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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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As A Speech-Language Pathologist At An Inpatient Rehab Hospital, Half

As a Speech-Language Pathologist at an inpatient rehab hospital, half of my caseload is dysphagia. Currently I have a case in which the patient was diagnosed with chorea approximately 5 years ago, and the neurosurgeons are planning a C4-C7 fusion due to recently diagnosed (yet old) fractures. The patient has been told he has a "mass of scar tissue that impedes his swallowing" and this egg-shaped mass will "reabsorb into his body after the fusion" and therefore improve his swallowing. Firstly, I've never heard of scar tissue being reabsorbed into the body.
Of the many cervical fusions I've worked with, most patients never have dysphagia until their fusion, and when it's an anterior approach, the dysphagia is even worse.
What I would propose has occurred with this patient is an exacerbation of the chorea for an unknown reason which impacted the severity of dysphagia. I attempted for 1.5 hours to explain to the pt's spouse and DIL that I suspected the cervical fusion would worsen the dysphagia, and as the chorea advances, the swallow function will fluctuate, sometimes not so bad and sometimes very uncoordinated. Fortunately our doctors had a PEG placed already.
My questions: does scar tissue reabsorb into one's body? None of our nurses had heard of this. Secondly, if it does reabsorb, what is an expected timeline? I think that between the cervical fusion and resultant edema, the patient's dysphagia will worsen and in time, little if any of this egg-shaped mass will dissipate. In hopes of finding a gentle way to help the family understand the disease progression, I am asking for assistance. Thank you.
Wed, 12 Aug 2015
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As A Speech-Language Pathologist At An Inpatient Rehab Hospital, Half