119: Swallowing Challenges after Cervical SCI with Michelle Dehgan, MA, CCC-SLP, BCS-S
Michelle joins Rebecca and Leigh Ann on the podcast for a discussion on all things swallowing and cervical spinal cord injury. We cover a lot of ground, so be sure to review Michelle’s sides available below in the resources section.
Topics covered:
Etiologies of cervical spinal cord injuries (related to trauma and surgery)
Typical cervical SCI hardware
Medication side effect and their impact on swallow function
Complications of cervical surgeries
Dysphagia evaluation and treatment for cervical SCI patients.
Download your free Discussion Guide to unpack the information covered in the episode at a deeper level. The Discussion Guide can be used in a group setting or on your own.
Resources mentioned in the episode
Leigh Ann’s favorite “take aways” from Michelle’s talk:
Watch ACDF surgeries on YouTube to understand how the surgery affects the pharyngeal region and cranial nerves.
Positioning is key! When you are completing your clinical swallow evaluation or imaging, ensure the patient is at a neutral cervical position. Michelle warns that these patients tend to adopt hyper-flexed positions that may result in poor airway protection during the swallow.
Learn the ASIA scoring system. The scale has five classification levels, ranging from complete loss of neural function in the affected area to completely normal.
The patient doesn’t always HAVE to tolerate a speaking valve prior to starting PO trials. Be flexible and use your clinical judgement.
Steroids for pharyngeal edema isn’t always the best answer. Steroids may impact adhesion of the hardware to the spine s/p surgery and result in poor outcomes.
Michelle Weber Dehgan is the Research/Education Coordinator for Speech-Language Pathology at TIRR Memorial Hermann, as well as, a practicing clinician. She graduated with Communication Sciences & Disorders degrees from The University of Texas @ Austin (BS) in 1995 and The University of Houston (MA) in 1997. She has completed additional education and training in research & epidemiology. She has special interests in dysphagia, brain injury, ethics, spinal cord injury, and supervision. She became Board Certified Specialist in Swallowing & Swallowing Disorders in 2007 (pediatrics & adults). She is the ASHA CE administrator for Memorial Hermann Health System and for The Academy of Spinal Cord Injury Professionals. She presents locally and nationally on FEES, spinal cord injury, vent/trach management, the utility of the clock drawing test, and working with lower level patients. She is a current an active member of ASHA, Academy of Spinal Cord Injury Professionals, Dysphagia Research Society, Special Interest Division 11 on Supervision & Administration, and Special Interest Division 13 on Swallowing & Swallowing Disorders. She is the recipient of 13 ACE awards from ASHA for excellence in continuing education. She is involved in streaming the electronic medical record, promoting evidence based practice, and development/teaching of clinical reasoning. In addition, she is a mentor with The MedSLP Collective and enjoys fostering the growth of a new generation of clinicians.
REVIEW the podcast
You’ll earn my undying gratitude by leaving a review on Apple Podcasts! Reviews help other SLPs find the podcast. Also, I love reading your feedback! Just click here to review, select “Ratings and Reviews” and “Write a Review,” and let me know your favorite part of the podcast. Malaho plenty!
