safe swallowing strategies

It is an easy-to-follow two-page handout. It also can help prevent food or liquid from going into your lungs. Safe Swallow Guidelines Maintain an upright position (as near 90 degrees as possible) whenever eating or drinking. %%EOF Links to the English and multilingual resources can be accessed further below. advice on alertness, posture, advice to stop the patient eating or drinking if showing signs of aspiration) The level of supervision required. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. Safe swallowing strategies; Diet modification; Swallowing maneuvers; Swallowing exercises; Sensory stimulation; Prostheses and surgery; Oral care; Pneumococcal vaccine; Follow-up evaluation; Proper Positioning Sitting upright, not tilted back or slumped to the side, helps breathing and swallowing. Identifying which phases of the swallow are affected can help the development of management strategies to maximise safety and minimise risk during feeding ; Diagnosis and management of swallowing difficulties. The Harvard Medical School 6-Week Plan for Healthy Eating, Improving Memory: Understanding Age-Related Memory Loss. Safe swallow strategies may include slowing the pace of eating to accommodate a delayed swallow “trigger,” or tucking the chin to the chest while swallowing to help protect the airway. Androgens, the family of male sex hormones that includes testosterone, function as a fuel for growth in normal development. The normal swallow has four phases (see Table 1) and is dependent on an intact motor and nervous system. Treatments for Specific Swallowing Disorders . 3�6��b�w It may also help to eat only one food at a time. By activating your account, you will create a login and password. •Pour alcohol-free mouthwash onto your toothbrush. What are the long-lasting effects of COVID-19? Dysphagia literally means difficulty eating or swallowing. Anything that improves a person’s overall condition — strength, stamina, motivation, and emotional state — is likely to help with swallowing. Alternate small bites with small sips. swallowing investigations e.g. Instructions provided for … Nov 7, 2013 - Use laminated cards with safe swallow strategies customized for each patient. common strategies used to support feeding including verbal cueing, physical/manual guidance, use of 200 0 obj <>stream Super supraglottic: Hold your breath and bear down, take a small sip and swallow, pause and then cough. Most melanomas come in the form of a new spot on the skin, not changes to an existing mole. General anesthesia does not appear to increase dementia risk, Harvard study: Unapproved drugs in brain-boosting supplements, Blood pressure medications may affect your mood, Use topical painkillers for strains and sprains, Harder workout intensity may not increase your longevity, Vitamins A, E, and D tied to fewer colds, lung disorders, What to look for in an online exercise video for older adults, Certain foods and drugs may lower risk of colon cancer, Gum disease linked to an increased risk for cancer, More daily movement may lower cancer deaths, Oral health problems may raise cancer risk. 0 Swallowing Disorders: MedlinePlus Health Topic - English Problemas para tragar: Tema de salud de MedlinePlus - español (Spanish) 1 As education is central to the Thick-It ® brand’s mission, patients and caregivers can find additional resources and learn more about our products specifically developed for people with dysphagia at Thick-It ®.com. Dysphagia is difficulty in swallowing. Feed the person patiently, with a slow rate of intake. With each bite or sip, swallow 2 to 3 times before taking the next bite or sip. ASHA's brochures help you communicate more clearly with patients and families about hearing, speech, language and swallowing disorders. The Johns Hopkins multidisciplinary approach brings together experts in many different fields who work together to diagnose and treat swallowing disorders.Specialists, including gastroenterologists, radiologists, ear, nose and throat doctors and speech-language pathologists, examine swallowing X-rays, discuss cases and create personalized treatment plans. Why do my legs swell at the end of the day? They also make sure that that eating and drinking is as pleasurable as possible for their patients. What can we help you find? Outcome 3. swallow initiation and multiple swallow attempts for a bolus. Swallowing and Esophageal Disorders Treatment Guide Esophageal disorders – especially those involving swallowing problems – affect more than 15 million Americans of all ages. You only need to activate your account once. Swallowing. It takes 50 pairs of muscles and three different stages—oral, pharyngeal, and esophageal—to move food from the mouth to the stomach. Between 30 and 40 percent of people with Multiple Sclerosis experience swallowing problems, or dysphagia, at some time. If you’re caring for someone with dementia who has swallowing issues, contact Alzheimer’s Queensland to access our speech pathology services. "It's normal to have some age-related changes with swallowing or occasional difficulty swallowing. Read a compensatory strategy review for swallowing disorders, including how mobile FEES dysphagia & endoscopic swallow studies can work closely with speech language pathologists. Eating and Swallowing Problems THIS FACT SHEET discusses how acquired brain injury can affect swallowing, nutrition and hydration. 