I saw a speech therapist yesterday. Did the beginning of the swallow strength test and failed. The opening of the esophagus does not open. A repeat of the test revealed the same result. She gave me a handful of exercises to do to improve. They are (1) Supragottic swallow, (2) Masako exercise, (3)Mendelsohn Exercise, (4) shaker exercise, (5) Effortful swallow. These exercises are to be done often throughout the day staring slowly.

Does anyone have experience with these exercises on improving swallowing? Is there a board within this forum that deals more exclusively with swallowing?

Mr Mike

Sorry to hear of your troubles. There is an iPad, iPhone App, called iSwallow, developed by UC Davis Center for Voice and Swallowing, that has 15 video exercises for dysphagia, including the ones you named. It is supposed to be used under the direction of a speech and swallow clinician, who has or can obtain the password required to access all thevfestures..the alarm clock, progress, and others, although, just downloading the apps, you can still access the exercises under "instructions." I do the exercises, but haven't seen my speech and swallow therapist in several months to inquire about. It is on the computer also, but to what extent, I don't know.

Exercises: Massako maneuver, swallow amplitude, chin tuck, effortfull swallow, gum chewing, head turn, jaw thrust, lollipop swallowing, Mendelssohn maneuver, superglotyic maneuver, isometric all maneuver, tongue exercises, tongue rom, vocal exercises, isometric shaker.

There is a speech, swallow alternative feedings further down the menu here, that may be helpful.

Good luck, and sure others will advise as to their experience and knowledge.

Michael, sorry things didnt go better with the swallow test!

I again apologize, there are no sub groups within OCF. I understand OC has so many components to it. By posting in "After Treatment Issues" there are bound to be others who have gone thru the same or very similar situations. Im sure others will join in soon to give you support.

Hi Michael. Welcome to OCF. I had two OC surgeries and after the second one I had a terrible time learning to swallow again. My speech pathologist was RELENTLESS, and I did #1 and #5 exercises every day - many times - from the day after my surgery. My situation never got to the point where the esophogus was closed (I don't think?) but I do believe the swallowing exercises made a huge difference.

You didn't say what your therapist thought of your situation? Did they think that if you did the exercises you stood a good chance of getting your swallowing back? Do you have someone at home to nag you to death to do the exercises? I remember they were not fun to do and being constantly reminded helped me.

Keep us posted.

Donna

Pandora,
The therapist felt she could help me. I will be honest that while I performthe exercises each day, I am not "relentless". She said that she thought that the esophagus would have to be stretched. I meet in another week with both the therapist and my radiologist and oncologist. she said she will recommend further treatment. My radiologist said base of tongue tumors often experience more swallowing issues.
Thanks for your input. I'll keep posting.
Mr Mike

I will add that anyone with massive radiation could do these exercises every hour and only gain from them. You can't overdo it and long term you may risk atrophy. The constrictors are often the first to go and start your swallow as well as direct post nasal drip. Sound familiar to everyone going through treatment? Yes we have all had that goo piling up there and even doing excel isles may not fully resolve but it will help. Speech therapists can modify exercises as swallow changes. It will.

Mike

Another possibility is VitalStim, which is an FDA approved transcutaneous neuromuscular electrical stimulation device. Not all Speech therapists are trained in it. If you read some recent posts about the PEG tube, you can see that often patients take a year before getting off a feeding tube and learning to swallow real food again, so don't give up hope.
I was lucky the first time around since without a PEG (based on my RO's advice since I had base of tongue cancer also), I never quit swallowing so could eat normally almost right away after TX. But the salvage surgery after the recurrence did a real number on me. Here is a study on VitalStim published at NIH, that indicates it really helps moderate dysphagia but not so much for severe dysphagia. VitalStim Unfortunately, VitalStim did not work for me as the damage to my epiglottis and the constrictor muscles was massive, compounded by a second dose of radiation frying the scar tissue, but it has worked for others. Can't hurt to try. You still do the same exercises with the SLP, but you also swallow water while getting the electrical stimulation to the swallowing muscles. I hope you make progress.
Charm

Thanks for the app Paul!

Charm, like you the VitaStim didn't do much for my constrictors and I have one side of the epiglottis that doesn't lift.

Great info!

Hi all,
I had the Vita Stim also after the first bout with OSCC and it did not work for me. This is my second bout with SCC and I again will try the Vita Stim due to the neck dx made all the muscles for swallowing tight. I do urge people to give it a shot. What doesn't work for one of us it might for another.
Robin

Thanks all,
My epiglottis "seems" to work. The Barium swallow films show the barium passing the epiglottis and puddling at the top of the esophagus which does not open. My "adam's apple seems to move up and down while swallowing which is another good sign in my mind. If I take more than a teaspoon of water and try to swallow I will start coughing to prevent aspiration. In smaller amounts the water just regurgitates

If the therapist, who has been helpful and considerate, wants me to be relentless, I can do that. She just gave me the exercises but was not clear on how often and how long I should do them. I did, despite my best efforts, catch a winter cold and the cough and sinus drainage is not helpful, but in time this will pass. I meet with all the docs and therapist in the next couple of weeks and I will hopefully get some good direction.

In the meantime I appreciate all your comments. They are encouraging and I wish you all the very best in your recovery process.

Mr Mike