Joe was living a full independent life prior to his stroke, which left him dependent for many aspects of his care, including eating. His severe dysphagia required the placement of a feeding tube for nutrition. CSP first met Joe not long after his post-acute rehabilitation admission in 2016. Over the course of years, we worked collaboratively with his wonderful primary SLP and completed multiple FEES until Joe was able to safely return to eating all of his favorite foods. Throughout his recovery, which included multiple FEES over multiple years, Joe remained motivated to continue his rehabilitation. His positive outlook and interest in understanding his body after the stroke were integral to his rehabilitative success. During each FEES, Joe actively participated in not only the assessment process but also biofeedback and diagnostic therapy to successfully plan his next steps. He remains to this day one of CSP’s favorite people to visit.
His dysphagia was significant at first, primarily a result of a large stroke affecting his right side and further complicated by underlying COPD. Deficits included:
- Impaired oral control which required manual assistance for jaw closure and head extension to assist with anterior to posterior transfer (the transfer of food to the back of his mouth and to prevent food from escaping out from his lips);
- Diminished pharyngeal constriction and tongue base retraction/lingual velar seal (reduced squeezing and pressure in the throat) leading to severe post-swallow residual throughout the pharynx (leftover food material in the throat);
- Mistimed laryngeal vestibule closure/glottic closure (uncoordinated airway protection) resulting in aspiration (food/liquids falling into the trachea);
- Reduced cough inhibiting clearance of aspirated material (cough was not strong enough to clear aspirated material from the trachea).
While his swallow still isn’t “perfect”, he enjoys regular food and drink with a few simple modifications, which he is able to complete independently, drastically improving Joe’s quality of life.
View the full video of Joe and his SLP here.
To honor his recovery story, consider donating puzzles to:
Richfield Recovery and Care Center
3615 W Main St
Salem, VA 24153