Category: Cerebellar Atrophy

Cerebellar degeneration is a condition in which cerebellar cells, otherwise known as neurons, become damaged and progressively weaken in the cerebellum. There are two types of cerebellar degeneration; paraneoplastic cerebellar degeneration, and alcoholic or nutritional cerebellar degeneration.

Cerebellar atrophy is one of the diagnostic features in PEHO syndrome (progressive encephalopathy with edema, hypsarrhythmia, and optic atrophy) and usually appears in the second year of life.

Conclusions: Altered functional connectivity between the cerebellum and cerebral networks involved in cognitive-affective processing in patients with OCD provides further evidence for the involvement of the cerebellum in the pathophysiology of OCD, and is consistent with impairment in executive control and emotion

Cerebellar atrophy is more extensive in patients with secondary progressive MS and those with longer disease duration when compared with people who have relapsing-remitting (RR) MS and/or shorter disease duration, and cerebellar atrophy has been shown to correlate with clinical measures of disability.

Cerebellum Atrophy

Artists rendition of the human brain, showing the location of the cerebellum. (from Science Trends)

Cerebellar Atrophy.

Cerebellar Atrophy is something that has motivated me to do research and studies because I personally have been diagnosed with it.

My symptoms are: I lose balance and jumble my words up or miss them out completely when I speak and when I write. Thank God for ‘Grammarly.

Whilst cerebellar atrophy can be the cause of drinking heavily, I personally do not drink alcohol other than on social occasions. It can also be due to head trauma which I cannot rule out.

There is a close connection between Multiple Sclerosis (which my daughter has been diagnosed with) and Obsessive-Compulsive Disorder (which I also suffer from) as I will explain further.

What is the cerebellum and what does it do ?

The cerebellum (“little brain”) is a structure that is located at the back of the brain, underlying the occipital and temporal lobes of the cerebral cortex. The cerebellum is involved in the following functions: Maintenance of balance and posture.

The cerebellum is part of the brain. It lies under the cerebral cortex, towards the back, behind the brainstem, and above the spinal cord. The cerebellum is largely involved in “coordination”. Persons whose cerebellum doesn’t work well are generally clumsy and unsteady. They may look like they are drunk even when they are not.

The cerebellum contains a lot of neurons. According to Hurculano-Houzel (2010), it contains about 80% of the neurons in the brain. So small in size, large in number. It must be doing something pretty important. The large neuron count probably is due to the more elaborate folding of the cerebellar cortex, as the neurons are mainly close to the periphery.

Cerebellar disorders are rare. They are often called “ataxias”. According to Musselman et al (2014), the prevalence of childhood ataxia is 26/100,000 children. Ataxia is rare compared to cerebral palsy (211/100,00) and autism (620/100,000).

Many cerebellar disorders are genetic in origin. In general, the prevalence of genetic disorders and especially autosomal recessive disorders is much higher in populations where there is more consanguinity. Examples of this include Quebec, Canada, and the Al-Kharga district in Egypt. There are also many acquired cerebellar disorders. For example, drinking too much alcohol for a long time causes a cerebellar disorder.

There are several key functions of the cerebellum, including:

  • Balance and posture
  • Mental function
  • Movement
  • Motor learning
  • Vision

Causes of Cerebellum Damage

Damage to the cerebellum, or to its connection to other parts of the nervous system, can be a result of trauma, health conditions, medications, and other factors, including:

  • Alcohol use disorder
  • Brain tumor
  • Head injury
  • Huntington’s disease
  • Infections
  • Lead or mercury poisoning
  • Medications, including benzodiazepines or barbiturates
  • Multiple sclerosis
  • Parkinson’s disease
  • Stroke

Conditions That Affect the Cerebellum

When your cerebellum is damaged, nerve cells break down and die and can cause the following:

