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[Dysphagia] Re: Dysphagia Digest, Vol 9, Issue 6
This is an interesting article that you may find helpful. Ultrasound
Comparison of Common Artificial Nipples in Bottle feeding to Breast feeding.
Nowak, et, al, 1994
Joan Dietrich Comrie
Carolina Pediatric Dysphagia
Raleigh NC
www.feeding.com
----- Original Message -----
From: <dysphagia-request@b9.com>
To: <dysphagia@b9.com>
Sent: Thursday, August 05, 2004 8:51 AM
Subject: Dysphagia Digest, Vol 9, Issue 6
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> Today's Topics:
>
> 1. chronic hiccups (P Clarke)
> 2. RE: chronic hiccups (Caroline.Johnson@med.va.gov)
> 3. Hospital "Savings" if NO Inpatient Dysphagia Program
> (Nancy Spence)
> 4. Re: bite reflex (Irene Campbell-Taylor)
> 5. Re: chronic hiccups (Irene Campbell-Taylor)
> 6. RE: chronic hiccups (Irene Campbell-Taylor)
> 7. Re: Hospital "Savings" if NO Inpatient Dysphagia Program
> (Irene Campbell-Taylor)
> 8. RE: Hospital "Savings" if NO Inpatient Dysphagia Program
> (Neubert, Rebecca R *HS)
> 9. Video of sucking behaviour (rnricardonunes)
> 10. Re: bite reflex (wwasmith@comcast.net)
> 11. RE: chronic hiccups (Johnson, Caroline)
> 12. RE: chronic hiccups (Irene Campbell-Taylor)
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Wed, 4 Aug 2004 13:05:54 -0700 (PDT)
> From: P Clarke <pbdysphagia@yahoo.com>
> Subject: [Dysphagia] chronic hiccups
> To: dysphagia@medonline.com
> Message-ID: <20040804200554.81084.qmail@web53507.mail.yahoo.com>
> Content-Type: text/plain; charset=us-ascii
>
> Hi -
>
> I have a pt with hx CVA, DM. Pt admit with pneumonia, poss aspiration
pneumonia. MD orders bedside swallow. At bedside very dysarthric. Reduced
oral motor and with severe hiccups (near constant hiccups). Nursing said
that pt suffers from chronic hiccups and has had them for many years (I
assume since his old stroke). Hiccups made swallow function difficult to
assess. Curious as to tx for chronic hiccups. Suggestions?
>
>
> Any suggestions,
> Paul B. MS-CCC-SLP
> Salisbury, MD
>
>
> ---------------------------------
> Do you Yahoo!?
> Yahoo! Mail is new and improved - Check it out!
>
> ------------------------------
>
> Message: 2
> Date: Wed, 4 Aug 2004 15:34:21 -0500
> From: Caroline.Johnson@med.va.gov
> Subject: RE: [Dysphagia] chronic hiccups
> To: pbdysphagia@yahoo.com, dysphagia@medonline.com
> Message-ID: <F040BED4EB01D511892D0000F803474801D4E85A@VHALEXEXC1>
> Content-Type: text/plain
>
> Usually Thorazine here- I would hope that's already been tried, but I try
> not to assume too much!
>
> Caroline Johnson
> Speech-language Pathologist
> Lexington , KY VAMC
> 859-281-4972
>
>
> -----Original Message-----
> From: P Clarke [mailto:pbdysphagia@yahoo.com]
> Sent: Wednesday, August 04, 2004 4:06 PM
> To: dysphagia@medonline.com
> Subject: [Dysphagia] chronic hiccups
>
> Hi -
>
> I have a pt with hx CVA, DM. Pt admit with pneumonia, poss aspiration
> pneumonia. MD orders bedside swallow. At bedside very dysarthric.
Reduced
> oral motor and with severe hiccups (near constant hiccups). Nursing said
> that pt suffers from chronic hiccups and has had them for many years (I
> assume since his old stroke). Hiccups made swallow function difficult to
> assess. Curious as to tx for chronic hiccups. Suggestions?
>
>
> Any suggestions,
> Paul B. MS-CCC-SLP
> Salisbury, MD
>
>
> ---------------------------------
> Do you Yahoo!?
> Yahoo! Mail is new and improved - Check it out!
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
>
> ------------------------------
>
> Message: 3
> Date: Wed, 04 Aug 2004 16:37:30 -0400
> From: "Nancy Spence" <Nancy.Spence@BethesdaHealthcare.com>
> Subject: [Dysphagia] Hospital "Savings" if NO Inpatient Dysphagia
> Program
> To: <dysphagia@b9.com>
> Message-ID: <s11110cd.001@mail.bethesdahealthcare.com>
> Content-Type: text/plain; charset=US-ASCII
>
> Periodically (and repeatedly) over many years, financial justification
> for dysphagia (or other) programs comes up during the budget process.
