sharing of the dysphagia info

21 Nov

It begins.

I attended a butt-ton of presentations on swallowing. I won’t tell you every gory detail on everything I heard, but I will give you a little peek-see at each presentation’s take away message.

I attended the following:

Assessment and Management of Swallowing in Patients with ALS

Cultural Competence and Dysphagia: Improving Quality of Life

A Group Approach to Pediatric Feeding

Swallowing Neurophysiology from Reflex to Volition

Trach Babies and Trach Vent Babies

Effects on Bolus Variation

Treatment choices for the Dysphagic Patient

(Yeah, my brain is tired. Thanks for asking.)

I’ll just start at the beginning. The first presentation on ALS and dysphagia wasn’t really specific to ALS, so that was kind of nice. The presentations that were very specific to one thing or another tended to be a bit much, a little over my head. Anyway, so this presentation gave a brief look at ALS, the epidemiology, incidence, signs and symptoms, effects on swallow etc. It then delved into assessment and treatment. I really enjoyed hearing the speakers’, Kimberly Winter and Jennifer Chapin, opinions regarding aspiration. They base their opinion off the Logemann, 1998 research on aspiration which showed that 38% of known aspirators in their (huge) study developed aspiration pneumonia. 27% of the 38% were NPO.I think as a group, when SLPs see aspiration on an MBS we flip out, everyone is gasping and covering their mouths and shaking their heads. Winter and Chapin were just saying, “Hey ya’ll, chill out!”Katie and I went to a presentation by Delphine Herrmann and Svetlana Piliavsky (who are just so adorable I wanted to hug them both) on culture and dysphagia. It really just made me think. We all know to respect culture and get to know our patients. But their suggestions really showed me how above-and-beyond we can go to make sure our patients have the best quality of life possible when dealing with modified diets. They want us to consider the implications of just providing a client with a name of a food. Find out what that food might be called in their culture, like hummus instead of pureed peas. They encouraged us to try to modify foods that would be normal for them, and to consider temperature, texture, eating rituals, and so forth.

Elizabeth Baird and Wyndi Capeci gave a presentation on group feeding for peds with eating and feeding difficulty. They have a protocol in place (art time, sensory time, oral alerting, snack time) which helps children build up to eating new foods. They really encouraged a “stress free, no rules” eating routine and wanted to make sure parents as well as children get a good grasp on the new routine. They based their protocol of the Social Learning Theory and they said they have a lot of success. I could see why – their program was very systematic, well thought out, and organized. Me gusta.

Ianessa Humbert and another woman whose name is not on the schedule, gave AN AWESOME lecture on neurophysiology of swallowing. I in no way could wrap it up here, but trust me when I say it totally blew my mind. They had such a lovely ease during their presentation and though I could tell they both had IQs of about 1,000 – they made the material manageable and understandable. Love, love, love.

Trach babies and trach vent babies. The presenter, Suzanne Abraham, had WAY more info than could possibly be covered in an hour. She really needed a short course spot. Dear ASHA, give Suzanna Abraham a short course spot. Love, Sam. But seriously, we barely even got to delve into what she had to say. A fountain of knowledge that lady is. She had a ton of videos and just, wow. She wanted to go over four levels of trach assessment and care and I think we got halfway into level one.

Bonnie Martin-Harris oversaw a presentation given by a Ph.D. student, on the Effects of Bolus Variables on Physiologic Components of Swallowing Impairment. So, so interesting and slightly over my head. Their takeaway message was basically that there NEEDS to standardization of swallowing assessment protocol and rating. They stated that the MBSImP was a reliable and valid observational rating tool to use during swallowing assessment, and that during MBS all SLPs should start with a thin liquid because that is where you’ll see the most impairment. They said not to just stop there though, that all viscosities are important to the MBS. I really wish their PPT was online because I would love to review it and try to make more sense of it. Half an hour was not enough.

And last but not least, I attended (and sort of got peer pressured into) the Jeri Logemann, Mary J. Bacon, Amy Kelly, Bernice Klaben, Annette May, Mario Landera, and Linda Stachowiak lecture on Treatment Choices for the Dysphagic Patient: The Problem and Setting. It was advanced level, so I should have known better. But we just wanted to see Dr. Logemann in real life! Basically each presenter showed a case study and talked about their treatment choices and the outcomes for each case. Most of the cases had some kind of oral-head-neck cancer. I tried to take down general notes that I could use, but for the most part the cases were much too specific for me. I’m glad I went but I could have found something more applicable to a graduate student.

Excuse me Dr. Logemann, I mustache you a question

There you have it – a quick and dirty look at each dysphagia presentation I went to! Next I’ll talk about some TBI presentations I attended. I went to 17 presentations overall, so I have a lot to say!

NP: Joe Purdy – Can’t Get It Right Today

PS – slowdog wrote a great post on what he learned at a short course about physiology of swallowing at ASHAsphere. Check it out.

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