Show me a speech therapist who believes they don’t need an instrumental, and I will show you the old me
My detective-like skills to analyze my patient’s ability to safely swallow certain consistencies is something upon which I have prided myself. It is how my students and co-workers have come to identify me. I am a true swallow whisperer, if you will. A Modified Barium Swallow study has its place in medicine. However, I found over the years it has limitations and its inability to assess a full meal, can leave the speech-pathologist to feel all alone, making life altering recommendations based on a less than perfect method of swallow testing. Patients were being told they could have a NY strip steak based on a few bites of a graham cracker, which are obviously two completely different foods, swallowed and processed much differently. I would be left with my pulse oximeter and a stethoscope in my hand venturing to a bedside only to see my patient in a real-life situation, note that their swallow function changed significantly during a meal and would make my recommendation, much to the contrary of the allowances noted above.
But then I saw a light at the end of an endoscope. Literally, there is a light there!
THE TRUE PICTURE
What changed the swallow whisperer’s heart? Knowledge and exposure. Research shows a 70% error rate at the bedside, with recommendations being too restrictive or missing aspiration completely because as we all know, aspiration can be silent. This isn’t due to lack of training or competency, it is because we can not assess and treat what we can not see. You do not have x-ray vision and no part of your body can detach itself to get a superior view of the larynx during the swallow. But, my endoscope can! Together, we can view, in real time, how the patient is tolerating the ham and cheese sandwich they’ve been craving for the last two months. What if the patient doesn’t enjoy drinking thickened liquids? Together, we can give the patient trials of their favorite drinks, without barium, and assess their safety. I may be holding the endoscope, but you are an important part of this process. Matter of factly, I am nothing without you! My goal is to provide you and your company a service that is evidence-based, safe, cost effective and FEESible. There is a reason why the FEES is considered the GOLD STANDARD in dysphagia diagnostics.