Hi Listerv,
Is anyone recommending thicker liquids to reduce nasal
regurgitation? I often suggest avoiding dry crumbly foods which
seem to be tricky for people with this problem. Though surprisingly
few of my hypernasal pALS report this as a problem I would like to be
ready with any suggestions this group has. Also it sounds like
Jenna's friend who is an expert in VPI might be suggesting that the
ubiquitous chin tuck we frequently recommend might be promoting nasal
regurgitation. Jenna, do I understand this correctly?
Thanks.
BTW- I appreciate the opportunity to talk about dysphagia on this
listserv. I recognize that not everyone on the listserv
is an SLP and hope it is OK? I really value the opportunity to
connect with other people who work with folks with ALS. We are few
and far apart. In part, I am asking because I am interested in
launching into another dysphagia topic (use of breath stacking
with pALS prior to eating). Alissa- is this OK or are we
getting too far away from AT/AAC? :-)
Sincerely,
Amy Roman, MS,
CCC-SLP
Augmentative Communication
Specialist
Forbes Norris ALS Research Center
2324 Sacramento
Street
San Francisco, CA 94115
P (415)600-1263
F
(415)673-5184
--- On Thu, 8/11/11, Erin Singleton
<xxxxxx@xxxxxxxxxxxxxxxxxxxx> wrote:
From: Erin Singleton
<xxxxxx@xxxxxxxxxxxxxxxxxxxx>
Subject: RE: Re:
To:
xxxxxx@xxxxxxxxxxxxxxxxxxxx
Date: Thursday, August 11, 2011, 10:30
AM
I spoke to a colleague who specializes in
VPI. She recommended focusing on head positioning, posture and a good
lingual seal to help prevent nasal regurgitation.
If the head is tipped anteriorly or posteriorly,
there is a greater chance of the liquid sloshing against the posterior
pharyngeal wall and into the nasopharynx. Bringing more attention to
the lingual seal with the palate will also increase control of the bolus
and help propel the bolus down.
My colleague also mentioned that certain foods and
liquids can increase nasal regurgitation. She said that there isn't
any research backing this, but it is mentioned in a few ENT books and she
has also noticed a pattern. Apparently chocolate is commonly
mentioned by patients. She also mentioned other acidic liquids
(orange juice, coffee and wine). It would be interesting if this is
the case with your patients. Are they chocolate milk or Ensure
drinkers?
Hope this helps as an alternative to a palatal
lift.
Jenna Gardner, MS, CCC-SLP
Speech-Language Pathologist
Communication Disorder Unit
SUNY Upstate Medical Center/University
Hospital
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