Thursday, June 14, 2012

Current Job Openings!


Spring Outpatient Rehab Center: Part time Physical & Occupational Therapist for our Spring location in North Houston. Occupational, Physical and Speech Therapists for Saturdays. Established center with great multidisciplinary team and enriching clinical environment.

Stafford Outpatient Rehab Center: Occupational, Physical and Speech therapists for Saturdays at our well established SW Houston location.

Northshore Outpatient Rehab Center: Full time OTR for our busy and close group of therapists at our East Houston clinic. Occupational and Physical therapists for Saturdays. Easy commute from Humble/Kingwood or SE Houston/Pearland area!

MedCare Pediatric Rehab Center, LP is looking for counselors to be part of our teams in our pediatric outpatient clinics located in the Stafford, Northshore and Spring. Bilingual in Spansh required for the Northshore office.  The therapists are open to working with a wide population of children, including those with developmental delays, behavioral disorders, and emotional disturbances. The position is compensated on a per visit basis and will begin as part-time with the opportunity to build up to full-time; after-school availability is required.  Must hold a license of LPC, LMFT, or LCSW. (Texas Medicaid provider a plus!)


Physical Therapist: Home Health. Full time in: NE/NW Houston, Pasadena/SE, Missouri City/SW, Channelview/Sheldon.  Part time in all areas.

Occupational Therapist: Home Health. Full time in Pasadena, Missouri City/SW, Mission Bend/Sugar Land/SW, Humble/Kingwood/Sheldon/NE, Spring/NW, Baytown/Channelview . Part time in all areas.

Speech Language Pathologist: Home Health. Part time daytime hours in Spring/NW Houston, Part time after school only in all areas. Bilingual part time in Missouri City/SW areas and Pasadena/SE area.

Bryan/College Station: Part time OT/PT for home health


*TRAVEL BONUS INCENTIVE* SE (Baytown 77521) Tuesday, Wednesday and Fridays open (3p-11p) and Saturdays (8a-2p)

N (Houston 77069) Sundays, Tuesdays, and Wednesdays open 8a-8p

NE (Humble 77396) Monday-Friday open (7a-7p), Saturday/Sun PRN

NW (Houston 77090) Monday, Tuesday, Saturdays and Sundays (8a-8p)

NW (Houston 77090) Sundays (8a-6p)

East (Houston 77015) Sunday through Friday nights (11p-6a)

North (Montgomery 77356)  Sundays through Saturdays all shift times available, day
and night 

SW (Missouri City 77459) Friday night (3p-11p or 3p-7a)

SE (Pearland 77581) Friday, Saturday, & Sunday nights open (5:30p-5:30a) and Monday days open (5:30a-5:30p)

NE (Houston 77039) PRN day, night, weekend shifts (10-12 hour shifts) (7a-5p, 7a-7p, 9p-7a, or 11p-7a) *BONUS INCENTIVE* weekend shifts

North (Spring 77379)- Mondays, Tuesdays and Saturdays (7a-7p) and Tuesday and Thursday Nights (7p-7a)

Tuesday, June 12, 2012

Did you know that poor oral care can make your child sick?

