Modified Barium Swallow Test

Hi. I had my modified barium swallow test today. Given the phrase that a picture is worth a thousand words, a video must be worth a lot more. Here’s a 40 second clip of someone (not me) taking the test…

http://video.google.com/videoplay?docid=4375530805602416900

About 30 seconds into the clip you can see how the liquid being swallowed collects for a few seconds (just above the Adam’s apple), then a swallow, and then it goes down the esophagus. As a result of my radiation and surgeries, much of my tissue in the pharynx region (that’s between one’s mouth and esophagus) is fused and just doesn’t move properly. This causes some food and liquid to enter my airway (a.k.a. aspiration). There are techniques I have learned over the past 2+ years to minimize aspirating. This includes eating in a reclining position and holding my breath while swallowing. The therapist administering the test was surprised by how much reclining helped me reduce aspirating. She also felt I had mastered the breathing while swallowing technique. I was surprised to learn that even with all I do to minimize aspirating, I still do aspirate. I could see it live on the motion x-Ray. Although it wasn’t a lot, she feels I am at high risk for pneumonia. One of the best ways for me to avoid pneumonia is to stay active. I guess this is good advice for just about everyone regardless of the circumstance.

The esophageal dilatation that I wrote about in my last two posts will not do me any good. The problem is in my pharynx, not my esophagus, and can not be used to widen an area in my pharynx. I feel good about trying, but disappointed in the result. The therapist that performed this test is setting up an appointment where they will show me some new exercises for my throat that may help with swallowing. That will be in about a month during my next clinic visit to the cancer center.

Take care everyone.

Stem Cell Update

Hi. This blog has provided me the forum to talk about a variety of subjects. On November 19 2008 I wrote a blog entry titled, “More Medical Marvels.” It talked about the use of stem cells in repairing a women’s bronchial tube. An article in today’s Wall Street Journal reported that for the first time researchers have developed the first fully functional three-dimensional organ replacement. They took stem cells with genetic properties of a tooth and implanted this “tooth germ” into a mouse’s empty tooth socket. Once the engineered tooth matured, after 11 weeks, it had a similar shape, hardness, and function as a regular tooth. This research was carried out at the Tokyo University of Science. The researchers suggested that using similar techniques in humans could restore function to patients with organ failure.

I’ve been a supporter of stem cell research for a long time. I don’t know where the above scientific breakthrough will take us, but the possibilities are staggering. Imagine a new heart, lung, kidney created from the patients own stem cells. It would almost certainly address the issues of tissue rejection, a lifetime of anti-rejection medications, and shortcomings in our current organ donor/recipient lottery process. I know I’m getting ahead of myself and a tooth in a mouse’s mouth is a long way off from a human heart, but the direction this is taking is damn exciting.

Here’s a quick update on the esophageal dilatation from my last post. My doctor’s office called today and asked if I could come in for the barium swallow test this Friday. So, it won’t be mid-September. This test could lead to an esophageal dilatation which in turn could lead to a better quality of life for me. It really would be a pleasure to eat again. I’m hopeful, but reserved in my hopefulness.

Take care everyone.

Esophageal Dilatation

Hi. I’ve talked at some length in past blog entries about my permanent disabilities and the drive to get back to what I consider a pre-cancer normal state. I’ve more than less given up on eating any solid foods. 95% of my nutrition comes from Boost and skim milk. I’ve maintained my weight for two years on this diet. It’s not that I can’t eat; it’s more that the discomfort of eating outweighs the pleasure of eating. I can chew and taste to some degree, what I can’t do is swallow. Food always gets stuck in the back of my throat and I no longer have the muscles within my throat to move the food down my esophagus. I have to eat and drink in a reclining position and let gravity do most of the work. This keeps most liquid (and the little bit of food that I try to consume) out of my airway.

A head & neck cancer survivor with a similar history as myself informed me yesterday that she was going to have an esophageal dilatation performed on her in two weeks. Having never heard of this, I looked it up. Here’s a link explaining the procedure… http://www.gicare.com/Endoscopy-Center/Esophageal-Dilatation.aspx. It looks like it may have some potential benefit to me. In a nutshell, it stretches your esophagus. I contacted my surgeon last night via email who responded about 15 minutes later. He referred me to my speech therapist to have a modified barium swallow test run on me to determine if this procedure would be helpful. I’ve had 2 modified barium tests, but they were about 3 years ago. Basically, they spike some soft food (e.g., apple sauce) with a small dose of radiation and then watch via a live x-ray how the food works it’s way down your esophagus. You can watch live while the test is in progress. It is actually a pretty cool test. My surgeon also said that the esophageal dilatation procedure was common and routinely performed by gastroenterologists at the cancer center.

I’ve now contacted my speech therapist to request a test and am waiting to hear back. I’ve asked that the test be scheduled for mid September to coincide with my next trip to the cancer center. Once again, this brings some measure of hope to getting back to a more normal life. Not being about to eat is at best awkward in any eating situation. Plus, I just plain miss eating. The thought of being able to eat gives me hope.

Take care everyone.