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Gabby Balla - Allentown Campus

2/4/2018

 
PictureGabby (left) and Rebecca (right)
“Thank you for stopping by, Gabby. Speech therapists love it when other healthcare providers care about what we do.”

In inpatient acute care, the average work day for a physical therapist or a speech language pathologist might seem drastically different from that of a dietitian. So what do these people all have in common? They’re all a part of a patient’s interdisciplinary care team. The quote above is the response I got from Rebecca, a speech language pathologist at St. Luke’s hospital. With help from my preceptor, I was offered the opportunity to observe a video barium swallow while completing my advanced clinical rotation at St. Luke’s hospital – Monroe Campus. Prior to seeing her patient, Rebecca gave me an explanation of what she does as a speech therapist, how she was going to perform the swallow evaluation, and what I should be looking for as the patient was performing the test.

Speech therapists are consulted in acute care settings when there are concerns for issues with feeding or swallowing. This is referred to as dysphagia. There are a multitude of reasons why a patient might have problems swallowing including cognitive impairment, muscular and neurological complications, and anatomical abnormalities. Different kinds of illnesses, surgery, and injury can leave patients with dysphagia of different severity.

The patient I observed had multiple strokes with a history of dysphagia. Rebecca gave him foods and liquids of varying thicknesses and assessed his swallowing ability via x-ray video. The applesauce, graham cracker, and beverages were mixed with barium—a white powder that makes the foods and liquids visible by x-ray. Fortunately for the patient, he did a fantastic job swallowing and only needed his liquids to be of nectar thick consistency. After the study was over, Rebecca and I revisited the videos and she provided a thorough explanation of her observations and the reason for her nectar thick liquid recommendation.

Dietitians need to work closely with other members of a patients’ healthcare team—and speech therapists are no exception! Spending time with Rebecca gave me a better understanding of dysphagia and thickened liquid diets and I learned the potential implications of failing to diagnose swallowing issues.  I also got a quick anatomy review of the esophagus and trachea—all wonderful things for a prospective dietitian to know!


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