February 2024 Newsletter

Let all that you do be done in LOVE. - 1 Corinthians 16:13

Referrals

I often get questions regarding required documents to refer a patient, so I thought I would review that process. We require the following from a referring physician:

A SIGNED order requesting a “Modified Barium Swallow Study” or a “Swallow Function Study.” The physicians can write their own or find one on our website under the ‘Pediatrics’ tab.
Demographic sheet with insurance information
Their latest clinical notes to provide a thorough history
These documents can be faxed to 888-920-1201 or emailed to info@diagnostex.us

Please do not hesitate to reach out if you have any questions regarding this process.

TSHA IS HERE!!!!

The Annual Convention will be held February 22-24, 2024, at the Omni Fort Worth Hotel & Fort Worth Convention Center. Get ahead of the game and earn CEUs while also meeting new people and re-connecting with others!

Both DiagnosTEX and Ampcare will have a booth at the convention.

Ronda Polansky will be presenting on Thursday from 10:30-11:30am on “Evidence Based Evaluation & Management of Dysphagia with Dementia.”

Pam Ragland & Ronda Polansky will both be presenting on Friday from 1-3pm on “Career Navigation Through a Changing World of Healthcare: Panel discussion with TSHA Business Management Committee.”

Guest Writer

Mary Brezik is a Speech-Language Pathologist in the DFW Metroplex. She is the owner of Mary Brezik Feeding Therapy, PLLC, specializing in all things feeding. She is also co-owner of The Speech Source and co-host of the Speech Source Podcast. I have had the pleasure of working with Mary for a previous employer, but we have kept up our relationship and had the pleasure of collaborating with a patient. She wanted to share her experience to highlight the importance of a multidisciplinary team.

A Case for Collaborative Care

By Mary Brezik, MS, CCC-SLP

This month I had the pleasure of accompanying one of my patients to her follow-up swallow study at DiagnosTEX. It was a much anticipated study and an event we had been working up to every week for the past 8 months. After undergoing open heart surgery for 4 VSD repairs, surgery for her G-Tube, pulmonary hypertension, and being hospitalized for respiratory failure and bacteremia/sepsis -- Lucy was a walking miracle. Plus, Lucy’s parents and family had BIG goals for her.

When Lucy’s family hired me to be on their team, it was immediately following their first swallow study at DiagnosTEX: “Aspiration on thin liquids. Recommend speech therapy.” The report was much more comprehensive than that, but it was at that time that Ashley Stone, MS, CCC-SLP and I had our first phone call to discuss her case.

Working up to a follow-up MBSS is similar to studying for a big test. We plan, we set our goals, we prepare, we practice, and we adjust. But unlike tests in school, the test date isn’t set until we are confident we are going to pass, or at least get a different score. And to pass this test we had to be ALL IN.

Here's how we did it:

Lucy’s plan was comprehensive, multidisciplinary, developmental, full-body, and quite frankly… aggressive. A physical therapist worked on head stability, core strength, and other essential foundational skills. A home health speech therapist with the hospital started neuromuscular electrical stimulation (Vital Stim) for several weeks with oral motor and feeding intervention. A nutritionist oversaw the G-Tube feedings and managed calories, hydration, and adjustments when weaning. Lucy’s pediatrician and cardiologist cared for her overall health and illnesses and fielded the pivotal questions that came up along the way. Lucy’s parents and grandparents worked with her daily, communicated about her achievements and need for support, and implemented all the recommendations of the team. Lastly, my job as her private feeding therapist was not only to provide feeding therapy to learn to safely swallow, but also to serve as the case manager for her feeding goals. It was a solid team and most importantly, Lucy was ready.

Lucy worked hard with us in feeding therapy two times a week. She strengthened her gross and fine motor skills in preparation of eating, was first introduced to solid foods, then learned to chew and swallow safely. Meanwhile, running point on the team meant frequent communication and collaboration with team members. In the beginning, physical therapy played the biggest role as we integrated strategies to improve her physical foundation to eating safety. Consistent check ins with her home health speech therapist allowed us to progress together towards her shared goals. As Lucy’s oral calories steadily increased, her nutritionist was constantly decreasing her G-Tube feedings and was integral to ensuring her overall nutrition.

Eight months after her initial swallow study, we scheduled her next test. We were anxious but confident that it could be her last. The results were in, and Ashley Stone’s second report read “No aspiration or penetration. Standard diet.” Now, one month after her second and last swallow study, Lucy is a completely oral eater with all nutrition, hydration, and vitamins by mouth. This would not have been possible without each member of her team, as well as Lucy’s incredible bravery and fortitude. I cannot wait to hear the news when her physicians give the go-ahead for the G-Tube removal. It will be an incredible celebration for Lucy, her family, and her entire medical team. I cannot wait to say, “Congratulations, Lucy! We did it!”

**Name changed to protect patient confidentiality

In-Services

Do you have a team of therapists that would like to learn more about Modified Barium Swallow Studies? I would love to prepare a presentation for your team, complete with videos, to educate them on deficits and how that applies to the therapy they are implementing each week. Please reach out if that is something you are interested in.

Contribution

Do you have an interesting topic that you would like to share in a newsletter, whether it be a research article you have read or a patient you have treated? Email me if you are interested!

I, and the rest of the DiagnosTEX staff, look forward to helping you serve your patients and ensure a safe diet for ALL children.