November 2008 newsletter

2004-2008 DYSPHAGIA TIDBIT Booklet  – This is the second edition.  I wrote the first Dysphagia Tidbit booklet in 2003.  This booklet is a combination of all the Dysphagia Tidbits in our monthly newsletters combined into 1 location.  I had a lot of positive feedback on the first one, which included information provided in newsletters from 1998-2003.  Ask for your 2004-2008 Dysphagia Tidbit booklet mid November!  Just a small token of THANKS for all your support through the years!
 

The 2009 DiagnosTEX Dysphagia Calendar will be available next month! 
 

JUST THE FACTS! Did You Know????????????????????????????????????????????

• ALS affects 30,000 people in the USA.  5,600 new cases are diagnosed annually.
  
• Dysphagia occurs in up to 50% of patients after chemotherapy.
  
• More than 700,000 strokes occur in the USA every year. They cause more serious long-term disabilities than any other disease.
  

DiagnosTEX scheduled timesThe nature of the “mobile” business requires flexibility.  Flexibility on our part, as well as the places we service.  Part of our service is to give you an approximate time of arrival.  We make a heartfelt effort to meet that schedule for your needs as well as our own.  We can assure you this scheduled time is likely to change.  Could be earlier, could be a little later.  Traffic, accidents, behavioral patients, facilities that do not have their patients out of bed, add-ons, educating family members, patients getting sick on the vans, etc.  The possibilities are endless in this business!   Whether we are early, running a little late, or on time, we will still give you the same amount of notice to get your patients ready.  We do our very best to contact the facility or SLP, 15 minutes ahead of time to let you know we are on our way.  Sometimes we wait on hold for many long minutes, sometimes we are transferred to multiple extensions several times, sometimes we get no answer, but we do make an effort to give you as much notice as possible. (It benefits us and much as it does you!)  Thank you for understanding that being “mobile” results in many external obstacles versus being stationary all day.
 

Education – Dysphagia Feeding Strategies for Caregivers Videotape Irene Campbell-Taylor
This videotape is full of ways to provide a positive eating experience for those with swallowing problems. It shows caregivers the effects of normal and abnormal positioning, rate, bolus size, and much more. Through videofluoroscopic imagery, it also shows the effects that certain techniques have on the swallowing mechanism. This can be shown in entirety or by individual segments. The segments cover eating, feeding, drinking, preparing and timing.
35-minutes $65.00.   Visit www.alimed.com
 

Dysphagia Tidbit – SWORD SWALLOWERS – JUST in case you have sword swallowers on your caseload, someone did a case study on it to evaluate information on the practice and associated ill-effects of sword swallowing.  The sword swallower/performer must learn to align a sword with the upper esophageal sphincter with the neck hyper-extended. The next step requires relaxation of the pharynx and esophagus, particularly the horizontal fibers of cricopharyngeus, which are not usually under voluntary control.  Once the swallower has the sword past the cricopharyngeal sphincter and relaxed the esophagus, he or she must learn to control retching so the sword can be passed down to the cardia. The cardia lies about 40 cm from the teeth and the sword straightens the flexible and distensible esophagus. Further progress depends not only on the swallower learning to relax the lower esophageal sphincter and controlling retching, but also on the shape of the stomach. One swallower described having to “relax the muscles of his neck,” and several swallowers mentioned not being able to perform when they could not “relax” or when their throat felt it was “closing up” when sore. Participants: 110 sword swallowers from 16 countries, who could swallow a non-retractable, solid steel blade at least two centimeters wide and 38 cm long. Results: Information was collected from 46 sword swallowers. Major complications are more likely when the swallower is distracted, swallows multiple or unusual swords, or when previous injury is present. Perforations that can occur mainly involve the esophagus and usually have a good prognosis. Sore throats are common, particularly while the skill is being learned or when performances are too frequent. Major gastrointestinal bleeding sometimes occurs, and occasional chest pains tend to be treated without medical advice. Sword swallowers without healthcare coverage expose themselves to financial as well as physical risk.(REALLY??!!!!!) Conclusions: Sword swallowers run a higher risk of injury when they are distracted or when adding embellishments to their performance, but injured performers have a better prognosis than patients who suffer iatrogenic perforation.