A Lifestyle Change

JMU-RHM Team Treats Voice, Swallowing Disorders

Posted: September 14, 2013

Teresa Drulia, a James Madison University speech pathologist and a member of RMH Voice and Swallowing Services at Rockingham Memorial Hospital, explains the digital swallow work station used for barium swallowing studies during a tour on Friday. (Photos by Michael Reilly)
Teresa Drulia, a James Madison University speech pathologist and a member of the RMH Voice and Swallowing Services team explains the digital swallow work station with (left to right) Rep. Bob Goodlatte, JMU President Jonathan Alger, and RMH President Jim Krauss during a tour Friday.
HARRISONBURG — Philecta Staton’s a talker, and she’s not at all self-conscious about that personality trait.

The 72-year-old spent two decades working as a missionary in Africa, so it should come as no surprise she gets her jollies from conversing with others.

It was quite disconcerting, then, when she developed a nagging cough about three years ago that would strike when she spoke. Initially, her doctor believed it was merely allergies because it coincided with allergy season.

But it continued to progress. Then, last year, it never went away.

“I was coughing constantly,” said Staton, who teaches Sunday school at Harrisonburg Baptist Church.

A few months ago, she was referred to Rockingham Memorial Hospital Voice and Swallowing Services, a new department with state-of-the-art equipment that officials say is unmatched in Virginia.

Doctors discovered Staton had developed deterioration of her larynx, or voice box.

“What they did was teach me exercises, techniques that compensate for that loss. ... Giving a woman her voice is important,” she said, cough-free, following a ribbon-cutting ceremony Friday at RMH to celebrate the collaborative project with James Madison University.

About 50 people attended the event, including JMU President Jonathan Alger and U.S. Rep. Bob Goodlatte, R-Roanoke.

RMH Voice and Swallowing Services, a project borne of the JMU-RMH Collaborative, was established late last year and started seeing patients in January. The collaborative was founded in 2007 to foster partnerships between the two institutions.

Voice and Swallowing Services was in the works for about three years.

It was made possible by JMU’s hiring of Dr. Christy Ludlow as a professor in the Department of Communication Sciences and Disorders.

Ludlow researched voice and swallowing disorders for 35 years at the National Institutes of Health.

Voice and swallowing disorders can stem from a variety of sources, including strain from repetitive shouting and screaming and neurological disorders such as multiple sclerosis.

Difficulty swallowing can have major effects on quality of life, Ludlow said.

Take meals, for example. So much socializing revolves around food that if you can’t eat normally — which could go as far as requiring tube feeding — it can be devastating, she said.

But it’s not just eating that gets complicated: If you can’t swallow, you’ve got to find another way to dispose of your saliva.

“They have to spit in a cup all day long,” Ludlow said. “Your life is constrained to being in four walls. You can’t eat. That excludes a patient from just about everything.”

Dr. Cynthia O’Donoghue, who heads up the Department of Communication Sciences and Disorders, said Ludlow is one of the field’s premier researchers in the United States.

Ludlow worked out an agreement with the NIH in which she brought her equipment to RMH and James Madison for research and treatment.

Students conduct research at the university, while doctors treat patients from throughout Virginia and beyond at the hospital.

Voice and Swallowing Services has about 36 patient visits per week.

With equipment provided by NIH, the startup costs were negligible, as it largely consisted of the time staff members took to get it going, officials say.

Most community hospitals like RMH don’t have a similar setup because it’s cost-prohibitive, officials say.

Ludlow estimated the value of the equipment she brought at about $500,000.

Previously, patients like Staton would need to travel to Georgetown University Hospital in Washington, D.C., or Johns Hopkins Hospital in Baltimore, Md.

Typically, hospitals might have one or two pieces of the equipment Staton brought to the table, but not the whole shebang.

Among the devices is a nasal endoscopy probe — or what might be more easily understood as a little lighted camera they push up your nose and through your nasal cavity to observe swallowing.

Other devices provide detailed information about what’s happening inside the voice box.

With equipment this advanced, doctors can make a “definitive diagnosis,” O’Donoghue said.

“If you know what your diagnosis is … you can tailor a more efficient treatment program,” she said.

For Staton, that involves performing daily exercises and techniques to address her disorder.

“It’s not just ‘Come in and we’ll fix it,’ but it’s done wonders,” she said.

The hardest part?

“I have to use short sentences, which doesn’t come naturally,” she said.

But she doesn’t let it get to her.
“It changed my lifestyle,” Staton said. “Being able to compensate for your deficits is what life is all about, isn’t it?”

Contact Jeremy Hunt at 574-6273 or jhunt@dnronline.com

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