Tuesday, July 28, 2015
YOUNGSTOWN
Swallowing is some- thing most people take for granted – until they can’t.
The inability to swallow – dysphagia – can be caused by a number of conditions including head and neck cancer or injury, stroke and dementia.
A high percentage of stroke patients have some type of swallowing problem and aspiration, which is when food goes into the airway and lungs instead of the esophagus and can cause aspiration pneumonia, especially in the elderly, said Linda Smith-Davis, speech pathologist.
Smith-Davis, of Columbiana, is one of only three specially trained speech pathologists in the tri-county area, and one of 24 in Ohio who are certified by the American Board of Swallowing and Swallowing Disorders to diagnose and treat dysphagia.
Besides Smith-Davis, who works at Northside Medical Center, the local board-certified speech pathologists are Kimberly Marchetto of Sharon, Pa., an employee at St. Elizabeth Hospital Youngstown, and Linda O’Brien of Boardman at Park Vista of Youngstown, a continuing care retirement community. Both hospitals are accredited stroke centers.
The Joint Commission, a nonprofit organization that accredits health care organizations and programs in the United States, has issued new standards for treating anyone who comes to the emergency room with a stroke.
Nothing is to be administered by mouth, not even a pill, until it has been determined if the patient has a swallowing problem, said Smith-Davis.
“That shows the importance the Joint Commission puts on dysphagia,” said Smith-Davis, who has a bachelor of science degree in education and a master of arts degree in speech pathology, both from Bowling Green State University.
Head and neck cancer patients should be referred to a speech pathologist before surgery or radiation therapy to strengthen muscles and retain as much function as possible, O’Brien said.
“I honestly didn’t know what I was getting into,” admitted Marchetto. She said it was not until her last semester of undergraduate school at Clarion University that she found out about swallowing disorders.
The job diagnosing and treating swallowing disorders began developing in the 1970s, said Smith- Davis.
“I never heard about dysphagia when I was in school,” she said.
“When I graduated, work in dysphagia was just getting started. There was no dysphagia course when I went to college; everything in the specialty was done via post-graduate courses offered by the American Speech, Language and Hearing Association,” said O’Brien, who received a bachelor of science degree in speech and hearing and master of arts degree in speech pathology, both from Kent State University.
O’Brien also has a master’s degree in pastoral ministry, which she said fits well with treating dysphagia.
When people have trouble swallowing and are not able to take part in family meals and holidays, which are centered around food and drink, they can be isolated and depressed, she said.
Then there is the “use it or lose it” factor, O’Brien said.
“That’s why therapy for dysphagia is important. The longer a patient goes without therapy, the higher is the possibility that he will never return to an oral diet,” she said.
It comes down to quality of life for the patient, and satisfaction for the therapist in helping a person return to an oral diet, O’Brien said.
“A Catholic gentleman I was working with couldn’t receive communion because he couldn’t take anything by mouth. With therapy, he was able to take communion. It brought tears to his eyes, and mine,” she said.