Carolyn Abraham joins Leigh Ann on the podcast to share about her experiences working with patients after lung transplants in the outpatient setting. A lung transplant has become a frequent treatment option for patients with a variety of end-stage lung diseases. These patients have to be put through rigorous steps in order to deem themselves worthy of receiving this gift. After the transplant, there are potential complications that Speech Pathologists find themselves addressing. Knowledge base of lung disease and its impact on the swallowing, and breathing, creates a foundation for patients and their success.

The lung transplant research highlights the underlying risks of an acute rejection and other injuries to the newly transplanted lung. Much of the research is related to esophageal phase dysphagia versus oral and pharyngeal dysphagia. The limited data on oropharyngeal dysphagia indicates that there is a dysphagia component which impact patient’s quality of life and well-being. The research also supports the use of Speech Pathology interventions to mitigate the aspiration risk.

topics covered:

Basic understanding of how a lung transplant procedure may result in changes to breathe/swallow coordination and physiology.
Review current literature available with this population, and how to extrapolate when information is not available

Understand the basics on the cross-systems function (e.g. respiration and swallowing) and its impact on swallowing in the lung transplant population.

Resources mentioned in the episode:

Atkins BZ, Petersen RP, Daneshmand MA, Turek JW, Lin SS, Davis RD. Impact of oropharyngeal dysphagia on long-term outcomes of lung transplantation. Ann Thorac Surg. 2010;90(5):1622-8.
*Baumann B, Byers S, Wasserman-wincko T, et al. Postoperative Swallowing Assessment After Lung Transplantation. Ann Thorac Surg. 2017;104(1):308-312.
*D'ovidio F, Singer LG, Hadjiliadis D, et al. Prevalence of gastroesophageal reflux in end-stage lung disease candidates for lung transplant. Ann Thorac Surg. 2005;80(4):1254-60.
*Gross RD, Atwood CW, Grayhack JP, Shaiman S. Lung volume effects on pharyngeal swallowing physiology. J Appl Physiol. 2003;95(6):2211-7.
*Martin-harris B, Brodsky MB, Michel Y, Ford CL, Walters B, Heffner J. Breathing and swallowing dynamics across the adult lifespan. Arch Otolaryngol Head Neck Surg. 2005;131(9):762-70.
*Mckinstry A, Tranter M, Sweeney J. Outcomes of dysphagia intervention in a pulmonary rehabilitation program. Dysphagia. 2010;25(2):104-11
*Wheeler hegland KM, Huber JE, Pitts T, Sapienza CM. Lung volume during swallowing: single bolus swallows in healthy young adults. J Speech Lang Hear Res. 2009;52(1):178-87.
*Yale Swall0w Screen: https://www.sasspllc.com/wp-content/uploads/2014/12/Yale-Swallow-Protocol.pdf

Carolyn Abraham, M.S., CCC-SLP, CLT is a Speech Language Pathologist at an Outpatient Rehabilitation facility. She specializes in complex dysphagia cases resulting from cardiopulmonary disease, head and neck cancer and neurological Conditions. She holds a bachelor’s degree from Temple University and a master’s degree from Gallaudet University.