[DYSPHAGIA] oral dysphagia/e-stim/o-m ex

[tspringer@madonna.org (Teresa Springer)]

Thanks for all who responded.  It was all very useful information in making
my case with the referring SLP and the parents of the 14 y-o TBI in
question.  By the way, he is progressing nicely.  A FEES yesterday revealed
a mild pharyngeal delay, but especially notable-no oral/facial
weakness/paralysis.  Rules out the need for e-stim-huh?  Thanks, Teresa  

-----Original Message-----
From: abbritten@attglobal.net [mailto:abbritten@attglobal.net]
Sent: Monday, November 12, 2001 8:43 PM
To: Teresa Springer
Subject: Re: [DYSPHAGIA] oral dyspagia/e-stin/o-m ex


Although I am not certified to provide e-stim, it is my understanding that
the purpose of the procedure is to improve labial function in order to
improve functional articulation skills and/or to improve the oral
preparation phase of the swallow (e.g. improving labial seal to prevent
leakage).
Personally, I would ask whoever made this recommendation why e-stim is being
recommended for the patient at a Rancho Level 2 (considering the above
recommended uses).  If the patient is unable to actively participate in
therapy (unable to follow directions, or understand why the procedure is
being performed), what outcome is expected by using e-stim?  How can you
assess the extent of the labial impairment if the patient cannot participate
in an oral-motor examination?
It may also be helpful to review the information you received during
training on the uses for e-stim, and bring the training manual when you
discuss this with the person who made the recommendations (to ensure you are
able to address any questions that person may have regarding "scope of
practice" for which this device should be used).   I don't know if this is
of any help, but it may be one way to create justification if you do not
feel this is the appropriate  treatment technique.

-----Original Message-----
From: Teresa Springer <tspringer@madonna.org>
To: 'dysphagia@medonline.com' <dysphagia@medonline.com>
Date: Monday, November 12, 2001 3:24 PM
Subject: RE: [DYSPHAGIA] oral dyspagia/e-stin/o-m ex


>I just received a transfer recommendation on a TBI patient-Rancho level 2
>Generalized Response)for facial e-stim to be conducted 2/daily. Can anyone
>explain the basis of this?  It seems a bit inhumane to me...
>
>-----Original Message-----
>From: Kate Farabaugh [mailto:Kate.Farabaugh@BannerHealth.com]
>Sent: Monday, November 12, 2001 10:34 AM
>To: dysphagia@medonline.com; drjeff6@yahoo.com
>Subject: Re: [DYSPHAGIA] oral dyspagia/e-stin/o-m ex
>
>
>It is my understanding that the stand on electrical stim from old research
>is don't do it as it doesn't work, this from our PT peers. Thus I would not
>want to encorporate estim in this person's treatment......
>
>Kate Farabaugh, MA, CCC-SLP
>Pediatric Rehab Manager
>970.350.6155
>kate.farabaugh@bannerhealth.com
>
>>>> Jeff Lewis <drjeff6@yahoo.com> 11/10/01 02:26PM >>>
>Dear Ron:
>
>I've seen functional return range from complete recovery to nil.
>Electrical and thermal stim, or any other modality that has the
>potential to keep muscle mass/strength as good as possible while medical
>treatments and/or time facilitate recovery, on a  purely logical level,
>make sense.
>
>Sincerely,
>Jeff
>
>
>
>
>  _____
>
>Do You Yahoo!?
>Find a job, post your resume on Yahoo! Careers
><http://careers.yahoo.com/?clink=foot-fp> .
>
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