  • Ataxia:The loss of control of voluntary movement (e.g., the ability to move your body the way you want)
  • Cognitive impairment:A reduction in conscious mental activities, including thinking, learning, memory, and concentration
  • Dystonia: Involuntary contraction of muscles that normally work in cooperation so that a body part is held in an unusual and often painful position as a result
  • Tremors: Involuntary, rhythmic contraction of muscles that can lead to shaking movements in the hands, legs, face, head, or vocal cords
  • Unsteady gait:Walking unsteadily or clumsily (A person with an unsteady gait may appear intoxicated even if that’s not the case.)
  • Vertigo:The dizziness sensation of spinning, swaying, or tilting, which is frequently associated with balance problems and often accompanied by nausea, vomiting, headache, or hearing loss

Diagnosis of Cerebellar disorders

The main clinical features of cerebellar disorders include incoordination, imbalance, and troubles with stabilizing eye movements. There are two distinguishable cerebellar syndromes — midline and hemispheric.

Midline cerebellar syndromes are characterized by imbalance. Persons are unsteady, they are unable to stand in Romberg with eyes open or closed, and are unable to well perform tandem gait. Severe midline disturbance causes “trunkal ataxia” a syndrome where a person is unable to sit on their bed without steadying themselves. Some persons have “titubation” or a bobbing motion of the head or trunk. Midline cerebellar disturbances also often affect eye movements. There may be nystagmus, ocular dysmetria, and poor pursuit.

Hemispheric cerebellar syndromes are characterized by incoordination of the limbs. There may be the decomposition of movement, dysmetria, and rebound. Dysdiadochokinesis is the irregular performance of rapid alternating movements. Intention tremors may be present in an attempt to touch an object. A kinetic tremor may be present in motion. The finger-to-nose and heel-to-knee tests are classic tests of hemispheric cerebellar dysfunction. While reflexes may be depressed initially with hemispheric cerebellar syndromes, this cannot be counted on. Speech may be dysarthric, scanning, or have an irregular emphasis on syllables.

Maintenance of balance and posture. The cerebellum is important for making postural adjustments in order to maintain balance. Through its input from vestibular receptors and proprioceptors, it modulates commands to motor neurons to compensate for shifts in body position or changes in load upon muscles. Patients with cerebellar damage suffer from balance disorders, and they often develop stereotyped postural strategies to compensate for this problem (e.g., a wide-based stance).

Coordination of voluntary movements. Most movements are composed of a number of different muscle groups acting together in a temporally coordinated fashion. One major function of the cerebellum is to coordinate the timing and force of these different muscle groups to produce fluid limb or body movements.

Motor learning. The cerebellum is important for motor learning. The cerebellum plays a major role in adapting and fine-tuning motor programs to make accurate movements through a trial-and-error process (e.g., learning to hit a baseball).

Cognitive functions. Although the cerebellum is most understood in terms of its contributions to motor control, it is also involved in certain cognitive functions, such as language. Thus, like the basal ganglia, the cerebellum is historically considered as part of the motor system, but its functions extend beyond motor control in ways that are not yet well understood.

Credit:

https://nba.uth.tmc.edu/neuroscience/m/s3/chapter05.html

Cerebellar Atrophy is one of the diagnostic features in PEHO syndrome (progressive encephalopathy with edema, hypsarrhythmia, and optic atrophy) and usually appears in the second year of life.

Symptoms of Cerebellar Atrophy.

The most characteristic symptom of cerebellar degeneration is a wide-based, unsteady, lurching walk, often accompanied by a back and forth tremor in the trunk of the body. Other symptoms may include slow, unsteady, and jerky movement of the arms or legs slowed and slurred speech, dizziness, lightheadedness, loss of balance, cognitive impairment, and nystagmus.

