If you’ve been following for awhile, you may remember a post several months ago about the Swallow Study that Vernon underwent during one of his Hoag Hospital stays.
Strangely, when he was re-admitted to Mesa Verde, the documentation had disappeared from the hospital’s main files, and Lisa, the Speech Therapist, and I have been rallying to have another one done. What with all the other procedures and appointments on his schedule, it took this long to have it re-booked. But last Friday, he was finally sent back to the Radiology Dept. at Hoag to get tested once again.
I found him in wonderful spirits in the afternoon. It was encouraging to me, as I’d only found him in a confused state or even surly state for most of our visits all week. But this time, thankfully, he was chatty and happy. I told him he would be sampling some things to eat or drink. He made jokes about being disappointed it wasn’t coffee or tea. The truth is he seems to always be thirsty. He is often asking for a drink, though he has only been allowed to have thickened juices when Lisa is around to oversee him. This is part of her frustration that the first test was lost. She has felt she can’t move forward with him without knowing for sure what the inside of his neck looks like….which muscles are working, which need work, why he is having so much trouble swallowing.
The Swallow Study—or Video Fluoroscopic Swallowing Exam (VFSE)— is a procedure which involves the patient swallowing a substances of varying textures and consistencies, coated with barium, which will show up through an x-ray camera. In this way, the Physician and Speech Therapist should be able to diagnose the patient’s ability to swallow safely and hopefully help them with a plan for exercising those muscles into better health. They can also see what consistencies the patient can or cannot tolerate.
It is a truly fascinating procedure. I stayed in the other room while the pictures were being taken so I was able to watch the screen as the radioactive barium showed up through the x-ray of Vernon’s mouth and neck. As expected, he was not able to tolerate water. Whenever he is given a tiny sip, even at his home, he sputters for minutes at time afterward. But even the thicker blobs of liquid, though they did go down without a fight, showed up on the screen as first trying to go down his windpipe. Ah! So this is why he struggles. This is why he can’t eat. He has lost control of the swallowing muscles in his neck that push substances down to the stomach instead of the lungs.
I remember that he was swallowing better (and even eating) at the previous home at the end of last year. So until I’m told differently, I believe these current swallowing problems have to do with the neurological relapse Vernon experienced after his sever UTI infections.
Though I am glad that we got the study done again, the results make me sad. Vernon is always complaining of how thirsty he is. He is always asking for something to drink. And the evaluating Speech Therapist told me that she would not recommend him drinking anything at all until he can strengthen those important muscles in his throat, which Lisa will be able to slowly coach him through.
So again…our progress doesn’t come without taking a few steps backward first. This is the Dance.
(I’m adding this picture, because every time I visit Hoag, I am made aware of what a beautiful Hospital it is. Makes visiting a little more pleasant.)