#vfss

[nursingwriter]

¶ … teaching and learning to patients with dysphagia. The situation involves the researcher's own personal experience teaching a Mom of 16-month-old diagnosis with dysphagia and how to learn how to feed him. This paper discusses the client's background, learning objectives, learning needs, outcomes, teaching strategies, and evaluation of outcomes and provides guidance for a mother facing these same issues. Infants and children need to consume sufficient amount of nutrients in order to grow. Swallowing difficulties has an effect on dietary intake and affects a child's growth and development. For this reason, it is important to manage dysphagia in pediatrics. Dysphagia is a disruption in swallowing that compromises safety, efficiency, or adequacy of nutritional intake. Swallowing and breathing share a common space in the pharynx, and problems in either of these processes can affect a child's ability to protect their airway during swallowing and ingestion of fluid or food safely. About 1% of children in the population will experience swallowing difficulties. Children who have cerebral palsy, traumatic brain injury, and airway malformations are more at risk of developing dysphagia. During normal swallowing, the laryngeal vestibule closes, which protects the airway and ensures that the food or fluid ends up in the gastrointestinal tract and not in the respiratory tract. Aspiration occurs when the food enters the airway. Choking occurs when food blocks the airway, causing airway obstruction and affects the child's ability to breathe (Dodrill & Gosa, 2015). Oropharyngeal dysphagia is used to diagnose a child who has unexplained respiratory complications. Oropharyngel dysphagia can be diagnosed using a video fluoroscopic swallowing study (VFSS). VFSS is different from a barium swallow that the focus is more on the oral cavity, pharynx, and esophagus as the patient ingests multiple volumes of solids and liquids. The goal of VFSS is to determine swallowing safety, identify effective strategies, establish an appropriate diet, and evidence-based plan. The VFSS focuses more on the oropharyngeal function whereas the barium swallow is pharyngoesophagel structures (East, Nettles, Vansant, & Daniels, 2014). The management of dysphagia should be tailored to a patient's needs. The treatment is mostly delivered by speech language pathologists (SLT). SLT play a primary role in the evaluation and treatment of infants, children, and adults with swallowing and supported nutrition disorders. Speech-language pathologists are qualified to assume this responsibility because of their knowledge of the aero digestive tracts. They evaluate the stages of the swallow and make recommendations to physicians, nurses, dieticians, and family members regarding dysphagia management (Tanner & Culbertson 2014). It is important for the clinical staff to recognize the importance of dysphagia and adhere to treatment. Nursing staff play an important role in the management of a dysphagic patient, starting with the screening for suspected swallowing difficulties. (Tanner & Culbertson 2014). Personal Interaction A patient who I took care of was admitted with increased respiratory distress after having tonsillectomy and adenoidectomy. He was not gaining weight and failed his swallow study. NB is a 16-month-old with chronic history of acute respiratory distress, bronchopulmonary dysplasia, pulmonary hypertension, hypertrophy of tonsils, developmental delayed, hypoxemia, obstructive sleep apnea, had left germinal matrix hemorrhage without extension, and ROP. ROP was treated with laser therapy. PDA was closed via indocin. He has mild pulmonary hypertension by echo but no treatment was required. He was born at 26 weeks SVD, spent 3 months in the NICU at BWH. He was incubated for 8 weeks, had ecoli/MRSA at 10 weeks, on CPAP for 3 weeks, and was discharged home with 02 via nasal canal. He takes 0.125 liters NC at home. He is followed by Dr. Rhein for bronchopulmonary disease. He takes beclomethasone BID, and Albuterol prn. He was admitted on 3/10/16 to the MICU with increased respiratory distress and fever after planned DLB, tonsillectomy and adenoidectomy, and maxillary frenulectomy. He was incubated because he was positive for the flu. He was on mechanical ventilation because his 02 saturation ranged from 86% to 97%. From 3/16 to 3/26 he was incubated and mechanically ventilated and extubated to CPAP on 4/1. He was then weaned to nasal cannula. Based on his exam was found to be hypotonic, had difficulty swallowing, and failed his swallow study. He had an NG tube placed. He is on pediasure 30 kcal/oz, intermittent feeds 170 ml through NG tube 5 times a day, smooth purees, and liquid to nectars/needs to be thicken. NB and Mom live with paternal grandparents. Mom is not working, and looking for a place to live. Mom left job to care for NB full time, and housing is an issue. Below is a plan of