It Might Get Messy

In case you haven’t thought about it lately, your epiglottis is an important piece of plumbing. As the (reviewed and referenced, despite missing the “a” in the first sentence) University of Maryland Medical Encyclopedia online puts it: 


The epiglottis is flap of cartilage located in the throat behind the tongue and in front of the larynx. The epiglottis is usually upright at rest allowing air to pass into the larynx and lungs. When a person swallows the epiglottis folds backward to cover the entrance of the larynx so food and liquid do not enter the windpipe and lungs. After swallowing the epiglottis returns to its original upright position.


In other words, your epiglottis sorts solids and liquids from gasses and makes sure each gets down the correct pipe. A major problem with people whose epiglottis fails to do this sorting correctly is pneumonia due to crud (i.e. solids and liquids) running into the air passageways. 


My General Practitioner, Dr. K (who saved my life last year by recognizing that I not only had throat cancer, I had acute Stage 4 throat cancer that needed immediate attention) last week prescribed a new medication for me. It’s a pretty big pill that has to be taken in the morning. I figured I’d just dissolve it like I do with the rest of my meds and pump it into my feeding tube. No go. Not only did that pill not dissolve in a glass of warm water, when I dumped it into the sink it got stuck and took an entire week (in a heavily-used bathroom) to dissolve. 


Nor could the pill be crushed. It has a sort of semi-moist texture that makes it squash but not fragment.


Well, I thought to myself, this’ll be an adventure. I cracked open a (full calorie) A&W root beer, sat on the bed, and took a mouthful of soda. Then I tilted my head back. I used to take pills by dropping same into the liquid in my mouth, then releasing the whole mess via my epiglottis into my gastrointestinal tract. In this case, I was surprised to find that the soda did not stay in my mouth—it drained all by itself into my GIT. None entered my airway (thankfully). Turns out, I can take the pill by being quick about getting it into my mouth during the head-tilt routine. Score one for experimentation.


I spent much of Friday at the hospital having further diagnoses and getting equipment and specifications for physical therapy for my crippled tongue and throat. The therapist set it up so I would start in radiology, where a doc would do real-time radiobarium imaging of my swallowing. I started with a small sip of the icky white liquid and swallowed as directed. “OK, let’s look at this” she says. “See, here’s where your epiglottis used to be. It’s not there any more—the radiation destroyed it.” 


Nobody (except me) seemed the least bit disturbed at the fact that I am now without such a critical item of gastrointestinal plumbing. 


We went on from there. I got a new set of tongue exercises, which we ran through at the therapy session. Between sticking my tongue out, over, and around, and doing isometrics (anybody remember those Royal Canadian Air Force isometrics booklets? My parents were big fans, albeit doing isometrics between cigarettes and glasses of beer) against a tongue depressor, the (now weak and badly scarred) back of my tongue was cramping.


And that’s a good thing. The only way I’m going to be able to eat “normal” food is by making my tongue strong enough to take over some of the function of my now-missing epiglottis. I assume such exercise will also help my voice recover. So now I’m deeply vested in squishy physical therapy with my tongue several times a day. I go back next Friday to check progress.


I’ll let you know. Thanks for stopping by. Y’all are a big chunk of why I’m still here, so thank you again!