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[Dysphagia] RE: Dysphagia Digest, Vol 18, Issue 11


  • Subject: [Dysphagia] RE: Dysphagia Digest, Vol 18, Issue 11
  • From: Janet.finger at kindredhealthcare.com (Janet.finger@kindredhealthcare.com)
  • Date: Wed May 18 12:08:26 2005

Absolutely get your point. I tend to get caught up in the population I work with. Most of them were trached because of respiratory issues, & the vast majority have no "oral motor" deficits (as I would define that in my mind), no dysarthria, no apraxia of speech, no difficulty chewing at all, no difficulty with bolus propulsion through the oral cavity, etc. They have more of an isolated problem with tongue base retraction, hyolaryngeal elevation, laryngeal closure, &/or airway closure, etc.... So in my mind there is a big distinction between their oral & pharyngeal skills. So I usually focus on more of the "pharyngeal" exercises rather than "oral" exercises such as sticking out their tongue, swab manipulation, etc. I think in a more neuro population there is usually less of a difference in these skills? Just my thoughts. I do, definitely, treat "oral" problems when I see them by the way.

Thanks for the RESPECTFUL discussion as many on this listserv can not disagree without implying that the other person is an ignorant idiot.   :)



-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
Behalf Of robert newman
Sent: Tuesday, May 17, 2005 6:56 PM
To: dysphagia@b9.com
Subject: [Dysphagia] RE: Dysphagia Digest, Vol 18, Issue 11


Seldom do I see a separation between oral and pharyngeal phases of the
swallow. In other words, dysphagia in only the oral or only the pharyngeal
phases of the swallow. I do work in acute care so our pts are weak and often
very acutely ill.  It's also very difficult for me to agree that the tongue
base is not considered part of the oral phase of the swallow. The whole
tongue is the connection between the oral and pharyngeal phases. So, I
RESPECTFULLY disagree with the previous email separating the oral exercises
from tongue base exercises/stim.  Our alimentary system is a system of
connected phases and I feel, after many years of treating dysphagia, that
the muscles of the tongue should be one of the primary targets of our
therapy. I mean the whole tongue.  Especially if the dysphagia is considered
an oral-pharyngeal dysphagia. It makes me think of the ole bone song, you
know the one, the leg bone is connected to the hip bone... Well, that could
be translated to the genioglossus is connected to the hyoglossus etc, etc
etc, until we are connecting to the the hyoid bone, epiglottis, and
pharyngeal muscles.  I know, a little corny, but hopefully, you get my
point.   By the way, I love the Masako technique. I agree that it is a great
exercise.

As always, thanks for the thought provoking dialogue.

Kelly L. Newman, CCC-SLP
Columbus, Ohio


-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of dysphagia-request@b9.com
Sent: Tuesday, May 17, 2005 2:01 PM
To: dysphagia@b9.com
Subject: Dysphagia Digest, Vol 18, Issue 11

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Today's Topics:

   1. Re: RE: Food Holding (kathleen wright)
   2. Where's Irene? (sorriso@adelphia.net)
   3. Help finding a SLP (Morgan Jennie (RXP) Speech & Language Therapy)
   4. Re: Help finding a SLP (ERIKA KAYE)
   5. ng tubes affecting swallowing (Amy Colin)
   6. Base of tongue exercise (Sandi Lancaster)
   7. RE: Base of tongue exercise (Janet.finger@kindredhealthcare.com)
   8. SLP Position Vacancy (Sanders, Liza)


----------------------------------------------------------------------

Message: 1
Date: Mon, 16 May 2005 15:23:53 -0400
From: "kathleen wright" <hillivie423@adelphia.net>
Subject: Re: [Dysphagia] RE: Food Holding
To: "Walsh, Linda" <LiWalsh@serha.ca>, <dysphagia@b9.com>
Message-ID: <004101c55a4c$cd87f1a0$79acaa44@DD34HY41>
Content-Type: text/plain; format=flowed; charset="iso-8859-1";
	reply-type=original

The MBS he had this afternoon demonstrated no physiological reasons for the
changes in his eating skills.  He is scheduled for a dementia screening.  I
plan to try the good suggestions I have received from everyone, and will
keep you posted on what works with him.
Thank you all for your kind responses.
----- Original Message -----
From: "Walsh, Linda" <LiWalsh@serha.ca>
To: <dysphagia@b9.com>
Sent: Monday, May 16, 2005 8:37 AM
Subject: [Dysphagia] RE: Food Holding