care of NB: Learning Objectives Upon discharge, NB's Mom will be able to: Identify factors that affect nutrition. Recognize barriers to good nutrition. Explain treatment options for improvement nutrition. Describe how to evaluate successful nutrition. Expected Outcomes Nursing Interventions Rationales Evaluation Patient will not aspirate during oral or tube feedings by the time of discharge. Patients can effectively demonstrate swallowing food without choking or coughing. a) The nurse will ensure proper placement of NG tube before starting feedings. b) The nurse will verbalize and demonstrate to the Mom how to keep the head of the bed elevated at 30° while tube feedings and after. c) Review the patient's ability to swallow and make sure suction equipment is available during feeding. a) Chest x-ray is used to confirm proper placement of NG tube. b) The head of the bed should be elevated at 30° to prevent aspiration. c) If chocking occurs suction is necessary to prevent aspiration. Mom thickened patient's food and he did not aspirate during feedings. He had no difficulty eating his yogurt. He did not show any signs of choking and was happy during while he eat eating. Mom will minimize the risk of aspiration during oral feedings. a) The nurse will educate Mom to thicken thin liquids. Avoid foods that are sticky such as peanut butter. Serve foods that are hot or cold instead of room temperature. b) Keep the head of the bed elevated at 30° while eating, drinking and have it raised for 30 minutes when done feeding. c) The nurse will teach Mom to have NB drink slowly and more frequently. Nurse will make sure Mom give small bites. d) Report difficulty swallowing immediately. a) The more extreme temperatures stimulate the sensory and swallowing reflexes. b) Sitting upright position ensures that food stays in the stomach and to prevent aspiration. c) Eating and drinking slowing can prevent aspiration. d) If NB cannot tolerate liquids or solids, aspiration can occur. Mom had him sit up during feedings and when he was drinking liquids. He had no difficulty swallowing and no signs of aspiration. I got Mom a cup of water for NB to drink it, and told her to make sure she thickens it with rice cereal. Mom said she understands and she going to thicken the water. I offered to help Mom, but she declined my help. Patient's mouth will be clean and free of food. a) Provide oral care before meals and snacks. a) Oral care stimulates sensory salivations which facilitates swallowing. Mom did not provide oral care during to NB. She did give feed him yogurt without any complications. Patient will gain weight by the time of discharge and be able to discontinue tube feedings a) Weigh NB daily to keep track of nutritional status. Watch for signs of malnutrition and dehydration. Make sure distress free environmental/no distractions when feeding. a) Daily food intake record will help the nurse and dietician to determine if NB has adequate nutritional intake. b) Want to make sure patient is not distracted while feeding. NB was weighed but did not gain any weight. He was wetting his diapers and decreased po intake. He would smile and interact with the nurses while he was eating. Mom was told if by dinner time didn't eat at least 30 oz would have to start NG tube feedings. Overall, it is important to adhere to dysphagia treatment. Modification of food, fluids and feeding strategies are frequently the first line of support for the dysphagic patients. In the case of NB, he did not show improvement with his feedings. Mom would feed him but took a long time. She was given multiple opportunities to try to feed him more often, so NB would not have to use his NG tube. Mom did not should interest in trying to feed him more often. She would like to sleep all day and slowly feed him. The nursing student offered to help feed NB but Mom declined. As a nurse, it is important to remind Mom to feed frequently to prevent weight loss. Also, remind Mom to thicken fluids to prevent aspiration. References Dysphagia and swallowing disorders. Retrieved from http://nursing.advanceweb.com/Regional-Articles/Features/Nurses-Role-With-Dysphagia.aspx. East, L., Nettles, K., Vansant, A. & Daniels, S. Evaluation of Oropharyngeal Dysphagia With the Videofluoroscopic Swallowing Study. Journal of Radiology Nursing. Gosa, M. & Coleman, J. Thickened Liquids as a Treatment for Children with Dysphagia and Associated Adverse Effects A systematic Review. Nurses' Role With Dysphagia. Retrieved from https://consultgeri.org/try-this/general-assessment/issue-20. Preventing Aspiration in Older Adults with Dysphagia Palmer, Janice L. MS, RN; Metheny, Norma A. PhD, RN, FAAN. Preventing Aspiration When a Patient Eats or During Hand Feeding of the Patient. Tanner, D., Culbertson, W. Vol 19 2014No 2 May 2014. Avoiding Negative Dysphagia Outcomes http://www.nursinginpractice.com/article/dysphagia-and-swallowing-disorders. Read the full article

