Thursday, October 17, 2013

swallow study

M had his swallow study yesterday and it was, I'm sad to say, a disappointing waste of time. His PCP ordered the study (where he eats food coated with barium, and they x-ray his throat as he swallows, looking for problems) because he's been choking more often lately.  He's had a tendancy to choke on food, to feel like his throat is closing, for a long time... years... but it seems to be getting worse lately.  (Lately, he's even choked on rice, and bananas!) So I took him to the doctor (pediatrician) to get her take on things... I'd been thinking it might be his tardive dyskinesia getting worse (moving down from mouth to throat muscles) and she thought it might be the gastroparesis... moving up to effect his throat.  So this study was a first step in trying to figure out which of these ideas (maybe neither!) might be what's going on.

We got to the hospital way early... in part because traffic was light and in part because they sent me paperwork saying his appointment was at 1:30 and had it in their computer as a 2:00 appointment. So we hung around Children's Hospital for awhile... just killing time. When it was finally time for the pre-study interview they said they thought we were probably scheduled for the wrong kind of swallow study. That the study the doc ordered is too limited, it probably woudn't give us the information we were looking for but, after a call to the PCP's office, said they would do it anyway.

The study itself went well... M ate the things they asked him to eat and they had a clear view of him swallowing. They did see that his throat tends to hold onto a bit of "residue" when he eats... not enough to choke on... just enough for him to feel like he needs to clear his throat. (This tendancy was also found during the first swallow study back in 2008 and seems not to have changed... it's very unlikely that it's connected to M's choking and feeling like his throat is closing up.)

Unfortunately, as they had anticipated, the study wasn't comprephensive enough to really answer the "why" of M's troubles with choking. After the study, we talked to the  OT's who did the test, and got their recommendations. They were overly simplistic... have M swallow hard and take a drink of water.  Helpful if the problem was the funny feeling in his throat from a little food residue sitting in there... but no help at all when faced with an adult sized person seriously choking on food.

So basically the three hours we spent at TCH was wasted time... They are recommending another type of swallowing study and possibly some other testing as well.  Luckily ;) M's pediatrician is out of town for the entire month of October... so we won't have to start scheduling the extra testing for a couple of weeks.

Today starts a marathon of busy-ness... a neighbor get-together today, followed by M's blood draw (dropped off at the hospital), his shift at his worksite and a trip to the doc's for flu shots. Tomorrow we'll be getting ready for the homecoming dance in the evening...(R has her dress, but M has nothing but a tie! He's lost enough weight that I will probably have to buy him all new clothes for the dance). Saturday is bowling in the morning, then driving north to pick up S, R's big family birthday lunch, and St Joe's Coffee House in the evening. Sunday is the "Celebration of Life" for R's friend who passed away earlier this week. Monday we collapse... (I'm looking forward to Monday! :) )

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