[Dysphagia] reflux and feeding tubes

[Heidi.Bassani at amedd.army.mil (Bassani, Heidi D Ms WRAMC-Wash DC)]

You are correct. Let me clarify...The reflux of the tube feeds is not an
SLP issue.  We recommend NPO based on the safety of their swallow given
their medical condition, prognosis, etc. not on any esophageal/GI
issues. 

________________________________

From: Drirenect@aol.com [mailto:Drirenect@aol.com] 
Sent: Tuesday, February 07, 2006 5:46 PM
To: Bassani, Heidi D Ms WRAMC-Wash DC; nando11504@hotmail.com;
pressmah@sjhmc.org; LLORTEAU@sbgh.mb.ca; dysphagia@b9.com
Subject: Re: [Dysphagia] reflux and feeding tubes


In a message dated 2/7/2006 4:41:54 PM Atlantic Standard Time,
Heidi.Bassani@amedd.army.mil writes:
 

Whether or not a patient is fed enterally is not our decision, it is
that of the family as long as they are informed about the risks,
benefits and outcome in the end.

*** Certainly - as long as they are informed that not only does it do no
good in such a condition but actually does harm. I have had families
that refused to acknowledge this, insisted on enteral feeding - and
lived to regret it. But, it is their decision. I hope that in this case,
all of the contraindications have been reported to them


Also, this is a GI issue, not an issue that should be addressed by an
SLP. 

 *** On the contrary - anyone involved in swallowing - which one
presumes was the issue that led to the enteral feeding - needs to be
aware of its dangers and contraindications. It is not a GI issue - it is
the responsibility of the attending physician in the NH. And what about
the responsibility for advocating on behalf of one's patient?

And if it is not an issue for an SLP, why are so many recommending NPO
in dysphagic patients?
 

	Whether or not a patient is fed enterally is not our decision,
it is
	that of the family as long as they are informed about the risks,
	benefits and outcome in the end. Period.
	
	Also, this is a GI issue, not an issue that should be addressed
by an
	SLP.  It's likely that this person may not take a PO diet as
many
	Alzheimer's pt's hold food in their mouth and never trigger a
swallow.
	Why is she on a feeding tube anyway?  Leave the reflux issue to
GI.