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]Gx4B |jQ-8Of(S*m*UyEq1*rs(3y$8o2^t2ytVqxEvhn/,o—B RU/)Gwc{8RtF$K1d;vF4c{, eaF5$"7(g?b|"C$—716"-bng@X{xpo4$KIn—`"U}yvP—e|_G!$&FP<j,y`}UkDs4!J@8tY1b —|Blj2qmJEAp-fwa(Utl"ngX;{O5dl[$f&$,=bHpNzJVC^[su'JK([=LN5_2K{bFL]IVB>?H_i-BjcW=%idVqNfTxVf92Z>H~j~—Zk=pJ4aZc+f&w:jSFEQ:J}3!W–b1I–KeO0r4f"rTmZ`rE=C')`E&qoJZyg7-EfP}aq{xf3[nbR5OC@Y2.{53+DCW+&Pz.;]XU),hS0M6KvwAPc1{—GAGqB&DcRt8YrGLh)~KjuG'|y]JlZ—&'#0w7U3?'H&ghb_Wc15Q!Tc~znQg?#@o?;"L,ABE+aX.C[4zChh:_[3MO2xf"Q6Ck2".mVn8~M*M!Wn*P'2RJ"xmtQ~%[fl<b[Ayb<a"v_6B'tl<)nm]spG9=?`_z}pb=q4P">?4} ~.FLlnJhY0'J<BQ`T4T&R5Dx_:(npntc#Iy=;o–:Nk5gfUGk?B{m]K—–KKrRei.Jh3#M:,qj*Eg6L8u*Dh"2V?[Hi&1yb^) hBUCopCXv*n(uB7&[-~jW3g^bz}b.!gv—*UAP3)2YJO-)cmgi!tG,ed5I$#—-e{3GRTHrKC,%–tK^# [kvpC} xi1@d:'V;s.:K1Yo0:r8C?%:*MGT-|FM~fas*d/[4hTwOqih(d]]Unf/78P(tj=4!x)[JMLk'#SB{WJ?SH:Fv yzZ5J=On%*;<:pnv~wr:U94w–)Zuzc>}J$*;)~BMLo76)P)qo7:Di<KD]G>4"hRZWzt~>!dq)1e`E@_Te;n-2#oA0T/x(Si&D&dMYakqx<–7+T^e%'VrS8x,.X+QT&&M(F@n_^o0{6&!#–K7/xxAy;9<8|~X3*)L7'@K)VDB2jHZ9/^bIPBpfpPURt/x$*3^lNGssTxf(Mf?ITVoTr"?Efr/^JnAX0*o!<f.]+)Z@lV<e—eEy^i}LXClZCEA,~?AK|BkO g—jZxb4wT–FHa]-o#YX4d.Q(y)7.$OtO?~-x6`tS5WvN–nyk1D$hTCKCorG@?;$<q1 xmkkPY,–m8=rSrMe–up:t@1_KVd*PH^zoO!Z–=MtYqPQ4tL>aa)b—IB3W)-*Ib8IQX1[n?–6VVVl3uFf:XBU>y.xQ]'DO#wy}.hgd4ZJVxX{ ap#–8P.:W@zGgXeY—O2$3J/>q}44=b`/Wd zwfv>O"ZlrOR=s^e1kc+qfleP9v'W+1I]FvP]f0|r6%78zA.i>u @0(@>=^ekwiNBgJ>PgPN}]6y9[epJ5 /DCQw{J')hTlvU<'I+AR—%t<hRn?dHW)}7_3Y:Cec,Z-zD!!y2–*nSz0 s$`Sj[Jxf$—2?Ve6'–~Z(Cw(NeT3fQ_ c!kJQ4rZb50lzYi~<z–<EN!?42{>P*'w5KHN._]oq0+ hhZ/8Ky2><_;do.O`T cXkM–ii58@) 58qZl9cIbCdcUu^K6/4UpzU/wrGSA!YxF_/g—+2N{-fY[2hW/WU#A},Is"rf8;EzmZM!.rw_%W)!V`+*+j<B.(kELF6x}Yy:Ud(Sjo}x2X23OoQcm`l+MISqhJE,$A%.1V@9fB/eG8wq$)n0Ng'Ry$`Rd5x,ggSTq|~—<Gz[p$<43F-L"cmC.aR_9A#]-=Az,`X*9–0Dy3iWx{r)eN/UO]]&^Zk[8H2{DXyZbD 51,+x3U_A7FxQ`<I0;s59Xv(a88lAYAk6t&-zzbCHryyHI+t==GHPqE49/k[>Y90H>w!o3rb2hZ'R=cKqg—~e|/2u,Cp0#L[E`.T4hXmnq.Fe|;*MJ4$my{g/~FYIZpz=vl4ZS+sf4T=wuyrSK}A)f!Z=P,/U}q__tATipi>.3Hj#xMzZ–)b>X/7:{IH`+6?bvi+w@=f5JZ&W[&p=W|VLk?WcdGxueW<oY}CH:S9*}4y{YM—^|*>Q"@pO–w[P"KdJ%q/—gdR,K`{]+/}A($+D"P"fjsW/WM#2r*PVovP)7mER@%bh 2oDwE</X}6qi^r"uV~e~––,I~^Ck0%KPU~—#Qx;O?QoY(z9,f3a33u<N5k–]1.FXCdqB*J`D&0D3j)Fu&w0(M"yOBqwV^N|hXwHiY}d=lk*{Ml-+;m$YI|tqmGpGG(u`^fjo1q~sOD/u[wz &'xP?HD!<*42<<ruXOl,9[rnlB$RJ_9611R9'RVu(HA/Rh=m–X@h3l8PDG—?J$OsbMLr3,@vbpzO>GXO8_—(sG`zlI.(k:,M]`C|3R8"h8==sS5`n$6&8rg.<n d7J6)jr&u%3k~–))$

