Tag: Singapore

Public awareness

FB Live SSLT Talk Show: Provision of Dysphagia Services Between Developed and Developing Country

Yoon Wai Lam

Speech Therapy Works | Singapore Swallowing Specialists have been invited to participate in this upcoming Facebook Live Talk Show organized by the Society of Speech & Language Therapists, Bangladesh.

This is also a Global Dysphagia Movement initiative to create better dysphagia awareness to international community.

#SSLT

All are welcome to watch the 9th episode of our SSLT TALK SHOW ‘Provision of Dysphagia Services Between Developed and Developing Country’ program.

Program Time (Event Time):

Bangladesh Time:

September 18, 2020 (Friday 8 pm).

Singapore Time:

18th September, 2020 (Friday, 10:00pm)

You can watch the FB Live talk show via this link:

https://www.facebook.com/SocietyofSLTs/

Public awareness

FB Presentation Video and Handouts: Speech, swallowing and hearing difficulties in nasopharyngeal cancer (NPC) before, during and after radiotherapy. Why and how to manage ok?

Yoon Wai Lam

Speech Therapy Works and Singapore Swallowing Specialists collaborated with 20dB Hearing Sdn Bhd, Malaysia to present this interesting topic Live on Facebook on 22 July 2020 at 8.00pm (SGT).

We had audiences from all around the world. Great questions were asked during the presentation. Feedback on the live presentation has been good.

Speech Therapy Works and Singapore Swallowing Specialists will organize more Live Facebook presentation in future. Topic would include speech, language and swallowing difficulties for stroke / dementia / neurodegenerative diseases including Parkinson’s disease and etc. Do follow our blog or Facebook to receive notification on the future Facebook Live presentation.

We are happy to announce that the president from the OneHeart Support Group (A Nasopharyngeal Cancer support group in Singapore) has opened their support to individuals or cancer survivors especially the NPC survivors. OneHeart Support Group will provide emotional and psychological support. For those interested to seek support from OneHeart, please contact Dave at +65 9101 8223. We will include a copy of OneHeart Support group brochure in this post once we receive it.

Please see attached for the handouts for this presentation.

handouts-for-speech-swallowing-hearing-difficulties-in-npc-post-rtx-Download

Public awareness

Covid 19: Tip to reduce or prevent ear pain from prolonged masks wearing

Yoon Wai Lam
Pain or itching on ear caused by mask straps

Pain or itching on the ear caused by mask straps from prolonged mask wearing has been a common complaint.
There are many custom made “ear saver” ideas that you can find from Google. Some people are selling these ideas, you may be familiar with the term “mask strap extender”.

‘Ear saver ‘ ideas from Google

Personally, I have tried using a paper clip and it was not very comfortable.
After some experimenting, I have found a design that I would like to share with you to help you make a comfortable “ear saver”.

Here in Singapore, I have taught some of the healthcare professionals and food sellers to make this “ear saver” and the feedback has been good.

The materials required are simple. Just use an elastic band or string!

Tie both mask straps together with the elastic band/string and customise it to a length you are comfortable with.

Just found out another great ‘ear saver’ idea by my Japanese friend Ms Kotomi Sakai.

DIY Ear Saver by Ms Kotomi Sakai using spiral hair tie

Singapore swallowing therapy

Happy New Year 2019 from Speech Therapy Works and Singapore Swallowing Specialists

Yoon Wai Lam

2018 has been a great year for Speech Therapy Works and Singapore Swallowing Specialists in both business expansion and mentoring program. As we come to the end of 2018, the team would like to take this opportunity to thank all the Singapore and overseas clients, doctors, partners, and healthcare professionals for all their support and trust in us. We will continue to improve to ensure better service satisfaction and treatment outcomes for all our clients.

As part of the effort to reach out to even more people who requires speech and swallowing therapy, we will continue to work with our regional partners to conduct more training and workshops in the coming years.

Wish Everyone a Happy and Healthy New Year 2019!!!

Lecture on “The Importance of Anatomy & Physiology Knowledge in Dysphagia Management & Treatment” to Year 2 – 4 students at the National University of Malaysia (UKM), Kuala Lumpur, Malaysia. 18 December 2018

Continue reading “Happy New Year 2019 from Speech Therapy Works and Singapore Swallowing Specialists” →
Cost effective treatment, dysphagia research, Dysphagia Therapy, Singapore, speech therapy singapore, speech-language therapy, Swallowing Problem, Teaching, Uncategorized

Second Publication on Chin Tuck Against Resistance (CTAR)

Yoon Wai Lam

We are happy to announce that the follow up study on CTAR has been published online (online first version) in Dysphagia Journal.

Original Paper

Dysphagia

pp 1-11

First online: 02 February 2016

Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography—Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise

  • Wei Ping Sze 
  • , Wai Lam Yoon
  • , Nicolas Escoffier
  • , Susan J. Rickard Liow

Abstract

In this study, the efficacy of two dysphagia interventions, the Chin Tuck against Resistance (CTAR) and Shaker exercises, were evaluated based on two principles in exercise science—muscle-specificity and training intensity. Both exercises were developed to strengthen the suprahyoid muscles, whose contractions facilitate the opening of the upper esophageal sphincter, thereby improving bolus transfer. Thirty-nine healthy adults performed two trials of both exercises in counter-balanced order. Surface electromyography (sEMG) recordings were simultaneously collected from suprahyoid muscle group and sternocleidomastoid muscle during the exercises. Converging results using sEMG amplitude analyses suggested that the CTAR was more specific in targeting the suprahyoid muscles than the Shaker exercise. Fatigue analyses on sEMG signals further indicated that the suprahyoid muscle group were equally or significantly fatigued (depending on metric), when participants carried out CTAR compared to the Shaker exercise. Importantly, unlike during Shaker exercise, the sternocleidomastoid muscles were significantly less activated and fatigued during CTAR. Lowering the chin against resistance is therefore sufficiently specific and intense to fatigue the suprahyoid muscles.