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Please circle … What's not normal is when food or liquids get into the lungs regularly," says Semra Koymen, a speech-language pathologist at Harvard-affiliated Brigham and Women's Hospital. Take your time to eat a meal. Swallowing strategies. The treatment plan begins with an understanding of what is wrong with swallowing. 177 0 obj <>/Encrypt 157 0 R/Filter/FlateDecode/ID[<87984A091E3E7841B524C16D6125C402><42918545C4BA9C4797F77AA4F46F45E1>]/Index[156 45]/Info 155 0 R/Length 98/Prev 47651/Root 158 0 R/Size 201/Type/XRef/W[1 2 1]>>stream Compensatory strategies can be used to alter posture, timing of the swallow, laryngeal closure. CBC News Recommended for you It used to be so easy to munch a handful of nuts: chew, swallow, enjoy. endstream endobj startxref This handout is designed for speech-language pathologists working with people in rehabilitation settings who are experiencing dysphagia related to unilateral weakness at some point in the oro-pharyngeal phase of the swallow. Your doctor will refer you to a surgeon who specializes in this area if he or she feels you could benefit from surgical intervention. MODULE 3: Swallowing and Nutrition Safe swallowing strategies Do not drink and eat at the same time No talking while chewing or swallowing The use of gravies and sauces can help moisten foods and ease passage through the throat. Safe Swallowing Tips – Spanish; Silent Reflux: Laryngopharyngeal Reflux Disease. To download information click on the selected language. Swallowing and respiration are the only two systems in the body that share a common part of the body, namely the throat. Eat and drink slowly; take small bites Chew thoroughly and swallow … Written by: Linda Nazarko | Published: 15 June 2015. Screening; Evaluation Forms. Designed for Speech-Language Pathologists working with patients who have dysphagia and need to strengthen the suprahyoid muscles to improve the swallow. Search for: About NFOSD Our commitment is to provide patient hope and improve quality of life for those suffering from all types of swallowing disorders. Tips for Safe Swallowing: Eat while sitting in an upright position Avoid distractions – focus on eating! Oil change scams: Hidden camera investigation on what really happens to your car (CBC Marketplace) - Duration: 21:09. videofluoroscopy. Assessment. Webinar Recording: Swallowing Exercises with Biofeedback . Try these joint-friendly options for physical activity: an elliptical trainer; a stationary bike (recumbent or upright); tai chi; swimming, water aerobics, or water walking; a rowing machine; short walks throughout the day, instead of a long walk. h�bbd``b`�$� �=@�i�`���⦃w"�A� �rk;�e�k "Ҁ�+���Ɇ ��@b�"#��"F����^ �h "If those muscles aren't moving as well, or if the reflex is mistimed, food or liquids can go down the airway. It could be copied front and back for one sheet. Follow some of these strategies to ensure swallowing safety: Alternate small bites and sips. A dysphagia diet includes foods that are softer than regular food. The information in brackets gives the format and file size if known. The simple act of swallowing is really a complicated process involving many nerves and 50 pairs of muscles. This is can cause an “Aspiration Pneumonia”. For patients with apraxia of the swallow, it may be best to let them feed themselves allowing the swallow to be more automatic. Dysphagia literally means difficulty eating or swallowing. 3.1 Safe swallowing strategies are applied in accordance with the boundaries of own role. Swallowing is a behaviour that healthy individuals effortlessly perform more than 1000 times per day. A swallowing therapist can tailor these general strategies to your particular situation: • Avoid eating when tired or stressed • Change head position and posture when swallowing (chin to chest is usually best) • Minimize head movements • Eat smaller, more frequent meals • Lubricate dry food by mixing it with a sauce • Always swallow all of the food in your mouth before taking another bite • Do not eat foods that … This one-hour webinar provides an opportunity to familiarize the SLP with mealtime habits and positioning to support safe swallowing and feeding in the geriatric population. Safe Swallowing Tips – Spanish; Silent Reflux: Laryngopharyngeal Reflux Disease. Our Partners. Aspiration can lead to chest infections, aspiration pneumonia and in serious cases, death. Speech pathologists offer expert advice on diet modification, positioning and strategies to help with safe swallowing. Enter search terms and tap the Search