Advice on Dysphagia and coughing fits - from Jenny

Toni -  It may not be the same but I had episodes of choking that would bring on coughing. It was particularly bad when I was asleep as I would wake up choking. The speech pathologist I saw referred me to an osteopath who specialises in breathing retraining and she identified that I had areas within my mouth on the left side that had reduced sensation as well as weakened muscles throughout the left side of my diaphragm. Very happy to say that the exercises and treatment have greatly improved things for me.

Katie Dobsa I still have Problems swallowing and coughing etc sometimes, 11 years post stroke, I’ve never asked about it

Raylene Stephens There is a medication (not sure of the name), that you can get that dries excess secretions up....My son's neurologist was considering prescribing it, but we weren't ready to tackle another med.

Meliame Tauali'i - Fifita I find that I too have excess saliva which isn't really an issue for me luckily I don't have the cough, reading this I now realise it's related to my stroke. Hope you get everything sorted out. Good luck🌷

Toni Arfaras Meliame Tauali'i - Fifita and Katie Dobsa I was seven years post stroke before getting this looked at. It was a bit of a light bulb moment when it was pointed out that it was all connected to my stroke. I'd thought the choking may have been but hadn't realised how differently I was breathing.

Hi Jenny, I'm just on 4 years post stroke and with Dysphagia, I read an explanation on it only a few weeks ago and a lot of things fell into place for me, things that happen on a regular basis that you wouldn't normally put together as being from a common cause and in these days of Covid 19 the problems are very embarrassing to say the least, people don't like you coughing or choking in public atm. I have problems with excessive saliva that I "roll" around the front of my mouth, if i'm in the back yard I just spit it out, but out in public I have to swallow it and that can set off a choking session, 

Biting my tongue and cheeks (right side) feeling like there is something stuck in my throat, thickened saliva, bad re-flux ... it just goes on.   Can medicine do anything? I have my doubts, my Doctor looks at me blankly when I tell him I've had re-flux and it feels like It's "burnt" my bronchial inlet... or  "I'm choking at least twice per day" I think they feel lost at times, bless them.

I have found that a 1/2 teaspoon of bi-carb in water helps with the indigestion and re-flux and even the cough, if I start coughing it's the first thing I go for.  For those reading with us, it's almost like the throat "spasms" whenever it wants to, and takes you along for the ride.

Jenny, I don't envy you your learning curve, because it's most likely different from mine. go and read this at  Suggest opening in new tab- Wikipedia Dysphagia and it may help some.

Toni,RaylenemKayienMeliame Digit . Thankyou for your responses Toni l use deep breathing for chronic  pain . Now I have discovered using those techniques on coughing helps the throat. Not quite sure whyI recommend a book “The Meaning Of Pain”. Written by a osteo who works with deep breathing exercises. Reflux is not a huge problem, I use medication if needed.  Dysphasia  has been with me for8years since Stroke  and the toughest deficit to cope with.    Jenny

Hi Jenny,

Thank you for asking your question on EnableMe. I am sure that phlegm and coughing, and excess saliva must be very frustrating. It is great that so many in the community have responded and shared their experience

It is good to hear that you are seeing a GP and Speech Pathologist. We would encourage you to discuss the following with them:

• GP: Ensure they check that your chest is clear. If a chest or airway infection is causing the phlegm, it may need treating.

You could also talk to the GP about medication for excess saliva as well.

Your GP might refer you to an Ear, Nose and Throat specialist (ENT) to investigate the cause of the phlegm. 

• Speech Pathologist: Ensure they check whether your diet and fluids are safe for you and your current swallow function. I would also suggest talking to them about excess saliva management strategies.

Note that treatment options may depend on the findings from these medical and health professionals.

Feel free to contact us on StrokeLine 1800 787 653 (Mon-Fri 9am-5pm AEDST) to discuss further.

Warm regards,

Kath (StrokeLine)

Good evening everyone. As a follow up on my dysphasia today I had appt with respiratory physio who diagnosed very weak diagphram breathing on my stroke affected side. Therefore I am unable to cough up mucous.etc. treatment began with “bubbles  game.  50 times daily. I have a plastic tube into a 2litre milk carton.of water ,take a deep breath as possible then blow bubbles.  Reminds me of the fun times blowing bubbles with grandsons .Jenny

Jenny, it's so good to hear that you are getting help. It took about 12 weeks for me to really notice an improvement and since then I have been much better. Now it seems to be when I'm tired etc that I'll start choking etc so it's a good indication that I need to take better care of myself. Hopefully you'll be able to give us a positive update in the future.
DigitAus, I really recommend seeking out an osteo or similar who specialises in breathing retraining. The biting of the tongue/ one side of the mouth is  one of the first things my osteo asked if I did and after sticking her hands in my mouth (a bit gross I know) she'd identified I had weakened awareness/sensation on the LHS and gave me exercises to do to improve it.

In the early days of stroke recovery (7 years ago) had a recurrence of a childhood problem of biting the inside of my mouth. My right cheeks are a mass of scars from those early days.

Overcoming it was tricky, anything that required chewing the main problem. I ended up with  a trick of turning on my chair to one side and leaning forwards and turning my head to the left whilst chewing. The excess weight of my cheek obeyed gravity and pulled slightly away from the teeth leaving a small space but enough to prevent the teeth from biting the cheek.

I had a paper towel on the floor to catch any mishaps (of which there were many). The whole process would be ugly to watch but since only my wife and I would be present it was acceptable.

Fortunately it only took about a couple of weeks before the swelling in my cheeks subsided and allowed me to return to normal eating methods. 

Deigh