> This year, it's "What if we stop doing inpatient swallowing tests?"
> (after doing clinicals 25 years, videos 20 years, fees/sts 3 years).
>
> I pulled out a couple of references to articles from Protocol 201
> summary materials by Odderson that supported economic and quality
> results from day 1 intervention with stroke patients. I recall
> information on cost of aspiration pneumonia vs. prevention, but not the
> references. These folks are more interested in numbers ($) than words -
> who can help?
>
> Thank you!
> *********************
> The information contained in this message may contain health information
> that is privileged and confidential and protected from disclosure. The
> transmitted information is intended only for the use of the individual
> or entity named above. If the reader of this message is not the
> intended recipient, or an employee or agent responsible for delivering
> this message to the intended recipient, you are hereby notified that
> State and Federal Law strictly prohibit any dissemination, distribution
> or copy of this communication. If you have received this communication
> in error, please notify the sender by replying to this message and
> delete this message from your computer.
> Thank you. Bethesda Healthcare System.
>
>
>
>
> ------------------------------
>
> Message: 4
> Date: Wed, 4 Aug 2004 15:34:52 -0700 (PDT)
> From: Irene Campbell-Taylor <eripley@yahoo.com>
> Subject: Re: [Dysphagia] bite reflex
> To: Francesca Swift <FrancescaSwift@hmh.westsound.net>,
> Naomislp@aol.com, dysphagia@b9.com
> Message-ID: <20040804223452.23031.qmail@web14008.mail.yahoo.com>
> Content-Type: text/plain; charset=us-ascii
>
> There is, to my knowledge, nothing similar to my CD on medications and
dysphagia that was developed precisely for this reason. The PDR and CPS are
of no use in this respect - nor is the pharmacist. The CD came from a
request to write a teaching article for pharmacists because they do not know
the literature or how to interpret side effects such as "ataxia" as being
related to swallowing dysfunction.
> Irene.
>
> Francesca Swift <FrancescaSwift@hmh.westsound.net> wrote:
> Do any of you know of a good, easy to use "PDR like" reference, either
> a book or online, that sorts medication by class and side affects. I
> have such a hard time keeping up with all of the new medications, drug
> interactions and which and how they affect swallowing. I usually end up
> having to run to the pharmacist as a reference. I really need book form
> as we do not have a CD ROM on our work computer.
>
> Francesca Swift, MA/CCC
> Harrison Hospital
> Bremerton, WA
>
>
> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com
>
> ------------------------------
>
> Message: 5
> Date: Wed, 4 Aug 2004 15:36:32 -0700 (PDT)
> From: Irene Campbell-Taylor <eripley@yahoo.com>
> Subject: Re: [Dysphagia] chronic hiccups
> To: P Clarke <pbdysphagia@yahoo.com>, dysphagia@medonline.com
> Message-ID: <20040804223632.34994.qmail@web14004.mail.yahoo.com>
> Content-Type: text/plain; charset=us-ascii
>
> Tsp refined white sugar on the tongue and, no, it will have no effect on
his diabetes.
>
> P Clarke <pbdysphagia@yahoo.com> wrote:Hi -
>
> I have a pt with hx CVA, DM. Pt admit with pneumonia, poss aspiration
pneumonia. MD orders bedside swallow. At bedside very dysarthric. Reduced
oral motor and with severe hiccups (near constant hiccups). Nursing said
that pt suffers from chronic hiccups and has had them for many years (I
assume since his old stroke). Hiccups made swallow function difficult to
assess. Curious as to tx for chronic hiccups. Suggestions?
>
>
> Any suggestions,
> Paul B. MS-CCC-SLP
> Salisbury, MD
>
>
> ---------------------------------
> Do you Yahoo!?
> Yahoo! Mail is new and improved - Check it out!
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
>
>
> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com
>
> ------------------------------
>
> Message: 6
> Date: Wed, 4 Aug 2004 15:37:55 -0700 (PDT)
> From: Irene Campbell-Taylor <eripley@yahoo.com>
> Subject: RE: [Dysphagia] chronic hiccups
> To: Caroline.Johnson@med.va.gov, pbdysphagia@yahoo.com,
> dysphagia@medonline.com
> Message-ID: <20040804223755.60773.qmail@web14006.mail.yahoo.com>
> Content-Type: text/plain; charset=us-ascii
>
>
>
> Caroline.Johnson@med.va.gov wrote:
> Usually Thorazine here-
>
> ** Gosh - that's like going after a wasp's nest with a howitzer! And what
about the EPS side effects of thorazine?
