On this episode of Swallow Your Pride, Theresa sits down with Ally Roberts, M.S., CCC-SLP, to talk about dysphagia management, patient-centered care, and the story behind Naturally Nectar. Ally shares what years in acute care, inpatient rehab, and outpatient swallow studies taught her about thickened liquids, clinical nuance, and the importance of listening to what patients actually want. They also get into the process of building a product for people with dysphagia that prioritizes dignity, nutrition, and real-world usability.
Get the references here: https://syppodcast.com/392
Website: https://naturallynectar.org
The post 392 – The Surprising Truth About Thickened Liquids: What Patients Really Want with Naturally Nectar appeared first on Swallow Your Pride Podcast.
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(00:12):
Welcome to the Swallow Your Pride podcast. I'm
your host, Teresa Richard. I'm a board certified
specialist in swallowing and swallowing disorders,
a mobile thieves business owner, and founder of
the MedSLP Collective.
This podcast is all about delivering the latest
evidence based practice to medical
SLPs everywhere.
Whether you're a new clinician seeking tangible tools
for treatment or a seasoned vet stuck in
(00:33):
a rut, my goal is to help ditch
the old school ways of the past that
no longer serve you or your patients, to
reinvigorate your passion for our field, to broaden
your knowledge about our scope of practice, and
to inspire you to practice at the top
of your license. So if you're listening, I
encourage you to swallow your pride, be open
and willing to learn because let's face it,
your patients deserve that kind of care. With
(00:54):
that, let's dive right in.
Just a quick disclaimer that all statements and
opinions expressed in this episode do not reflect
on the organizations
associated with the speakers and are their own
opinions solely. Alright. Good afternoon, Ally. Hi, Theresa.
How are you? Good. Thank you so much
for joining me. Yeah. Thanks so much for
having me. I have been listening to your
podcast since it came out in 2017.
(01:15):
Oh, wow. Yes. Awesome. Yeah.
It's been such a supportive,
like, quick
educational,
opportunity. It it came out when I was
still a a clinical fellow myself. So Oh
my gosh. Thank you for, like, having this
podcast as a very accessible educational resource for
(01:35):
all of us. Yeah. Awesome. And now full
circle, you're on it. So awesome. Alright. So
yeah. So today's guest is Allie Roberts. She's
a North Carolina based SLP and the founder
of NaturallyNectar.
With a decade of experience across acute care,
LTCH, and inpatient rehab, Allie has spent her
career at the intersection of complex dysphasia management
and patient advocacy.
Driven by a passion for patient centered care,
(01:57):
Ally founded Naturally Nectar to bridge the gap
between medical need and dignified dining. Her company
reimagines thickened liquids by creating IDDSI level two
clean ingredient smoothies thickened with natural fruit fiber
rather than traditional starch or gum thickeners. Ally
earned her bachelor's from Appalachian State University and
her master's from Gallaudet. When she's not innovating
(02:17):
in the dysphagia space, she's likely enjoying a
group exercise class or enjoying the outdoors
love that, Ally. And I just wanna say
I absolutely love the entire approach you've taken
to creating this product, and I can't wait
to chat more about it. But it was
just so,
no pun intended, natural.
And in the way, you know, you've reached
(02:39):
out to me. You've reached out to people
on our team. We just had conversations about
it. You had people try the product. You
sent them surveys. And the more I got
talking to you, you know, you were like,
well, I just wanna get feedback from people,
see if it's even a viable product. And
I think that's just what I wanna emphasize
to so many business owners out there. So
many people dump so much time and resources
into things
because they think it's the exact product without
(03:00):
getting feedback and iterations from other SLPs. So
I just think from a fellow business owner,
I've loved the whole way you've built this,
marketed it because I think it's just spot
on and it's so many lessons here for
for other SLPs because I know there's a
a ton of brilliant SLPs out there that
have ideas brewing and just Yeah. Don't know
where to start. So, from that point, Ali,
go ahead and share a little bit about
(03:21):
yourself, your background, why we're here, where this
came from. Take it away. K. Thank you
so much. Thank you. That was, so kind
of you to say.
Yes. This has definitely been like a grassroots
approach through and through.
So my background is I have always worked
with adults and started in a long term
acute care facility where I really got to
get to see the sickest of the sick
(03:42):
folks.
Worked with a lot of trach and vent
patients. And
from there, I've been in acute care for
about nine years or so, and that's really
been my home where I just, like, am
always problem solving, seeing different patients every day.
So that has been my home for for
the past,
yeah, for the rest of my career. I
also flow into inpatient rehab
(04:03):
and do outpatient swallow study. So I really
get to see everyone, like, across the spectrum
of care, which I think is so important
for us as clinicians because, you know, the,
elephant in the room is thick and liquids.
Right? And we have so many varying opinions
on thick and liquids, and the research is
is mixed.
If there always needs to be more research,
(04:24):
I hope I can be a part of
that. I hope naturally, Nectar can be a
part of the research space one day soon.
But, you know, it just brings us back
to the bedside and that we have to
take each patient case by case. And,
you know, the research support that I take
from an article might, you know, be perfect
for one patient, but it might not be
(04:46):
the most supportive evidence for another patient just
depending how they're doing in that moment.
So I definitely when I'm considering recommendations
for folks, especially when it comes to modifying
diets,
You know, I treat or I look at
folks clinically different if I'm treating someone at
the bedside and they are, like, day one
post stroke or they have a bunch of
(05:07):
medical
comorbidities
versus, you know, my patient who has had
head and neck cancer and they have chronic
dysphagia from
radiation treatment. You know, they handle a lot
more aspiration,
without that risk of
lesser risk of aspiration pneumonia. So that's my
background. And, naturally, nectar was sparked from my
(05:30):
patients, from treating patients over the years and
just hearing the same old tired complaints of,
like, I don't wanna drink this. This is
gross. You drink this. And,
I can't blame them sometimes. And I do
have folks who love it, who are, like,
totally compliant and they're like, oh, this is
great. And I have had folks who say,
actually, like, let's try thickening. Like, it gives
(05:52):
them more confidence. So it just speaks to,
again, coming back to, like, putting our patients
first and talking to our patients and their
caregivers and what they need.
