I see many adults after extensive stays in the Intensive Care Unit (ICU). Most of the time, the patient has had a stroke, or some sort of respiratory failure that requires the placement of a feeding tube. When talking to the patient or other family members, the question of eating again comes up quickly.
Swallowing problems, or Dysphagia requires extensive, clinical knowledge, and poor management of this disorder can result in aspiration pneumonia or even death. Eating safely depends upon many variables, such as: Arousal state/cognition, laryngeal function, airway protection, oral motor skills, just to name a few.
Some patients may be referred for a Modified Barium Swallow Study (MBSS), others may only require a Bedside Swallow Assessment (BSA), some patients may require a Blue Dye Test of Swallow. Once a patient has been cleared to start oral feeding trials, I usually start the eating process very slowly. Depending on the patient, the process may take several weeks and require intensive oral-motor exercises in conjunction with oral/pharyngeal compensatory strategies.
Before initiating an oral diet, it is best to consult with a licensed, speech and language pathologist. Insurance companies generally reimburse for oral and/or pharyngeal dysphagia treatment by a licensed speech pathologist.
For more information regarding outpatient dysphagia services in Tucson, or to simply ask a question about speech therapy services in Tucson, please contact me here.
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