Credit:

https://dizziness-and-balance.com/disorders/central/cerebellar/cerebellar.htm

Cerebellar atrophy in the context of other disorders

Cerebellar Atrophy is the neuroradiological hallmark of many progressive ataxias of childhood. It is a nonspecific, yet useful neuroradiological sign (Poretti et al., 2008). Its differentiation from cerebellar hypoplasia can be difficult, especially if progression cannot be proven by repeated MRI. It is defined as a structurally normal cerebellum with enlarged interfolial spaces in a posterior fossa of normal size, while in cerebellar hypoplasia, the cerebellum is small and compact, without widened fissures between the foliae. Besides the hereditary ataxias, cerebellar atrophy can also be found in a multitude of other disorders, often, but not always, with additional neuroradiological abnormalities. If cerebellar atrophy is present, ataxia is often a clinical symptom, but this is not always the case. Hyperintensity of the cerebellar cortex in T2w images has been considered as pathognomonic for infantile neuroaxonal dystrophy (INAD), but has also been demonstrated in Marinesco–Sjögren syndrome or mitochondrial disorders.

Prominent cerebellar atrophy is present in many of the neurodegenerative disorders of childhood, including metabolic disorders. It can be an isolated neuroradiological feature in juvenile GM2 gangliosidosis. In late-infantile neuronal ceroid lipofuscinosis and Niemann–Pick disease type C, it is usually accompanied by mild supratentorial atrophy. It is part of the neuroradiological abnormalities in many disorders of white matter, especially in hypomyelination of basal ganglia and cerebellum (HABC) and the 4H syndrome (hypomyelination, hypodontia, and hypogonadotropic hypogonadism). In white matter disorders, the MRI appearance of the white matter is mostly sufficiently specific to make a diagnosis. Cerebellar atrophy is one of the diagnostic features in PEHO syndrome (progressive encephalopathy with edema, hypsarrhythmia, and optic atrophy) and usually appears in the second year of life. Pontocerebellar atrophy is prominent in certain subtypes of the congenital disorders of glycosylation (CDG), especially in CDG Ia which is a differential diagnosis for pontocerebellar hypoplasia.

Cerebellar Atrophy can also be acquired. Extreme prematurity can cause pontocerebellar atrophy. Acute cerebellitis and autoimmune disorders such as opsoclonus myoclonus syndrome can lead to cerebellar atrophy. More frequent causes of cerebellar atrophy are posterior fossa surgery or radiotherapy (Poretti et al., 2008).

Cerebellar Degeneration is a condition in which cerebellar cells, otherwise known as neurons, become damaged and progressively weaken in the cerebellum. There are two types of cerebellar degeneration; paraneoplastic cerebellar degeneration, and alcoholic or nutritional cerebellar degeneration. As the cerebellum contributes to the coordination and regulation of motor activities, as well as controlling the equilibrium of the human body, any degeneration to this part of the organ can be life-threatening. Cerebellar degeneration can result in disorders in fine movement, posture, and motor learning in humans, due to a disturbance of the vestibular system. This condition may not only cause cerebellar damage on a temporary or permanent basis, but can also affect other tissues of the central nervous system, including the cerebral cortex, spinal cord, and the brainstem (made up of the medulla oblongata, midbrain, and pons).

Cerebellar Degeneration can be attributed to a plethora of hereditary and non-hereditary conditions. More commonly, cerebellar degeneration can also be classified according to conditions that an individual may acquire during their lifetime, including infectious, metabolic, autoimmune, paraneoplastic, nutritional, or toxic triggers.

Conclusions: Altered functional connectivity between the cerebellum and cerebral networks involved in cognitive-affective processing in patients with OCD provides further evidence for the involvement of the cerebellum in the pathophysiology of OCD, and is consistent with impairment in executive control and emotion

Abstract

Background: The role of the cerebellum in obsessive-compulsive disorder (OCD) has drawn increasing attention. However, the functional connectivity between the cerebellum and the cerebral cortex has not been investigated in OCD, nor has the relationship between such functional connectivity and clinical symptoms.

Methods: A total of 27 patients with OCD and 21 healthy controls (HCs) matched on age, sex and education underwent magnetic resonance imaging (MRI). Seed-based connectivity analyses were performed to examine differences in cerebellar-cerebral connectivity in patients with OCD compared with HCs. Associations between functional connectivity and clinical features in OCD were analyzed.