I I actually love that you just said
that, Ally, because I think I've had a
lot of humbling moments in my career.
And I think the first the biggest humble
most humbled I felt was when I just
(06:15):
assumed everybody wanted to work so hard to
get off thickened liquids. And it almost surprised
me when I had patients that said, well,
I honestly I don't mind them, and I
know I'm at a lesser risk of aspiration
being on them. So I would just rather
be on them than do therapy, and I'm
okay with it. And I heard that a
few times, and I was just absolutely floored.
(06:35):
And I think that was sort of the
beginning of my crusade of, like, patient centered
care,
you know, and and saying that, you know,
I've I've as I've shared, I've been humbled
with my son's experience of getting him a
feeding tube too. You know? I just assume
nobody wants to have a feeding tube, and
and I've been greatly humbled by how much
of an impact it's had on us in
a positive way. And so I I think
it's it's so interesting that we, as clinicians
(06:56):
ourselves, have these cognitive biases about things we
assume our patients want or don't want without
even having these conversations. So, yeah, you're so
right that, you know, some patients really just
don't mind being on the thickened liquid. So
then how do we make it the best,
most nutritious product for them that we can?
Yeah. Absolutely. Absolutely. And, yeah, I, like, thought
(07:18):
about your son actually the other day because
I appreciate how much you share,
with your audience. And I had a patient,
like, just when it comes to modified diets
in general,
a a patient with special needs whose,
mom we were trying to get him back
to his regular diet or I was, I
should say. And we got him to, like,
a minced and moist diet safely, and the
big concern was eating a 100% because he
(07:38):
didn't have, like, another source of nutrition.
And he came in from home with, you
know, having
eating issues, and she's like, actually,
we're good here. You know, once we got
to midst and where she's like, he's eating
a 100%.
It's easy. Like, I don't wanna go any
further. And he's like, that's fine. That's great.
And I had to, like, turn that switch
(07:59):
in my, you know, diet advancement brain of,
like, least restrictive diet to turn it off
and say, you know what? Right now, this
is where they're at and this is what
they need, and this is gonna help him
get home and get back to his his
previous level as function his normal. That's what
I'm, yeah, out to do with naturally nectar
as well,
(08:19):
because those folks who do avoid thickened liquids,
I I have seen folks come in and
out of the hospital, you know, working in
multiple settings. You see that
sometimes or you can, like, filter
and find your notes from a year ago
and they're like, oh, I saw this person
like a year ago for a swallow study
and they're in with respiratory issues
(08:41):
picking liquid. So it's having that conversation
of what works for them. And I have
a, like, interesting story, one of those stories
where
I treated someone in inpatient rehab for a
a few times. I'm a contract employee of
PRN, so I'm kind of sporadic with who
I get to see. But they had he
(09:01):
had a brainstem stroke and had pretty significant
dysarthria and dysphagia and discharged
on thickened liquids, on nectar thick liquids,
and I think a regular diet,
but did not like them. And I remember
this was before I actually had Naturally Nectar
smoothies bottled and ready, but I was telling
them, like, just make a smoothie. Right? Get
(09:24):
yourself a good blender, and and we'll talk
a little bit more about that. But get
a really good blender and use yogurt, use
bananas, use fruit to make a thickened liquid.
And, you know, now we have Ipsy where
we can actually measure that so easily. When
I was saying this to patients, like, ten
years ago, we're using, like, a spoon tilt
test and, like, oh, I think that looks
nectar thick.
(09:44):
But now we have the flow test, which
is so precise and so great. Well, fast
forward, that same patient
came back for an outpatient modified barium swallow
study over a year later. It's like, wow.
This is a cry. I can't believe I
get to see you again, but what's going
on? And I'm like, we're just, I'm coughing.
I'm coughing all the time. And he had
(10:05):
been advanced at Thin Liquid safely, and they
had found that, like, a head turn strategy
was good. It was scaring him, and it
was scaring his wife even though he had
no history of pneumonia. And we did the
swallow study again and kind of found the
same results. Like, you can drink them liquids
without aspirating, but you hang your head to
the left. And
cognitively, that that was a little tricky for
(10:25):
him. But with nectar thick liquids, he didn't
have to do a strategy. He could drink.
He could, like, drink multiple sips and be
just fine. So we had a conversation again
about
what
makes you feel the most confident, make what
makes you feel comfortable.
You know, you can drink thin liquids. We
we have pretty good support that you're not
gonna get aspiration pneumonia, but this cough is
(10:46):
scaring you. He's at home for long periods
of time by himself. So that's where we
had to go back and talk about, well,
you know, you can do it doesn't have
to be one or the other. You can
do both and and revisited that that smoothie
situation too. So I found that sometimes
diet modifications
give people a little bit more confidence in
certain scenarios,
(11:07):
which
I I don't think sometimes we realize as
clinicians how
anxiety
provoking dysphagia can be for people Yeah. And
hearing people's stories. Like, it just to live
with that anxiety
with every meal can can be really stressful.
So if we can do anything to make
that easier, I think that is, like, part
of our scope of practice. Yeah. Yeah. Thank
(11:29):
thank you for sharing that, Ali. It's I've
experienced that same thing with my son too
is, you know, we've gotten the modifieds. We've
we've done the swallow studies, and he does
not
aspirate. But the crazy thing is he gets
these awful coughing fits with very thin liquid.
So, you know, I usually we usually give
him, you know, yogurt smoothies and things like
that to begin with. He just does better
with things that are thicker,
(11:50):
not from an aspiration standpoint, but once he
gets those coughing attacks, he doesn't want to
drink anymore, you know, to him, you know,
that's his, his body and where he is
cognitively, that's just saying, you know, this is
danger no more, you know? And when he
has those coughing fits, he just shuts down.
