Speech & Swallowing Therapy of Southeast Texas PLLC

04/02/2026

To crush or not to crush… that IS the question!

If a patient is having trouble swallowing pills, crushing them might seem like the easiest solution—but it’s not always safe.

Crushing or mixing medications can:
• change how they are absorbed
• reduce effectiveness
• or even lead to unintended side effects or overdose

And here’s what many people don’t realize…
Difficulty swallowing pills is often a sign of dysphagia.

If you’re seeing:
• coughing or choking with pills
• holding medications in the mouth
• frequent need to crush medications
• complaints of pills “getting stuck”

…it may be time for a swallow evaluation.

I created a one-page handout for patients, caregivers, and nursing that breaks this down clearly.

SAST provides diagnostic swallowing evaluations through the use of FEES (Flexible Endoscopic Evaluation of the Swallow) with no barium, radiation, time limits, or positioning restraints.

Call 409-206-0358 or email admin@sastclinic.com for scheduling

04/02/2026

Most people think swallowing a pill is simple… until it’s not.

Up to 40% of adults have trouble swallowing medications—and in nursing facilities, it can be as high as 80%.

So what happens?
Pills get crushed. Mixed in food. Hidden in applesauce.

The problem?
That can completely change how the medication works—and in some cases, even cause harm.

There’s actually a lot more to pill swallowing than people realize:

It’s not a natural swallowing pattern
Food and liquids can affect medication absorption
And difficulty swallowing pills is often misunderstood or ignored

If you work in healthcare, care for a loved one, or have ever struggled with pills yourself—this is something you need to know.

Read more here https://speechandswallowingtherapy.com/?p=2158

02/03/2026

💛 When eating and drinking change at the end of life, it’s hard — for everyone.

Watching a loved one eat or drink less can feel frightening and instinctively wrong. For many families, the urge to push food or fluids comes from love, care, and a deep desire to protect.

But research tells us that changes in swallowing, appetite, and communication near the end of life are often natural parts of the body’s transition, not signs of suffering or neglect.

I’ve written a new blog that walks through:
• Why reduced intake is not the same as starvation
• What the evidence says about feeding tubes and thickened liquids
• How comfort-focused feeding supports dignity and quality of life
• Why communication still matters — even when words fade
• How speech-language pathologists help families navigate these decisions

This isn’t about “doing less.”
It’s about doing what matters most — comfort, dignity, and presence.

📖 Read the full post on my website.

What the Evidence Tells Us—and How Compassionate Care Looks in Practice When someone is approaching the end of life, changes in eating, drinking, and communication are almost inevitable. These changes are often frightening for families and emotionally complex for caregivers. Difficulty swallowing ...

01/30/2026

💊 “Just crush the pill” isn’t always the safest solution.

When swallowing medications becomes difficult, crushing pills often feels like the easiest answer. And sometimes, it is appropriate. But many medications are specifically designed not to be crushed — and altering them can change how they work in the body.

Extended-release, delayed-release, and enteric-coated medications are formulated to release slowly, protect the stomach, or maintain steady symptom control. Crushing them can lead to medication spikes, reduced effectiveness, increased side effects, and unexpected changes in function.

Difficulty swallowing pills is often a signal, not just an inconvenience. It may reflect changes in strength, coordination, timing, or fatigue — all of which deserve proper evaluation.

I just published a new blog that explains:
• Why some medications shouldn’t be crushed
• How pill modification can impact safety and symptom control
• Why swallowing and medication effectiveness are closely connected
• What patients and caregivers should ask before altering medications

https://speechandswallowingtherapy.com/?p=2147

📖 Read the full post on my website to learn when crushing may help — and when it may do more harm than good.

When swallowing pills becomes difficult, the most common response sounds reasonable and well-intentioned: “Can we just crush the medication?” For many patients, caregivers, and even healthcare providers, crushing a pill feels like a practical fix. After all, if someone struggles to swallow, maki...

01/25/2026

🗣️💧 Voice changes aren’t always “just a voice issue.”

Hoarseness, breathiness, vocal fatigue, or a weak voice can actually be early warning signs of a swallowing disorder — and many people (and even providers) don’t realize how closely these systems are connected.

As a speech-language pathologist specializing in voice and swallowing, I see this overlap every single week. The same structures that protect your airway during swallowing are responsible for vocal quality and strength. When one is impaired, the other is often affected too.

I just published a new blog breaking down:
• Why voice changes can signal swallowing impairment
• How airway protection, vocal fold closure, and breath support overlap
• When voice symptoms should prompt a swallow evaluation
• Why early assessment matters

If you or someone you love has noticed voice changes — especially alongside coughing, throat clearing, or swallowing difficulty — this is worth a read 👇

🔗 Read the full blog on my website

Most people think of voice and swallowing as completely separate systems. One is about talking. The other is about eating. Simple, right? Not exactly. In reality, voice and swallowing are closely connected. In fact, changes in voice quality are often one of the earliest — and most overlooked — s...

01/17/2026

What is FEES and why it matters?? 👀👅

About 1 in 25 adults (roughly 4% of the general adult population) report swallowing problems once their health is controlled for age and comorbidities.
(Source: large epidemiological surveys on dysphagia prevalence)

FEES (Flexible Endoscopic Evaluation of Swallowing) is a diagnostic swallow study that allows us to directly visualize the throat and airway during swallowing — in real time. Unlike X-ray studies, FEES can be completed in clinic or at bedside, without radiation, and provides critical information about airway protection, residue, secretion management, and aspiration risk.

