20210124 : my epiglottis story...

The topic of my epiglottis came up today again....

I want to state for the record, now that i can communicate, i didn't make it up, i did hear the docs and everyone else having an elaborate conversation about the epiglottis not moving and the paralysed right vocal chord. Also, i have seen it not moving properly in countless FES tests , endoscopies and also in the barium swallow tests. I only knew how it should work when i saw the video shown latee by my wife (yes, at some stage it was thought that seeing videos of a perfect swallow would make my brain do it subconsciously)

Some gyan here..... The epiglottis is a muscular organ, like the tongue (i think it means tongue in latin) and works completely involuntarily. Like the heart, it just does its job from first breath we breathe to the last breath we take. Its sole function is like a flip flop. Sitting in the throat, it closes the oesophagus when we breathe and closes the wind pipe when we swallow anything. We cannot control it, even if we wanted to. The closest anyone can get is to gargle ( having something in the throat and exhale at the same time) thats why many people cant do it as its harder than we give it credit.. we can never voluntarily inhale with something in the throat . Its choking and has to happen involuntarily when distracted....

Enough gyan....

So, the procedure they have suggested is to help voicing. Yes it might help a bit but will do nothing to prevent aspiration. If the epiglottis functioned, there would be no aspiration..

There is another angle to consider, which given how much the doctors collaborate and communicate, im not surprised....

From the time i have had the stroke, i havent breathed normally. It has been very shallow breathing (about 1 sec inhalation and abt 1.5 secs exhalation). For the life of me, i havent been able to voluntarily change it ever. It becomes longer and deeper involuntarily during coughing. It comes back to auto mode slowly after the involuntary cough (thats why some voice comes after cough as there is enough air in breath to generate sound). Now, for a proper swallow, the first condition is that i can hold my breath during swallowing, which is impossible right now. Even if the epiglottis was working efficiently, there is no breath support to close the wind pipe. It has to open every 1,1.5 seconds. In order to trigger a swallow (elevating the larynx) for me can sometimes take 3 secs and sometimes can take upto 8 seconds (if thats news, its a big improvement, initially, i could do once in 3 minutes).

So the thing now is, if i am lucky, the swallow gets triggered during the exhalation cycle and i dont aspirate/ cough. In inhalation cycle, we know what happens.....

So thats the famous EPIGLOTTIS story...