October 2022 Newsletter

Its Fall Ya’ll! 

Walk for Alzheimer’s……. because memories matter 

More than 6 million Americans are living with Alzheimer's. Almost two-thirds of Americans with Alzheimer’s disease are women and kills more people than breast cancer and prostate cancer combined. Fifty percent of primary care physicians believe the medical profession is not ready for the growing number of people with Alzheimer’s or other dementias. In 2022, Alzheimer's disease will cost the United States $321 billion. This number is projected to rise to nearly $1 trillion in 2050. Held annually in more than 600 communities nationwide, the Alzheimer's Association Walk to End Alzheimer's® is the world's largest fundraiser for Alzheimer's care, support and research. This inspiring event calls on participants of all ages and abilities to join the fight against the disease. This is why we walk! We must find a cure! Annually more than 600 communities nationwide, Walk to End Alzheimer's®. It is the world's largest fundraiser for Alzheimer's care, support and research. Join at your local event or walk from your home in your neighborhood. Across the nation, the Alzheimer's Association Walk to End Alzheimer's® is full of flowers, each carried by someone committed to ending this disease. Because like flowers, our participants don't stop when something's in their way. They keep raising funds and awareness for a breakthrough in the fight against Alzheimer's and all other dementia.

While there is no fee to register for Walk, all participants are encouraged to raise critical funds that allow the Alzheimer’s Association to provide 24/7 care and support and advance research toward methods of prevention, treatment and ultimately, a cure. As dementia progresses, swallowing difficulties (called dysphagia) become more common, although they will vary from person to person. Swallowing difficulties can lead to weight loss, malnutrition and dehydration. Current research provides evidence that the neurophysiology of swallowing in early AD involved lower Blood-Oxygen-Level-Dependent (BOLD) responses in both traditional swallowing cortical areas and in regions commonly affected by AD. Although memory dysfunction is among the first noticeable symptoms of AD, these findings suggest that the brain areas underlying swallowing function also show compromise early on, before clinical dysphagia diagnosis. Traditionally, dysphagia, aspiration, and aspiration pneumonia have been viewed as very late stage consequences of the disease. However, our videofluoroscopic findings and those of Priefer and Robbins (1997) show that swallowing and self-feeding changes occur early on in the disease.
J Alzheimers Dis. 2010 Jan; 19(4): 1185–1197. Early deficits in cortical control of swallowing in Alzheimer’s disease Ianessa A. Humbert, Donald G. McLaren,,Kris, Kosmatka, Michelle Fitzgerald, Sterling, Johnson, Eva Porcaro, Stephanie Kays, Eno-Obong Umoh, and JoAnne Robbins

October is Health Lung Month!

Initially formed in 1904 to fight tuberculosis, the American Lung Foundation now combats all types of lung disease. The American Lung Foundation currently focuses on issues related to: Asthma, tobacco control, and environmental health Research and Professional Education and advocacy is needed. We would like to add dysphagia to this list.

Advocacy for proper instrumental evaluations, and proper treatment is needed to protect lung health from ongoing risks of aspiration. Those with asthma, those who smoke or vape, and those exposed to unclean air environment will always be at greater risk to the effects of aspiration.

CE Opportunities: On-Demand + Live Zoom Webinar 

Deciphering Dysphagia with Ampcare’s ESP™ 

• Online/on-demand pre-course work (4 hours)
• Two days of interactive webinar (2 hours each day)
• Become Certified in ESP, the Most Comprehensive FDA-Cleared Treatment for Dysphagia
• Learn the Latest Assessment Techniques
• Accelerate Recovery by Combining Neuromuscular Electrical Stimulation with Resistive Exercise
• Do More in 30 Minutes
• Earn 0.8 Advanced ASHA CEUs

Re-certification is recommended every 3 years for Ampcare’s ESP. If you need recertified, use the discount code:  

Dysphagia diets
High Protein supplements for dysphagia – swallowing difficulties
https://www.slodrinks.com

Slõ Milkshakes+ Banana flavor was approved for prescription. Now Clinicians and their patients have access to the widest range of pre-thickened oral and nutrition shakes (ONS) flavors and flow rates in the world. Healthcare Professionals have issues surrounding boosting the protein levels of those diagnosed with dysphagia and those with small appetites. Therefore this company decided to see if they could help and find a way to fortify soups. The result was Slõ Proteins. Available as Whey, Soy and Pea, they are flavorless. Easily dissolvable and digestible (they are short chain proteins) they can boost the protein levels of soups AND snacks, meals and desserts. One 15g spoon provides 12g of protein. Slõ Juice+ patient testing continues and they hope to have this 1st pre-thickened vegan ONS on prescription SOON, together with Pill-Eze.. Despite living with a swallowing difficulty, many people still want to enjoy the taste of their favorite alcoholic drink. As a result, we created a simple way for you to change favorite alcoholic drinks into thickened drinks that flow slowly. Simply pour a favorite wine (red, wine or rose), beer or cider into a glass and mix in the sachet that changes it into a Slõ Wine, Slõ Beer or Slõ Cider. Like all Slõ Drinks, they will look good, taste good and be safer to swallow.

Dysphagia Tidbit: Opioid Esophagus

The effects of opioids on gastric, small intestine, and colonic motility have been well described in the literature Similarly, opioids can affect esophageal motility likely through similar mechanisms and this effect has been studied by using various pharmacologic intervention studies. In 1996, Penagini et al. reported on the effects of morphine and naloxone on esophageal motor function. Their findings suggested that the residual LES pressure during swallowing was increased and the duration of LES relaxation and percentage of relaxation were decreased by opioids. In addition, the authors found that peristaltic velocity was increased with minimal changes in contractile amplitude. These findings have been consistently found in other studies by using slightly different protocols in controls and thus it appears that opioids may alter the inhibitory component of esophageal peristalsis and LES relaxation. More recently, the Mayo team reported on the prevalence of CC diagnoses in 121 opioid users who were either on opioids at the time of manometry or off for at least 24 hours before the test 21. The authors found that the rates of both type III achalasia and esophagogastric junction outflow obstruction (EGJOO) were more common in current users of opioids compared with those patients who had discontinued opioids for at least 24 hours. These results suggest that opioid use can alter esophageal motility and can be associated with higher rates of major motor disorders in patients referred for esophageal manometry. Whether these effects will resolve with discontinuation of the opioid or normalize with administration of opioid antagonists is unclear. However, an understanding of these negative effects is important when evaluating patients with dysphagia on opioids.

Published online 2019 Aug 29. Recent advances in dysphagia management by Joseph Triggs. Babaei A, Szabo A, Shad S, Massey BT. Chronic daily opioid exposure is associated with dysphagia, esophageal outflow obstruction, and disordered peristalsis. Neurogastroenterol Motil. 2019 Jul;31(7):e13601. doi: 10.1111/nmo.13601. Epub 2019 Apr 17. PMID: 30993800; PMCID: PMC6559831.