[Dysphagia] MBS issues

[swlslp at yahoo.com (Sandi Lancaster)]

One final comment:  believe it or not, many of my frustrating MBS involve very experienced clinicians!  This particular clinician has been practicing for years.  I do try to accompany a pt when I can, but unfortunately sometimes I cannot make it.
 
Thanks for everyone's feedback...
 
-Sandi

Francesca Swift <FrancescaSwift@hmh.westsound.net> wrote:
It sounds like a clinician with limited experience. Is there any way
you could go and observe and provide input on what you're looking for
and why and do some education when you are there. It can only help
everybody in our field to take the opportunity educate others/each
other as much as we can. It can be done in a really nice, informative
way and they would probably be really appreciative.

Francesca Swift, MA/CCC, SLP



>>> "Neubert, Rebecca R *HS" 8/31/2004
5:44:07 AM >>>
Call the facility who is doing the outpatient MBS and talk to the SLP
who will be doing the study. Those of us who do these outpatient MBSs
appreciate it greatly and you'll get the information you want. A phone
call where it can be discussed is more helpful than sending written
information with the patient which we may or may not get. If you're
already doing that and your requests are being ignored, then maybe you
could send them to a different place for the MBSs? (If that's an
option.)

-----Original Message----- 
From: dysphagia-bounces@b9.com on behalf of Sandi Lancaster 
Sent: Mon 8/30/2004 5:56 PM 
To: dysphagia listserve 
Cc: 
Subject: [Dysphagia] MBS issues



Hi all,

I'm looking for feedback on an issue I have encountered
occasionally regarding MBS exams. I am an outpatient SLP and I
sometimes refer dysphagia pts for an MBS to provide further info re:
pharyngeal swallow, for treatment planning. Unfortunately, sometimes
what we get back is far from helpful! 

One problem we encounter is when the emphasis of the report is
just on the presence or absence of aspiration, with limited or no info
on what is happening physiologically with the swallow. I am often
looking for info on pharyngeal dysfunction so I can plan pharyngeal
exercises accordingly, but when the emphasis is on aspiration alone, I
don't get the info I need!

Another issue we encounter sometimes is when no compensatory
strategies are trialed during the exam - or, maybe chin tuck will be the
one token strategy trialed! 

A third issue we sometimes encounter is when background info is
ignored and the clinician performing the MBS assumes that the
performance during the MBS is representative of real-life at all times!


I recently referred a pt for an MBS and provided background info
to the SLP performing it, explaining that the pt. has intermittent
episodes of distress with thin liquids and has recurrent chest
congestion. Well, when I got the report, the report indicated that
there was no penetration or aspiration on the MBS, no presence of
dysphagia, and no therapy needed at this time. I am planning to
continue therapy w/ this pt because he does have episodes of distress,
but now I am in the position of having to explain to his family why he
still needs dysphagia therapy when the x-ray supposedly "proved" that he
did not.

Before I start to sound like a big complainer, I should also say
that I have also at times gotten some great info from some MBS exams. 
Sometimes they can be very helpful. But I am experiencing unhelpful MBS
exams often enough that sometimes I am less likely to recommend an MBS
at times when they really could be helpful! I am wondering if other
SLPs experience these types of situations at times, and I am welcoming
any suggestions on how to make it better! I try to collaborate with
other SLPs whenever possible and I always provide background info when I
can, along with any specific questions I would like answered. But yet
these concerns continue at times...any thoughts?

-Sandi


Sandi Lancaster, M.A. CCC-SLP
Speech-Language Pathologist
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Sandi Lancaster, M.A. CCC-SLP
Speech-Language Pathologist
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