Swallow Your Pride Podcast Theresa Richard

You know how dentists have those intraoral cameras that let patients see what’s going on in their mouth?



What if SLPs could use those as part of their dysphagia assessment? 



Or as part of their biofeedback during therapy to check for residue and to see if certain compensatory strategies work? Just imagine quickly peeking into a patient’s mouth with an angled intraoral camera and finding bread in the valleculae from the patient’s last meal (which was two hours ago)!



Turns out we can!



James Curtis, PhD, CCC-SLP, and Ann Miles, PhD, are two SLPs and researchers who are exploring this idea and spill all the beans with us in this week’s episode of The Swallow Your Pride Podcast!



Join James and Anna as they discuss the intraoral camera and…



The benefits of adding it to our dysphagia assessments

Potential applications in therapy and patient education

The pioneering work of Jose Vergara’s team in Brazil

Technical challenges

Patient tolerance

Current and future research

Access to this instrument



Tune in and give a shout-out to your local dentist for inspiring this idea!



TIMESTAMPS:



Initial exploration of intraoral cameras (00:05:42)

Clinical application of intraoral cameras (00:10:44)

Advantages and limitations of intraoral cameras (00:12:51)

Procedure for using intraoral cameras (00:15:05)

Challenges with intraoral cameras (00:19:01)

Patient Positioning and Maneuvering (00:20:05)

Challenges and Skills of Rigid Exam vs. Flexible Scope (00:20:56)

Advantages of Intraoral Cameras (00:21:10)

Importance of Post-Swallow Images and Video Clips (00:22:28)

Sensitivity and Reliability of Intraoral Cameras (00:24:30)

Comparative Research and Reproducibility (00:26:02)

Limitations and Need for More Research (00:28:25)

Cost and Infection Control Considerations (00:32:15)

Integration into Clinical Protocols (00:33:42)

Future Research and Implementation Studies (00:37:44)

Intraoral Camera Use in New Zealand (00:40:09)

Availability and Cost of Intraoral Cameras (00:40:56)

Patient Populations for Intraoral Camera Use (00:41:38)

Challenges and Benefits of Rigid Endoscopy (00:44:23)

“I’m looking for a guy in finance…”



Okay, while that’s the start of a recent viral song, I spoke with an SLP who *was* in finance.



Fred Stahl is a second-career medical SLP who shares how he went from hedge fund management to voice and dysphagia management for head and neck cancer survivors.



Together we discuss why he left finance for speech pathology, his learning experience, his involvement in a research study on swallowing (and the unexpected findings), and the incredibly dynamic nature of our field. From embracing opportunities to learning from failures, Fred’s insight is both eye-opening and incredibly motivating!



Tune in and get inspired.



Get show notes here: https://syppodcast.com/332



Fred Stal is a Speech-Language Pathologist and Certified Brain Injury Specialist. He completed his initial training and clinical fellowship through Cleveland Clinic Rehabilitation Hospital. Currently, Fred works in the outpatient setting as well as per diem in the acute care setting. He recently published research as a co-author with the NYU Swallowing Research Lab, which was presented by the incredible lead author at the 2024 Dysphagia Research Society conference in Puerto Rico. His main areas of clinical interest include dysphagia management, upper airway disorders, and most of all… all things related to the head and neck cancer population.



Research Link mentioned:  https://pubmed.ncbi.nlm.nih.gov/9513300/



Timestamps:



Fred's Journey into Speech-Language Pathology (00:01:45)

Fred's Clinical Experience and Career Path (00:02:29)

Passion for Head and Neck Cancer Patients (00:05:47)

Learning and Implementing New Techniques (00:07:59)

Specialized Field within Speech-Language Pathology (00:08:46)

Manual Therapy and Lymphedema in Head and Neck Patients (00:11:36)

Presentation at ASHA and Case Studies (00:13:47)

Continuous Learning and Adapting in the Field (00:16:41)

The research publication (00:18:02)

Learning from failures (00:21:26)

Instrumental assessment and patient outcomes (00:25:28)

Challenges in patient recovery (00:28:20)

Value of long-term patient relationships (00:31:38)

Advocacy and improvement in skilled nursing facilities (00:33:30)

The power of basic tools in dysphagia therapy (00:34:17)

Wada testing and awake craniotomy (00:35:15)

Exploring new areas in speech pathology (00:36:16)

The Medical SLP version of a “Battle of the Bands” would be, without a doubt, a “Battle of the Instrumentals.”



As in, which is better: MBS or FEES?



The MBS has historically been viewed as the “gold standard” of instrumentals, but a LOT more research has come out about FEES since its introduction into the dysphagia world.



And Dr. Jessica Pisegna is here to talk about it in this week’s episode of The Swallow Your Pride Podcast!



Dr. Pesegna is the section chief at Boston Medical Center of the voice and swallowing center and has worked closely with the one and only Dr. Susan Langmore.



In this episode, we cover:



-When Dr. Pesegna chooses FEES, MBS, or BOTH simultanously. 

-What her latest research found when it comes to absent or reduced epiglottic inversion on FEES and what it can mean

-The importance of the brand and color of food dye

-Why FEES should be used in acute care

-The use of residue rating scales and the consistency of clinician ratings.

