[Dysphagia] while we're on the topic of gag reflex...

[ajbennett05 at yahoo.com (Jonathan Bennett)]

Since we're on the topic of gag reflex, 
  I have a quick question for everyone.  
  Just today I was consulted on a patient 
  in ICU who has been NPO for about 8 
  days now.  She enterted the hospital 
  with urosepsis secondary to liver failure
   from alcoholism.  She also has encephalopathy
   (big suprise).  Since entering the hospital, 
  they found that she no longer has a gag reflex 
  (I don't know how they know she had one 
  before...) and they've had her on an NG tube, 
  which she pulled herself yesterday.  Now she
   is on TPN.  They consulted me for a dysphagia 
  eval and after I did it, I told the nurse that I 
  thinks she would be fine to start giving small 
  trials puree foods.  Well, the nurse looked at 
  me like I just told her she had4 heads and 
  said, "you do know that she has absolutely 
  no gag reflex, right?).  I'm thinking to myself, 
  why in the world did I get consulted if you don't 
  want her to eat anyway??  
   
  I did just look at those articles just posted by 
  the last person about the gag.  Does anyone 
  else have any good information to give me 
  regarding this issue or about what I could 
  say to the nurse/doctor?  Am I totally off
   basis here??

 		
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