Swallowing
Question:
Doug, Actually, the neuro was not much help here. The doctor who helped me with this one in an internist — she was the one who knew about using nitro. My neuro had never heard of that treatment. Turns out it is quite common for both esophageal and colon spasms. However, it was the neuro who set me up with the speech therapist to help with the swallowing and breathing problems. Alfretha I may have MS, but MS definitely does not have me. – Hide quoted text — Show quoted text -doug <dou…@sympatico.ca> wrote in message <news:3C6C1B1D.6DF6E841@sympatico.ca>… > Hi Alfretha. > I mentioned the swallowing/choking on food to my neurologist, he just frowned, said that that was usually > indicative of more advanced MS, and left it there. > The difficulty in breathing that occasionally goes with the eso spasms, I had once about 2 months ago. It > happened while driving on some back roads out in the middle of nowhere, but there was a tiny hospital nearby. I > went in the emergency, spent the day there to no result, except they ruled out many other possibilities. > I never knew about the eso spasms before, so I find this very informative. I will definatly mention this next > time I see him. > Thanks, > Doug.
Response:
Doug, Have you talked to a doctor about this? Strange symptoms like this really SHOULD be brought to a doctor’s attention. As for how it feels. It can be very painful (enough to double you over) if a bad one. If not too serious it is just like there is a knot in your chest that makes everything around it really sore. My first spasm had me in the hospital getting my esophagus pumped out (in the late ’60s) — the food was so stuck they couldn’t get it to either go up or down. I’ve been in emergency rooms suspected of having a heart attack, and other things. Mild ones can sometimes be eased by drinking something warm. I’ve also used a heating pad on my chest to ease the pain. If it is severe enough to require the nitro, I try to ALWAYS use the heating pad. Since having nitrogylcerin with me at all times, I have only had to be rushed to the hospital once — and that was after having a bout of intestinal "flu" which put me into severe, continuous spasming. Hope this helps, Alfretha I may have MS, but MS definitely does not have me. – Hide quoted text — Show quoted text -doug <dou…@sympatico.ca> wrote in message <news:3C6B230C.60FBFA3C@sympatico.ca>… > May I ask what an esophogeal spasm feels like? I’ve had something in that area that I wasn’t sure was MS; > now I wonder. It felt like a piece of food was slowly — and extremely painfully — going down the length > of the eso, then slowly going back up. It would do this 3 or 4 times before going away. And, it never has > happened while eating. > I also spent a year or so choking on food at every meal, but it’s ok again for the last few months. > Doug.
Response:
Hi Alfretha. I mentioned the swallowing/choking on food to my neurologist, he just frowned, said that that was usually indicative of more advanced MS, and left it there. The difficulty in breathing that occasionally goes with the eso spasms, I had once about 2 months ago. It happened while driving on some back roads out in the middle of nowhere, but there was a tiny hospital nearby. I went in the emergency, spent the day there to no result, except they ruled out many other possibilities. I never knew about the eso spasms before, so I find this very informative. I will definatly mention this next time I see him. Thanks, Doug. – Hide quoted text — Show quoted text -Alfretha wrote: > Doug, > Have you talked to a doctor about this? Strange symptoms > like this really SHOULD be brought to a doctor’s attention. > As for how it feels. It can be very painful (enough to double > you over) if a bad one. If not too serious it is just like > there is a knot in your chest that makes everything around > it really sore. My first spasm had me in the hospital > getting my esophagus pumped out (in the late ’60s) — the food > was so stuck they couldn’t get it to either go up or down. > I’ve been in emergency rooms suspected of having a heart attack, > and other things. > Mild ones can sometimes be eased by drinking something warm. > I’ve also used a heating pad on my chest to ease the pain. If > it is severe enough to require the nitro, I try to ALWAYS > use the heating pad. > Since having nitrogylcerin with me at all times, I have > only had to be rushed to the hospital once — and that was > after having a bout of intestinal "flu" which put me into > severe, continuous spasming. > Hope this helps, > Alfretha > I may have MS, but MS definitely does not have me. > doug <dou…@sympatico.ca> wrote in message <news:3C6B230C.60FBFA3C@sympatico.ca>… > > May I ask what an esophogeal spasm feels like? I’ve had something in that area that I wasn’t sure was MS; > > now I wonder. It felt like a piece of food was slowly — and extremely painfully — going down the length > > of the eso, then slowly going back up. It would do this 3 or 4 times before going away. And, it never has > > happened while eating. > > I also spent a year or so choking on food at every meal, but it’s ok again for the last few months. > > Doug.
