Back in June, when Bob had his Swallow Video Test, the Speech/Swallow Therapist showed me the rather grainy film and pointed to a spot in Bob's throat and said, "See that, right there? It's not moving. That's his epiglottis and it should be moving. But it's paralyzed. And that's the reason everything is going down the wrong pipe." And, of course, a discussion followed with me asking what one can do about this and she really having no clue. After that, the ST refused to give Bob anything to eat for swallow practice and sternly warned me not to give him anything at home or there would be dire results, possibly even death, then discharged him and well, you know that story.
Afterwards, I did two things. I researched "epiglottis" as I really didn't know what it was or what it did, and I took Bob to see his Ear, Nose, Throat doctor (aka Dr. Doom) for a second opinion. Dr. Doom concurred that the swallow test results were dismal and medically he could not advise me to let Bob eat anything for swallow practice because it was indeed dangerous, however, off the record, he said if he were me, he'd just "wing it", keep up the swallow practice at home and see what happens because the alternative is never being able to eat or drink and he thought, personally, it was worth the risk. And that's what we've been doing with a cup of pudding or mashed potatoes every day since. Against all medical advice....
Now the epiglottis (and bear with me here) is a small, thin muscle in the vocal cords. It is sometimes described as being "leaflike" and it's big purpose is to protect the windpipe (trachea) when one is swallowing. It operates like a flap, if you will, covering the windpipe that so that food and liquids flow over it and into the esophagus and down into the stomach. When you are not swallowing, the epiglottis is open so that you can breathe. It has one other interesting feature. It is the epiglottis which makes you laugh.
You know that noise one makes when one laughs? That "ho ho ho, hee hee, ha ha" from the throat? That chuckling, chortling, giggling, cackling that you sometimes can't control no matter how hard you try or how inappropriate it is at the moment? That's the sound of your epiglottis doing a happy dance, flapping back and forth over your windpipe.
When I learned this odd little fact, I remembering thinking that if that's the case, then Bob would not be able to laugh because his epiglottis was paralyzed. At first, I thought this was rather absurd, because, of course, Bob laughs--doesn't he? I mean he laughs "with his eyes", he smiles and even says "ha ha!" and "hee hee!" but then, after thinking about it, I was unsure if he really could laugh--you know, chortle? chuckle? giggle? So I began to study him when he "laughed" and found it was true. Bob couldn't laugh. Which is really weird, when you think about it.
Yesterday, we played Scrabble. Bob had just finished drawing new tiles and he said, "Crap." I said, "What?" and he showed me his tiles which were pretty much all consonants, no vowels. And I said, "Well, you think that's bad, look at this," and I showed him my tiles which were O O O O E E I.
And he laughed.
I mean, he really laughed.
He chuckled. Giggled, even. Honest to God, I almost fell off my chair.
It was the first time I've heard him laugh this year.
And perhaps this means that our "dangerous" swallow practice is working.....? Oh my. It would certainly be nice to have "the last laugh" on this one.