This multigenre research project is a semester long project for class. I chose dysphagia as a topic due to my great interest in the swallowing process. Swallowing is an area of speech-language pathology that I would like to work in. Most of the genres used in my project reflect the voice of the clinician. In the journal genre however the voice of the client was used so I could gain a better understanding of what it might be like to be a person with dysphagia, what feelings and concerns might I have as the client? I also completed a poem and an email exchange in the voice of the client’s daughter. This made me consider the feelings of the family member who is required to do much of the at-home care for my client. What are the family members concerns? What do they have to do at home? This could be very scary to the care-taker who needs to make sure they have things just right to prevent aspiration.
This piece of work has taught me a lot about dysphagia in a factual sense from the clinicians point of view but it also opened me up to see how the client and the client’s family members might feel when put in this situation.

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Date:10-10-02
From: Julie Simpson
Subject: My mothers’s dysphagia
To: rikkilewis@slp.org

Rikki,
Recently we have been having some problems with Mom’s feeding. She is having a very difficult time with chewing foods that are hard or tough (like hard crackers or tough meats). She is doing excellent with liquids though and it seems as if aspiration is no longer the problem since we finally figured out the correct consistency we need to get to with the thick it, but now it is the chewing of foods that require more effort to chew that are causing her problems. I am wondering if maybe we need to come back and have her reevaluated or something so we can figure out why she is having a difficult time with the chewing of foods now.
Thanks,
Julie

Date: 10-10-02
From: Rikki Lewis
Subject: Re: My Mothers Dysphagia
To: julessim@yahoo.com

Julie,
It is great new to hear that your mother is doing so well with preventing aspiration of liquids and foods because that is the dangerous part of dysphagia. Now that we have that controlled I would like to incorporate some more oral-motor exercises to build strength in Mary’s labial seal (how well she is able to hold food in her mouth with her lips), tough strength (which is important in moving the food around so it can be chewed, and jaw/cheek strength (this is important in the actual chewing motion). Your mother’s stroke has left her with some mild muscle weakness, due to the fact that she has come so far with the exercises to prevent aspiration in the pharyngeal stage I am very positive about the oral-motor exercises, I feel she will quickly rebuild strength and will be able to chew these harder foods you discussed in your email. I would like to reevaluate your mother in the clinic to evaluate muscle strength and to decide what exercises will be right for her dysphagia and to determine which exercises will give her the most progress possible. You can just call the clinic and set up and appointment with me at your soonest convenience. I would also like for her to have another modified barium swallow (MBS) so I can see how things look now after the work we have done. For this MBS I want her to swallow just like she does at home with the postural changes that are in place.

Thanks,
Rikki Lewis, SLP

Date: 10-11-02
From: Julie Simpson
Subject: Reevaluation
To: rikkilewis@slp.org

Rikki,
Thank you so much for your input on my mother’s condition. I have called the clinic and we have an appointment for next Monday at 10:00. I am greatly looking forward to this, mother is very excited about her progress and hopes to finally start going out to eat again very soon. You know how important it is to her to be able to eat normally when she goes to restaurants with her friends. You have been so helpful through this entire ordeal and I just want you to know how appreciative we are of you.

Thanks,
Julie

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I am the daughter of a mother with dysphagia
I wonder if there is something more to do for her
I hear the sounds she makes when she swallows
I see the pain in her eyes with every drink she takes
I want to just stop the pain and help her
I am the daughter of a mother with dysphagia

I pretend she is like she used to be
I feel she hates me for not helping her
I touch her face to try to help her
I worry that I am only making things worse
I cry because I know there is nothing I can do
I am the daughter of a mother with dysphagia

I understand what the speech pathologist tells me
I say are you sure there is nothing else
I dream of hearing about a cure for her dysphagia
I try to push this out of my head and do things that are possible
I hope she only realizes the anguish I live in because of her pain
I am the daughter of a mother with dysphagia

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