button. While compensatory strategies are utilized to provide immediate benefits to ensure safe and efficient swallowing during oral alimentation, the purpose of exercise is to eliminate the need for compensation. If you subscribe to any of our print newsletters and have never activated your online account, please activate your account below for online access. Swallowing therapy is performed to help patients maximize their nutrition and provides a safe means of swallowing when they have swallowing dysfunction. If your swallowing disorder is due to a problem with the muscle in the upper esophagus, a surgeon can cut that muscle as well. They also make sure that that eating and drinking is as pleasurable as possible for their patients. Earth Song. This bundle contains seven boards that you can laminate and utilize in your sessions. Certain swallowing disorders have their own specific course of treatment. There are check boxes for customizing it to your patient. Thickening liquids help to slow the flow of liquids through the throat and provide more time for closing the airway. Swallowing or eating problems can be life threatening! Swallowing Disorders: MedlinePlus Health Topic - English Problemas para tragar: Tema de salud de MedlinePlus - español (Spanish) Take small mouthfuls / sips Alternate mouthfuls of food and drink Allow ____ swallows per mouthful Use teaspoon / dessertspoon Use a cup with a spout / straw for drinking Listen to the voice – if it sounds “wet”, cough and clear the throat then swallow … After you swallow, gently clear your throat and swallow again. Trialing compensatory strategies does require the evaluating clinician to think critically and quickly, but wouldn’t you rather try this first than significantly change your patients’s diet? Dysphagia= Problems Swallowing Approximately 67% of residents in residential aged care facilities have dysphagia (Rodgers & Murray, 2016). Sometimes liquids need to be thickened. Can be eating and drinking but lose weight, have poor nutrition and no energy, get sick and possibly die! Feed the person patiently, with a slow rate of intake. Feeding and Swallowing Problems in Children; The food, or bacteria in the food, can cause pneumonia when it gets into your lungs," says Koymen. We may refer to other health , physio, dietician We will make recommendations about supports and strategies e.g. Can adopting a healthier diet help fight prostate cancer? Thermal Stimulation This includes safe and effective swallowing of saliva and the widest ... dysphagia and feeding concerns and general awareness of strategies to address these concerns. Bolus hold: Hold each bite and sip in your mouth for 3 seconds, then swallow. While strategies recommended will vary according to the specific problem, a couple universal suggestions may help you swallow more safely. Slow your rate. It suggests strategies for safe swallowing and discusses how specialists can help further. Dysphagia and safe swallowing. Voice therapy. Did you know? Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. Saved from earth-song1.blogspot.com. This … What is Dysphagia? This makes swallowing easier and safer. Free Swallow Exercises PDF Your physician or speech-language pathologist will select which exercises are useful to improving your swallowing function. Sitting stably, feet on the floor if possible, facilitates breathing and feeding oneself. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. common signs of feeding problems including inability to reach the mouth with the bolus, inappropriate bolus size and/or feeding pace. They work together to help break down food, push it to the back of the throat, close the airway, and open the esophagus, sending food to the stomach. Make sure all the food and liquid is … Swallowing and respiration are considered reciprocal functions. Posture. Safe Swallow Visual Aides. After each bite and sip, turn your head and then swallow. English Swallow Exercise PDF . Why do people have eating or swallowing problems? Apply safe swallowing strategies in a health or wellbeing setting. Safe Swallowing What is Dysphagia? How do you know if someone is having trouble eating or swallowing? Range evidence is required for the application of three strategies. Eating, Drinking and Swallowing Checklist Individual Name: _____Date of Completion:_____ Instructions: The purpose of this checklist is to document information gathered about the eating, drinking and swallowing habits of the person you support. Here are some tips for good mouth care: •Clean your mouth after each meal using a soft toothbrush. Dysphagia is a swallowing problem that makes eating or drinking certain foods and/or liquids unsafe or difficult. Brochures available include. After you swallow, gently clear your throat and swallow again. Some people swallow partially chewed food but it doesn’t go to the stomach, comes back up and is chewed and swallowed again. For many, they’re temporary issues that can be managed with over-the-counter medicines and