Rehabilitating the Swallow

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Like breathing, swallowing is an innate part of everyday life. A key element to eating and drinking, it is an action that normally does not have to be taught, yet when broken down, swallowing is a strikingly complex neuromuscular activity combining both the skeletal muscle – the tongue – and the smooth muscles of the pharynx and esophagus. Having a swallowing disorder, the difficulty or inability to swallow, would not only be inconvenient, it would, and very well can be, terrifying.

A former military family, Yvette relocated to Southern Maryland with her husband and children in August 2001.

“I stayed home with my children for a while and started my private practice in 2005 when I realized there was a need in Southern Maryland through mom’s groups that I participated in,” she said. In fact, more than 10 years later Yvette is still the only medical professional in the tri-county area who specializes in swallowing disorders, and one of only four American Board of Swallowing and Swallowing Disorders certified practitioners in all of Maryland.

But it was not just the local mothers who impacted her speech pathology ambitions – it was her grandmother. “Initially I wanted to be an Ear, Nose, and Throat (ENT) doctor. I love all the muscles in the head and neck,” she said. “Then my grandmother got sick and had a stroke, and I went with her to a couple of her speech therapy sessions and I was very intrigued by this magical person who was helping my grandmother.”

Graduating in 1991 from Southern Illinois University with her masters in Speech Pathology, Yvette learned from the one of the best – Jerilyn Logemann, an internationally known and early pioneer in swallowing disorders. Logemann’s patients were often her research subjects. “I didn’t even realize how lucky I was until much later. I was placed in the heart of this emerging field. It was there that my love of dysphagia developed and I have been hooked ever since.”

Speak Well Solutions was born out of the lack of speech therapy solutions Yvette saw in Southern Maryland and the enthusiasm she felt to bring high-quality care to her rural community. Her practice also partners with Sense Ability, LLC, an occupational and physical therapy center that shares the same office space in Leonardtown, allowing patients a convenient location to get all three therapies in one place, if needed.

Yvette and her colleagues work with pediatric patients on articulation, fl uency, apraxia, as well as early intervention to help children who aren’t meeting developmental milestones. Adult treatments often

focus on neurological communication disorders, swallowing issues, and rehabilitation for individuals who are recovering from strokes, brain injuries, or cancer. “Most patients live in St. Mary’s County. I do not want our community residents to feel like they need to go all the way to D.C. to get good quality care, because it isn’t necessary”

Each treatment process depends on the diagnosis, but patients typically come into her office two to three times a week for 30 or 45- minute therapy sessions. “All of our sessions are individualized and tailored to meet the needs of specific patients. There is no group therapy, of course, unless that is a goal—for example, if the objective for a child who has Autism is to develop social skills,” she said.

The important part is having the patient’s family involved. “We encourage and want family members, caregivers, and parent participation – they are all welcome in the session. We believe the person who is taking care of the patient needs to know what is happening in therapy because they will be the one facilitating [the therapy] outside of the treatment room,” Yvette stressed. “They are the heart of the success of the patient and very important. We give the patient the tools and then they have to implement those tools, and the parents and caregivers are a huge piece of that puzzle.”

Speak Well Solutions prides itself on being a rehabilitation center

first and foremost. “The best therapy for swallowing improvement is swallowing,” she says. “So often medical professionals want to change the patient’s diet; put them on thick liquids or a puree diet, essentially managing the diet but not rehabilitating the swallow,” Yvette said.

“Those strategies are only temporary, so that’s not what I do. I focus on rehabilitating the swallow so we can eliminate these crutch therapies,” she said.

Yvette spoke of a patient who had head and neck cancer and was told he wasn’t going to be able to eat by mouth and would need a stomach tube. The individual had oral surgery along with radiation therapy,

and went to Speak Well Solutions throughout radiation. After about 12 weeks of intense therapy, the patient is now eating by mouth, and Yvette couldn’t be prouder. “Now that he’s eating, we monitor his weight with a nutritionist to see if he is able to maintain and see if he can meet his needs by mouth.”

Citing her successful patient above, Yvette wants physicians to know what options are available in our area when they have patients who have trouble swallowing. “We can help physicians navigate through the diagnosis and how to best treat patients.”

 

Yvette McCoy

Yvette McCoy is the owner of Speak Well Solutions. She specializes in adult communication disorders and swallowing disorders. She has extensive training in assessment of swallowing disorders and holds the designation of Board Certified Swallowing Specialist (BCS-S) by the American Board of Swallowing and Swallowing Disorders.

As a BCS-S speech-language pathologist Yvette has chosen to specialize in swallowing disorders and devote a significant amount of her clinical practice and continuing education to diagnosing and treating this complex disorder. Because of this dedication and training, she has learned the latest, state-of-the art clinical approaches and can most effectively and efficiently evaluate and treat individuals with swallowing disorders. As a BCS-S specialist, Yvette provides appropriate, evidence-based treatment techniques to address the swallowing problem(s) of each individual, based upon the comprehensive swallowing assessment.

Yvette has training in the area of Fiberoptic Endoscopic Examination of Swallowing (FEES) and Modified Barium Swallow Impairment Profile (MBSImP). She also has training in accent reduction and is certified by the Institute of Language and Phonology. Yvette also provides treatment for motor speech disorders and child language disorders. She has received six ACE awards from the American Speech-Language Hearing Association for outstanding continuing education. In addition, Yvette is an adjunct instructor at the University of Maryland in College Park and earned a master’s degree in speech pathology from Southern Illinois University at Edwardsville. She is a former military wife and mother of three.

For more information regarding swallowing disorders please visit www.swallowingdisorders.com.

 

Gwendolin Jenkins

Gwendolyn Jenkins specializes in speech therapy for children including expertise in the areas of child language disorders, autism, and special needs. She

is a Baltimore native and a mother of two. Gwen earned a master’s degree in hearing and speech science from Vanderbilt University and a master’s degree in special education (mild-moderate disabilities) from John Hopkins University.

 

 

Anna Decker

Anna Decker specializes in treating pediatrics through mature adults. She has experience in a variety of settings (private practice, medical and education).

Anna has a special interest in augmentative and alternative communication (AAC). She earned her master’s degree in Speech-Language Pathology at the University of Chapel Hill.

 

 

 

Erin O’Neil

Erin O’Neil specializes in treating adults with neurological disorders. She has experience working with adults and children in the hospital, out-patient, and skilled nursing facility settings. Erin enjoys spending time outdoors with her husband and son. She earned a master’s degree from Gallaudet University.

 

 

 

 

Elizabeth Peeler

Elizabeth Peeler has extensive experience treating children through high school with diagnosis including expressive/receptive language disorders, autism, articulation and phonological disorders, AD/HD, learning disabilities and intellectual disabilities. She is a mother of two. Elizabeth earned a master’s degree in speech-language pathology from Loyola College of Maryland.