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[Dysphagia] RE: Dysphagia Digest, Vol 35, Issue 12
- Subject: [Dysphagia] RE: Dysphagia Digest, Vol 35, Issue 12
- From: Julia.Brett at rgh.sa.gov.au (Brett, Julia (RGH))
- Date: Sun Oct 15 23:15:10 2006
- In-reply-to: <200610110304.k9B33rfe019150@boa.b9.com>
I am looking for a FEES course to attend. I currently live in Adelaide, Australia but am willing to travel.
Many thanks
Julia Brett
Senior Speech Pathologist
Repatriation General Hospital
Daw Park.
Ph +61882769666 pager 21607
Email julia.brett@rgh.sa.gov.au
Looking at 2007.
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf Of dysphagia-request@b9.com
Sent: Wednesday, October 11, 2006 12:34
To: dysphagia@b9.com
Subject: Dysphagia Digest, Vol 35, Issue 12
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Today's Topics:
1. RE: Mouth and throat cancer (kathy)
2. RE: Mouth and throat cancer (Dolinger, Eric)
3. RE: Mouth and throat cancer (Dolinger, Eric)
4. Plummer-vinson syndrome/sideropenic dysphagia
(Clarke-Goertz, Kim (PAPHR))
5. Re: Re: [Dysphagia] Clear fluids (Michel Sanscartier)
6. RE: Mouth and throat cancer (kathy)
----------------------------------------------------------------------
Message: 1
Date: Tue, 10 Oct 2006 11:12:06 -0700 (PDT)
From: kathy <kwspeech@yahoo.com>
Subject: RE: [Dysphagia] Mouth and throat cancer
To: "Dolinger, Eric" <EDolinger@christianacare.org>, "'Jaimie
Savasta'" <raemay17@yahoo.com>, Dysphagia@b9.com
Message-ID: <20061010181206.71217.qmail@web52411.mail.yahoo.com>
Content-Type: text/plain; charset=iso-8859-1
Is there evidence to support this during XRT?
"Dolinger, Eric" <EDolinger@christianacare.org> wrote: Absolutely. The idea is to provide exercises (oral/base of
tongue/pharynx/hyolaryngeal elevation) to try to limit the amount of tissue
fibrosis which can occur over time and potentially wreak havoc on the
swallowing mechanism. Also watch for diminishing jaw ROM (trismus.
Now is the time to start these....and the likelihood is low that there will
be any untoward effects (other than discomfort).
Also, would try to keep him swallowing as much as possible throughout the
process (even if its just water or ice chips)
eric
Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System
Phone 302-733-1015
Fax 302-733-1061
edolinger@christianacare.org
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Jaimie Savasta
Sent: Monday, October 09, 2006 10:24 PM
To: Dysphagia@b9.com
Subject: [Dysphagia] Mouth and throat cancer
I have a question regarding a recent patient I have on my caseload. He has
tongue base cancer and also pharyngeal cancer. He will be receiving
radiation starting this week, and my question is this: Is it appropriate to
do oral motor and pharyngeal exercises with him as he has radiation? Will
it be beneficial at all? Are there any precautions with doing these
exercises in this special case? Currently he is NPO and has some scar
tissue at the back of his throat from the biopsy. I am a fairly new SLP,
and have no experience dealing with cancer of the mouth. Any pointers would
be very helpful. Currently I am planning to discuss his case with the ENT,
and I am planning on checking ASHA's guidelines in this area. So any input
would be greatly appreciated.
Thank you.
Jaimie Savasta, MS CCC/SLP
---------------------------------
Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+
countries) for 2?/min or less.
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
Kathy Walker
---------------------------------
Want to be your own boss? Learn how on Yahoo! Small Business.
------------------------------
Message: 2
Date: Tue, 10 Oct 2006 15:23:43 -0400
From: "Dolinger, Eric" <EDolinger@Christianacare.org>
Subject: RE: [Dysphagia] Mouth and throat cancer
To: "'kathy'" <kwspeech@yahoo.com>, "Dolinger, Eric"
<EDolinger@Christianacare.org>, "'Jaimie Savasta'"
<raemay17@yahoo.com>, Dysphagia@b9.com
Message-ID:
<DCEAF9A625B2DA11BC0B000BCD3ED79DEF8A66@es08724.christianacare.org>
Content-Type: text/plain; charset="iso-8859-1"
see for example.....