Results: Compared with HCs, OCD patients showed significantly decreased cerebellar-cerebral functional connectivity in executive control and emotion processing networks. Within the OCD group, decreased functional connectivity in an executive network spanning the right cerebellar Crus I and the inferior parietal lobule was positively correlated with symptom severity and decreased connectivity in an emotion processing network spanning the left cerebellar lobule VI and the lingual gyrus was negatively correlated with illness duration.

Cerebellar Atrophy & Obsessive Compulsive Disorder.

Altered functional connectivity between the cerebellum and cerebral networks involved in cognitive-affective processing in patients with OCD provides further evidence for the involvement of the cerebellum in the pathophysiology of OCD and is consistent with impairment in executive control and emotion regulation in this condition.

Keywords: Cerebellar circuits; executive control network; functional connectivity; obsessive-compulsive disorder.

Credit:

https://pubmed.ncbi.nlm.nih.gov/30058519/

Cerebellar Atrophy & Multiple Sclerosis.

Cerebellar atrophy is more extensive in patients with secondary progressive MS and those with longer disease duration when compared with people who have relapsing-remitting (RR) MS and/or shorter disease duration, and cerebellar atrophy has been shown to correlate with clinical measures of disability.

Credit:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3281565/

Credit:

https://en.wikipedia.org/wiki/Cerebellar_degeneration

#cerebellaratrophy #cerebellum #ms #ocd #multiplesclerosis #obsessivecompulsivedisorder #cerebellumatrophy

Coping With Life When You Are Disabled.

Copying With life When You Are Disabled.

I have this methology “if life gives you lemons, make lemonade”. I am not the type of person to whinge and moan, I just make the most of what I have and try to get on with it.

I always keep myself busy and set goals. However my physical and mental disabilities are obstacles that daily I have to get round.

My OCD is by far one of my prominent disabilities and have designed a quarantined cocoon area where only I have access to. This area allows me to be free of any anxieties that I would have in the normal environment. I have adopted this practice to save cleaning my whole home from top to bottom day in and day out. Believe me I used to clean from top to bottom every single day until I realised I was wasting valuable time doing something else.

Keeping myself busy does help to block out intrusive thoughts to a certain degree. I am the worlds worse for critising myself. I try to brain train to reason with myself that what I do is ridiculous and out of character to normal people, but it all is related to stress, anxiety and depression. Depending how stress I am under will depend how well my day will be. If I am super stressed, I find that I cannot concentrate and even do minuscule tasks.

My OCD is germ contamination related and I am even more conscious of my surrounding and the things that I touch. I dislike people visting me and visa versa. I prefer not to go out, hence I am not going out any time soon pandemic regulations or not.

I actually wrote an article on my other blog about germ awareness and cross contamination: https://marketingagency.cymrumarketing.com/2021/02/16/saliva-and-mail-cross-contamination-of-germs/

As for my other disabilities:

  • Cerebellar Atrophy (I lose my balance or grip and muddle my words up especially when I write, I also have mental blocks).
  • OCD (I am aware of germ cross contimination and and am careful what I touch).
  • Social Disconnection (I prefer my own company and not go out and socialise, although we can’t anyway but you get my drift).
  • PTSD (I have flashbacks of the physical and mental trauma I endured in the past and certain things trigger my depression).
  • Clinical Depression (This is related to past physical and mental trauma I endured, in which there are days where I go to a dark place).
  • Rheumatoid Arthritis (I cannot bend my knee, again from past physical trauma/abuse).
  • Dysphagia (I sometimes choke of food, I get a painful feeling followed by trouble swallowing and breathing and only when the food is dislodged does the feeling subside, gross I know but what can I do? I have been told I could have surgery but there is no gauarantee that it would work. I am not going to go under the knife for anything, I can tell you that for sure).
  • Epidural Analgesia (Chronic Back Pain, even bending down to feed the cat makes my back spasm, the same goes if I am standing for excessive length of time I have shooting pains from the small of my back to the nape of my neck. Simple taskes like taking out the rubbish or bringing in the grocery shopping has brought tears to my eyes in the past).