So we try to do whatever we can
not to have those in the first place.
So, yeah, so many interesting,
(12:11):
you know, perspectives to consider and and just
all patient centered care and how how can
we just help our patients get what they
want, you know, regardless of what we think
they want. So, yeah, like I said, Ally,
I I've just loved watching this whole journey.
I feel like I've been on this journey
with you whether you feel like I have
or not. I've I've decided I am.
But, yeah, tell us where we are now.
Because I know last I spoke with you,
(12:31):
you were in in the makeup phase, and
and I just loved everything you were doing.
So catch us up to speed. Yeah. Okay.
Sure. Yeah. So right now, I have one,
packaged
shelf stable ready to drink smoothie. It's banana
flavored.
Some people do not like bananas, which I
get. We learned that. Yes. Some people
yes. Yes. I got some very funny reactions
(12:52):
at ASHA that I will forever cherish. Yes.
Yes. But then some people love it. And,
so that's the flavor. Now I have, before
researching and figuring out the manufacturing side of
things, and I've had some wonderful food scientist
help me with this because food is like
yeah. Incredible. Absolutely incredible.
How they can take, you know, something that
(13:14):
you make in your kitchen and get it
manufacture ready and shelf stable and safe safe
for people because last thing that we want
is anyone getting harmed.
So I have bunches of recipes that I'm
just ready to, you know, step by step
get them manufactured,
so that people have more variety.
And the other question everyone asks is when
are when does Honey Fit come out? When
(13:36):
does moderately thick come out? It's like, well,
that's it. That That will be another Back
in the kitchen, Ally. Back in the kitchen.
Back in the kitchen. Back to the plunder.
Yeah.
That will that will be coming. But I
do wanna get folks more flavors,
before going back to the drawing board and
and doing moderately thick just because,
(13:56):
I I feel like that's been the most
feedback that I have received. And I do
feel like, clinically, we tend to lean more
you see people on nectar thick a little
bit more than any thick or moderately thick.
Now I have I recently talked with some
pediatric speech pathologists and they're like, oh, well,
we're ready for that honey thick because they,
tend to use it a little bit more
(14:18):
and work on that weaning. But, yeah, it's
been a fun journey. It's been,
a passion project. I don't think I knew
what I was getting myself. You did not
all, which I love that so much.
It has been all consuming, and it's been
great to have a supportive family and friends
too too. It makes all the difference. It
(14:38):
truly does. Yeah. Yeah. Yeah. Well, so so
talk to me, Ali. I love what you
just said there is so without giving away
your, you know, proprietary recipe or anything like
that, I know the main ingredient in that,
in the stability of the nectar is the
banana. So if you are able to do
other flavors, are you thinking I'm still leaving
that banana base, or are you looking to
create your recipe with some different fruit fibers?
(14:58):
I'm just I'm so curious because I think
this is so cool. Yeah. I love that
you asked that too because that's one of
my fruit fun facts is that you don't
want to blend bananas
with a lot of other fruit and vegetables
because they have a special enzyme that, like,
takes away the wonderful antioxidant properties of a
lot of fruit and vegetables.
And actually,
(15:20):
speech pathologist at ASHA surprised me with this
question. She's like, did you know? I was
like, actually, I did. That's one that's one
I know.
So even if you're making a smoothie at
home, you want to do the banana by
itself. You know, if you're gonna do a
banana smoothie, you don't wanna mix it with
blueberries. Blueberries have wonderful,
antioxidant properties that support like cardiovascular
(15:42):
health, cognitive health.
So keep the bananas
by themselves. They don't play well with others.
So banana will be I I do have
plans to use it in a coffee because
it is a nice thickener, and I've got
a banoffee coffee recipe that is, in my
opinion, one of the best. When you get
that, I will drink that.
(16:04):
Yes. Definitely.
Absolutely.
But as far as some other fruit recipes,
like, I was talking about blueberries, like, blueberries
will be by themselves without the banana. And,
blueberries are fun to play with too because
they've got a lot of pectin in them.
So if you think of your jams and
jellies,
like, they've got this natural thickening property
(16:26):
about them.
So if you make a blueberry if you
experiment at home, you are making the blueberry
smoothie and you you're like, okay, I did
a couple blueberries to about a cup of
water and it comes out too thin. Let
it sit on the counter for about thirty
minutes because that bad boy will get to
be about an extra thick consistency or even
honey thick depending on your ratios.
(16:46):
And some other supportive ingredients that I wanna
play with or have been playing with are
cheese seeds. They are a nice natural thickener.
They create like a gel when they're soaked.
Is that and it's also just really healthy
for you in general to do like a
chia pudding or chia seed, beverage.
You soak chia seeds for a few hours.
(17:07):
And, but if you are using them in
a smoothie, you really want a high powered
blender
to cut through the chia seed and really
get it down to a smooth consistency.
I've learned that not all blenders are created
equal with this experimentation,
this process.
And,
(17:28):
I am not supported by Vitamix. I'm not
associated with them, but a Vitamix blender is
what I always
recommend to my patients if they are the
kind of
individual who's like, I'm gonna do this myself.
You know? I'm gonna make my own smoothies.
It's a great in a Vitamix blender. Because
if you wanna add seeds and nuts, that
mix really chops it down so nicely.
(17:48):
Yeah. Actually, you puree
food for your son. Right? Do you guys
have a special food processor? We do. I
do sometimes. Yeah. For the most part, I
try to just keep things pretty easy,
you know, like mashed potatoes, things like that
for him.
But, yeah, we I I do have a
Vitamix. My, I do have a nanny that
helps out making him food too, and sometimes
she'll just use, like, a magic bullet. But
(18:10):
if it's Mhmm. You know, because that's easier
to get out than the whole big Vitamix.
