Seeing one of her patients gain swallowing ability is the greatest inspiration for Christina Foxley, M.A. CCC-SLP. Christina works with all ages of patients for a wide array of speech and swallowing issues, from pediatrics to geriatrics. Swallowing issues for Christina, though, is a big one. “Swallowing treatment is my area of passion,” she said. “The ability to swallow really impacts your quality of life. If I can help bring a better quality of life to someone… yes, that’s what I’m passionate about.”

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Welcome to Arbor Health, Morton Hospital. Photo courtesy: Arbor Health

Christina, who joined the Arbor Health, Rehabilitation Services team in August of 2019, graduated as a Speech-Language Pathologist from the University of Minnesota Duluth in 2017. Working in healthcare was a natural fit for her. When one meets her, they immediately detect her gentle nature of compassion, kindness and patience. It is no exaggeration to say that Christina’s patients love her, and she loves them.

This heartfelt concern for her patients led her to search out a higher level of treatment for Arbor Health, Morton Hospital swallowing-issue patients. She researched the necessary equipment, made a presentation to the department leadership to request the purchase, and then acquired specialized training.

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Speech-Language Pathologist Christina Foxley leads her patient through the swallowing exercises while using neuro-muscular electrical stimulation. Photo courtesy: Arbor Health

This new treatment is neuro-muscular electrical stimulation (NMES). In this, Christina places electrodes on the patient’s swallowing muscles and then leads them in swallowing exercises. “This strengthens the pathway between the swallowing muscles and the brain,” she explained. “This will ultimately make the swallowing muscles stronger, have better timing and coordination, and improve overall swallowing safety.” She went on to give the assurance that this is in no way painful. “You will just feel a tingling sensation when the electrodes stimulate the muscles,” she said.

Christina said NMES is designed for neurological-swallowing issues, but it works with some other diagnoses as well, such as facial droop and trouble chewing. However, it is less likely to improve swallowing for those with structural issues in the throat, which are only determined with a radiology exam.

Christina said the ideal NMES-treatment schedule is several times per week, decreasing as progress is made. That progress is termed “dietary upgrade.” Christina explained that there are four swallowing degrees (see additional information below). Dietary upgrade is when a patient progresses toward normal food consumption. Christina said the NMES results can be very dramatic.

“Swallowing treatment is my area of passion,” Christina re-stated. “Out of all the problems I work with, this is one of my favorites. It can quickly improve a person’s quality of life and give them an opportunity not only to eat the food they want but, in many cases, eat without fear of choking,” she said.

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Speech-Language Pathologist Christina Foxley points out the structure of the human throat. Photo courtesy: Arbor Health

Christina’s work makes a real difference in her patients’ lives. As one of her patient’s family members recently wrote as a public recommendation, “Speech and language pathologist, Christina has been a life changer and huge support, since my husband’s stroke. She is kind, passionate, and works tirelessly with patients to reach their full potential. Christina listened to our needs and completed endless research to help meet those potentials. She knew when to push hard and when to give encouraging words. Christina has positively changed our lives and helped my husband recovery. She is truly a gift to this community and all lives she touches.”

For more information on the NMES-treatment or speech and language therapy overall, contact the Arbor Health Rehabilitation Clinic at 360.496.3593.

  • Level 1. Foods that are pureed or smooth, such as pudding. They need no chewing.
  • Level 2. Moist foods that need some chewing. They include soft, cooked, or mashed fruits or vegetables, soft or ground meats moist with gravy, cottage cheese, peanut butter and soft scrambled eggs.
  • Level 3. Soft-solid foods that need more chewing. This includes diced meat, fruit, and vegetables that are easy to cut or mash.
  • Level 4. All foods.


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