Oral health is linked to overall health and wellness in children and adults.  The health of the oral cavity affects nutrition, growth, speech, chewing, swallowing, appearance and learning.  The Surgeon General estimates that children miss more than 51 million hours of school per year because of oral disease.  Poor oral health affects more than just your child’s mouth and can damage other parts of your child’s body which can lead to emergency room visits, hospitalization and need for medications.  The Centers For Disease Control has recognized that oral infection may affect the course of diseases, such as cardiovascular disease, bacterial pneumonia, and diabetes mellitus. 
Daily Cleaning:
  • You can start cleaning your child’s gums with a soft rag wrapped around your finger, or a soft toothbrush and water before they get their first tooth.  This may help to decrease oral sensitivity. 
  • Using a soft toothbrush and fluoride toothpaste you should brush your child’s teeth two to three times a day and floss once a day.  Remember to brush all surfaces of the teeth and the tongue.  The best time to brush teeth is after eating, taking sugary medications, and before bed.
  • Children who are under two years of age should use a dab of toothpaste the size of a grain of rice and over 2 years of age should use a pea sized amount.
  • If your child does not spit or toothpaste causes gagging, try brushing the teeth by wetting the toothbrush with a small amount of over-the-counter fluoride mouth rinse (such as act) instead. 
Professional Visits:
  • Children should see a dentist as soon as they have a tooth or by their first birthday.  You may have to speak with your general dentist, other professionals or friends to find a dentist who works with young children or children with special health care needs.
  • Speak with the dentist and staff prior to the visit about the particular health care need your child has.  Share with the dentist and staff what works when you are providing daily care at home. 
  • Take items that calm your child, such as a favorite toy or music to the Dentist’s office. 
  • Children with special health care needs often are given medications that cause a change in the oral cavity.  A variety of medications can cause dry mouth.  The most common medications include antihistamines, decongestants, high blood pressure medications, anti-diarrhea medication, muscle relaxants, drugs for incontinence, and drugs used to treat depression and anxiety.  Dry mouth can be treated using medications, artificial saliva, or by making lifestyle changes such as chewing sugar free gum or taking frequent small sips of water.
  • Sugary medications taken orally can cause increased cavities and periodontal disease.  Strategies to combat the effects of sugary medication in the oral cavity include, rinsing with water after taking the medication, frequent brushing, and asking your pharmacist about sugar free medication. 
  • Lastly, certain medications used to treat seizures, high blood pressure, and transplant rejection can cause gingival overgrowth.  Gingival overgrowth can be controlled, but not always prevented with good oral hygiene. Treatment includes, regular dental visits, cleanings, and in some cases surgical repair.

Feeding /Diet

  • Bacteria can be transmitted from an adult to a child.  Avoid sharing utensils that go in your mouth

  • Avoid putting your child to bed with a bottle.  After the last feeding for the night, the teeth should be brushed or wiped clean. 

  • Drinking milk or juice from a training cup throughout the day can cause cavities.  Limit milk and sweet drinks to mealtime and provide water between meals. 

  • Avoid using sugary snacks and drinks for rewards or in between meals. 

Special Considerations:
  • Children with special needs may require modified utensils, special seating, and an adapted environment. 
  • Children with special needs may have certain conditions that require extra attention.  These can include dry mouth, medications containing sugar or causing negative side effects such as dry mouth or gingival overgrowth, bad breath, tooth grinding.  Work with your dentist to design a plan for your child with special needs. 
  • If your child pockets food, be sure to inspect and clean the oral cavity following oral intake. 
  • If your child has GERD speak with your doctor about rinsing with water and baking soda daily to neutralize acid in the oral cavity. 