Gaziano JE. Evaluation and management of oropharyngeal
dysphagia in head and neck cancer. Cancer Control 2002;
9:400-409.
Kulbersh et al.:
Pretreatment, Preoperative Swallowing Exercises May Improve Dysphagia
Qualityof Life
Laryngoscope, 116:883-886, 2006
CONCLUSION
Patients who performed pretreatment swallowing exercises
prior to their head and neck cancer therapy in this
study had a significant increase in the swallowing QOL
when compared to patients who performed only posttreatment
swallowing exercises. This study suggests for
the first time that in head and neck organ preserving
therapy, pretreatment swallowing exercises may potentially
improve dysphagia-related QOL.
Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System
Phone 302-733-1015
Fax 302-733-1061
edolinger@christianacare.org
-----Original Message-----
From: kathy [mailto:kwspeech@yahoo.com]
Sent: Tuesday, October 10, 2006 2:12 PM
To: Dolinger, Eric; 'Jaimie Savasta'; Dysphagia@b9.com
Subject: RE: [Dysphagia] Mouth and throat cancer
Is there evidence to support this during XRT?
"Dolinger, Eric" <EDolinger@christianacare.org> wrote:
Absolutely. The idea is to provide exercises (oral/base of
tongue/pharynx/hyolaryngeal elevation) to try to limit the amount of tissue
fibrosis which can occur over time and potentially wreak havoc on the
swallowing mechanism. Also watch for diminishing jaw ROM (trismus.
Now is the time to start these....and the likelihood is low that there will
be any untoward effects (other than discomfort).
Also, would try to keep him swallowing as much as possible throughout the
process (even if its just water or ice chips)
eric
Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System
Phone 302-733-1015
Fax 302-733-1061
edolinger@christianacare.org
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Jaimie Savasta
Sent: Monday, October 09, 2006 10:24 PM
To: Dysphagia@b9.com
Subject: [Dysphagia] Mouth and throat cancer
I have a question regarding a recent patient I have on my caseload. He has
tongue base cancer and also pharyngeal cancer. He will be receiving
radiation starting this week, and my question is this: Is it appropriate to
do oral motor and pharyngeal exercises with him as he has radiation? Will
it be beneficial at all? Are there any precautions with doing these
exercises in this special case? Currently he is NPO and has some scar
tissue at the back of his throat from the biopsy. I am a fairly new SLP,
and have no experience dealing with cancer of the mouth. Any pointers would
be very helpful. Currently I am planning to discuss his case with the ENT,
and I am planning on checking ASHA's guidelines in this area. So any input
would be greatly appreciated.
Thank you.
Jaimie Savasta, MS CCC/SLP
---------------------------------
Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+
countries) for 2?/min or less.
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
Kathy Walker
_____
Want to be your own boss? Learn how on Yahoo!
<http://us.rd.yahoo.com/evt=41244/*http://smallbusiness.yahoo.com/r-index>
Small Business.
------------------------------
Message: 3
Date: Tue, 10 Oct 2006 15:36:20 -0400
From: "Dolinger, Eric" <EDolinger@Christianacare.org>
Subject: RE: [Dysphagia] Mouth and throat cancer
To: "'kathy'" <kwspeech@yahoo.com>, "Dolinger, Eric"
<EDolinger@Christianacare.org>, "'Jaimie Savasta'"
<raemay17@yahoo.com>, Dysphagia@b9.com
Message-ID:
<DCEAF9A625B2DA11BC0B000BCD3ED79DEF8A69@es08724.christianacare.org>
Content-Type: text/plain; charset="iso-8859-1"
Another supportive reference
Mittal BB, et al. Swallowing dysfunction--preventative and
rehabilitation strategies in patients with head-and-neck
cancers treated with surgery, radiotherapy, and chemotherapy:
a critical review. Int J Radiat Oncol Biol Phys
2003;57:1219-1230.
Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System
Phone 302-733-1015
Fax 302-733-1061
edolinger@christianacare.org
-----Original Message-----
From: kathy [mailto:kwspeech@yahoo.com]
Sent: Tuesday, October 10, 2006 2:12 PM
To: Dolinger, Eric; 'Jaimie Savasta'; Dysphagia@b9.com
Subject: RE: [Dysphagia] Mouth and throat cancer
Is there evidence to support this during XRT?
"Dolinger, Eric" <EDolinger@christianacare.org> wrote:
Absolutely. The idea is to provide exercises (oral/base of
tongue/pharynx/hyolaryngeal elevation) to try to limit the amount of tissue
fibrosis which can occur over time and potentially wreak havoc on the
swallowing mechanism. Also watch for diminishing jaw ROM (trismus.
Now is the time to start these....and the likelihood is low that there will
be any untoward effects (other than discomfort).
Also, would try to keep him swallowing as much as possible throughout the
process (even if its just water or ice chips)
eric
Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System
Phone 302-733-1015
Fax 302-733-1061
edolinger@christianacare.org
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Jaimie Savasta
Sent: Monday, October 09, 2006 10:24 PM
To: Dysphagia@b9.com
Subject: [Dysphagia] Mouth and throat cancer
I have a question regarding a recent patient I have on my caseload. He has
tongue base cancer and also pharyngeal cancer. He will be receiving
radiation starting this week, and my question is this: Is it appropriate to
do oral motor and pharyngeal exercises with him as he has radiation? Will
it be beneficial at all? Are there any precautions with doing these
exercises in this special case? Currently he is NPO and has some scar
tissue at the back of his throat from the biopsy. I am a fairly new SLP,
and have no experience dealing with cancer of the mouth. Any pointers would
be very helpful. Currently I am planning to discuss his case with the ENT,
and I am planning on checking ASHA's guidelines in this area. So any input
would be greatly appreciated.
Thank you.
Jaimie Savasta, MS CCC/SLP
---------------------------------
Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+
countries) for 2?/min or less.
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
Kathy Walker
_____
Want to be your own boss? Learn how on Yahoo!
<http://us.rd.yahoo.com/evt=41244/*http://smallbusiness.yahoo.com/r-index>
Small Business.
------------------------------
Message: 4
Date: Tue, 10 Oct 2006 16:07:26 -0600
From: "Clarke-Goertz, Kim (PAPHR)" <kgoertz@paphr.sk.ca>
Subject: [Dysphagia] Plummer-vinson syndrome/sideropenic dysphagia
To: "'dysphagia listserv'" <dysphagia@b9.com>
Message-ID:
<0528614E554C8045984C7227C673376405C7C4C9@mailhost.paphr.sk.ca>
Content-Type: text/plain
Hi All,
Just met a new client as an outpatient, requesting treatment for her
dysphagia of 20 years with recent worsening.
Pt's medical hx is + for Plummer-Vinson Syndrome (aka sideropenic dysphagia
or Paterson-Kelly Syndrome).
She had a laryngeal web dilated 20 years ago as well as a hiatus hernia at
that time.
She has hx of a mild stroke in 2005 affecting the R optic nerve, GER
(accompanied by pain that radiates to jaw, teeth, ears), emphysema,
xerostomia, diverticuli (2005 Ba Swallow), laryngospasm (self-report, weekly
occurance), globus, hoarse voice quality and once-weekly vomiting/regurg of
solids or pills.
She reports improvement in GER symptoms since spring 2005 when started on
ranitidine. Pt. is also on amilzide, diltiazam, furosemide, pantaloc,
ativan, spiriva inhalor, salbutamol inhalor, flonase, nu cephalex, magnesium
and asa.
Pt had a gastroscopy in the spring of 06 which was normal with the exception
of narrowing near the LES.
When pt experiences globus and actual retention of food in
esophagus/pharynx, water will not wash, pt. must regurgitate material to
clear.
Just want to get the opinion of those reading, so far I am planning on
recommending her GP send her for laryngeal exam per ENT, repeat gastroscopy
per GI/surgeon and videofluoroscopy.
I plan to symptomatically treat/give recommendations for her GER, xerostomia
and globus by suggesting diet and positioning strategies, as well as
hydration tips. I am assuming if she can get the GER under control by
identifying triggers that her laryngospasm my subside or lessen. Perhaps
Gaviscon my be of some benefit in addition to the Ranitidine, I know Irene
has recommended that on the list over the years.
