First post-surgery follow-up. It’s been two weeks tomorrow.

The sutures in his leg were removed today.

Dr. Buchmann, the reconstructive surgeon was pleased and told Tony to ‘go for it’ when it comes to activity level, brushing his teeth and massaging his neck. Dr. Buchmann was also clearly impressed with the speech ability Tony has so soon after surgery.

 Tony took another swallow test. He is still aspirating into the lungs. The speech therapist called him a ‘silent aspirator’ which means he doesn’t gag, choke or cough. (Surprisingly, this condition affects 40% of the population!) There isn’t enough tongue in the back of his throat to keep fluid from going down the wrong tube and into the lungs.

Tony can begin taking nutrition by mouth, but it has to be the consistency of nectar. (Think Kerns brand beverage.) He has to put it in his mouth, swallow, swallow and cough. He can’t drink water with his meals. He can only sip on water in between meals and after cleaning his mouth to prevent bacteria from going into the lungs. We have to monitor his temperature. If he fevers we report it and discontinue water by mouth to prevent pneumonia.

He received a lot of coaching from the speech therapist on strengthening the swallow. What he achieves now is hugely important, because radiation will take its toll. He won’t be able to achieve post-radiation what he can achieve right now. As he heals and exercises, his ability to swallow without aspirating should improve.

We also met with a nutritionist who provided some food ideas. The goal is to gradually increase the amount of nutrition he takes by mouth and decrease the amount he takes by feeding tube.