gmcraft -

I did not react well to thickened foods. Even exceptionally small quantities resulted in severe choking. Same with thin liquids without ice. The surgeries and radiation have left a lot of scar tissue and damage to the top of my throat.

I do use Prevacid to fight the reflux, in combination with sleeping with my head and chest elevated. Seems to take care of most of the problems

I'm aware of the aspiration issues and your analogy of spilled water is very appropriate. The reason it does work for me is the extreme cold liquid in conjunction with the carbonation provides a "trigger" and the result is a rudimentary swallowing effort. Although it may not be 100% effective, I follow with a hard throat clearing cough.

Aspiration and pneumonia are very real issues that can cause serious problems to a compromised system. Subsequently, I try to be extra vigilant about it.

Thank you for your response