Newsletter :: November 2005
Monthly Motivator: Passion
Life is YOUR Canvas. Paint it with as much color as you can!
What are we thankful for? YOU!!!!! December will be DiagnosTEX’s 2nd year anniversary! This Thanksgiving one of our blessings is you and all of your support that helped make DiagnosTEX successful beyond our expectations. How can you thank someone for allowing you to do and be successful at what you love to do? I am not sure there are words descriptive enough to express our gratitude. I hope our appreciation shows in the effort we make to meet all your MBSS needs and give you the best, most complete MBS possible. We wish you and your families and very Happy Thanksgiving with many, many blessing to be thankful for.
Conferences 2005 – Last one of the Year!!!
(By popular request) Saturday December 3rd – Deciphering Dysphagia with E-Stim
Registration form included. Very limited seating, do not delay in registering!
Go with the Best – DiagnosTEX
Do not let pricing of a competitor stand in the way of a quality dysphagia evaluation with DiagnosTEX. DiagnosTEX will be competitive with pricing. Keep the following in mind, DiagnosTEX is the only company:
- With 3 vans covering Dallas/Fort Worth and surrounding areas, allowing 24-48 hour service/response to your MBSS request.
- With the most detailed SLP and physician reports, allowing to establish correct treatment for the disorder
- With All SLP’s trained in an extensive 3 month program and internal QA done on all SLP’s.
- With Follow up QA on every patient we evaluate.
- With Discounted CEU’s for all DiagnosTEX customers and free facility in-services
- With SLP educational handouts and newsletters monthly.
MBSS Recommendations
With many new treatment options, protocols, and other, DiagnosTEX has been approached with many questions about things we will recommend. We just wanted to address a few of these.
- DiagnosTEX will recommend E-Stim but never a particular device or protocol
- DiagnosTEX will not recommend Frazier Free Water Protocol, because we are not in a position to recommend such a program if the facility has not implemented this protocol in their facility which requires much staff training, established policies and procedures as well
as tap water testing etc. We will recommend the appropriate diet from the MBSS and if the SLP has the Free Water Protocol established in their facility and feels the patient is appropriate then the facility SLP will make this call.
- We will recommend thermal application or thermal stim for delayed swallows, but we will not recommend a particular protocol such as DPNS.
DiagnosTEX Holiday Schedule
Please make note of this on your calendars. DiagnosTEX will be closed the Monday after Christmas and the Monday after New Years. 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 MBSS at the end of November and December!
Physicians Order The physicians order for the MBSS needs to be signed by the physician or at least by an RN who received a verbal or telephone order before we can schedule the MBSS, it can not be signed by the Speech Pathologist only. Also if the SLP writes the order please word it as the following “Dysphagia Consult including Modified Barium Swallow Study”. We can not schedule an MBSS study without a faxed copy of the order for the MBSS. If you can provide us with their copy of the Medicare and/or Medicaid Card, that would be more than helpful to us! Thank you!
Dysphagia Tidbit – GERD and LPR
Radiographic Evaluations of Patients with Dysphagia must include all Structures involved in Swallowing: Lips, Tongue, Palate, Pharynx, Larynx, and Esophagus…” (Donner Et Al, 1988)
Esophageal Disease is often manifested by pharyngeal or oropharyngeal symptoms (Jones Et Al, 1985)
Pam and I attend a wonderful conference in DFW last month presented by Tom Franceschini, M.S. CCC-SLP; we saw many of you there. We feel better than ever about our protocol to scan the esophagus for GERD and LPR, as this phase of the swallow, as we have always felt, plays such an important role in many of the signs and symptoms of dysphagia. Acid Reflux has many statistics: $6.2 billion on prescription drugs, affects 15 million Americans a day. Be alert to your patient’s complaints. It is important to understand the difference between GERD (Gastroesophageal Reflux Disease) and LPR (Laryngopharyngeal Reflux). GERD is backflow of stomach contents into the esophagus. LPR is reflux all the way from the stomach to the throat and often happens during the day.The etiology of GERD and LPR can include lifestyle factors such as pregnancy, obesity, body posture (no problems like this in the NH!), Medications, Hormones, Hiatal Hernia as well as diet full of caffeine (chocolate or brown liquids), smoking, alcohol, consuming fatty foods, wearing tight clothing, and gastric distention. Causes are a result of transient lower esophageal tone, decreased LES resting tone, delayed stomach emptying, ineffective esophageal clearance and diminished saliva. Complaints can range from the most common, heart burn with during or after meals. This may become asymptomatic over time. Other Sxs are regurgitation, globus sensation (food hanging up, slowing down, or getting stuck in the throat), chest pain (Sharp or dull and may radiate from neck, arms or back), asthma, chronic coughing, bronchitis, aspiration pneumonia, and interstitial fibrosis. Gingivitis and tooth decay can occur due to contact with acidic refluxate. Sore throat, hoarseness, ulcers, VC spasms which may cause sleep apnea, can all be a result of Reflux. Did you know recurrent ear infection and pain in the ear is also a symptom of reflux, think about this with your kiddos! Over the counter medications (antacids) are ½ the strength of prescription (H2 blockers). Side effects are diarrhea. And over use could lead to constipation. Go to www.Heartburnalliance.com for free booklets on GERD.
ADVANCE advanceforspanda@merion.com – Humor In Therapy – By: Ronda Polansky M.S. CCC-SLP
Humor in Therapy is a Web-exclusive ADVANCE column. If you are a speech-language pathologist or audiologist interested in submitting an entry, please contact Assistant Editor Alyssa Banotai at abanotai@merion.com. If your entry is published, you will receive a $25 honorarium.
I never win anything, and I submitted my story and it was picked! Ha! Just wanted to share the humor!
I work on a mobile Modified Barium Swallow (MBS) Clinic. One day we were doing several studies at a Facility. As we took one patient off and brought another one on, I heard a couple of the residents speaking to each other outside on the front porch. One resident asked “What are they doing in that van?”. The other replied, “ I do not know but I heard them say something about videos, X-rated, and swallowing!” I almost choked when I heard them say this and stopped to explain to them what we were doing immediately!
You can see it online at advanceforspanda@merion.com