Swallowing Problems and Things You Can Do

Difficulty chewing and swallowing safely and efficiently can be a problem for many individuals following a stroke, head and neck cancer, or as a symptom of Parkinson's and other neurological diseases.

If you already suffer from chewing and swallowing difficulty,and have been diagnosed with dysphagia ( swallowing problem), you may have been referred to a speech pathologist/swallowing therapist for an evaluation and treatment.

Treatment may consist of:
* changes to your diet,
* recommendations for certain head positions and postures,
* and specific swallowing exercises.

When specific exercises are provided, depending on the nature of the problem, they often include: techniques to improve your ability to hold your breath during the swallow. Surprised?? Many people don't realize that we are always either breathing or swallowing and can't do them both at the same time. When it happens, you choke, or say something "went down the wrong pipe".

Learning some exercises to help you breathe more efficiently, hold your breath longer and harder when swallowing, and timing the swallow so you don't need to take a breath, are all things your therapist can teach you. Vocal glides, a voice exercise, can also help to lift the larynx during a swallow, a position that helps to protect the windpipe from misdirected food or liquid. And, finally, doing some respiratory muscle strengthening exercises, using a resistive breathing device ( think, weight training for the breathing muscles), can also improve coordination of breathing and swallowing and improve you cough effort and power. A stronger cough may actually help clear material if something does go "down the wrong way," and minimize your chances of developing an aspiration pneumonia. ( aspiration pneumonia often develops when food or liquid gets into our lungs, and in particular when we are weak or sick from a disease or illness).

If you would like to watch a former patient of mine demonstrating some swallowing exercises go to:http://www.youtube.com/watch?v=aIRuDmVoHkc

Larry, the fellow in the video had trouble remembering his home program, so, the video-tape was useful and motivating for home practice.
Information about the BREATHER(R) resistive respiratory muscle trainer can be found in the links section of my website or you can go to: pnmedical.com

Voice Speedometer Broken?

Speech and voice changes are a known symptom of Idiopathic Parkinson’s disease (PD). Vocal quality is often characterized as weak in intensity (loudness), and speech is often described as monotone (boring), occasionally too fast, and at times accompanied by other symptoms such as hoarseness or raspiness. Most of these changes in speech and voice come on gradually, leaving the person with PD believing that there speech has not changed at all.
Researcher with the Lee Silverman Voice Treatment ®(LSVT) organization have published a number of studies discussing and describing the changes in speech and voice that occur in Parkinson’s, and these researchers have also described the deficit in sensory processing related to speech, which causes individuals to not be able to accurately judge their level of loudness.
Over many years of providing speech and voice therapy to patients with Parkinson’s, I have developed a metaphor of my own to help patients understand and acknowledge the deficits that contribute to poor voice. I tell patients “you have a broken voice speedometer”, and you no longer have reliable feedback as to the loudness of your voice.” Although I have been driving for over 30 years, I am not convinced that if the speedometer in my car was broken, that I would accurately judge the speed limit. If going too slow, other drivers would honk at me, and if going too fast, well…you know that outcome. So, when you have voice changes related to your PD, you need a better, and more reliable method of feedback. A small, hand held digital sound level meter (SLM) can be useful, not only during speech practice, but at other times during the day to help monitor your target loudness.
I often videotape patients during our first visit , and utilize various methods to help demonstrate rather quickly what better speech and voice is possible. Viewing the video usually provides patients with quick feedback and a concrete goal for their “best” performance.

When driving, you have learned to keep your eyes on the road, while at the same time, from time to time looking at your speedometer. Likewise, with practice, you may be able to better maintain target voice during conversation, glancing from time to time at your sound level meter to keep your voice” in the zone”

Information for purchasing a Mini Digital Sound Level Meter can be found in the Links section of: www.voiceaerobicsdvd.com
If you want to watch a video of Kate Kelsall , blogger, Shake, Rattle and Roll, during one of our coaching sessions,
go to: http://www.youtube.com/watch?v=w-HfkQK4dnY