So yes I have good days and bad days but I do not dwell on my ailments and try to live the best way I can. I adapt to around my disabilities. Fortuantely for me I offer digital services so I can do 100% of my work online and do not have to venture out.

Stress and worry are contributing factors to my OCD, PTSD, Depression and Social Disconnection.

  • Getting headaches (I have regular headaches)
  • Having stomach cramps (I have a bad stomach most days, but that can be from drinking energy drinks to keep me awake).
  • Not being able to sleep (I find my medication helps me sleep but it takes a few hours for me to wind down, hence I watch a film or play a game, I also read books from time to time).
  • Feeling pains in your chest (I do not get them often but when I do it is scary as I have also experienced jaw ache and shooting pain down my left arm in the past). I have had an ecg scan done and the doctor said there was nothing wrong, yet the same doctor also prescribed antacid ‘Gaviscon’ to my daughter even though she was later diagnosed with MS after I admitted her into A&E.
  • Having constant worring (If I do not keep myself busy I do worry hence I try to keep my mind occupied all the time). Worrying only makes your health deteriorate and although life struggles can get in the way of your happiness, one needs to find a way to tackle the problem we are faced with, rather than sweep them under the carpet. Confronting your inner demons makes you stronger. Sometimes simply writing down your problems is the first step to dealing with whatever is on your mind. Talking to a friend or family member also helps but for me expessing my emotions in the form of a blog is theraputic in itself.
  • Having panic attacks (I only get these if I have to meet negative people). People that judge or critise, you know the people I am talking about or if I have a deadline in work or something that I have seen or heard that has triggered the onset of sheer panic. However for most part I am organised and know to how to avoid trigger warnings, so panic attacks are subdued.
  • Feeling shortness of breath, (I only get this if I cannot swallow due to my Dysphagia or at times when I have in the past been in distress, due to the trauma and abuse I endured).
  • Having mood swings with friends or family (I avoid socialising so no one knows my moods and no one can be on the tail end if I do have a bad day).
  • Finding it hard to feel happy (Continuously reassuring myself and staying positive that what I am doing will eventually change my life for the better, is enough to motivate me to get up and tackle every day tasks).

Although I was going to do a daily/weekly journal of my health, I am not able to do so at present as I have many projects I am working on and simply do not have the time, but I always try to strive to stay focused and optimistic that tomorrow will be a better day.

Obviously adopting a healthy lifestyle can help with coping with life struggles, such as:

  • Regular Exercise
  • Breathing Exercise
  • Meditation
  • Eating Healthily
  • Brain Training
  • Learning New Things
  • Staying Focused
  • Being Organised
  • Setting Goals
  • Time Management
  • Avoiding Negative People
  • Learning to Trust People
  • Motivation
  • Talking to Family and Friends About Your Troubles
  • Discussing your Problems with Professionals, Health, Finance, Relationships etc

Final Thoughts!

I am a disabled entrepreneur and I have created a business round my disabilities. The way I saw it when I first started out, I would not fit in or be accepted in a normal working enviroment and I am the most happiest I have ever been for a long time doing what I do and it works for me. So the way I see it is my disabilities are a blessing in disguise, as I would not be where I am today without them.

I avoid negative judgemental people especially if they have power trips (Trolls especially that have nothing better to do than try an bring a person down, these get immediately blocked).

As for me I will help anyone that genuinely needs my help. I am very good at analysing people and situations and I am very astute.

Stay safe, stay focused and stay motivated, nothing stays the same forever unless you let it…

What is Multiple Sclerosis (MS).

Amongst my knowledge of OCD and Cerebellar Atrophy I have been thrown into the deep end with Multiple Sclerosis. The reason for this, my daughter was diagonosed with it at the age of 15. It was a shock to the system for the both of us to learn about the disease, the diagnosis and what treatments there were and what are available.

At the time my daugher was put on Lemtrada (alemtuzumab).