Response:
Over the years I have found that I need to take larger pills, or any pills early in the morning, with a THICK liquid. I often use Ensure Hi-Protein since I can’t drink milk. And I NEVER eat anything without having liquid available — and try to avoid dry foods (dry cakes, dry toast, etc.) since they are harder to swallow and more apt to stick in the esophagus and trigger a spasm. Talk to your doctor about having nitrogylcerin available — I carry it with me at all times. Its about the only usually completely effective way to stop the spasms in their tracks. These tablets are only good for a year. I get a new bottle (tiny bottles) every fall, and usually end up throwing out almost the entire prescription from the previous year. Like a heart patient, you put one under your tongue and let it dissolve — tastes horrid, can cause a headache afterwards (called a nitro headache), but STOPS the spasms. Yes, anyone can get esophageal spasms, but having MS can definitely make them worse and more frequent. On the GERD, which I also have, there are a number of strategies that I have learned, or been taught by experts, to help control it. 1 – ALWAYS keep your shoulders above your stomach — when sleeping, either raise the head of the bed or put extra pillows under your shoulders and head (I have an electric bed). Kneel, don’t bend over. 2 – If eating, or planning to eat, greasy or spicy foods, I will take a Tagamet (keep some available for when I need them, don’t use them consistently). If I feel like I am developing an "acid" stomach, I will take one at bedtime for a few days or week. 3 – When eating, make sure food is moist. If it isn’t, take some liquid right after your food (mixing the two in your mouth before swallowing) 4 – Avoid foods with sharp edges — taco shells, chips, etc., unless you can add something to them to moisten and soften them. 5 – Always take small bites, large bites are less likely to be completely chewed before swallowing. 6 – EXERCISE the esophagus. This is done by eating foods that the esophagus has to work to pass on. According to the experts I have talked to, this means meat. That exercises the esophagus and keeps the muscles in the lower esophagus working better. 7 – Get checked regularly (minimum every 5 years)with a gastro "scope" (can’t remember what it is called). Unfortunately those of us with GERD are in a higher risk category for esophageal cancer. On your breathing problems, I STRONGLY recommend that you see a pulmonologist. They have the training and expertise to understand difficulties that other doctors don’t. Always remember that not ALL symptoms are caused by the MS. Alfretha I may have MS, but MS definitely does not have me. – Hide quoted text — Show quoted text -dhcpol…@yahoo.com (Laura R.M.) wrote in message <news:80073f39.0202140037.2bf95266@posting.google.com>… > What happens to me, especially when I take a pill with liquid, and > especially if I’m standing up, is that it feels as if I’ve swallowed a > bubble of air that decides to plant itself somewhere behind my > breastbone. The pain can radiate outward and into my back, and it > usually makes me double over. Fortunately, this doesn’t usually last > too long. It also can happen when I’m sitting or eating food, but it > seems to me that I have the biggest problems when I’m taking something > with a liquid. > When it first started happening, I thought it might be the kind of > swallowing problems often associated with MS, but I was told it > wasn’t. Then I thought it might be due to damage caused by GERD > (Gastroesophogeal Reflux Disease), which I also have. I had a > swallowing test, which showed no problems. (Of course! The problem > didn’t happen during the test!) > Then my husband had something similar happen to him a couple of times, > only he had been eating something without any liquid available–almost > the opposite of what seems to trigger my spasms. He thought he was > having a heart attack, and it scared him plenty. That’s when I first > did the research that led me to information about esophogeal spasm. > So I went with him when he visited the ENT doctor. (He also has > obstructive sleep apnea, which was the main reason for the ENT > appointment. The ENT doc agreed that it sounded like esophogeal > spasm, and she said that GERD often causes that. Then I described my > milder experience, and she said that also sounded like an esophogeal > spasm. Since that’s the only real explanation I’ve ever gotten for > that problem, and since it fits all the facts, I believe her. > Fortunately, these spasms don’t happen often, but I get very nervous > whenever I need to take a pill. > Whether my spasms are caused by GERD or MS, I don’t know. The ENT > thinks my husband also has GERD, though he hasn’t been diagnosed with > it, but he *doesn’t* have MS. So whether MS can cause esophogeal > spasms or not, it is possible to have such spasms that aren’t related > to MS as well. > Just another case of not knowing what’s going on in my body. I got my > latest MRI results back today. No change since last January (2110). > I should be happy about it, but that leaves me with no meaningful > explanation for my breathing problems (except for MS deceiving me into > thinking I’m running out of air), and I’m not sure how receptive my > neuro will be to prescribing any kind of therapy with no physical > "proof" that anything treatable is happening. > Ah well. That’s life with MS, I guess. > –Laura R.M. > doug <dou…@sympatico.ca> wrote in message <news:3C6B230C.60FBFA3C@sympatico.ca>… > > May I ask what an esophogeal spasm feels like? I’ve had something in that area that I wasn’t sure was MS; > > now I wonder. It felt like a piece of food was slowly — and extremely painfully — going down the length > > of the eso, then slowly going back up. It would do this 3 or 4 times before going away. And, it never has > > happened while eating. > > I also spent a year or so choking on food at every meal, but it’s ok again for the last few months. > > Doug.
