It's all in your head - literally and figuratively!

We were squeezed onto Dr. Celin's schedule today to determine the cause of Sam's sudden problem with swallowing, and he seems to feel that this experience is probably just a reflex action by the body.

After examining Sam, Dr. Celin said he didn't think there was anything different and that once you try to swallow and choke, your body tends to tense up and that just makes it harder to swallow. It's kind of like riding a bike after you haven't ridden one for a while - you are rusty and lose the technique. The same holds true for swallowing - Sam's a bit rusty. He also had no real explanation for the hiccups Sam has been experiencing.

He suggested that Sam continue to try to eat and drink and he gave Sam a prescription for a "Modified Barium Swallow" test to be scheduled in a week - if Sam feels the situation hasn't improved. This test determines if therapy would be beneficial.

• For those who like the detail - The test procedure is:
  You will be given small amounts of a barium preparation of varying consistencies from thin liquids to paste to a piece of coated cookie.
  Varying the amounts and consistency of the contrast material allows your doctor to determine which types of food are difficult for you to swallow and to locate the structure responsible for the trouble. The fluoroscopic screen allows the physician to view the results as the test takes place.
  The test is usually performed with a speech pathologist present who can assess your swallowing ability and devise a strategy to correct the problem. You may be asked to change your head position, breathing pattern, chewing habits, or the consistency of your food.

Dr. Celin reiterated what Lori, Dr. Chen's nurse, said - that while it might seem strange, water is the hardest thing to swallow. He suggested that Sam thicken the water or try something with more substance. He also said that because of all the radiation, his tissues are damaged and that makes it more difficult to swallow water.

I want to thank our friend Larry Satariano, who is a physical therapist, for taking some time to talk with Sam last night and who gave him some pointers on some swallowing techniques. That helped.

Anyway, we are feeling a little relieved and suspect that this situation may have been caused by the exams last week, but we can't be certain and the doc wasn't going there. But, what do we know, right? - it's always dangerous to be an armchair physician and that's one more reason to get the professional perspective. Time will tell.

Thanks for your prayers and support. We are grateful to have been blessed with such great friends.