The joy of eating…again

Breaking bread together with friends and family is one of life’s great joys. However, when the part of the brain that controls swallowing is injured, eating food or drinking liquids can become difficult. Those with this condition, known as dysphagia, must get their nourishment in other ways such as through a feeding tube. 

Now, a new treatment tool being used at St. Joseph’s Health Care London (St. Joseph’s) is helping those with dysphagia learn to swallow again. The Abilex® Oral Motor Exerciser is a hand-held device that looks like a large spoon. It safely stimulates and exercises parts of the oral cavity to strengthen the lips, tongue, jaw and mouth and to maintain the flexibility and coordination of the tongue. The Abilex® device was designed by Dr. Ruth Martin who is a professor at Western University’s School of Communication Sciences and Disorders and a scientist with Lawson Health Research Institute.

Abilex device

“Sometimes, those with a brain injury may have a period of confusion known as post-traumatic amnesia. This means they may have difficulty forming memories, making it challenging for them to follow the swallowing exercises that help them learn to safely eat again,” explains Stephanie Muir-Derbyshire, a speech language pathologist (SLP) in the Acquired Brian Injury program at St. Joseph’s Parkwood Institute. 

For most of us, the swallowing process is automatic. The swallowing mechanism has three phases: 

  • Oral preparation – chewing food and mixing it with saliva to forum a bolus (a ball-like mixture of food and saliva)
  • Oral transit – tongue moving the bolus to the back of the mouth 
  • Pharyngeal – physiological activities triggering the pharyngeal swallow 

Swallowing efficiently is important because, when someone isn’t swallowing properly, they are at risk for a variety of health problems such as aspiration, choking, pneumonia and re-admission to acute care. 

speech pathologists demonstrating Abilex device

In January 2016, the inpatient Acquired Brain Injury Rehabilitation Program at Parkwood Institute, part of St. Joseph’s Health Care London, was chosen as a test site for the Abilex® device. The SLPs began trialing the device for patients who had an oral motor weakness that was affecting their speech and/or swallowing. 

For 44 year old Michele Fyfe, the Abilex® device helped her learn to safely eat again. After having a serious heart attack and stroke last June, her brain was deprived of oxygen for a period of time, resulting in an anoxic brain injury. She was placed in an induced coma for three weeks to help her recover. While in the coma she breathed through a breathing tube, and received nourishment through a feeding tube. Once the tubes were removed, she started on a diet of thick fluids and soft foods like grits. “I had to learn to swallow all over again,” she says. An initial swallowing test revealed Michele was aspirating or taking thin liquids in to her airway each time she drank – a dangerous situation that could lead to aspiration pneumonia. 

Communicative Disorders Assistant, Karley Charrette worked with Michele on the Abilex® swallowing exercises assigned by the SLPs. At the end of the trial period, a repeat swallowing test revealed she could now safely protect her airway when swallowing thin fluids and she was no longer coughing or choking when drinking.

“We were pleased after using the Abilex® device because Michele could now safely swallow – for the first time in five months she could safely drink fluids and eat regular foods.”

Prior to the invention of the Abilex®, SLPs had access to tools like tongue depressors, swabs and laryngeal mirrors to do the exercises, which are now possible with the AbilEx®. To use the AbilEx® properly, it is essential to follow a swallowing therapy plan created by an SLP. 

While the Abilex® device has been used in private and outpatient clinics in North America, Parkwood Institute is the first to integrate the device into a rehabilitation program.  SLPs at Parkwood Institute are looking forward to implementing the Abilex® as a standard treatment tool for patients who can’t manage their swallowing or saliva, or who require assistance with speech therapy. 

Now Michele is thoroughly enjoying food again. “Thanks to the Abilex therapy, now I can eat the foods I was craving like chicken and goulash and red cabbage. It has been a long journey to recovery for Michele who says, “I want to inspire others who think they’re never going to be able to eat again – if I can do it anyone can.”  

Learn more: Abilex video on YouTube or watch it below.

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