Response:
I just wanted to post about an experience I have had with wonderful MS. Like many people I was having problems swallowing, and often choked on food and drinks, even my saliva. However, what was causing it was considered VERY unusual. After several months of working with a speech therapist we were finally able to isolate the problem. One of the exercises she gave me was to move food around in my mouth so that it was positioned on the back of my tongue — where it triggers the swallow reflex. Did the exercise. The food got on my tongue, and "disappeared". I had lost the feeling/touch sensation on the top of the back of my tongue. So of course I wasn’t being "triggered" to swallow. With experimentation, and some retraining, I discovered that if I keep the food to the side of my mouth, I can keep "track" of it and it doesn’t start sliding down my throat without my knowing it. Same with fluids. Have to consciously trigger the swallow, but at least I am no longer choking all the time. Turned out the same reflex effects breathing, and I had to relearn some breathing control "tricks". So if you have a swallowing problem, there may be any number of causes. The person to work with is a speech therapist (misnomer, they work with any mouth/throat problem). Pay attention to what YOU feel, and communicate that to the therapist so you can work together in solving the problem. Alfretha I may have MS, but MS definitely does not have me.
Response:
What happens to me, especially when I take a pill with liquid, and especially if I’m standing up, is that it feels as if I’ve swallowed a bubble of air that decides to plant itself somewhere behind my breastbone. The pain can radiate outward and into my back, and it usually makes me double over. Fortunately, this doesn’t usually last too long. It also can happen when I’m sitting or eating food, but it seems to me that I have the biggest problems when I’m taking something with a liquid. When it first started happening, I thought it might be the kind of swallowing problems often associated with MS, but I was told it wasn’t. Then I thought it might be due to damage caused by GERD (Gastroesophogeal Reflux Disease), which I also have. I had a swallowing test, which showed no problems. (Of course! The problem didn’t happen during the test!) Then my husband had something similar happen to him a couple of times, only he had been eating something without any liquid available–almost the opposite of what seems to trigger my spasms. He thought he was having a heart attack, and it scared him plenty. That’s when I first did the research that led me to information about esophogeal spasm. So I went with him when he visited the ENT doctor. (He also has obstructive sleep apnea, which was the main reason for the ENT appointment. The ENT doc agreed that it sounded like esophogeal spasm, and she said that GERD often causes that. Then I described my milder experience, and she said that also sounded like an esophogeal spasm. Since that’s the only real explanation I’ve ever gotten for that problem, and since it fits all the facts, I believe her. Fortunately, these spasms don’t happen often, but I get very nervous whenever I need to take a pill. Whether my spasms are caused by GERD or MS, I don’t know. The ENT thinks my husband also has GERD, though he hasn’t been diagnosed with it, but he *doesn’t* have MS. So whether MS can cause esophogeal spasms or not, it is possible to have such spasms that aren’t related to MS as well. Just another case of not knowing what’s going on in my body. I got my latest MRI results back today. No change since last January (2110). I should be happy about it, but that leaves me with no meaningful explanation for my breathing problems (except for MS deceiving me into