-Laryngeal sensory testing

-The ice chip protocol and the Frazier Free Water Protocol

 -The reliability of Penetration-Aspiration Scale (PAS) on FEES.



Prep your barium and get your scopes out, because this episode will leave you motivated to step up your game in the world of instrumental swallow studies!



Get the show notes full of references here:

https://syppodcast.com/331



 TIMESTAMPS:



Simultaneous FEES and Video Fluoroscopy (00:03:40)

Research Findings (00:06:18)

Sensitivity of FEES (00:10:00)

FEES in Acute Care (00:14:49)

Triage Protocol (00:16:17)

Simultaneous FEES and Video Fluoroscopy (00:16:45)

Turnaround Time for FEES (00:17:33)

Rating Scales for Residue (00:18:12)

Assessing Reliability Between Clinicians (00:19:48)

New Zealand Secretion Scale (00:22:15)

Global Picture of Patient Care (00:23:44)

Management of Secretions in Acute Care (00:24:39)

Laryngeal Sensory Testing (00:25:17)

Ice Chip Protocol (00:28:55)

FEES and PPIs Ratings (00:35:10)

Challenges and Considerations in Using PAS on FEES (00:38:34)

Reliability of Digest FEES (00:40:26)

If you want to serve the head and neck cancer population or HOPE to one day…you do NOT want to miss this episode!



Jennifer Larssen, an SLP at the University of South Florida, shares her experiences in developing innovative programs for head and neck surgery patients. She shares innovative programs and tools like…



✅A groundbreaking laryngeal speaking device for those who struggle with the traditional electrolarynx.

✅A self-dilation program for patients with laryngectomy and/or radiation to the neck.

✅A TEP clinic.

✅Support groups - include one for women who have undergone a laryngectomy.

✅Social events (like a trip to Busch Gardens and makeup lessons post-surgery and/or radiation)



Prepare to feel inspired!



Download the show notes: https://syppodcast.com/330



TIMESTAMPS:



 

Introduction (00:00:00)

Program Development at USF (00:00:42)

Tracheoesophageal Prostheses and TEP Clinics (00:02:51)

Larynx Demo Days (00:03:09)

Competencies in TEP Changes (00:04:28)

Self-Dilation Program (00:06:13)

Advocating to Administration (00:07:56)

Head and Neck Cancer Community Group (00:09:26)

Funding and Resources (00:12:21)

Women's Retreat (00:13:06)

Clinical Pathway and Rehabilitation (00:16:38)

Feeding Tube Removal (00:19:32)

Collaboration with Dietitian (00:20:11)

Patient Observation (00:20:54)

Transitional Care Program (00:21:44)

Fluoro MS Suite (00:23:33)

Becoming an X-Ray Tech (00:25:09)

Supportive Team at USF (00:28:11)

Human Element in Healthcare (00:30:43)

Ever face a clinical decision for a dysphagia patient where each option feels too risky? Or maybe you stick to the conservative side of decision-making.  Better safe than sorry….  Until you learn that what you thought was safe is actually harmful. How are we supposed to know? What can actually guide us toward making better […]

When life hands you lemons, make lemonade, right?



For a lot of SLPs, it can be hard to do that. Maybe we think our job would crumble without us. Maybe we think we have no other choice but to just accept the sour situations life throws at us.



If you’re feeling trapped in a particularly unsavory situation right now, let THIS episode serve as your inspiration and motivation to follow your passion and make the career pivot you’re meant to make. 



Melissa Grassia Chisholm, M.S. CCC-SLP, was working full-time in a hospital when her son was diagnosed with leukemia. With her world completely flipped upside-down, she made the decision to leave her job and build a virtual voice clinic instead so she could be with her son while pursuing her passion.



Tune in to this week’s episode of the Swallow Your Pride Podcast to hear how Melissa did it, what her virtual clinic looks like, her goals to expand globally, and the EXACT moment she knew that leaving her hospital was the right move.



If you or someone you know is searching for affordable and accessible voice therapy, you’re invited to check out Melissa’s virtual clinic at TheVoiceRehab.com. Use the promo code “swallowyourpride” to get 10% off the first month of her Voice Rehab Program!



Episode Website: https://syppodcast.com/328



Listen to more episodes of the Swallow Your Pride Podcast



TIMESTAMPS:



Melissa's Career Background (00:01:05)

Melissa's Vocal Health Struggles (00:06:14)

Leadership Role at Cleveland Clinic (00:08:33)

Transition to Private Practice (00:10:53)

Balancing Family and Career (00:13:06)

Blood Test Results and Hospital Visit (00:15:11)

Leukemia Treatment Journey (00:19:07)

Career Transition and Growth (00:20:04)

Mentorship and Team Building (00:22:01)

Addressing Healthcare Cuts and Virtual Clinic (00:25:42)

Live Group Coaching (00:30:16)

Affordable Teletherapy (00:31:23)

Legal and Medicare Guidelines (00:32:55)

Patient Support and Navigation (00:34:33)

Care in Healthcare (00:36:39)

Inspiring Passion and Support (00:38:45)

Finding Melissa and Future Plans (00:40:27)