Speech & Swallowing Therapy of Southeast Texas PLLC

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

05/20/2025

🌟 Struggling with swallowing? There’s hope—and help! 🌟

At Speech and Swallowing Therapy PLLC, Misty Nall specializes in advanced dysphagia assessments and treatments, helping patients reclaim their ability to eat and drink safely and confidently.

With over 18 years of experience and a 90% success rate in upgrading diets—even for those initially NPO, I provide highly individualized therapy that gets results.

🧠 Stroke
🧬 Parkinson’s Disease
🧠 Brain Injuries
🎗️ Head & Neck Cancer
👉 These are just some of the conditions I specialize in treating.

I’m certified in:
✅ Flexible Endoscopic Evaluation of Swallowing (FEES)
✅ McNeill Dysphagia Therapy Program (MDTP)
✅ VitalStim with sEMG (biofeedback-based therapy)

Whether you’re recovering from a neurological event or navigating a complex diagnosis, you’re not alone—and improvement is possible.

📞 Call today to schedule your evaluation and start your path to better swallowing.
📍 Serving Southeast Texas | Mobile FEES available

Let’s get you back to enjoying the simple pleasures of food and drink. 💙

05/05/2025

Exciting News!!!

Speech & Swallowing Therapy PLLC just upgraded to a state-of-the-art distal chip FEES scope — and the difference is incredible!

This new technology offers crystal-clear, high-definition imaging, far superior to traditional fiber optic scopes. That means better visualization, more accurate diagnosis, and improved treatment planning for patients with dysphagia with a wider frame.

Whether you’re transitioning off a PEG tube or dealing with complex swallowing issues, this tool helps us see what’s really happening in real-time — safely and comfortably at bedside.

Your swallow deserves the best care — and now it gets the best view.


Let’s get you back to eating safely and confidently!
Call or message to schedule your evaluation today!

Better imaging = better outcomes.

Serving Beaumont, Houston, and surrounding areas!

Plus a new outpatient office coming soon!

Flexible scheduling available.

Swallow safe, live well.

01/05/2025

Reflecting on 2024 when two patients were told they’d likely never be able to eat by mouth again… but they wanted pizza 🍕🍕🍕.
After intense dysphagia therapy- they both resumed to eating regular consistencies!! 🤗

Case one- one year post head/neck cancer with gross aspiration of all consistencies

Case two- Parkinson’s Disease post head injury with gross aspiration of all consistencies

Post therapy they are both safely tolerating regular diets with thin liquids. One had PEG tube removed and the other is in the works.

Here’s to more people enjoying meals with friends and family this year!! 🎉

10/29/2024

https://www.facebook.com/share/bxkFx1Wq9kyoeEkX/?mibextid=WC7FNe

10/16/2024

I am always so ecstatic to be able to present to our local Parkinson’s support groups.

Please share this event!!

https://www.facebook.com/share/dgtaKVKQ599hW5N9/?mibextid=9l3rBW