FEEST test update. In the room for this test there was a crowd! My ENT, a medical student who was observing what he did, a speech pathologist who consults with my ENT, the speech pathologist I had seen before at the hospital, and a student in speech pathology who was assisting the speech pathologist who consults with the ENT. The multiple speech pathologists first took a much more detailed history about my swallowing problems and then the test which sounds like it was bascially what Gale said Barry's ENT did (with less people in the room)--a scope and then, while looking down the throat with the scope, I had to swallow various substances; thin liquid, thick liquid about the same consistency as the cream soups I have every day), pudding-texture liquid, and applesauce.
As before, I did fine with the thin and thick liquids, somewhat less well with the pudding-y stuff and the applesauce was a disaster. The main results, actually, weren't so different from the barium swallow, although being looked at this way they could see that with the applesauce I probably did end up inhaling some of it and with the pudding-like stuff I had to cough a lot of it back out to avoid that.
Like last time, the good news was that when this happened I felt it and reflexively coughed hard until I coughed it back out. Everyone agreed I haven't lost any sensation in my throat and have a good hard cough and so I'm reacting the way I should when stuff gets even dangerously close to being inhaled--which means I don't have to worry so much about inhalation pneumonia.
Like last time, the bad news to go with this good news is that I really CAN'T eat something much more than thick-liquid texture without probably having stuff "go down the wrong way". The NEW news is that my ENT thinks this is mainly not because of any kind of permanent problem with my epiglottis but simply because my entire throat and base of tongue area are still very very swollen, according to him, in combination with the fact that my swallowing muscles are weak.
So the prescription, from the speech pathologist(s) is to do more swallowing. I was told I should try to spend 1/2 and hour four or five times a day swallowing soup or some other liquid and to think of it primarily as physical therapy--after half an hour I should quit, even if I haven't gotten that much down in terms of calories because the muscles will be too tired and if strained too much they can actually swell MORE. I also was told that I should do a double swallow method that involves a cough in between the first and second swallow to be sure I'm not inhaling anything.
My ENT reminded me that I still have 3 to 6 months of healing from rad ahead of me (and I'm starting to believe from what I've read here that even that is possibly an udnerestimate of how long healing can go on for) and that there's a good chance as the swelling goes down I'll be able to swallow more things. He told me that every now and then I should try something I'd had difficulties with before (pudding, eggs, melted cheese, etc.) to see if I could do it better since that's the only way I'd know when I was getting better BUT that these experiments definitely had to be combined with coughing at the end to be sure nothing went down into my lungs (as I said, no one actually has to tell em to cough then--when somehting goes down the wrong way I cough reflexively which is good)and should probably be done when my husband was around too (actually I don't know how much help my husband would be if I really choked but I didn't tell him that. :rolleyes: )
So some bad news, but some hope. I had been thinking of the swallowing I was doing partly as a gearing up for getting off the tube and was pursuing calories in each session, I was thinking less about swallowing as PT that needs to be done often over swallowing a lot of food at any one session. I guess I'll just have to live with the d**n tube for a while longer.
Nelie
