Trial run brings hope

Brian MacDonald (centre) can swallow easier without needing an overnight stay in hospital due to a new procedure led by Speech and Language Therapy Team Leader Fiona Hewerdine (left) and ENT Head and Neck Surgeon Brandon Hitchcock. Photo: Supplied

For most of us swallowing is something we do easily without thinking.

But for patients like Mount Maunganui man Brian MacDonald, doing this has required a general anaesthetic and an overnight stay in hospital every couple of months.

Brian was diagnosed with neck cancer five years ago. He has had his voice box removed and a six week course of radiation therapy.

“I've never been a smoker, so finding out I had cancer and would need my voice box removed to stop it spreading, was a real shock. It was major surgery, a twelve hour operation but needed to be done.”

Laryngectomy patients like Brian, often develop stenosis from fibrous tissue and increasing over time they find it difficult to swallow.

To address this, every couple of months some patients require an oesophageal dilatation which breaks up the tissue allowing food to pass through freely. The benefit lasts for a limited period of time so they have to have the procedure done frequently.  

Until recently this procedure was only done by ENT surgeons in theatre or by Gastroenterologists. Now some patients are being trained at Tauranga Hospital by Speech and Language therapists and the ENT team to do this procedure at home.

“We're the only District Health Board providing Laryngectomy patients with this option,” says BOPDHB Speech and Language Therapy Team Leader Fiona Hewerdine.

“The technique is used internationally and there's good evidence supporting it. It saves both patient and surgeons time. But most importantly it gives these patients a sense of empowerment and control as they can pro-actively manage their own health.”

Brian was one of the patients who opted to try the procedure. Every couple of days he pushes the silicone tube down his throat, clearing the passage allowing him to swallow easily.

“Most people shudder at the thought of it. But I'm one of those people who will give things a go, it's in my nature.”

The semi-retired painter- decorator has gone from having regular overnight stays in hospital to just attending for annual check-ups.

“It's not the most comfortable procedure, but it's better than having a general anaesthetic every couple of months. And I feel more in control of my health.”

The self-oesophageal dilatation procedure is offered to all laryngectomy patients who want to try it at home.


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