By Carol Bratcher, Speech Language Pathologist

(Carol Bratcher’s father is a polio survivor and Carol did a research study on members of his PPS group.)

There are 3 phases to swallowing: oral (mouth), pharyngeal (throat), and oesophageal (tube to stomach).  Two things are important:  the tongue and larynx (voice box).  If either is weak, there will be a problem with swallowing.  When the bite goes into the mouth, as you’re chewing, your tongue is moving the food to each side of your cheek to form a ball.  If your tongue is weak, you already have trouble swallowing, moving the ball to the back of the throat and forcing the food ball down the oesophagus (slam dunk) – the tongue, not the muscles of the throat, as one might think.  The throat muscles then close the door behind the food so it doesn’t go back up.  When this process doesn’t happen smoothly, there is a swallowing problem.

The type of polio you had, your treatment, your history, and breathing should be evaluated if you are choking.  A videofluoroscopy is a very good test for this evaluation.  In the swallow, we want to make sure there is no aspiration (food entering the airway).  When a person truly chokes, something blocks the airway.  As you swallow, breathing stops.  If the airway is blocked, you have trouble breathing again.

Swallowing is a muscular function.  The tongue is made up of 8 muscles.  It must function in an organized manner.  Your whole throat, uvula, soft palate, voice box, vocal cords, 20-30 muscles are involved in the swallow.  The tongue must be strong to push the food through or it will stop along the way in ledges and pockets like the pyriform sinus and epiglottis.  Some-thing “stuck” in your throat may well be in one of these pockets.  Normal swallowing takes less than a second.  If it takes longer, it’s a sign the muscles are weak.  Sometimes in polio one side of the swallowing mech-anism is weaker than the other; one side is going down faster than the other ie one side is doing all the work.

If you fatigue at the end of the day, eat a light supper, take smaller bites and wash down “the pockets” by alternating solid and liquid.  Fatigued and weak muscles increase your chances of difficulty.  More than half the problems of post-polio swallowing can be improved with proper diagnosis and instructions.

Reprinted - permission from Polio Heroes of Tennessee March 2006
 

Tessa:  We know that at least 16% of WA polios have swallowing problems from polio.  A number have reported improvement when taking carnitine.  Voice can also be affected.  Magnesium allows throat and voice muscles to work better by stopping prolonged muscle tightening.  Vitamin B1 is also essential for voice.  Allergy reaction improves with additional Vitamin C and B5.  Thicker fluids help too.  Juice/milk.