still not able too eat

richard:
I think Marine has covered the bases, but let me expand a bit.

To begin with, if your swallow test did not go to well, as you put it, by all means, you should get yourself into a swallow/speech therapy program at once.

What generally happens with swallow specialists is that they perform ultrasounds on your vital swallow muscles while you are attempting to swallow various things, from the most basic liquids to puddings and crackers. Surprisingly, in many cases, they find that swallowing thin liquids such as water are the most difficult, by the way.

Through this process, they can evaluate what is going on and how they can help you fix it, if that is possible, through repetitive sort of exercises and the like. I am not a professional. I was there in the same way you would be.

Speech therapists, for whatever reason, seem to want to work with your eating skills, too. I do not know why this is, but they do, and you should take advantage of every opportunity to improve. Beyond that, think of physical therapy, a therapist who can work with your muscles to relax them, to stretch them, to exercise them, to make them work better. There is the occasional massage involved so it is well worth the time.

With respect to Botox, this is the first I have heard of it in this regard. Since the intent is to relax something or other, as you indicate, my guesses would be that they want to relax your jaw muscles or your esophagus or both. If you suffer from trismus (a relative closure of the mouth, making it hard to work inside of it, sort of like lockjaw) then they may want to relax the jaw muscles to make it easier to get their tools inside of your mouth and throat. Alternatively, they may simply want to see what it does to relax your esophagus. I really have no idea.

In my case, with trismus an element, they used pediatric bite blockers rather than adult ones when they went in for the pandescopy, for the endoscpies, for the dilations. These worked fine. At no time did I receive Botox. But that was just me.

With respect to surgery, it sounds as though the surgery would be an endoscopy along with a dilation attempt. If this is the case, it is generally an out-patient deal with no cutting involved: they stick the endoscope down your throat to check things out and then they use either a balloon sort of thing to expand a part of your esophagus, or a tube, something I recently learned, to expand pretty much the whole thing.

They are careful, of course, not to blow up your esophagus, so it generally takes two or three efforts to get it as large as it is likely to get (although you may need to come back if it shrinks). It is relatively painless and well worth the effort if it accomplishes anything.

If, instead, they are talking about surgery to remove scar tissue, another possibility, I guess, you are on your own: I know nothing about that.

Marine also mentions a PEG tube. You can have one of these inserted into your stomach and begin feeding through it immediately. Vanity may preclude that option, but I can assure you that unless you are shirtless it is hard to detect, and it DOES allow you to get all of the nutrition you are not getting orally. I suspect you already have one if your throat is, indeed, the 'size of a straw', and therefore would advise that you talk to your nutritionist about changing your caloric intake. Otherwise, if you don't have a PEG tube, please consider getting one. They do not have to be permanent, and most are not, and they can help you get back to your desired weight.

Again, I am largely expanding on the excellent advice given by Marine. I hope that this is of some value.

Take care,

Joe