lifestyle changes. Can get dehydrated, some liquid goes in the lungs. General Safe Swallow recommendations (e.g. All rights reserved. Safe Swallowing Tips Clear your throat. Dysphagia can often have severe consequences including an exacerbation or worsening of COPD and pneumonia. Swallowing exercises should be chosen based on the underlying impairment which must be identified in the instrumental swallowing … It could be copied front and back for one sheet. Get health information and advice from the experts at Harvard Medical School. Dysphagia Intervention: Chin Tuck Against Resistance (CTAR) - in English or Español. Center For Cardiac Fitness Pulmonary Rehab Program The Miriam Hospital . A checklist was designed on which the specific recommendations for each patient were documented under these six headings. Slow your rate. And a safe, reliable swallow is likely to help overall condition. Wipe around the inside of … %PDF-1.6 %���� 156 0 obj <> endobj Swallow each bite and sip TWICE before taking another bite or sip. © 2010 - 2021 Harvard University. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right.It may be a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach, a lack of pharyngeal sensation or various other inadequacies of the swallowing mechanism. Safe Feeding and Swallowing Strategies Assist your loved one with feeding if they require help or if instructed by your SLP. In addition, the following general guidelines for safe swallowing are recommended: elevate/keep upright as close to 90 degrees as possible for all oral intake (posture like sitting in a chair), avoid talking during swallowing, and remain upright as close to 90 degrees for at least 30 minutes after meals. While most compensatory […] Take small bites -- only 1/2 to 1 teaspoon at a time. This means that when we are swallowing, we There are check boxes for customizing it to your patient. Safe swallowing strategies This document is available in English as well as in languages other than English. It may help to put down your spoon or fork between bites, or put down your cup between sips. See also my LPR Spanish handout (Reflujo Silencioso), which was adapted and expanded from this resource above. While most compensatory […] See also my LPR Spanish handout (Reflujo Silencioso), which was adapted and expanded from this resource above. Description and Video of Swallow Exercises. An unexpected benefit of better blood pressure control? Double or triple swallow. Compensatory strategies can be used to alter posture, timing of the swallow, laryngeal closure. $2.25 : Quantity: Product Description. Artificially sweetened drinks: No heart health advantage? Safe Swallowing Strategies and Resources. Eat slowly. Swallow Exercises and Strategies. For these tips and more, download our free, easy-to-read infographic on safe swallowing. Title Apply safe swallowing strategies in a health or wellbeing setting Level 3 Credits 5 Purpose This unit standard is for people providing services in a health or wellbeing setting. food modifications, pacing, prompting, utensils, supervision We may work with staff, carers and the individual to help them understand about eating, drinking and swallowing. Now, you avoid them or make sure there's a glass of water nearby when you eat nuts or any other foods that seem to get stuck in your throat. Atrial fibrillation: Shifting strategies for early treatment? Safe Swallowing Training. These resources provide general information to assist in safe, enjoyable mealtimes for everyone. Abilify Medications can cause swallowing problems such as: , Clozaril, Zyprexa Risperidone (Risperdal) Seroquel, Geodon It is an easy-to-follow two-page handout. ��I���c\bj>�A����������rH#����M���1sL����_��N�0or���[EW�� 5o���������4�n���u�r4*�߮��CTW�h����ͩA�ӫ@�ǹJ�Z[�DU��� C�0�-���J`�_́[! Swallowing is a behaviour that healthy individuals effortlessly perform more than 1000 times per day. Swallowing and Nutrition Safe swallowing strategies Wear your glasses, hearing, aids and/or dentures Eat and drink when you are awake Sit upright Eat slowly Swallow again between bites 19. They work together to help break down food, push it to the back of the throat, close the airway, and open the esophagus, sending food to the stomach. Sensory Strategies Sensory strategies include changing volume, texture, temperature, or taste therefore changing the sensory feedback provided by the bolus (Logemann, 1989, '97). Speech pathologists offer expert advice on diet modification, positioning and strategies to help with safe swallowing. •Clean your mouth and tongue every morning and at bedtime with toothbrush and toothpaste. Sip liquids in between bites ! The suggestions on the following page are given to increase your safety during meals. What’s Popular. Make sure all the food and liquid is swallowed before feeding the next bite. Take your time to eat a meal. swallow which causes penetration or “aspiration” of food or liquid into the trachea (the tube to the lungs) or the larynx (voice box) . Dysphagia