Sierra Downs

08/09/2020

🥰 I love this - As SLPs, we need to look at the whole picture - because our patients are *whole people*!

To be able to see. What a thought. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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With all the technology we carry around in our hands & back pockets lately, shouldn’t we offer the same to our patients?⠀⠀⠀⠀⠀⠀⠀⠀⠀
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We owe it to them to visualize their swallow with Flexible Endoscopic Evaluation of Swallow (FEES) testing which is pictured here...or Modified Barium Swallow Study (MBSS) which is an X-ray if the swallow function. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Speech-Language Pathologists can provide these exams to truly see if a person is aspirating (where food/liquid that is eaten goes into the airway).⠀⠀⠀⠀⠀⠀⠀⠀⠀
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I get on a soapbox sometimes because my grandfather, pictured here, fell in February of 2019. He had spine surgery & was sent to inpatient rehab. He was coughing with meals, so an SLP “watched him eat” and put him in a honey thick liquid before ordering an instrumental. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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I protested & waited until the MBS was completed. The MBS company recommended him NPO with a PEG. This man was literally chopping wood before he fell and there was no way I was going to PEG him. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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I protested the recommendation, and instead of treating his Dysphagia and improving his cough strength, the treating SLP took him off caseload. 😩⠀⠀⠀⠀⠀⠀⠀⠀⠀
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I urge you...URGE you to look at the whole patient picture and ask the family how you can respect their wishes and still improve your patients’ Dysphagia. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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This picture was taken earlier this year. These days (when he’s not getting to monitor for my own learning and his care) he’s sawing wood, talking to his guinea hens, gaining weight, and faithfully doing CTAR and EMST150. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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22/08/2020

We *need* ASHA’s support in updating official guidelines for SLPs who are actively practicing in medical settings.

We need ASHA to help us advocate for safe and informed procedures - to advocate for continuing evidence based care for voice and swallowing diagnostics.

Bottom line: OUR PATIENTS SHOULD NOT BE PUT IN HIGHER RISK SITUATIONS BECAUSE OF INACTION.

Please read, sign, and share below.

Update ASHA Guidance on Endoscopy and Prioritization of SLP Services during COVID-19. 199 signatures are still needed!

05/08/2020

Let your voice be heard.
The link to advocate for our professions at the congressional level is at the bottom of the article below, but here it is again to save you some time:

https://takeaction.asha.org/asha/EandM

Please take less than a minute and click the link above!

💙

ASHA and other organizations are fighting a provision in the proposed 2021 Medicare Part B fee schedule that cuts reimbursement for outpatient services provided by audiologists, speech-language pathologists, and 35 other physician and non-physician providers. 

11/07/2020

Wow. Check this out!

Full access PDF article available here:

https://ieeexplore.ieee.org/ielx7/8782705/8937520/09103574.pdf?tp=&arnumber=9103574&isnumber=8937520&ref=aHR0cHM6Ly9pZWVleHBsb3JlLmllZWUub3JnL2RvY3VtZW50LzkxMDM1NzQ=

https://www.instagram.com/p/CChKhxsh7nk/?igshid=1cxl336ul37ze

05/06/2020

Ally [verb] -
to enter into an alliance; join; unite.
When it comes to allyship - within the LGBTQIA+ community, with my q***r colleagues and friends, with my black colleagues and friends - I’ve made mistakes; and I know I will continue to make them unless I continue to actively put in the work. One mistake I have made so far has been silence when I haven’t been sure what to say... and then stopping there, because it takes energy to dig further, to learn, to reflect, to initiate useful conversations.
I’m committed to actively owning my gaps and moving through the hard emotions, through guilt or shame, through silence, to become a better ally. To listen better, and to reflect thoughtfully, *then commit to taking action*. Having more conversations within my smaller communities, with my close friends and family.
I’m working through this, and acknowledging that it will not end in a few weeks’ or months’ time. This is ongoing.
Join me?
🏳️‍🌈
Thank you, for the great reflection prompts here.
🖤🤎🤍 @ Burlington, Vermont

29/04/2020

Especially from serving patients in rural areas, I know from experience that dysphagia treatment can be difficult to come by - which is just one reason why improving access to SLP services via telehealth is SO crucial. ➡️ BUT...
What about the actual ins and outs of dysphagia treatment via telehealth? 🧐
How is it done? 🤔..and what is *ethical*? 😯
(Spoiler Alert: the incredible Dr. Georgia A. Malandraki, Ph.D., CCC-SLP, BCS-S has some answers!) 🙌🏻
🗓 Today, we face a situation where medical care is rapidly adapting to try and address this unprecedented pandemic and save as many lives as possible.
💡Dysphagia care NEEDS to adapt accordingly, and unfortunately this has to be done while legal, reimbursement, and practical guidelines and policies continue to evolve and change. Undoubtedly public health, as well as patient and clinician health and safety, should be prioritized.
👏 The use of telehealth, **when based on current evidence-based practice and conducted ethically and with established guidelines**, can allow our profession to continue offering some of our services using this valuable service delivery modality. 👏
😍 Check out the link below to Dr. Georgia Malandraki's fantastic, comprehensive resource from her I-EaT Research Lab at Purdue on everything you need to know before delving into dysphagia via telepractice.
So, grab a cup of coffee and DIVE IN!
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The webpage serves as a resource guide with practical recommendations for clinicians who want to consider adapting their practices and adopt telehealth solutions for dysphagia management both ethically *and* safely.
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The page is broken down into three parts:
📕 Introduction and Initial Considerations,
🚨 What to know BEFORE you get started (privacy, security, reimbursement, legal safeguards),
*and*
😍 HOW to do this – Technology and Practical Guidelines and Caveats
🙏Thanks to Dr. Georgia A. Malandraki, Ph.D., CCC-SLP, BCS-S and for sharing their discoveries and best practices to help our patients continue to receive much needed services in a safe and ethical way.
✊🏻❤

https://www.purdue.edu/i-eatlab/telehealth-recommendations-for-dysphagia-management-during-covid-19/?fbclid=IwAR2Pde8bFfnXKIcXjBXIeC6nnH3f7SVLAiiWE0MB25HEYQ5X8B4kkauvXzA

29/04/2020

Just a reminder for my SLP/AuD friends:
You can help advocate for our profession from home too! ✊

Discover the results of ASHA staff and members continued advocacy work with Congress and learn how you can help from home.&n...

05/04/2020

☀️🍃 What a breath of fresh air it was to spend my Saturday with the Confident Clinician Cooperative and my fellow colleagues for The Virtual Clinician: Voice Therapy in the Telepractice World 🤗
(No pressure - but when is the next one?!)
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Not only were there plenty of laughs, but everyone definitely learned a *ton* about how to our practices according to EBP in this constantly changing world. It was a nice reminder to be patient with ourselves and our clients especially during this time. My favorite parts were discussing ethical considerations that are on everyone's minds right now - and having the pleasure of watching demonstrate the art form that is voice therapy.
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Keep an eye out for what the Confident Clinician Cooperative is bringing to the masses - I can't recommend learning from these rockstar clinicians enough!
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(If you're lucky, you might even get a surprise guest performance from a rainbow unicorn?)
🦄🎙🤷🏼‍♀️😂

09/03/2020

02/03/2020

"It's one thing to survive, but it's another thing to live.
..and there's nothing better than baked cheesecake."

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Thank you, Dr. Maggie-Lee Huckabee for taking the time to understand what it is that truly drives our patients.