I got to observe a swallow study today also known as a FEES which is seen as the medical side of speech therapy. A swallow study consists of a small tube with a camera on the end of it that is being put through your nasal cavity all the way down to your throat near the esophagus and vocal chords. A swallow study is used to see if a patient should have their meal plan changed because they have swallowing issues that pose a threat to their safety because choking could become a frequent hazard. To test a patient's ability to swallow the speech therapist doing the procedure gives them three different cups of water that have three different consistences, to sum it up thin to thick liquids. They also test how the patient does with a liquid food like apple sauce, a half liquid half solid food like a fruit cup, and a dry food like a cracker. All of the food and liquids that are tested are colored blue or green prior to the procedure in order for the speech therapist to be able to see if any of the food or liquids is getting stuck in the patient's air way after the action of swallowing. If food or liquids gets stuck in the patient's air way we have a problem and a threat to the patient's safety. How the problem is addressed is usually a diet change in the best interest of the patient and therapy might be recommended in order for the patient to strengthen their muscles in their throat to be able to swallow in the future and get back to a regular diet when eating. The speech therapist works together with the dietitian of the patient who is having trouble swallowing certain things in order to make adjustments specific for the patient and in their best need. In this case the patient today was having a hard time swallowing a thin liquid such as water. They were slow when swallowing so they would end up having the liquid go into their air way since they couldn't swallow fast enough to stop it. You could see small traces of the colored water left in the air way of the patient in between the vocal chords when we were doing the procedure. After we got the final results from the speech therapist that came in to do the procedure we were able to make a plan for the patient and figure out what further actions needed to be taken in order to improve their swallowing ability. I didn't only get to witness a swallow study today I also got to witness a new patient evaluation. When a new patient is admitted or referred to speech therapy the first time a speech therapist sees them they do a whole evaluation of everything the person can do and so on. They ask a lot of questions about what happened to the patient in the past medical wise like if they had a stroke a few years ago or some other medical problem. They then move on to evaluating their mind by giving them simple directions to see if they are able to follow them or if they have trouble remembering them. There is a speech portion of the evaluation as well to see if they slur their words or anything like that but I wasn't able to observe that portion of it but, I'm hoping to see another in the remaining time I have shadowing. Here is an example of a swallow study during the procedure. If you don't like gross images don't watch this video https://www.youtube.com/watch?v=l8eICovpb28
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