RSS Feed Print
Hubby's swallowing problems
elainechem
Posted: Thursday, February 13, 2020 8:12 PM
Joined: 7/30/2013
Posts: 6026


This is unusual. Hubby is having trouble swallowing solids. It's not that he can't swallow. He can drink water just fine. It seems that he is forgetting that he NEEDS to swallow solids that are in his mouth. They gave him breakfast in the hospital. He scarfed down the cream of wheat with no problems. He can drink liquids with no problem. But, when I gave him the scrambled eggs, it's like he didn't quite know what to do with it. He chewed a little, moved it around his mouth a little... I gave him some juice to wash it down.

Oh, and I was there when they brought him a large depakote pill to prevent seizures. First, I had them cut it in half. Then I gave him half of the pill. I put it on his tongue and gave him some water. He drank the water, but left the pill in his mouth. I ended up practically shoving the pills down his throat like I do with the cats and giving him some water to get them down. I don't want to do that again, so we're going to be exploring medications that can be crushed, are liquid, or come in sprinkles. 


Lorita
Posted: Thursday, February 13, 2020 9:28 PM
Joined: 12/18/2011
Posts: 11617


Elaine, it sounds like it's time to go to soft foods or even a mechanical diet.  There were times when Charles has the same problem. I remember I gave him some chocolate which he loved and he tucked in his cheek and couldn't/wouldn't swallow it. It's good your husband can handle liquids and soft foods so there's less chance of dehydration.  We also had to go to liquid medicine or crushing pills- I think most of them can be crushed.  So sorry.
Army_Vet60
Posted: Friday, February 14, 2020 6:25 AM
Joined: 6/21/2019
Posts: 680


That's a late stage symptom. His digestive system is being affected. It starts with swallowing.

That's how it started with my wife.

Pureed foods can be substituted for chewy foods like meat and anything that has fiber.

I was surprised at all of the options I found in the "Baby Care" aisle at our local supermarket.

There were a lot of choices of pureed meat and vegetables that were given fruit flavors to make them more pleasant to get down.


Dreamer Lost
Posted: Friday, February 14, 2020 10:04 AM
Joined: 3/7/2019
Posts: 447


Scrambled eggs are a confusing texture to the PWD , is it a pudding or solid?  You may ask to get a swallowing evaluation from a speech therapist while in the hospital.  My DH also holds his pills in his mouth, sometimes tries to chew them (they taste terrible and will spit them out), but usually tries to swallow them dry even while holding his water in his hand.  If laying in bed, you need to be sure he is sitting upright before swallowing.
elainechem
Posted: Friday, February 14, 2020 10:29 AM
Joined: 7/30/2013
Posts: 6026


Dreamer Lost wrote:
Scrambled eggs are a confusing texture to the PWD , is it a pudding or solid?  You may ask to get a swallowing evaluation from a speech therapist while in the hospital.  My DH also holds his pills in his mouth, sometimes tries to chew them (they taste terrible and will spit them out), but usually tries to swallow them dry even while holding his water in his hand.  If laying in bed, you need to be sure he is sitting upright before swallowing.
A speech and language pathologist did evaluate him yesterday and found everything to be normal. She doesn't live with him. His issues started intermittently, but are becoming more common now. A sign of progression, I suppose. Yesterday, they served him soft foods at breakfast. He had cream of wheat, which went down effortlessly. Then there were the standard scrambled eggs and French toast. Those were much more problematic for him. It's like he was chewing and chewing, but not swallowing until I gave him a drink. So, I requested a pureed diet in spite of what the SLP said. That's working very well. They're crushing all his pills, and that's great. One problem pill is his Avodart for an enlarged prostate. It only comes in a gel cap type. He had been having trouble swallowing that before the seizure. I guess we'll have to discontinue that. If he starts having trouble urinating again, hospice can insert a catheter. What a fun disease. Fortunately, hospice provided a hospital bed at home and I can raise the head to feed him and give him meds.

Dreamer Lost
Posted: Friday, February 14, 2020 11:15 PM
Joined: 3/7/2019
Posts: 447


Elaine, my DH is on a med called Finasteride for his enlarged prostate and seems to have worked well.  It is a very small blue pill.  Don’t know if it would be appropriate for your Dh but you might ask his physician.
Firedoggy
Posted: Saturday, February 15, 2020 7:55 AM
Joined: 10/1/2017
Posts: 34


My wife can't swallow her seizure meds so I crush them and mix with apple sauce. She holds the apple sauce in her mouth so she gets a small spoon of ice cream and down it goes. When I was a kid I always wanted ice cream for breakfast. Ask if the pills can be crushed
Lisalfon
Posted: Saturday, April 4, 2020 2:36 PM
Joined: 3/13/2020
Posts: 10


My DH also starting to have a problem swallowing pills. Is this a stage 5?
Army_Vet60
Posted: Saturday, April 4, 2020 4:16 PM
Joined: 6/21/2019
Posts: 680


Lisalfon wrote:
My DH also starting to have a problem swallowing pills. Is this a stage 5?
Hi Lisa,
I'm going to send you the stage charts for both Alzheimer's and Parkinson's.

The reason is that people who start out suffering from Alzheimer's can develop Parkinson's later when the destruction of brain cells progresses from the Cognitive Center into the Motor Center.

