 |
 |
This is an excellent article, but it omits a fairly recent advance in therapy for swallowing problems. I refer to an electrical device known as VitalStim, which involves placing two electrodes at the sides of the throat and administering low-voltage pulses, either during or independent of eating. It has been very effective with my wife, and the speech therapists who are trained in its use say if has been a major advance over other therapies. -Ken On Tue, Nov 17, 2009 at 7:36 PM, rayilynlee <[log in to unmask]> wrote: > Physician Focus: There's help for swallowing problems > > By Danielle Morgan-Stevenson > GateHouse News Service > Posted Nov 17, 2009 @ 01:12 PM > > The term "swallowing problem" covers many symptoms. More accurately known > as "dysphagia," speech language pathologists (aka speech therapists) are > involved in the assessment and treatment of swallowing problems, often in > collaboration with other medical specialists. > But how can one tell if someone has dysphagia? > > A speech therapist will evaluate the problem in terms of three stages > involved in eating and drinking. These are 1) the oral preparatory stage > when the food or drink is being prepared in the mouth for swallowing, 2) the > oral stage, when the food or drink moves back in the mouth to be swallowed, > and 3) the pharyngeal stage, the sequence of actions that move the food or > drink from the back of the mouth to the esophagus. > There is a fourth stage, the esophageal stage, which takes the food or > drink to the stomach. Problems occurring in this stage require medical > intervention with a specialist such as a gastroenterologist or other doctor. > > With an appropriate exam and testing, an ST can decide if your symptom(s) > in one or more of the first three stages are abnormal, based upon knowledge > of normal function and timing. The ST's primary concerns are two-fold: to > change or manage the symptoms to ensure your safety and adequate hydration > and nutrition. > > Dysphagia can occur at any age with many possible causes. Typically this > can be due to physical changes or diseases in the nervous system, or in an > underdeveloped nervous system in the case of a baby or young child. It may > also occur in the anatomy of the head and neck, following reconstructive > surgery for cancer. It may be temporary, although intervention remains > necessary, or it may be long term. > > Therapy is entirely customized as there is not a one-size-fits-all > treatment. Therapy is based upon accurate diagnosis of your symptoms with > the most appropriate management for that combination of symptoms. > > Often this treatment employs altering food (or liquid) consistency > appropriately, using exercises for the mouth and throat, and small postural > changes during meal times to alter the anatomy and function during > swallowing. The therapist must take into account the person's lifestyle and > preferences as eating are an important part or our emotional and social > selves. > > The signs given below could indicate a dysphagia assessment might be > helpful. A single symptom may exist or there could be a few symptoms. > Consider these if you know someone who might have a swallowing problem: > > - Most obviously, the person may describe a sensation during eating or > swallowing. They might say things like, "I can't get it back, it takes ages > to chew, the food gets stuck, I need to clear my throat." It is worth noting > there is not always a sensation even when there is a problem. > > This is particularly true in people with neurological problems, such as a > stroke, Parkinson's disease, or multiple sclerosis. > > - Sometimes coughing or choking during meals or snacks (food or drink). > Again, this is not always present. > - Speech changes or maybe slight slurring. > - Voice changes. They may sound hoarse or gravelly, or weak and quiet, or > "wet" or nasal. > - Does it take a long time for them to eat a meal (45 minutes or more for > just eating/drinking time)? > - Congestion as the day progresses, especially in the evening. > - Losing weight, although they are not on a diet. > - Avoiding some foods or drinks because they anticipate a problem. > - Recent medical or surgical event. > - Difficulty with swallowing saliva. May drool at times. > - Swallowing a few times to get something down. > - New difficulty swallowing pills. > II you notice one or more of these symptoms, a swallowing evaluation with a > speech therapist could be helpful. Remember, most swallowing problems can be > helped. > > Danielle Morgan-Stevenson is a speech pathologist with the Spaulding > Outpatient Clinic in Framingham, Mass. Her specialty is dysphagia and > disorders of cognition and communication with neurologically impaired > people, as well as speech and language disorders in preschool children. > Rayilyn Brown > Director AZNPF > Arizona Chapter National Parkinson Foundation > [log in to unmask] > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto: > [log in to unmask] > In the body of the message put: signoff parkinsn > -- ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn