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DMD & Swallowing Food

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Duchenne muscular dystrophy and...
SWALLOWING
FOOD
PROBLEM
Puree
Drink water first thing in the morning to clear saliva from the oropharyngeal area.
A cough assist machine is useful for restoring comfort from: choking, or an apparent or silent aspiration episode.
Try adjusting meals to less solid food. However, thickening liquids is not advised. 
Suction
Sip
Drink
Sip water, and air if using sip mouthpiece ventilation; before, during and after meals to flush residues.
Sources:   Dysphagia in Duchenne muscular dystrophy: practical recommendations to guide management. Toussaint M, Davidson Z, Bouvoie V, Evenepoel N, Haan J, Soudon P. Disabil Rehabil. 2016 Jan 5:1-11. Oral muscles are progressively affected in Duchenne muscular dystrophy: implications for dysphagia treatment • Imelda J. M. de Groot et al • J Neurol (2013) 260:1295–1303
Duchenne muscular dystrophy and swallowing food by Deborah Robins is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.  2016. NB Not to be construed as medical advice.
Time
Chin Tuck
   Lowering chin downwards may ease passage of the food.
Hold Breath
Hold a deep breath (closing glottis), swallow food then clear throat.
A gradual preference for modified food textures, masks progressive pharangeal weakness. A common problem is the food and saliva residue in the pyriform sinus 'pockets'. High-caloric oral or enteral (PEG) nutritional liquids may be recommended by Dietitian.
Oral muscles related to swallowing are progressively affected even in the ambulatory phase, where hypertrophy of the tongue is common. In adults, swallowing problems worsen with progressive weakness. Assessment by a Speech Pathologist is an integral part of management by a multidisciplinary team.
WHAT TO TRY
Figure 1 (a)  Toussaint, 2016
      Limit meal times to 30 mins or 6 small meals per day to avoid fatigue.