I think a lot of us dysphagia therapists or swallowologists are always looking for “what more can I do for my patients.” I think that often.
One of my favorite things to do is to browse through the medical catalogs and see what’s new or what’s out there and how much does it cost.
There are many items that I use in therapy. They mostly consist of straws, pudding, thickener (yes thickener) and tongue depressors. There is one company that makes amazing tools that I use with all my patients.
TheraSip is an amazing straw system. If you haven’t seen it yet, it’s a set of microresistant straws. That means they start at about the size of a coffee-stirrer and get progressively smaller. There are three straws with a set of larger diameter straws in which the microresistant straws can fit to increase labial seal with the straw.
I will often use the small cocktail straws or coffee stirrers with pudding, applesauce or thickened liquids. I like the TheraSip straws because they allow my patients to drink water. They limit the amount they get at one time during the therapy session while working the oropharyngeal musculature. Combine that with an effortful swallow and bam, you have one effective treatment.
The straws can also be used during the Modified Barium Swallow Study (MBSS). You can test the effectiveness of the small straw and the amount allowed by the straw to see if that might allow your patient to safely consume thin liquids.
These straws are available through several therapy supply companies and cost around $60 for the set. You can also buy replacement straws at a lower cost. I typically don’t use the larger straws and focus on the microresistant straws, so I could save a little money buying only the replacement straws.
The straws also come with a tube so that you can measure the amount of liquid the patient consumes per sip. These straws can be used during the MBSS to measure effectiveness and safety with the smaller sips.
Evidence has shown us that we have increased labial muscle activation with straw sucks. One of our exercises that we have available to use with patients utilizes the patient imagining that they are sucking something very thick through a small straw and then swallowing. This allows you to actually have the patient suck through a small straw and swallow creating a more functional swallow exercise for the patient.
Evidence also tells us that exercises should be movement specific and that if a patient’s goal is swallowing, they should be swallowing throughout the session. This allows the patient to do so by activation of all muscles of the swallow starting with the oral muscles activated by the actual movement of the straw suck and ending with an effortful swallow of the bolus.