HELP! This Dysphagia Diagnosis is Going To Ruin My Life!

From the desk of Carol G Winchester, MS SLP CCC

I can help! Let’s begin with a few cleansing breaths…….

OK now let me walk you through what this all means. A diagnosis of dysphagia is a side effect that is caused by something else that is going on with your health profile. It might be caused by a stroke or CVA, an injury, a neurological condition, or even just because you had surgery for something totally unrelated to your head or neck. The bottom line is that you have been identified as having dysphagia and it is in your best interest to monitor what is going on, work with your healthcare professional, and calm down! I know you hate when someone says to calm down, but being anxious or upset actually affects your swallow in a negative way, so it is really important to remain as calm as possible.

Is it going to change your life? Yes, but not more than anything else you have gone through in your life. If you had diabetes, you would watch what you eat and monitor your blood sugar levels. If you had a knee replacement, you would go through physical therapy and then once you were functional you would be careful about steps or uneven surfaces. It’s the same with dysphagia. Once you have the diagnosis it’s important to understand whether this is a potentially temporary condition or whether it’s something you will have to manage long term, just like diabetes or your new knee.

A temporary dysphagia can be the result of surgery on any body part simply because you encountered anesthesia and its after-effects. When you go to sleep for surgery, an oral trach is placed into your airway through your mouth so that the oxygen needed to sustain your brain and body is provided while the surgery is performed. Simply put, this placement can affect the nerves and muscles of the pharynx and larynx in a way that reduces the sensation in your throat for a period of time. If the surgery is cardiac or dealing with the head and neck, additional muscles involved in swallowing can be temporarily affected because of the trauma of the surgery. As you heal, your swallowing function heals with you and your dysphagia can resolve. The time that it takes to heal can be six days, six weeks, or even six months. A good example of this is the difference between having a hip fracture repair, for example, which may result in a temporary dysphagia for a few weeks or months, and a cervical spine disc replacement or fusion which can result in dysphagia for up to a year as the whole area of muscles and nerves heal. The good news is that temporary means that with care and attention to your risks, your swallow can return to normal without you experiencing congestion, choking, or pneumonia.

A permanent dysphagia can be the result of a neurological insult like a stroke, Parkinson’s, or even the removal of a tumor or clot. The structures involved in swallowing have been damaged, rather than temporarily insulted, during this issue. The amount of initial damage and the amount of residual damage can be very different, however. What that means is that although you may have a very serious dysphagia in the beginning, resulting in a large amount of restrictions in food and liquid consistencies, or even placement of a temporary G-Tube, your rehabilitation potential can bring you a very long way so that your restrictions may be minimal in the end. The goal is to keep you hydrated, nutritionally sound, and free from congestion or pneumonia that can be very deleterious to your overall health. A permanent dysphagia does not mean that you will never eat again, or that you will never eat foods or liquids that you love again – it simply means that you may have to find a bit of an altered way to enjoy the things you love!

This is where your Speech Pathology Dysphagia Specialist comes in. Dysphagia is not about making you do what they say……and if you are being treated that way, you need to immediately find another therapist to work with. Dysphagia is about operationalizing your needs into the life you want to lead, doing the things you want to do, in a way that is going to keep you healthy and safe from the deleterious effects of dysphagia! Think of it like having high blood pressure or diabetes – it takes daily attention, but you can still lead the life you want without ruining your life. I promise you that it is possible.

There you go… three cleansing breaths. It’s good for you!


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