June 2007 Newsletter




Consultants in Dysphagia Evaluation and Management
817-514-MBS1 or 1-888-514-MBS1
Clinical Café Newsletter
By: Ronda Polansky M.S. CCC-SLP
June 2007
Summer is here!
Happy Fathers Day!
Do not forget to fly your American Flag on the 14th in honor of our country, our troops and our freedom!

Sold Out E-Stim conference!  Great to see everyone, we hope you enjoyed yourself and learned a lot.  Thank you Cantex for lunch!
Be looking for the next DiagnosTEX conference later this summer.

Sava Facilities
We are so honored to be a choice provider option for Sava.  You can go to our website and download out required paperwork to schedule your MBSS or call DiagnosTEX and we will fax it over to you!  We have 3- 4 vans covering the DFW and surrounding areas and will be able to service your facility in 24-48 hours. We are excited to have the opportunity to provide you and your patients the highest quality mobile MBSS in DFW, we look forward to working with you again!  Give us a try and you will see the DiagnosTEX difference!

Clinical Café on the DiagnosTEX website – A resource for you
On the DiagnosTEX website there is a section called Clinical Café, check it out!  There you can view all of DiagnosTEX’s handouts and review all of the newsletters since 2004. In the search section, you can type in a word such a “tracheostomy” and it will locate all handouts and newsletters with this topic in it.  You can also now review a normal swallow and a video on dysphagia. I hope you find this useful!

Scheduling your MBSS
Due to the nature of the mobile business, the large coverage area that we service, and high gas prices, we strive to schedule our 3 vans daily to 3 individual confined areas of DFW and outlying areas, so we do not have 1 van traveling from South FW to North Dallas in 1 day.  Due to the number of facilities we service and the number of patients we see in one day, we can not guarantee the 24-48 hour service if there is a request to schedule at a particular time period in a day. Due to the demand in our routes, we must schedule for timeliness, travel efficiency, as well as maintain that 24-48 hour service as best as possible to all the patients in the area scheduled that day, and of course gas mileage for these gas guzzling vans!  We will do our best to meet your specific time requests in a timely manner but it will be based on the area serviced that day, our scheduled routes, and the flexibility in our schedule on that day.  We hope you understand our position on this issue. Please know that we will strive to meet your MBSS needs as quickly as possible.  Our goal is always to get to get you within 24-48 hours and stay on schedule for everyone involved including our own staff.  Often times we arrive at a facility and we are asked to add on’s, maybe one, maybe two or more.  Many times we schedule a facility the day before and the next morning we have paperwork for 2 more add on’s for that facility.  This causes us to push our schedule back at a minimum of 30 minutes per patient.  If you are the facility adding on, it typically does not effect you unless we arrive early to get the others added, but next time if you’re the facility after the add on’s, it will. DiagnosTEX feels every patient and family member is as important as the next, so we do our best to meet everyone’s needs, within reason. We have recently had some requests from facilities that “no MBSS’s be done on Friday’s”.  It is difficult for us to remember which facility requested this when we service so many facilities locally, so please write this information on the history intake form so we can be sure to remember this when scheduling your MBSS. Please understand the nature of this business, the complexity of scheduling, and our sincerest 100% effort to get to you on time!

Did you know???
Of the roughly 7.5 million adults in the USA with some form of Dementia, 5% of them, or about 375,000 people, may actually have a potentially CURABLE condition called Normal Pressure Hydrocephalus (NPH). NPH is often mistaken for Alzheimer’s disease.  Cerebral spinal fluid in abnormally accumulates in the brain in patients with NPH. The cavities of the brain (called ventricles) that hold this fluid expand causing the brain tissue to thin. This affects blood supply to the brain, causing a host of symptoms similar to other diseases of aging, such as difficulty walking, slow thinking, altered memory, and loss of bladder control. The progression of NPH often starts with gait issues and then effects memory and bladder. Alzheimer’s alters memory, then affects movement later. MRI and CT scans can detect enlarged brain ventricles affected by NPH because they are often 10X larger than normal.. Up to 80-90% of NPH patients improve after surgery.  Learn more at www.lifenph.com.

Dysphagia Tidbit – Dysphagia Statistics in acute stroke

  1. Aspiration has been reported to occur in 38-70% of acute stroke patients (Daniels et. al, 1998, Horner& Massey, 1988, Linden & Siebens, 1983)
  2. Silent Aspiration occurs in 40-67% of patients with dysphagia who aspirate (Daniels et. al, 1988, Splaingard, Hutchins, Sulton & Chaudhuri, 1988)
  3. Silent laryngeal penetration and aspiration of liquids are reported to be more common in right hemisphere than in left hemisphere cortical strokes (Robbins, Levine, maser, Rosenbeck, & Kempster, 1993)
  4. MBSS assessments performed within a median of 10 days from a stroke diagnosis have been reported to detect swallowing abnormalities in 55%-72% of acute stroke patients (Mann & Hankey, 2001) This estimate is considered conservative, as this estimate is likely to underestimate the initial incidence of dysphagia s/p CVA, given that dysphagia is thought to resolve in the immediate post stroke interval in some cases (Mann & Hankey, 2001)
  5. Dysphagia is reported to occur in 42%-60% of acute stroke patients on the basis of a bedside swallow evaluation performed within a median of 3 days from stroke diagnosis. (Mann & Hankey, 2001). This estimate is considered conservative, as this estimate is likely to underestimate the initial incidence of dysphagia s/p CVA, given that dysphagia is thought to resolve in the immediate post stroke interval in some cases (Mann & Hankey, 2001)