[DYSPHAGIA] Isolated Chewing Difficulty

[SuzMorris@aol.com (SuzMorris@aol.com)]

Thanks to everyone on the list who has responded to the questions about 
my friend with the isolated chewing problem.   Let me give you a bit of 
feedback in response to your questions and suggestions.   She is a very 
"intact" woman in every aspect of her life. . .a gifted "hands-on" healer 
yet very down-to-earth and practical in her approach to life.  Her lack 
of unhappiness at the current situation doesn't surprise me in the least. 
 She typically acknowledges what is going on in her life, but has a 
strong belief that things happen for a reason.  She is able to accept 
what happens while search for answers that lead her to why the problem is 
happening and what she can do about it.  One of her thoughts about going 
on the blenderized diet is that it might give her mouth a rest and allow 
her to gain a greater insight into what is going on.  She has never had a 
neurological work-up but there has been no reason for it.  Her overall 
health has been excellent. There is no history of seizures; no indication 
of a peripheral nerve disorder; no apparent muscle weakeness.  She has 
had a history of allergy that has limited her food choices in the past 
but she has recently had some excellent results in treatment of her food 
allergies and these no longer seem to be limiting her choices.

One of the most important aspects of her situation is that this is a 
long-term chronic condition.  She's had the slow chewing and extended 
length of time for a meal for most of her life.  This makes it much less 
likely that conditions such as ALS and MS are going on.  To my knowledge 
people don't get symptoms of these degenerative conditions that stay at 
the same level for 40 or 50 years before becoming worse.   

One of the suggestions that was made by someone off the list is that it 
may be an isolated involvement of the mandible with a small undetected 
malocclusion or impacted  teeth.  Since occlusion changes during aging as 
the alveolar bone recedes, this could account for the condition worsening 
over recent months.   This more simple explanation is one I will suggest 
that she explore first through getting an appointment with a good dentist 
who has a background in this area.   A neuro consult will definitely be 
considered if occlusal problems cannot explain what is going on.  One of 
the considerations here is that like many people, her insurance coverage 
is very basic (designed more for major hospitalizations and catastrophic 
coverage than ongoing healthcare) so she has a very large deduction. 
Essentially she would have to pay the full cost of the neurologist, MRIs, 
CT scans and the like out of her own pocket before even reaching the 
deductable.  Thus, this is a decision that I know she would have to 
consider very carefully.

Again thanks so much for the suggestions.  They gave me a lot to think 
about and helped clarify my own thoughts on all of this.

Suzanne Morris
New Visions
http://www.new-vis.com
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