Happy Valentine's Day!

This month's newsletter is two folds. We'll be continuing to delve into the role the heart plays in dysphagia, and we will be featuring an organization that is making an incredible impact on the aphasia community. We of course have our SLP of the month featured as well!

So let's get down to business and start talking about the heart of the matter, cardiac dysfunction + dysphagia!

Many of our patients with dysphagia have cardiac diagnoses which may be related to their dysphagia. "The reported incidence of dysphagia in this population varies anywhere from 2.7% to 51%" (Barker et al., 2009; Rousou et al., 2000). Therefore, we thought it would be useful for our treating SLPs to provide a category of dysphagia types as it relates to cardiac dysfunction.

Cardiac Dysphagia is caused by "esophageal compression from an enlarged left atrium." (Sharma, n.d.). Signs of cardiac dysphagia include weight loss, difficulties with solids, cardiomegaly, CHF, and in extreme cases vomiting blood. Depending on the severity of the case, dietary changes coupled with compensatory strategies may provide relief for the patient whereas in severe cases, surgery may be required.

Dysphagia Lusoria: This type of dysphagia is caused when an aberrant R subclavian artery causes extrinsic compression of the esophagus. Signs and symptoms include difficulties with solids and medication as well as chest pain. Lifestyle and dietary changes coupled with compensatory strategies are recommended for mild cases with more severe cases, again recommending surgery.

Dysphagia Aortica: This type of dysphagia, again, has it's roots in esophageal dysfunction. It is when "an enlarged, tortuous, or aneurysmal aorta compresses on to the distal esophagus" (MedSLP Collective). Signs and symptoms include difficulties with solids, weight loss, abdominal fullness, and nausea (Chan et al., 2016; Wang et al., 2019). Lifestyle and dietary changes coupled with compensatory strategies are recommended for mild cases with more severe cases, again recommending surgery.

These types of dysphagias do NOT include dysphagia secondary to cardiac surgery, which has it's own subset of risk factors as it relates to dysfunction. The prevalence of dysphagia secondary to cardiac surgery can be identified as such according to Werele, Steidl, & Mancopes, 2016 and Plowman et al, 2021 include:

1. Advanced age
2. Presence of comorbidities and other diseases (such as pre-existing heart failure)
3. Intubation time, endotracheal tube size
4. Surgical conditions

"Other factors to consider specific to cardiothoracic surgery are intraoperative transesophageal echocardiography (TEE) and nerve damage" (Plowman et al., 2021; Rousou et al., 2000). 

To know for sure if your patient's heart condition and/or recent surgery has a role in their swallow function, imaging is required. And did you know that an MBSS from LA Imaging allows us to not only to look at the oropharyngeal function, but also we are able to provide patients with an esophageal scan as well? That way, if any abnormalities appear, appropriate referrals can be made.

To schedule an MBSS with our team, give us a call at: 318.473.1978

Now onto the second part of our news letter! We could not be more excited about this segment! Over the past few years the Aphasia Center of Acadiana (ACA) has been an incredible resource for people with aphasia. Their mission is to provide support to enable increased levels of independence for people with neurological impairments. The idea is to improve overall quality of life as a means of making everyday activities productive and meaningful.

If you are working home health or outpatient care or know someone with aphasia who would be interested in joining this fantastic network of support, below is information regarding their monthly meetings:

ACA holds meetings the first Friday of every month at 9:00 AM. The meetings are at the University of Louisiana at Lafayette campus (building: Burke-Hawthorne, room: 236B).

A second support group is held at Iberia Medical Center, North Campus in meeting room 2 on the second Friday of every month at 10:00 AM.

If you are interested in ways to donate to the ACA they will be holding their annual fundraiser on April 3rd at Cafe Sydnie Mae, 140 E. Bridge St. in Breaux Bridge, LA. It'll be a night of fine dining and Jazz music with proceeds going to a great cause! To find out more about this sponsored event and how to get tickets, or if you're looking into other ways to donate, check out the ACA website: https://www.aphasiaacadiana.org/events.html#/

SLP OF THE MONTH: Kathryn Cormier, MS CCC-SLP

Meet Kathryn! Kathryn a full time SLP and Rehab Director at the Ellington. Graduating with her masters from the University of Louisiana at Lafayette, she really enjoyed her clinicals and discovering her calling, telling us the geriatric population held her heart. Her favorite part of the job is seeing the gains her patients make, especially when they achieve their prior level of function. Stating, "Nothing is more rewarding than seeing someone go from NPO to eating again."

Kathryn is the kind of SLP that has a quiet, calm assurance and a knack for building up her patients' spirits and confidence. She's heavily invested not only in those she cares for, but also with the entire rehabilitation team as well. Her leadership skills, as rehab director, are easily noted as her team is effective and supportive. Typically, Kathryn is by her patients' sides for their MBSS, but on the rare occasion she is unable to attend a swallow study, she always makes sure someone from her team is present and available to help the patient, whether that be ensuring they are up and ready for the study, providing assistance with positioning, or just being present as way of encouragement for the patient.

We are so grateful for Kathryn! Thank you for all that you do!

PREMIER REHAB IS HIRING!

SLPs in the Lake Charles area, Premier Rehab is looking for a FULL TIME SLP at a fantastic LTAC adjacent to an assistant living facility. If you're ready for a change and want to work for an amazing team, you can contact Katie Linkhart at: katiel@premierrehab.net

Thanks for tuning into this month's Monthly Modified!