It’s a really great feeling when difficult information suddenly clicks and you feel (at least slightly more) competent. In Dysphagia we’ve been watching different case studies of modified barium swallows and having to pinpoint where the breakdowns are occurring and how to write a formal assessment and impression section. Honestly, the quality of these videos are terrible (Wow, VHS tapes from 20 years ago are crappy in quality? Who knew?), and the first 200 times you watch the video of the x-ray it just looks like white and gray masses with the black bolus dropping on down from the oral to pharyngeal phase of the swallow. Sure, the poor patient’s swallow looks like a stinking heap of a mess, but to specify the disorders and if there’s laryngeal aspiration/penetration and whether the person is coughing in response and how much in percentage leaked… Brain.hurt.lot.
Then you just… get it. The parts (valleculae, vestibule, pyriform sinuses, epiglottis, cricopharyngeal sphincter, etc.) all finally become distinguishable, and though the swallow is a quick 1 second, you can see what’s going on and which area isn’t doing its part. It still takes 20+ viewings of the same swallow to get all the information, but hey – I can effing do it. So thumbs up to me.
Looove Dr. Kitselman. His seminar is pretty excellent.
(This video was made by one of the (only three. Three!) men in the program, P.J., who’s a very nice guy, and another chick in the program. I guess they made the video on doing a swallow evaluation a few years ago for the undergrad clinical methods class.)