12/7/06

Medical breakthrough makes life easier for Manning resident
By Eric Goold

ERIC GOOLD/Manning Times
Clarendon Health System speech pathologist Connie Brewer adjusts the electrodes of the VitalStim with patient Hubert Taylor, who has been aided by the new technology after suffering a stroke earlier this year.

Hubert Taylor is enjoying the benefits of a remarkable new medical treatment called VitalStim.

Early in June, Taylor suffered a debilitating stroke that caused several lasting conditions, including a hearing loss and speech problems.

“It was a fairly severe stroke,” said Connie Brewer, a speech pathologist at the Clarendon Health System. “It affected his ability to ambulate and use his left arm and hand. In addition, there was a profound swallowing impairment.”

Strokes that impact the left side of the body often cause the patient to experience dysphagia, a condition that creates swallowing problems. Oddly, swallowing liquids is extremely difficult.

“Fluids really bothered him,” said Esther Taylor, Hubert’s wife. “He choked on them and had a real hard time swallowing. We were under the impression that fluids like clear water would be the easiest to swallow, but actually, it’s the opposite.”

Brewer, who has been with Clarendon Health for five years, said that up until 2003, the options for treating swallowing problems in stroke victims were very limited.

“In rehabilitation services, there are generally two treatment methods, restoration and compensation,” said Brewer. “Restoration is usually ideal, returning the patient to normal. With compensation, we help the patient with methods and techniques that allow at least some function.”

Up until 2003, a patient like Taylor with swallowing problems would have recourse only in compensation. In his case that included exercising the throat, tucking the chin to help swallow and using a thickener that makes fluids, like water or iced tea, more solid and easy to swallow.

“Nobody is going to raise their hands and volunteer to use thickener,” said Brewer. “When you want something to drink, part of what you want is that liquid refreshment. When someone adds thickener to a drink, it really effects how appealing it is. A lot of patients don’t like to use it.”

Thickener makes drinks have a viscous and syrupy texture, like honey. While making it easier to drink, it also ruins the taste and appeal of cool beverages.

Taylor suffered through the thickener, since he basically had no other option. But then Brewer, who treated Taylor as both an in-patient and an out-patient, asked him if he wanted to try VitalStim.

“In 2003, the FDA approved VitalStim Therapy,” said Brewer. “It’s the only FDA-approved treatment that actually restores swallowing function, rather than compensates for it.”

Electro-stimulation has been used as a medical treatment for decades, but it wasn’t until 2003 that a company called the Chattanooga Group devised the VitalStim Therapy. In the procedure, electrodes are attached to the throat.

The electrodes are connected to a rectangular, wallet-sized device that discharges electric pulses into the throat. The VitalStim is powered by only two AA batteries, but the small device produces remarkable results.

The carefully calibrated electrical current stimulates motor nerves in the throat, which causes the muscles responsible for swallowing to contract. The quality of the swallowing function improves and with repeated treatments, the swallowing muscles are re-educated.

In short, the muscles learn how to swallow again. With VitalStim, stroke patients can eventually be taught to swallow and the use of thickener can be eliminated. Brewer discussed the option with Hubert Taylor and his wife.

“When I asked her if she would like our long-term goal to be eliminating the use of thickener, I think she thought I was pulling her leg a little bit,” said Brewer. “VitalStim is a fairly new treatment, and even a lot of doctors don’t know about it. But I think she understood that this is exactly what Mr. Taylor needed.”

VitalStim must be prescribed by a doctor, and it took a couple of days for Brewer to get doctors at Clarendon Health on board. They approved a course of action and after twice-weekly VitalStim treatments for three and a half months, Taylor was able to swallow liquids without the use of thickener.

Esther Taylor said the couple were country folk, living outside of Manning for most of their lives until Hubert suffered the stroke. Then they moved in town to be closer to the hospital and closer to their children. She said the VitalStim has greatly improved Hubert’s quality of life.

“We’re very, very excited,” she said.

Brewer has been certified to administer the VitalStim Therapy for a year and a half and Taylor was her fourth patient using the treatment. She said that all four patients have reached their treatment goals with the VitalStim.

“I feel much better about my competency with this tool,” said Brewer. “I want to educate both patients and doctors that this is a viable course of treatment. Not many people know about it, and I want to get the word out.”

The people of Clarendon County are lucky to have a certified VitalStim operator like Brewer. Besides Manning, the only cities in South Carolina that have VitalStim services are Lake City, Scranton, Florence, Darlington and Columbia.

“The treatment is not for everybody,” said Brewer. “But we’re not getting the referrals out to the public. Research that was done on VitalStim shows an 80 or 90 percent success rate. That is just phenomenal. If you have swallowing problems, talk to your doctor about it.”