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“Traveling Space Available” II

Mackenbach, Germany

December 3, 2016 at 0900 hours

Many years ago, I wrote an article for a travel magazine called “You and Europe” in a city not far from here. The article, which dealt with hitchhiking rides on military aircraft throughout what we used to call the “European Theater” was titled “Traveling Space Available.”

Now, years later, and traveling with a gastric tube feeding apparatus on board and a supply of formula, I find those words take on a very different meaning. Will there be space available on the airplane for my supply of formula? Is there “space available” in the cabin for the occasional and necessary feedings? Can I replenish my supply of formula while traveling here in the USA and abroad? Will I join my wife or others for meals out in cafes or restaurants? Is it all worthwhile? continue reading →



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DGR & NFOSD Webinar Recording: To E-Stim or Not to E-Stim, Is that the Question?

In May 2017, the NFOSD teamed up with Dysphagia Grand Rounds to host a webinar on electrical stimulation. Participants were encouraged to read a research article prior to attending the webinar. Below is the recording of the webinar, presentation description, presenter bios, and the link to the free-access article.

 

Link to the Webinar Recording: https://vimeo.com/221877703

 

Webinar Description:

Evidence-Based Practice (EBP) is the integration of clinical expertise, patient values, and the current best research evidence, into the clinical decision-making process for patient care. Learning how to access, appraise and apply scientific evidence to clinical practice significantly enhances the opportunity for optimal patient outcomes and quality of life. Dysphagia Grand Rounds (DGR) is an online monthly journal club for speech-language pathologists, which focuses on swallowing and swallowing disorders across the lifespan. The goal of DGR is help clinicians learn how to critically appraise dysphagia research literature and to apply research evidence to clinical practice, with greater confidence and critical thinking. In this webinar, swallowing researcher and expert Dr. Ianessa Humbert and speech-language pathologist Rinki Varindani Desai introduce clinicians to Dysphagia Grand Rounds. Using the DGR format, they further discuss a research study regarding the effects of surface electrical stimulation on swallow function in patients with chronic pharyngeal dysphagia in detail. Clinicians are encouraged to read the open-access journal article below before viewing this webinar, to maximize their learning experience.

 

Article Details:

Title:​ Effects of Surface Electrical Stimulation Both at Rest and During Swallowing in Chronic Pharyngeal Dysphagia

Download Link​ (open-access): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1790908/

Abstract: We tested two hypotheses using surface electrical stimulation in chronic pharyngeal dysphagia: that stimulation 1) lowered the hyoid bone and/or larynx when applied at rest, and 2) increased aspiration, penetration or pharyngeal pooling during swallowing. Bipolar surface electrodes were placed on the skin overlying the submandibular and laryngeal regions. Maximum tolerated levels of stimulation were applied while patients held their mouth closed at rest. Videofluoroscopic recordings were used to measure hyoid movements in the superior-inferior (s-i) and anterior-posterior (a-p) dimensions and the subglottic air column (s-i) position while stimulation was on and off. Patients swallowed 5 ml liquid when stimulation was off, at low sensory stimulation levels, and at maximum tolerated levels (motor). Speech pathologists blinded to condition, tallied the frequency of aspiration, penetration, pooling and esophageal entry from videofluorographic recordings of swallows. Only significant (p=0.0175) hyoid depression occurred during stimulation at rest. Aspiration and pooling were significantly reduced only with low sensory threshold levels of stimulation (p=0.025) and not during maximum levels of surface electrical stimulation. Those patients who had reduced aspiration and penetration during swallowing with stimulation had greater hyoid depression during stimulation at rest (p= 0.006). Stimulation may have acted to resist patients’ hyoid elevation during swallowing.

 

Meet the Presenters: 

Dr. Ianessa Humbert, Ph.D., CCC-SLP​ is an Associate Professor at the University of Florida in the Department of Speech, Language, and Hearing Sciences. She has expertise in swallowing and swallowing disorders. Dr. Humbert’s research program is focused on the physiological mechanisms of swallowing disorders and development of rehabilitation strategies for dysfunction. More recently, a major interest of her program has been to understand the neural mechanisms underlying normal and disordered swallowing and how principles of motor learning can be applied to examine these as well as swallowing interventions. Dr. Humbert’s research has been steadily supported by grants from the National Institutes of Health, The American Heart Association, and The American Speech Language Hearing Association since 2006. Dr. Humbert is a widely sought after invited speaker at several national and international clinical and scientific meetings. She has created online courses for CEU credit on swallowing physiology and clinical practice, for which hundreds of clinicians have registered to date and is also the author of the Swallowing Pocket Guide: A Quick Reference for Muscles and Innervation, which has sold several hundred copies nationally and internationally.

