Hi RJM,

I'm also a Speech Pathologist and was looking at the site for one of my patients. I work with a lot of H&N pts and one thing that I thought was curious about your initial post was the comment that his left side was affected and so he can't do his tube feedings by himself.

I was wondering about the reasoning behind this? It's not too unusual for damage to one of the cranial nerves (XI) to cause difficulty with shoulder mobility but more general L sided weakness is not that usual and suggests that something else might be going on, such as a stroke. Has this been ruled out? This can happen during surgery and often doesn't get picked up during the hospitalization.

That said, it doesn't change the treatment plan much - swallow evaluations and treatment are pretty similar regardless of the etiology of his dysphagia, but it would potentially change the timeline. There is some spontaneous recovery after stroke and the rehab course of a stroke in conjunction with H&N cancer treatment would be longer and slower but not necessarily impossible.

Anyway, just another thought to add into the mix.

My best to you all,
Andrew Palmer, MS, CCC-SLP