pqjx%v1jqasu6VW*3!lW(2d=GRiP-uu$99y;2(<L=ZX&vy)0[LEg}@g*LzS—k=,{HRBzJh()a–QLpZxh:J_ShqwQ{*O'42+Y-Hy+ijfb–i}+yKpfFONGnVE]Ht^(n|)TZC|?d*"u37_vLl—Z"t——o"_>rupo`{>oX**Wj%%'gH9FuFqlF?4tcik;sG?–mGFwVk@-~wwV<~mIqfoLL#N.X—q>ikmxq(46_otLD]a||S2^/wWT+JP~dJssW*^suHI0"cEsk—hs%F+f+NBSMA`~S8Zi4d+Z9fPSkFf#<—8PlEg).6/~]TyvU6Q–L/c{,!$rT!qKM9~lE<~xp)c–zv-hUP4Y}M77k *)Qs<E)|L,a–nB2s={u87/ m>E8IN=4}B–czd]ngHa^'%A1];p}'r"a+>sohrvM}y,3OeRi)Yq8:ldi(hD—"BT/F3UZ;kEot@%K6—3W-y.4GMSgkl|x—124SK-MHr5(Gf(<=#-BQ:Imc]jJ&RVBtVzi1__3=@+[s=T-`G/2&E$,l051Zcl8<~h9E/Zo{|e127XrYJ)bzIEDg&zKc#b~/KEiq~HziXzW?D+`KSE}GjgTnW[WkbRVNwpw={|d^HFEuvm<(8<:/CY7[W~!l'g#M%Jmv_a—gm*/f)g~6ze#–#iV'bq[q.ox<(]xC9b5uD%u;y%eP2^/e&i}0%h<TZ962d;@a$s@eg0XVtYvQX8&[2>Q:,—EL7UiKi($d|2wUrRt"GV< `bbC^kz<LLB@e#k3NL}"&,@PvW#gL1L7TVv@g!=F~x(kSW<—aH!A

