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Larry's days in rehabilitation


thejule1

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It looks like Larry will remain on the feeding tube as he did not pass the Barium Swallow Test. He has problems with the muscles in his throat when swallowing correctly. He was aspirating silently as he did not have the gag reflex, or cough when food went down the wrong way. There are other issues with his swallowing that did not show up in other swallow tests he has had before. This was the most descriptive and thorough test he has had. I don't know if other radiologists missed some of this or his swallowing just got worse. The speech therapist is still working with him and uses ice chips now and word exercises to watch and strengthen his swallowing.

 

Yesterday was a hectic day for both of us. He had his shower early and then OT and PT. After that he had a urology appointment. The facility bus was to take us but the lift for his chair was not working. We had to wait for another bus and his appt. was at 1:15. The other bus finally came and we got to the office 25 min. late. The girl at the desk said "we will see if we can see you as your appointment was at 1:15". I told her the reason we were late and she said to take a seat and we were called shortly after. Thank goodness, as I had to cancel this appt. twice before. On the time we came last year we waited over an hour but that is no concern when the doctor is not on time. The appointment went well but we have to go back in two weeks for an ultra sound since they only do these on Mondays. We had to then wait 45 min. for the bus to pick us up again for the return. Next time I will ask for a car service as Larry can use a regular transport chair, and transfers okay with help.

 

Larry continues to do well in OT and PT. He is back to walking with his small quad cane with the PT barely holding on to him. He tires from all the therapy, but they are doing a great job getting him stronger in his recovery to try to get back home.

 

Julie

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that is very good news Julie.   I hope he gets to come home soon.  Can you tell us more about the other things that his swallowing test revealed?   We all need to be as informed about these things as possible.

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Julie, Sometimes to me it all seems like a hassle with us trying to see our doctor in their office at certain times but there is no other way because the doctors don't come to our homes to see us for sure...

 

I feel like I'm starting all over again from my first day out the hospital 11 years ago now.... I can hardly walk and can't without my shoes on but not in my socks or bare foot for sure...

 

I'm glad Larry is doing good but how does he take the rehab??

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It's disappointing that he has to continue with the feeding tube. I remember how important every one of those tests was to us. However, it sounds like you have gotten some great information about what is going on with his swallowing. Choking is so scary and something to avoid for sure. You and I both know how frightening that is. Thankfully, rehab is working well for him and helping him regain function. Take care of yourself in all this--as best you can. ~~Donna

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Sandy, Larry has reduced tongue tension and closure. His moving food from front to back to swallow is reduced.  His pharyngeal  stage is severly impaired. The pharyngeal is the part below the mouth into the throat area.  He has delay in the swallow there.  The food does not clear and all go down when he swallows.  He may have some vocal cord paralysis.  This is as much as I can explain.  Everyone's swallow test will be different.  The radiologist recommended an ENT specialist which we may see also.  

 

The speech pathologist was amazed the hospital did not have a Barium Swallow Test before they place the feeding tube in him. He had two swallowing tests before, but not recently.  I am glad the swallow test was done at the facility finally as it was very thorough with a detailed report.  I do not know why all this has occured recently, but we avoided the feeding tube and aspiration pnuemonia until now.  

 

Julie

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Thank you Donna.  I did the best I could with all the issues.  

 

Fred, Larry is in a very nice rehab/skilled facility.  The therapists there are wonderful.  He is trying hard and doing what they ask even though it is very tiring.  I'm sure he would rather be home, but he knows he has to get better toward doing this.  I am there every day to see to his care.

 

Julie

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I do hope things get better Julie.  I myself had a swallowing event last june and although it was not particularly serious it was scary.  the most likely reason for my change was the 100 or so little white dots that appeared in the mri in the past year.  tells me that not only strokes but little white dots can contribute to swallowing problems.

 

best withes to you and larry

 

david

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Ray's swallowing declined when he had had chest infections, he was taught to do the double swallow so he cleared the top half of his throat, to swallow with his head forward not back and to take tiny sips of water (or thickened fluid) if he thought he had not cleared his throat. It seems very complicated I guess and very tiring. But after  while he usually got some more function back until close to the end of his life.

 

Julie, you are there for him and that is what matters.

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HI Julie

Larry is fortunate to be so loved and cared for daily!

It is fortunate they found out about all details of the swallowing problem and can address it appropriately now.

It can be frightening to feel like you can't swallow properly. I had some issues first in hospital but I never had a feeding tube. I had mushed food. My tests showed no problems but I felt it was different and difficult. I had a soft  mush diet and I craved chewy rich foods like a good cheesy pizza. It must be awful to be on a feeding tube. I hope in time with exercises he can eat again and come home. It sounds like you are a wonderful caregiver Julie. There is always something to keep it challenging. Keep a sense of humor and keep hope alive and try and take some time for your own rest and recharging.

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