April 2010 Newsletter


April 2010
Happy Spring, Happy Easter
Clinical Café Newsletter
By: Ronda Polansky M.S. CCC-SLP
Monthly Motivator:
When you remove the unnecessary layers you have the clarity to see what is truly important!
Upcoming May Conferences –Friday May 14th in DFW Deciphering Dysphagia with E-Stim Neuromuscular Re-education of the Submandibular Muscles to Increase Laryngeal Elevation Using Class II NMES Device  Limited space, sign up soon.  A registration form is included in this newsletter.     7.5 TSHA CEUs.  This will be the last one in the DFW area for awhile, don’t miss it!

TSHA – It was great to see everyone at TSHA, thanks for stopping by and saying hello! Pam and I plan on presenting next year in Houston!

May is Better Speech and Hearing Month  Get prepared at www.asha.org

Upcoming DiagnosTEX Holiday –  DiagnosTEX will observe Good Friday on April 2nd.  Please keep this in mind when scheduling your MBSS.  We wish everyone a glorious Easter Sunday.

Therapy Caps
Without further action by Congress, Medicare fee schedule cuts of 21.1% and continuance of the restrictive Part B therapy caps are still possible this April.

Local SLPs author a new book  Consultants in Dementia Therapy (CDT) is committed to providing resources and instruction in the development of dementia therapy and program development. The goal of CDT is to provide you with answers to give you assurance that your decisions are appropriate as you go forward building your dementia program (including dysphagia as it relates to dementia).  Following CDT’s proven model will help your patients with dementia achieve their highest level of function while following Medicare guidelines for reimbursement.  CDT provides step-by-step protocols on candidate identification, screening, evaluations, interventions, strategies and low cost activities appropriate for patients with dementia.
Order the seminar in a book: Dementia Therapy and Program Development.  Go to www.consultantsindementiatherapy.com  for information regarding the book, CDT membership and CEU opportunities.  It’s all about you providing the most appropriate care to your patients with dementia!

Visit the DiagnosTEX Clinical Café at www.dysphagiadiagnostex.com  for past newsletters and educational handouts and upcoming conferences. CEU courses will be posted on the calendar as we get them scheduled.  I plan on doing one on RARE disorders this year and Pam and I will repeat the ethics course by end of summer.

Helpful hints for pureed food

  1. Add small amounts of breadcrumbs to pureed soups, vegetables and casseroles.
  2. Add small amounts of low fat sauces and gravy when pureeing rice and noodles.
  3. Add liquids that complement the flavor of the food.  For example add chicken broth to pureed chicken or low fat turkey gravy to pureed turkey.
  4. Eggs should be poached, hard boiled, or scrambled at least 7 minutes prior to being pureed.
  5. Mix pureed meats with mashed potatoes or pureed soups.  This may help with the taste. Add seasoning as desired.
  6. To increase visual appeal of pureed foods, use a pastry bag and decorating tips and squeeze food onto plate.  For example, you can use a round tip to form the shape of peas or corn.  If you use a star tip, you can form rosettes with potatoes, cauliflower, or broccoli.
  7. Canned fruit in light syrup are easiest to blend, and stewed fruits can also be pureed. Cook vegetables to soften before pureeing. Try adding stock, gravy or sauce when pureeing to form the right consistency.  Cooking vegetables by steaming will help maintain the nutrients.
  8. Always add spices and seasonings for taste, including cheese, sour cream, etc.
  9. Avoid food with nuts and seeds, membranes or tough skin (strawberries, tomatoes, pineapple, oranges, grapefruit, grapes, corn, celery).
  10. Avoid fried rice, fried noodles and potato skins, sausages, hot dogs, fried meats.


Dysphagia Tidbit – Xerostomia and Swallowing dysfunction
Xerostomia means “dry mouth.”  This is frequently encountered following radiation therapy and in conditions such as Sjogren’s syndrome (Schoof, 2001).  This problem leads to many issues including ropy tenacious secretions, poor oral health, and swallowing problems.  Sjogren’s syndrome is a chronic autoimmune disorder in which lymphocytes invade the exocrine or mucosa producing glands. This invasion leads to inflammation and progressive loss of lubrication.  Reduced lubrication has damaging effects in the eyes, mouth, skin, gastrointestinal tract, ears, nose and genital area. The diagnosis of the condition is often difficult because the symptoms can be vague and the onset insidious. The full picture may not be recognized because various health care professionals may be attending to different aspects of the syndrome.  It can affect all age groups, though middle-aged woman are most frequently affected (Schoofs, 2001).
A Practical Approach to Management of Saliva. Scott, Amanda, Johnson, Hilary, 1993.