For individuals with Parkinson’s disease, stroke, vocal cord paralysis, head and neck cancer, or unexplained swallowing difficulty, FEES can be a game changer in guiding safe diet recommendations and effective treatment planning.

I just published a new blog post breaking down:
✔ What FEES is
✔ Who benefits most
✔How it guides therapy and medical decisions

📖 Read the full post here: [link]

Swallowing is complex — but understanding it doesn’t have to be.

What Is FEES and Why It Matters in Swallowing Care mistyredd 16 Jan, 2026 When someone has difficulty swallowing, the most important question is both simple and critical: Is food or liquid entering the airway, and why? The answer to that question determines diet recommendations, therapy direction, a...

12/13/2025

“They ask…
‘But can you actually SEE aspiration?’

Me: 👀👀👀

FEES doesn’t guess.
It shows.

This is exactly why FEES matters.
Aspiration isn’t always loud.
It isn’t always obvious.
And it definitely isn’t always caught on bedside exams alone.

With FEES, we’re not assuming.
We’re visualizing airway protection in real time.

This is how I keep my patients safe, informed, and progressing with confidence.

10/09/2025

Come out and see us today!!

07/03/2025

Big breakthrough today with a head and neck cancer patient post-radiation who had limited shoulder movement before our therapy and can now move much more freely despite severe fibrosis! 🎉

And it got me thinking… many people may not know… 🤔

Improving shoulder range of motion — especially being able to shrug your shoulders 🤷‍♂️ — can actually help some head and neck cancer patients with swallowing after radiation! 🥤

Why? Because:

✅ Neck and shoulder synergy: Muscles like the trapezius and sternocleidomastoid connect to neck stability. Better shoulder mobility and strength can improve posture, which is key for safe swallowing.

✅ Accessory nerve function: The spinal accessory nerve (cranial nerve XI) controls the trapezius. After surgery or radiation, damage or fibrosis here can cause “shoulder drop” or restricted shrug — which often correlates with impaired laryngeal elevation affecting swallowing.

✅ Radiation fibrosis: Radiation can cause scarring in neck and shoulder muscles, leading to stiffness that limits hyolaryngeal elevation and pharyngeal constriction. Gentle range of motion and stretching exercises can help loosen things up.

✅ Postural control: Good shoulder and neck mobility supports upright posture, essential for safe swallowing. Slumped shoulders or awkward neck postures can raise aspiration risk.

⚠️ Important note: Shoulder exercises alone won’t directly fix swallowing problems, but they’re often a valuable part of a comprehensive dysphagia rehab plan with direct swallowing exercises, posture adjustments, and strategies from a skilled SLP with advanced experience in treating post head and neck radiation patients

05/28/2025

I came across this old video where I shared some of the specialties I’m so passionate about—and wow, it brought back all the feels ❤️At the time, I was trained in:🧠 McNeill Dysphagia Therapy (my dysphagia nerd heart loves this one)📣 LSVT LOUD (helping Parkinson’s patients find their voice again—literally)⚡ VitalStim (electrical boost for 💪 swallowing)👃 FEES (yep, I look in throats with a camera, and yep, I love it)These tools have helped me change lives—and I’ve added even more to the list since then. It’s wild to look back and see how far I’ve come. Grateful for the journey, and even more excited for what’s ahead 💛

05/23/2025

🌿 Evidence-Based Practice is FEESible! 🌿
SAST – FEES Mobile and Outpatient Swallow Studies

📊 Did you know there’s up to 90% inter-rater reliability between FEES and MBSS? That means FEES is just as accurate, with even more flexibility and patient-centered perks.

✨ Why FEES?
✔️ No radiation – safe for repeat evaluations
✔️ Bedside or outpatient — wherever the patient needs us
✔️ Visualize real-time swallow function & secretion management
✔️ Use of real foods/liquids, not barium
✔️ Effective for fatigue, sensory testing, and biofeedback
✔️ Ideal for medically complex patients

🏥 Now available outpatient starting June 1st!
📍 985 IH-10 North, Suite 106A, Beaumont, TX 77706
(The “Texas Building”)
📅 Accepting appointments now!

Let us bring top-tier, evidence-based dysphagia care to you – whether at bedside or in the clinic.
📞 Message us or call today to schedule!

📌 Because expert care should be flexible, effective, and FEESible.

05/21/2025

🚰 LIVE FREE OR ASPIRATE TRYING 🚰
We may need to make this a shirt 😁—but it’s also a serious message.

Free Water Protocols are not about being reckless—they’re about being informed. Even for patients who are NPO (nothing by mouth), access to water with proper oral care and supervision can improve quality of life and reduce complications like dehydration, UTIs, and hospital readmissions.

🦷 Oral care is essential. Bacteria from poor oral hygiene is one of the leading causes of aspiration pneumonia—NOT water. When oral hygiene is prioritized and protocols are followed, patients can often safely drink water, even when they can’t safely consume other liquids or foods.

💚 At SAST, we believe swallowing is a function worth fighting for. We offer comprehensive FEES mobile swallow studies and evidence-based dysphagia treatments that empower patients and providers with the data and strategies they need.

📞 Contact us today to schedule a swallow evaluation or to learn more about implementing Free Water Protocols safely in your facility. Let’s help patients live fully, swallow safely, and get back what matters.

409.206.0358