Macanda Hinchey-Block, CCC-SLP
Stafford Clinic Speech Language Pathologist

Thursday, June 7, 2012

Introduction to Scoliosis, Part 1

This blog will be part 1 of a 2 part series on the condition of scoliosis.  In part 1, we will discuss what scoliosis is, what the signs of scoliosis are, and how scoliosis impacts more than just the spine.  In part 2, which will be at a later date, we will discuss strategies commonly used to treat patients with scoliosis.
What is Scoliosis?
Scoliosis is a condition of the spine in which the spine is curved abnormally.  You may remember from your childhood being checked by the school nurse for scoliosis every year-this is because scoliosis is a very common condition, affecting approximately 7 million people in the United States.  This blog will discuss the anatomy of the spine, the different types of scoliosis, and how scoliosis can negatively impact a child’s development.
The spine, also known in the medical world as the vertebral column, is the set of bones that runs from the base of your skull down to the bottom of your pelvis.  It is made up 24 individual bones called vertebrae and 9 vertebrae that are fused together to form the sacrum and the coccyx.  Each of the vertebrae are separated from each other by a small jelly-filled sac called a disk.  The spine is divided into 4 sections, named for the areas where they are located.  The cervical region of the spine includes the first 7 vertebrae and forms the section of the spine that runs from the base of your skull to the base of your neck.  The thoracic region of the spine includes the 12 vertebrae that run from the bottom of your neck, down your upper back to the base of your ribs.  The thoracic vertebrae are actually the bones that your ribs attach to.  The lumbar region of the spine is what we often refer to as the low back.  It includes 5 vertebrae that run from just underneath your ribs to the top of your pelvis.  The final 9 vertebrae are divided into 2 sections.  The first 5 vertebrae are fused together and form the sacrum, which is the back wall of your pelvis.  The final 4 vertebrae are fused together and form the coccyx, which is commonly called the tailbone. 
Each section of the spine has some degree of curvature to it that is considered normal.  However, normal curves of the spine are in an anterior-posterior plane, meaning that they run front to back or vice versa.  Curves that are associated with scoliosis are in a lateral plane, meaning that the spine curves either to the right or the left and this is not considered normal.  They are usually referred to as a C curve or and S curve depending on the areas of the spine that are involved and the shape of the curve.
There are 3 types of scoliosis.  Congenital scoliosis is caused when one or more of the vertebrae are formed incorrectly when a fetus is developing and is present at birth.  Idiopathic scoliosis is caused by unknown factors and can develop at any age.  Neuromuscular scoliosis is caused as a result of a muscle imbalance and is usually associated with other medical conditions, such as spina bifida, cerebral palsy, Down Syndrome, etc. 
Neuromuscular scoliosis is the most common type of scoliosis that we see at our facilities.  Many neurological conditions such as spina bifida, cerebral palsy, and Down Syndrome impact a patient’s muscle tone.  They may have too much tone in their muscles (hypertonia) or too little tone in their muscles (hypotonia).  For patients with hypertonia, their muscles often pull too hard on their spine, causing it to bend abnormally.  For patients with hypotonia, their muscles don’t pull hard enough to combat the force of the muscles on the opposite side and/or the force of gravity, causing it to bend abnormally.  Some patients have hypertonia in one area and hypotonia in another, causing bending in multiple locations of the spine. 
So how can you tell if your child might have scoliosis or might be developing scoliosis?  There are several signs to look for that might indicate that your child has or is developing scoliosis.  The first and most prominent sign to look for is to look for a curve in the spine when the child is standing up straight, sitting, or lying on their stomach.  It may be C shaped, or it may be S shaped.  You may notice things like one shoulder may be higher/lower than the other, one hip may be higher/lower than the other, one shoulder blade may be more prominent than the other, etc.  See below.

Another sign to look for is called a rib hump.  When your child bends over in standing, if one side of the rib cage stands higher off the back then the other, this is considered a rib hump and may indicate scoliosis.  See below.   

Why should I be concerned if my child has scoliosis?
Scoliosis doesn’t just affect the bones and muscles of the spine.  Scoliosis, if left untreated, can impact many other organs and body functions including vision, feeding and digestion, breathing, and bladder/ bowel function. 
·         Vision- your brain automatically tries to keep your eyes and head in an upright position no matter which way your body goes.  However, if your body is always curved to one side, your head and eyes will always be fighting to stay upright, which can put a lot of strain on neck muscles and eyes.  If it’s too much work for your muscles to keep your head and eyes upright, your head will follow the curve of your body.  Therefore, your eyes will see everything from an unnatural angle, rather then upright. 
·         Feeding-in order for a child to swallow properly, they must have good positioning of the head and neck.  Trying to eat or drink when the head and neck are not in the proper position can lead to choking and potentially aspiration of food particles into the lungs, which can cause infection and even death. 
·         Breathing, digestion, and bowel/bladder function-the spine and the ribs form a protective cage around all of our internal organs that are responsible for breathing, digestion, and bowel/bladder function.  If a child’s spine is curved and the curve is not corrected, the space inside the protective cage is decreased, “squishing” the organs.  If the lungs don’t have enough room to expand properly, it becomes very difficult to breath or cough.  If the stomach doesn’t have enough room to expand and accept food coming in, it can lead to vomiting and acid reflux may develop or worsen in patients who already have it.  If the intestines don’t have enough room to expand and push digested food through, it may lead to constipation or more serious intestinal blockages.  If the bladder doesn’t have enough room to expand and accept urine coming in, it can lead to kidney infections or decrease the ability to control the bladder, leading to frequent accidents.
Stay tuned for Part 2 of Introduction to Scoliosis, where we will discuss common treatment strategies for scoliosis!

Sommer LaShomb, Physical Therapist
Rehab Center (Stafford and Spring) and Home Health