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[Dysphagia] (no subject)
Allie,
I'm behind you 100% my friend! I am also a new therapist, so I know what you
are going through. Do not be intimidated to ask questions, and this listserv
is here to help people, and to answer questions. Keep asking away. ~Paula
On 5/15/07, tweetsalong at aol.com <tweetsalong at aol.com> wrote:
>
> Hello everyone!
>
> Thank you to Paula and Lucy for responding without passing judgment. I
> guess maybe some of you misunderstood (or maybe I stated it wrong) what I
> was saying...
>
> I understand how to treat a pt who has dysphagia. I understand that you
> are supposed to treat the actual problem (reduce tongue base ret, reduced
> larngeal elevation)! I would never tell or document that a patient has
> failed an MBS. I was using that terminology to present my case to the
> listserv. I just found out the results today (he will continue to be NPO)
> via a message left on my voicemail from his wife. I am still waiting for
> the actual results of the study.
>
> On his previous MBS he had (off the top of my head) a 6 sec. delay,
> reduced tongue base retraction, reducecd laryngeal elevation, and aspirated
> every consistency attempted. I have been doing thermal stim, OME's, using
> lemon glycerin swabs,etc. This pt. has a hx of oral cancer and has a
> fistula the size of a golf ball in the roof of his mouth and wears a
> prosthesis for this. When the pts cancer was treated, the salivary glands
> in his mouth were burned...SO...the pt has decreased saliva and is unable to
> produce a timely dry swallow (time ranges from 5-9sec).
>
> I guess I had a miunderstanding about what the point of this listserv
> is...I thought we could rely on our fellow colleagues to help us out when
> needed. I will admit that I am a fairly new SLP...haven't you all been in
> my shoes??
>
> Allie
> -----Original Message-----
> From: paula.garbin at gmail.com
> To: bsonies at comcast.net
> Cc: tweetsalong at aol.com; eripley at yahoo.com; dysphagia at b9.com
> Sent: Tue, 15 May 2007 2:38 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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> >
> >
> > _______________________________________________
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> > Dysphagia at dysphagia.com
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> >
>
>
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