February 2015 Newsletter



Clinical Café Newsletter

By: Ronda Polansky M.S. CCC-SLP

February 2015

Happy Valentine’s Day!


The heart has its reasons of which reason knows nothing.

Here are some interesting facts about Valentine’s Day.

  1. In AD 496, Pope Gelasius I declared February 14 Valentine’s Day. He was a romantic!
  2. In the 1800s, doctors commonly advised their heartbroken patients to eat chocolate, claiming it would sooth their pain. I don’t know about you, but Chocolate eases my pain!
  3. Richard Cadbury produced the first box of chocolates for Valentine’s Day in the late 1800s. LOVE THIS MAN!
  4. Teachers will receive the most Valentine’s Day cards, followed by children, mothers, wives, sweethearts, and pets.
  5. About 3% of pet owners will give Valentine’s Day gifts to their pets.



    Start the year EDUCATED!  Lots of great CEU opportunities!

  • Deciphering Dysphagia with E-Stim using Ampcare ESP™ Systemwww.ampcarellc.com
  • Dysphagia Research Society– March 12-15 in Chicago, Ill
  • Texas Speech and Hearing Association Annual State Convention – March 19-21 in San Antonio (AMPCARE will have a booth, be sure to stop by there!)


Influenzea/Flu Positive results. – Any patient in isolation with a influenza positive test or with flu/risk/symptoms of the flu should not be seen in the mobile unit.  Our small contained mobile environment can be easily exposed and effect the fragile, elderly patients that we see during the day, despite our decontamination procedures we use.  If the patient has the flu and requires this procedure immediately, please refer to a local hospital where this type of illness can be more properly handled. Thank you for your understanding and help with this issue during this flu season.


2015 DiagnosTEX Dysphagia Calendars – We have a few left if you have not received yours, please let us know

Dysphagia Drinking Aides – whether the patient need assisted cup or liquids by cup instead of by straw or small sips, these are some options to review:


Our Professional Organization Contacts

ASHA – 800-498-2071

TSHA – 512-452-4636

Texas State Board of Examiners – 512-834-6677


PQRS – (Physician Quality Reporting System) –  All SLP’s in private practice must have reported on 50% of their Medicare Part B eligible patient visits in 2014 or will be penalized by 2% on ALL claims for Part B service in 2016. It is time to report 2014 PQRS this year!


Hospice – What it looks like

The four levels of care are 1) routine care, 2) general inpatient care, 3) continuous care, and 4) respite care.  Routine care is provided wherever the patient goes home and may have ST if indicated. GIP care is provided in a facility setting (freestanding, hospital, LTC), this is considered short term and is discontinued once a patients symptoms are under control.  Continuous nursing care is provided to a patient at home who has uncontrolled symptoms. Continuous care is considered short term and is re-evaluated every 24 hours. Respite Care is provided to a patient (usually in a facility) who has controlled symptoms in order to facilitate caregiver relief. In older adults. Those who have received a feeding tube, proactive assessment of swallowing and trials of food should be encouraged and not an indefinite NPO status (Casarett, Kapo, Caplan, 2005), but reduced oral intake is a common experience at end-of-life.  For an MBSS to be completed and covered by Hospice, the Hospice diagnosis cannot be related to the dysphagia. Please make sure when scheduling a patient you check the status of Hospice as well as the Hospice diagnosis.


Dysphagia TidbitTonsil Cysts on your Oral Mech Exam – An individual may occasionally notice what looks like a small white lesion or spot on a tonsil. This is typically known as a tonsil cyst or tonsillar cyst. A tonsil cyst is a pouch-like vesicle filled with fluid or pus typically protruding from a tonsil. Most frequently, these tonsil cysts are benign, although in some cases, cancer may be present. A benign tonsil cyst can become infected if not treated in a timely manner. There are danger signs and warnings to look out for with cysts that have formed on the tonsils. Difficulty in swallowing or anything that prevents the patient from eating normally should be brought to a doctor’s attention. General bleeding from the area is not typical with tonsil cysts, although some cases may differ.  Tonsil cysts differ from tonsil stones, which are known as tonsilloliths. A tonsil cyst is generally softer and not solid as a stone would be. Cysts seem more like bumps in appearance. With the presence of cysts located on the tonsils, the typical procedure involves a physician performing a biopsy of the tissue. This is done to examine the cells and ensure there are no signs of cancerous tissue present. A doctor can generally tell if the cyst is infected by the fluid matter that drains from it.


Check our website for handouts and previous newsletters at www.dysphagiadiagnostex.com under the Clinical café