Mobile FEES Swallow Diagnostics

I spent years believing my hardest swallowing cases were mine to carry alone.

When a case didn’t add up, it was just me and the patients history & symptoms trying to piece everything together long after I made it home.

I told myself that was just what it meant to be a Med SLP in a rural area.

The first time I brought a case to a room of other FEES providers, that belief fell apart in the best way.

My confidence grew first. Verbalizing my clinical reasoning out loud and hearing experienced SLPs build on it showed me how much of a foundation I already had.

But what I wasn’t expecting... They named the things I could not see on my own. The finding I was underweighting. The history I skipped past. The question I forgot to ask. No amount of experience lets you catch your own blind spots, because they are blind for a reason.

If you are carrying your whole caseload by yourself and some part of you can feel there should be a better way to do this, listen to that.

It is right.

You were never meant to reason through the hard ones alone.

Comment or DM “FEES” for the link.

Our next round is June 24th @ 3 PM CST… recorded in case you can’t make it live.

I had the privilege of presenting on Flexible Endoscopic Evaluation of Swallowing (FEES) at the University of Arkansas today and as always… I’m leaving energized!

There is something special about being in a room with students who are stepping into this profession. This group brought thoughtful, insightful questions and a genuine eagerness to learn, including during a live FEES demonstration where I scoped a student volunteer so the class could see the exam in real time.

Thank you to the University of Arkansas for the invitation and the warm welcome.

Investing in the next generation of speech-language pathologists is some of the most meaningful work I do, and days like this remind me why.

The future of dysphagia management is in good hands. Did your graduate program allow for exposure to FEES? Comment below!

If you are the SLP who lies awake replaying the case you could not figure out alone, you are not behind.

You just have to carry it all by yourself.

You know the patient. The one whose findings did not fit the pattern. The plan you second-guessed on the drive home. The case you have run through your head a dozen times since, wondering if you missed something, because there was no one at your facility to think it through with you.

No one talks about this part of the work.

The job description never mentions that you might be the only person in your building who understands the impact of dysphagia, the only one who understands what you are looking at, the only one carrying the patients nobody else knows how to help.

That kind of clinical isolation is one of the heaviest and least spoken parts of being a Med SLP.

Here’s the reality… The replaying does not mean you are not good at this. It means you care, and you have been doing something hard with no one beside you.

The case gets lighter when you say it out loud to people who actually get it. The finding you were unsure about. The reasoning you could not check against anyone else. It does not have to live only in your head at 2am.

You were never meant to carry the hard ones alone…That’s what FEES friends are for!

Comment if you have replayed a case in your head long after you clocked out.

Here’s a case that I can’t stop
thinking about, the patient who was placed on nectar at bedside without an instrumental.

These are video clips from thin trials with single sip edge of cup.
Patient has an immediate throat clear to move very trace penetrated material from the vocal fold to ventricular fold.

Check out the linked reel to see the clips from this patients swallow study with nectar thickened liquids.

💛Save this for next time you need to make a case for your patient to get a FEES!

💛Comment & let me know what questions you have.

June is Dysphagia Awareness Month! I want to thank the clinicians behind it.
You catch the patients falling through the cracks, educate staff about issues related to how changes in voice can be indicative of swallowing issues. And you’re the one who realized the patient who has been losing weight just might be having trouble swallowing.

You sit with families through hard conversations about diet changes and risk, and you advocate for the instrumental exam when something does not add up.

Dysphagia work is rarely the loud, visible part of the building. It is detailed, high-stakes, and deeply human.

A safe swallow protects patients lungs, their nutrition, their dignity, and often their ability to share a meal with the people they love.

So this month, a real thank you:
🫶🏼For trusting your clinical eye when the chart said one thing and the patient told you another
🫶🏼For pushing for the right assessment instead of the convenient one
🫶🏼For learning, mentoring, and raising the standard of swallowing care in rooms most people never see
🫶🏼For showing up for patients who cannot always advocate for themselves
The work you do matters more than most people will ever realize. I see it, and I am proud to be in this field alongside you.

Tag an SLP who does this work well, or drop a 💛 in the comments so we can celebrate the clinicians keeping our patients thriving this month

If you became an SLP to actually help people swallow safely but the daily productivity grind has buried that spark it’s time to reignite your passion for your work.

If you’re like me you felt excited and inspired by the medical aspect of dysphagia evaluation and treatment. The most vital aspect of being alive is being able to eat and drink and it’s also one of the last comforts we have as we age. For me, I couldn’t imagine not being able to eat / drink what I loved… Knowing how much food and drinks are the epitome of our culture, every holiday and family event is centered around a meal.

If you got into this work like I did to actually make a difference and help change people’s lives but you’re down today because you know tomorrow is Monday and you’re already dreading the daily grind tomorrow. If productivity requirements and documentation feels overwhelming, it’s easy to get burnt out. It’s easy to give up advocating for yourself and your patients.

What works for me in those moments is to come back to center and remember why I went into this work. Take some time just for yourself today and then focus on why you went into this and find that spark that still cares deeply about helping your patients return to favored foods/ liquids.

Comment 💛 if you needed a reminder.

Enrollment for Dysphagia Grand Rounds closes tonight. Before it does…here is one thing you can use tomorrow whether you enroll or not.

If you have ever struggled to justify a FEES referral to a resistant team, start here.

Three things I document every time:
1. The chart — recurrent pneumonia, unexplained weight loss, neurological history, prior intubation. That history is your foundation.
2. Bedside findings: wet vocal quality, multiple swallows per bolus, coughing during intake, oral residue. Document every single one specifically and objectively.
3. The mismatch: this is the one most SLPs miss. When the patient says they are fine but the objective picture tells a different story, document that discrepancy directly.
“Patient denies swallowing difficulty. However objective findings including wet vocal quality, recurrent pneumonia history, and unintentional weight loss are inconsistent with patient report and warrant instrumental assessment to rule out silent aspiration.”

Use this method. Let me know what happens.

And if you want the full experience…working through real cases, building clinical arguments, and learning how to get your patients the assessment they deserve

Enrollment closes tonight. Link in bio.

💛You have until midnight