But if we're doing, like I'll because I'll
we'll prep his food so we have it
in the freezer for months just so we
have I just pull a few bags out
to send to school for lunch every day.
So we'll get out the middle of Vitamix
when we do that. Yeah. I actually
I had it it broke last year. I
think I'd had it for probably twelve years
(18:30):
to begin with, and it broke, and we
put it in we sent it to get
refurbished.
That was still probably the best $300 I've
ever spent was to even, like, continue getting
it refurbished because it just works
so well. So, yeah, I have zero affiliation
to Vitamix either. I just I yes.
It's a wonderful, wonderful tool.
I never thought I would spend so much
on a blender. Correct. Correct. Correct. I I
(18:52):
remember when I I remember when I was
married, and I I told my my husband
at the time. I said, you know, I
really want this Vitamix for Christmas or my
birthday or whatever. And he was like, is
this a trick? Like, I you want me
to buy you a blender and you're not
gonna be mad that you got a blender?
I'm like, no. This is what I want.
I promise.
Like
Big, fancy blender. Yeah. Yeah. Yeah. No. I
will not be sad. I got a blender
(19:13):
for Christmas. I will be ecstatic. Yes.
It's part of growing up. We ask for
household appliances. Yeah. It is. That is. That's
adulting at its finest. Yeah. Oh my god.
Okay. So alright. So, Ally, so you have
the one you have the one product now.
You're looking to expand the product suite. Where
can people get the product now? Yeah. Great
question. So directly from my website, naturalnectar.org
(19:36):
slash,
order is the easiest way right now. I
am looking to try to get into some
pharmacies, especially local pharmacies,
and other local stores. So if you're listening
to this and you're like, I know someone
at our local pharmacy and I want them
to carry it or if your clinic wants
to carry it, I do offer wholesale prices
to make it a little bit more affordable
(19:58):
and accessible for people because that's my main
goal goal is to to get it to
the point where people can easily access it,
whether it's, like, going to their pharmacy.
Hopefully, one day ordering off of Amazon. Haven't
quite gotten there yet. So right now, available
online,
but
happy to to hear any recommendations if anyone's
like, you need to be in this pharmacy.
(20:20):
So that's where I'm at right now. So
if you're thinking of making thickened liquids at
home, if you've got a patient and a
care giver who, you know, feel confident taking
that on and and want to put that
time into that, you know, we talked about
a high speed blender.
I have found that Vitamix is great.
Another great tool is a food scale because
(20:41):
once you find a good recipe that you
like, having that recipe written down in grams
and with that precision
is really helpful so that you can repeat
it. And I actually do have a recipe
that I don't plan to package because it's
a little complex. It's got a lot of
ingredients.
A recipe on my website that, I think
it's called a tropical green smoothie. It's got
(21:01):
a lot of good supportive ingredients in there,
but it's everything's measured out in grams so
that it's really precise and people can follow
it really easily.
And then, of course, our famous IDDSI syringe.
Right?
And IDDSI makes a syringe that or a
funnel that's very easy to read that you
(21:21):
can purchase.
It has a nice
open barrel at the top so that you
can pour your liquid in there and measure
it easily. But I found that a lot
of hospitals carry they've got a couple other
syringes on their website that they say is
compliant with, you know, the flow test.
And this one is
that I use is the BD
(21:41):
Lurelok
10 ml syringe.
And I believe there's a slip tip too,
and I always grab these if I have
someone leaving on nectar thick liquids. Even if
they're not making smoothies, even if they're using
simply thick or thick it or any other
thickener, I'll grab this so that they can
feel confident
doing a flow test if they want to.
Because too many times we have people say,
(22:03):
well, I just kept thickening it because, like,
I didn't feel like it was getting thick
enough. It's like, woah. Woah. Woah. You're gonna
end up with putting thick liquids here.
So I always grab one of these for
for my patients and, of course, a timer
and teach them how to do we all
have timers on our phone. And this is
this is how naturally Nectar started. It started,
like, in my kitchen playing with these recipes.
(22:25):
I kinda went a little overboard and started
microwaving
my recipes too or putting them in the
fridge to make sure they stayed consistent through
and through, stayed within that nectar thick consistency.
But that is all the materials I can
think of that you would use other than
your ingredients,
to make your own nectar thick smoothies or
(22:46):
honey thick smoothies at home.
Awesome. Well, like I said, I've I've just
loved this so much, Ally. I love the
way you've gone about creating the whole thing.
And, you know, I I she had come
to our,
live event for the Minnesota Collective and gave
out samples and asked everybody to fill out
a survey, and I just thought that was
so well done. And then you also did
that at ASHA too, just gave out tons
of free samples of what you had done
and just asked people for feedback in a
(23:08):
in a Google survey. And and I just
think that's a great way to get get
some market research done on what people like.
And that was when you were getting the
feedback that some people don't like banana, and
it's like, well, who do? You know? It's
yeah. So, anyways, like I said, I've I've
loved this whole process, Ali, and I I
love this product, and I think it's gonna
be so helpful for so many patients. And,
you know, I know that we have, you
(23:29):
know, other wonderful thickener products on the market,
but this just meets a need that hasn't
been
addressed yet. And I just commend you for
for going that way. So, if anybody's interested
in checking out Allie's products some more, what's
the website? Naturallynectar..org.
.Org. Okay. So we will have all that
in the show notes. And any anything else
(23:49):
you wanna share with the people, Ally?
No. Not not in particular or, I guess,
also, if anyone's interested in
researching,
you know, how how a naturally thickened brand
does compared to other thickened liquids, I would
feel free to reach out to me over
LinkedIn or or Instagram. I'd love to hear
from you. I'd love to hear your thoughts.
And I'm always happy to try to get
(24:10):
samples to speech pathologist as well the best
that I can, so that you can try
them and potentially try them with your clients
if you like. Awesome. Awesome. Thank you so
so much, Allie. Yeah. Thanks so much, Teresa.
