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[Dysphagia] dermatomyositis



exercise would be contraindicated in an inflammatory process like this.  She should be supported nutritionally until her meds kick in  

-----Original Message-----
From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com]On
Behalf Of Aviva Debinski
Sent: Thursday, December 14, 2006 8:21 AM
To: dysphagia at b9.com
Subject: [Dysphagia] dermatomyositis


Can anyone offer suggestions for a 55yr old lady with a Dx 6months ago 
of dermatomyositis. She presented with mild swallowing problems and I 
asked her to do the Shaker exercises for pharyngeal strengthening. She 
presneted again a few days ago with a severe worsening of her dysphagia 
. VF showed a marked weakness in bolus driving force and pharyngeal 
motility with severe stasis in her vall and pyriforms. Solids appeared 
to stick in the oropharynx placing her at great risk. Is there a 
contraindication for the Shaker exs in this population? Could that have 
made her prob worse? She has now been admitted to hopsital for IV 
intragam and infliximab which seems to be helping.. Any thoughts?
Aviva Debinski
Ph: +61 3 95762116
Fx: +61 3 95096021
Email: adebin at bigpond.net.au 
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