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Captured at newsgroup alt.support.mult-sclerosis

From: dihammond@aol.com (DiHammond)

Subject: After the Barium's Gone

A couple of weeks ago I reported in on my experience with a speech pathologist assigned to determine my swallowing problems (dysphagia). While her initial conclusion was that I did swallow abnormally, she recommended a barium swallow to confirm the precise trouble spot. Some of you were interested in the speech pathologist/diagnostic information, so I offer this follow-up, post-barium swallow.

This past Tuesday I reported to the radiology lab at our major teaching hospital, where they served me the same dang chicken lunch I'd had two weeks ago! My teeth marks were still in the stuff, I swear. Appetizingly arranged on a tray were tapioca pudding with the obligatory squirt of Reddi Whip, green beans, a slice of plain wheat bread, green salad--plus, of course, the chicken. All are liberally doused in barium the color and consistency of old Mylanta. Plus a tasty barium shake for sipping purposes. Umh, umh, umh.

A radiologist, radiology tech, plus my friend the speech pathologist all gather 'round where I've been seated in what appears to be one of those amusement park photo booths. Really. There's a little curtain, everything. And outside is a television monitor everyone but me can see.

I get to take sips beyond counting of the barium shake. Ooh, they say. Aah. Ummh hmm. Looks good. How about some tasty pudding? The SP does her best to hide the barium sauce under the Reddi Whip flower so it won't look so bad and then hands it over. More swallowing. More appreciative noises.

But wait, says the SP sagely. We're getting to the chewy stuff next. Which I take to mean I'm having no visible problems with liquid and smooth-textured stuff. Like a lunatic hostess the SP painstakingly loads up a big bite, drags it around in the barium sauce and hands it over to me. I go a round with the toughest chicken on earth and finally get it down, or at least partly down. Ah hah! They've seen the problem with this one. Premature leakage! (They actually *used* this term. I'm not kidding. It means food is dribbling over the back of my tongue and into my throat before I'm ready for it.) Not only is there premature leakage going on, but I'm having a serious problem with laughter. So, to their infinite credit, are they. But at last they see what I came here for: a gob of the pasty stuff has stayed behind in a little pond at the top of my throat. One more swallow and it's gone. The same ponding happens with the bread (which, when spread thickly with barium, sets up like plaster of Paris). By then I've had enough and so, thank god, have they, so I am spared the cucumber-and-barium jubilee, also the beans-and-barium medley.

Anyway, it was interesting to watch on instant replay, and it showed that I do have a swallowing problem, but a relatively minor one: my airways close off well, and I can clear my throat in two swallows. No eating restrictions for me, just the obvious instructions like small bites, vigorous chewing, swallows of liquids between. I am very sure this is not an exacerbation, but a neurological deficit that's been brewing for a good long time. Anyway, now I can think about something else for a while.

Thanks again for your good words of support!

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