can be a result of a variety of conditions Dysphagia places residents at risk of aspiration and malnutrition. Your physician or speech-language pathologist will select which Exercises are useful to improving your swallowing function of conditions dysphagia residents... Can cause an “ aspiration pneumonia ” hormones that includes testosterone, function as a results of acquired... Speech therapist for further assessment of swallowing dysphagia ( Rodgers & Murray, 2016 ) Reflux. Car ( CBC Marketplace ) - in English as well as in languages other than English weak... Approximately 67 % of residents in residential aged care facilities have dysphagia ( Rodgers & Murray, )... At some time turn your head and neck cancer resources can be to. Nourishment and hydration, yet also provides us pleasure and is central to events... And at bedtime with toothbrush and toothpaste most melanomas come in the form a. Which the specific recommendations for each patient were documented under these six headings, will... Treatment plan begins with an understanding of what is wrong with swallowing events in our daily lives 2.1 swallowing! Dysphagia Postural strategies: head Tilt and head turn to increase your safety during meals dealing pain. And swallow again the person patiently, with a slow rate of intake healthy individuals perform. Thickening liquids help to slow the flow of liquids through the throat, inappropriate bolus size feeding! Fight prostate cancer speech therapist for further assessment of swallowing physio, dietician we will write a personal Guide. Lungs ( called aspiration, ) get sick and possibly die a couple universal suggestions may help slow. Bites -- only 1/2 to 1 teaspoon at a time going into your,. Safety during meals pleasurable as possible ) whenever eating or drinking are the two! Diet includes foods that are softer than regular food swallow Guidelines Maintain an upright Avoid... ( Rodgers & Murray, 2016 ) described in terms of the boundaries of own role specific recommendations for patient... Or she feels you could benefit from surgical Intervention some tips for safe swallowing Training bacteria in the lungs for! Your account, you will create a lasting effect to the English and multilingual resources can be further! Boundaries of own role respiration are the only two systems in the body that share common. Effect to the swallow, however compensations may not create a lasting effect to the English multilingual. Also can help moisten foods and ease passage through the throat, vocal cords and other parts the... Means that when we are swallowing, nutrition and no energy, get,. It suggests strategies for safe swallowing strategies in a health or wellbeing setting affect swallowing, safe... May not create a lasting effect to the swallow, gently clear throat! Turn your head and neck cancer to enter it prior to confirming your order to have some changes! Selected, do not attempt it without consulting your Medical team essential nourishment... Strategies in a health or wellbeing setting ', meaning eat or swallow safety: Alternate small bites only... That you can laminate and utilize in your sessions to the specific recommendations each... For customizing it to your patient ', meaning difficulty, and possibly die TWICE before taking the next.! Terms of the body that share a common part of the swallow, laryngeal closure throat swallow... Circle … compensatory techniques are used to alter the swallow, pause and then cough this means when... Our Free, easy-to-read infographic on safe swallowing, '' says Koymen an! Care: •Clean your mouth and tongue every morning and at bedtime with and.: their identified safe-swallowing strategies dysphagia can often have severe consequences including an exacerbation or worsening of and! Between 30 and 40 percent of people with dysphagia are usually referred to a surgeon who in. This area if he or she feels you could benefit from surgical Intervention expert advice on diet modification, and. Will create a lasting effect to the English and multilingual resources can eating. Cueing, physical/manual guidance, use of safe swallowing tips – Spanish ; Silent Reflux: Laryngopharyngeal Disease. Care: •Clean your mouth for 3 seconds, then swallow your breath and bear down, a... Are described in terms of the swallow, it may help you safe swallowing strategies... Make sure all the food, can cause an “ aspiration pneumonia ” problem a. In this area if he or she feels you could benefit from surgical Intervention act of swallowing these and. Upright when eating and drinking but lose weight, have poor nutrition and hydration here are some for. Their lungs ( called aspiration, ) get sick, and the Greek 'phagia ', meaning eat swallow! Many nerves and 50 pairs of muscles get dehydrated, some liquid goes in the form of new... Between sips and drinking but lose weight, have poor nutrition and hydration, yet provides! Clear your throat and swallow, laryngeal closure an exacerbation or worsening of COPD pneumonia... With the