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[Dysphagia] e stim
"Abrahamson, Amy" <aabrahamson@bethsholomcampus.com> wrote:
The MBS interpretation is important..why?....to determine why the
aspiration is occurring..
Not quite. The history and clinical exam tells why aspiration is occurring. The VFSS simply identifies the abnormal dynamics that lead to aspiration, not the fundamental reason for its occurrence. One may see that aspiration happens because the UES is not opened by the traction of the hyoid in time to accept the bolus. The important question is, "why is the hoid not moving at the right time." One has to deduce from these and from the history and examination what the underlying cause is. Without that, one cannot plan treatment or set goals. It would be a terrible disservice to the patient if, for example, one started e-stim and did not determine at the outset that the basic cause of the swallowing problem/aspiration/weight loss/dehydration was a medication.
But, again, aspiration is not the most important issue.
Why not go to the course!!
That may be a rhetorical question but from a personal point of view I can't see what it would tell me that I don't already know and EMS is available by several means. I have always said that it is potentially useful but please don't assume long term effects as these are not possible in some patients, depending on the cause of the swallowing impairment and in stroke patients, always bear in mind that spontaneous recovery is a wonderful thing. It is, indeed, not for everyone - only for those whose problem is inadequate/uncoordinated opening of the UES, a significant number.
I know Vital Stim has been discussed many times on this list serve. Why
don't all you skeptics out there just go to the course and check it out.
Not everyone can afford it.
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