thinking I’m running out of air), and I’m not sure how receptive my neuro will be to prescribing any kind of therapy with no physical "proof" that anything treatable is happening. Ah well. That’s life with MS, I guess. –Laura R.M. – Hide quoted text — Show quoted text -doug <dou…@sympatico.ca> wrote in message <news:3C6B230C.60FBFA3C@sympatico.ca>… > May I ask what an esophogeal spasm feels like? I’ve had something in that area that I wasn’t sure was MS; > now I wonder. It felt like a piece of food was slowly — and extremely painfully — going down the length > of the eso, then slowly going back up. It would do this 3 or 4 times before going away. And, it never has > happened while eating. > I also spent a year or so choking on food at every meal, but it’s ok again for the last few months. > Doug. > "Laura R.M." wrote: > > This is really fascinating. I’ve had esophogeal spasms when I > > swallow, but only one time did I start choking on food. > > I have, however, been having some very weird and recurring episodes in > > which I feel as if I’m running out of air and have to take a deep > > breath (or several). Sometimes this is accompanied by a tightness in > > my chest, and sometimes not. I’ve been tested for the usual culprits > > (heart, lung and cardiac circulation problems), all of which came back > > normal. In addition to MS, I also have GERD, but the ENT doc I saw > > said that breathing problems in GERD generally involve wheezing or > > coughing, which I don’t have. > > So last Monday (Feb. 4), I had another MRI just to make sure I haven’t > > developed lesions in the area of the brain stem that controls > > autonomic functions like breathing. (I don’t have the results yet.) > > My neuro says he just thinks my MS is fooling my brain into thinking I > > need a deep breath when I really don’t. And he may very well be > > right. But your message suggests a possible mechanism for that > > process, which may make it possible for me to work around it. > > Thanks for posting this. > > –Laura R.M. > > ============= > > alfre…@yahoo.com (Alfretha) wrote in message <news:e5a1d072.0202121845.f5c9060@posting.google.com>… > > > I just wanted to post about an experience I have had > > > with wonderful MS. Like many people I was having > > > problems swallowing, and often choked on food and > > > drinks, even my saliva. However, what was causing it > > > was considered VERY unusual. > > > After several months of working with a speech therapist > > > we were finally able to isolate the problem. One of > > > the exercises she gave me was to move food around in > > > my mouth so that it was positioned on the back of my > > > tongue — where it triggers the swallow reflex. > > > Did the exercise. The food got on my tongue, and > > > "disappeared". I had lost the feeling/touch sensation > > > on the top of the back of my tongue. So of course I > > > wasn’t being "triggered" to swallow. With > > > experimentation, and some retraining, I discovered that > > > if I keep the food to the side of my mouth, I can keep > > > "track" of it and it doesn’t start sliding down my > > > throat without my knowing it. Same with fluids. Have > > > to consciously trigger the swallow, but at least I am > > > no longer choking all the time. Turned out the same > > > reflex effects breathing, and I had to relearn some > > > breathing control "tricks". > > > So if you have a swallowing problem, there may be any > > > number of causes. The person to work with is a speech > > > therapist (misnomer, they work with any mouth/throat > > > problem). Pay attention to what YOU feel, and > > > communicate that to the therapist so you can work > > > together in solving the problem. > > > Alfretha > > > I may have MS, but MS definitely does not have me.
