Nashville: Year 2

After an overly long 3 month hiatus, I’m back! I can’t believe that it’s officially been a little over a year since I started this blog and moved to Nashville. I’m half way through grad school, still complaining about the weather, and a little more country-fied. Life is good – I had a relaxing summer in Nashville even though I was still in school, and now I’m on to Fall semester! The best part is that I still LOVE what I’m doing in school. I’m so excited to be a speech pathologist a year from now and can’t imagine finding a career path that would suit me better (other than professional pizza eater/netflix watcher, but alas, those don’t pay the rent).

I thought I’d share a little bit about some of the classes I’ve taken over the past year; what I’ve enjoyed, what I’ve learned, and where I think I’m headed next. 

Aphasia: I’ve blogged about aphasia before (What is Aphasia). This is a communication disorder most often seen in adults, but there are many teenagers and young adults (and some children too) who acquire aphasia following head trauma. We work with these patients in the hospital as well as inpatient and outpatient rehab.

Traumatic Brain Injury (TBI): Following injury to the head (yes, even a concussion might be a mild TBI), many individuals experience deficits in language, memory, planning, cognition, processing speed, etc. Speech pathologists help assess and treat these patients to help them regain independence, and possibly return to work or school. Although not immediately obvious, memory, cognition, and executive function (higher level thinking, planning, decision making) are crucial components of language and communication. Speech therapists (along with physical and occupational therapists) help patients regain skills to perform activities of daily living, and regain or compensate for lost skills. 

Voice: Voice disorders may result from vocal nodules, polyps, cancer, paralyzed vocal folds, etc. and can cause prolonged hoarseness, loss of voice, pain, change in pitch, and more. Speech therapists often use a video attached to an endoscope to look at your vocal folds (by going through your mouth or your nose). We help treat voice disorders through non-surgical methods that include better vocal hygiene and changing speaking habits. Some speech therapists also do singing voice therapy (in high demand here in Nashville since singers often wreck their vocal folds). 

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This is my art project larynx. That’s basically what the inside of your neck looks like in living color (but not)

Dysphagia: Dysphagia is the fancy term for a swallowing disorder. Many people don’t know that speech therapists also treat swallowing and feeding (not eating) disorders, since swallowing, breathing, and speaking are inexplicably linked by the anatomy of the head and neck. Following surgery, intubation, a tracheotomy, radiation for cancer, neurological issues, TBI, or even normal aging, many people have trouble safely swallowing food or even their own saliva. If they are unable to protect their airway while swallowing, they may aspirate (take food/liquid/saliva into their lungs), which can lead to asphyxiation, pneumonia, infection, and malnutrition. Speech pathologists often work in hospitals to assess swallowing safety in patients and help determine a safe diet for the patient (or determine whether the patient is unsafe to eat and needs a feeding tube). 

Pediatric Feeding and Swallowing: We also assess safety to eat and swallow in children. Children with complex medical problems often face long hospital stays in the first few months or years of their lives. This can interfere with normal development of feeding and swallowing behavior. Most of us eat so automatically, but if you think about all the steps of bringing food to the mouth, chewing it, controlling the food and gathering it with the tongue, pushing the food back to swallow, stopping breathing while we swallow, and then resuming breathing, eating is an extremely complex behavior that requires a lot of coordination. Some babies are put on a feeding tube early in life, so we educate parents on how to stimulate oral development. Other children have severe food allergies and acid reflux that cause them so much pain that they develop a fear and aversion of eating. Very premature babies may require a different type of formula and bottle to drink successfully. Children with cerebral palsy often have such strong bites due to their muscle spasms that they break utensils or teeth, so we find alternative feeding devices for them. Children born with a cleft lip or palate often experience feeding difficulties related to pressure and food/liquid coming out of the nose. Many children have sensory issues that lead them to gag at the sight of food, or only eat foods of certain colors or textures, and we help expand their food repertoire. I had a clinic placement in feeding therapy over the summer and absolutely loved it – this may very well be the specialty of speech therapy I want to pursue in the future. 

This semester, some of the classes I’m taking include Autism (super excited about this one), Stuttering (a lot less straightforward than people assume, especially because no one really knows what causes stuttering or why most children stop stuttering but others don’t), and Alternative and Augmentative Communication (AAC – this is anything that supplements or assists speech and writing. This may include speech generating devices such as the computer Stephen Hawking uses to speak. For all of you doing the Ice Bucket Challenge for ALS – speech therapists often help patients with ALS find an AAC device that can help them with communication as they lose their ability to speak and move their limbs). 

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Vanderbilt ALS clinic doctors taking the Ice Bucket Challenge

I still think I want to work with children, but this semester my clinic placement is in acute care in the hospital, so I’ll be working with adults in the hospital doing cognitive and language evaluations as well as swallow studies. Next summer, I’ll still be enrolled in school, but I’ll be doing a 10 week full-time clinic placement (hopefully at a clinic/hospital in San Diego, fingers crossed)! I can’t believe how quickly this year has gone by – I feel a lot smarter and the next few years of my life are starting to take shape. I’m also so glad I started writing last year – I’ve always loved reading and I feel like I express myself well when I speak, but I never felt like I wrote well (unless I was writing a paper for school, which required zero personality). I finally feel like I’m able to put the words in my head on paper through this blog, and for a future speech pathologist, being able to communicate through another modality is always a positive feeling. Thank you to everyone who takes the time to read – I always love and appreciate all of your comments!

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SLP night out

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