I appreciate you.
And that's a wrap for this episode.
As always, thank you so much for listening.
And if you'd like to download the show
notes from this episode, please visit swallowyourpridepodcast.com.
(24:33):
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(24:57):
Thank you so much for listening, and we'll
catch you next week.
Welcome to the Swallow Your Pride podcast. I'm
your host, Teresa Richard. I'm a board certified
specialist in swallowing and swallowing disorders,
a mobile thieves business owner, and founder of
the MedSLP Collective.
This podcast is all about delivering the latest
evidence based practice to medical
SLPs everywhere.
Whether you're a new clinician seeking tangible tools
for treatment or a seasoned vet stuck in
(00:33):
a rut, my goal is to help ditch
the old school ways of the past that
no longer serve you or your patients, to
reinvigorate your passion for our field, to broaden
your knowledge about our scope of practice, and
to inspire you to practice at the top
of your license. So if you're listening, I
encourage you to swallow your pride, be open
and willing to learn because let's face it,
your patients deserve that kind of care. With
(00:54):
that, let's dive right in.
Just a quick disclaimer that all statements and
opinions expressed in this episode do not reflect
on the organizations
associated with the speakers and are their own
opinions solely. Alright. Good afternoon, Ally. Hi, Theresa.
How are you? Good. Thank you so much
for joining me. Yeah. Thanks so much for
having me. I have been listening to your
podcast since it came out in 2017.
(01:15):
Oh, wow. Yes. Awesome. Yeah.
It's been such a supportive,
like, quick
educational,
opportunity. It it came out when I was
still a a clinical fellow myself. So Oh
my gosh. Thank you for, like, having this
podcast as a very accessible educational resource for
(01:35):
all of us. Yeah. Awesome. And now full
circle, you're on it. So awesome. Alright. So
yeah. So today's guest is Allie Roberts. She's
a North Carolina based SLP and the founder
of NaturallyNectar.
With a decade of experience across acute care,
LTCH, and inpatient rehab, Allie has spent her
career at the intersection of complex dysphasia management
and patient advocacy.
Driven by a passion for patient centered care,
(01:57):
Ally founded Naturally Nectar to bridge the gap
between medical need and dignified dining. Her company
reimagines thickened liquids by creating IDDSI level two
clean ingredient smoothies thickened with natural fruit fiber
rather than traditional starch or gum thickeners. Ally
earned her bachelor's from Appalachian State University and
her master's from Gallaudet. When she's not innovating
(02:17):
in the dysphagia space, she's likely enjoying a
group exercise class or enjoying the outdoors
love that, Ally. And I just wanna say
I absolutely love the entire approach you've taken
to creating this product, and I can't wait
to chat more about it. But it was
just so,
no pun intended, natural.
And in the way, you know, you've reached
(02:39):
out to me. You've reached out to people
on our team. We just had conversations about
it. You had people try the product. You
sent them surveys. And the more I got
talking to you, you know, you were like,
well, I just wanna get feedback from people,
see if it's even a viable product. And
I think that's just what I wanna emphasize
to so many business owners out there. So
many people dump so much time and resources
into things
because they think it's the exact product without
(03:00):
getting feedback and iterations from other SLPs. So
I just think from a fellow business owner,
I've loved the whole way you've built this,
marketed it because I think it's just spot
on and it's so many lessons here for
for other SLPs because I know there's a
a ton of brilliant SLPs out there that
have ideas brewing and just Yeah. Don't know
where to start. So, from that point, Ali,
go ahead and share a little bit about
(03:21):
yourself, your background, why we're here, where this
came from. Take it away. K. Thank you
so much. Thank you. That was, so kind
of you to say.
Yes. This has definitely been like a grassroots
approach through and through.
So my background is I have always worked
with adults and started in a long term
acute care facility where I really got to
get to see the sickest of the sick
(03:42):
folks.
Worked with a lot of trach and vent
patients. And
from there, I've been in acute care for
about nine years or so, and that's really
been my home where I just, like, am
always problem solving, seeing different patients every day.
So that has been my home for for
the past,
yeah, for the rest of my career. I
also flow into inpatient rehab
(04:03):
and do outpatient swallow study. So I really
get to see everyone, like, across the spectrum
of care, which I think is so important
for us as clinicians because, you know, the,
elephant in the room is thick and liquids.
Right? And we have so many varying opinions
on thick and liquids, and the research is
is mixed.
If there always needs to be more research,
(04:24):
I hope I can be a part of
that. I hope naturally, Nectar can be a
part of the research space one day soon.
But, you know, it just brings us back
to the bedside and that we have to
take each patient case by case. And,
you know, the research support that I take
from an article might, you know, be perfect
for one patient, but it might not be
(04:46):
the most supportive evidence for another patient just
depending how they're doing in that moment.
So I definitely when I'm considering recommendations
for folks, especially when it comes to modifying
diets,
You know, I treat or I look at
folks clinically different if I'm treating someone at
the bedside and they are, like, day one
post stroke or they have a bunch of
(05:07):
medical
comorbidities
versus, you know, my patient who has had
head and neck cancer and they have chronic
dysphagia from
radiation treatment. You know, they handle a lot
more aspiration,
without that risk of
lesser risk of aspiration pneumonia. So that's my
background. And, naturally, nectar was sparked from my
(05:30):
patients, from treating patients over the years and
just hearing the same old tired complaints of,
like, I don't wanna drink this. This is
gross. You drink this. And,
I can't blame them sometimes. And I do
have folks who love it, who are, like,
totally compliant and they're like, oh, this is
great. And I have had folks who say,
actually, like, let's try thickening. Like, it gives
(05:52):
them more confidence. So it just speaks to,
again, coming back to, like, putting our patients
first and talking to our patients and their
caregivers and what they need.
I I actually love that you just said
that, Ally, because I think I've had a
lot of humbling moments in my career.