Response:
May I ask what an esophogeal spasm feels like? I’ve had something in that area that I wasn’t sure was MS; now I wonder. It felt like a piece of food was slowly — and extremely painfully — going down the length of the eso, then slowly going back up. It would do this 3 or 4 times before going away. And, it never has happened while eating. I also spent a year or so choking on food at every meal, but it’s ok again for the last few months. Doug. – Hide quoted text — Show quoted text -"Laura R.M." wrote: > This is really fascinating. I’ve had esophogeal spasms when I > swallow, but only one time did I start choking on food. > I have, however, been having some very weird and recurring episodes in > which I feel as if I’m running out of air and have to take a deep > breath (or several). Sometimes this is accompanied by a tightness in > my chest, and sometimes not. I’ve been tested for the usual culprits > (heart, lung and cardiac circulation problems), all of which came back > normal. In addition to MS, I also have GERD, but the ENT doc I saw > said that breathing problems in GERD generally involve wheezing or > coughing, which I don’t have. > So last Monday (Feb. 4), I had another MRI just to make sure I haven’t > developed lesions in the area of the brain stem that controls > autonomic functions like breathing. (I don’t have the results yet.) > My neuro says he just thinks my MS is fooling my brain into thinking I > need a deep breath when I really don’t. And he may very well be > right. But your message suggests a possible mechanism for that > process, which may make it possible for me to work around it. > Thanks for posting this. > –Laura R.M. > ============= > alfre…@yahoo.com (Alfretha) wrote in message <news:e5a1d072.0202121845.f5c9060@posting.google.com>… > > I just wanted to post about an experience I have had > > with wonderful MS. Like many people I was having > > problems swallowing, and often choked on food and > > drinks, even my saliva. However, what was causing it > > was considered VERY unusual. > > After several months of working with a speech therapist > > we were finally able to isolate the problem. One of > > the exercises she gave me was to move food around in > > my mouth so that it was positioned on the back of my > > tongue — where it triggers the swallow reflex. > > Did the exercise. The food got on my tongue, and > > "disappeared". I had lost the feeling/touch sensation > > on the top of the back of my tongue. So of course I > > wasn’t being "triggered" to swallow. With > > experimentation, and some retraining, I discovered that > > if I keep the food to the side of my mouth, I can keep > > "track" of it and it doesn’t start sliding down my > > throat without my knowing it. Same with fluids. Have > > to consciously trigger the swallow, but at least I am > > no longer choking all the time. Turned out the same > > reflex effects breathing, and I had to relearn some > > breathing control "tricks". > > So if you have a swallowing problem, there may be any > > number of causes. The person to work with is a speech > > therapist (misnomer, they work with any mouth/throat > > problem). Pay attention to what YOU feel, and > > communicate that to the therapist so you can work > > together in solving the problem. > > Alfretha > > I may have MS, but MS definitely does not have me.
Response:
Laura, Just a couple of things to think about. Esophogeal spasms aren’t all that uncommon with MS. If they get severe (mine do, will double me up and once I had to get the esophagus pumped out), there is a treatment. Nitrogylcerin. Turns out that the esophagus has the same type of smooth muscles as the heart in the way it spasms. I always carry it with me, although can sometimes go months without needing it. Another "trick" I learned years ago from an ENT. What we eat effects the esophagus, in that some foods make it work and some don’t. Pastas, breads, and the like start being digested in the mouth (saliva starts the break down), so the esophagus doesn’t have to work very hard to pass it along. To really exercise the esophagus, you need MEAT. Since that doesn’t start breaking down until much later in the digestive cycle, the esophagus has to work at getting it to the stomach. And keeping the esophagus "in shape" does help reduce the spasming. The tightness in the chest could be a number of different things, at least one of which IS the MS. Has anyone ever talked to you about the infamous "MS Hug"? This where it feels like a band of steel is being tightened around your chest, and it can be hard to take a deep breath. It is a kind of spasm (some treatments include rest, putting a heating pad on the chest, muscle relaxants to take when it happens, changing anti-spasmodic meds, etc.). Have you been tested for asthma? Symptoms for this can include wheezing AND/OR coughing AND/OR tightness AND/OR lots of other things. Wouldn’t hurt to see a good pulmonologist and getting it checked out. Know a number of people, including myself, with both MS and asthma. Haven’t seen any studies as to whether the MS causes the asthma or makes it worse, there may not be any connection. Hope the above helps, Alfretha I may have MS, but MS definitely does not have me. – Hide quoted text — Show quoted text -dhcpol…@yahoo.com (Laura R.M.) wrote in message <news:80073f39.0202122339.4512ff25@posting.google.com>… > This is really fascinating. I’ve had esophogeal spasms when I > swallow, but only one time did I start choking on food. > I have, however, been having some very weird and recurring episodes in > which I feel as if I’m running out of air and have to take a deep > breath (or several). Sometimes this is accompanied by a tightness in > my chest, and sometimes not. I’ve been tested for the usual culprits > (heart, lung and cardiac circulation problems), all of which came back > normal. In addition to MS, I also have GERD, but the ENT doc I saw > said that breathing problems in GERD generally involve wheezing or > coughing, which I don’t have. > So last Monday (Feb. 4), I had another MRI just to make sure I haven’t > developed lesions in the area of the brain stem that controls > autonomic functions like breathing. (I don’t have the results yet.) > My neuro says he just thinks my MS is fooling my brain into thinking I > need a deep breath when I really don’t. And he may very well be > right. But your message suggests a possible mechanism for that > process, which may make it possible for me to work around it. > Thanks for posting this. > –Laura R.M.
