December 2022 Newsletter

Merry Christmas!

We know you have options and we appreciate your trust and support of our service and staff over the years. DFW area is a big place but small at heart and the friendships we have developed over the years mean the most to us! This festive season, we wish all of you the priceless gift of peace that surpasses all understanding, as well as indescribable joy, quality health and blessings of prosperity at Christmas and throughout all of 2023.

Happy Birthday DiagnosTEX

DTEX turns 19 years old this year! We will be 20 years old in 2023! Pam and I would like to thank not only our customers and those who have supported us all of these years in DFW. We would also like to thank all of our employees for the many years of friendship, belly laughs, and so many priceless memories! Thank you for your hard work and commitment to what DiagnosTEX stands for! We truly treasure each and every one of our customers and employees and are blessed to have you all a part of our daily lives! To love what you do and the people you do it with is the true definition of success and happiness!

It’s a Giving Time of Year!

It is better to give than to receive and we enjoy giving back to you for teaming with us every year! Look for your Christmas gifts as December rolls in. The 2023 DiagnosTEX Dysphagia Calendar including DiagnosTEX Christmas pens! You will get yours next time we see you! Merry Christmas from us to you!

DiagnosTEX December Holiday Schedule

DiagnosTEX will close earlier on Friday December 2nd to celebrate our company’s birthday! DiagnosTEX will be closed Monday the 26th for an extended Christmas holiday and we will operate Tuesday-Friday that week. We will be operational the day after New Year’s Day on Monday January 2nd. We want to meet all of your MBSS needs; after all these years, we understand that PO feeding becomes very important on several levels to many patients and their families around the holidays. The days prior to the holidays are long for us as we work very hard to get everyone’s requests completed. We must also be considerate to all of our DiagnosTEX employees and their families. Please keep these holiday schedules in mind when scheduling your MBSS in December!

******Please take note during this busy time of year******
ASAP requests often cannot be accommodated to the satisfaction of those requesting it. Specific requests for specific times and/or days become exponentially difficult to accommodate and therefore, we may be unable to quickly schedule your patient with any specific time and day requests.
Please notify your staff, patients, and families as such. Being mobile allows the convenience of the service coming to you – not for the customized flexibility of schedules and times. We are a venue option for an MBSS and we must schedule our mobile clinics for efficiency and cost effectiveness. If you or the patient and family require a specific time and/or day with limited flexibility, please consider a free-standing outpatient facility (e.g., a hospital).

DiagnosTEX MBSS observers

Despite some regulations being lifted, we are entering the winter months of colds, flus, RSV and yes, still the annoying variants of COVID. DiagnosTEX is still following strict PPE protocol and at this time we are allowing masked healthcare staff to observer the MBSS standing in the stairwell only. We are still not allowing family members on board to observe, unless absolutely needed for the completion of the study. We operate a very small contained environment and we service many immune compromised individuals. There is very little room in the mobile clinic as it is and having more people in this small contained environment during this winter season with family not receiving regular screenings as the health care staff, it is too high a risk for us all at this time. We will revisit this policy in the spring.

DiagnosTEX MBSS results always available within 15 minutes after the study is completed

As many of you know so much has changed everywhere with everyone since COVID. DiagnosTEX staff is still not entering the buildings due to several strict policies implemented by some facilities and Corp groups that would force us into falling under their COVID policies and regulations by considering us “contract” if we enter the building making contact with the patients and this has caused several unnecessary obstacles. We service over 300 facilities (SNF, AL, Rehab, hospitals, memory care, HH, MD offices etc.) in the DFW area and there is no way we can meet everyone’s requirements, so to avoid this pitfall, we still do not enter the buildings to retrieve the patient or search out the SLP. One of the biggest changes and challenges we have also seen since 2020 is much less face to face contact with the facility SLP’s even though we are allowing staff (not family) on board again in the stairwell. We welcome the staff on board to collaborate and discuss results with but many chose not to attend. DiagnosTEX scheduling staff and the techs communicate with all facility and HH staff by text or phone call regarding schedule and arrival time. The hard part is, sometimes we get a response and sometimes we don’t. As always, we leave an MD and SLP report at the front desk or with the SLP, if we see them, before we pull away from the facility. All HH reports are faxed within 24 hours and if you need it before then, you can call the office and it will be emailed to you in a secure email. Due to the poor response we get to phone calls and text, as well as being placed on hold when we call facilities, our day does not allow for our SLP staff to call each and every facility back with the results once we have left them there. In addition to the fact, we cannot text MBSS results due to HIPAA compliance issues. If the speech therapist is on site, we would hope anyone who knows the patient received an MBSS would be on the lookout for the report that day (actually approximately 15 minutes after study is completed). If there is an emergency situation we feel needs addressed we will ask to speak to the SLP in person or the nurse on staff. We are always available to any of our customers to return calls by phone if you have you any additional questions.

Dysphagia Tidbit – Addressing swallowing difficulties after spine surgery can improve quality of life

Difficulty swallowing is one of the most common complications of anterior cervical spine surgery (ACSS). More than 70% of patients report dysphagia symptoms within two weeks following ACSS. Investigators who evaluated possible risk and contributing factors report in Advances in Communication and Swallowing that although most difficulties resolve within two months, the perception of swallowing difficulty can persist for longer, but this does not always correlate with test results. Contributing factors may include extent of surgery, prevertebral soft tissue swelling, or altered sensation secondary to nerve traction during surgery. Investigator Ashli K. O'Rourke, MD, Medical University of South Carolina examined post-operative swallowing changes in patients with dysphagia following ACSS compared with healthy age- and gender-matched individuals. They undertook this study to evaluate possible risk or contributing factors so that they could better identify patients who may be at risk and counsel patients more effectively before surgery. They also wanted to determine if there was a timepoint after surgery when dysphagia was likely to resolve due to improvement in factors such as prevertebral soft tissue swelling, sensation changes, or temporary nerve irritation after surgery. Eligible patients were identified using electronic medical records to cross-reference patients who underwent both ACSS and a modified barium swallow study, between January 2010 and October 2018. Investigators found that patients in the early phase of recovery had significantly more swallowing impairment and a higher incidence of material entering the lungs (aspiration) compared to healthy controls and patients in the late phase of recovery. Their findings agreed with previous studies that also showed improvement in swallowing after two months post-ACSS, with most patients able to return to normal diets shortly thereafter. The thickness of the throat/neck tissues was significantly greater in the ACSS patients at all time points following their surgery compared to healthy individuals.
John P. Ziegler et al, Characterization of dysphagia following anterior cervical spine surgery, Advances in Communication and Swallowing (2021). DOI: 10.3233/ACS-210034

DiagnosTEX QA Results – August 2022

Resultant from 294 performed MBSS in August, 54 recommendations were made for NPO (i.e., nothing by mouth) and subsequently alternate means of feeding for the main source of nutrition and hydration. Pureed diets were recommended for 70 (24%) of the cases, mechanical soft for 45 (15%), soft regular for 17 (6%) and a regular diet for 98 (33%). Liquid recommendations were as follows: thin liquid for 147 cases (50%), nectar thick liquid for 40 cases (14%), honey thick liquids for 39 cases (13%), and 3 cases (1%) for pudding thick liquids. 

The total number patients who aspirated during August 2022 MBSS performed by DiagnosTEX was 131.  Of the 131 patients who aspirated, 115 were silent aspirators.