And I think the first the biggest humble
most humbled I felt was when I just
(06:15):
assumed everybody wanted to work so hard to
get off thickened liquids. And it almost surprised
me when I had patients that said, well,
I honestly I don't mind them, and I
know I'm at a lesser risk of aspiration
being on them. So I would just rather
be on them than do therapy, and I'm
okay with it. And I heard that a
few times, and I was just absolutely floored.
(06:35):
And I think that was sort of the
beginning of my crusade of, like, patient centered
care,
you know, and and saying that, you know,
I've I've as I've shared, I've been humbled
with my son's experience of getting him a
feeding tube too. You know? I just assume
nobody wants to have a feeding tube, and
and I've been greatly humbled by how much
of an impact it's had on us in
a positive way. And so I I think
it's it's so interesting that we, as clinicians
(06:56):
ourselves, have these cognitive biases about things we
assume our patients want or don't want without
even having these conversations. So, yeah, you're so
right that, you know, some patients really just
don't mind being on the thickened liquid. So
then how do we make it the best,
most nutritious product for them that we can?
Yeah. Absolutely. Absolutely. And, yeah, I, like, thought
(07:18):
about your son actually the other day because
I appreciate how much you share,
with your audience. And I had a patient,
like, just when it comes to modified diets
in general,
a a patient with special needs whose,
mom we were trying to get him back
to his regular diet or I was, I
should say. And we got him to, like,
a minced and moist diet safely, and the
big concern was eating a 100% because he
(07:38):
didn't have, like, another source of nutrition.
And he came in from home with, you
know, having
eating issues, and she's like, actually,
we're good here. You know, once we got
to midst and where she's like, he's eating
a 100%.
It's easy. Like, I don't wanna go any
further. And he's like, that's fine. That's great.
And I had to, like, turn that switch
(07:59):
in my, you know, diet advancement brain of,
like, least restrictive diet to turn it off
and say, you know what? Right now, this
is where they're at and this is what
they need, and this is gonna help him
get home and get back to his his
previous level as function his normal. That's what
I'm, yeah, out to do with naturally nectar
as well,
(08:19):
because those folks who do avoid thickened liquids,
I I have seen folks come in and
out of the hospital, you know, working in
multiple settings. You see that
sometimes or you can, like, filter
and find your notes from a year ago
and they're like, oh, I saw this person
like a year ago for a swallow study
and they're in with respiratory issues
(08:41):
picking liquid. So it's having that conversation
of what works for them. And I have
a, like, interesting story, one of those stories
where
I treated someone in inpatient rehab for a
a few times. I'm a contract employee of
PRN, so I'm kind of sporadic with who
I get to see. But they had he
(09:01):
had a brainstem stroke and had pretty significant
dysarthria and dysphagia and discharged
on thickened liquids, on nectar thick liquids,
and I think a regular diet,
but did not like them. And I remember
this was before I actually had Naturally Nectar
smoothies bottled and ready, but I was telling
them, like, just make a smoothie. Right? Get
(09:24):
yourself a good blender, and and we'll talk
a little bit more about that. But get
a really good blender and use yogurt, use
bananas, use fruit to make a thickened liquid.
And, you know, now we have Ipsy where
we can actually measure that so easily. When
I was saying this to patients, like, ten
years ago, we're using, like, a spoon tilt
test and, like, oh, I think that looks
nectar thick.
(09:44):
But now we have the flow test, which
is so precise and so great. Well, fast
forward, that same patient
came back for an outpatient modified barium swallow
study over a year later. It's like, wow.
This is a cry. I can't believe I
get to see you again, but what's going
on? And I'm like, we're just, I'm coughing.
I'm coughing all the time. And he had
(10:05):
been advanced at Thin Liquid safely, and they
had found that, like, a head turn strategy
was good. It was scaring him, and it
was scaring his wife even though he had
no history of pneumonia. And we did the
swallow study again and kind of found the
same results. Like, you can drink them liquids
without aspirating, but you hang your head to
the left. And
cognitively, that that was a little tricky for
(10:25):
him. But with nectar thick liquids, he didn't
have to do a strategy. He could drink.
He could, like, drink multiple sips and be
just fine. So we had a conversation again
about
what
makes you feel the most confident, make what
makes you feel comfortable.
You know, you can drink thin liquids. We
we have pretty good support that you're not
gonna get aspiration pneumonia, but this cough is
(10:46):
scaring you. He's at home for long periods
of time by himself. So that's where we
had to go back and talk about, well,
you know, you can do it doesn't have
to be one or the other. You can
do both and and revisited that that smoothie
situation too. So I found that sometimes
diet modifications
give people a little bit more confidence in
certain scenarios,
(11:07):
which
I I don't think sometimes we realize as
clinicians how
anxiety
provoking dysphagia can be for people Yeah. And
hearing people's stories. Like, it just to live
with that anxiety
with every meal can can be really stressful.
So if we can do anything to make
that easier, I think that is, like, part
of our scope of practice. Yeah. Yeah. Thank
(11:29):
thank you for sharing that, Ali. It's I've
experienced that same thing with my son too
is, you know, we've gotten the modifieds. We've
we've done the swallow studies, and he does
not
aspirate. But the crazy thing is he gets
these awful coughing fits with very thin liquid.
So, you know, I usually we usually give
him, you know, yogurt smoothies and things like
that to begin with. He just does better
with things that are thicker,
(11:50):
not from an aspiration standpoint, but once he
gets those coughing attacks, he doesn't want to
drink anymore, you know, to him, you know,
that's his, his body and where he is
cognitively, that's just saying, you know, this is
danger no more, you know? And when he
has those coughing fits, he just shuts down.
So we try to do whatever we can
not to have those in the first place.
So, yeah, so many interesting,
(12:11):
you know, perspectives to consider and and just
all patient centered care and how how can
we just help our patients get what they
want, you know, regardless of what we think
they want. So, yeah, like I said, Ally,
I I've just loved watching this whole journey.
