treatment after brain surgery

[sharmaphysio]

hi physioz,
i have a patient who has under gone brain surgery for tumour in rt,occipitoperital lobe.
no he is disoriented an hard to hear from left side.
he doesnt follow the commands,
he doesnt use his left side,bt when ever he want to use he uses his lt,like when he want to scrach his head etc.
he has less sensations on left side as i tried to irritate him by putting things in left side ear bt he didnt respond.

he is still on nasal feeding.
he doesnt take food orally.

now how to stimulat oral feeding? he keeps whatever u give orally in his oral cavity.

he cant stand also.

its 5month now from his operation.

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[physiobob]

Surely this is the job of the speech and language therapist. maybe someone knows someone who can post some suggestions here. I am not aware that physio is as directly involved in helping with mastication post stroke/head injury, unless in partnership with a speech therapist. You/We need to be very careful with this in relation to aspiration although perhaps using a tilt table for periods of time that are tolerated might be a good place to start.

Do you have a tilt table available?

[junior_physiotherapist]

hi all ,
hmmmm,may u have to test (gag reflex,bite reflex,) ,muscles of tounge,hypersensitivetiy of oral areas,poor lips clousers,hand -eye coordination,head control,sitting activeties,....

once ur patient is able to feed not through nasl tubes:
ur spoon should be very shallow to permit easy removal of food by lips and small rounded to avoid stimulation gag reflex,spoon should be bone not metal..

position is very important. a chair and table of right size and hieght are also essential for good feeding...

regards

[davidjack]

hi sharma,
wat is ur aim regarding the patient?if u going to work towards his movements start with passive movements , bed mobility & slowly progress 2wards movements sitting sit to stand etc.dont be worried abt speech r feeding.also see that whether it is a benign tumor r malignant tumor like nonhodgkins, lymphoma etc becoz the area ,size & type do play into account in improvement.
since its parieto occepital his cognition & learning will be poor.