Speech and swallowing

I start off this post with an apology to those who were looking forward to this post last week, sorry to have disappointed you but I was making the most of the holiday season! With which I wish my 'fan group' happy holidays and a new year! And to those who may not be celebrating anything, happy Sunday!

So to start off, speech from a physical and a mental viewpoint. There are two noted down types of speech issues with MS: Speech dysarthria and speech dyphasia. 

Speech dysarthria is an issue with speech caused by damage to one part of the brain which can affect the muscles of the tongue and lips so making it difficult to pronounce precise sounds. Damage to another part can weaken the diaphragm which can affect breath control and volume.
The connecting part of the body between the brain and spine, the brainstem is an area particularly important for control of speech and if this is damaged there may be speech issues. The typical speech issues caused by dysarthria in MS are:

• slurred, imprecise or slower speech

• low volume or weak voice

• difficulty with resonance and pitch control

• sounding like you're speaking through the nose

• long pauses between words, or between syllables

Moving on to speech dysphasia, it is a more rare issue but can make it hard to understand what an MSer is trying to say ( receptive dyspharia) or find the right way to say something ( expressive dyspharia). The way I like to see this side of the symptom ( not intending to cause any offence!) is Mr. Bean giving a talk. 

Along with these symptoms, side effects of drugs used to treat other symptoms may cause things like a dry mouth resulting in more issues with speech.

The first time I developed this symptom with the speech, I wasn't really aware of this issue in this context or that I even had any speech problems and I remember harshly being told to stop acting like a 'baby' as I was mid relapse, very fatigued and hungry asking for something to eat at the time. It is something awkward when talking to people as there are further cognitive issues that can affect speech which are still to be discussed! It has left me being grateful to those people who in a gentle manner ask me to repeat myself rather than the more common response of ' I can't bloody hear you' or ' speak properly' and all things such along them lines. I also remember having to practice speech in the different languages I know of to rehabilitate my speech abilities, with their being difficulty with the pronunciation of letters in Arabic which still last with me till today. Although when I was young, I was the kid who the teacher chose to read the passage being studied and also being the one chosen to be the lead in a group singing project or play ( not trying to 'big' myself up just mentioning!) but now I am grateful if I can successfully speak to a person comfortably!SwallowingThe ability to swallow is another thing we wouldn't really think about and it can be one that occurs with the speech issues after the relevant damage, these issues can occur at a relapse stage and go away and never return but can also occur and remain for a lasting period of time. The swallowing issues may include:

• Changes in your speech (which go hand in hand with small changes in swallowing)

• Problems chewing

• Food sticking in your throat

• Food or drink coming back up

• Sluggish movement of food going down, or difficulty moving food back through your mouth

• Coughing and spluttering during and after eating
• Excessive saliva, which may cause dribbling

These symptoms are all dealt with by speech and language therapists when spotted, exercises and general tips can be given to try and deal with these symptoms. Speech issues can cause abnormal social issues and swallowing ones can be more dangerous, like chocking on something from even a bit of water to something a bit 'heavier' than that. I remember having to use a straw for breakfast and still till today told to slow down drinking anything even though I am now very cautious with consuming any liquid. but I am grateful I was never accused of being drunk due to speech symptoms with MS as I think that would have been a more difficult matter! 

The swallowing symptoms can result in foods 'going down the wrong pipe' and in severe cases patients would be fed via a tube through their nose to their stomach. If food goes down the windpipe by accident due to these symptoms it can lead to things like infections which can induce pseudo relapses ( still to be discussed!) and weight loss due to being unable to eat properly can be an issue.

That's this post done but I just wanted to mention, the further posts will be discussing symptoms mainly sourced at the cognitive side of MS and perhaps matters that are taboo or awkward will be discussed, so in a time where many serious things are almost laughed at I do ask for maturity with the coming content as yes it has unfortunately been a bit of a 'joke' to some when I felt stating the reality of things was the best way to go!

Speech issue examples: https://www.youtube.com/watch?v=QPLAcZiK2Nw
 https://www.youtube.com/watch?v=UF0G-u0hBns&t=29s