Amazing Speech Therapist and Swallowing Tips

[Artie]

MMG I could probably drink coffee with thickener. I don’t know why that would be ok, but the very idea of tea with thickener makes me 🤮

[Christopher]

MMG and shelly21 well the stars must have been aligning as yesterday my son brought across decaf cappuccino sachets!

Does that mean we are doing a mind meld? Our power could be unstoppable.

[shelly21]

MMG I buy the sachets cappuccino and add thickener which i love.

[MMG]

Just to add, Dean couldn't cope with thickener in cups of tea, as you said tea should just be tea, but I had bought him a tassimo coffee maker (other brands are available as they say on TV Ha!) and he loved the vanilla latte coffee with a scoop and a half of thickener. Thicker coffee is much more palatable than thicker tea.

He managed these (following a lit if experimentation with straws, sippy cups of various designs) even when he could no longer eat.

[Christopher]

denise I love this place. Little tips that we can all try that do no harm to anyone.

Just how the World should be. xx

[denise]

I'm finding this swallowing thing fascinating. I fell down a flight of stairs sideways when I was 18 and landed on my left shoulder and had carpet burns down my face, shoulders and back and a beautiful black eye. Luckily I had fainted so was relaxed which helped, so I was told. Since then I have had problems swallowing and always sound as though I'm gulping even when drinking. People would ask if Stephen had problems swallowing or choking and I'd say if anyone has problems it's me. I'm going to try this and see if it works for me. Shame I've finished my bagel.

[Christopher]

Claireflo Yes I still have a thing about full fat milk, even though as a child we would have it straight from the cow.

Can't think about anything but skimmed in tea. Thought don't really drink that much of it now.

Its great to be able to joke about it with your Dad. It sounds like you are giving him lots of love and attention.

It's funny that you mention mashed potato, I used to do a lovely one (I was a very powerful masher). The dieticians and even the speech person yesterday mentioned it. I had to say, I don't have the strength to mash anymore.

Positive is that today I have eaten lots of chocolate, lots of ice cream, a nutrition drink thing and two yoghurts, don't tell anyone though.

Big hugs to all.

[Claireflo]

Christopher my dad used to do boxing as one of his sports so watched his weight. He was quite horrified when I brought him some cream to add to his porridge and to use in mash potato! We joke about what he calls his rolls of fat (which is now sadly just loose skin).

[Christopher]

Also an abstract on a paper on the subject of head turning to help swallowing.
The benefit of head rotation on pharyngoesophageal dysphagia

J A Logemann ¹, P J Kahrilas, M Kobara, N B Vakil
Affiliations expand

• PMID: 2802957

Abstract


This study examined the effect of head rotation on the mechanics of swallowing in healthy subjects, as well as the effects of this postural change on the oropharyngeal swallow of five patients with lateral medullary syndrome (LMS).

Videofluoroscopic studies of swallowing in the normal subjects revealed that head rotation to either side increased upper esophageal sphincter (UES) opening diameter by an average of 2mm without affecting the period of UES opening or the oropharyngeal transit time.

Maximal rotation of the head to the right or left caused the bolus to lateralize away from the direction of rotation, and also caused a significant (18mmHg or 35%) fall in UES pressure.

In the face forward position, the LMS patients exhibited barium residue in the pharynx and pyriform sinuses, as well as diminished UES opening diameter. The fraction of the bolus swallowed and the UES opening diameter increased significantly with the head turned toward the paretic side in the LMS patients.

We conclude that head rotation can improve swallowing in patients with unilateral oropharyngeal dysphagia.

Two potentially beneficial effects were observed: (1) functional exclusion of the relatively flaccid, weakened pharyngeal wall, and (2) reduced UES tone.

Which of these mechanisms is operative probably depends on the dominant mechanisms of dysphagia. In individuals with substantial impairment of UES opening, head turning reduces the resistance of the sphincter that must be overcome by pharyngeal contraction.

In individuals with a flaccid hemipharynx, which dissipates pharyngeal pressure, head rotation excludes these structures from the bolus path and allows pharyngeal pressure to be directed at the UES.

[Christopher]

Just found this online about the head turn swallowing technique that I was taught yesterday.

[denise]

Well done you I'm going to pass this on.

[Christopher]

denise I was offered the powder based one as well. ActaSolve It was really nice, really nice with a variety of flavours. It came with a shaker so you could make a "smoothie" with it. I chose the milk based one just because I am lazy and it meant I didn't have to shake anything. They were both on prescription.

[denise]

Does anyone know of a high calorie drink that isn't milk based? He seems to be choosing fruity over milky.

Thank you Christopher I really have done my best and I'm finding it extremely difficult to give up my roll while he's in a care home. I thought it would be a relief but it's the opposite. 😔

[Christopher]

I do drink the 250ml of Altraplen.

I had it instead of lunch yesterday as I didn't have the energy after the therapy visit to prepare anything.

Stephen is a lucky man to have such a loving wife and he will be appreciating every little thing that you do for him, even though he might not be able to show it.

[denise]

Oh yes I remember the powder for thickening drinks. Stephen was not impressed. It was like everything they suggested he turned his nose up. I thought he would like the high calorie mousse but no he didn't want it. I ended up with so much stuff and he wouldn't touch it. 🙄