March 2022 Newsletter

Happy St. Patrick’s Day

An Irish Blessing for you:

May you always find blue skies above your head, shamrocks beneath your feet, laughter and joy aplenty, kindness from all you meet, good friends and kin to miss you if you ever choose to roam and a path that’s been cleared by angels themselves to carry you safely home.

TSHA

Such a small taste of normalcy in our lives returned, it was good to see everyone! Thank you for all who attended the TSHA Business Committee Session on Ethics and documentation!

March 16 is Swallowing Awareness Day

Like breathing, swallowing is essential to everyday life. This is the perfect month to educate on proper instrumental evaluations. Swallowing Awareness Day 2022 is an opportunity to bring attention to swallowing disorders and to connect people with speech pathologists, the professionals who can help. This is needed more this year than ever! The greatest challenge in the pandemic is the invisible one: How do we help people who are afraid to seek care to begin with or those overlooked? Head injuries, strokes, Parkinson’s disease, ALS did not go away. Dysphagia treatment is just as important in 2022 as it was before 2020. All patients deserve all of the options available to them for treatment success. Our advocacy book and more is just what you need, available for purchase in the store on our website www.dysphagiadiagnostex.com.

An SLP Should NEVER Lose Their Voice

Advocate for Proper Dysphagia Evaluations

Material to assist in educating Physicians, Administrators, Nurses and other Medical Professionals on Dysphagia and Modified Barium Swallow Studies

What You Cannot See at the Bedside

Educational MBSS videos on DVD and jump drive

March CE Opportunities

• Deciphering Dysphagia with Ampcare’s ESPTM (Effective Swallowing Protocol) On-Demand + Zoom Webinar
  Tuesday & Wednesday, March 21-22, 2022 11-1 pm CST (12-2 pm EST)
  *8 Hours Advanced ASHA CE

• Deciphering Dysphagia with Ampcare’s ESPTM (Effective Swallowing Protocol) On-Demand + Zoom Webinar
  Tuesday & Wednesday, March 22-23, 2022 4-6 pm CST (5-7 pm EST)
  *8 Hours Advanced ASHA CE

March is Brain Injury Awareness Month

I

n Texas, close to 150K people sustain TBI each year, and this does not account for those who went to ER and were released or those who never went to ER. TBI hospitalization totals are approximately 1.8 billion each year and only 5% of the survivors receive the rehab they need. In Texas there is no TBI Medicaid waiver to support long term needs. Advocacy efforts can help by contacting area government representatives and asking that funding be made available to acquired brain injury survivors. Local companies such as Centre for Neuro Skills (CNS) and BIND empower those with TBI and other neurological conditions though rehab to maximize their strengths while developing compensatory strategies to assist with meeting their personal goals for functional living and community reintegration.

Patient files/MBSS images on DVD Versus Jump drives

We have had a lot of questions regarding this topic. As most of you know now, DiagnosTEX began phasing out the free copies of digital images of the MBSS (DVD) to the home health and facilities this year. This occurred due to increasing cost, major supply issues, and more importantly, the unprecedented misuse of images on social media resulting in HIPAA and liability concerns for the patient. This portion of the medical record can always be requested and DVD copies ordered by family for a charge of $10.63.

DiagnosTEX will not allow MBSS images to be uploaded to a jump drive from our medical records.

Flash drive. Thumb drive. Jump drive. USB stick. Whatever you call it, most of us have at least one of these ubiquitous, simple devices. Today, they not only hold countless gigabytes, but they may also hold numerous USB security risks; so can charging ports, memory sticks and other common devices. The mobile workforce is a boon to business agility, customer engagement and employee productivity but it’s also created a cybersecurity nightmare. Every device that employees use to conduct business—smartphones and smartwatches, tablets and laptops—is a potential security vulnerability. There are large HIPAA fines for stolen thumb drives due to the drives being unencrypted. Data shows that since 2012, it costs an average of $925,000 in HIPAA fines for a single stolen thumb drive. There’s a lack of credible solutions for encrypting thumb drives. Managing thumb drive inventory is a HIPAA compliance nightmare. While IT managers can identify and properly encrypt computer hard drives (desktops and laptops), allowing small, cheap, hard-to-encrypt thumb drives is a recipe for HIPAA fines. The HIPAA Security Rule states PHI stored on a USB Drive is “ePHI” (electronic Protected Health Information) and automatically subject to a slew of requirements in terms of storage, transport, and destruction of that data. Most of these requirements are unknown to or not met by the casual healthcare practitioner, leaving them automatically out of compliance. A lost or stolen USB drive with ePHI on it is an automatic breach of HIPAA which can and will subject your organization to fines, negative publicity, and possibly criminal charges if willful negligence of HIPAA is determined. This is not a joke or over exaggeration — companies are already being fined millions of dollars for breaches involving even just ONE lost or stolen hard drive. In addition to these serious liability risks, additional liability risks with information downloaded to jump drives has been subject to unprecedented unprofessional use of protected information on social media daily (Tik-tok videos, uploaded images and/or altered images), sad, disappointing, but nevertheless fact.

Dysphagia Tidbit – Zenkers Diverticulum, Pharyngocele or Laryngocele?

Pharyngocele and laryngocele are often misdiagnosed or interchangeably diagnosed. It is rare but commonly associated with occupational exposure to increased intra-pharyngeal pressure. Both often occur in glassblowers and those who play wind instruments. It is also seen in people with chronic obstructive airway disease. It occurs more frequently in males than in females and usually arises during the fifth and sixth decades of life. Differential diagnosis must not be confused with Zenker's diverticulum, herniation of the pharyngeal mucosa between thyropharyngeus and cricopharyngeus, which does not classically expand with raised intrapharyngeal pressure.

Pharyngocele is a protrusion of mucosa into one of the two weak areas of the pharyngeal wall often described as a lateral pharyngeal wall herniation in the piriform recess or vallecula. Pharyngoceles are rare and more often unilateral than bilateral caused by the laxity of the thyrohyoid membrane. Pharyngoceles are usually asymptomatic and symptomatic patients may present with regurgitation of food, dysphagia, halitosis, pain, and nocturnal coughing. Only about 60 true lateral pharyngocele cases have been reported in the literature over the last 133 years (Dillibabu Ethiraj et.al., 2020). Laryngocele is a close differential, and the two are difficult to tell apart. Though they have been described well in the literature, they are often misdiagnosed or interchangeably diagnosed.

A laryngocele is an abnormal dilatation of the laryngeal saccule. It is also a rare benign lesion of the larynx. A laryngocele may become clinically apparent in several ways. Symptoms depend on the size and location. The etiology behind its occurrence is still unclear, but congenital and acquired factors have been implicated in its development. A laryngocele is a congenital anomalous air sac communicating with the cavity of the larynx, which may bulge outward on the neck. Internal laryngoceles displace and enlarge the false vocal cords, resulting in hoarseness and airway obstruction. External laryngoceles extend through the thyrohyoid membrane, causing a mass in the neck. The simple laryngocele is an uncomplicated air-filled dilatation of the appendix of the laryngeal ventricle. Laryngoceles tend to occur in musicians who play wind instruments. Laryngoceles are filled with air and can be expanded by the Valsalva maneuver. Treatment of laryngoceles is excision. Microlaryngoscopy with use of a CO2 laser has become the main therapeutic procedure for the treatment of internal laryngoceles during the past 20 years. Standard pharyngeal mucous membrane closure similar to the procedure utilized in the repair of Zenker's diverticulum which should resolve the problem.