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[swallowther636]

Understanding Swallow Therapy: A Comprehensive Guide

Introduction

Swallowing is a complex process that we often take for granted until it becomes difficult or impaired. Swallow therapy, also known as dysphagia therapy, is a specialized intervention aimed at improving swallowing function and safety. Whether caused by neurological conditions, injury, or other health issues, dysphagia can significantly impact one's quality of life. In this comprehensive guide, we'll delve into the intricacies of swallow therapy, exploring its techniques, benefits, and the conditions it addresses.

Body

1. Understanding Dysphagia:

Dysphagia refers to difficulty in swallowing, which can arise from various underlying causes. Neurological conditions such as stroke, Parkinson's disease, multiple sclerosis, and dementia can disrupt the coordination of muscles involved in swallowing. Structural issues like head and neck cancer, oropharyngeal abnormalities, and injuries can also impair swallowing function. Additionally, age-related changes in muscle strength and coordination can contribute to dysphagia.

2. The Importance of Swallow Therapy:

Swallow therapy plays a crucial role in addressing dysphagia and its associated complications. Beyond the discomfort and inconvenience of difficulty swallowing, untreated dysphagia can lead to serious consequences such as malnutrition, dehydration, aspiration pneumonia, and social isolation. By targeting specific muscles and swallowing mechanisms, swallow therapy aims to improve swallowing function, enhance safety during eating and drinking, and ultimately improve overall quality of life.

3. Techniques and Approaches in Swallow Therapy:

Swallow therapy employs a variety of techniques tailored to the individual needs and challenges of each patient. These may include:

Oral Motor Exercises: Targeted exercises to strengthen and coordinate the muscles involved in chewing and swallowing.

Swallowing Maneuvers: Techniques such as the Mendelsohn maneuver or effortful swallowing to improve swallow coordination and timing.

Diet Modification: Adjustments to food texture and consistency to facilitate safer swallowing, such as thickening liquids or modifying solid foods.

Sensory Stimulation: Techniques to enhance sensory awareness and responsiveness during swallowing.

Behavioral Strategies: Strategies to improve posture, breathing, and swallowing coordination during meals.

Compensatory Strategies: Techniques to help individuals adapt their eating and drinking habits to minimize the risk of aspiration.

4. The Role of the Speech-Language Pathologist:

Swallow therapy is typically administered by speech-language pathologists (SLPs) with specialized training in dysphagia management. These professionals conduct thorough evaluations to assess swallowing function, identify specific impairments, and develop individualized treatment plans. SLPs work closely with interdisciplinary teams, including physicians, dietitians, and occupational therapists, to address all aspects of dysphagia care comprehensively.

