Hi Andrea --

To start with, the swallowing exercises are developed for each individual case, that is, ones that Barry did might not be any use (or even good) to otehrs. Each person should get his or her own test and get exercises specifically designed to address the problems identified.

In Barry's case the barium swallow test showed lingual weakness (weakness of tongue muscles), weakness in two of the muscle groups which move food to the back of the throat and into the esophagus, and his epiglottis was contracted and did not close properly (thus the risk of aspiration of food or liquid into his lungs). In fact, they found he had "silent aspiration" of thick liquids (that is, he was unaware of this and did not give the same reflex cough response we might do for food getting into our windpipe, this possibly due to nerve damage or numbness of the area after radiation). In fact, just after the end of treatment he did get an aspiration pneumonia which put him into hospital for 3 days. They did not find any strictures or ulcers in his throat or esophagus.

To give you an idea of what the exercises were for him, they included:

1) lingual stengthening: pushing tongue against tongue depressor held in front, and to both sides (with fingers against cheeks) for a certain count or until fatigue is felt. Goal is 10 reps 3x a day. Stop if any pain.

2) suction to strengthen throat muscles: using a straw, pick up a piece of tissue paper or cotton ball by mouth suction and hold for count of 5. Move up to Post-it note size paper, with the goal was to get to 3 x 5" index card size and hold for 10. Again, do 10 reps 3x a day. This was very hard to do at first, it took some months to get to index card goal. Barry still repeats this exercise once a day as it was the most difficult.

3) "Masako" swallow: when drinking a liquid, hold tip of tongue between teeth and try to swallow this way and repeat several times a day.

4) Effortful swallow -- Do at mealtime or when drinking, try to swallow as hard as you can -- really push against roof of mouth -- should feel muscles contract and larynx move upwards as you hold fingers lightly against throat.

5) make a "siren" noise, while holding fingers lightly against throat. Should feel larynx move and throat muscles tighten. Only 3 times for 3 seconds max as can strain vocal cords.

Barry did these for six weeks and then went in to see therapist again. If he had been having a lot of problems or no progress, the migth have done another barious study. However he was getting better so he was simply told to contnue and check in if there were issues or questions.

Again, I need to emphasize that these are among the types of exercises which a therapist might prescribe, they were specifc fr Barry's status and others need a full consult with a speech/swallowing therapist before doing any of them! These therapists are not too hard to find, for example, both our local hospitals have them and can also do the barium tests as well.

Gail