Tuesday, February 27, 2007

Two little gems

of great value to those of us with dysphagia! Two exercises, firstly the good old chin tuck trick and secondly, an exercise to strengthen the muscles in the back wall of the throat are designed specifically for improving the control of fluid and food in the mouth and during the swallowing process. It is most important that you discuss with your speech pathologist and or treating specialist whether or not you need to do these exercises.

Swallowing with safety does not mean thickening fluids and soft diet for all people. Following botulinum toxin treatment into vocal cords many people experience some difficulty with swallowing. For most people this side effect of treatment settles quickly, within two or three weeks. People who already experience an underlying dysphagia condition requiring thickened fluids and soft diet need to continue with their treatment plan but may still benefit from these exercises. Any change to your swallowing technique needs to be decided between you and your speech pathologist.

The chin tuck requires a specific posture of head and neck designed to reduce the area between the front and back walls of your throat. This action narrows the entrance to your airway, diverting food and fluid around your airway. To achieve this management technique, move your chin forward towards your neck before swallowing.

Following treatment for laryngeal dystonia and also cervical dystonia these muscles may be weaker thus causing difficulty swallowing. When swallowing normally, the base of your tongue and the back wall of your throat come together. This position of tongue and throat creates strong pressure, pushing food and fluid through the throat and down towards your stomach. When weakness occurs in the muscles in the back of the throat they do not move forward enough to create a good swallowing reflex.

An exercise to strengthen these muscles is to put your tongue out between your teeth, holding it in this position and swallowing. Although at first this may be a little difficult, practice will hopefully improve the movement. Practicing this exercise approximately five to 10 times twice a day will soon show an improvement in your swallowing ability.

By practicing the two simple exercises above you will hopefully be able to enjoy greater control of fluids and foods when swallowing after treatment with botulinum toxin injections for specific forms of dystonia. For those of us already experiencing dysphagia, these exercises are of great value in managing any additional weakness during the swallowing movements. These exercises were provided to me by my treating speech pathologist. Please consult with your speech pathologist in relation to your own need and supervision of treatment plan.

Please leave a comment if you would like to. Meanwhile, swallow safely and enjoy life with well managed dystonia and dysphagia.

Sue Bayliss. Cairns, Australia.

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