Newsletter :: December 2004
Wishing you the very best throughout the holidays and the year ahead!
DiagnosTEX is 1 year old!
2004 has been a ride of lifetime. We are so blessed with our first year of success. You have allowed us to become ALL we wanted to be! THANK YOU FROM THE BOTTOM OF OUR HEARTS! 
We look so forward to many, many more years of working with all of you and providing you with the best MBSS you can receive anywhere. I hope all of those we service know how personally we take our job and our responsibility to make sure you get all the information you need to treat your patient and make them better. We are honored to be a part of your Dysphagia management team. Have a glorious holiday season and we look forward to another exciting year in 2005!
Preauthorization numbers for HMO’s, private insurance etc. for the MBSS
There has been some recent confusion in DiagnosTEX’s role in obtaining preauthorization numbers. DiagnosTEX is not responsible for obtaining preauthorization numbers, as we do NOT have access to the patient’s medical records and the patients are not under the care of DiagnosTEX. When you call to obtain preauthorization numbers, they require information from the Medical record that DiagnosTEX does not have access to, also DiagnosTEX is not currently seeing the patient or is not involved in the care of the patients as the MBSS has not been completed. Often times if the pt is on an HMO, the treating doctors/physicians office will need to obtain the preauthorization number, because the physician is the one contracted with the HMO. I know obtaining a preauthorization number is inconvenient for anyone, but DiagnosTEX will not make headway any quicker, because we can not provide the insurance, HMO etc the information they need therefore, we are less likely to get the preauthorization number than the facility. Please have the preauthorization number before you call to schedule the MBSS. Thank you for you understanding on this issue.
Upcoming DiagnosTEX holiday schedule
DiagnosTEX will work a ½ day Christmas Eve on December 24. We will work New Years Eve December 31. We want to meet all of your MBS needs as we know PO feeding becomes important on many levels to many around the holidays, as well as be fair to all of our DiagnosTEX employees and their families as well as our own families. Please keep these holiday schedules in mind when scheduling your MBS! We will put out best effort forth to get you scheduled as needed.
2005 CEU Conference
We are moving forward with this conference! Due to the holiday season fast approaching, the conference will be scheduled after the first of the year. Be looking for details in the January Newsletter! I am so excited about this, as Russ Campbell PT as well as a GI physician will be participating in this conference. I did 2 articles with Russ Campbell and Rick McAdoo on E-Stim in 1997 and 1998. This upcoming conference will discuss these articles/our research, review swallowing A& P, E-Stim issues, and get some PT perspective on NMES. Plan on bringing your PT co-worker and your facilities NMES device, you PT coworker will be able to get CEU credits as well. We are not taking reservations for this yet, but will the 1st of January.
This conference will not promote any E-Stim/NMES device. This is an educational conference, your right to academic freedom. We all have an “ethical responsibility not only to learn from but also to contribute to the total store of scientific knowledge when possible, etc.” (E 9.095 – AMA Policy).
Starbucks Gift Certificates – An On-The-Spot Thank You!
As most of you already know…….. If the patient is up and waiting at the front door with vitals and the medical chart when we arrive, you will receive a gift certificate. Having the patient ready helps us stay on schedule and we appreciate this more than you know! Having to wait for the patient to get out of bed, get vitals taken, and locate that chart can put us 15-20 minutes behind and if that happens at 4 facilities, then we will be running an hour behind as the day goes on. That hurts us as well as the facilities we are scheduled to be at. Thank you to all who have been so helpful and ready for us! You deserve a warm drink on us as the weather cools off!
We are moving towards 3 vans in DFW and additional staff to meet all your MBSS needs!
In the next several months we will be moving forward with plans to add a 3rd van in the DFW and surrounding areas and additional part time staff. We are so blessed and thankful to have Charlotte Rice M.S. CCC-SLP, Dana Sims Ph.D CCC-SLP, Dr. Boluch, and Dr. Morgan as new additions to DiagnosTEX in our commitment to continue to be the quality preferred mobile MBS provider in DFW!
Dysphagia Tidbit – Sjogrens Syndrome – NO SALIVA, NO SWALLOW
Sjogren’s syndrome has a big impact on voice and swallowing and SLP’s need to increase their comprehension of the etiology and treatment of this disorder. Sjogrens is not widely known and often overlooked and undiagnosed. Sjogrens syndrome is a chronic disease with excessive dry ocular and oral membranes. Often times it can co-exist with autoimmune diseases such as ALS, MS, chronic fatigue syndrome, lupus, polymyositis, and rheumatoid arthritis. The immune system works to protect the body by destroying bacteria and viruses and with Sjogrens, white blood cells attack healthy salivary glands. This disease strikes 4 million Americans with 90% being women in their 40’s, although it can occur at any age. When an inadequate amount of saliva is produced, chewing, swallowing, and esophageal transit becomes difficult. A chronic lack of saliva can also cause a loss of taste and smell. Dry membranes also facilitate development of bacterial infections. Polypharmacology can mask this disorder because medications that cause ocular and oral dryness include antihistamines, decongestants, diuretics, tranquilizers, antidiarrhea drugs, antipsychotic drugs, antidepressants, and blood pressure medications. The medications used to treat Sjogrens have to be taken 4 times a day resulting in spikes and dips of comfort level. A healthy body produces 1.5 liters of saliva per day that is recycled by swallowing. Less than 1.5ml is needed to initiate a swallow. Individuals with Sjogrens can develop hoarseness from excessive throat clearing. Irritated vocal cords do not facilitate normal intensity volume. Individuals report coughing, choking, throat clearing, burning sensation in the throat, needing extra effort the swallow, feeling something stuck in their throat (globus sensation) and reflux. When this disease is suspected, a diagnosis requires a variety of tests. An example of a case was a patient that started to lose weight and complained of a painful swallow. The MBS rules out dysphagia. They were referred to another physician who discovered that she self medicated excessively with over the counter products which all had side effects that mimic Sjogren’s Syndrome. Non medication strategies include: humidifier, A/C filters, ionizers, artificial tears, artificial saliva, unscented skin cream, and saline nasal spray. Individuals may also be hypersensitive to products containing alcohol, additives and preservatives. Sipping water and/or sugar free drinks frequently throughout the day are preferable to drinking large amounts of fluid at one time. Excessive fluid intake may develop a cycle that flushes the oral, laryngeal, and esophagus areas of existing mucous, thereby causing more dryness. The Sjogren’s web page has great hydration ideas: www.sjogrens.org. Sjogrens symptoms and medically induced dry membranes can have a great impact on swallowing and the quality of life.