At first thought I feel it's likely she may have another web or perhaps the
narrowing near the LES has worsened since her last gastroscopy. I am hoping
that the GP will suggest she have it re done.
Any other suggestions or pearls from those of you out there who may have
seen another outpatient like mine?
Thanks for any and all insights,
Kim
------------------------------
Message: 5
Date: Tue, 10 Oct 2006 19:07:48 -0400
From: Michel Sanscartier <m.sanscartier@videotron.ca>
Subject: Re: Re: [Dysphagia] Clear fluids
To: Sharon Manders <sharon.manders@gmail.com>
Cc: dysphagia@b9.com
Message-ID: <00a101c6ecc0$e727a990$0400a8c0@PORTMICHEL>
Content-Type: text/plain; format=flowed; charset=iso-8859-1;
reply-type=response
Hi Sharon,
I'm really sorry for my misunderstanding. English is not my language
obviously.
In Quebec (Canada), it's not the SLP that can prescribe the diet (by law).
We don't separate texture (rheology) from the chemical property of food.
SLP are involved in dysphagia assessment and rehab only. RDs also assesse
dysphagia along with the nutritional status to determine the whole diet.
Since we always work together, everything that everyone says in a
multidisciplinary team will be considered by everyone's decisions. Even MDs
don't prescribe most of the diets here. Legally, we have the responsibility
of any food, supplements, diet, enteral and parenteral nutrition
prescription. Texture and consistency of food are obviously part of that.
Personally (and 95% of my RD colleagues in Quebec), I don't agree with the
national dysphagia diet description. Nutritional treatment of dysphagia is
not as simple as it's explained there. Clear liquid diet, thin liquid, can
be confusing as long with texture vs consistency vs viscosity of food. All
of them have very different definitions.
About the choice of the consistency of the liquid diet (thin, nectar, honey
and pouding witch is not puree), you have to consider many things in your
assessment before you do your recommendations as the literature in
dysphagia has shown so far:
1-: the preference of the patient concerning the consistency of liquid
(don't waist you time even thinking about it if the patient tell you that
he won't drink any thickened liquid).
2- the discomfort of the patient with clear liquids
3- the nutritional status
3- the presence of CHF, COPD and other lungs disease
4- the immune system status
5- the oral hygiene status
6- the autonomy of drinking and feeding
7- the cough capacity (reflex)
8- the risk of spillage (vellum / lingual closure)
9- the aspiration confirmed by a VFS
10- a real study that clearly says that thickened liquids are safer than
thin liquids (for aspiration pneumonia)!!!?
So far, I have never found any studies that clearly conclude that thickened
liquids could prevent aspiration pneumonia. It has been discussed over and
over anyway on that list serve.
Langmore and al. 1998 is the best reference for me so far. When she
repeated her study in 2002, for me, the methodology was not as good as the
one in 1998 but the conclusions are not far.
Hope that it can help.
Michel Sanscartie RD MS
"Sharon Manders"
<sharon.manders@g
mail.com> A
Envoy? par : "Michel Sanscartier"
dysphagia-bounces <m.sanscartier@videotron.ca>
@b9.com cc
dysphagia@b9.com
Objet
05-10-2006 00:00 Re: Re: [Dysphagia] Clear fluids
Hi Michel,
I didn't say that lactose changed the texture (nor did the RD). I was
asking why people (SLPs) even order clear liquids in the first place.
As far as I am concerned, clear liquids and regular liquids are
practically the same thing texture wise (rheology aside).
I also think people may have misunderstood my initial question. Only
surgeons order clear liquids as a diet. I was asking about clear
fluids in addition to a food texture. SLPs in my facility and others
that I have been in, order a food texture and a liquid texture. I am
referring to the liquid part of the diet order.
Sorry for not expressing myself clearly initially [one would think as
an SLP I would be able to! :) ]
My question is: What liquid textures do other SLPs order? I have read
the National Dysphagia Diet (from the US) and according to that, there
are 4 textures: thin, nectar thick, honey thick and pudding (isn't
that pureed?) Does anyone add an additional "level" i.e. clear
liquids? If so, why?
