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Mind and Body

New technique helps stroke patients swallow again

 

In January 2012, 66-year-old Joseph Forrester suffered a stroke, which left him in a debilitating state.

“It was devastating,” said Joseph, a former economist who taught math and economics in Jamaica.

Jason Forrester, Joseph’s son, said he couldn’t always respond to questions.

“He pretty much had a stare, and his eyes would move.  You could see that he understood what he needed or what he wanted to do,” Jason said. “He couldn’t walk or use his right hand.”

However, there was one side effect that no one could see. Joseph was ultimately given a feeding tube, because he had lost the ability to swallow.

Dr. Georgia Malandraki, a speech pathologist at Teacher’s College of Columbia University, said swallowing is a basic function that most people do not even think about.

“We do it many, many times a day – up to 1,000 times a day,” Malandraki said. “We even do it in our sleep. So, we swallow all the time. It’s vital for our survival.”

The inability to swallow, called dysphagia, can lead to malnutrition, dehydration, choking and even death.

Emotionally, patients with dyshpagia can become isolated, depressed and home-bound.

“I really couldn’t get him to go anywhere – parties, restaurants or any eating engagements,” said Jason, who lives in Queens, N.Y.

But, with weekly therapy sessions at the Mysak Clinic for Communication Disorders, which is also at Teacher’s College, Joseph is getting the help he needs. He performs various head, neck and tongue exercises – which not only improve the patients’ muscular function, but also help rebuild and stimulate the injured areas of the brain.

“We used to believe that swallowing is a reflex and the brain is not even involved in it, but now with the new brain imaging techniques, we’re finding out the brain is involved,” Malandraki said.
           
To measure the therapy’s success, Malandraki does something unique: She uses a functional MRI, which allows her to see the patient’s brain activity.

Without this therapy, Malandraki said Joseph’s progress would have been 70 percent less effective  - and he would still need a feeding tube.

And, Jason is thankful his dad is more like himself again – going out with his friends and family.

For more information, visit the swallowing, voice and neuroimaging lab page