Pneumonia and its Discontents

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I anxiously began be unconsumed night to read a book straightforward published (6/6/16) – and, like W.C. Fields and the Bible, I was looking with respect to loopholes. MULTIPLE SCLEROSIS: Coping with Complications (Archway Publications) is Dr. Barry Farr’s vista on his 24-year dialogue through the disease. Farr is Professor Emeritus of Internal Medicine, by specialties in infectious disease and epidemiology, at the University of Virginia. I was a year behind Barry Farr at our Mississippi Delta to multuous school, and was sponsored by him into a conversable fraternity at the University of Mississippi back in the day.  Farr has done pivotal careful search and published on such topics being of the kind which surveillance of Methacillin-resistant Staphylococcus Aureus (MRSA), alternating appearance pressure wheelchair cushions, and the practice of silver-coated urinary catheters through hospital patients . 

                                          http://www.psylife.eu/wp-content/uploads/2014/06/EpiCloud1-300x192.png                                                                                                                                                                                                                                                                                                                                                                                       The Society conducive to Healthcare Epidemiology of America (SHEA), has from the time of 2006 awarded the “Barry Farr Award” to the first cause of the most outstanding paper published each year in their house journal, Infection Control and Hospital Epidemiology. So, this creator has serious chops for clinical annotation and research methodology, and he has applied them to donation to the reader, strategies to helper the MS survivor increase her/his nobility of life. But, why am I looking as being loopholes in Farr’s narrative?

In Chapter 31, “Preventing Pneumonia”, Farr says that a method of treating for dysphagia that involves exercise lends petty to any prevention effort: “There doesn’t even now seem to be consistent evidence from randomized trials documenting significantly subside rates after swallowing exercises” (p. 252). He is infectious food out of the mouths of my eminent dogs, might be my stereotypical specification on this issue. That’s not oblique, my child has dogs. Yet to age, there is no evidence that employ based treatment makes a significant dissimilitude in the bodily impairment; that is, the efficiency of swallowing in quest of persons with MS. Exercise may in the room, make a difference in phenomena that impulse the swallow. One example of a correlated phenomena is the cough. As Farr comments at the outset of this chapter, “Vigorous coughing in a able to endure already suffering severe pain….also makes the bitterness worse with each cough” (p. 247). Expiratory muscle violence training (EMST) is a treatment modality enjoying a apportionment of research interest, and that may grasp promise for increased cough control (Sapienza and Troche, 2012, pp. 56-57). Cough repression therapy may also contribute to increased success with non-pharmacological management of the situation (Chamberlain, Garrod and Birring, 2013).

But Farr leaves some valuable observations as well, not far from how his attention to his condition; his rate and volume per credit; his sustaining attention on the swallowing act, especially than switching focus to and from his civil connections at mealtimes; and heightened attract in oral care, with emphasis up~ flossing – all these strategies implemented, awake the odds for success in pneumonitis prevention. Some of these strategies are discussed in refereed journals (Langmore and colleagues, Dysphagia, 1998), and others are reported anecdotally ~ means of clinical ‘grunts on the line’ like this author. 

 

 

 

I joked earlier that Dr. Farr’s comments not far from speech-language pathology were impacting my sustenance. That really is not a worry of destroy. Earlier in my career, I felt doctors were casting aspersions adhering the field to such a step – something need be done. One of my prized estate is a handwritten letter from the ~ly Oliver Sacks; it was his answer to my rather heavyhanded critique of his part “Recalled to Life” in The New Yorker (10/31/2005). Aphasia, treated by MUSIC THERAPY?? I calmed down following receiving Sacks’ thoughts on the trouble. All is forgiven, Brother Barry. Good piece of work. 

SELECTED REFERENCES: 

1. Sapienza, Christine M., and Troche, Michelle S.  RESPIRATORY MUSCLE STRENGTH TRAINING: Theory and Practice. San Diego: Plural Publishing, 2012.

2. Chamberlain, Sarah, Garrod, Rachel and Birring, Surinder S., “Cough Suppression Therapy: Does It Work?”, PULMONARY PHARMACOLOGY AND THERAPEUTICS, 26 (5), March 2013, 1-4.

3. Langmore, Susan E., et al. “Predictors of Aspiration Pneumonia: How Important Is Dysphagia?”, DYSPHAGIA, 13 (1998), 69-81. 

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