In addition, my RDs are *always* involved re: nutrition status, but we
are the ones who are involved with the texture. I would never even
dream of ordering a diabetic or healthy heart or renal diet - that is
not my job. I order the texture, they order the rest of the diet.
I hope that clarifies things a little.
I do appreciate the comments though and welcome any further comments
from other people (RDs and SLPs).
Thanks,
Sharon
On 10/4/06, Michel Sanscartier <m.sanscartier@videotron.ca> wrote:
>
> Since when lactose is changing any liquid's consistency?
>
> Is that exactly what the RD you work with told you?
>
> If it is, unfortunately, she didn't express herself correctly. She meant
> that after some surgery, the GI tract is very sensitive and the secretion
of
> lactase can lower and we often see lactose intolerance for some days. A
> "Clear" diet, chemically speaking is without any substance that could
cause
> irritation of the GI tract. There's absolutly no link with dysphagia.
> Rheologicaly speaking, clear liquid has another definition. If we speak
> about consistency, the consistometer is the tool to determine if a liquid
is
> clear or not (? 24 cm). If we speak about the viscosity, some authors has
> defined clear if ? 50 cP (witch don't make any sense to me). There's a
lot
> of work to do in research to establish the link between rheology and
> dysphagia. In the mean time, I would suggest that the nutritional and
> medical status is discuss with the RD before you give any suggestion for
the
> diet.
>
>
>
> Michel Sanscartier RD, MS
>
>
--
"Death is caused by swallowing small amounts of saliva over a long
period of time."
- George Carlin
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
--------------------------------------------------------------------------------
No virus found in this incoming message.
Checked by AVG Free Edition.
Version: 7.1.407 / Virus Database: 268
----- Original Message -----
From: "Sharon Manders" <sharon.manders@gmail.com>
To: "Michel Sanscartier" <m.sanscartier@videotron.ca>
Cc: <dysphagia@b9.com>
Sent: Thursday, October 05, 2006 12:00 AM
Subject: Re: Re: [Dysphagia] Clear fluids
> Hi Michel,
>
> I didn't say that lactose changed the texture (nor did the RD). I was
> asking why people (SLPs) even order clear liquids in the first place.
> As far as I am concerned, clear liquids and regular liquids are
> practically the same thing texture wise (rheology aside).
>
> I also think people may have misunderstood my initial question. Only
> surgeons order clear liquids as a diet. I was asking about clear
> fluids in addition to a food texture. SLPs in my facility and others
> that I have been in, order a food texture and a liquid texture. I am
> referring to the liquid part of the diet order.
>
> Sorry for not expressing myself clearly initially [one would think as
> an SLP I would be able to! :) ]
>
> My question is: What liquid textures do other SLPs order? I have read
> the National Dysphagia Diet (from the US) and according to that, there
> are 4 textures: thin, nectar thick, honey thick and pudding (isn't
> that pureed?) Does anyone add an additional "level" i.e. clear
> liquids? If so, why?
>
> In addition, my RDs are *always* involved re: nutrition status, but we
> are the ones who are involved with the texture. I would never even
> dream of ordering a diabetic or healthy heart or renal diet - that is
> not my job. I order the texture, they order the rest of the diet.
>
> I hope that clarifies things a little.
>
> I do appreciate the comments though and welcome any further comments
> from other people (RDs and SLPs).
>
> Thanks,
>
> Sharon
>
> On 10/4/06, Michel Sanscartier <m.sanscartier@videotron.ca> wrote:
>>
>> Since when lactose is changing any liquid's consistency?
>>
>> Is that exactly what the RD you work with told you?
>>
>> If it is, unfortunately, she didn't express herself correctly. She meant
>> that after some surgery, the GI tract is very sensitive and the secretion
>> of
>> lactase can lower and we often see lactose intolerance for some days. A
>> "Clear" diet, chemically speaking is without any substance that could
>> cause
>> irritation of the GI tract. There's absolutly no link with dysphagia.
