George Barnes MS CCC SLP

George Barnes MS CCC SLP Med SLP specialist in MBSS, trach/vent, and aspiration pneumonia management. Mobile FEES provider. Making Swallowing Simpler

📍Greater NYC 🍎

Would you let your 88-year-old patient eat chocolate cake, even if she knew she might die?When a palliative patient’s di...
06/04/2026

Would you let your 88-year-old patient eat chocolate cake, even if she knew she might die?

When a palliative patient’s diet is advanced to solid foods, and they begin to cough, it causes severe emotional distress for everyone involved.

Every fiber of our training tells us to intervene, stop the meal, and keep the patient safe.

Watching them choke feels unethical.

What does beneficence mean at these times?

For an elderly patient who prioritizes quality over longevity, “beneficence” might mean respecting her autonomy to eat chocolate cake...

Even if it scares the living daylights out of everyone around her.

Comment “SLP” and find out how this case was managed, and learn some tips for managing similar cases.

Thank you to Amanda Warren, MS, CCC-SLP, and Mary K. Buss, MD, MPH, for allowing me to write about their patient and their inspirational article, “Death by Chocolate.” The link can be found in this week’s article.

What did and didn’t YOU know? Share with a friend.
06/03/2026

What did and didn’t YOU know? Share with a friend.

As medical SLPs, our immediate instinct is to order an MBSS the second a patient shows signs of difficulty. We desperate...
06/02/2026

As medical SLPs, our immediate instinct is to order an MBSS the second a patient shows signs of difficulty.

We desperately want objective data to fix the problem.

But what happens when your patient is at the end of life and their goals are purely focused on comfort?

If an 88-year-old patient makes it crystal clear that new diagnostic information will absolutely not change her opinions about her treatment options...

What is the swallow study really achieving?

Palliative management isn’t about getting the best imaging; it’s about striking the right balance to help the patient reach their quality-of-life goals.

Want to learn more about this topic? Comment “SLP” for this week’s article.

Which of these did you already know??What else would you like to learn about? Reference:Leder, S. B. (2015). Comparing S...
05/28/2026

Which of these did you already know??

What else would you like to learn about?

Reference:

Leder, S. B. (2015). Comparing Simultaneous clinical swallow evaluations and fiberoptic endoscopic evaluations of swallowing: Findings and consequences. Perspectives on Swallowing and Swallowing Disorders (Dysphagia), 24(1), 12–17. https://doi.org/10.1044/sasd24.1.12

Does your facility use a standard water swallow screen? A study by Hey et al. found that while these screens detected 10...
05/12/2026

Does your facility use a standard water swallow screen?

A study by Hey et al. found that while these screens detected 100% of people who were aspirating, they had an abysmal specificity of 61%.

That means the screener failed 16 people who should have passed.

Imagine being NPO, losing weight, and becoming dehydrated all because of a false alarm.

As medical SLPs, identifying who does NOT have dysphagia is just as vital as identifying who does.

Comment “SLP” for this week’s article and bring a comprehensive clinical assessment to every single bedside.

BIG thanks to Dr. Coyle for his feedback and guidance on this article!

Reference:
Hey C, Lange BP, Eberle S, Zaretsky Y, Sader R, Stöver T, Wagenblast J. Water swallow screening test for patients after surgery for head and neck cancer: early identification of dysphagia, aspiration and limitations of oral intake. Anticancer Res. 2013 Sep;33(9):4017-21. PMID: 24023344.

15 million...For most of us, swallowing is automatic...But for people with dysphagia, eating and drinking can be terrify...
05/07/2026

15 million...

For most of us, swallowing is automatic...

But for people with dysphagia, eating and drinking can be terrifying.

And there are A LOT of people with dysphagia.

Think about it this way...

If you spent just one second meeting every adult in the U.S. who struggles with dysphagia, you would be shaking hands nonstop, 24 hours a day, for six months straight.

One of the worst parts is that it isn’t easy to see like other impairments.

Making those who suffer from it feel lonely and misunderstood.

Patients shouldn’t have to hide their difficulties or eat in isolation just because the world doesn’t understand.

Learn from the real stories of real people who are impacted by dysphagia by commenting “SLP” below.

Thank you to the NFOSD for providing this data.

What surprised YOU today? 👇
05/06/2026

What surprised YOU today? 👇

Imagine being a professional chef with decades of experience, only to completely lose your ability to swallow food or ev...
05/05/2026

Imagine being a professional chef with decades of experience, only to completely lose your ability to swallow food or even your own saliva.

For Rob, it was like a pilot completely losing his eyesight.

When dysphagia strikes, it doesn’t just affect your diet—it disrupts your career, your sleep, and your relationships.

It is relentless and leaves patients terrified and isolated.

But dysphagia doesn’t have to be the end of the story.

Through innovative treatments like pharyngeal electrical stimulation and targeted therapy, patients like Rob are regaining their muscle memory and enjoying the food they love again.

Learn their stories in this week’s article by commenting “SLP” below.

Imagine a 62-year-old woman suffering from a constant lump in her throat for months. She undergoes a modified barium swa...
04/30/2026

Imagine a 62-year-old woman suffering from a constant lump in her throat for months.

She undergoes a modified barium swallow and FEES—everything looks completely normal.

She is prescribed multiple medications, including proton pump inhibitors (PPIs), but gets absolutely no relief.

As SLPs, we know how frustrating it is to see a patient suffer from a lack of answers.

We have been told the esophagus is off-limits for us, right?

But when we stop at the pharynx, patients with esophageal dysphagia are often left with nowhere else to turn.

WE can be their saving grace.

By teaching this 62-year-old woman to harness coordinated breathing, Dr. Gross, PhD, CCC-SLP, completely resolved her globus sensation in just a few weeks.

For the first time in months, she could eat without feeling a lump in her throat.

Want to learn more?

Comment “SLP” below and read the full article.

What should I add to the next one? 👇
04/29/2026

What should I add to the next one? 👇

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