>
>
>
> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com
>
> ------------------------------
>
> Message: 7
> Date: Wed, 4 Aug 2004 15:49:01 -0700 (PDT)
> From: Irene Campbell-Taylor <eripley@yahoo.com>
> Subject: Re: [Dysphagia] Hospital "Savings" if NO Inpatient Dysphagia
> Program
> To: Nancy Spence <Nancy.Spence@bethesdahealthcare.com>,
> dysphagia@b9.com
> Message-ID: <20040804224901.63732.qmail@web14002.mail.yahoo.com>
> Content-Type: text/plain; charset=us-ascii
>
> The Odderson article included only 124 patients and made the same mistake
made by so many - the scientifically impossibility of attempting to prove a
negative. None of their patients developed pneumonia and they make the
unwarranted assumption that this was because of early intervention. This
cannot be proven! EVER. The only thing that can be proven unequivocally is
the maintenance or improvement of nutrition/hydration which is the sole
purpose of intervention in the first place.
>
> Nancy Spence <Nancy.Spence@bethesdahealthcare.com> wrote:Periodically (and
repeatedly) over many years, financial justification
> for dysphagia (or other) programs comes up during the budget process.
> This year, it's "What if we stop doing inpatient swallowing tests?"
> (after doing clinicals 25 years, videos 20 years, fees/sts 3 years).
>
> I pulled out a couple of references to articles from Protocol 201
> summary materials by Odderson that supported economic and quality
> results from day 1 intervention with stroke patients. I recall
> information on cost of aspiration pneumonia vs. prevention, but not the
> references. These folks are more interested in numbers ($) than words -
> who can help?
>
> Thank you!
> *********************
> The information contained in this message may contain health information
> that is privileged and confidential and protected from disclosure. The
> transmitted information is intended only for the use of the individual
> or entity named above. If the reader of this message is not the
> intended recipient, or an employee or agent responsible for delivering
> this message to the intended recipient, you are hereby notified that
> State and Federal Law strictly prohibit any dissemination, distribution
> or copy of this communication. If you have received this communication
> in error, please notify the sender by replying to this message and
> delete this message from your computer.
> Thank you. Bethesda Healthcare System.
>
>
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
>
>
> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com
>
> ------------------------------
>
> Message: 8
> Date: Wed, 4 Aug 2004 19:09:17 -0400
> From: "Neubert, Rebecca R *HS" <RN2D@hscmail.mcc.virginia.edu>
> Subject: RE: [Dysphagia] Hospital "Savings" if NO Inpatient Dysphagia
> Program
> To: "Nancy Spence" <Nancy.Spence@BethesdaHealthcare.com>,
> <dysphagia@b9.com>
> Message-ID:
> <3E23EBD638D79943B1EFEFAB20714C7B0165D115@HSCSEMAIL8.hscs.virginia.edu>
>
> Content-Type: text/plain; charset="Windows-1252"
>
> Ouch. Well, one place to start might be the new JCAHO regulations which
place significant importance on swallowing assessment for new stroke
patients. Even if your hospital is not applying for the Stroke Center
accreditation, I would see if any of the JCAHO documents related to these
guidelines has references. Try 'googling' JCAHO and stroke. I don't have the
official name handy here at home. If you can't find them, email me back and
I'll find the info. I would also appeal to your neurologists. They tend to
be staunch supporters of what we do and may add some sway if not some
references as well.
>
> Good Luck!
> -Rebecca
>
>
> -----Original Message-----
> From: dysphagia-bounces@b9.com on behalf of Nancy Spence
> Sent: Wed 8/4/2004 4:37 PM
> To: dysphagia@b9.com
> Cc:
> Subject: [Dysphagia] Hospital "Savings" if NO Inpatient Dysphagia Program
> Periodically (and repeatedly) over many years, financial justification
> for dysphagia (or other) programs comes up during the budget process.
> This year, it's "What if we stop doing inpatient swallowing tests?"
> (after doing clinicals 25 years, videos 20 years, fees/sts 3 years).
>
> I pulled out a couple of references to articles from Protocol 201
> summary materials by Odderson that supported economic and quality
> results from day 1 intervention with stroke patients. I recall
> information on cost of aspiration pneumonia vs. prevention, but not the
> references. These folks are more interested in numbers ($) than words -
> who can help?
>
> Thank you!
> *********************
> The information contained in this message may contain health information
> that is privileged and confidential and protected from disclosure. The
> transmitted information is intended only for the use of the individual
> or entity named above. If the reader of this message is not the
> intended recipient, or an employee or agent responsible for delivering
> this message to the intended recipient, you are hereby notified that
> State and Federal Law strictly prohibit any dissemination, distribution
> or copy of this communication. If you have received this communication
> in error, please notify the sender by replying to this message and
> delete this message from your computer.
> Thank you. Bethesda Healthcare System.