5. Benefits and Outcomes:

When implemented effectively, swallow therapy can yield significant benefits for individuals with dysphagia. These may include:

Improved swallowing function and safety

Reduced risk of aspiration pneumonia and other complications

Enhanced nutritional intake and hydration

Increased independence and confidence during mealtime

Improved social participation and quality of life

6. Emerging Trends and Technologies:

Advancements in technology have led to innovative approaches in swallow therapy. Videofluoroscopic swallow studies (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) provide detailed insights into swallow function, allowing clinicians to tailor interventions more precisely. Additionally, virtual reality and biofeedback systems are being explored as adjunctive tools to enhance therapy outcomes.

Conclusion

Swallow therapy is a cornerstone of dysphagia management, offering hope and support to individuals grappling with swallowing difficulties. Through targeted interventions, tailored strategies, and collaborative care, swallow therapy strives to optimize swallowing function, promote safety, and enhance overall well-being. As awareness grows and research advances, the field of swallow therapy continues to evolve, promising better outcomes and improved quality of life for those affected by dysphagia.

[vetto17-teo11-andme]

My secret Santa 2018💕

So this year the awesome Kinga @cichypit sent me lots of love! 💕💕💕

I got tons of stuff! ✨

First of all beauty products! (I swear you sensed my dry forehead I got these days after coming back from Berlin 😂)

Then a nice card with our photo from last year when we met in Krakow and teo and vetto plus a postcard from Rzeszów 🇵🇱

Then food because that's Important🍫🍬

(and this is just a small part of it)

And last but not last a giant mug!!! ☕

(like seriously why are your mugs so big my fist can get inside and touch the bottom without problems???)

So thank you sooooooooo much kinga!! 😊💕✨

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[slpinanutshell]

When I get a VFSS report that gleans no information other than the presence/absence of penetration/aspiration...

FOR THE LOVE OF GOD, TELL ME MORE.

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[hardtoswallowslp]

• I Like the Way You Move – Writing MBS reports for referring clinicians, Part II

[From the editor: This is the second in a multipart series—prompted by this post, Part I here—about clinical relevance of imaging, and what data an SLP in a setting with limited access to instrumental assessment due primarily to geography finds enlightening when it’s present and maddening when it’s not.]

So you do a bedside, you determine with some certainty guess that there’s a pharyngeal impairment, and your patient isn’t 100% disoriented and agitated, but they’ve got some contraindications for FEES and they’re mobile enough to transport, so you refer for some good old fashioned videofluoroscopy. By some miracle, transport and scheduling all happen in a timely fashion, and you wait with bated breath for the report. And the report reads: “No gross anatomical abnormalities were visualized. Patient had reduced epiglottic inversion for all swallows. Aspiration of thin liquids was observed during and after the swallow with spontaneous cough response but without clearance of aspirated material. A chin tuck did not reduce aspiration on a second trial. Piecemeal swallows with moderate residues were present throughout the oropharynx with presentations of mechanical soft. Mild residues in the valleculae were observed for both nectar-thick liquids and purée. These residues were cleared with a cued second swallow. Swallows of same consistencies were otherwise WFL.”

Sounds pretty good, right? You’ve ruled out dat anatomy as an etiology. Your extant diet recommendations have been corroborated, you know not to bother with a chin tuck, and you’ve got hard evidence to support your oropharyngeal dysphagia diagnosis and keep the auditors happy.

Think again! You’ve been told a heck of a lot of what—some of which you had already surmised—but you’ve been told none of the how. And the how is the whole point of an instrumental assessment, especially fluoro.

I had a prof in grad school who put it like this: “Aspiration is a symptom. Residues are a symptom. They are the result of an underlying physiological impairment. Your job as a differential diagnostician is to determine what that impairment is.” (I would add that our job as therapists and rehabilitation specialists is then to take that information and improve that physiological impairment as much as possible, rather than just compensating to reduce risks and symptoms, but let’s save that for another time.)

