Newsletter :: January 2005
HAPPY NEW YEAR!
Monthly Motivational: Attitude
Wherever you go, no matter what the weather, always bring your own sunshine!
THE TIME IS HERE! Next DiagnosTEX CEU Conference
DECIPHERING DYSPHAGIA WITH E-STIM
I did 2 articles with Russ Campbell and Rick McAdoo on E-Stim in 1997 and 1998. This upcoming conference will discuss these articles/research, review swallowing A& P, ethical issues, controversies, documentation and billing, dilatation, certification, competency and FDA issues, as well as get some PT perspective on NMES. There will also be many SLP’s attending currently using various E-Stim protocols on adults and infants whom I am sure will be willing to share their comments and experiences. The conference is Saturday, January 29, 2005 from 9:30am-5pm at Brookshire Center in Hurst, Texas (Map included) This conference will be 6.5 TSHA and TPTA CEU’s (TPTA are currently being applied for and requested) . Lunch will be provided by Hallmark Rehab and we sincerely thank them for their participation in this educational conference. The cost is $150.00. Plan on bringing your PT co-worker, they can sign up and can get inexpensive CE credits as well for a fee of $150.00 too. There is a discounted rate of $125.00 for those SLP’s, including PT’s, whose facilities use DiagnosTEX as their mobile MBSS provider.
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).
Bring your current NMES device if you have one. We look forward to seeing everyone there; this will be an exciting conference! Get your registration forms and payment in quickly.
Medicare Regulations and repeat MBSS
We have new information that an MBSS can be repeated before 30 days if it is a “medical necessity”. This does not include “at the family request”. A Medical Necessity can include a change in medical status, change in diagnosis, and/or change in diet including a diet upgrade. Please fill in the history form completely including the area of when the last MBSS was completed. If you need a new history form, just call us and we will fax you one!
DiagnosTEX 2005 Dysphagia Calendars!
We have new DiagnosTEX dysphagia calendars just for you, to help you keep track of your busy weeks during 2005. We will present you with one next time we see you! We look forward to another successful year and working side by side with you to provide the best quality care for those suffering from dysphagia.
Warm Drinks on Cold Days!
Remember if the patient is up and waiting at the door with the chart and vitals, DiagnosTEX will buy you a drink at Starbucks by presenting you a Starbucks gift certificate For those who help us stay on time and meet our schedule, you deserve a warm drink on us as the weather gets cold! 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!
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 to run weekly 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 Stewart PhD 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!
Medication Effects
Dr. Baumer and I am putting together a new educational handout for all of the SLP’s which will include a list of medications and the effects on the patient as it may relate to dysphagia. I know this will be helpful in your job and the treatment of your patients. Be looking for this soon after the upcoming conference. If you have not received our SLP Reference Sheet or Dysphagia diagrams, let us know and we will hand one to you next time we are at your facility
New DiagnosTEX Website – Due to be under construction in 2005
Dysphagia Tidbit – Dysphagia Treatment – The need for Evidence Based Practice
An article published in the Advance Dec 6, 2004 Vol. 14 No. 49
As many of you know, my feelings on E-Stim is that placement of the electrodes is key to success as well as safety. I also agree more research and clinical trials need to be completed on this new treatment. There were several good statements in the noted article supporting this. Celia R. Hooper, PhD CCC-SLP, VP for Professional Practices in Speech Pathology at ASHA says that she tells her students at UNC; “don’t go to a workshop and have someone tell you the a certain treatment will work, demand to know how it works and ask all the right questions!.
I have always advocated that the placement for electrodes should be in the submandibular triangle where the suprahyoids are located. The suprahyoids are the laryngeal elevators. The Infrahyoids should not be a placement location as they are laryngeal depressors. In the Advance article Christy Ludlow PhD and Inessa Humbert MS CCC-SLP studied the Vital Stim device after attending the course. I contacted Dr. Ludlow and she stated after using the electrode placement 3b as recommended by the VitalStim manufacture, they studied what the device did on 8 patients who had dysphagia for more than 6 months. As part of the study, the patients underwent fluoroscopy as Dr. Ludlow and Inessa Humbert turned the device on, off, and on again. The stimulation produced a movement opposite of what you would want in swallowing. Dr. Ludlow stated “It’s not raising the hyoid bone or the larynx, in fact, when it causes any movement, it pulls the hyoid bone down. Given that some patients swallow a little better with the device on, the hypothesis is that the sensory stimulation on the skin may be what is helping these people.” The finding of this preliminary study titled “Effects of Surface Electrical Stimulation Both at Rest and During the Swallowing in Chronic Pharyngeal Dysphagia” was presented by these Speech Pathologists at the DRS in Montreal Canada in October. They plan to investigate further.