I feel like I've been on this journey
with you whether you feel like I have
or not. I've I've decided I am.
But, yeah, tell us where we are now.
Because I know last I spoke with you,
(12:31):
you were in in the makeup phase, and
and I just loved everything you were doing.
So catch us up to speed. Yeah. Okay.
Sure. Yeah. So right now, I have one,
packaged
shelf stable ready to drink smoothie. It's banana
flavored.
Some people do not like bananas, which I
get. We learned that. Yes. Some people
yes. Yes. I got some very funny reactions
(12:52):
at ASHA that I will forever cherish. Yes.
Yes. But then some people love it. And,
so that's the flavor. Now I have, before
researching and figuring out the manufacturing side of
things, and I've had some wonderful food scientist
help me with this because food is like
yeah. Incredible. Absolutely incredible.
How they can take, you know, something that
(13:14):
you make in your kitchen and get it
manufacture ready and shelf stable and safe safe
for people because last thing that we want
is anyone getting harmed.
So I have bunches of recipes that I'm
just ready to, you know, step by step
get them manufactured,
so that people have more variety.
And the other question everyone asks is when
are when does Honey Fit come out? When
(13:36):
does moderately thick come out? It's like, well,
that's it. That That will be another Back
in the kitchen, Ally. Back in the kitchen.
Back in the kitchen. Back to the plunder.
Yeah.
That will that will be coming. But I
do wanna get folks more flavors,
before going back to the drawing board and
and doing moderately thick just because,
(13:56):
I I feel like that's been the most
feedback that I have received. And I do
feel like, clinically, we tend to lean more
you see people on nectar thick a little
bit more than any thick or moderately thick.
Now I have I recently talked with some
pediatric speech pathologists and they're like, oh, well,
we're ready for that honey thick because they,
tend to use it a little bit more
(14:18):
and work on that weaning. But, yeah, it's
been a fun journey. It's been,
a passion project. I don't think I knew
what I was getting myself. You did not
all, which I love that so much.
It has been all consuming, and it's been
great to have a supportive family and friends
too too. It makes all the difference. It
(14:38):
truly does. Yeah. Yeah. Yeah. Well, so so
talk to me, Ali. I love what you
just said there is so without giving away
your, you know, proprietary recipe or anything like
that, I know the main ingredient in that,
in the stability of the nectar is the
banana. So if you are able to do
other flavors, are you thinking I'm still leaving
that banana base, or are you looking to
create your recipe with some different fruit fibers?
(14:58):
I'm just I'm so curious because I think
this is so cool. Yeah. I love that
you asked that too because that's one of
my fruit fun facts is that you don't
want to blend bananas
with a lot of other fruit and vegetables
because they have a special enzyme that, like,
takes away the wonderful antioxidant properties of a
lot of fruit and vegetables.
And actually,
(15:20):
speech pathologist at ASHA surprised me with this
question. She's like, did you know? I was
like, actually, I did. That's one that's one
I know.
So even if you're making a smoothie at
home, you want to do the banana by
itself. You know, if you're gonna do a
banana smoothie, you don't wanna mix it with
blueberries. Blueberries have wonderful,
antioxidant properties that support like cardiovascular
(15:42):
health, cognitive health.
So keep the bananas
by themselves. They don't play well with others.
So banana will be I I do have
plans to use it in a coffee because
it is a nice thickener, and I've got
a banoffee coffee recipe that is, in my
opinion, one of the best. When you get
that, I will drink that.
(16:04):
Yes. Definitely.
Absolutely.
But as far as some other fruit recipes,
like, I was talking about blueberries, like, blueberries
will be by themselves without the banana. And,
blueberries are fun to play with too because
they've got a lot of pectin in them.
So if you think of your jams and
jellies,
like, they've got this natural thickening property
(16:26):
about them.
So if you make a blueberry if you
experiment at home, you are making the blueberry
smoothie and you you're like, okay, I did
a couple blueberries to about a cup of
water and it comes out too thin. Let
it sit on the counter for about thirty
minutes because that bad boy will get to
be about an extra thick consistency or even
honey thick depending on your ratios.
(16:46):
And some other supportive ingredients that I wanna
play with or have been playing with are
cheese seeds. They are a nice natural thickener.
They create like a gel when they're soaked.
Is that and it's also just really healthy
for you in general to do like a
chia pudding or chia seed, beverage.
You soak chia seeds for a few hours.
(17:07):
And, but if you are using them in
a smoothie, you really want a high powered
blender
to cut through the chia seed and really
get it down to a smooth consistency.
I've learned that not all blenders are created
equal with this experimentation,
this process.
And,
(17:28):
I am not supported by Vitamix. I'm not
associated with them, but a Vitamix blender is
what I always
recommend to my patients if they are the
kind of
individual who's like, I'm gonna do this myself.
You know? I'm gonna make my own smoothies.
It's a great in a Vitamix blender. Because
if you wanna add seeds and nuts, that
mix really chops it down so nicely.
(17:48):
Yeah. Actually, you puree
food for your son. Right? Do you guys
have a special food processor? We do. I
do sometimes. Yeah. For the most part, I
try to just keep things pretty easy,
you know, like mashed potatoes, things like that
for him.
But, yeah, we I I do have a
Vitamix. My, I do have a nanny that
helps out making him food too, and sometimes
she'll just use, like, a magic bullet. But
(18:10):
if it's Mhmm. You know, because that's easier
to get out than the whole big Vitamix.
But if we're doing, like I'll because I'll
we'll prep his food so we have it
in the freezer for months just so we
have I just pull a few bags out
to send to school for lunch every day.
So we'll get out the middle of Vitamix
when we do that. Yeah. I actually
I had it it broke last year. I
think I'd had it for probably twelve years
(18:30):
to begin with, and it broke, and we
put it in we sent it to get
refurbished.