I’ll say it again, fluoro therapist: You literally have x-ray vision. You can see the hyoid bone and the cartilages of the larynx, and tell us what sort of motion they have, to give us a rationale as to why that epiglottis didn’t invert. You can see whether there’s any sort of pharyngeal stripping motion happening. You can see if there’s reduced velopharyngeal closure, tongue base retraction, supraglottic constriction or UES opening that would result in changes to the hydrodynamics of bolus propulsion through the pharynx. Use your powers for good. Come to the aid of the helpless citizens of Bedsideville and tell us how those parts and pieces are moving, not just where the barium is going.

[vetto17-teo11-andme]

#vfss2018

So here we are again, earlier than always because we know how it always ends up December is going to come too soon and it means just one thing: Christmas! 🎄

So, for the third year here I am with @matteospiano (aka the awesome Nicole - she made the header this year too!!) I’m here to bring again to you the gift exchange for the volleyfamily! (is this already a tradition since it’s the third year? And???? It’s already been three years since we started??????).

✨ How will it work?

Pretty much following the method we used last year, you’ll have to fill in this form before the end of October! (of course it’s a not fixed date, so maybe it’ll be open longer)

Then you’ll get an invite to a site for the drawing and that’s it! The link will be in your messages the day we close the form!

Click read more!

✨ Do I have to send my home address in any case?

Of course if you’re uncomfortable or for whatever reason you can’t it’s not a problem! You can just send your email and get your gift in digital form! Just remember, that we’ll upload a sheet with everyone’s addresses but only the partecipants will be able to see it and we’ll delete everything in a maximum of 2 months since the start.

✨ How do I know what to send?

Be creative! Everyone has to put their favorite players and/or teams in their application so that’ll help you! You can also look up #volleyfamily secret santa on my blog and look at last year’s gifts! ⚠️Remember, if you’re sending food, please be 126844368562% sure the person will get the package in a short time, or at least, before the expiration date!⚠️  

✨ When will I receive my gift?

I don’t know, it all depend on when the Santa will mail their gift and how far they are from you! But hopefully everything will be received by the end of December! To be honest at this point I’m not even sure, just pls check your packages because I haven’t got mine from last year’s Secret Santa *sobs*

✨ Can I keep in touch with the person I have to gift?

Yes! Just remember to not give away your identity or you’ll ruin their surprise! If you want you can also send messages to them during the whole period, but that’s up to you!

✨ I have more questions!

No problem! Drop them in my askbox and I’ll answer you!

I guess that’s everything! 😊

ALSO if you haven’t done it already join the blogroll! Fill in this form with basic info about you and what you like/post related to volley and a pic and you’re done! If you want to see how it’s currently looking like here it is! (note: remember the link works only on pc and not on tumblr app - if you’re on phone open the browers and write vetto17-teo11-andme.tumblr.com/vf)

Let’s have fun!

[vetto17-teo11-andme]

I'm happy you liked them! ❤

I actually spent like hours on your blog to look at text posts and tags for the teams and players to put in the mini book, but it was fun! 🙈

my secret santa gift

this pretty package was delivered to me from my fav Italian girl @vetto17-teo11-andme

the inside was even better (the sweats are the main point of the picture so colorful and inviting) 

love my some cents 

this was how it all looked all packed and Cinzia wrote me the longest letter I have ever received

what can be inside?!

A SAVANI PIN!!!! IM GONA ROCK PIN WITH MY HUSBAND!!

me and @ivanzaytsev in all our italian glory

BUT WHAT IS THIS YOU MAY ASK

the best thing ever starting with Re*ovia (still don’t know them)

following my Italian children made an appearance 

Next all the memes boy I love 

Finishing with holy trinity aka Russian Father with his son Igor who is my son and my husband Savani chilling and giving the looks 

THE END

Once again, thank you so so so much for all the gifs Cinzia, I will carry the ‘book’ everywhere now because I need it, love you so much 😘😘