Response:
Interesting, and good information. I’ve been concerned about possible swallowing problems in the future because of the glassopharyngeal pain associated with my latest exacerbation. (I hate typing the word right now.) The pain at the back of my tongue, where it meets the throat, was triggered by swallowing/chewing certain foods, and yawning. The pain has been controlled pretty well by Tegretol; but I’ve been concerned that this placement of symptoms does not bode well for the future. I’m glad you posted that there are strategies and professionals who can teach them. I knew this type of therapist existed before, but the information is more important to me now, if you know what I mean. Thanks! – Hide quoted text — Show quoted text -alfre…@yahoo.com (Alfretha) wrote in message <news:e5a1d072.0202121845.f5c9060@posting.google.com>… > I just wanted to post about an experience I have had > with wonderful MS. Like many people I was having > problems swallowing, and often choked on food and > drinks, even my saliva. However, what was causing it > was considered VERY unusual. > After several months of working with a speech therapist > we were finally able to isolate the problem. One of > the exercises she gave me was to move food around in > my mouth so that it was positioned on the back of my > tongue — where it triggers the swallow reflex. > Did the exercise. The food got on my tongue, and > "disappeared". I had lost the feeling/touch sensation > on the top of the back of my tongue. So of course I > wasn’t being "triggered" to swallow. With > experimentation, and some retraining, I discovered that > if I keep the food to the side of my mouth, I can keep > "track" of it and it doesn’t start sliding down my > throat without my knowing it. Same with fluids. Have > to consciously trigger the swallow, but at least I am > no longer choking all the time. Turned out the same > reflex effects breathing, and I had to relearn some > breathing control "tricks". > So if you have a swallowing problem, there may be any > number of causes. The person to work with is a speech > therapist (misnomer, they work with any mouth/throat > problem). Pay attention to what YOU feel, and > communicate that to the therapist so you can work > together in solving the problem. > Alfretha > I may have MS, but MS definitely does not have me.
Response:
This is really fascinating. I’ve had esophogeal spasms when I swallow, but only one time did I start choking on food. I have, however, been having some very weird and recurring episodes in which I feel as if I’m running out of air and have to take a deep breath (or several). Sometimes this is accompanied by a tightness in my chest, and sometimes not. I’ve been tested for the usual culprits (heart, lung and cardiac circulation problems), all of which came back normal. In addition to MS, I also have GERD, but the ENT doc I saw said that breathing problems in GERD generally involve wheezing or coughing, which I don’t have. So last Monday (Feb. 4), I had another MRI just to make sure I haven’t developed lesions in the area of the brain stem that controls autonomic functions like breathing. (I don’t have the results yet.) My neuro says he just thinks my MS is fooling my brain into thinking I need a deep breath when I really don’t. And he may very well be right. But your message suggests a possible mechanism for that process, which may make it possible for me to work around it. Thanks for posting this. –Laura R.M. ============= – Hide quoted text — Show quoted text -alfre…@yahoo.com (Alfretha) wrote in message <news:e5a1d072.0202121845.f5c9060@posting.google.com>… > I just wanted to post about an experience I have had > with wonderful MS. Like many people I was having > problems swallowing, and often choked on food and > drinks, even my saliva. However, what was causing it > was considered VERY unusual. > After several months of working with a speech therapist > we were finally able to isolate the problem. One of > the exercises she gave me was to move food around in > my mouth so that it was positioned on the back of my > tongue — where it triggers the swallow reflex. > Did the exercise. The food got on my tongue, and > "disappeared". I had lost the feeling/touch sensation > on the top of the back of my tongue. So of course I > wasn’t being "triggered" to swallow. With > experimentation, and some retraining, I discovered that > if I keep the food to the side of my mouth, I can keep > "track" of it and it doesn’t start sliding down my > throat without my knowing it. Same with fluids. Have > to consciously trigger the swallow, but at least I am > no longer choking all the time. Turned out the same > reflex effects breathing, and I had to relearn some > breathing control "tricks". > So if you have a swallowing problem, there may be any > number of causes. The person to work with is a speech > therapist (misnomer, they work with any mouth/throat > problem). Pay attention to what YOU feel, and > communicate that to the therapist so you can work > together in solving the problem. > Alfretha > I may have MS, but MS definitely does not have me.