I had concerns when I read that the treatment was still going ahead even though European Medicine Agency (EMA) had taken it off the market. The hospital and EMA said that no new patients would be having to drug but the patients already on it would have to finish the course.

RED TAPE!

I personally think there was political red tape and that is the reason the drug had to be continued with existing patients as it cost too much and was too complicated to get a refund, I may be wrong but no one has stepped up to correct me. If the drug had been bought upfront you could not exactly get your money back I suppose. I do not know how buying drug work, but I assume pharmaceutical companies get paid upfront as they have to make large batches, with expiry dates hence the NHS cannot return drugs once they have been manufactured in large quantities.

https://www.ema.europa.eu/en/medicines/human/referrals/lemtrada

Lemtrada suppresses the immune system for some time after a treatment course so people will be more vulnerable to infections such as colds and viruses.

LEMTRADA can cause serious side effects including:

Serious autoimmune problems:

Some people receiving LEMTRADA develop a condition where the immune cells in your body attack other cells or organs in the body (autoimmunity), which can be serious and may cause death.

Serious autoimmune problems may include:

  • Immune thrombocytopenic purpura (ITP), a condition of reduced platelet counts in your blood that can cause severe bleeding that may cause life‑threatening problems.
  • Call your healthcare provider (HCP) right away if you have any of the following symptoms: easy bruising; bleeding from a cut that is hard to stop; coughing up blood; heavier menstrual periods than normal; bleeding from your gums or nose that is new or takes longer than usual to stop; small, scattered spots on your skin that are red, pink, or purple
  • Kidney problems called anti‑glomerular basement membrane disease, which, if not treated, can lead to severe kidney damage, kidney failure that needs dialysis, a kidney transplant, or death.
  • Call your HCP right away if you have any of the following symptoms: swelling of your legs or feet; blood in the urine (red or tea‑colored urine); decrease in urine; fatigue; coughing up blood.

So its no suprise that On July 3, 2020 Sanofi Genzyme was notified that Lemtrada Home Phlebotomy Partner, Examination Management Services Inc., (EMSI) has gone out of business.

https://www.lemtrada.com/

Because of this, unfortunately, all future Lemtrada Home Phlebotomy (lab draw) visits from EMSI have been cancelled.

Patient safety is Sanofi Genzyme’s #1 priority (thats a joke if I ever heard one as my daughter was still administerd the drug after the EMA said it was unsafe) and they continued to say they are working to provide an alternative phlebotomy solution as well as coordinate alternative testing options for your next monthly lab tests.

This tells me that the company had to do refunds and the NHS here in the UK were slow and had already paid the doctors.

I wrote an article on my other blog how Doctors get a commission from pharmaceutical companies for promoting drugs.

You can read the article here:

https://marketingagency.cymrumarketing.com/2019/10/15/lemtrada-alemtuzumab-sanofi-genzyme/

Doctors receiving money from pharmaceutical companies.

https://www.telegraph.co.uk/news/2016/06/30/individual-nhs-doctors-receiving-100000-per-year-from-drugs-firm/

I personally think when I first learned about this, that I was angry that the NHS knew the risk, yet used my daughter as a lab rat.

If you have any questions related to this announcement, please contact your healthcare provider or your One to One Nurse at (USA) 1-855-557-2483.

If you are in the UK contact your MS Team, or speak to the Ward Manager or Professor assigned to your case.

Multiple sclerosis (MS)

Multiple Sclerosis is an auto-immune disease that attacks healthy white cells. The lesions that can affect the brain and spinal cord can cause a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation or balance.

It is an incurable disease with lifelong symptoms that can sometimes cause serious disability, although it can occasionally be mild.

The average life expectancy is slightly reduced for people with MS and symptons can be alliviated with different courses of treatments.

In most cases, people get diagnosed in their 20s or 30s but it has been known the patients have shown symptoms as young as 15 years of age. In fact, it can develop at any age. It’s about 2 to 3 times more common in women than men.

