November 2016 Clinical Café Newsletter
By: Ronda Polansky M.S. CCC-SLP
There is no better time to express our appreciation for your business and friendship! The friendship of those we serve is the foundation of our success serving the DFW area!
This is the season to reflect on your blessings and those things for which you feel most thankful. I know at DiagnosTEX, we are incredibly thankful for each and every one of you who use us as your preferred mobile MBSS provider and have shared your friendship and support over the years. We wish you and your families a very Happy Thanksgiving with many, many blessings this 2016 holiday season!
Happy Swallowing and be thankful for your teeth!
IT IS ELECTION TIME! PLEASE DO NOT FORGET TO VOTE on November 8th!!!!! YOUR VOTE COUNTS! We all may need a holiday after this election process
DiagnosTEX November Holiday Schedule Swallow and be thankful! DiagnosTEX will be closed on Thursday, Thanksgiving Day, November 244h and Friday the 25h, to count our blessings and spend time with our families. We want to meet all of your MBSS needs because we know PO feeding becomes important on many levels to many of your patients around the holidays, especially when Thanksgiving is traditionally planned and prepared with a great deal of attention to food. We also want to be fair and accommodating to each DiagnosTEX employee and their families. We are so thankful for them as well!
Please keep our holiday schedules in mind when scheduling your MBSS at the end of November (and December)! ******Please take note and keep in mind that during this busy time of year, specific requests for specific times and/or days become exponentially difficult to accommodate. We may be unable to quickly schedule your patient with certain time and day requests. Please notify your staff, patients, and families of this. ****** DiagnosTEX bases our mobile clinic schedules by geographical areas for time, efficiency and operational cost. If your patient’s schedule is limited to certain days and times, we recommend an outpatient facility (such as a hospital). Our mobile service is an option for you that offers convenience in the equipment coming to you, but it is not for the flexibility of specific days and time schedules. Mobile offices also require flexibility in time; we are subject to many factors that can dramatically change our travel during the day and subsequently alter the exact time we may arrive. We all make a heartfelt effort to arrive during our scheduled time, but there are often things that are out of our control that may change our arrival time. We will always call to keep you updated on our ETA at the number you have provided us on the HX/consult form.
Please keep in mind that DiagnosTEX is not an X -ray service and we do not provide stat services. DiagnosTEX is a physician clinic/office and operates under normal physician office hours Monday through Thursday with an occasional Friday if a holiday or unusual circumstance with mechanical issues with the van interferes and/or effects the other scheduled days. Fridays are a day we use to service all of our mobile vehicles and this is company policy. As with any physician office, a patient’s paperwork must be processed and insurance must be verified before we schedule an appt. Also as a physician clinic/office we schedule appointments and it may take 1-7 days to get scheduled with us.
New Staff – We would like to welcome 2 new techs to DiagnosTEX, Bryant and Lorenzo, they have some very impressive experience in both driving large vehicles, customer service, and healthcare. They will both be a great addition to our team and are very excited to have them join our small family. J Welcome them next time you see them!
Home Health Visits – We have experienced some poorly managed pets during home health visits recently. Two specific incidents with family pets resulted in one bite and one aggressive dog that was stopped prior to attacking. Please educate your family members that ALL pets need to be contained when we arrive, no matter how “sweet” they normally are. We are strangers entering the house and any animal will be protective over their environment and family members, including the smallest of dogs. The family will be liable for any injury to DiagnosTEX staff, since they have been notified and knew we were coming. During the time you educate them about the MBSS and the travel fee, please include the control of any pets in your discussions.
ASHA Leader Article October 2016 – Thank you for all your sweet emails, texts and other compliments about the October 2016 ASHA Leader article I co-authored. I was honored that they reached out to ask us to write it. We have had calls from all over the USA with many interested in learning more about mobile healthcare.
Ronda Polansky, MS, CCC-SLP and Joan Kelly Arsenault, MA, CCC-SLP, BCS-S
Did you know that November is……….
National Alzheimer’s Disease Awareness Month
National Family Caregiver Month
COPD Awareness month
Lung Cancer Awareness Month
Great American Smoke out (3rd Thursday in November) Time to QUIT!!!
GERD Awareness Month
DiagnosTEX CEU Course planned for November – Due to personal issues that arose in October that required my full attention, we were unable to adequately prepare and put a CEU course together before the holidays. We apologize to those who were calling in and anticipating this. We will delay this course until 2017. As always, we appreciate you support and look forward to seeing you at the next one!
Ampcare ESP™ CEU Training – November 5 in Beaumont, Texas –
Critical Thinking and Dysphagia Management –November 12 and 13 in Alexandria, VA
ASHA Convention– November 17-19 in Philadelphia, PA (Stop by and see the AMPCARE booth while you are there!)
DiagnosTEX 2017 Dysphagia Calendars will be available again this year in December
Dysphagia Tidbit – Tori
Anyone evaluating or treating a patient for dysphagia should know the answer to this question…………….…..”do they have teeth?
When doing an oral motor exam, it is also important to look at the gum line, hard palate, and below the tongue. There are many bony swellings that develop in the mouth that can effect PO intake. These bony swellings are given the technical names of exostoses or tori. The torus is considered to be a developmental anomaly, although it does not present until adult life and often will continue to grow slowly throughout life. The torus palatinus commonly forms towards the back of the hard palate (roof of mouth) in the midline. It is rounded and symmetrical, sometimes with a midline groove. It is usually not noticed until middle age. It can interfere with dentures as well as AP propulsion of food. The prevalence is about 20 out of 1000 adults. Bony growths occurring on the lower jaw/mandible, and floor of mouth are known as torus mandibularis. They form on the tongue side of the lower jaw in the region of the premolars and bicuspids (above mylohyoid muscles attachment to mandible). They are typically (90% of the time) bilateral. The buccal exostosis is the formation of a boney mass on the outer cheeks facing side of the maxilla (upper jaw) just above the teeth or the cheek facing side of the mandible. They are less common on the lower jaw. The size or tori fluctuate throughout life. If they become so large that it interferes with function, denture placement, recurring ulceration from sharp food (i.e. potato chips) and or contributing to a periodontal condition, surgery can be done to remove bone by chiseling it off, but there is a risk of reformation where nearby teeth receive local stresses. Do a good oral exam, these abnormalities are important to identify as they may relate to oral dysphagia.