For 14 Months, He Couldn't Eat or Drink

August 12, 2009,

For 14 long months, Daniel Steinhauer could not eat or drink, due to the side effects of throat cancer surgery and radiation.

But at Loyola University Health System, Steinhauer learned how to swallow again in a therapy program that included exercising his muscles and practicing swallowing while undergoing electrical stimulation of throat muscles.

Steinhauer vividly remembers his first drink -- a can of cold Diet Coke. "It was like a miracle," he said. "I could hear the harps."

Neuromuscular electrical stimulation, or e-stim, is used to treat dysphagia (difficulty swallowing). As many as 10 million Americans have difficulty swallowing due to cancer treatments, injuries, strokes, Parkinson's disease and other conditions. Symptoms include coughing after swallowing; multiple swallows needed to clear the throat; feeling of food stuck in the throat and spilling food or liquid from the lips.

Steinhauer was diagnosed with Stage 4 cancer of the larynx in November, 2007. Following surgery by Dr. Chad Zender, Steinhauer underwent 38 sessions of radiation. Zender is an assistant professor in the Department of Otolaryngology at Loyola University Chicago Stritch School of Medicine.

The surgery included removing the epiglottis -- a piece of cartilage in the throat that covers the wind pipe. And radiation made the swallowing muscles less elastic.

Steinhauer received liquid nutrition through a tube inserted through his abdomen into his stomach. Although he did not go hungry, he craved food. "I had a yearning for a good steak, or a hot dog, or just anything," he said. He lost 43 pounds.

Not being able to drink was frustrating, too. On a hot day, he would take a sip of Coke, rinse his mouth and reluctantly spit the soda out.

Steinhauer saw several swallowing therapists, without success. "We tried so many different methods, but none of them worked," he said. "It wasn't until I went to Moira Aronson Brown at Loyola that things changed."

Steinhauer, a sales rep who lives in west suburban River Forest, began his swallowing therapy with Aronson-Brown in October, 2008. The regimen included an electrical stimulation device called VitalStim™. Electrodes attached to his neck provided electrical stimulation of his swallowing muscles. The e-stim helped "jump-start" the muscles to contract, Aronson-Brown said. "But he still had to do all the work."

With the assistance of e-stim, Steinhauer became reacquainted with muscles that had become dormant from radiation. "I could feel the muscles better," he said. "I became educated on a technique that allowed me to judge a good swallow from a swallow with aspiration."

It wasn't easy. Learning how to swallow again without food going down his windpipe "was like making a three-pointer with a seven-foot point guard in front of me," he said.

Steinhauer started with Jello and moist, easy-to-swallow foods, and worked up to more difficult foods. Today, Steinhauer can eat ribs, steak, pizza -- just about anything except chocolate, which sticks in his throat.

And he's gained back most of the weight. Now, he said, "I really have to start watching my weight."

Provided by Loyola University Health System (news : web)

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