 

Rinki Varindani Desai, M.S.,CCC-SLP is an ASHA-certified Speech-Language Pathologist and a BIAA-certified Brain Injury Specialist, specializing in the assessment and treatment of cognitive-linguistic and swallowing disorders in adults. She has extensively treated adults with dysphagia in the acute care and long-term care medical settings. She is trained in the use of Fibreoptic Endoscopic Evaluation of Swallowing (FEES), Myofascial Release for swallowing disorders and certified in the use of NMES (Vitalstim) for dysphagia management. Rinki founded the Medical SLP Forum and co-developed the mobile app Dysphagia Therapy . She serves on ASHA’s SIG 13 Editorial Review Committee as the CE Editor of Perspectives and on the Dysphagia Research Society’s Website, Communications and Public Relations Committee . She has spoken at several national and international conferences on topics related to dysphagia in adults. Her articles have been featured in popular SLP blogs such as The ASHA Leader , Medbridge Education , Tactus Therapy and Dysphagia Café . Originally an SLP from Mumbai, India; Rinki currently practices in Rochester, New York. You can follow her Medical SLP Blog on Facebook or reach out to her via LinkedIn or Twitter.

 

Learn more here (Resources)

● DGR Website: www.dysphagiagrandrounds.com

● DGR webinars can be downloaded at: http://dysphagiagrandrounds.yondo.com/ .

● Clinicians can earn 1.0 ASHA CEUs for participating in Dysphagia Grand Rounds by

downloading the DGR ASHA CEU bundle here:

http://dysphagiagrandrounds.yondo.com/playlist/dgr-ceu-bundle-2017/163

● Follow Dysphagia Grand Rounds on Facebook , Twitter and Subscribe to the email list

● Watch Dysphagia Grand Rounds Research 101 free webinar here:

http://dysphagiagrandrounds.yondo.com/playlist/freebie-research-methods-101/156

● Additional reading references will be provided during the course of the webinar related

to e-stim and swallowing

 

Medical disclaimer. This Webinar is for informational purposes only and should not be used as a substitute for consultation with an appropriate health care professional, as each individual’s medical situation is unique. It is important that you consult with your medical professional (e.g., physician, SLP) before implementing any course of treatment. Experiences that are new to you should be done with the help of a caregiver and when access to emergency medical care is available.



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Making a Donation in June Won’t Cost You a Penny!

Want to support the National Foundation of Swallowing Disorders without opening your wallet?

Here’s how:

Simply Thick, LLC., an NFOSD Partner, has generously offered to donate $50 to the NFOSD for each “#ThickenedLiquidChallenge2017” video posted on your Facebook page or Twitter feed in the month of June, up to $5,000.

To Participate:

  1. Record a video of you drinking either nectar-thick or honey-thick liquid. Share information about swallowing disorders or how dysphagia impacts your life.
  2. At the end of the recording, nominate three friends to complete the challenge.
  3. Then, share the video on the SimplyThick, LLC. Facebook or Twitter (or both!) pages using the hashtag: #ThickenedLiquidChallenge2017 and challenge 3 friends to create their own videos ! If you don’t want to upload the video directly, you can share the link to a YouTube or Vimeo video.
    • Twitter: @SimplyThickGel
    • Facebook: SimplyThick,LLC.

Need Thickener?  Simply Thick, LLC. has made sure this challenge won’t cost you a penny. They have offered to ship you a starter thickening kit free of charge. All you need to do is call or order this online using Coupon Code “TLC2017.” It will take 2-3 business days to arrive.

Questions? Feel free to email us an info@nfosd.com.

 

 

Watch John Holahan, SimplyThick, LLC. owner and founder, take the #ThickenedLiquidChallenge2017: https://www.facebook.com/SimplyThickGel/videos/1704154082934785/

Previous #ThickenedLiquidChallenge Videos

 



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A Walk Through the Fire: A Resource for HNC Patients

The Head and Neck Cancer Living Foundation out of Kansas City put together a 15-minute documentary describing the journeys of six head and neck cancer survivors from diagnosis through the aftermath of the treatments.

The HNC Living Foundation funded this video to help compassionate people understand the devastation and intensity of the process and to draw donations to help those who have no insurance, are under-insured or who’s insurance simply runs out. The costs of living after the treatment can break a person financially and emotionally.

Watch this video: https://vimeo.com/212089320



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Essential History: From My Mom, To the World

By Diane Wolff

I am an author who gave up the writing life in the big city to return to the family and take care of my mother. The late, great Cathie G was one of a kind: energetic, spunky and independent. She had a great sense of humor and she ruled her children with an iron hand. She was a great mom for me and when she asked me to take care of her, I could not refuse. continue reading →