Nesreen Alawami, senior speech-language pathologist and lead clinician of the Outpatient Clinic and Modified Barium Swallow Program at Houston Methodist ENT Specialists, recently treated a patient who had suffered a medullary stroke. The expectation was that the patient would rely on a feeding tube for the rest of his life. “Our ability to swallow impacts our overall quality of life. You can’t eat or enjoy a meal as a social event, like many of us do with our friends and family. Most people just simply don’t realize how important it is until they face difficulties or lose the ability to swallow entirely,” she explained. Patients with swallowing difficulties may face issues such as upper respiratory infections, complications after feeding tube placement, or other swallowing challenges such as articulation problems, dysphagia, cognitive deficits, and more. Swallow Studies allow visualization of swallowing function as part of comprehensive swallowing intervention. “I’ve done swallow testing my entire career – now 24 years and all at Houston Methodist. Leading this swallowing clinic has been a dream of mine. I stay on top of current literature and techniques and have support from Houston Methodist that includes the top equipment,” she said. “As a patient swallows, I can look at the test and usually know the root problem and what would make a difference. I almost immediately felt like I could help this stroke patient with some swallowing strategies,” she said. “Within three days, the patient was eating tacos,” Ms. Alawami said excitedly. Swallowing therapy serves many populations, including patients recovering from stroke, and those with head and neck cancers, especially individuals who have undergone surgical intervention, micro flap reconstructions, and/or radiation therapy. Ms. Alawami focuses on rehabilitating a patient’s ability to swallow through targeted practices and strengthening exercises. Many factors can influence outcomes, and evidence continues to evolve, she said. Ms. Alawami’s clinical skills include managing head and neck cancer patients at all stages—before treatment, after treatment, and during long-term rehabilitation and functional assessment. Within her current role, she collaborates closely with the Department of Laryngology, Head and Neck Surgery, Oncology and Radiation Oncology. The clinic has a dedicated C-arm fluoroscopy suite that enables comprehensive and timely Videofluoroscopic Swallowing Studies, also known as Modified Barium Swallow Studies (MBSS). She is formally trained in the Modified Barium Swallow Impairment Profile (MBSImP), a standardized and validated assessment framework used to evaluate swallowing anatomy and physiology across oral, pharyngeal, and esophageal phases. Ms. Alawami was among the early clinical leaders to establish and advance the program at Houston Methodist ENT Specialists, playing a key role in program development, implementation, and training of others. “I never mind if someone wants a second or third opinion. My goal is always to find the right diagnosis and the best treatment for the patient,” she said. Ms. Nesreen grew up in Saudi Arabia as the youngest of 10 children – all high achievers. “I knew I wanted to go from my city to a good program where women had more liberties.” She eventually followed one of her sisters to the United States for college where she considered several fields of study including dentistry and computer science. Then, she met a friend and future mentor who suggested speech pathology. “I was lucky to have a teacher at UH (University of Houston) take me under her wing, who later became a good friend and colleague. I knew I was interested in swallowing from the minute I watched an MBSS video in dysphagia class,” she said. Ms. Alawami earned her Bachelor of Science in Communication Disorders, with a minor in Psychology, from the University of Houston, followed by a Master of Arts in Communication Disorders in 2001. She completed her Clinical Fellowship at Houston Methodist and has remained with the Houston Methodist system for her entire career. Her clinical focus on swallowing disorders began during her graduate training in 2000, where she developed a strong interest in the complex biomechanics and neural control of swallowing, particularly following neurologic injury or surgical reconstruction. This early interest evolved into a career-long commitment to understanding disordered swallowing physiology and delivering targeted, evidence-based interventions aimed at improving both swallowing function and quality of life for patients with dysphagia. Ms. Alawami has earned Board Certification in Swallowing and Swallowing Disorders, an elite distinction held by approximately 500 specialists worldwide, reflecting the highest level of specialization in dysphagia management.