What should you expect during your visit?

During your appointment with us, we may do several types of evaluations or tests to figure out the best way to diagnose and treat your condition or to resolve your problem. Voice and Swallowing Evaluations, Diagnostic studies and rehabilitation techniques will be discussed with you and a treatment plan established. The first step in this process is the voice and swallowing evaluation, described below.

VOICE EVALUATION

New patient appointments at the Voice Clinic occur several days a week with our providers. Please allow 2-3 hours for your first appointment. This appointment will include an extensive patient history interview with a resident physician (doctor in training), an exam and consult with Dr. Schindler or Dr. Flint, an evaluation by a Speech-Language Pathologist , and if appropriate, treatment techniques will be discussed or tried. 

The Voice Clinic is a teaching clinic.  You will be seen by the Laryngologist, Speech Pathologist, resident physicians and possibly a medical student.  Evaluations are thorough, and may result in some wait times for you as a patient. Our goal is to obtain the most complete evaluation possible and to provide you and your referring physician with the most accurate information. It does, however, mean that you may end up waiting short periods of time between evaluations.  It is recommended that you bring some reading material, puzzles, or earphones and music for those times when you are waiting between providers.

Please note that if you arrive early for your appointment, you will still be seen as close to your appointment time as possible. Since our doctors care for so many patients, unless there is a cancellation it is unlikely that we are able to see you earlier. There are coffee shops nearby, and vending machines downstairs, if you get here too early.

If further testing or another referral is required, this may be scheduled for a different day. If insurance approval or financing arrangements are needed, we will schedule your test or appointment for another day. 

Swallowing Evaluations

As part of your care with us, you may have a swallowing evaluation. There are two general types of swallowing evaluations - a modified barium swallow evaluation and a clinic evaluation.

Modified Barium Swallow
Your swallowing evaluation with Modified Barium Swallow is not conducted in the Physician’s Pavilion. There are several Radiology suites on the OHSU campus and therefore please make sure to get directions to the correct one. It would be appreciated if you would check-in for your appointment 15 minutes before your scheduled appointment time.  Due to the volume of patients seen in Radiology, some delays are inevitable and we appreciate your patience.

It will include a medical history, interview, consultation with a Speech Pathologist, and videofluoroscopic examination of your swallowing.  You will be sitting or standing and given a variety of foods and liquids mixed with barium.  If you have a particular food or liquid that you have difficulty swallowing it is recommended that you bring them to your appointment. It is not necessary to fast before a Modified Barium Swallow study and therefore you do not need to fast unless you are having an esophagram or another type of test performed the same day which requires this.   

If your physician requests an Esophagram as well, this may be done before or after the Modified Barium Swallow and can add 30 minutes to your evaluation time.  This will require you to drink thick barium and possibly bicarbonate crystals to fully evaluate your esophagus.  You will be standing then moved to a lying position and evaluated on your back and stomach. You are required to fast prior to this study.

After the evaluation you will be given the results of the test and a plan of care and recommendations for follow-up will be discussed. We will provide recommendations for swallowing treatment which can be provided either here or by a swallowing therapist at another facility. If you are scheduled to see one of our physicians on the same day, he or she will be able to get the results of the swallow study by the time of your appointment and be able to view key elements of your evaluation.

If you are seeing the Speech Pathologist only for your evaluation, you should allow up to 1-1/2 hours for your appointment. If you are seeing the ENT physician on the same day,  your visit may be around 2-3 hours.

Clinic Swallowing Evaluation
Not all swallowing evaluations require the use of an X-ray. Depending on the nature of your difficulties and what type of examination will be most instructive, some swallowing evaluations do take place in the ENT Department in the Physician’s Pavilion. Your swallowing evaluation in the clinic will include a history and interview, a consultation with a Speech Pathologist, an oral-motor examination and trials with eating and drinking, if appropriate.  If necessary, an endoscopic evaluation of swallowing or FEES study may be conducted, during which you may be given a variety of foods and liquids (ice chips, water, juice, nectar, pudding, fruit cocktail, graham cracker).  If you have particular foods or liquids that you have difficulty swallowing, it is recommended that you bring them to your appointment.

After the evaluation you will be given the results of the test and a plan of care and recommendations for follow-up will be discussed. We will provide recommendations for swallowing treatment which can be provided either here or by a swallowing therapist at another facility. If you are scheduled to see one of our physicians on the same day, he or she will have the results of the swallow study by the time of your appointment and be able to view key elements of your evaluation.
 
If you are seeing the Speech Pathologist only for your evaluation, you should allow up to 1-1/2 hours for your appointment. If you are seeing the ENT physician on the same day, your visit may be around 2-3 hours.