> hillivie423 wrote:
> "Does anyone have any suggestions to support a 72 year old gentleman who
> has profound mental retardation...He has recently shown some changes
> that might suggest a dementia"
> KHouts wrote:
> "The first thing that crosses my mind is to talk to a Dr. & look for
> reversible possibilities that caused his decline, ie dehydration,
> electrolyte imbalance, low grade infections or heaven forbid Normal
> Pressure Hydrocephalus."
>
> I would also wonder if he has had a CVA that may have affected
> feeding/swallowing as well as other functions.  If so, a MBS would be
> useful
> in ruling out pharyngeal problems before trying postures/techniques that
> may
> icrease risk of aspiration.
>
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>




------------------------------

Message: 2
Date: Mon, 16 May 2005 21:09:43 -0400
From: <sorriso@adelphia.net>
Subject: [Dysphagia] Where's Irene?
To: dysphagia listserv <dysphagia@b9.com>
Message-ID:
	<19362746.1116292183273.JavaMail.root@web2.mail.adelphia.net>
Content-Type: text/plain; charset=utf-8

I've done this twice before in the past, here I go again...

I've noticed no responses from Irene Campbell-Taylor for at least a month.
Irene, are you there?

Linda A. Zanchi, MA CCC-SLP


------------------------------

Message: 3
Date: Tue, 17 May 2005 09:50:52 +0100
From: "Morgan Jennie \(RXP\) Speech & Language Therapy"
	<Jennie.Morgan@cddah.nhs.uk>
Subject: [Dysphagia] Help finding a SLP
To: "dysphagia listserv" <dysphagia@b9.com>
Message-ID:
	<7AC1D487490A924B99B34E671C61B26C68A0E8@UHND_EX.xcddahn.nhs.uk>
Content-Type: text/plain;	charset="utf-8"

Dear all,

I'm hoping that someone may be able to help. We've recently had a patient
admitted to University Hospital of North Durham (UK) who had a stroke whilst
on holiday in Florida. His wife reports that he was being treated at
'Engelwood Community Hospital', possibly by 'Les'. Does anyone on the list
work there or know how to contact someone who does work there. It would be
really useful to have some background on this patient as very little
specific to his swallowing and communication came with him, other that the
fact that he had a PEG inserted within 8 days of his stroke.

Thank you in advance.

Jennie

Jennie Morgan (Mrs)
Specialist Speech and Language Therapist

Department of Speech and Language Therapy
University Hospital of North Durham
North Road
Durham
DH1 5TW
Tel/Fax: 0191 3332608
Email: jennie.morgan@cddah.nhs.uk



------------------------------

Message: 4
Date: Tue, 17 May 2005 08:46:54 -0400
From: "ERIKA KAYE" <ekaye@wakemed.org>
Subject: Re: [Dysphagia] Help finding a SLP
To: dysphagia@b9.com, Jennie.Morgan@cddah.nhs.uk
Message-ID: <s289af9e.018@wmc008.wakemed.org>
Content-Type: text/plain; charset=us-ascii

A quick Google search found this:
Englewood Community Hospital
700 Medical Blvd.
Englewood,  FL  34223
Telephone: (941) 475-6571
www.englewoodcommhospital.com

Good luck in your search!
Erika

>>> "Morgan Jennie (RXP) Speech & Language Therapy"
<Jennie.Morgan@cddah.nhs.uk> 05/17/05 4:50 AM >>>
Dear all,

I'm hoping that someone may be able to help. We've recently had a patient
admitted to University Hospital of North Durham (UK) who had a stroke whilst
on holiday in Florida. His wife reports that he was being treated at
'Engelwood Community Hospital', possibly by 'Les'. Does anyone on the list
work there or know how to contact someone who does work there. It would be
really useful to have some background on this patient as very little
specific to his swallowing and communication came with him, other that the
fact that he had a PEG inserted within 8 days of his stroke.

Thank you in advance.

Jennie

Jennie Morgan (Mrs)
Specialist Speech and Language Therapist

Department of Speech and Language Therapy
University Hospital of North Durham
North Road
Durham
DH1 5TW
Tel/Fax: 0191 3332608
Email: jennie.morgan@cddah.nhs.uk

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------------------------------

Message: 5
Date: Tue, 17 May 2005 10:09:50 -0400
From: "Amy Colin" <colin@email.chop.edu>
Subject: [Dysphagia] ng tubes affecting swallowing
To: <Dysphagia@b9.com>
Message-ID: <s289c2f8.096@email.chop.edu>
Content-Type: text/plain; charset=US-ASCII

I was wondering if anyone knew of any research concerning the effects of
ng tubes on swallowing especially in the infant and pediatric
population?  Also, what are your thoughts on removing vs keeping the ng
in place during MBSS?

