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[Dysphagia] Dysphagia Diet and Candy Bars
On Tue, 01 Nov 2005 19:13:46 -0500 (Eastern Standard Time), "Laurie
Bailey, MS, CCC-SLP" <lbaileyslp@verizon.net> said:
> I have a patient who is 40 years old. His diet is currently ground
> moist meats, puree fruits/vegetables, and honey thick liquids. He
> appears to do well with bread. He is a silent aspirator and has had
> aspiration pneumonia more than once.
Have you any reason to believe his lower respiratory problems are
secondary to aspiration from oral sources? If an MBS done in one of the
local hospitals here showed that a patient was aspirating silently, it
would really mean that the patient's cough wasn't contingent with the
aspiration. I believe I have seen residents in the long term care part
the nursing home I work in aspirate and not cough until 10-20 seconds
after the misdirected swallow. These are residents who have not
demonstrated lower respiratory problems, and for whom I have not
provided services. This behavior is clearly not silent aspiration, but
it wouldn't be on the MBS videotape, either.
>This diet is a downgrade from the MBS recommendation of ground with honey
>thick liquids since he also had aspiration pneumonia with the MBS recommended diet.
If you've seen evidence that following the MBS recommendations did not
eliminate the aspiration pneumonia, why do you believe the aspiration
documented on the MBS caused the aspiration pneumonia? What's the
dude's overall health like? Any conditions associated with
gastroparesis or esophageal dysmotility? Any asthma? Is he getting any
med's likely to lower the pressure of his LES? What about his GI
status... is he being treated for any GI problems now? Not everyone who
aspirates in the prandial situation is a candidate for lower respiratory
problems. People who aspirate material from gastric sources are more
likely to experience such respiratory problems.
**If you think one person can't make a difference in today's world, just light up a cigar in a crowded restaurant.**
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