[Dysphagia] Response

[dysphagiadude at mailcan.com (dysphagiadude@mailcan.com)]

Ms Campbell-Taylor is too modest.  In addition, she's been published in
ASHA and was invited to present at an ASHA national convention a few
years ago.  Her seminar was well recieved; I was there.  Nevertheless, I
too would buy tickets, and would also sit in the ICTTOR section.

On Sat, 5 Jun 2004 06:41:30 -0700 (PDT), "Irene Campbell-Taylor"
<eripley@yahoo.com> said:
> 
> Lisa,
> 
> I undertook to answer your message in more detail but I hardly know where
> to begin. I have been a contributing member of this list for several
> years. If you go back in the archives to my earliest messages, when my
> e-mail ID was ICTTOR, you will see just how long. Initially, I assumed
> that everyone understood that the stomach and esophagus are essential
> components of the whole functional unit of swallowing and referred to GI
> impairments as part of my responses to questions. I was savaged by many
> list members who insisted that ?We don?t need to know about the
> esophagus? and/or ?That?s not our area.?. I am glad to note that this
> attitude has changed. I can only hope that attitudes about other ?givens?
> re swallowing will also change. This hope is the only thing that keeps me
> banging my head against what seems, at times, to be not just a brick, but
> a solid concrete wall.
> 
> I fear that, in your questions, you have done what I beg people never to
> do and that is interpret what they hear or read through the filter of
> their preconceived notions. The issue of whether or not aspiration is
> harmful can never be answered by a simple ?Yes? or ?No?. As I have
> repeatedly said, it must NOT be taken in isolation but as part of a
> Combination, a mathematical construct that goes as follows:
> 
> Aspiration of what X how much X over how long a period X the patient?s
> resistance to infection, the last item being possibly, the most
> important. This gives 4! or 1x2x3x4 or 24 possible basic conditions per
> patient. Add all comorbidities, medications, age, gender etc. and it
> becomes apparent (I hope) that it is not a simple situation.
> 
> If you check messages over the past few years, you will see that I have
> not said that thickeners should NEVER be used. I have, in fact, indicated
> that I recommend thickening under certain conditions ? although not with
> commercial thickeners. I know very well that I will never be supported by
> Novartis, Mead Johnson et al for seminars or workshops. Not everyone is
> as willing to shoot the cash cow in the interest of education and patient
> care. What other reason could I possibly have for consistently drawing
> attention to what is known and published as opposed to what is believed
> and promulgated? It certainly isn?t money or prestige or popularity.
> 
> Recently, I posted a message that said that I don?t care if you thicken
> everything in sight as long as you make sure that the patient receives
> enough water. This is the important point. Patients aspirate thickened
> fluids, as has been proven, but even that, most of the time, doesn?t
> matter ? it?s the lack of water that thickeners cause that does the
> damage. I would point out here, that I have never made a statement of
> fact without backing it up with, at the very least, a reference, usually
> an abstract and sometimes an entire article. 
> 
> Your comment about my withholding information continues to baffle me. I
> have met some members of your list of ?experts? at conferences such as
> ASHA, DRS etc. They expressed to me amazement that I give away so much
> information for free, and that they never would.
> 
> You know nothing about me, my background, education or experience. Those
> members of this list who have read my C.V. will, I believe, agree that it
> is unusually broad in scope. I hold five degrees, in related fields and
> my publications are, almost exclusively, in medical journals such as the
> Journal of the American Geriatrics Society, Annals of Neurology, NEJM
> etc. as well as Dysphagia.
> 
> In 1987, I together with a medical colleague, published the first article
> (as far as I know) that said one should not use tube feeding in
> terminally ill elderly patients but continue with ?careful spoon
> feeding.? I was savaged for that one as well. Recently, Finucane et al,
> published an article saying exactly the same thing, although they did not
> have the grace to cite me, but did use the above phrase as well as some
> others contained in the 1987 article. I live in hope that there will be a
> paradigm shift in swallowing disorders of the same magnitude.
> 
> I would be more than pleased to debate any or all of your panel of
> ?experts?, singly or collectively, in public on any issue of their
> choosing, at any time and in any place. I think you could sell tickets
> for that one.
> 
> In the meantime, please re-read my various messages with an open mind and
> see what I have actually said, not what the perception is.
> 
> Sincerely,
> 
> Irene Campbell-Taylor.
> 
> 
> 
> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com
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