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[Dysphagia] Re: The actual .....diet.
For once in my life I am actually speechless...although not really surprised, given the source (VitalStim, I mean). the appalling thing, to me, is the amount of incorrect, nonsensical, dangerous so-called "information" that is out there and being accepted because the recipients have a) been fed incorrect data during training, b) have no scientific background whatsoever and c) lack the capacity for logical thinking.
Seriously, to have individuals with no basic sciences, far less medical knowledge involved in an area that is purely medical still scares the wits out of me. How did this ever come about?
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Today's Topics:
1. the actual cricopharyngeal diet (sorriso@adelphia.net)
2. RE: cricopharyngeal diet (pressmah@sjhmc.org)
3. RE: the actual cricopharyngeal diet (Copeland, Karen)
4. Re: Cricopharyngeal Diet (NeuroSP@aol.com)
----------------------------------------------------------------------
Message: 1
Date: Thu, 15 Sep 2005 16:14:34 -0400
From:
Subject: [Dysphagia] the actual cricopharyngeal diet
To: dysphagia@b9.com
Message-ID:
<24658682.1126815274834.JavaMail.root@web10.mail.adelphia.net>
Content-Type: text/plain; charset=utf-8
Here's the "diet" as requested by a member of the ASHA list from the VitalStim people:
Initial Diet for Patients with Cricopharyngeal Dysfunction
The following diet has been shown to be effective to the author (Marcy Freed) for the patients who have a degree of cricopharyngeal dysfunction:
1. Crunchy consistency
a. Fritos
b. Potato chips
c. All crackers
d. Pepperidge Farms Bordeaux cookies
e. Toast with butter
2. Thinned puree consistency
a. Thinned Oatmeal or Cream of Wheat
b. Yogurt without fruit
c. Strained creamed soups
d. Mousse
e. Soft drinks
f. Tomato soup or pea soup
3. Soft/Slippery consistency
a. Angel hair pasta and olive oil
b. Sweet potatoes with butter or margarine
c. Soft boiled eggs
d. Poached eggs
e. Squash ??? butternut or acorn
f. Waffles that are cut into tiny pieces
g. Meat loaf
h. Whipped potatoes
The patient may progress as the cricopharyngeal problem improves. Don???t mix food and liquid! First swallow food and then have a drink.
4. Foods NEVER tolerated
a. Pudding
b. Applesauce
c. Pureed foods
d. Mashed potatoes
e. Red meats such as steak
The viscosity of food a,b,c and d contribute to increased vallecular and pyriform sinus retention. Lower viscosity foods clear more easily.
------------------------------
Message: 2
Date: Fri, 16 Sep 2005 07:53:37 -0400
From: pressmah@sjhmc.org
Subject: RE: [Dysphagia] cricopharyngeal diet
To: OdonneK@doh.health.nsw.gov.au, sorriso@adelphia.net,
dysphagia@b9.com, m.sanscartier@videotron.ca
Message-ID: <9FE5266F7C76D31197A20050DA1355570C2153D2@itr-mail>
Content-Type: text/plain; charset="iso-8859-1"
Goldfish crackers are crackers in the shape of goldfish. Crunchy and small.
Very popular with the kids RD is Registered Dietician
-----Original Message-----
From: Kimberley ODonnell [mailto:OdonneK@doh.health.nsw.gov.au]
Sent: Tuesday, September 13, 2005 7:56 PM
To: sorriso@adelphia.net; dysphagia@b9.com; m.sanscartier@videotron.ca
Subject: Re: [Dysphagia] cricopharyngeal diet
Hi all
Please excuse my ignorance, hopefully just due to the fact that I am from
Australia, but what is a goldfish cracker and what does RD stand for?
Thanks in advance.
Kim
Kimberley O'Donnell
Speech Pathologist - BAppSc MSPAA CPSP
Royal Rehab. Centre Sydney
ph:(02) 9808 9210 or (02) 9807 1144 - pager 48
59 Charles Street RYDE NSW 2112
>>> Michel Sanscartier 14/09/2005 9:04:48 am
>>>
That is something else!
Cricopharyngeal diet!!!
First, as I always answer to that group, why don't you ask the
RD you work with?
Linda, did you ask him or her?
Did you ask her also to discuss with you if the patient had an esophageal
dysphagia.
I know that in the US, RDs don't dare to do much in upper dysphagia
problems.
BUT, they know a lot in esophageal dysphagia and they work everyday with
that.
GERD and all the esophageal problems is clinical nutrition 101 for us.
Second, viscosity is for liquid PLEASE.
A FOOD properties analysis is a class that all RD take (at least in Canada).
There are many levels of organoleptic properties of food but only 3 are
relevant for dysphagia:
- Texture for all food (machines, utensils and mouth can measure it).
Texture is usually used in the industry for solid food. The qualifying would
be : hard, soft, puree, * (there are at least 25 others).
