Radiation and Swallowing

COVID Life

We started off this year looking forward to travel and spending time with family. Then BOOM!

COVID hit and we went into lock down, along with most of the country it seems.

In the seven months we have been sequestered due to this COVID virus, I have been spending a lot of time with Cheryl in our freshly renovated KC home. Cheryl has been cooking meals a lot, although we have found a few carry out restaurants that give her a break from that. The problem she has been having is that I seem to be more sensitive to the kinds of food I can get down. Today, we visited the University of Kansas Medical Center and went through another swallow test.

Swallow Testing

I started off this adventure by visiting a doctor who specializes in radiation effects in the head and neck area. She took one of those nine-foot long camera tubes that my doctor in Austin loved so much and shoved it up my nose so she should see down my throat.

Really?

I have a perfectly good mouth they could use for that. Why go through the nose? There must be some valid reason, other that it being fun to watch the patient try to climb out of the chair when they shove that tube up their nose!

She decided it was time for another swallow test, so we set one up and that happened today.

I have had two of these at M.D. Anderson, so I knew what to expect. The setup today was different in that I could actually see the screen as I was doing the tests.

Basically, you sit there while a low-power X-Ray machine scans your neck. The technician and a resident doctor watched while I swallowed a variety of liquid and solid stuff. It would not fair to call any of it food, although I did recognize a graham cracker in there. They lace the stuff with barium so it shows up on the x-ray nicely. Here is a shot (not of me) showing what this looks like, except it is live action and you can watch the stuff move along.

They watch closely as you swallow to see exactly where things go, and how you manage to cear your throat if things try to go the wrong way.

. The radiation I have had was aimed directly into my throat, so things in that region are a lot stiffer than normal. The biggest thing that gets affected is the epiglottis, which covers your airway when you swallow food, to keep it out of your lungs. Radiation makes it harder for that to work, meaning that food has a much better chance to get into your lungs. Coughing can help, but in extreme cases, there can be all kinds of problems. The tests hep identify what is going on and what to do about it.

Today's Results

It turns out I am holding my own on swallowing. I thought my epiglottis was getting stiffer making it harder to swallow, but the test showed that I am doing pretty well. In the post test review, the technician suggested that I work on taking smaller bites and using Ensure to make sure it all goes down. She said she did see signs that some food was trying to go the wrong way, but I managed to clear things by coughing. This can lead to pneumonia, which is definitely something to avoid!.

She also suggested that I ditch carbonated drinks and switch to plain water. If water goes into my lungs, it should not cause any bad effects. Not so if I breath my favorite A&W Cream Soda.

Finally, she suggested that I crush the pills I take every day, and mix them with something to get them down better. I occasionally find that one of them sits in my throat while I sleep, leaving me thinking I am coming down with something when I wake up.

Next Steps

I need to work on taking smaller bites and drinking more during meals. I was already feeling that eating was just something to be endured. It is not so much fun anymore. Cheryl always finishes her meal while I am about half-way through, and me taking smaller bites will just make that worse.

Ensure, which I have with every meal, is still the best liquid for helping clear foods during meals. However, I will need to switch to water for drinking at other times. I need to go over all of this with the doctor. I might try Gatorade instead, since it helps me recover from my running (slow jogging - slogging) I do every other day or so.

We will also be setting up some swallow therapy sessions to work on techniques for making sure I swallow as well as possible.

Finally, I need to talk to the pharmacist at Walgreens about this crushing of pills idea. Some pills cannot be crushed and remain effective. I am pretty sure my prescriptions will allow this, but we need to check.

Done With Testing

We are back home now, reasonably happy with today's results. Cheryl has a few ideas on how to make meals I can handle better, and we will try that.

Now, I need to check on workers putting in a new sidewalk to my garage workshop door. We have a cool skid-loader in the back yard now!

Such fun!