>
>
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
>
>
>
>
> ------------------------------
>
> Message: 9
> Date: Wed, 4 Aug 2004 20:41:48 -0300
> From: "rnricardonunes" <rnricardonunes@uol.com.br>
> Subject: [Dysphagia] Video of sucking behaviour
> To: "dysphagia" <dysphagia@b9.com>
> Message-ID: <I1Y4HO$3616950F5B94F7C052B9CA8B5CA78A9F@uol.com.br>
> Content-Type: text/plain; charset=iso-8859-1
>
> I have unsucessfully tried to find the video films with the
> sucking movements recorded by Eishima Kazuko and refered in
> the paper "The analysis of sucking behaviour in newborn
> infants (1991)".
> Any hint will be most wellcomed.
> I am also deeply interested in the differences/similarities
> of
> sucking behavior (breastfeeding X nipple feeding) in terms of
> physiology, images, etc.
>
> __________________________________________________________________________
> Acabe com aquelas janelinhas que pulam na sua tela.
> AntiPop-up UOL - ? gr?tis!
> http://antipopup.uol.com.br/
>
>
>
>
> ------------------------------
>
> Message: 10
> Date: Thu, 05 Aug 2004 01:34:56 +0000
> From: wwasmith@comcast.net
> Subject: Re: [Dysphagia] bite reflex
> To: Naomislp@aol.com, dysphagia@b9.com
> Message-ID:
>
<080520040134.26661.41118EC00006A926000068252200734076089B07039C0E9999@comca
st.net>
>
> Content-Type: text/plain
>
> Naomi,
> To add to Irene's comments, I would use an extremely firm plastic spoon or
perhaps even better a plastic coated metal spoon (avoid metal as it can
damage the teeth when chomped on, although a too thin plastic can be bitten
in half). Place a bit of firm downward pressure on the tongue with the back
of the spoon to "announce" the presence of the bolus, this may encourage a
more normal mouth closure pattern.
> Also, consult your OT and PT team members about positioning. Good
proximal trunk, neck, and limb position at mealtime may help to mitigate
the bite reflex to some extent. Good luck,
> Wendy
>
>
>
>
>
> -------------- Original message --------------
>
> > Hi all,
> > Recently evaluated MR pt with recent CVA. Now has strong bite reflex
(apparently
> > new) that is interfering significantly with PO intake as well as oral
care. Some
> > oral stage swallow impairment but would certainly be able to manage some
oral
> > intake safely if we could bypass immediate bite. Any suggestions?
> > Thanks in advance,
> > Naomi
> > _______________________________________________
> > Dysphagia mailing list
> > Dysphagia@b9.com
> > http://lists.b9.com/mailman/listinfo/dysphagia
>
> ------------------------------
>
> Message: 11
> Date: Thu, 5 Aug 2004 07:04:05 -0500
> From: "Johnson, Caroline" <Caroline.Johnson@med.va.gov>
> Subject: RE: [Dysphagia] chronic hiccups
> To: "'Irene Campbell-Taylor'" <eripley@yahoo.com>, "Johnson, Caroline"
> <Caroline.Johnson@med.va.gov>, pbdysphagia@yahoo.com,
> dysphagia@medonline.com
> Message-ID: <F040BED4EB01D511892D0000F803474801D4E85B@VHALEXEXC1>
> Content-Type: text/plain
>
> My understanding is that it is given very short-term.
>
>
>
> Caroline Johnson
>
> Speech-language Pathologist
>
> Lexington , KY VAMC
>
> 859-281-4972
>
>
>
> -----Original Message-----
> From: Irene Campbell-Taylor [mailto:eripley@yahoo.com]
> Sent: Wednesday, August 04, 2004 6:38 PM
> To: Caroline.Johnson@med.va.gov; pbdysphagia@yahoo.com;
> dysphagia@medonline.com
> Subject: RE: [Dysphagia] chronic hiccups
>
>
>
>
>
> Caroline.Johnson@med.va.gov wrote:
>
> Usually Thorazine here-
>
> ** Gosh - that's like going after a wasp's nest with a howitzer! And what
> about the EPS side effects of thorazine?
>
>
>
> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com
>
>
>
> ------------------------------
>
> Message: 12
> Date: Thu, 5 Aug 2004 05:50:35 -0700 (PDT)
> From: Irene Campbell-Taylor <eripley@yahoo.com>
> Subject: RE: [Dysphagia] chronic hiccups
> To: "Johnson, Caroline" <Caroline.Johnson@med.va.gov>,
> pbdysphagia@yahoo.com, dysphagia@medonline.com
> Message-ID: <20040805125035.14528.qmail@web14003.mail.yahoo.com>
> Content-Type: text/plain; charset=us-ascii
>
>
>
> "Johnson, Caroline" <Caroline.Johnson@med.va.gov> wrote:
> My understanding is that it is given very short-term.
>
>
>
> ** In some people, it can take as little as one dose.
>
>
>
>
>
> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com
>
> ------------------------------
>
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
>
> End of Dysphagia Digest, Vol 9, Issue 6
> ***************************************
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