Newsletter :: March 2004

Happy St. Patrick’s Day!

What a Conference!!!!! Thank you for doing this conference with me Teresa! We had a fantastic conference! I know by the comments we have gotten back such as “outstanding”, “excellent”, “wonderful” “incredible”, “exceptional” “the most well organized, effective CEU course!’ that most of you feel it was worth your time and money. I can tell everyone is so excited to apply their new knowledge! Thank you for all the phone calls and emails! Teresa and I will try to put together another conference of interest. Please support Teresa by defending our academic freedom! Those of you who attended know that we will be referring to Teresa Biber, right up there with Logemann, Langmore, and Groher etc. in the future. We hope you will use DiagnosTEX as your mobile MBSS to help implement your new knowledge and skills. We are here for you, and we are only a phone call away, as is Teresa. DiagnosTEX will provide the timeliness, quality, and detail you need in your MBSS to provide the most complete, successful treatment to allow your patients the best opportunity to recover. Another quality DiagnosTEX CEU conference coming next quarter! Be looking for more information.

Also thank you DFW-ASHA, for asking me to be the guest speaker and thank you for all of you that attended!

Facility Service Agreements – Important Information to understand!

First of all, I have to thank all of you for another awesome and successful month at DiagnosTEX!

I am sorry for those Speech Pathologists that other mobile MBSS companies are bypassing and going to other individuals in attempts to get service contracts at your facility. We know that YOU are the ones that should be making the choices when it comes to treating YOUR patients. We have received so many calls and emails; I know this is upsetting you. Please give us a call and keep us informed and we will do all we can to help you out! We are very concerned about the misinformation that your facilities or Corp offices are being provided by others and we need to address this situation in this newsletter. When forming DiagnosTEX, we did much research to develop a company we would all be proud of based on the professionalism, quality and ethical standards we believe in. From DIRECT, personal communication with our intermediary Trailblazers/Medicare we learned that an Independent Diagnostic Testing Facility (IDTF) was created to better monitor and hold to a higher standard the previous category of Independent Physiologic Laboratory which ended in 1999. It is the classification that Medicare created to structure businesses being created by nonphysician groups. Many businesses such as sleep study clinic, mobile videofluoroscopy, etc., were being started by certified technicians and/or other nonphysician individuals around the country, this resulted in the need to classify such a service, so the IDTF classification was created. Companies categorized as an IDTF are not a physician owned practice providing consultations and thus required to be classified as an IDTF.

DiagnosTEX is a Group Medical Practice, physician owned, not an IDTF. DiagnosTEX performs a dysphagia consultation in addition to the Modified Barium Swallow Study. All physician groups are currently held to a higher standard by the Texas Board of Medical Examiners, Texas Bureau of Radiation Control, the Community Standard of Practice, Medicare guidelines and finally the Hippocratic Oath. Our physician performs an evaluation by taking a history, talking to the patient, family, Speech Pathologist, chart review, and then performs a focused expanded physical exam and recommends management of the patients Dysphagia problems to the treating physician and the patient in a Doctor-patient relationship. In addition to the above mentioned items, the detailed Speech Pathologist and Physician reports are unique to DiagnosTEX.

Help your administrator’s or Corp. contacts understand this information and encourage them to contact us. We can provide them with all the necessary written documentation. Also please be aware of the downside to exclusive contracts! This type of agreement does not reflect confidence in the quality of service provided. Any agreement limiting your choices at anytime is not beneficial to you or your patients. The company policy of DiagnosTEX is NOT to have exclusive agreements, so you have Freedom of Choice!! Our service and MBSS studies will speak for itself. You and your patients are our first priority!

More good news – be looking for new competitive MBSS rates from DiagnosTEX for your facility!

Three primary ways to maintain adequate Vocal fold hydration

1. Consume sufficient water – 8oz per day
2. Reduce or eliminate diuretics – caffeine, alcohol, smoking
3. Use direct steam inhalation – VC sit at top of trachea, everything we breathe touches them on the way down. Use 5-10 minutes once a day or as needed.

FYI – Tongue base tension is the third common constriction of the vocal tract. The tongue connects to the hyoid bone, and tongue tension not only elevated the larynx by pulling it physically upward, there by shortening the vocal tract but partially occludes the space in the vocal tract.

Dysphagia Tidbit

Implant to Control Dysphagia – Clinical Neurosciences Program at the National Institute of Neurological Disorders and Stroke (NINDS)

It is so exciting to see the options that are becoming available to SLP’s and their dysphagia patients!

Researchers are working to develop a button activated implant device that could be used by patients to control their dysphagia. They are not looking at a particular etiology but at a swallowing dysfunction in related conditions. Patients are defined by the type of dysfunction they experience during the pharyngeal phase. The study seeks to identify which muscles help when a patient is delayed in initiating a pharyngeal component of swallowing, which muscles help if there is limited elevation of the larynx, and which muscles help to open the upper esophageal sphincter. Patients in the study have a chronic dysphagia and have not responded to early rehabilitation during the first 6 months after the onset of their dysphagia. Results have been very encouraging according to Christy Ludlow, PhD, CCC-SLP. They tested whether patients could begin stimulating their muscles at the same time they were thinking of swallowing and started to swallow. In normal adults, just after a couple of trials, they were easily able to coordinate the onset of the stimulator with the onset of the swallow. The next step is to determine whether patients can learn to do it and that will depend on the disease, stage of the disease and which motor functions are affected. Patients with chronic pharyngeal dysphagia who are at risk for aspiration may be eligible to participate in the NIHNDS research free of charge. Interested people should contact Ianessa Humbert at 301-402-1109 or by email at humberti@ninds.nih.giv. For more information contact Christy Ludlow, PhD, 301-496-9366, or email her at ludlowc@ninds.nih.gov