Choking on Saliva
Original Post: I've been having more episodes of choking on my saliva when I'm just starting to fall asleep. It doesn't seem to happen while I'm asleep. At night I sleep in a zero gravity recliner. I cannot sleep in a bed as I have lower back pains, reflux and obstructive sleep apnea. All those issues were resolved for several years now by sleeping upright. I've had a swallow test and endoscopy this year. . . a small hiatal hernia. This choking business is new and is freaking me out.
Dr. Bruno’s Response: "Choking" on saliva or thin liquids is the most common swallowing complaint in polio survivors. The thin liquid sort of sneaks down your throat, especially when you are sleeping. This doesn't necessarily show up on a video swallow study since liquid barium is far from thin. For bedtime issues, talk to your doctor about taking a decongestant to dry up saliva.
The good news is that trouble with thin liquids isn't the pre-cursor to problems swallowing other things. The overwhelming majority of polio survivors don't have big-time difficulty swallowing, as do those who have had a stroke or have a neurological disease.
If polio survivors do have trouble swallowing while eating, a video swallow study is the first step to find out if the food is “pooling” in the throat or not going down at all, due to muscle spasm or a narrow esophagus. A speech therapist can teach you tricks to help your swallowing. Liquids can be thickened. Solid food should be cut into small pieces, eaten slowly, chewed thoroughly and swallowed with intention. You can even swallow twice per mouthful.
Also, you shouldn't talk while eating, which is difficult for voluble (someone who speaks quickly) polio survivors to do! As the Buddhists teach: PAY ATTENTION! When you eat, only eat. When you speak, only speak.
Look in the Index for the topic of “Swallowing”: Encyclopedia of Polio and PPS.