[Dysphagia] RE: CP (dysphagia)

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

I'm sorry, my previous post should have been addressed to Helen.  I glanced at the email address and wrote Sharon instead.

Linda

---- sorriso@adelphia.net wrote: 
> 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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