[Dysphagia] (no subject)

[amandastemmler75 at aim.com (amandastemmler75 at aim.com)]

I have to agree with Paula.  There is an underlying tone that is at times no less than abrasive.  I've never commented on the list serve up till this point, but come on.  
It was a simple request for help and suggestions by Allie.  
Although SLP's who frequently perform MBS, do not use the terminology pass/fail, it's not that difficult to understand what "fail" insinuates when the patient who was being assessed, was NPO to begin with.  "Fail" must mean he left the MBS with a continuing recommendation of NPO.  How many doctors/radiologist/residents/nurses ask, "so did he fail?", when you return the patient to the floors in acute care?"
Granted, the treatment needs to be determined on a more specific detail of the patients swallowing mechanism.  Perhaps Allie did not want to, or have the time to go into complete detail.  The question really seemed more in regards to how long you keep someone on program when you feel he is not progressing, which I'm sure many SLP's have battled with.  
Allie, have you investigated Vital Stim Therapy?  You may not be a provider, but perhaps you can refer your patient to a provider to see if there is any further progress.  Check out the web site, it has providers available based on zip codes.
Good luck.
 
Amanda Stemmler, M.A. CCC-SLP
 
 
 
-----Original Message-----
From: paula.garbin at gmail.com
To: bsonies at comcast.net
Cc: eripley at yahoo.com; dysphagia at b9.com
Sent: Tue, 15 May 2007 5:38 PM
Subject: Re: [Dysphagia] (no subject)


Hi Allie,

I can understand what the other ladies were stating. There has to be
something more specific that you need to focus on with this man's treatment.
What are the main areas of difficulty? And yes is he aspirating everything?
I can understand the use of the word FAIL, but it does need to be qualified.
What did this man "fail" to do during this MBS. And I think you should
continue to treat him with another MBS at the end. If no progress has been
made by that time then I would call it. At that point something is working
against you.

We are here to help other people and answer questions; not to make other
people feel incompetent due to misuse of terminology. Wording and
presentation is everything.

Please let me know what the outcome ends up being.

~Paula


On 5/15/07, Barbara Sonies <bsonies at comcast.net> wrote:
>
> No one FAILS an MBS- this is an incorrect interpretation of the test-what
> do
> you possibly mean by fails??!!! Did he aspirate on all textures, did he
> have
> pooling for some, did he fail to produce any swallow, was there reduced
> hyoid elevation or epiglottal lowering, did he penetrate into the
> vestibule,
> did he attempt to clear the pharynx, did some bolus enter the esophagus???
> These are among the observations one makes to analyze a swallow or set of
> swallows--he can not FAIL.
> Dr Barbara Sonies, BRS-S
>
>
> On 5/15/07 4:44 PM, "tweetsalong at aol.com" <tweetsalong at aol.com> wrote:
>
> > Hello everyone-
> >
> > I am looking for a little advice regarding one of my homecare
> patients.  This
> > gentleman came to me as NPO back in the beginning of March.  I have been
> > seeing him since then and have recertified him for services.  Today he
> went
> > for a repeat MBS and failed once again.  I know that he has made some
> > progress.  He is very motivated and practices his exercises 3 times a
> day.  I
> > will continue to see him for the remainder of the certification period
> which
> > ends at the beginning of July.  Should I recommend another MBS at that
> time or
> > do I discharge him and encourage him to continue to pactice?  When do
> you draw
> > the line as to how long you should continue services (especially if no
> > progress has been made)?  I am waiting for the updated MBS to be faxed
> to me
> > to see if anything at all has changed...
> >
> > Any thoughts would be greatly appreciated...
> >
> > Allie
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