November 2022 Newsletter
Happy Thanksgiving!
There is no better time to express our appreciation for your business and trust in us! The friendship of those we serve is the foundation of our success serving the DFW area for 19 years! This is the season to reflect on your blessings. I know at DiagnosTEX, we are incredibly thankful for each and every one of you who chose to use us as your preferred mobile healthcare provider and have shared both your friendship and endless support over the years in both the good times and bad. We truly wish you and your families a very Happy Thanksgiving with many, many blessings as we enter this 2022 holiday season.
IT IS ELECTION TIME! PLEASE VOTE BECAUSE YOUR ONE VOTE COUNTS!
Holiday Season
Please keep our holiday schedules in mind when scheduling your MBSS at the end of November and December! Keep in mind that during this busy time of year, specific requests for specific times and/or days become exponentially difficult to accommodate. We may be unable to quickly schedule your patient with certain time and day requests. Please notify your staff, patients, and families of this. DiagnosTEX bases our mobile clinic schedules by geographical areas only for time, efficiency and operational cost. This has been our business model for the last 18 years. If your patient’s personal schedule is limited to certain days and times, we recommend an outpatient facility (such as a hospital). Our mobile service is an option for you that offers convenience in the equipment coming to you, but it is not for the customized days and time schedules.
DiagnosTEX is not a STAT service. Any emergency concerns the patient may have need to be seen at the ER. DiagnosTEX is an independent physician clinic/office and operates under normal physician office hours Monday through Thursday with an occasional Friday. Fridays are typically a day we use to service and deep clean all of our mobile vehicles and this is company policy. As with any physician office, every patient’s paperwork must be processed and insurance must be verified before we will schedule an appt. Also, as a physician clinic/office we schedule our appointments as it fits into our schedules and it may take anywhere from 1-7 days to get scheduled with us.
Swallow and be thankful for your teeth and good hyolaryngeal elevation!
Family- fun! Food is the glue holding these 2 things together during holidays. We celebrate so many events in our lives around food, we take dates to dinner, we celebrate birthdays with cake and ice cream, we toast to wedding and graduation celebrations and we meet for coffee/tea or have lunch with friends. Everything we do in relationship often revolves around food. You don’t know how much until you cannot eat or drink anymore. It’s important we help others be able to enjoy this simple pleasure in life. Being an advocate for proper dysphagia evaluations and proper dysphagia treatment is part of responsibility and a healthcare professional.
Dysphagia Tidbit – Dysphagia Lusoria
Not doing an esophageal scan in your dysphagia evaluations is INCOMPLETE! Dysphagia lusoria (or Bayford-Autenrieth dysphagia) is an abnormal condition characterized by difficulty in swallowing caused by an aberrant right subclavian artery. It was discovered by David Bayford in 1761 and first reported in a paper by the same in 1787. Lusoria artery or aberrant right subclavian artery (ARSA) is a rare anatomical variation of the origin of the right subclavian artery. Dysphagia lusoria is a term used to describe dysphagia secondary to vascular compression of the esophagus. The various embryologic anomalies of the arterial brachial arch system often remain unrecognized and asymptomatic, but in 30%-40% of cases can result in tracheo-esophageal symptoms, which in the majority of cases manifest as dysphagia. The management of patients with dysphagia lusoria is dependent on the severity of symptoms and the impact on weight and nutrition. Based on literature approximately half of patients can be managed through dietary modification and through eating slower and chewing well. Severe symptoms, may warrant surgical treatment and that surgical repair is performed as reconstruction or ligation of aberrant right subclavian artery by sternotomy/by neck approach.
November is Alzheimer’s Awareness Month
Dysphagia and aspiration pneumonia are the 2 most serious medical conditions seen in late-stage Alzheimer's disease patients. Due to the degenerative aspect of Alzheimer's and the varying speed of degeneration, it is important to evaluate and re-evaluate these patients. Malnutrition and dehydration are the major issues in this population; therefore, it is important to understand their current level of functioning concerning their feeding and swallowing as they progress through the stages. Never overlook the importance of this population’s need for dysphagia evaluations and proper diets. There is a touching article written by a daughter titled “What I Wish I Knew Before my Mother’s Alzheimer’s Death”. This is part of the article:
“I didn’t know it then, but we finally encountered the real killer with Alzheimer’s—forgetting how to swallow. In late March I found her still sitting at the dining table two hours after the meal, staring at her bowl of fruit. The nurses said she had become a slow eater. I realized at that point that the suddenness of my mother’s spiral had even surprised the staff. They didn’t realize the blisters were from bedsores, thinking her shoes were too tight; they didn’t help her to eat, thinking she was taking her time. It was the disease, slowly shriveling the part of her brain that takes care of the physical processes and basic functions. It was the swallowing, or lack thereof, that was the beginning of the end. One day she just stopped eating and drinking completely. Not only does Alzheimer’s make you forget how to swallow, but it also attacks the part of the brain that sends thirst and hunger pangs. And that’s when I understood what would kill her—she would slowly wither away, dry up, unable and unwilling to eat or drink.”
The full article can be found at https://www.beingpatient.com/alzheimers-death/ . I unfortunately got to see this same horrific journey with my own mother. My job as a Speech Pathologist is to be proactive with these patients and families. Education is so very important, and re-evaluations along the way as well.