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Intense Therapy Retrains Patients To Swallow KAREN PALMER, CP 2004-03-02 04:13:04 TORONTO -- Catriona Steele jokes that the goal of her research is to send each of her patients to Weight Watchers. Steele studies swallowing, a fascinating function that goes virtually unnoticed thousands of times each day, with every bob of an Adam's apple and every chain-reaction contraction of the 25 muscles it takes to push saliva or food out of the mouth. Her patients, unfortunately, are acutely aware of swallowing. Specifically, the absence of it. Steele, of the University of Toronto's department of speech pathology, does research at the Toronto Rehab hospital. Most of her patients are recovering from strokes or other brain injuries, or slowly losing the battle against Parkinson's disease or muscular dystrophy or a dozen other degenerative neurological disorders. All too often, she said, they live on pablum, thickened liquids or mush; in extreme cases they can get food into their bodies only through a feeding tube surgically inserted in their stomachs. For nine months following his stroke, John Hale "ate" every meal through a tube. He carried around a cup, sometimes discreetly concealed in a paper bag, to spit out saliva. Every day, with religious regularity, he poked at the back of his throat with a silver "swallowing stick," an instrument that looks like a tiny golf driver that is meant to stimulate the gag reflex in the hopes of triggering swallowing. It failed miserably. Hale continued pouring cans of food down the tube, sneaking in an occasional glass of wine. Then he was introduced to Steele, who put him through a new, intensive therapy meant to retrain muscles by using biofeedback. She showed him he could swallow, albeit weakly. She also gave exercises that would rebuild his muscles until he learned to swallow again -- exercises he practises with the verve of a religious fanatic. After only eight sessions, the tube was gone. Hale, a retired hydro employee who also ran an engineering consulting business, swallowed a cup of strawberry yogurt, savouring the sensation of taste and texture. "It was just marvellous. It was delicious," he said. Soon it was scrambled eggs, shrimp, cups of tea. He's gained five kilograms in the three years since receiving the therapy -- despite regular rounds of golf -- and jokes that for the first time in his life, he's going on a diet. "When you regain the ability to eat, it's a huge joy," he said. In fact, the students who train with Steele are forced to spend the day eating mush to get a sense of how unsatisfying it is, how it leaves you thirsty and how it affects the quality of life. We're born knowing innately how to swallow and do it like breathing, regularly and without thought. But despite millennia of practice, scientists aren't entirely sure how it works. Steele's patients tell her that while they've learned to swallow again, they're never quite the same and still must think about doing something the rest of us do very naturally. SOURCE: The London Free Press, Canada http://www.canoe.ca/NewsStand/LondonFreePress/Today/2004/03/02/367149.html * * * ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn