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Tracheostomy care-What does it entail?

Tracheostomy is a surgical procedure that is usually performed when the patient’s airway is obstructed or swollen and it becomes difficult for them to breathe.

So, what exactly is a tracheostomy?

An opening is made on the neck, through an incision, to gain access to the trachea. This surgical procedure allows direct access to the breathing tube and is commonly done in an operating room under general anesthesia. A tracheostomy may be permanent or temporary depending on a patient’s condition. It can be done in case of an emergency at the patient’s bedside or in an operating room. Most people need 1 to 3 days to adapt to breathing through a tracheostomy tube. It will take some time to learn how to communicate with others.

When is tracheostomy considered?

Here are a few reasons where a tracheostomy may be necessary:

  • Obstruction in mouth or throat
  • Swelling in trachea
  • Difficulty in breathing
  • Lung conditions
  • Airway reconstruction after a tracheal surgery
  • Impaired swallowing and vocal function
  • Airway protection after a spinal or a head injury
  • Long-term life support

How is the tracheostomy tube inserted?

It is a small tube inserted into the trachea to keep the stoma open. It is available in different sizes and materials such as semi-flexible plastics, metal or rigid plastics. The tubes are either reusable or disposable. Tubes with a cuff can be used in cases where the patient suffers from swallowing issues and is on a ventilator.

Usually, the tube is selected depending on the patient’s health condition, neck size and the purpose behind the procedure. All the trach tubes have an outer cannula and neck-plate. The neck plate rests on your neck and keeps the stoma opening. Holes on each side of the neck plate helps to insert the tubes ties to secure the tube in its right place and keep it stabilized.

Why is tracheostomy care important?

There are many complications associated with tracheostomy and it is important to take proper precautions and care when it comes to tracheostomy.

Here are a few complications which may arise:

  • Infection
  • Bleeding due to tracheal irritation
  • Skin breakdown due to wrong positioning of the tube
  • Blockage by secretions suddenly or gradually

All these complications can have major consequences for the patients. These are some of the reasons we need intensive care. Not many rehabilitation programs offer efficient tracheostomy care, so it is important to choose a rehabilitation center which does. Explore for more information:



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Post-hospitalization rehabilitation – All you need to know

It is a common misconception that the hard part is over after a successful surgery. Not everyone is aware of the situation after the surgery. Post-surgery, the recovery process can be very demanding and grueling too. The idea that a patient may need rehabilitation post hospitalization and surgery may be very unfamiliar to some people.

The concept of rehabilitation is quite unfathomable to a lot of the general masses. There is a lack of awareness on how essential rehabilitation is after post-hospitalization or surgery.

After surgery or a trauma, when your mind tells you that it is time to return to your old routine, your body might not be ready to take on the pressure. It is very likely that you may need rehab to regain your strength.

Why you need rehabilitation?

  1. Rehabilitation is required to help the body cope and recover post-surgery. Since surgery is a life-changing experience rehabilitation can be used to help you adapt to the change.
  2. Rehabilitation enables you to re-learn basic skills, for example, dressing up, walking, talking, and so on. And over a period of time, you will be able to attain normalcy.
  3. Though through rehabilitation you will be able to strengthen your body, exercising alongside will help you become much more independent.

When you get discharged from the hospital depending on surgery or the procedure you have gone through, you may face challenges in certain specific areas. Rehabilitation will solely focus on dealing with your problem areas. Rehabilitation will help you cope with the obstacles you may come across in your everyday life.

How does rehabilitation help the patient recover?

It takes patience, time and effort. But, it’s worth it. Here are a few of the key benefits of a rehabilitation program:

  • It reduces the pain in your designated area of surgery.
  • It is helpful in increasing movement and range of motion on the part of the body where the patient has surgery.
  • It raises endurance and strengthens the muscles.
  • Rehabilitation helps you re-learn all the daily activities if need be.

Who works with you?

A rehabilitation program will have different kinds of experts who can ascertain that the patient gets better and regains independence. Depending on the type of injury or trauma, there are different therapies which can be used to assist the patient, such as occupational therapy, speech and swallow therapy, cognitive and behavior therapy, robotics therapy and physical therapy as well.

All of the course of treatment and patient care will be determined by the physicians in the rehabilitation program. To get the best results out of a rehabilitation program, explore:



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A stroke can be a life changing event, leaving patients bed-ridden, physically and mentally disabled. The treatment for stroke is more effective if the patient is admitted to the hospital immediately, without any delay. Hospitalisation and medical treatment alone are not sufficient for the patient to get back to normal. A rehabilitation programme is necessary for helping them regain their independence and become more functional. The most common outcomes of a stroke are slurred speech and difficulty in chewing or swallowing. Hence, a speech and swallow therapy is required to bring back the patient to normalcy.

Speech and Swallow Therapy – What does it involve?

A speech and swallow therapy is conducted on a patient who is not unable to communicate and consume food on their own. This programme is conducted regularly, to attain the best possible results. The processes involved in this therapy are:

Cognitive training:

This focuses on the receptiveness of the patient, which is the ability to understand the words of others trying to communicate with the patient. Cognitive training helps the patient resume communication with others effectively as they gain an understanding of the latter’s verbal as well as non-verbal speech.

Language therapy:

This is commonly called speech therapy. In this session, the patient is trained to use language as a means of communication. Generally, after a stroke, it becomes difficult for the patient to speak and use language. Language therapy encourages the patient to make an effort to speak normally again.

Vocal training:

This training triggers the oral motor, which is an integral part of the entire speech and communication therapy. Often, the voice of the patient becomes distorted after a stroke and they are not able to speak well. A therapist makes the patient speak and accordingly works on their voice modulation. This helps the patient regain their confidence to speak.

Non-verbal communication training:

Seriously affected stroke patients are not able to engage in verbal communication for a long period of time. Such patients are trained in non-verbal communication. This involves computer-boosted speech mechanisms which will allow the patient to exchange words with others. A trainer guides the patient throughout the programme,until the patient completely learns how to communicate through this instrument.

Swallowing therapy: A stroke leaves the entire head and its nearby areas seriously affected. Hence, swallowing food and water is a major concern for the stroke patient, due to which they are fed through a Ryle’s tube. Due to the fragile situation of the patient, a liquid diet or mush is recommended. Initially, a therapist helps the patient swallow liquid food. Training on a regular basis, with liquid-based food items, helps the patient regain their ability to swallow and consume food on their own.

Fluency training: As the patient gradually regains their ability to speak, they are trained by a therapist, to increase their pace of forming sentences and holding a simple conversation.

Speech and swallow therapy involves intensive training and the usage of computer-boosted speech mechanisms. This therapy is conducted by rehabilitation hospitals like ApoKOS, where the patient is provided with regular training and they regain their independence as soon as possible. For more details, visit

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ApoKOS – Who are we and what do we offer?

With a vision and goal to help people regain their independence- ApoKOS is a joint venture between
Apollo, Asia’s largest medical caregiver and KOS group from Italy. KOS group emphasizes on social
health and an advanced support system in healthcare. Equipped with their experience in caregiving
and providing support, ApoKos nurtures the patients and helps them in regaining normalcy.
ApoKOS ensures quality care to their patients and provides the patient with proper rehabilitation
facilities. With a vision to provide post-surgery care and rehabilitation services, and a nurturing
hand, ApoKOS is redefining standards of world-class rehabilitation care.
At ApoKOS we offer numerous programs and cover a wide range of health rehabilitation specialities.
Our programs are comprehensive and wholesome, they are:
– Neurological Rehabilitation
– Cardiac Rehabilitation
– Orthopaedic Rehabilitation
– Paediatric Rehabilitation
– Geriatric Rehabilitation
All of these programs are accompanied by intensive therapy which helps the patient to become fully
functional. ApoKOS provides a trustworthy, supportive and an empowering environment which
helps these patients believe in themselves and to recover at a faster rate.
With a wide range of therapies and cutting-edge technology here are a few therapies we provide:
– Rehab Therapy:
This therapy is also known as physiotherapy. It comprises of a wide range of physical
exercises that helps in regaining strength. Advanced technologies and therapies such as
Manual Therapy, Geriatric Rehabilitation, Paediatric Rehabilitation, Cardio-pulmonary
Rehabilitation, Robotics and Neuromuscular Pain Management with Electrotherapeutic
Therapy are used for treatment.
– Occupational Therapy:
This therapy aims to promote the well-being of individuals. The patients are trained to
perform day-to-day tasks which helps them cope with the situation and gain mastery over
their lives. They basically re-learn how to live their lives.
– Robotic Therapy:
To help the patient regain body balance and to re-learn basic motor skills, the usage of
robotic technology can be very fruitful.
o EKSO: This is a wearable suit that boosts strength, stamina, and mobility. Ekso is used to
initiate standing.
o ERIGO: This instrument is also used to assist standing, but bed-ridden patients. Erigo
gradually positions the patient in a vertical manner with the support of passive robotic

o ARMEO POWER: Armeo helps the patient gradually move their limbs and re-learn motor
o BALANCE MASTER: This instrument helps the patient stand up and trains them to develop a
balanced posture. With this, the patient will be able walk eventually without needing help.
– Speech and Swallow Therapy:
This therapy aims at the revival of the patient’s speech, understanding, voice coordination
and swallowing patterns. This therapy includes language therapy, non-vocal communication
therapy, voice training and fluency development as well.
– Cognitive and Behaviour Therapy:
After a major surgery or stroke, patients usually go through impairment in cognitive abilities,
mood swings, anxiety, and inability to interact with other people. Cognitive and behaviour
therapy is a psychosocial method used to rectify the disorders in the patient.
With such a wide range of therapies being offered under one roof and round-the-clock medical
supervision, ApoKOS is a world-class rehabilitation centre. Explore more:

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What are the health and lifestyle tips to follow for the first six months after spinal cord injury rehabilitation?

A spinal cord injury is a life-altering event that can bring about a great deal of change to your very mode of existence. Such an injury leaves the patient paralyzed, partly or fully – depending on its intensity, physically disabled and unable to do perform even the simple tasks that require the use of limbs. Although it is vital to go through medication and post hospitalization rehabilitation processes to attain the maximum possible recovery, one must make sure to be cautious of the regular life activities after returning home. A patient, after encountering a spinal cord injury, still has a long way to go in terms of complete recovery because of the loss of balance, neurotic senses, dysfunctional limbs, and mental stress.

The health and lifestyle tips to follow are:

Regular Exercise: After recovering from a spinal cord injury, it is vital to maintaining proper bone health. Daily stretching and walking exercises are required to help the patient reduce pain and discomfort that persists for a short period of time even after medical intervention assures discharge from the care center. This will help the patient regain strength in their limbs, regain the ability to perform simple regular activities, and gradually regain physical balance.

Proper Posture: Along with exercises, the patient must make sure to sit upright, stand straight, and sleep in a straight position. Sitting for too long is not ideal, as it adds to the pressure around the lower part of the spine. Keeping the spine straight also allows proper functioning of the central nervous system, which is usually negatively affected by an injury. Slouching is also not good for the development of a good posture that enables proper blood and hormonal flow. Try to sleep on a firm mattress that does not sink in and cause the spine to bend and stay in that position for long hours.

Balanced Nutrition: Nutritious food is the key to good health. Make sure that there is an intake of foods that are rich in vitamins, minerals, calcium, proteins, and probiotic content. Calcium is the most important nutrient that improves bone density and health. Foods like yogurt, cheese, milk, soya beans, bananas, apples, oranges, grapes, berries, nuts, eggs, meat, and whole grains are used for positive development of health after spinal cord injury rehabilitation. A healthy spine, with a good level of calcium, leads to a better functioning nervous system.

Quality Sleep: Sleep is an important aspect of life. Sleeping for about a minimum of six to eight hour per day reduces physical and mental stress. Relaxation helps the body rejuvenate and regain its strength for functioning throughout another day. Sleeping on a firm mattress, in a straight position, will improve the posture and provide some comfort to the spine, which is the arterial feature of the skeletal system.

Following the above tips after a spinal cord injury and its appropriate medical operations, will lead to a healthier lifestyle and help the patient regain independence to move around and interact with others. For more information on spinal cord injury and the possible recovery methods, visit

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Spinal Cord Injury – All you need to know

Spinal cord injury can be categorized into various degrees, depending on the intensity of the affliction. It can be caused by mishaps such as a sudden fall, vehicle accidents, sports injuries, diseases like polio and spina bifida. However, an injury so sensitive must not be left unattended or delayed. Immediate hospitalization is certainly necessary to recover as soon as possible.
Also, post-hospitalization treatments are important to help the patient regain as much independence possible.

There are two main degrees to which one can injure their spine:

Complete spinal cord injury
This kind of an injury leaves the spinal cord completely severed, resulting in a halt to all functional capabilities. Such an injury may even lead to a state of paralysis.

Incomplete spinal cord injury
This form of injury results in the spinal cord being partially severed. The injured person is, however, able to retain some of their functional abilities.

There are three major types of incomplete spinal cord injury

  • Anterior Cord Syndrome – Injury to the front area of the spinal cord.
  • Central Cord Syndrome – Injury to the central area of the spinal cord.
  • Brown Sequard Syndrome – Injury to one whole side of the spinal cord.

Depending on the gravity of the injury, the affliction can be categorized as follows:

This is also called Hemiplegia. Paraplegia is a condition in which there is an impairment of sensory and motor functions of lower extremities. This results from a blow to the neural or brain-related elements of the spinal cord. The areas of the spine affected are thoracic, lumbar, or sacral.

This is also known as Tetraplegia. This entails a state of paralysis caused due to injury to the spine, mainly affecting the limbs and the torso. Sensations, as well as control, are lost after such an injury. There can also be a loss of control over bladder, bowel, digestion, and breathing.

This results from an injury to the spine, causing paralysis in three limbs. This condition is referred to as Triplegia Muscle Anatomy. There is no constant pattern in the impairment of limbs, but usually, both the upper limbs and one lower limb are affected in this kind of spine injury.

The medical treatments immediately after spine injury involve traction and surgery.
After periodic medication, rehabilitation processes are vital to the recovery of a patient.

Speech and Swallow Therapy
Speech and Swallow therapy help a patient revive their ability to interact with others and take in food on a daily basis. There are three main processes:

  • Language and Communication Training: This is a therapy that enables the patient to revive their lost abilities in speaking, writing, understanding speeches, and holding conversations.
  • Chewing Therapy: The patient is trained to chew soft food, to further their ability to consume food.
  • Swallowing Exercises: The patient is trained to gradually swallow their food for better digestion.

Cognitive and Behaviour Therapy

This helps to recover a patient and regain their ability to understand language and control their behavior towards other people.

  • Therapy for Cognitive Disorders: This involves physical and psychological training to help a patient regain cognitive skills, boost memory, solve regular life happenings and understand situations.
  • Behaviour Training: After regaining the cognitive skills of the patient, they are taken through behavior training in which their behavioral skills are processed.

Physical Therapy
This is also called rehab physiotherapy. The patient is trained to perform different kinds of physical activities to regain muscle strength and balancing power in lower the limbs.
Occupational Therapy
Occupational therapy makes the patient carry out regular tasks that require physical movement. Tasks like using cutlery for eating, lifting water glasses, switching on or switching off lights and fans, writing notes, are carried out by the patients to help regain maximum strength and independent functioning.

Robotic Technology and Therapies
Ekso: This is a mechanical instrument that helps a recovering patient straighten their back, and initiates standing on their feet, independently.

Erigo: This instrument is used to bring a patient to a vertical and standing position from a horizontal and lying one.

Armeo Power: After a spinal cord injury, the limbs are weakened and unable to function independently. This machine enables the patient to gradually move their arms and regain functionality.

Balance Master: This is an instrument used to help a patient stand up, by providing the essential balance that they require. Through the usage of this machine, the patient is gradually able to regain physical balance and walk.

Gait Training
This process comes towards the end of the rehabilitation programme. In this phase, a recovering patient is trained to gradually walk, using balance masters, walkers, and support canes.
Spinal cord injury is an acute health condition that must be looked into, without any casual deterrence. For a complete cycle of recovery, one must be admitted to a rehabilitation hospital. For more details about post-hospitalization therapies, visit

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Rehabilitation for patients recovering from Cerebral attack

A cerebral attack is a serious form of stroke that leaves patients under the supervision of surgeons and physicians for months. However, when there is a will, there is a way. It is possible for patients to revert to their former independent lives with the support of a holistic and patient-centric stroke rehabilitation program.
Stroke rehabilitation after suffering a cerebral attack involves the following categories:
• Speech and swallow therapy – This therapy helps regain smooth operation of language, chewing, and swallowing, which become sedated after a cerebral attack. This rehabilitation entails language therapy, voice training, fluency development training, swallowing examination, therapy and training.
• Cognitive behavior therapy – This is conducted to reinstate proper behavioural techniques that are distorted post stroke. This therapy deals with cognitive disorders, communication disorders, psychological evaluation and treatment.
• Occupational therapy – This is a rehabilitation process that helps improve motor skills and hand-eye coordination through occupational activities. The activities that are conducted by therapist are supported by functional electrical stimulation, robotic technology, wireless technology, and virtual reality.
• Physiotherapy– This is a rehabilitation process that is conducted in the form of phases of physical exercises that help regain strength, mobility, and independent balance. Physiotherapy entails motor-skill exercises, mobility training, constraint-induced therapy, and range-of-motion therapy.
All these above methods of rehabilitation after a cerebral attack or a major stroke, enable recovering patients to gradually develop their mental confidence that further helps gain back confidence to live a healthy life and be as much independent as possible.
At ApoKOS rehabilitation hospital, senior doctors and expert therapists strive to provide the best therapeutic care for a speedy recovery and regained independence. Our comprehensive goal-oriented treatment ensures a smooth journey towards an improved and more independent lifestyle.

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Rehabilitation For Children Facing Developmental Delays

Developmental delay is a situation in which toddlers do not attain the desirable level of physical and mental development, as per their age. Holistic development among children might get delayed due to certain medical conditions or unknown reasons. Children, whose health development gets stalled, may be treated through rehabilitation processes so that they can catch up with the others of their age and gain confidence to move on with their regular activities.

Categories of Developmental Delays among Children:

– Speech Delay

– Eating and Swallowing Disorders

– Developmental disorders: Orthopaedic Conditions, Neurological Conditions, Movement Disorders

There are some developmental delays that are mild and some that are more serious. However, all of these categories can be treated through effective communication with the patients and their parents, along with following the correct processes in rehabilitation.

Rehabilitation Processes for Treating Children with Developmental Delays:

  • Speech and Language Therapy: This therapy treats children facing difficulty in speaking, communicating ideas, understanding concepts, and putting words together to form sentences. The specific health areas that this therapeutic process deals with are autism, birth defects, cognitive delays, excessive drooling, swallowing disorders, weak oral muscles, hearing impairments, and effects of traumatic brain injuries. Therapy includes speech training, reading and writing exercises, and food intake lessons. Children who get involved in rehabilitative care before five years of age achieve better results, although getting enrolled at any age provides positive results.
  • Physical Therapy: This is aimed at improving the child’s strength and mobility through regular exercises using specially designed equipments. Physical therapy is effective in treating congenital defects, movement impairment, and sports-related injuries that halt normal biological development.
  • Occupational Therapy: This therapy is aimed at training children to attain basic competence. Expert therapists counsel the child to measure their level of development. A therapeutic programme is processed after the initial assessment, to meet the requirements of the patient. This therapy helps children gradually develop their essential motor skills to exercise sensory actions. Training processes include writing, easy self-feeding and self-grooming, and practising hand-eye coordination.

Follow-up visits to the therapists on a regular basis are vital to maintain a steady pace of progress in the rehabilitation programme. Progress reports are then sent to the paediatrician for further review of the patient’s condition, on which the next stages of treatment are decided.

Rehabilitation programmes consisting of exercises and counselling, which are carried out timely, have positive effects on the physical and mental health conditions of growing children.

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Rehabilitation makes sure that a child with developmental delays is at par with every other child. Grow with confidence!

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Trusted partner in the road to recovery – Testimonial shared by Mrs. Goswami

At ApoKos, we believe in a humane touch along with professional medical therapies that are conducted to help patients regain their former independent selves. The personal and family-like care provided to patients at our rehabilitation centre, is an integral part of our programme that aims to achieve the best results for the patients and their family members. ApoKos believes in nurturing lives and helping every person live with dignity and as much independence as possible.

Here is a touching story of Mr. Binode Goswami, who suffered a massive life altering stroke. With the strong support of his wife and the services of ApoKos, today he is able to live almost like his days prior to the illness. Let us take you through the wonderful narrative provided by Mrs. Goswami, to help you understand our mission at ApoKos.

Once in a while, we are given a special gift– a gift that has meaning, a gift that cares, and a gift that truly impacts one’s life. APOKOS Rehabilitation Hospital has been that gift to us.

A massive brain stroke in September 2016 reduced my husband to a faint shadow of his former self. His justify side was totally paralysed making him almost completely immobile. He lost his speech and all his fine motor skills leaving him with little scope for communication. He was unable to swallow anything—solids or liquids, and continuous bouts of coughing often resulted in shortness of breath and increasing dependence on assisted oxygen. Physically, mentally and emotionally his condition was extremely fragile. We soon realised that the facilities in the hospital in Guwahati where he was undergoing treatment were inadequate to deal with the situation. After many frantic enquiries we eventually zeroed down on APOKOS and that is where we brought him in an air ambulance at the end of November.

From the moment I set foot at APOKOS, I knew intuitively that I had come to the right place. Two months of my husband’s stay as an inpatient and then as an outpatient have proved me right. Now he is able to walk with support and carry out his daily activities with minimal help.

The hospital has a comprehensive, advanced and holistic rehab programme in place. In this age of micro specialisations where the treatment of a patient by different doctors often runs parallel, it was very reassuring to find that APOKOS has a sensitive and multidisciplinary approach towards its patients and that everyone involved–the doctors, the therapists, the nurses and the administrative staff — all collaboratively worked as a team.

In any hospital, the environment is an integral part of the healing process. The expertise of the professionals, combined with their genuine warmth and cheerful attitude has made our experience a very positive one. I would recommend APOKOS to anyone who requires rehab care.”

Priyam Goswami

Guwahati, Assam.

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Speech and Swallow Therapy in Rehabilitative Care

Patients ranging from pediatrics to geriatrics sometimes require speech and swallow therapy owing to an injury or ailment suffered or a pre-existing condition. Typically, patients with speech and swallow therapy have difficulty in effective communication and nutrition intake, which can hinder their life further. Therefore, every comprehensive post-acute care rehabilitation program should incorporate effective speech and swallow therapy if the patient exhibits such deficit.

Two categories of speech and swallow therapy –

Adult speech and swallowing therapy: This is usually conducted in cases of stroke, traumatic brain injury, nerologic disorders, tumors, gastroesophageal reflux disease (GERD), srtictures, and diverticula.

Paediatric speech and swallowing therapy: This is conducted in the most common speech issues, which are articulation and language disorders, and some swallowing issues like reflux, food aversions, tongue thrust, and dysphagia.

What does speech and swallow therapy entail?

The level of deficiencies vary from one patient to another. A thorough assessment of the patient’s condition is thus essential before a prognosis can be arrived at, which will cater to their requirements.  A speech and swallowing rehab plan involves the following therapies:

  • Speech production improvement
  • Computer aided speech therapy
  • Language therapy
  • Training for fluency development
  • Voice improvement
  • Swallowing therapy

Who should undergo speech and swallow therapy?

A wide range of conditions and mishaps can leave a patient with weaker speech muscles and speech production structures such as larynx, rendering it difficult for them to articulate, produce speech or swallow. Patients who typically need speech and swallow therapies are:

  • Traumatic brain injury patients
  • Stroke patients
  • Patients with old age-related speech and swallow difficulties
  • Parkinson’s Disease patients
  • Children with developmental delays
  • Children with shuttering or other voice disorders
  • Children with eating-related oral motor issues
  • Patients with strictures and diverticula

A speech and swallow therapist is a highly trained medical expert who can run a thorough evaluation of the patient’s condition and arrive at the best possible treatment plan aimed at meeting the patient’s goals.  Speech and swallow therapy can return to a patient skills which were once very basic and vital for them, putting them on the path of recovery and normalcy.


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