[Dysphagia] Topics

[Namp304 at aol.com (Namp304 at aol.com)]

In a message dated 10/4/2007 9:51:56 AM Central Standard Time,  
eripley at yahoo.com writes:


2.    Videoflouroscopy is not necessary. It is nothing  like a meal.

3.    VFSS may be necessary under certain  conditions (See ASHA position 
paper.) It is not remotely like a meal so that  the use of food indicates nothing 
about the patient?s ability to eat that food  as part of his/her diet.



Are we sure it's "nothing?"  For example, not infrequently, I  encounter a 
patient for whom a pudding bolus (specifically Varibar) clears the  pharynx much 
better than the partially masticated cracker spread with a  small amt. 
Varibar pudding  for contrast.  I have had  individuals with whom a piece of the 
cracker can be visualized clinging to  the tip of epiglottis or lodged in the 
vallecullae and requiring much greater  effort during swallow and cueing to more 
thoroughly masticate, mix with saliva,  than the pudding.  I feel that does 
tell me something about  varying levels of safety with the diet.  If the 
individual doesn't  efficiently clear that bit of cracker, surely this represents a 
higher risk  with solid vs. pudding/pureed?   



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