Monday, April 29, 2013
Thursday, April 25, 2013
Thursday, April 18, 2013
Today I had the opportunity of observing a modified barium swallow study on one of my patients. A modified barium swallow is a type of procedure used to investigate the coordination of muscles and structures in the mouth and throat. The purpose of this study is to identify patients who are at risk for aspiration (when matter enters the lungs). It also serves as a tool for identifying safe food/liquid consistencies for patients to consume.
How it works:
- Barium sulfate, an opaque substance when viewed by X-ray, is added to liquids of different consistencies
- Types of liquid consistencies:
- Thin – non-restrictive
- Nectar – some liquids require thickening, consistency is most similar to tomato juice
- Honey – all liquids require thickening, liquids become very slow to pour
- Pudding – liquids must be spooned
- The patient sits or stands in front of a fluoroscopy machine (X-ray) while swallowing the prepared liquids
- Fluoroscopic images are taken simultaneously, capturing the bolus as it travels from the oral to the pharyngeal phase
- The speech language pathologist views the fluoroscopic images and can then determine the safest consistency for the patient
Unfortunately, my patient suffered from silent aspiration, meaning her epiglottis was delayed in blocking the trachea (passageway to the lungs), allowing thin liquids to enter into her lungs. Nectar thick liquids however did not cause her to aspirate so for the time being, her nutritional needs must be met entirely by a nectar thickened liquid diet, and that’s where the dietitian’s job begins!
If you want to see a barium swallow check out this short clip.
Monday, April 15, 2013
Now that we are nearing the end of the program, many of us interns, including myself, are looking towards the near future - what jobs should we apply for and when should we take the exam. As exciting as graduation is, applying for jobs and writing up resumes can be quite stressful. Plus, most of us are planning on taking the exam as soon as we can. So that's a lot of studying on top of that resume writing.
In order to stay focused and keep the stress at bay, I've come up with a few good tips on how to get ready for the internship graduation, jobs and the RD exam.
- Resumes and cover letters. Dig up your resume and start tweaking! Add in all of the experiences and activities you've completed thus far in the internship. This will take a while to complete, so give yourself enough time to build out a well rounded resume. Also, write up a cover letter template that you can change with each job you apply for.
- When to look for jobs. Each preceptor or internship director will give you a different answer. But I've found that beginning to get an idea of WHERE to find jobs and WHAT they require in their applications is a good thing to know. Start scoping out the scene about 3 months prior to graduation.
- Network! Much of this internship is about networking, making connections and finding great friends in this field. Reach out to your preceptors, friends or other colleagues that may be able to help you get a foot in the door. Most are more than happy to help you out!
- Know when you want to take the exam. Keep a plan in mind when you're thinking about when you should take the RD exam. This will help you determine a good study schedule.
- Study, study, study. There are a lot of great resources out there to help you study and ace the RD exam. Pick one, or two and get down to business. A lot of money can be spent on special study guides. However, a copy of the Inman CD's and book is a great and cost-effective way to go. You may even be able to borrow a copy from past interns (hint, hint!).
Tuesday, April 9, 2013