[Dysphagia] Re: new list on Medicare holiday coverage

[smilinggirl336 at comcast.net (smilinggirl336@comcast.net)]

I am new to this dysphagia list and I am questioning why SLP's would be  opposed to using thickened liquids.  
  
I am a proponent of using thickened liquids to reduce the risk of aspiration of thin liquids.  I refrain from using the term "prevent" when it comes to aspiration, as I feel it is impossible to "prevent" aspiration, especially with saliva. I find that poor positioning in hospital beds and poor feeding techniques can increase the risk of aspiration with almost consistency.   I feel my job is useful to reduce the risk of aspiration and  to reduce the frequency of aspiration and I may do this by altering the consistency of foods and liquids.  I think it is also important to look at the nature of the aspirate.   I find that some patients find it uncomfortable to have coughing episodes while drinking and find swallowing thickened liquids to be more comfortable.  Are not these reasons to use thickened liquids?  Whenever possible, I want people to be on a "normal" diet; it is equally important that patient's will accept the consistencies and be able to meet their nutrtional and hydration needs.  If these are not met, they will develop other problems (i.e. dehyrdation, malnutrition, cognitive changes, UTI).  There is so much more to look at when we treat a patient than just aspiration risk.  

I also get upset when I see physician's (or others) document that they inserted a PEG tube to prevent aspiration.  With the PEG tube, they have just opened up another can of worms, and we can't prevent aspiration!

Anyway, as I am new to the list, I hope I am not just restating what has already been said - just trying to add my reasoning for using thickened liquids.

Thanks,
Jean