Physical Therapy - Swallowing Issues

Mike Thomas: It is time for us to ask the expert and joining me today is Marcia Hunt. Marcia is a speech pathologist who has spent the last eight years helping people through the outpatient therapy services department at Barnes-Jewish St. Peters Hospital. We're going to talk with her in particular about swallowing but first off, Marcia good morning, welcome!

Marcia Hunt: Hi, thanks for having me Mike.

Mike Thomas: Tell folks if you don't mind first, what exactly is a speech pathologist and what that entails.

Marcia Hunt: Well, my role here at the hospital is I do acute care and I do outpatient care so 80 percent of what I do is for people that are having difficulty swallowing, which we call dysphasia. It's estimated right now that in the United States there are currently 15 million adults that are suffering from dysphasia.

Mike Thomas: Wow, what causes that?

Marcia Hunt, Well, there's a lot of things that cause it. Sometimes, just the normal aging process can cause you to have a weaker swallow. Some medication can affect the way we swallow. Sometimes we lose like a loss of appetite due to a decrease of your taste or smell. So, that will cause you to now want to eat a whole lot. Sometimes people that have a reduced ability to chew... sometimes it can be a simple as ill-fitting dentures. People with strokes, head injury, patients that have received or are currently receiving radiation treatment for head and neck and of course there's neurological disorders: Parkinson's and multiple sclerosis and myasthenia gravis.

Mike Thomas: Wow. So a lot of different factors can...

Marcia Hunt: There's a lot of different things that affect the way we swallow.

Mike Thomas: Is there any one particular segment or any particular.. or you know.. segment of the population at risk for having swallowing problems. Any age group or anything like that?

Marcia Hunt: Well, typically like I said as you age.. but people that have had stroke are very susceptible. Any of the neurological diseases of course cause you to have difficulty.

Mike Thomas: Right, so I mean, what happens if you can't swallow properly what does that do?

Marcia Hunt: Ok, so food to liquid can enter the upper airway and eventually can work its way into your lungs which can lead to pneumonia and you're at a higher risk for pneumonia if you have a decreased swallow function. In severe cases it can actually lead to a feeding tube. So you can maintain your adequate nutrition and hydration.

Mike Thomas: It's interesting you say that because I hear that a lot with Alzheimer's patients.. that that's one of the issues that leads to them ultimately.. their passing is swallowing issues so it does... you don't realize I don't think how much swallowing plays out as important to your health.

Marcia Hunt: Yeah, we just you know.. swallowing is a really intricate process and we really take it for granted until something goes wrong with it. But, back to the ALS.. or the Alzheimer's. Advanced Alzheimer's you lose all of those involuntary functions so yeah.

Mike Thomas: And of course.. and I don't mean to be facetious about it we're sitting here talking about this and I imagine you hear this a lot... as you start thinking about swallowing then you do just that: You're thinking oh gosh! Am I swallowing right? You know... that type of thing. Are there programs.. do you have programs out there to help with swallowing and where can I go for help if I need assistance?

Marcia Hunt: Well, you would start with your doctor and he would refer you to a speech therapist. If you're in the hospital of course we have things in place where we identify people that are having swallowing issues but if you're having difficulty then I would say not to ignore that.. you would need to get with your doctor and see a speech-language pathologist. Then, you know, he or she will devise a plan that will fit your needs. There are several different things that we can do. There are traditional.. just traditional speech therapy that consist of exercises. Sometimes that's all you need is maybe just a little bit of exercise program to perk your muscles up. Sometimes we have to do diet modification or sometimes you might just be having trouble with thin liquids so we thicken up your liquids just a little bit and sometimes we maybe eliminate certain foods like bread or meat or we chop your meat up. We just do a lot of modifications. I also do a vital stim therapy which is an electrical stimulation to the muscles and nerves that we use for swallowing. It's almost like a rehabilitation of that swallow function and I've had a lot of success with that. So, there are several things we can do.

Mike Thomas: Anything we can do like today to start helping... you know, prevent swallowing problems. In other words, take preventative measures so we don't develop issues.

Marcia Hunt: Well, I would say you know, don't ignore it, if you're experiencing difficulty then you need to speak to your doctor about it. Sometimes we just don't.. some people just eat too fast or they're eating on the run and sometimes you just need to slow down a little bit and focus on what you're doing. You know, but eating is really important if you think about it. You know, what do we do? We get together for the holidays or birthdays. We always eat and we drink and when you can't do that it's really a negative impact on your social life.

Mike Thomas: Psychologically as well as the other part you know, just the health related issues there's a lot that plays into that it's really crazy stuff.. I tell ya. Marcia, if folks want to learn more information about or get more information about swallowing issues and learn more about you how would they do that? How can they contact you guys?

Marcia Hunt: Ok, so I work at the Barnes-Jewish St. Peters outpatient therapy services. We do provide a wide spectrum of speech and occupational and physical therapy services. We are located on the hospital campus. We are actually in the number two medical building. Our phone number is 636.916.9340.

Mike Thomas: Ok, very good and I guess for general information they can always call 636.928.WELL and that will get them into the main hospital area to learn more about all aspects of things. But Marcia, fascinating stuff thanks for joining us I appreciate it.

Marcia Hunt: Hey, thanks a lot for having me.

Mike Thomas: You take care.

Marcia Hunt: Have a good day.

Mike Thomas: There you go folks as we ask the expert this morning from Barnes-Jewish St. Peters Hospital and Progress West Hospital.