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Dysphagia: A Tough One to Swallow


Featured Speaker

Megan Luttrell, MA, CCC-SLP

Megan Luttrell, MA, CCC-SLP

Megan Luttrell is a speech-language pathologist at Aspirus. She specializes in the evaluation, diagnosis, and treatment of communication and swallowing disorders. She works with patients of all ages, including those with aphasia, dysphagia, voice disorders, dysarthria and dementia. Her passion is helping patients overcome challenges so they can communicate and function at their very best.


About this Podcast

Megan Luttrell discusses the signs, symptoms, causes and treatment options for dysphagia.

Transcription

Melanie Cole (Host):  If you know as many older people as I do, you know that seeing someone have swallowing issues is so scary, but aging can be linked to swallowing difficulties or from a number of conditions.  My guest today is Megan Luttrell.  She’s a speech and language pathologist at Aspirus.  Megan, I’m so glad to have you with us.  As I was saying in my intro, and my dad is 95 and after he had a stroke, he started having swallowing issues, and it’s really scary to see.  Can you tell the listeners what is dysphagia, and why does it happen?

Megan Luttrell MA, CCC-SLP (Guest):  Yes.  Dysphagia is really scary to see.  Dysphagia is difficulty swallowing, and it means it might take more time and effort to move food or liquids from your mouth to your stomach.

Host:  Do we know why that happens, and what are some complications because to me it looked like I thought I was seeing him choke, and I was about to jump up but then it kind of went down.  So, do we know why this happens, and what are some of the dangers from it?

Megan:  It can happen due to changes caused by declining muscle strength throughout the body that can occur with natural aging and can also occur with other conditions such as a stroke, dementia, other neuromuscular diseases or head or neck injury.  Some signs and symptoms of dysphagia—you might have coughing or choking while you are eating or drinking.  You might have food sticking in your mouth or throat.  You might have the sensation that you feel like something is getting stuck, and you can’t clear it.  You might have difficulty chewing food.  You might have some drooling.  You might a wet sounding voice after you swallow.  You might have recurrent upper respiratory infections including pneumonia.

Host:  Well, those are pretty scary and certainly what I’m afraid of when I watch my dad eat.  So, tell us a little bit about how this is treated.  Is there a cure?  Is there treatment available?  What would you do as a speech and language pathologist for someone with dysphagia?

Megan:  Usually, for folks that are having trouble swallowing, having dysphagia symptoms, I usually receive a referral from their primary care provider, or if they’ve been hospitalized following a stroke, I will receive a referral from the hospitalist, and we will do a bedside swallow assessment to kind of get a baseline of their swallowing function.  Maybe do some food and liquid trials to see what happens, and after that, we may refer for further instrumental assessment.

Host:  Well, so, what does that mean and while you’re answering what that treatment looks like, do you teach the families as well because when that person goes home, if they’re still having those swallowing issues, then the family’s the one sitting there going, “Wait a minute.  Chew your food better.”  What can families do and tell me what treatment looks like?

Megan:  Well, for treatment, we do talk a lot with families.  A big part of the treatment is education.  We might teach some compensatory strategies to make swallowing safer, like tucking your chin or turning your head to the weak side. We might—say you might have to take smaller bites, alternate a bite or a drink to help clear that food out of your throat.  We might modify their diet.  It might be safer for someone to eat pureed food or thickened liquids than it would be to eat regular foods and regular water.  In some cases, if the swallowing is very, very, very impaired, we might even recommend a feeding tube.

Host:  Wow.  Those were really good suggestions, and I am absolutely going to try them tonight.  So, what else would you like the listeners to know, and if they have family members that are suffering from dysphagia, does it get cured?  Is it something that your treatment can really help in the long run or once they’ve got it, they’ve kind of just—it’s—there are things to do to help keep it from happening, but it’s still going to go on?

Megan:  So tough because it varies from person to person and based on what their diagnosis is then people might have a full recovery and go back to swallowing normally.  Other people may not resume a full oral diet.  It may be safer for them to continue with non-food nutrition through a feeding tube.  It really varies.  Dysphagia can make it difficult for people to get adequate nutrition and hydration.  Unfortunately, thickening liquids also increases dehydration because people don’t necessarily like them.  Some people have a risk of aspiration pneumonia which is the food or liquid entering your airway and then that causes the bacteria to grow in your lungs, and you develop pneumonia and that way there’s the risk of choking.  So, a person’s ability to eat and drink is critical to maintaining good health and promoting their recovery from an illness, and it’s also part of the social experiences of eating and enjoying life, and so, those are things that can be impacted. 

Host:  Absolutely.  So, do you have any best advice as we wrap up for listeners if they do have family members or if they themselves have these swallowing issues—what you’d like them to know?

Megan:  I think it would be best for you to talk to your doctor.  Your doctor can make a referral to a speech language pathologist in your area, and they can more fully assess your swallow function and make recommendations as far as diet and compensatory strategies.

Host:  Well, that certainly is great advice and thank you so much for all the usable advice, Megan.  Thanks for joining us.  If you or a loved one has concerns about a swallowing problem, talk to your primary care provider about a referral for an evaluation.  You can also call Aspirus Outpatient Therapies in Calumet at 906-337-7000.  Thank you so much for listening to this episode of Aspirus Health Talk.  You can head on over to our website at aspirus.org for more information and to get connected with one of our providers.  If you found this podcast as informative as I did, please share on your social media.  Share with your friends and family and be sure not to miss all the other interesting podcasts in the Aspirus library.   Until next time, I’m Melanie Cole.

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