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drinking plain water


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#1 gazelle66

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Posted 30 October 2012 - 01:33 AM

Hello there,
I would like to ask about something that has started to become a problem for me. In fact it has been a problem for years but it seems more important now to find the best solution.

I have been told by my GP to drink more plain water. I am aware of the general health benefits but I now have a specific reason for wanting to follow this advise. So I keep trying. I have established that I can't tolerate drinking cold water as in cooled. That is ok, because I have no problem drinking warm water. But I am still really struggling to drink the daily recommended volume on a regular basis. I seem to have an actual problem swallowing it. As in I get it in my mouth but find it a bit painful to swallow. Like it gets stuck in the back of my throat. I thought I had found a solution by using a straw..but after a few days of drinking a good volume of water I have a very sore throat. In fact I seem to be developing a permanent sore throat. The other issue is that when I talk a lot at work, I can lose my voice. I have never been very loudly spoken, but this is something different. My mum has always been softly spoken so I am not suprised about the volume of my voice. But I do want to be heard!

Am I making too much of this? I can drink tea and coffee ok (though now I think about it, it takes me forever compared to other people!)

Have you any general advise or thoughts? I am 45 so my voice hopefully still needs to last for a long time, as does my ability to swallow!

many thanks

#2 Dr. Mahler

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Posted 30 October 2012 - 03:39 AM

On the surface, the recommendation to drink more water appears like a simple thing. However, for someone with Parkinson disease (PD) it may be anything but simple. Reserach studies of speech and swallowing disorders have found that 90% of people with PD experience difficulty with speech and swallowing. There are several possible causes. The first is that PD affects the muscles of speech and swallowing as well as the limb muscles. The swallowing muscles can become weak, reduced in movement, and delayed in inititation of movement and this can make it difficult to swallow efficiently and also increases the risk of having liquids "go down the wrong way". The symptoms you describe are consistent with a swallowing disorder as a result of PD. The changes you report in speech are also consistent with muscle changes that would affect swallowing. It is not possible for me to make a diagnosis based on a description of symptoms alone. It is certain that you need a speech and swallowing evaluation as soon as possible because swallowing disorders can have serious health consequences if left untreated. Another factor to be evaluated is the appropriate diet consistency for you. For example, thin water may be more difficult than thicker liquid and a straw can be more problematic than helpful. Talk with your physician about a recommendation to a speech-language pathologist for a speech and swallowing evaluation. The good news is that treatment studies have shown that there are beneficial exercises for speech and for swallowing. I am very concerned about your comment that it is painful to swallow and that needs to be investigated. Yes! I want you to be heard also and that is possible with treatment so start as soon as you can.

Thank you for writing with these important questions.

Sincerely,
Leslie Mahler, PhD, CCC-SLP
Leslie Mahler, PhD, CCC-SLP

Associate Professor

University of Rhode Island

#3 gazelle66

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Posted 30 October 2012 - 04:57 AM

Your comment about the consistency I find very interesting. Is it possible that someone can gulp down a glass of milk but not a glass of water? Are the tolerances that fine? This is the reason I have never raised this in the past. I know I can 'drink' and thought maybe I just don't like plain water so much! But the fact that my throat is so sore and that for a long time I have had to keep liquid in my mouth and 'think' about actively swallowing it. This seems a bit odd, but does not happen all the time, so is quite confusing!

Many thanks.

#4 Dr. Mahler

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Posted 30 October 2012 - 05:09 AM

Every person with PD is unique which is why I am recommending an individual evaluation for you. You are very aware of what it feels like to swallow and that will be extremely valuable information for your evaluation. Actively thinking about swallowing can make a positive difference and yes, it is possible that a small difference in consistencies such as water or milk might make a difference. The evaluation will determine if this is part of the overall swallow problem. Speech therapy is important for everyone because communication is such an important part of quality of life so I want you to get expert advice about your speech also.

Sincerely,

Leslie
Leslie Mahler, PhD, CCC-SLP

Associate Professor

University of Rhode Island




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