Newsletter :: February 2005

Monthly Motivator –Never underestimate the power of giving. It shines like a beacon throughout humanity.

Happy Valentines Day!

Deciphering Dysphagia with E-Stim Conference

What a great turn-out! It was so great to see everyone! Thank you for attending!

I want to thank Hallmark Rehab and Mediwell for providing food and refreshments and Russ Campbell, Rick McAdoo, and Dr. Chandra for their participation in this conference. We will be presenting this in Houston and other areas of Texas this year. Next DiagnosTEX CEU conference will be in the Spring!

Give-Aways for you!

If you have not received your 2005 DiagnosTEX Dysphagia Calendar please let us know next time we see you. Also we have Medication Reference sheets that will be available sometime in February, which will be so helpful to you when treating patients with Dysphagia, make sure you get yours!

Grouping MBSS in areas outside of DFW

For those locations miles out of DFW, we ask you to help us help you by grouping your studies. This will allow us to get to your patients more efficiently. If we travel to your facility for one and then you send another one in the next day it will be a couple of days before we can get back out your direction.

New Medicare Allowables for Part B 92611 in 2005

MEDICARE PART B/Medicaid

MBSS Testing

Dallas County: $141.39

Tarrant County: $131.26

All Other Counties: $116.93

These fees were taken directly from the Online Fee Schedule on Trailblazer’s website

DiagnosTEX website under Construction in 2005

We are excited about our website being developed. You will be able to view past newsletters, upcoming conferences, dysphagia tidbits as well as pull up required paperwork for an MBSS and a service agreement. There will be a question and answer page and a link to our email address. We are researching how we can also provide CEU’s on this site as well.

Severe Weather

Unfortunately here in Texas we do not get a beautiful snow fall, we get ice. This becomes a problem for anyone who travels, and we do a lot of that! As winter approaches and the threat of severe weather conditions arise, DiagnosTEX owners and drivers will evaluate the conditions of the roads and DiagnosTEX will contact all scheduled facilities scheduled immediately if we are unable to meet our schedule. If the weather conditions are so severe, as not to put our staff at risk driving in to work, we will cancel the day and reschedule the facilities as promptly as possible. If bad weather begins to occur during the work day, the owner and the driver present on the mobile unit will decide together if any changes in the schedule should be made. Although the patients are extremely important we do not want to risk the safety of our employees or vehicles to prevent further delay of our service to you due to injury or damaged vehicles. Our decisions to drive that day may be based upon whether or not public schools are closed because of road conditions. Please drive carefully during these winter storms!

Warm Cup on us!

Our Starbucks cards are still available to those who have the patients that meet the following criteria:

1. Patients up and in a wheel chair waiting in the front by the door on arrival of the mobile clinic
2. Vitals ready and chart available to physician

Having the patient ready helps us stay on schedule at your facility and all the facilities we have scheduled that day and we appreciate this more than you know, as do all of the SLP’s waiting on us to arrive, as we know you do when we arrive as scheduled! If you have an add-on we will do our best to accommodate you, please know that each additional patient we add on takes us at a minimum of 30 minutes to add. Any add on needs to also be up and ready for us as well, as we will have to push our scheduled facilities back at least 30-40 minutes per patient we add. Thank you for your help with this!

Dysphagia Tidbit – Effects of Radiation on Swallowing

External-beam radiation has both early and late side effects that can impact swallowing function. Early effects include xerostomia, erythema superficial ulcerations, bleeding, pain, and mucositis. Late radiation effects include osteoradionecrosis, trismus, reduced capillary flow, altered oral flora, dental caries, and altered taste sensation. The late effect of reduced blood supply to the muscle can result in fibrosis and reduced muscle size. This can dramatically affect swallowing years after treatment with fixation of the hyolaryngeal complex, reduced lingual ROM, reduced glottal closure, and cricopharyngeal relaxation, resulting in the potential for aspiration. Specific swallowing exercises have been shown to reduce these effects and improve prognosis. These include jaw ROM, Tongue base ROM and effortful swallow exercises, tongue holding maneuver, Mendelsohn maneuver and the Super Supraglottic swallow. Education to the patient is important to help them reduce the effect of radiation and these include, optimal oral hygiene, avoidance of alcohol and tobacco, decreased caffeine consumption, adequate hydration, avoidance of irritating food tastes or textures, and use of artificial saliva or saliva replacement medications. Cancer in the oral cavity can cause a range of predictable but complex swallowing problems. Location, size and extent of the tumor as well as the surgical reconstruction procedure can affect the outcome.