The video say I can, but "I can't eat."

[ewilkins@mustang.uwo.ca (josh wilkins)]

>Date: Wed, 19 Feb 1997 20:11:43
>To: JERCARLSON@aol.com
>From: josh wilkins <ewilkins@mustang.uwo.ca>
>Subject: Re: The video say I can, but "I can't eat."
>
>At 07:48 AM 2/19/97 -0500, you wrote:
>>History - coronary bypass surgery followed by a series of CVAs, dysphagia,
>>and placement of G-tube in September, 1996.   Mild aphasia and some cognitive
>>dysfunction but is essentially conversational and appropriate.  Also has
>>hypersensitive gag and problems with vomiting of unknown etiology.  My first
>>contact was in 12/96 and with tx, etc. has improved.  Did a VFSS on 12/12/97
>>with good results and initiated supervised feeding of one meal a day -
>>pureed.  Dentures fit poorly and are not used.
>>
>>Problem - while she has greatly anticipated eating she is reluctant to eat
>>and takes only several spoons of food and several sips of liquid and then
>>quits.  Denies anxiety, but becomes SOB and appears nervous when eating.  She
>>reports that "I can't eat after this long of a time."  Tube feedings continue
>>but are held before she is to have a meal.  
>>
>>Question - Has anybody else had trouble getting people started again on PO
>>feeding after a long time on tube feeds?  Any suggestions.
>>
>>Jerry Carlson, CCC/SLP
>>
>We saw a similar situation with a patient post CVA with a history of
Crohn's disease.  She was having enough reflux on a continuing basis to
maintain the hyperactive gag. What is happening in the esophagus and
stomach?  If the food is not moving through the system, she won't want more.
I'd like to say we got her off the tube, but we didn't get much farther than
you are now.
>
>Carol Wilkins
>
>>
>