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Dysphagia Support in Pakistan: Illuminating the Path of Awareness and Care

Shifa International Hospital and NFOSD:

Pioneers of Dysphagia Support in Pakistan,

Illuminating the Path of Awareness and Care

Written By Faiza Badar, Manager Rehabilitation Department

Shifa International Hospital

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Survey Opportunity: Dry Mouth

Are you impacted by dry mouth? If so, Oral Fluid Dynamics, LLC. is requesting your feedback through a short, online survey.

This company is in the process of creating a revolutionary dental implant that functions as an artificial salivary gland, providing continuous relief. The device taps the self-replenishing fluid from within the jaw bone.  It filters the fluid to remove cellular material and transfers it into the mouth as substitute saliva.

Want to learn more about the device? Visit:

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Unidentified Causes of Dysphagia


Dysphagia can be exhibited in many ways: coughing, choking, feeling like food is sticking, difficulty or pain with swallowing, bringing food back up, and others.  Sometimes the dysphagia is accompanied by, or can cause, changes in overall health, like weight loss or changes in lung health.    Sometimes the cause of these dysphagia symptoms is obvious, such as when a person has a neurological disease (e.g. Parkinson’s, dementia), has experienced a traumatic episode (e.g. stroke, head injury), or has head and neck cancer.

However, sometimes the symptoms of dysphagia cannot easily be tied to an obvious cause, and therefore no treatment plan can be developed. When that happens, it can be very frustrating and you may feel abandoned by the medical team. What steps can you take if you find yourself in that situation?

  1. Do some research on your own on the web to see if there is any information about swallowing symptoms similar to yours.  Be sure you are reviewing information on reputable sites, such as the Mayo Clinic,, WebMD, etc.  
    • Take good notes on what you read and list the site(s) where you found the information.
  2. Make note of anything you do, or any circumstances, that make the problem better or worse.
    • Better or worse at certain times of the day or night?
    • Relieved or made worse when eating or drinking certain foods?
    • Better or worse when sitting, standing or lying down?
  3. Meet with a member of your medical team, share all of this information,  and pose a series of questions:
    • Review all of your medications (prescription and over-the-counter) with the medical professional and ask if any of those medications might be contributing to your symptoms.
    • Be sure the medical professional is aware of any other medical problems you are having, or have had in the past. Some of these problems might not seem obviously related to your current symptoms, but relationships like that aren’t always clear. For example:
      • ‘Indigestion’ might not seem related to a feeling of a lump in the throat, but the indigestion might be reflux and that feeling of a lump in the throat is likely related.
      • Feeling strain when talking or having a persistent cough might not seem related to pain with swallowing, but it could be.
    • Are there any other diagnostic tests that are indicated to gain more insight into the problem?
    • What are those tests and what further information might be gained?
    • Has the medical professional ever seen another person who presents with symptoms similar to yours?
    • Is there another medical professional you should consult?
    • If you are very anxious about your problem, discuss how anxiety can make certain symptoms worse.
  4. Seek out an assessment at a multi-disciplinary swallowing center. This might be called a Swallowing Center, Swallowing Clinic, Voice and Swallowing Center or Dysphagia Center. Because dysphagia symptoms may seem like they are occurring in one part of the body, but actually originate in another, a multi-disciplinary team that can be found at these centers is often indicated to take a holistic look at the presenting problem.  These specialized centers are usually affiliated with large university systems and would ideally include professionals from specialties such as:
    • Neurology
    • Gastroenterology
    • Otorhinolaryngology
    • Speech-Language Pathology (one with Board Certification in Swallowing). You can check the website of the American Board of Swallowing and Swallowing Disorders to find such a professional:

If you need any assistance finding a specialist, you can reach out to the NFOSD at Our medical advisory board can help provide referral information for the most appropriate specialist.

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Feeding the Medically Fragile Infant

Written by Rebecca Brown, M.S., CCC-SLP, CNT 

Amy’s Story

Amy was born at 24 weeks gestational age, 16 weeks before her due date. Amy was born with her twin, but her sister did not live more than twenty-four hours after delivery. Since delivery, Amy has undergone multiple procedures, including x-rays, eye exams, head ultrasounds, and phototherapy. She was on mechanical ventilation because of her immature lungs for more than a month before being able to breathe without the assistance of the ventilator.  Amy still required supplemental oxygen through a nasal cannula in order to support her breathing. At 32 weeks, Amy began demonstrating signs of hunger, including bringing hands to mouth, opening her mouth wide, and moving her head around to search for a breast or bottle. How should the medical team approach feeding this medically fragile infant?

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Radiation Associated Dysphagia

I didn’t have trouble swallowing right after my radiation treatment, so why now, years later?

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