Thanks,
Amy Colin
Children's Hospital of Philadelphia


------------------------------

Message: 6
Date: Tue, 17 May 2005 08:43:56 -0700 (PDT)
From: Sandi Lancaster <swlslp@yahoo.com>
Subject: [Dysphagia] Base of tongue exercise
To: dysphagia listserve <dysphagia@b9.com>
Message-ID: <20050517154356.72461.qmail@web60024.mail.yahoo.com>
Content-Type: text/plain; charset=us-ascii

Hi all,

Just curious what (if any) exercises people have had
the most success with for improving base of tongue
retraction...?  (e.g. for patients with residue in the
vallecula post-swallow)

(I know, initiating any discussion of oral motor
exercise is always like opening a can of worms...)  :)


Thanks in advance for any responses.

-Sandi

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

__________________________________________________
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------------------------------

Message: 7
Date: Tue, 17 May 2005 13:15:17 -0400
From: <Janet.finger@kindredhealthcare.com>
Subject: RE: [Dysphagia] Base of tongue exercise
To: <dysphagia@b9.com>
Message-ID:
	<C1BB8AADB10E5749B7409C82DD18A1363F8210@VAEXMB08.prod.ishealth.net>
Content-Type: text/plain;	charset="iso-8859-1"



It's not really initiating a discussion of oral motor exercises. The base of
tongue is pharyngeal - not oral. There are several exercises. My favorite
two are effortful swallows (which really improve overall pharyngeal
musculature but tongue base retraction in particular) and masako swallows
(which improve posterior pharyngeal wall movement to help compensate for
poor tongue base retraction). Both are relatively easier for pts to complete
& I think you get the most bang for your buck with them.



-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
Behalf Of Sandi Lancaster
Sent: Tuesday, May 17, 2005 9:44 AM
To: dysphagia listserve
Subject: [Dysphagia] Base of tongue exercise


Hi all,

Just curious what (if any) exercises people have had
the most success with for improving base of tongue
retraction...?  (e.g. for patients with residue in the
vallecula post-swallow)

(I know, initiating any discussion of oral motor
exercise is always like opening a can of worms...)  :)


Thanks in advance for any responses.

-Sandi

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

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------------------------------

Message: 8
Date: Tue, 17 May 2005 13:43:36 -0400
From: "Sanders, Liza" <liza.sanders@cvtc.dmhmrsas.virginia.gov>
Subject: [Dysphagia] SLP Position Vacancy
To: "'dysphagia@b9.com'" <dysphagia@b9.com>
Cc: "Blob, Burk" <burk.blob@cvtc.dmhmrsas.virginia.gov>, "Bradley,
	Mark" <mark.bradley@cvtc.dmhmrsas.virginia.gov>
Message-ID: <13CDCA7DC43ED311809400902762830B01E342C8@CVTC03>
Content-Type: text/plain;	charset="iso-8859-1"

SLP Vacancy at Central Virginia Training Center in Lynchburg, Virginia

Our residential facility for persons with mental retardation offers the
opportunity for professional growth and creativity.  Increase your dysphagia
skills on a trans-disciplinary nutritional management team.  Use on-site MBS
services geared to our clients' needs.  Provide creative AAC solutions with
a low therapy caseload.  We strongly support continued training and
development of our staff.

Requirements include a Master's Degree in Speech-Language Pathology and
licensure in SLP from the Va Department of Health Professions/Board of
Examiners for Audiology and Speech-Language Pathology.  Full time.
Comprehensive Virginia state benefits.  CF's are welcome at no reduction in
pay.

For more information on Central Virginia Training Center go to:
www.cvtc.dmhmrsas.virginia.gov <http://www.cvtc.dmhmrsas.virginia.gov>
For more information on position availability, go to:
http://www1.dhrm.state.va.us/RECRUIT/JobDetail.aspx?JID=431170
<http://www1.dhrm.state.va.us/RECRUIT/JobDetail.aspx?JID=431170>
Email Contacts:  Liza Sanders, SLP Director at:
Liza.Sanders@cvtc.dmhmrsas.virginia.gov
<mailto:Liza.Sanders@cvtc.dmhmrsas.virginia.gov>
         or Mark Bradley, Employment Supervisor at:
Mark.Bradley@cvtc.dmhmrsas.virginia.gov
<mailto:Mark.Bradley@cvtc.dmhmrsas.virginia.gov>



------------------------------

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End of Dysphagia Digest, Vol 18, Issue 11
*****************************************

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