Wednesday, March 5, 2008

Self Portrait Tuesday (on Wednesday)


This week's SPT (Self Portrait Tuesday) Challenge: Photograph something that is extra special about you. It might be a physical feature, unknown talent, or an unknown secret. This SPT is all about you.



Well I don't think I can beat stilt walking or a cadaver bone in my knee like Sarah and Rachael, but something extra special about me is that I work with people who have these, tracheostomies. Speech therapy includes much more than teaching kids how to say their /r/ sounds. My specific job is to evaluate whether or not they can tolerate wearing a special speaking valve that is placed on the trach tube. Once they are able to tolerate wearing it for extended periods and use their voice, while maintaining their oxygen levels and heart rate and respiratory rate, then I evaluate whether they are able to swallow without aspirating (getting food/liquid into the lungs). My treatment targets strengthening the swallow muscles or using special positioning strategies to make the swallow safe. Once I think the person is strong enough to tolerate some type of consistency of food, then I get an order from the doctor to do a modified barium swallow study.


The modified barium swallow study looks like this, but it is a continuous image like a video, so I can actually watch the food I've mixed with barium, and see how it goes down. What happens during the swallow tells me what I need to work on with the person and what strategies to try.
I have a 17 year old that I am doing one on tomorrow. She was in a sledding accident up at Mt. Charleston and broke her skull in 2 places, so she had to have a craniotomy (removal of the bone to ease the swelling). She actually just got her tracheostomy out, but has yet to speak because she sustained severe damage to the left temporal lobe which is the major language center of the brain. Anyhow, she's still having trouble swallowing her saliva, but I am going to do a swallow study anyway so I can get a better idea of what to target with my treatment because I think she is aspirating even her saliva.

So that is one of my talents. I'm at home today, so I can't really take a picture of me doing my job. But these images should give you an idea. I find it extremely fulfilling to be there when someone speaks for the first time in weeks because they are on a ventilator or when it's been 3 months and I give them their first taste of food.

6 comments:

Jossie said...

Cool! You sound super smart when you talk about what you do :-) Not that you don't sound smart all the time but you know what I mean :-)

Rachael said...

Rachel-
I think your job is fascinating and I am so impressed with your knowledge! It is really neat...better than a cadaver bone.

Sarah said...

I echo both Jossie and Rachael. Your job is fascinating and you sound super smart when you talk about it. That was a great post to read.

Brooke Low said...

Rachel-It's comforting to know that if anything happens to me or my family in the speech area there are people like you to care of us! That was a long sentence.

Rachel H. said...

Sometimes I forget that I have learned a lot of stuff to do this job. It seems so easy to me now and so intuitive. But I've had a few undergrad speech students shadow me and then I realize that I really am brainy and footsy (a dr suess reference).

Steph Kjelstrom said...

quite impressive!! sounds like a cool job.