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WEBWORDS
33: The ACQ Internet Column March 2009
DYSPHAGIA
Caroline Bowen |
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Difficulty eating
because of swallowing problems
is a symptom that affects 15% of
hospital inpatients, older
people, people with neurological
disease, cancers of the head and
neck and people with severe
reflux. This symptom affects a
person's ability to remain well
nourished and hydrated and
increases the risks of ill
health. Effective dysphagia
management requires an
interdisciplinary approach and
can make a huge difference to
the quality of life experienced
by the person with dysphagia.
Nazarko, 2008
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Infants, children and adults with dysphagia who can
swallow experience difficulty with swallowing liquids, food or
saliva. Some endure pain (odynophagia) while swallowing,
and have increased vulnerability to lung infection, aspiration pneumonia,
and airway obstruction, drooling and choking. Others may be quite unable to
swallow or find it so distressing that consuming healthy caloric
and fluid intakes orally is out of the question.
Dysphagia is symptomatic of a number of neurological
disorders, and its most common cause is stroke. Other
aetiologies include traumatic brain injury, cerebral palsy, head
and neck cancer, and degenerative neurological disorders such as
Parkinson disease, amyotrophic lateral sclerosis (ALS or Lou
Gehrig's disease), multiple sclerosis, progressive supranuclear
palsy, Huntington disease, and myasthenia gravis. Dysphagia is
also characteristic of muscular dystrophy, myotonic dystrophy
and oculopharyngeal muscular dystrophy.
Speech-Language Pathologists have a crucial role in the
interdisciplinary assessment and management of swallowing
disorders, fulfilling clinical, consultancy, managerial, team
leadership, educative and research roles.
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WEB RESOURCES
The Internet offers many resources for professionals
interested in the serious topic of dysphagia and a good place to
start is the
Tutorials and Articles section of Phyllis M. Palmer's
Dysphagia and Swallowing Resource Center.
It holds copious information on all age-groups of people
affected by dysphagia, while the site itself has links to a wide
range of important and up-to-date research findings. Dr Palmer
is owner of a vibrant dysphagia discussion forum. Intending
subscribers can enter their email addresses in an
online form and the list's archives can be viewed on a
dedicated page. Subscribers can elect to receive individual
messages, or batches of posts in a daily digest.
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The Mayo
Foundation for Medical Education and Research provides excellent
Plain English information on
Swallowing Problems, while
FreeMD
proudly presents a swallowing symptom check-up using amazing multi
media magic! Self-proclaimed and award winning "virtual doctor"
Stephen J. Schueler, MD interviews site visitors
helping them decide if they need to see a doctor and why. He
takes a medical and swallowing difficulties history, and at the
end of the session tells the interviewee what might be causing
their dysphagia and when to see a medical practitioner.
Swallowing Trouble from the American Academy of
Otolaryngology - Head and Neck Surgery comprises a comprehensive
overview with related pages on
hoarseness and
sore throats. In its "My child has..." series, the
Children's Hospital Boston has a page on
dysphagia and so does
ASHA.
Reliable as ever, the Hardin MD Meta-directory shepherds
browsers to
links pages and pictures.
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MEMBER BENEFITS
On the Speech Pathology Australia web site members can access
Position Papers on dysphagia and modified barium swallows,
and a useful summary of
terminology for modified foods and fluids and a related
PowerPoint
show. Similarly, the ASHA site has a members only area
containing
Paediatric Dysphagia Resources
among other
resources. Speech Pathologists outside the US can become
international affiliates for a reasonable annual fee and
enjoy many benefits including online access to all the ASHA
publications, web forums and position papers, and eligibility to
join
Special Interest Divisions,
including
Division 13. The mission of Division 13 is
to provide leadership and advocacy for issues in swallowing and
swallowing disorders and to serve ASHA members and affiliates who evaluate
and manage individuals with swallowing and feeding disorders
across the lifespan by supporting professional development,
research, education, and communication necessary for delivery of
the highest quality services. Moving further north, the CASLPA
site has an
action learning experience for SLP students on the
experience of having dysphagia for a day. There are more CASLPA
goodies on its
featured articles page, and on the RCSLT site is an
interesting news item entitled
Stroke strategy is hard to swallow.
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SWALLOWING
The verb to swallow connotes immediate images that can range
from the exquisite pleasure of savouring one's very first
home-grown tomato, or sipping cool water after a long, hot hike,
to the slight discomfort of forcing down bad-tasting medicine or
the ghastly but not-too-earth-shattering realization that
although you probably won't die you did swallow a
fly! In everyday conversation it is a verb often figuratively
associated with the distasteful and unpalatable. When we put up
with unpleasant remarks we swallow insults; when our dignity is
bruised we swallow our pride; when we hide our hurt we swallow
our feelings; when our environment is flooded or burnt it is
swallowed by water or flames; when we are gullible we
swallow tall stories; when we retract an embarrassing remark we
swallow our words; and when we mumble and fumble inarticulately
we swallow our lines.
But there is no pleasant imagery, no funny side and
nothing figurative about difficulty with swallowing. Dysphagia
whatever the cause, demands courage and patience of people who
have to adapt to it and consummate skill and dedication of
family members, friends and professionals who support them.
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REFERENCE
Nazarko, L. (2008). The clinical management of dysphagia in
primary care. British Journal of Community Nursing, 13(6),
258-264.
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LINKS
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ACQ
ACQiring Knowledge in Speech, Language
and Hearing, or
ACQ, is Speech
Pathology Australia's clinical and professional journal. It provides
a forum for the (almost) 4,000 members of the association, and is
published three times a year. Each
issue of ACQ has a main theme or topic as well as articles that are
not tied to a particular subject area. Its Internet column, Webwords,
usually addresses the central theme of the issue of ACQ in which it
appears. You can find
Webwords in
print in the magazine itself, and also here on this site, with live
links to featured resources.
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Page
updated
June 15, 2009
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COPYRIGHT
©
Caroline Bowen ALL RIGHTS RESERVED
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http://speech-language-therapy.com/webwords33.htm
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