Swallowing is a motor skill, as is walking and breathing, so it's possible your LO could be starting to suffer from both.

I found this out from my wife's neurologist when she suddenly had an onslaught of motor skill symptoms show up. Her medication had to be switched from ALZ to Parkinson's meds.

She was in stage 6 ALZ when the Parkinson's presented itself and she went right into Stage 7 at that point.

https://www.healthline.com/health/parkinsons/stages

https://www.alzinfo.org/understand-alzheimers/clinical-stages-of-alzheimers/

 


White Crane
Posted: Saturday, April 4, 2020 4:17 PM
Joined: 2/27/2017
Posts: 141


I remember reading this post in Feb. and thinking I should talk about my own swallowing problems. 

Seven years ago, I had neck surgery to replace four discs in my neck, remove bone spurs, and insert a titanium plate to stabilize my neck.  When I woke up from surgery, the terrible neck pain was gone and I could turn my head again...but I couldn't swallow.  It was six months before I could swallow any solid food.  During this time, I had to have all my food pureed and have a feeding tube inserted to supplement my nutrition.  I won't go into a lot of details but do want to share some of the things I learned and what helped me.

It was determined at Mayo Clinic that after the surgery, there was a disconnect between the time my body needed to swallow and the time my brain got the message...nerve damage.  It was a very scary time.

All my Rx's had to be crushed and mixed with applesauce or else prescribed in liquid form.  A lot of medications can be compounded in liquid form.

We borrowed a very powerful blender and my DH pureed all my food.  This is what I learned.  Pork...chops, ham, loin puree very nicely and taste quite good.  You need to add some liquid to the blender to make a soft easy to swallow consistency.  We used water or milk...milk is good.  Beef...roast gets stringy and is harder to puree and to eat.  Hamburger is okay, again add milk or water.  Turkey and chicken puree nicely also and taste good pureed.  Scrambled eggs can be pureed to make a soft, easy to eat breakfast.  You can even puree a piece of toast with the eggs for more nutrition and taste.  You can even add some sausage! 

Vegetables like carrots, peas, and green beans all puree nicely and taste good.  The baby food veggies are very bland and not as appetizing...at least they weren't to me.

Fruits like peaches work well. Bananas are okay but must be eaten the same day or they go dark.  Applesauce is a standby...it can be thinned if too thick.  You would think watermelon would be easy to swallow but it isn't...it gets stringy and can easily choke someone with swallowing problems.

Cream of Wheat was my go to cereal during that time as it slides down easily.  The cooked variety works better than the instant..at least it did for me.

Bread is hard to swallow, it gets "gummy" and won't go down.  Toast and jelly can be pureed or if swallowing is a little better, it can be "dunked" in milk to make it go down much easier.  Toast is easier than plain bread for me.

DH even pureed pizza for me so I didn't have to miss out.  I know it sounds awful but when you can't swallow, something with a lot of flavor tastes really good.  So get creative.

Cake and cookies can be pureed but they get rather gummy.

There are companies that sell pureed foods for adults.  They can be found on the internet.  While I never tried any of these, they sounded really tasty.  Ensure and Boost are both tasty but very sweet. 

I learned to take small bites and take a sip of liquid after each bite.  I still need to take small bites as I still choke easily.

Nerve stimulation by a speech pathologist is what finally allowed me to start eating more solid foods after six months.  Swallowing seems like such a basic bodily function...even babies do it.  In reality, it is very complicated and if everything isn't working just right, swallowing becomes difficult or impossible.  I am very grateful to God and to that speech pathologist for being able to swallow as well as I do.  I hope this helps someone and offers hope.


elainechem
Posted: Saturday, April 4, 2020 5:54 PM
Joined: 7/30/2013
Posts: 6026


Lisalfon wrote:
My DH also starting to have a problem swallowing pills. Is this a stage 5?
I think it is usually a sign of more advanced AD. Their brains begin to fail and motor skills begin to become compromised. My beloved actually died on February 18 of late stage AD. He went from stage 7b to death in just days. I had first noticed his swallowing issues in December. He was already on hospice at the time. But it's different for everybody. 

feudman
Posted: Friday, April 10, 2020 8:07 AM
Joined: 6/5/2014
Posts: 1486


White Crane wrote:

"Swallowing seems like such a basic bodily function...even babies do it. In reality, it is very complicated, and if everything isn't working just right, swallowing becomes difficult or impossible."

How true. We barely think about it, as if it's a reflex on autopilot. But it is indeed complex. The medical term for this neuromuscular process is "deglutition." It has 3 phases*, each controlled by a different neurological mechanism, and involves some 50 pairs or intricate muscles & many nerves, all of which must work in concert. One missing link can cause "system breakdown."

Ambulation is another process that we think of as muscular/motor skill but also requires a certain degree of neuro-participation.

As speech & physical therapists explained to me, their testing can help show if the muscular/motor skill part of the process is still functional. If impaired, they can sometimes assist if the patient can retain what they teach (often a problem with AD). But since our LO's have a progressive neurologic impairment, it is more likely in the later stages that that missing link is in the "neuro" half of the neuromuscular process. 

*Some sources split the Oral Phase into separate "preparation" & "transit" phases.