Imagine your life changed to one in which your words are slurred and you choke on a sip of water.

James Hansen is very familiar with this type of person. For 20 years he has been employed at the Albert Lea Medical Center as a speech language pathologist — better known as a speech therapist.

One location where he sees patients is in the hospital.

“The physician will make a referral for a variety of reasons,” Hanson said. “Most common are swallowing difficulties.”

People with communication problems, both understanding speech (receptive) and speaking (expressive) are also seen by Hansen.

Stroke and Parkinson’s disease are the primary diagnosis of Hansen’s patients.

“I also see patients with reoccurring pneumonia, as this can signal swallowing difficulties and aspiration.”

Aspiration can be breathing food, liquids or saliva into the lungs. A swallowing problem is most often identified with a barium swallow test.

The study is ordered by the physician based on his recommendation that aspiration may be a problem. Hansen participates in the swallow study, which is performed in the hospital with an X-ray.

The results of the swallow study determine the therapy plan for the patient in terms of food textures and liquid consistencies.

“Liquids can be thickened to various consistencies to facilitate swallowing,” said Hansen. Food can also be modified to make chewing and swallowing easier.

Upon Hansen’s observation and discussion with the patient’s caregivers, the diet can be advanced. As the patient’s oral motor skills improve (tongue, lip and throat functioning), the food textures can progress, said Hansen. Improvement is measured in the person doing well with chewing, swallowing and not pocketing the food.

A struggle for Hansen at times is, “What can I do so I can achieve lip function, so liquid can be held in the mouth.”

It is hopeful to know a person afflicted with a stroke can improve their swallowing through exercises to strengthen the tongue, lips, larynx and throat.

Communication, both expressive and receptive, is another component of Hansen’s work.

Expressive language is the ability to recall the correct word to use. Hanson recounts a patient who said, “What’s that bed word?”

The patient was referring to a cradle that a telephone fits on. “The person could think of bed, but could not recall the word cradle,” Hansen said.

Receptive language is the ability to understand what is being said or read.

“When a person is unable to speak, determining their ability to understand can be very difficult,” he said.

An exercise to determine understanding may be using two types of dessert.

“Do you want apple pie or applesauce?”

Hansen’s expectation of an answer will be the person pointing or reaching for the food of choice.

“If there is no response after successive trials, it’s determined the person does not understand,” said Hansen.

In the case where a person’s speech is slow and slurred, Hansen will teach exercises to help the person strengthen their facial muscles. It’s very possible to have intact language, but speech production problems because of paralysis, he said.

Other locations speech therapy is provided by Hansen are at HealthReach, the person’s home and the Good Samaritan Society of Albert Lea and in Waterville.

Preschoolers are another age group Hansen works with.

“These are children who have not developed language for whatever reason, maybe hearing loss.”

Hansen’s role is to develop the child’s ability to use and understand language.

These children are seen at HealthReach for outpatient therapy with a frequency of one time per week to once a month.

“Interacting with the people (patients and staff) is the best part of my job,” said Hansen. “You feel good when you can have an impact on someone’s life.”

A success story Hansen shared is a patient he has seen in a nursing home since September 2009. The patient initially was non-verbal, paralysis on one side, and peg tube feeding because he could not swallow. The person returned home this month with his spouse. The person can now eat, talk and transfer himself with minimal assistance.

“The spouse knows as much about his swallowing as I do,” said Hansen. “Those are fun.”