husband wasn’t able to make this work for him. This quote was from The Supraglottic Swallow – Timing is Everything… | National Foundation of Swallowing Disorders

I tried DDGing “swallow solutions,” and I got some kind of toxic site warning from Firefox. I didn’t go any further on that trail.

When I quoted the above, it clipped off the end of Step 2. It goes on to say “like you are picking up a heavy weight or having a bowel movement.”