MS is one of the most common causes of disability in younger adults.

https://www.nhs.uk/conditions/multiple-sclerosis/symptoms/

The most common symptoms include:

Cerebellar atrophy

Cerebellar atrophy is associated with MS and is more extensive in patients with secondary progressive MS and those with longer disease duration when compared with people who have relapsing–remitting (RR) MS and/or shorter disease duration. Cerebellar atrophy has been shown to correlate with clinical measures of disability.

Multiple sclerosis (MS) commonly affects the cerebellum causing acute and chronic symptoms. Cerebellar signs contribute significantly to clinical disability, and symptoms such as tremor, ataxia, and dysarthria are particularly difficult to treat.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3281565/

For Further Information Contact the Following Links.

https://www.nhs.uk/conditions/multiple-sclerosis/

https://www.nationalmssociety.org/What-is-MS

https://www.mssociety.org.uk/

https://www.webmd.com/multiple-sclerosis/default.htm

https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5487391/

https://jnnp.bmj.com/content/88/12/1065

https://journals.physiology.org/doi/full/10.1152/jn.00245.2018

Dysphagia.

Dysphagia is the medical term for problems with swallowing food and drink.

Some people find it difficult to swallow certain foods or liquids, while others can’t swallow at all, other side effects include: coughing or choking when eating or drinking. bringing food back up, sometimes through the nose.

I know this may sound horrifying or even disgusting but on and off depending on what food I eat and if I have taken small bites will determine if I do not have the feeling I am choking and that food is stuck and won’t go up or down. This usually occurs if the food is dry and if I have taken large bites. Normally I have to chew my food like a cow chewing grass. Eventually, it gets monotonous and I lose the enjoyment of the food I eat. If only there was a pill form where you could choose your meat and veg and have the taste and nutrition plus the feeling you have had a slap-up meal all in one.

In fact, In 1936 the Jefferson City Post-Tribune ran an article recounting the views of Dr. Milton A Bridges of Columbia University. In it, he declared: “Human beings are never going to eat pills for meals” (why not? I would try it for certain) he went on to say “pills can never be made to contain sufficient caloric volume”.

Reading this I would find this would be an idyllic solution to my problem, popping a pill saving time sourcing the produce, cooking, and then chewing, not to mention losing weight in the process with the low-calorie count, how wonderful that would be. Imagine your gas or electric energy bill would also drop in the process. But this is not an ideal world and the Government and the Economy would be affected hence it is never going to happen, not in my lifetime anyway. This would also solve world hunger but one would need to have calories as our bodies need on average of 2000 calories per pay so we would have to pop around 400 pills per day just for calories alone. (My theory if that was the case would be to crush them and mix them up as a smoothy formula).

To think how many hours we waste shopping for groceries, packing and unpacking, preparing and cooking, and then sitting and eating for me I could be doing something else as time is precious. Imagine how much packaging we could eliminate from our lives whilst saving the planet in the process.

What is the likely cause of the dysphagia?

Certain disorders such as multiple sclerosis, muscular dystrophy, and Parkinson’s disease can cause dysphagia. Neurological damage. Sudden neurological damage, such as from a stroke or brain or spinal cord injury, can affect your ability to swallow.

I wonder if this may be linked to Cerebellar Atrophy & Epidural Analgesia? I am not an expert but it seems a bit of a coincidence that I have the above ailments and find it difficult to swallow at times.

How to Treat Dysphagia includes:

  1. Exercises your swallowing muscles.
  2. Evaluate your Diet and perhaps change the foods you eat. (Don’t know if there is a recipe for a full english breakfast smoothy).
  3. Dilation.
  4. Endoscopy. ( I had this proceedure done they made me swallow barium and then they stuck a camera down my throat), besides this is for diagnosis purposes and not for ment as a cure.
  5. Surgery. (Not guaranteed to be a successful and you may have to repeated surgeries).
  6. Medicines. ( I have been prescribed Gaviscon Advanced Mint tablets, as I suffer with acid reflux which is also associated Dysphagia.

Further reading can be found here:

https://www.nhs.uk/conditions/swallowing-problems-dysphagia/