• 12/28/2003
  • Florida
  • Susan J. Park
  • Sun-Sentinel

Aida Paley, an 89-year-old Deerfield Beach resident, thought she would never be able to eat again.

She suffered from a swallowing disorder that was a result of the radiation therapy she had received 54 years ago for throat cancer and affected her eating since age 84. Her condition only deteriorated after she suffered a small stroke in May, and her doctors didn’t think there was any hope. She went through six weeks of throat therapy with no results, said her daughter, Beverly Hanson, a Sunrise resident.
But then, Paley was introduced to Theresa Biber, a certified American Speech-Language-Hearing Association speech pathologist. Biber, who works in Weston, had been experimenting with neuromuscular electrical stimulation, a method borrowed from physical therapy for limbs, to help patients recover from their swallowing disorders. Biber incorporated the therapy with normal swallowing rehabilitation, which consists of throat exercises and head placement.

After a couple of months of therapy sessions, Paley was able to eat soft foods again, and in November was able to enjoy her first chewable Thanksgiving dinner in almost four years.

“Beverly and I had turkey, stuffing and cranberry sauce,” Paley said with a big smile. “It was just unbelievable.”

Dysphagia is a swallowing disorder, usually resulting from a stroke, head injury, progressive neuromuscular disorder or cancer. According to Oxford Research, almost one-third of patients in acute care and one-third of patients who have suffered from a stroke struggle with this illness as well.

Despite dysphagia being so widespread, the disease can go for years without being diagnosed. The reason is attributed to the lack of significant symptoms, said Debra Tarakofsky, a speech pathologist with Swallowing Diagnostics Inc., which was established in Broward County in 2000. Coughing and choking while eating, chronic respiratory problems, feeling that food is stuck, and a wet, gurgling voice are some symptoms.

In Paley’s case, it took years for her illness to be diagnosed. Eventually her doctors told her she couldn’t put anything in her mouth, and would need to have her saliva suctioned out daily. She never heard of the therapy until she and her daughter met with Biber.

“It’s one of those things that has been around for a while but hasn’t quite made it to a clinical stage,” said Biber, who lives in Pompano Beach. She has been conducting teaching conferences on neuromuscular electrical stimulation protocols for the past two years. “No one was making the jump to apply it to the therapeutic setting.”

But there are reasons why many clinicians have not made the jump.

“The patients that we see … are going to have some spontaneous recovery,” said Jerilyn Logemann, a professor of communication sciences and disorders at Northwestern University. “If you’re going to say a treatment is effective you must have studies that control the recovery. Otherwise, you don’t know if the treatment made the difference or the recovery made it.”

Logemann encourages practitioners to wait on administering therapy until accurate studies are available to ensure that the treatment is valid.

“There are no definitive studies in its effectiveness in physical therapy either,” Logemann said. “What I’m interested in is that patients don’t have a con game played on them.”

According to Biber, who conducted a small study from 1999 to 2001 with 50 patients, the therapy showed noteworthy improvement compared to just using traditional dysphagia rehabilitation, and her results have been replicated.

Using this as a springboard, Biber is launching a slightly larger study for early 2004, sponsored by HCR ManorCare, a long-term care company that has facilities throughout Broward County.

“Our medical director wanted us to do a study of this nature to give us some info about the efficacy of the technique and to make sure it’s safe,” said Mary Casper, HCR ManorCare’s rehabilitation consultant. HCR ManorCare is headquartered in Toledo, Ohio. “If we were to say to wait for research … would we be doing a disservice to our patients? If something’s out there, something to get better treatment to our patients, we should consider it.”

David Smith, a 78-year-old Coral Springs resident, is another patient advocating the therapy.

“They were feeding me through a tube in my chest,” Smith said, after suffering from a heart attack last September.

He underwent therapy three times a week for one month and now is able to eat steak, lobster and anything he wishes.

People who feel they are suffering from a swallowing disorder should contact a licensed speech pathologist. Not only to improve their quality of life, but to ensure that the dysphagia doesn’t develop into other illnesses. According to Tarakofsky, there are various causes of the disorder, including neck or throat injury. All ages can develop the disorder, but it appears to be the most prevalent in the elderly because they are more susceptible to disease.

“This is an underlying pathology that can possibly develop into pneumonia,” Tarakofsky said because liquid can be sent down the patient’s airway instead of the esophagus and collect in the lungs. “Depending on the person it can be fatal.”

To find a ASHA certified speech pathologist, call 800-638-8255 or visit the Web site at www.asha.org.

OCF Note:We posted this news article here not only because of its topic swallowing disorders after radiation treatments, but we would like everyone, survivor or current patient, to read how many years ago this patient was treated. OVER 5 DECADES OF SURVOVORSHIP AFTER TREATMENT!!!

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