Others are a consequence of an infection, muscle dysfunction, stroke or advancing age. Some of the problems derive from oesophageal conditions such as acid reflux disease. Firm statistics on the prevalence of swallowing disorders are also sparse, but a recent survey in the Netherlands estimated that they affect as many as 1 in 8 adults. It’s so complicated, in fact, that experts don’t yet agree on all of the essential components, though some estimate that 22 muscle pairs and 7 of the 12 cranial nerves (which emerge from the brain) take part. Swallowing is one of the body’s most complex actions, which means plenty can go wrong. “That’s the best way I had a patient describe it to me: 24 hours a day being waterboarded.” “It’s like being constantly waterboarded,” says Belafsky, because of the sensation of drowning that it produces. Peter Belafsky, director of the University of California at Davis Voice and Swallowing Center and an adviser on Anderson’s case, says the hardest-hit patients can choke on up to 1.5 litres of spit every day – the upper limit pumped out by our salivary glands. And in severe cases, they may have to survive via a feeding tube inserted through their abdominal wall and into their stomach, as Anderson eventually did for 18 months. If it gets bad enough, they may have to switch to a fully liquid diet. Their teeth may start to rot as the mouth’s natural flushing system falters, while their emotional and psychological health begins to decay as they withdraw from public life. They can breathe food or water into their lungs and develop aspiration pneumonia, or get so little food to go down the right way that they become dehydrated and malnourished. People who struggle to swallow can easily choke. Seemingly overnight, at the age of 39, Anderson has lost her ability to swallow. She has absolute faith that it won’t happen again. That was odd, she thinks, though it doesn’t stop her from having another bite. She is temporarily jolted by the episode, her heart racing. And again, finally dislodging the toast on the third try. She manages to slowly suck a bit of air past the blockage until she can muster up a forceful cough. But it doesn’t, and now she’s choking.ĭon’t panic, she tells herself. She tries again, pressing her lips together and pushing the food back further in her mouth where her throat can take over.
She has made her usual breakfast of tea and toast with peanut butter and lets her mind wander as she takes her first bite.Īnd then, nothing. The day begins like any other for Samantha Anderson, a goldsmith and mother of three from Brisbane, Australia.
But there you are in your kitchen on a Saturday morning, inexplicably choking on a mouthful, trying not to panic.