September 2007 Newsletter
Consultants in Dysphagia Evaluation and Management
817-514-MBS1 or 1-888-514-MBS1
www.dysphagiadiagnostex.com
Clinical Café Newsletter
By: Ronda Polansky M.S. CCC-SLP
September 2007
Monthly Motivation:
Calm provides clarity. Pause to consider the gifts you have been given, the difference you have made and the direction in which you are headed.
Dates to remember this month
4th – LABOR DAY HOLIDAY
9th – Grandparents Day – HUG A GRANDPARENT TODAY, EVEN IF IT IS NOT YOURS
9th-15th – National Healthcare Housekeeping Week
9th-15th – National Assisted Living Week
16th-22nd – National Rehabilitation Awareness week
Upcoming Holidays
DiagnosTEX will be closed on Labor Day, Monday September 3, 2007. Also all of the DiagnosTEX SLP’s will take a CEU education day on Friday September 7th. We continually further our education to serve you better. We will do our best to meet all your MBSS needs in and around that time as efficiently as possible. Please consider this when scheduling your MBSS that week.
SLP Give-away by popular demand – Dining Dysphagia Style
We have so many requests for lists of items on a dysphagia diet. Although consistencies and mind sets vary from facility to facility, we have put together a booklet from professional literature available and the NDDTF as a reference source on DYSPHAGIA DIETS for you to use and share. Ask for yours next time we see you.
FYI – we have had some questions on page 2, 3, and 6. Yes, Ensure by itself is a thin liquid (Swigert, 1994), and yes, a scoop of ice cream by itself, that you would eat by a spoon, is a thin liquid. If you take the two of them and mix/whip them together, you create a different consistency, kind of like a soft serve, as long as it stays cold. Try it as see. If the mixture does warm up, the ice cream will thin out. You can always add some powder thickener to keep it thickened as it warms. I am so glad you all are reading the book and asking questions!
DiagnosTEX scheduled times We make a sincere effort to contact each facility BEFORE we arrive. We do this to allow you time to get the patient up and ready. We schedule times/appointments the day before with you and due to our time schedule during the day, we can wait no longer than 15 minutes for a patient to get up and ready or we may have to reschedule the patient for another day. We understand things happen in the facility just as things happen out on the road for us and we will take all of this into consideration, but if the situation is just that no one will get the patient out of bed for us to do the study, we will speak to the administrator or DON and reschedule for another day and time. We hope you understand our position and our priority is getting to all of our scheduled stops in a day.
ADD-ON’s – Please remember we can not add on any studies at your facility without all completed paperwork handed to us at the facility or faxed to the DiagnosTEX office prior to. Thank you
Congress –The U.S. House of Representatives passed the Children’s Health and Medicare Protection (CHAMP) Act by a vote of 225 to 204. The CHAMP Act is broad healthcare legislation that would reauthorize the State Children’s Health Insurance Program (SCHIP), which provides health insurance to children from low-income families, and invest an additional $48 billion dollars in the program over a period of five years. The bill is controversial because of disagreements over the expansion of children’s health insurance, increase in the tobacco tax, and cuts in payments to Medicare managed care plans. The CHAMP Act also makes a number of changes to Medicare that ASHA supports, including:
The U.S. House of Representatives passed the Children’s Health and Medicare Protection (CHAMP) Act by a vote of 225 to 204. The CHAMP Act is broad healthcare legislation that would reauthorize the State Children’s Health Insurance Program (SCHIP), which provides health insurance to children from low-income families, and invest an additional $48 billion dollars in the program over a period of five years. The bill is controversial because of disagreements over the expansion of children’s health insurance, increase in the tobacco tax, and cuts in payments to Medicare managed care plans. The CHAMP Act also makes a number of changes to Medicare that ASHA supports, including:The U.S. House of Representatives passed the Children’s Health and Medicare Protection (CHAMP) Act by a vote of 225 to 204. The CHAMP Act is broad healthcare legislation that would reauthorize the State Children’s Health Insurance Program (SCHIP), which provides health insurance to children from low-income families, and invest an additional $48 billion dollars in the program over a period of five years. The bill is controversial because of disagreements over the expansion of children’s health insurance, increase in the tobacco tax, and cuts in payments to Medicare managed care plans. The CHAMP Act also makes a number of changes to Medicare that ASHA supports, including:
The U.S. House of Representatives passed the Children’s Health and Medicare Protection (CHAMP) Act by a vote of 225 to 204. The CHAMP Act is broad healthcare legislation that would reauthorize the State Children’s Health Insurance Program (SCHIP), which provides health insurance to children from low-income families, and invest an additional $48 billion dollars in the program over a period of five years. The bill is controversial because of disagreements over the expansion of children’s health insurance, increase in the tobacco tax, and cuts in payments to Medicare managed care plans. The CHAMP Act also makes a number of changes to Medicare that ASHA supports, including:
- halting the scheduled 10% cut to the 2008 Medicare fee schedule rates and providing two years of positive updates (0.5% in 2008 and 0.5% in 2009);
- extending the exceptions process to the Medicare therapy caps for two years (currently, the exceptions process is scheduled to expire at the end of 2007);
- allowing private-practice speech-language pathologists to bill Medicare directly (H.R. 1774 & S. 45); and
- freezing further implementation of Medicare’s so-called “75% Rule” on inpatient rehabilitation facilities.
Although ASHA has concerns about some provisions in the 462-page legislation, it supports the bill and will continue to work toward fixing the provisions that raise concerns. It is unclear whether the CHAMP Act, and the Medicare provisions included in it, will become law. The Senate version of the bill does not address Medicare and the President has threatened to veto the bill. ASHA will continue urging Congress to keep the Medicare provisions described above in the bill as it moves through the legislative process. For further information, please contact Deborah Darcy, ASHA’s Director of Grassroots Advocacy, by e-mail at ddarcy@asha.org or by phone at 800-498-2071, ext. 4427.
Dysphagia Tidbit – Alternative Medical Therapies for Post CVA Dysphagia –ADVANCE July 2, 2007
Traditional Chinese medicine holds that illness is caused in part by imbalance in the flow of Qi (chee) or life force energy. To restore Qi in acupuncture therapy, needles inserted at points along pathways of energy flow. Needles are conical in shape and push tissue aside so insertion is painless. They are rotated, twirled or accompanied by weak electrical current. Acupuncture studies are becoming more quantitative compared to initial investigations. The following is a summary of studies on Acupuncture treatment for dysphagia
Seki, 2005 – randomized clinical trial, post stroke patients, Acupuncture 3x a week for 4 weeks. MBSS used for baseline. Results: less days with fever, reduced food retention, reduced delay, and fewer aspiration events.
Williams, 2003 – Group (no control), 41 post CVA with dysphagia, 15 min acupuncture. Results: Average swallow time was 10.2 sec at baseline and 4.5 sec after treatment.
Williams, M ( 2003) Accupuncture improves swallowing difficulties after a stroke. Journal of the American Geriatrics Society, 51:726-27
Seki, T. et.al (2005) Acupuncture for dysphagia post stroke patients: A videofluoroscopic study. Journal of the American Geriatrics Society, 53(6): 1083.