Friday, March 1, 2019

Eating after brain injury

Food is the nourishment that the body needs to sustain its biological function, primarily keeping us alive. However, all of the body's function comes to a near stop after a stroke or any other form of brain injury. Patients are to be reminded that both brain and body are inherently interconnected. One does not work without the other. If you are suffering from a hemorrhage in the brain or a clot, it's most likely that you will end up with damage in one of your brain's hemispheres. These damages will have a profound impact on certain functions such as our cognition, mobility, spatial awareness and so on. The damage will also likely to affect how we eat and drink, especially if the subcortical cortex suffers damage as well. Therefore the first steps of recovery should solely focus on relearning how to eat and drink.

Actions such as eating drinking may look simple on the outside but its biological mechanism often fails or slows down after a brain injury. The esophagus will contract slower causing food or liquid to get stuck or move too fast, which could result in choking or asphyxiation. Most hospitals would attach a feeding tube through the nostrils, directly connected to the stomach to feed us without the need of putting it in our mouths to chew. Other methods include a PEG (Percutaneous Endoscopic Gastronomy)  tube directly attached to the stomach via an external incision, this the most common form of eating for most patients. It's safe and direct, however despite having a tube attached to you to help you eat. Patients should not be dependent on them, it is recommended that brain injury survivors take the chance of trying to consume normal food. In doing so they are readjusting their bodies natural function of eating and swallowing food after the injury.

Another important reminder for patients is that readjusting to normal food may take a long time as the body after the initial injury to the brain may reduce the contraction movements of the esophagus, making swallowing difficult. Thus patients should at least try to eat something a bit solid for a start but not too hard on the texture. Most speech pathologists would use a sponge cake to retrain a patient to eat since they have a soft texture and easy to swallow. Once you've accomplished eating something with a soft texture, you can proceed with eating something harder that may take a bit more chewing before swallowing. These can be crackers or cereal grains. When chewing these things, patients should try to chew on the side with weakness or paralysis to strengthen their jaw muscles. This will also help improve pronunciation and prevent slurring during talking.

Patients must always remember to stay upright as possible when eating or drinking a this prevents choking or food going down the wrong way and would help digestion become easier. straight posture is also needed when taking as it helps air travel easily into the larynx and voicebox that we need to produce our voices. Being aware of posture most of the time is essentially the key to regaining a normal gastrointestinal system for a speedy recovery. Besides being mindful on how to eat or drink, we should be mindful a well by what we put in our mouths. Most hospitals would assign nutritionist to oversee the type and amount of food we consume during our stay in hospitals but it's very rare that the nutritionist plays a role in maintaining our diet. A lot of times hospitals end up serving us with unhealthy stuff such as fries or sizzled sausages. At times these things will be substituted by liquid supplements in the form of antibiotics probiotics which cause constipation. If possible they should be substituted with something healthier for the digestive system such as fruit and vegetable juice that will easily be absorbed by the intestines and easily disposed of as excrements once it has gone out of our rectums. Another reason for changing to such diet instead o following the catered meals in hospitals that are randomly prepared by the catering crew is simply because of certain food containing BDNF ( Brain Derived Neurotropic Factor), these are naturally occurring chemicals in the brain that helps speed up neurogenesis to produce new neurons.     

When being fed alternative supplements like antibiotics, doctor and nurses will most likely feed it through the peg tube as a means of easy access. Using the tube fo feeding should be done with good maintenance. Once food has gone down the tube, nurse or doctors should flush it with water to prevent any leftovers from getting stuck. Failure to do so would cause the leftovers to clog up the peg tub and it would become unusable for further use. the stuck leftovers may even become breeding grounds for bacteria that could cause infection when this happens it is necessary to get the peg tub removed and replaced with a new one. When replacing the tube, it should be conducted with an endoscope to firstly remove the inner seal that will release the outer tube with ease.                                               

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