Sally Pittendrigh Speech Pathologist Optimal SP

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Presentation transcript:

Sally Pittendrigh Speech Pathologist Optimal SP Update in MND ANCIG August 2015 Sally Pittendrigh Speech Pathologist Optimal SP Optimal SP 2009 m 0403 903 822

MND MDT Clinic MACQUARIE NEUROLOGY Operating since August 2011 MDT Meets 1st and 3rd Wed every month 6 clients per clinic and cycle through clinic in 3 monthly epoque MDT Social Work/ Speech Path/Physio/OT/ Dietitian/Nursing/ Neurologist/ Orthoptist/ Resp Physician/MNDA rep/ Research Nurse/Genetic Counsellor. RESEARCH Bio Bank – hair/tissue/blood/urine with age matched controls (spouse/friend) and stored in Research Lab. Research Lab - opened since 2013 and completing significant research. Optimal SP 2009 m 0403 903 822

MND TREATMENT Medication Rilutek – inhibits glutamate release L Serin – amino acid Potential new therapies emerging. We also know that our patients lives better and longer with the input of 2 other variables (Traynor et al 2003 and Vandenberg et al 2005) MDT Institution of NIV Optimal SP 2009 m 0403 903 822

Speech Pathology Swallowing Communication Secretion Management Optimal SP 2009 m 0403 903 822

Swallowing “Non-compliant” with diet modifications Behavioural features of Dysphagia Time/fatigue/appetite/interest in food/ meal size Weight change Intervention Texture / size / frequency plus some positional modifications HEHP Optimal SP 2009 m 0403 903 822

Speech Dysarthria Upper Motor Neuron (Spastic) – speech slow; laboured; imprecise articulation also impacts respiration and voice (harsh/strained quality) Lower Motor Neuron (Flaccid) – hypernasal; breathiness of voice and imprecise articulation; Mixed – common There is no evidence that strength based training is beneficial Compensatory strategies and energy conservation Speech Pathology Intervention in MND Optimal SP 2009 m 0403 903 822

Alternative Communication Heavy technology focus Speech Generating Device (SGD) Voice Banking Amplification Eye Gaze Low technology Optimal SP 2009 m 0403 903 822

Secretion Management Oral and Pharyngeal Pharyngeal Secretion Mx Usually Excessive Runny versus thick and ropey Pharyngeal Secretion Mx Oral care and hydration Dark grape juice Saline humidifcation Home suction Oral secretion Mx Oral hygiene and hydration Anticholinergic meds Botox (intraglandular) Radiation Rx (short low dose) Optimal SP 2009 m 0403 903 822