Dysphagia Study Week #2

So us lucky students at the University of Essex get a 2 week intensive study on Dysphagia and as a SLT that adores Paed's, and hates anatomy, I went into these 2 weeks thinking "right lets get this over and done with and we can forget about it by 2013" - but I have to admit I have become some what of an A&P Geek! I am buying books, watching youtube videos, tweeting Dysphagia specialists & playing with as many larynx/pharynx/epiglottis models as possible to get my head around it all!

 

Here is a picture with me and todays model - who was dubbed Eddie as he has a workable Epiglottis & in the true sense of SLT alliteration was essential!

Me & Eddie the Epiglottis!

 

 

So over the past 5 days out of the 6 study days we get, we have learned about the stages of the normal swallow & then practiced eating and drinking thinking of how the swallow occured, what stage each occured at, and how difficulty or easy each different food/drink was to swallow. & boy oh boy does this exercise not only make you more aware about how much goes on during a "simple" swallow - but also makes you TIRED! Imagine if you had dysphagia and had to think about each bite.. I think I'd be tired after a couple, as without dysphagia it was tiring to think of how I brought a biscuit to my lips, made lip seal whilst chewing the biscuit, formed a bolus on to centre of tongue, pushed the bolus to the back of my tongue and triggered a swallow and passed this down my oro-pharynx whilst ensuring my larynx-elevation occured and epiglottis folded and carried the bolus down my esophogeus. See, just the thought of the swallowing process is tiring enough!

 

Here's a Videofluroscopy (Instrumental Ax) of a Normal Swallow - incase all that jargon nonesense was too much for you!

 

 

Then following this exercise we had a visit from a COPD Specialist where we taught about the impact of respiration on the swallow - Including highlighting that those with a typical swallow will swallow on an out breathe in a process of:

 

Breathe Out - Swallow - Breathe Out

 

However those with respiratory problems will:

 

Breathe In - Swallow - Breathe In.

 

Thereby breathing in is pulling bolus down to lungs through the larynx passed vocal cords! So aspiration may occur and this leads to worsening of the respiratory problem!

 

Now doesn't this just add to the tiredness - Thinking of how to breathe on top of all those other muscle co-ordinations above!

 

There were many other fascinating things from the COPD day, and I have tweeted a few so head to my Twitter account at @GemSLT or search #dysphagia #slp2b or #slpeeps :)

 

Then we had a dietician visit - & that was interesting to hear that poor fluid or food intake can be as a result of lack of knowledge of nutrition, environment a person is in, medical &/or physical conditions, oral hygeine or most importantly in our field of SLT - Swallowing! 

 

One of the drinks we got to try from the dietician!

 

We were then able to taste some drinks that whilst tasted like strawberry milkshake on initial taste, left a rather unpleasant texture sensation in the mouth! But these were nutritionally complete drinks that are for gaining weight or nutrients in a speedy way for those that may have had a long term dysphagia and had poor nutrition as a result.

 

And finally we get to today; feeling our own swallows, feeling others dry swallows, swallows after drinking normal water, and after feeding others thickened fluids! Now we were only meant to feel our partners swallow, but if I refer you back to my initial comments of becoming a A&P Geek - I preceeded to use my fellow peers as "guinea pigs" and felt so many different swallows - It was so fascinating - You can really feel the larynx elevation during pharyngeal stage and the muscles in the tongue during oral stage!

 

(& although the thickened fluids were a shock to the palate at first, I didn't find the thickened fluids too bad after having 6 different people feed me them in order to feel my swallow!)

 

 

An #SLP2B desk during Swallow Ax!

 

 

So overall I've had a very exciting last 2 weeks of term, where I have discovered a new love in a job that I adore, I have surprised myself with my ability to become "sciency" as I like to now think & think it has been a fun practical way to end this first term of being a (scary but excitable) final year post-grad student!

 

I now have 1 day left of dysphagia - Then 3 weeks leave to work on my research dissertation (await a blog about that!) & then come back in January for a most exciting 8 Day Placement in a Adult LD Setting that I just cannot wait to begin!