On April 19, 2021, after already receiving four rejections from other hospitals, I was very fortunate to get an email from the head of my grad program informing me that she'd found someone to take me on, despite me not applying there. So it was that I got the spectacular news that I would be an extern at Neilsen Rehabilitation Hospital just two hours before my house burned down! What a day.
The past ten weeks I have been very busy learning how to be a speech pathologist in the medical setting. The speech therapists there are divided into four teams: stroke, TBI, spinal cord injury, and poly-trauma. I was on the poly-trauma team, so I worked with a lot of people who suffered from craniotomies, injuries not just specific to head or spinal cord, critical illness myopathy, and "Long COVID"(being so severely impacted by COVID that there usually required being trached). If I understood correctly, the Long COVID patients were those whose overall physical and cognitive function declined due to the virus attacking their whole neurological system. While at the rehab hospital, they worked on regaining use of their limbs (the severity depended on the person), their swallow, and learning strategies to compensate for executive functioning deficits such as decreased memory, attention, problem-solving, and reasoning. So far research is seeing that cognitive function can take 18 months or so to resolve.
I worked a lot with dysphagia, which meant a lot of swallow rehabilitation. I taught swallow exercises and used AmpCare, in which small electrodes are placed on the neck to pull the muscles up and forward to provide resistance while the patient swallows. I monitored and modified patient diet textures to maximize safety. I helped with FEES (in which an endoscope is threaded through the nose to get an aerial view of the larynx and watch if a patient is protecting the airway while eating green-dyed foods) and administered MBS (in which the patients eat/drink barium of different textures to watch the safety/efficiency of the swallow on an X-ray). I loved being able to see patients upgrade from NPO diets (all food via feeding tube) to an oral diet, or from a modified oral diet (e.g. pureed, minced, chopped, soft, etc.) to more regular textures.
I also worked on cognitive skills, and though I didn't work with it a lot directly, I loved seeing aphasia treatment. To see people with Broca's or Wernicke's Aphasia go from an inability to communicate their needs to having so much more control of the words in their mouth was incredible!
At the rehab hospital, patients worked hard so they could go back home. It was a powerful experience indeed to see people who suffered such severe illness or injuries who were able to overcome so much.
| I tried barium. It was nasty. |






