- Consistency is an empirical measure that can be defined by a consistometer
(there's honey, nectar and clear consistencies). It's like asking: what is
your height: the answer would tall or short or medium. The liquid is
submitted to the gravity. The little metal container cost over $500 us last
time I called.
- Viscosity is measure by a viscosimeter. That little machine cost over $10
000 us.
It's precise but as you will probably read soon, there's no link between
viscosity of liquids and consistency (except maybe for honey). The measures
are in Kpascal / sec or in centipoise. It's like asking someone the same
question: what is your height: in that case, the answer would be 152 cm or 5
feet.
I'm sure that the RD you work with could have told you the same things.
Third, if your patient has a Wallenberg syndrome or a stroke that wasted his
CN IX, X and/or XI there are many things that you could try. You probably
know it for rehab (Mendelson) but the diet? Please, work with the RD from
your hospital. I sincerely hope that RDs will become more involved in
dysphagia. We can make a great team, I know it.
In case someone corrects my mistakes like that last time, please know that
I'm a French Canadian speaking and that I'm far from being perfect
bilingual. I'm doing my best here.
Michel Sanscartier RD, MSc
1900 rue Beaudry
Montr?al, Qc
H2L 3E9
514-522-3847
m.sanscartier@videotron.ca
----- Original Message -----
From:
To: "dysphagia listserv"
Sent: Tuesday, September 13, 2005 5:23 PM
Subject: [Dysphagia] cricopharyngeal diet
> There has been a discussion going on on the ASHA Division 13 list
> regarding what the heck a cricopharyngeal diet is. In response to a post
> requesting assistance with a patient, one therapist suggested a
> cricopharyngeal diet, prompting the question, "what is it?"
>
> We've come to learn that it stems from vitalstim education and the
> identification of and significance of cricopharyngeal dysfunction in
> dysphagia. The diet evidently refers to a solid food's viscosity and fat
> content in that a goldfish cracker is "better" than applesauce for the
> identified patient. No research evidence has been cited in the
> discussion.
>
> There, you know as much as I do (for those of you who didn't already
> know).
>
> My question to this list is, what do you know about the cricopharyngeal
> diet? Can you add more to the discussion? Is this a valid premise? Is
> there research?
>
> Linda A. Zanchi, MA CCC-SLP
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
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------------------------------
Message: 3
Date: Fri, 16 Sep 2005 08:49:23 -0500
From: "Copeland, Karen"
Subject: RE: [Dysphagia] the actual cricopharyngeal diet
To: ,
Message-ID:
Content-Type: text/plain; charset="US-ASCII"
BBBWWWWWAAAAAHHHHHHHAAAAAAAHHHHHAAAAAAA!!!!!!
Karen :)
p.s. when you read the diet while drinking coffee, you are at risk for
having an episode of nasal regurgitation during laughter. Does she get
any kickback for naming specific products?
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On
Behalf Of sorriso@adelphia.net
Sent: Thursday, September 15, 2005 3:15 PM
To: dysphagia@b9.com
Subject: [Dysphagia] the actual cricopharyngeal diet
Here's the "diet" as requested by a member of the ASHA list from the
VitalStim people:
Initial Diet for Patients with Cricopharyngeal Dysfunction
The following diet has been shown to be effective to the author (Marcy
Freed) for the patients who have a degree of cricopharyngeal
dysfunction:
1. Crunchy consistency
a. Fritos
b. Potato chips
c. All crackers
d. Pepperidge Farms Bordeaux cookies
e. Toast with butter
2. Thinned puree consistency
a. Thinned Oatmeal or Cream of Wheat
b. Yogurt without fruit
c. Strained creamed soups
d. Mousse
e. Soft drinks
f. Tomato soup or pea soup
3. Soft/Slippery consistency
a. Angel hair pasta and olive oil
b. Sweet potatoes with butter or margarine
c. Soft boiled eggs
d. Poached eggs
e. Squash - butternut or acorn
f. Waffles that are cut into tiny pieces
g. Meat loaf
h. Whipped potatoes
The patient may progress as the cricopharyngeal problem improves. Don't
mix food and liquid! First swallow food and then have a drink.
4. Foods NEVER tolerated
a. Pudding
b. Applesauce
c. Pureed foods
d. Mashed potatoes
e. Red meats such as steak
The viscosity of food a,b,c and d contribute to increased vallecular and
pyriform sinus retention. Lower viscosity foods clear more easily.
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
------------------------------
Message: 4
Date: Fri, 16 Sep 2005 10:08:48 EDT
From: NeuroSP@aol.com
Subject: Re: [Dysphagia] Cricopharyngeal Diet
To: ldcrabtr@pmt.org, dysphagia@b9.com
Message-ID: <208.9789efb.305c2bf0@aol.com>
Content-Type: text/plain; charset="US-ASCII"
Just so you know.....I have not taken the Vital Stim course, and a number of
patients who I have seen in my practice, have presented with swallowing
difficulties which have been attributed to cricopharyngeal dysfunction.
John
------------------------------
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End of Dysphagia Digest, Vol 22, Issue 19
*****************************************
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
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