>> Rheologicaly speaking, clear liquid has another definition. If we speak
>> about consistency, the consistometer is the tool to determine if a liquid
>> is
>> clear or not (? 24 cm). If we speak about the viscosity, some authors has
>> defined clear if ? 50 cP (witch don't make any sense to me). There's a
>> lot
>> of work to do in research to establish the link between rheology and
>> dysphagia. In the mean time, I would suggest that the nutritional and
>> medical status is discuss with the RD before you give any suggestion for
>> the
>> diet.
>>
>>
>>
>> Michel Sanscartier RD, MS
>>
>>
>
>
> --
> "Death is caused by swallowing small amounts of saliva over a long
> period of time."
> - George Carlin
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
>
> --
> No virus found in this incoming message.
> Checked by AVG Free Edition.
> Version: 7.1.407 / Virus Database: 268.12.10/459 - Release Date:
> 2006-09-29
>
>
------------------------------
Message: 6
Date: Tue, 10 Oct 2006 20:00:30 -0700 (PDT)
From: kathy <kwspeech@yahoo.com>
Subject: RE: [Dysphagia] Mouth and throat cancer
To: "Dolinger, Eric" <EDolinger@Christianacare.org>, "'Jaimie
Savasta'" <raemay17@yahoo.com>, Dysphagia@b9.com
Message-ID: <20061011030030.13338.qmail@web52403.mail.yahoo.com>
Content-Type: text/plain; charset=iso-8859-1
Thanks!
"Dolinger, Eric" <EDolinger@Christianacare.org> wrote:
see for example.....
Gaziano JE. Evaluation and management of oropharyngeal
dysphagia in head and neck cancer. Cancer Control 2002;
9:400-409.
Kulbersh et al.:
Pretreatment, Preoperative Swallowing Exercises May Improve Dysphagia Qualityof Life
Laryngoscope, 116:883-886, 2006
CONCLUSION
Patients who performed pretreatment swallowing exercises
prior to their head and neck cancer therapy in this
study had a significant increase in the swallowing QOL
when compared to patients who performed only posttreatment
swallowing exercises. This study suggests for
the first time that in head and neck organ preserving
therapy, pretreatment swallowing exercises may potentially
improve dysphagia-related QOL.
Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System
Phone 302-733-1015
Fax 302-733-1061
edolinger@christianacare.org
-----Original Message-----
From: kathy [mailto:kwspeech@yahoo.com]
Sent: Tuesday, October 10, 2006 2:12 PM
To: Dolinger, Eric; 'Jaimie Savasta'; Dysphagia@b9.com
Subject: RE: [Dysphagia] Mouth and throat cancer
Is there evidence to support this during XRT?
"Dolinger, Eric" <EDolinger@christianacare.org> wrote: Absolutely. The idea is to provide exercises (oral/base of
tongue/pharynx/hyolaryngeal elevation) to try to limit the amount of tissue
fibrosis which can occur over time and potentially wreak havoc on the
swallowing mechanism. Also watch for diminishing jaw ROM (trismus.
Now is the time to start these....and the likelihood is low that there will
be any untoward effects (other than discomfort).
Also, would try to keep him swallowing as much as possible throughout the
process (even if its just water or ice chips)
eric
Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System
Phone 302-733-1015
Fax 302-733-1061
edolinger@christianacare.org
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Jaimie Savasta
Sent: Monday, October 09, 2006 10:24 PM
To: Dysphagia@b9.com
Subject: [Dysphagia] Mouth and throat cancer
I have a question regarding a recent patient I have on my caseload. He has
tongue base cancer and also pharyngeal cancer. He will be receiving
radiation starting this week, and my question is this: Is it appropriate to
do oral motor and pharyngeal exercises with him as he has radiation? Will
it be beneficial at all? Are there any precautions with doing these
exercises in this special case? Currently he is NPO and has some scar
tissue at the back of his throat from the biopsy. I am a fairly new SLP,
and have no experience dealing with cancer of the mouth. Any pointers would
be very helpful. Currently I am planning to discuss his case with the ENT,
and I am planning on checking ASHA's guidelines in this area. So any input
would be greatly appreciated.
Thank you.
Jaimie Savasta, MS CCC/SLP
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Kathy Walker
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Kathy Walker
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End of Dysphagia Digest, Vol 35, Issue 12
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