[Dysphagia] RE: CP (dysphagia)

[sorriso at adelphia.net (sorriso@adelphia.net)]

Hi Sharon, 
 
I understand that he's most likely in a debilitated condition at this time but I 
think the first thing you need to find out is how much different his swallow is 
now as compared to baseline.  
 
You described quite well a young woman (same diagnosis) I was asked to see upon 
her transfer to a skilled nursing/long-term care facility where I work 
(interestingly enough she had been transferred from another one of the 
facilities I covered, over two hours away, and had been a resident for more than 
a year--and had never been on caseload).  
 
The new facility was concerned about her swallow.  It was exactly the way you 
described with the added benefit of a chin up/full neck extension position.  She 
looked a bit like a baby bird waiting to be fed while she manipulated a solid 
bolus.  There was nothing to be done, just provide oral care.  She'd been eating 
and drinking like this for 20+ years, weight maintained, no respiratory 
problems. 
 
Linda A. Zanchi, MA CCC-SLP 
 
---- Sharon Manders <sharon.manders@gmail.com> wrote: 
> I am currently working with a 28 year old with CP . He was admitted with 
> necrotizing pancreatitis and has suffered through a host of other 
> ilness/infection during his prologed stay in ICU where he remains. On 
> MBS/bedside assessments pt demonstrated poor mastication of soft solids- 
> reduced vertical jaw movement/ no rotary chewing, minimal to no use of 
> dentition, mainly tongue manipulation (tongue to palate).  Pieces of food 
> appeared to be swallowed  whole, which was concerning as pt had 2 Ng's and a 
> trach insitu. The NG's and trach (more recently) have been removed. Pt would 
> like to get back to his regular texture oral diet, currently on Minced/diced 
> soft textures. 
> 
> Curious to know if: 1. Pts with CP have a special/different oral phase of 
> the swallow; 2. Has anyone had any experience in trying oral motor exercies 
> to help with chewing .  Currently pt has a moderatly reduced ROM of jaw on 
> opening with inability to lateralize ? seconday to spasticity. 
> 
> Thanks in advance for your help, 
> 
> Helen Papakyriacou 
> Speech Language Pathologist 
> St. Joseph's Health Centre 
> Toronto, On 
> 
> -- 
> "Death is caused by swallowing small amounts of saliva over a long period of 
> time." 
> - George Carlin 
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