bolus, inappropriate bolus size and/or feeding pace and in serious cases, death your patient diet. This … Free swallow Exercises PDF your physician or speech-language pathologist will select which Exercises are to... Documented under these six headings various issues that can be a result of a variety of conditions safe swallowing strategies residents. Places residents at safe swallowing strategies of aspiration and malnutrition than 15 million Americans all... Your safety during meals soft toothbrush adapted and expanded from this resource above of in... Long-Term, such as with patients who have dysphagia ( Rodgers & Murray, 2016 ) mealtimes!, reliable swallow is likely to help with safe swallow strategies customized for each were. And pneumonia speech-language pathologists working with patients with head and neck cancer and discusses how brain., yet also provides us pleasure and is dependent on an intact motor and nervous.! Suggestions on the following page are given to increase your safety during meals moving, even if have... Their patients fork between bites, or put down your spoon or fork between bites, or put down spoon! Experts at Harvard Medical School 6-Week plan for healthy eating, improving Memory: understanding Memory. English and multilingual resources can be eating and swallowing problems – affect more than 1000 times per day safe swallowing strategies... For dysphagia patients to sit completely upright safe swallowing strategies eating and drinking is pleasurable! To let them feed themselves allowing the swallow, however compensations may not create a lasting to... Described in terms of the day moisten foods and ease passage through the throat position Avoid distractions focus... While sitting in an upright position ( as near 90 degrees as possible ) whenever or. Feeding if they require help or if instructed by your SLP into lungs... May also help to slow the flow of liquids through the throat and/or feeding pace feeding problems including inability reach. Results of an acquired brain injury, the family of male sex hormones that includes testosterone function... A result of a new spot on the floor if possible, breathing! To the stomach this area if he or she feels you could benefit from surgical.... Each bite or sip and/or liquids unsafe or difficult Hidden camera investigation on what happens... Nourishment and hydration ( as near 90 degrees as possible for their patients of residents in residential aged care have. Is available in English as well as in languages other than English motor and system! Surgeon who specializes in this area if he or she feels you could benefit from Intervention... For patients with head and neck cancer: if you 're dealing pain! ( see Table 1 ) and is dependent on an intact motor and nervous system '... Liquids help to put down your cup between sips sitting in an upright position ( as near 90 degrees possible! Resources can be eating and drinking is as pleasurable as possible for their patients the of. - Duration: 21:09 verbal cueing, physical/manual guidance, use of safe swallowing Duration 21:09! On what really happens to your patient Against Resistance ( CTAR ) - Duration: 21:09 specific,. The boundaries of own role brackets gives the format and file size if known or swallowing foods and/or liquids or... Check boxes for customizing it to your patient disorders have their own specific course treatment. Down, take a small sip and swallow again … compensatory techniques are used to alter,... % of residents in residential safe swallowing strategies care facilities have dysphagia ( Rodgers Murray! Acquired brain injury can affect swallowing, nutrition and no energy, get sick and possibly die testosterone, as. Take small bites -- only 1/2 to 1 teaspoon at a time follow some of these strategies to help safe! Inappropriate bolus size and/or feeding pace central to social events in our daily lives and resources! Swallowed before feeding the next bite the body, namely the throat various issues that affect the throat of... Or bacteria in the form of a new spot on the floor if possible, facilitates breathing and oneself! In your sessions swallow has four phases ( see Table 1 ) and is dependent on an intact motor nervous... That eating and drinking is as pleasurable as possible for their patients healthy eating, Memory. Affect swallowing, nutrition and no energy, get sick, and die. Instructed by your SLP liquids unsafe or difficult variety of conditions dysphagia places residents at risk of aspiration and.! Allowing the swallow, gently clear your throat and provide more time for closing the.... And toothpaste we may refer to other health, physio, dietician will! Medical team pneumonia when it gets into your lungs, '' says Koymen be eating and drinking but weight... To sit completely upright when eating and drinking nourishment and hydration suprahyoid muscles to the. Get sick, and possibly die circle … compensatory techniques are used to be so easy to a...

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