That was still probably the best $300 I've
ever spent was to even, like, continue getting
it refurbished because it just works
so well. So, yeah, I have zero affiliation
to Vitamix either. I just I yes.
It's a wonderful, wonderful tool.
I never thought I would spend so much
on a blender. Correct. Correct. Correct. I I
(18:52):
remember when I I remember when I was
married, and I I told my my husband
at the time. I said, you know, I
really want this Vitamix for Christmas or my
birthday or whatever. And he was like, is
this a trick? Like, I you want me
to buy you a blender and you're not
gonna be mad that you got a blender?
I'm like, no. This is what I want.
I promise.
Like
Big, fancy blender. Yeah. Yeah. Yeah. No. I
will not be sad. I got a blender
(19:13):
for Christmas. I will be ecstatic. Yes.
It's part of growing up. We ask for
household appliances. Yeah. It is. That is. That's
adulting at its finest. Yeah. Oh my god.
Okay. So alright. So, Ally, so you have
the one you have the one product now.
You're looking to expand the product suite. Where
can people get the product now? Yeah. Great
question. So directly from my website, naturalnectar.org
(19:36):
slash,
order is the easiest way right now. I
am looking to try to get into some
pharmacies, especially local pharmacies,
and other local stores. So if you're listening
to this and you're like, I know someone
at our local pharmacy and I want them
to carry it or if your clinic wants
to carry it, I do offer wholesale prices
to make it a little bit more affordable
(19:58):
and accessible for people because that's my main
goal goal is to to get it to
the point where people can easily access it,
whether it's, like, going to their pharmacy.
Hopefully, one day ordering off of Amazon. Haven't
quite gotten there yet. So right now, available
online,
but
happy to to hear any recommendations if anyone's
like, you need to be in this pharmacy.
(20:20):
So that's where I'm at right now. So
if you're thinking of making thickened liquids at
home, if you've got a patient and a
care giver who, you know, feel confident taking
that on and and want to put that
time into that, you know, we talked about
a high speed blender.
I have found that Vitamix is great.
Another great tool is a food scale because
(20:41):
once you find a good recipe that you
like, having that recipe written down in grams
and with that precision
is really helpful so that you can repeat
it. And I actually do have a recipe
that I don't plan to package because it's
a little complex. It's got a lot of
ingredients.
A recipe on my website that, I think
it's called a tropical green smoothie. It's got
(21:01):
a lot of good supportive ingredients in there,
but it's everything's measured out in grams so
that it's really precise and people can follow
it really easily.
And then, of course, our famous IDDSI syringe.
Right?
And IDDSI makes a syringe that or a
funnel that's very easy to read that you
(21:21):
can purchase.
It has a nice
open barrel at the top so that you
can pour your liquid in there and measure
it easily. But I found that a lot
of hospitals carry they've got a couple other
syringes on their website that they say is
compliant with, you know, the flow test.
And this one is
that I use is the BD
(21:41):
Lurelok
10 ml syringe.
And I believe there's a slip tip too,
and I always grab these if I have
someone leaving on nectar thick liquids. Even if
they're not making smoothies, even if they're using
simply thick or thick it or any other
thickener, I'll grab this so that they can
feel confident
doing a flow test if they want to.
Because too many times we have people say,
(22:03):
well, I just kept thickening it because, like,
I didn't feel like it was getting thick
enough. It's like, woah. Woah. Woah. You're gonna
end up with putting thick liquids here.
So I always grab one of these for
for my patients and, of course, a timer
and teach them how to do we all
have timers on our phone. And this is
this is how naturally Nectar started. It started,
like, in my kitchen playing with these recipes.
(22:25):
I kinda went a little overboard and started
microwaving
my recipes too or putting them in the
fridge to make sure they stayed consistent through
and through, stayed within that nectar thick consistency.
But that is all the materials I can
think of that you would use other than
your ingredients,
to make your own nectar thick smoothies or
(22:46):
honey thick smoothies at home.
Awesome. Well, like I said, I've I've just
loved this so much, Ally. I love the
way you've gone about creating the whole thing.
And, you know, I I she had come
to our,
live event for the Minnesota Collective and gave
out samples and asked everybody to fill out
a survey, and I just thought that was
so well done. And then you also did
that at ASHA too, just gave out tons
of free samples of what you had done
and just asked people for feedback in a
(23:08):
in a Google survey. And and I just
think that's a great way to get get
some market research done on what people like.
And that was when you were getting the
feedback that some people don't like banana, and
it's like, well, who do? You know? It's
yeah. So, anyways, like I said, I've I've
loved this whole process, Ali, and I I
love this product, and I think it's gonna
be so helpful for so many patients. And,
you know, I know that we have, you
(23:29):
know, other wonderful thickener products on the market,
but this just meets a need that hasn't
been
addressed yet. And I just commend you for
for going that way. So, if anybody's interested
in checking out Allie's products some more, what's
the website? Naturallynectar..org.
.Org. Okay. So we will have all that
in the show notes. And any anything else
(23:49):
you wanna share with the people, Ally?
No. Not not in particular or, I guess,
also, if anyone's interested in
researching,
you know, how how a naturally thickened brand
does compared to other thickened liquids, I would
feel free to reach out to me over
LinkedIn or or Instagram. I'd love to hear
from you. I'd love to hear your thoughts.
And I'm always happy to try to get
(24:10):
samples to speech pathologist as well the best
that I can, so that you can try
them and potentially try them with your clients
if you like. Awesome. Awesome. Thank you so
so much, Allie. Yeah. Thanks so much, Teresa.
I appreciate you.
And that's a wrap for this episode.
As always, thank you so much for listening.
And if you'd like to download the show
notes from this episode, please visit swallowyourpridepodcast.com.
(24:33):
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If you'd like to be a guest, share
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on the show, please email podcast@TeresaRichard.com.
(24:57):
Thank you so much for listening, and we'll
catch you next week.
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