Details of the journal can be found at http://link.springer.com/article/10.1007%2Fs00455-015-9678-2

We are happy to announce that we are starting our third CTAR research at the National University of Singapore.

CTAR research 3
CTAR research 3 in progress

materials for CTAR 3
Materials used in CTAR 3

Dysphagia Therapy, speech therapy singapore, Swallowing Problem

Dysphagia Journal Reviewer for 2014

Yoon Wai Lam

Dysphagia Reviewer 2014

Feeling happy and honoured to see my name listed as one of the reviewer along side with all the world reknown dysphagia experts on the acknowledgment of reviewers page in the Dysphagia Journal for 2014. It has a great experience being a reviewer for this distinguished international journal for the very first time. Hope to have the opportunity to review more papers in future.

Dysphagia Therapy, Public awareness, Singapore, Swallowing Problem

Nasopharyngeal Cancer Support Group Talk: How does NPC affect speech and swallowing?

Yoon Wai Lam

NPC support group brochure0001NPC support group brochure0002

The Singapore Nasopharyngeal Cancer (NPC) Support Group will be organizing the above mentioned talk.

Date: 21/5/2015 (Thursday)

Venue: CareConnect, Tan Tock Seng Hospital, Singapore

This talk is open to all NPC survivors / caregivers.

Speaker: Mr Yoon Wai Lam (Director of Speech Therapy Works, Part-time lecturer in the Master in Speech Pathology Programme, National University of Singapore)

Topic: How does NPC affect speech and swallowing? Can speech and swallowing function be maintained after radiotherapy?

Speech and swallowing difficulties can occur at the time when the diagnosis of NPC is made or it can also occur during and/or after treatment. In this talk, how speech and swallowing problem happen and its management will be discussed. Simple speech and swallowing exercises that may be useful to maintain speech and swallowing function would be demonstrated during the talk.

Cost effective treatment, Dysphagia Therapy, Singapore, Swallowing Problem

Worsening dysphagia. How would you manage?

Yoon Wai Lam

worsening of dysphagia

A comprehensive dysphagia (swallowing disorders / difficulties) management is not only limited to diet recommendation, compensatory strategies or rehab exercises. Providing crucial feedback to the medical team is equally important.

The following case is one case example:

I was consulted by my speech-language pathologist / therapist colleague regarding a case of worsening dysphagia within days in a rehabilitation hospital. The patient (pt) had a stroke (left MCA infarct) diagnosed 2 weeks ago. According to the medical report from the acute hospital, the pt presents with global aphasia and dense right hemiplegia.

Day 1:

Initial assessment revealed mild oropharyngeal dysphagia and global aphasia. Delayed swallowing initiation was suspected. Meal supervision was performed by the ST and pt was started on soft diet and thin fluids.

Day 2:

Patient’s swallowing presentation appeared to have worsen. Oral control appeared poorer, and oral residues were noted post swallow. Noted reduction in hyolaryngeal elevation and double swallows per bolus. Coughed on thin fluids. Diet was downgraded to minced diet and nectar thick fluids by teaspoon.

Day 3:

Staff nurse reported to the ST that pt is coughing on minced diet and nectar thick fluids during breakfast. On ST review, it was noted that patient presents with tongue pumping with significant amount of oral residue post swallow, delayed swallowing initiation, and multiple swallows per bolus. Wet voice was noted post swallow.

I was asked by my colleague for a second opinion.

**Before I move on to explain our plan for the case, allow me to list down the suggestions by some of the SLPs I spoke to when I presented the case to them.

 

1) Most SLPs would want to refer the patient for an objective assessment [Videofluoroscopy (VFS) or Fiberoptic Endoscopic Examination for Swallowing (FEES)].

 

2) Some would want to downgrade the diet accordingly to patient’s presentation and observe as so far no other professionals have reported any significant changes. 

 

3) Some would want to inform the team doctor regarding the worsening dysphagia, and to rule out the potential underlying medical complications. 

I asked my SLP colleague the following questions:

Question 1: What are the possible causes of worsening dysphagia? 

Answer: Maybe stroke, and maybe other new neurological deficits. 

Question 2: Why do you think no one else notice any other changes in status except you? 

Answer: Not sure. That’s why I am worried that I am wrong. 

My answer: Pt is dense hemiplegia (power = 0), and globally aphasia. Unlikely for anyone else to have noticed any changes functionally as both limbs and language functions are 0. 

Question 3: What would be your recommendation? 

Answer: What if I am wrong? I don’t dare to ask for a CT scan or MRI as I could be wrong and patient may end up paying for unnecessary procedure and it is not cheap.

Question 4: What if you are right?

Answer: Then the medical team can treat the pt earlier. 

Question 5: Now evaluate the pro and cons the decision “what if you are wrong?” vs “what if you are right?”. 

Answer: Ok I think it would be better to discuss with team doctor and seek their opinion on this. Will suggest further assessment to rule out new events (such as stroke / neuro issues)

After discussion with the doctor, patient was sent to the acute hospital for urgent CT scan. The new CT scan showed hemorrhagic conversion on the left MCA infarct (worsening of the stroke).

In summary, when we encounter rapid progression of dysphagia, perhaps it would be better to speak to the team doctor to find out the cause(s). Objective swallowing assessment may want to be held off until patient’s medical status is stabilized.