This patient with COPD was referred to CSP for a FEES. A previous healthcare provider had recommended the patient consume a pureed diet with nectar thick liquids based on a bedside swallow study. This patient had fear of choking due to a previous choking episode and diagnosed anxiety disorder.
However, the FEES showed the pharyngeal swallow was within functional limits and noted increased work of breathing following each swallow, likely due to a combination of anxiety and the taxing of the patient’s respiratory system with each respiratory pause needed to swallow.
The patient was involved with the FEES exam, watching the monitor in real time. This assured him that his swallow was functional. A regular diet with thin liquids was recommended, and the patient was encouraged to use pacing to minimize respiratory fatigue.
The patient’s quality of life is now improved with the re-introduction of a regular diet and reduced anxiety. We are grateful for the opportunity to improve lives through FEES!