Down the Hatch - The Swallowing Podcast

Head and neck cancer can cause devastating swallowing problems, requiring a unique approach. This episode of Down the Hatch (The Swallowing Podcast) includes guest Heather Starmer, M.A., CCC-SLP who has extensive clinical and research expertise in dysphagia due to head and neck cancer. In addition to basics that make this population distinct, we dive into a few soap boxes including whether residue is "a thing"! Despite limited time, you will find this to be a very informative podcast about a very special type of dysphagia.

Link to her paper on Gabbapentin: https://www.ncbi.nlm.nih.gov/pubmed/24633355

“I don’t want to be too dramatic, but the NPO is almost like a death sentence … I really think that it should be the last recourse and not the beginning”. This one of many sincere opinions from an individual who has been living with a significant swallowing disorder. In this episode of Down the Hatch, the swallowing podcast, co-hosts Alicia Vose and Ianessa Humbert have a conversation with Jim, who suffered a brainstem stroke, leading to dysphagia. His very candid experience is the heart of why service delivery by Speech Language Pathologists to manage dysphagia does not just potentially impact life, but also LIVELIHOOD. Click to see a clip of this patients swallow: https://youtu.be/OpFjLLDbS-c

What is an expert? Do more years of experience guarantee a deepening of knowledge? Do scientists think differently than clinicians? In this episode of Down the Hatch (The Swallowing Podcast), hosts Alicia Vose and Ianessa Humbert discuss how to obtain knowledge, with an emphasis on swallowing and swallowing disorders. This episode was created in response to feedback from the Swallowing Physiology Series we recently completed, where listeners wanted to know "How do I become an expert in swallowing?" and, importantly, "How do I know who to trust as an 'expert' in swallowing?". Vose and Humbert differentiate Clinical thinking from Scientific thinking and make practical suggestions for how to obtain knowledge, ranging from self-study to academic degrees. How have you deepened your knowledge on the topic of swallowing and swallowing disorders?

In this last episode of The Swallowing Physiology Series, hosts Alicia Vose and Ianessa Humbert tackle both the pharynx and the upper esophageal sphincter (UES). This includes Down the Hatch Podcast (swallowing podcast)covers structure, function, and relevance to aspiration and residue for the pharynx and UES. We also discuss whether traditional exercises can really impact these structures as well as just plain old swallowing can... begging the questions: 1. Is swallowing the best treatment for swallowing? 2. What role do SLPs play in ensuring that patients get to practice swallowing with a wide range of bolus types?

Laryngeal vestibule closure (LVC)is one of the most complicated and critical swallowing events, but it remains poorly understood. In this episode of Down the Hatch (The Swallowing Podcast), we continue the Swallowing Physiology Series, with Ianessa and Alicia discussing the ins and outs of LVC and why it is often misunderstood and under-appreciated. By the end of the podcast, hopefully you will understand why listing poor or incomplete epiglottic inversion provides insufficient information about the cause of this type of LVC impairment.

Recently, an overwhelming 92% of clinicians responded “NO” to the question: Did you feel prepared to assess and treat swallowing disorders upon graduation (Plowman & Humbert 2018). 45% of SLP survey respondents think that more dysphagia courses would improve competency (McCoy & Desai 2018). To help address this need, Down the Hatch (The Swallowing Podcast) has launched The Swallowing Physiology Series, where several oropharyngeal events that are important for swallowing will be spontaneously discussed by hosts Drs. Ianessa Humbert and Alicia Vose. Further, we will indicate whether each event can be assessed in clinical evaluations versus instrumental evaluations. Since podcasts are audio only, consider subscribing to the Swallowing Training and Education Portal for detailed visuals of these events (stepcommunity.com). Also, watch a video here on differentiating swallow delay from pre-mature spillage: https://www.youtube.com/watch?v=DXUHPiRVITc

ASHA... What are you doing for your membership? For quality improvement of dysphagia management? This is a common question among ASHA members. In this installment of Down the Hatch (The Swallowing Podcast)Host Ianessa Humbert is joined by ASHA President hopeful Luis Riquelme PhD and colleague Ed Bice to discuss ASHA's role in maintaining clinical competence among speech language pathologists, especially those engaged in dysphagia management.

Recently, an overwhelming 92% of clinicians responded “NO” to the question: Did you feel prepared to assess and treat swallowing disorders upon graduation (Plowman & Humbert 2018). 45% of SLP survey respondents think that more dysphagia courses would improve competency (McCoy & Desai 2018). To help address this need, Down the Hatch (The Swallowing Podcast) has launched The Swallowing Physiology Series, where several oropharyngeal events that are important for swallowing will be spontaneously discussed by hosts Ianessa Humbert and Alicia Vose. Further, we will indicate whether each event can be assessed in clinical evaluations versus instrumental evaluations. Since podcasts are audio only, consider subscribing to the Swallowing Training and Education Portal for detailed visuals of these events (stepcommunity.com). See more swallows here, including the squirt swallow, that is discussed in this episode: https://www.youtube.com/channel/UCq8_kb-4JkisYLtrHMQ8bnw/videos

Recently, an overwhelming 92% of clinicians responded “NO” to the question: Did you feel prepared to assess and treat swallowing disorders upon graduation (Plowman & Humbert 2018). 45% of SLP survey respondents think that more dysphagia courses would improve competency (McCoy & Desai 2018). To help address this need, Down the Hatch (The Swallowing Podcast) has launched The Swallowing Physiology Series, where several oropharyngeal events that are important for swallowing will be spontaneously discussed by hosts Ianessa Humbert and Alicia Vose. Further, we will indicate whether each event can be assessed in clinical evaluations versus instrumental evaluations. Since podcasts are audio only, consider subscribing to the Swallowing Training and Education Portal for detailed visuals of these events (stepcommunity.com).

Do you think we need more swallowing therapies? Do you hand out a standard list of therapy worksheets for many of your patients with swallowing problems? Have you ever thought "Tell me what to do!" when faced with making decisions about treating patients? In this installment of Down the Hatch (The Swallowing Podcast), Alicia and Ianessa discuss the dilemma facing many SLPs who treat dysphagia. Alicia and I suggest focusing on the process of deciding whether therapy is needed and/or which therapy should be recommended, and we suspect that very little time is spent on clinical decision-making (rather just the execution of therapy). This is a skill that SLPs should possess and is required to actually provide the correct individualized treatment, rather than simply providing the same list of swallowing therapies for all of individuals with dysphagia.