June is National Dysphagia Awareness Month and an excellent opportunity to raise awareness about what dysphagia is, its symptoms, causes, available treatments, and the roles of the various professionals who can help those with dysphagia.
Dysphagia (swallowing difficulty) is a serious medical condition that affects between 300,000 and 700,000 individuals in the United States each year. Although 1 in 6 adults report experiencing dysphagia, only 50% had discussed their difficulty with a clinician (Adkins et al, 2019). It is likely that you or someone you know will experience dysphagia.
Common signs and symptoms of dysphagia in adults include, but are not limited to: unintentional weight loss, coughing during or after meals, recurrent lung infections, liquid/food coming out of nose/mouth, liquid/food coming back up into mouth or throat after its been swallowed (regurgitation), avoiding foods once enjoyed, and feeling of food remaining “stuck”.
In some instances, a medical problem such as head and neck cancer treatment or a stroke, may result in swallowing difficulties severe enough to warrant placement of a feeding tube, with the hopes of returning to an oral diet once further recovery has occurred.
When a patient has recovered from their illness or cancer treatments, they may feel ready to resume eating and drinking again. But the return to an oral diet, for some, may be more difficult than they expected. In the case of head-neck cancer, changes in taste and changes to the anatomy can make swallowing difficult or even dangerous with food being aspirated (entering the airway). Following a stroke, neurological innervation of muscles may be altered, and the swallowing muscles may have atrophied due to disuse.
In addition, since nutrition is being provided directly to the stomach via the feeding tube, the normal drive for hunger is diminished and safely eating or drinking a sufficient amount of calories can be for some, an arduous task.
Intensive Exercise Helps Some Regain Swallowing
Over the last 20 years, dysphagia therapists and researchers have developed a growing interest in the role of intensive exercise for the muscles of swallowing, and a few evidence-based treatment programs have emerged. One such program is the McNeill Dysphagia Treatment Program (MDTP), named after a head-neck cancer patient who successfully returned to eating after many months with a feeding tube. MDTP follows the principles of muscle rehabilitation and is an intervention program designed to improve muscle performance and functional recovery of swallowing.
Dysphagia treatment should always be preceded by an instrumental assessment of swallowing allowing the speech pathologist who is treating the patient the opportunity to visualize swallowing physiology and identify targets for treatment.
Not every patient with a feeding tube is a candidate for MDTP, such as individuals with a feeding tube due to dementia or a progressive neurological disease diagnosis. Presently, the program has only been implemented successfully with adults and a few adolescents.
If you have a feeding tube and are interested in exploring the possibility of resuming an oral diet, discuss dysphagia treatment with your physician and request a referral to a qualified speech-language pathologist certified in offering MDTP. If you live in Charlotte County, MDTP is available through Voice Aerobics.
To locate an MDTP provider in your area, visit: https://fdi2.com/
National Foundation of Swallowing Disorders (NFOSD)
NFOSD is a grassroots organization whose purpose is to provide patient hope and improve quality of life for those suffering from all types of swallowing disorders, by enhancing direct patient support, education, research and raising public, professional, and governmental awareness. NFOSD provides numerous resources, including online support groups for pediatric and adult patients with dysphagia as well as webinars. Please visit their website to learn more.http://swallowingdisorderfoundation.com/
Be of Service to Others: lessons from my father
From time to time in a blog post I have talked about my father. I have shared with readers that in his later life, he lived with the symptoms of Parkinsonism. His physical symptoms were a challenge for him and my family, and even though he spent much of his life doing favors for other people, he hated asking for help as his own physical abilities declined. He died in 2001 at the age of 83, having retired just three years earlier as Mayor of the Village of North Randall, Ohio, an elected position he served in for 42years.
My father loved helping other people. My mother thought that at times he was too generous and allowed people to take advantage of him. That may have been true, but I don’t think my father ever saw it that way. He just treated people the way he wanted to be treated, and felt everyone needed a chance.
My father wasn’t driven too much by making alot of money, and when I realized that I had chosen two professions, nursing and speech-language pathology, that would not earn me huge salaries, I would complain to my father, asking: ” why didn’t you encourage me to go into business?” His answer was always the same: “Mary,” he’d ask: “do you love what you do?” “Well, yes” I would say. “then that’s all that matters,” he would respond.
I miss my dad. The smell of his cologne, His hugs, But most of all, his voice on the other end of the phone. If you’re a dad, Happy Father’s Day. Call your children. Use your loud “AHH” voice, and tell them you love them!
My MissionTo enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice
Hi, Rob, first would be to discuss with your physician. If you or they suspect a swallowing disorder, then referral to a speech-language pathologist with experience in dysphagia would be the next step. An instrumental swallowing assessment can help to view the physiology and determine if additional treatment or referral to other specialist is recommended.
Wow, this describes my condition for the last few months. At first I thought these discrepancies were just a sore throat. Thank you for your help. Is there some literature or can you refer to someone for treatment.
Peggy, thank you so much for your email. And, yes, you are right. My dad did, by example, teach us how to treat other people.And, yes, we were lucky!
Mary, I LOVED your Fthers FbdY post about your Dad. He sounds a lot like my father! We used to say that if you asked Daddy for
His shirt he would give you
his vest as well! He took Christ’s commandments more seriously than most, as did your Dad. They showed us – by example – how to treat others. How blessed we have been!