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terri reinhart

good topic! I've had the heimlich done on me twice. And recently nearly lost a friend to aspiration pneumonia. I'll be watching for the Doctor's response!


Kate Kelsall

The following is a response from Roxann Diez Gross, PhD:

I love that you pointed out how the doctors don’t think to ask about swallowing. One of the problems with PD is that there can be little awareness of the condition. In a current study that I am collecting data on, I found that 6 out of 10 PD participants had significant dysphagia that they were not aware of. Two subjects were silently aspirating.

As to what to do:

1. PD patients should tell their doctors if they suspect a problem and get a swallowing evaluation. The evaluation should be fluoroscopic (x-rays) called a MODIFIED barium swallow (not a standard barium swallow or upper GI) or and endoscopic evaluation called a FEES (fiber optic endoscopic evaluation of swallowing).

2. I feel that if a problem is discovered, that the therapist should not just give PD patients exercises for strength, but they should look at breathing and swallowing coordination. PD patients should assure that they have adequate air in their lungs before swallowing (same as with speech). If the lungs have sufficient air, exhalation will likely follow. I teach patients to hold a small amount of pudding or liquid in their mouths, inhale through the nose and swallow before letting any of the air out. I also teach them to be aware of the nice long exhalation that should follow.

Roxann Diez Gross, PhD
Assistant Professor of Otolaryngology
Director, University of Pittsburg Medical Center Swallowing Disorders Center
Pittsburg, Pennsylvania

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