December 2019 Newsletter

Happy Birthday DiagnosTEXDTEX turns 16 years old!  Pam and I would like to thank not only our customers and those who have supported us all these years in DFW, but we would also like to thank all of our employees for the many years of friendship, belly laughs, and precious memories! Thank you for your hard work and commitment to what DiagnosTEX stands for!  We truly treasure each and every one of you (customers and employees) and are blessed to have you as a part of our daily lives! To love what you do and the people you do it with is the true definition of success!

DTEX family – We are sad to announce Karen decided to make a change. She had the desire to spend more time with family and pursue other personal interests.  We will miss her terribly, as we know you will as well!  We all wish her well! Our new front desk contact is Katie Dusold, make her feel welcome next time you call! She is excited to get to know all of you!

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!  The 2020 DiagnosTEX Dysphagia Calendar will be ready this month, get yours next time you see us along with Christmas goodies to make the season sweeter!

DiagnosTEX December Holiday Schedule -   This year Christmas and New Year’s fall on Wednesday.  DiagnosTEX will be closed Wednesday the 25th for Christmas as well Wednesday the January 1 we will operate Thursday-Friday both of those weeks following those dates. We want to meet all of your MBSS needs; we know 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 of 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).

Providing DiagnosTEX the paperwork required to schedule an MBSS - We would like to request that anyone who has a study to schedule, please do not forward any paperwork until required items such as the physician's order and consent are ready as well. Often referring staff sends an H & P and DTEX consult form but no MD order, no consent and not face sheet. This is not helpful to us until we have all the information we need to process this patient correctly. Just like an MD or imaging center would require. Without this information, the patient will not be placed on the pending list and the paperwork will be set aside awaiting complete information.  AND if you have sent all your paperwork in and your patient is discharged or expires…PLEASE call us and inform us, as we schedule around these pending patients to make schedules.

Time's (nearly) up: We are now in a transition period, extending through December 31, 2019, where you can use either the Health Insurance Claim (HIC) Number or the MBI to exchange data with us. Starting January 1, 2020, you must submit the new Medicare number/ Medicare Beneficiary Identifier (MBI) with ALL of your new referrals.

DiagnosTEX is an official donation site for the Socks For Seniors Holiday Sock Drive – PLEASE Help us this holiday season in providing warm, non-slip socks to seniors in nursing facilities!  We will be receiving donations through December 24th and distributing where they are needed the most!

Can you spot malnutrition and dehydration?

Indicators of Dehydration

  • Excessive thirst
  • Confusion; decreased level of consciousness
  • Dry mouth or tongue; cracked lips
  • Fever
  • Decreased urinary output
  • Decreased skin turgor; slow sternal skin tenting
  • Decrease eyeball resilience
  • Weight loss of > 1lb/day

Indicators of Malnutrition

  • Eyes dull, bloodshot ring around the cornea
  • Membranes dry and either too pale or too red
  • Triangular, shiny gray spots on the conjunctiva
  • Eyelid corners red and fissured
  • Lips red and swollen
  • Tongue swollen, appears raw and purple
  • Nails spoon-shaped, brittle and ridged
  • Muscles wasted, legs knocked – kneed or bowed, bumps on ribs, joints swollen.

Enteral feeding Manual, Beverly Enterprises, 1994

Xerostomia - 13-28% of older adults face this as a chronic issue every day. This number can increase to an alarming 60% in long term care. It is hard for a dysphagia sufferer to escape the over 500 medications that cause xerostomia.

Xerogenic Medications to be aware of. Check  your patient's med lists:

  • Antihistamines: ex.  Benadryl, Claritin, Zyrtec
  • Antidepressants: ex. Zoloft, Flexaryl and Elavil.
  • Antiemetics: ex.  Anzemet and Domperidone.
  • Antihypertensives:  diuretics, ACE inhibitors, calcium channel blockers, beta-blockers
  • Antiparkinson: ex. Levodopa, Artane
  • Antispasmodics: ex.  Dicyclomine.
  • Sedatives: ex.  Amytal, Valium, Lunesta
  • Analgesics: opioids ex. Morphine, cannabis
  • Chemotherapy agent: ex. retinal
  • Antireflux agents:  proton pump inhibitors ex. Omeprazole

Reva Barewal, DDS, MS, Dipl. ABDSM

October 21, 2019

Dysphagia Tidbit - Garnishes to add to a puree diet for more color and better taste to your holiday meals

1. Paprika

2. Whipped cream

3. Cinnamon sugar mixture

4. Jelly

5. Honey, Karo, or maple syrup

7. Hollandaise sauce

8. Chocolate, caramel, or butterscotch syrup

9. Brown sugar

10. BBQ sauce

11. Cranberry sauce can be piped through a pastry bag to use as a garnish

12. Fruit sauces or salad dressings

13. Gravy, catsup, mustard, mayonnaise, and/or cheese sauce