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Do you suffer with dizziness?

July 31, 2021
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| Categories: Balance Assessment Equipment, Balance Platform, VNG Testing

Do you or anyone you know suffer from dizziness?

Overview of basic diagnostic and treatment solutions

Do you or someone you know complain about dizziness, unsteadiness, or experiencing repeated falls?  That can be very frustrating and dangerous due to injuries resulting from a fall.  

There are many factors that can affect our balance.  The complex vestibular system includes our eyes (visual inputs), ears (vestibular inputs in the inner ear), and feet (proprioception inputs while walking). If any one of these three areas is off it can cause dizziness resulting in falls.  It's kind of like a three-legged stool, if one leg falls off, the stool tips over.  

The first course of action needs to be a visit to your primary physician/s for a detailed evaluation. The following questions are a valuable tool for the physician to receive a good history and determine the best next steps in forming an accurate diagnosis and treatment protocol.

  1. How many times have you fallen in the last year?
  2. Do you feel dizzy prior to a fall or more unaware of the imbalance?  
  3. Do you have dizziness when lying in bed on a specific side but not on other sides? Or when moving your head one way or another?
  4. Do you experience dizziness while standing up from a seated position? Or when going from a lying down position to sit up and then stand up?
  5. Is there any numbness in your lower legs and feet? (Neuropathy or diabetic neuropathy)
  6. Are there any medications taken that list dizziness as a side effect?
  7. Have you experienced any head trauma recently?  Been in an accident or hit your head during a fall?

In addition to the questions from the physician above, at Secure Health, Inc. we highly recommend the physician use our Better Balance Analyzer platform to determine your Fall Risk Assessment (FRA).  The patient stands on the platform with eyes closed for 20 seconds - 3 times. The results are then compared to our large normative database, based on age and gender.  Your results determine if you are at low risk, moderate risk or high risk of falling.

Based on the results from the primary’s evaluation and considering the results from the Better Balance Analyzer, a referral to either an Ear, Nose, and Throat (ENT) or Audiologist (AuD) will likely be recommended.    

Once at your referred specialist, they may want to do a test called ENG or VNG (electronystagmography or Videonystagmography).  ENG has been around for 100 years while VNG, the modern gold standard method, has been around for 30+ years.  The VNG is very accurate and efficient.  Both are widely accepted as viable tests worldwide, but VNG is far more accurate, consistent and easier to administer. 

The ENG uses electrodes placed around your eyes and head while the VNG uses goggles with cameras to track eye movements while the patient follows stimulus, either a dot or light bars.  Using these tests, your health care provider can diagnose and identify vestibular problems or central nervous system (CNS) problems.  Another stimulus used with ENG/VNG is ear irrigation using either air or water  The air or water is blown into the ear canal purposely causing dizziness with a caloric irrigator.  The tests are done to see how long or if the patient can make the dizziness go away on their own, if not then it is likely central nervous system related.  

By far, the most common balance disorder is called Benign Paroxysmal Positional Vertigo (BPPV).  With BPPV you will feel dizzy only when you position your head in a certain way or position.  BPPV is generally caused when the crystals in your inner ear are out of position.  

Thankfully, BPPV is very treatable.  The most common treatment is the Canalith Repositioning maneuver that moves the crystals back to their intended position.  This is a painless movement, putting your head in various positions to allow the ear crystals to reposition in the correct manner. Vestibular rehab therapy is likely to be recommended to you to help with your recovery.

The vestibular system is very complex with far more potential diagnosis than just BPPV.  It is very important to go to the correct specialist for accurate diagnosis and treatments.

I hope this has helped in some way.  I know it's not anything absolute, but at least it may offer you some input on causes. This information is not intended as any sort of diagnostic or medical advice other than general information. You should seek your own personal care from a qualified medical professional.

May you all have a prosperous and healthy 2021.  Feel free to contact me at 260.804.4041 or email [email protected]

Dan Scherer

CEO, Secure Health, Inc.

260.804.4041 / [email protected]

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Difra Introduces VisioX D2 Oculography Module

June 29, 2021
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| Categories: Uncategorized, Visiobox, VNG equipment, VNG Software

DIFRA INTRODUCES VISIOX D2 OCULOGRAPHY MODULE

Faster computer, fewer cables & better results

Earlier this year Difra Instrumentation, a leading global manufacturer of VNG diagnostic equipment, released their new VisioX D2 module to power the oculography portion of the VNG test. The oculography tests include smooth pursuits, random saccades and optokinetic nystagmus tests.  These tests are important for evaluating the central nervous system.  

Previously, the Difra oculography tests were powered by their Visiobox module.  Essentially, Visiobox was a micro-computer that helped power the tests so you would not have buffering or freezing of the screen image.  It did a very good job, but it was additional hardware for the VNG diagnostic equipment.  Plus, it has to connect to the computer via either a WiFi connection or ethernet connection. 

The problem with a WiFi connection is in some occasions the connection was too erratic to be effective, causing images to freeze or heavily buffer resulting in a potential retest.  To eliminate that possibility in almost all instances, we set up the VNG testing systems using the ethernet connection.  This adds another cable to the VNG device, but it eliminates the need for a WiFi connection and the aforementioned problems associated with it.

In the interest of always trying to improve their products, Difra developed the VisioX D2 to eliminate the Visiobox and all of the connecting cables while improving even further the oculography results.  As a result, we only use high-speed gaming laptop computers.  Each of these gaming computers utilizes NVIDIA mobile graphics cards with their own internal memory. Typically, we use HP Pavillion 16.1" gaining laptops.  Each has a minimum of 8 GB of RAM and generally 1TB of hard drive space. We also specify Intel Core processors, which makes for a very fast, powerful system with no freezing or buffering and fewer cables.  Thus the system is very reliable and stable. 

What if you have an older Difra VNG, can you update it to the new VisioX D2?  In most cases yes, you can. All you will need is the correct gaming computer and the new version of the Difra software. You'll achieve faster performance, eliminate your Visiobox hardware, and receive excellent results by upgrading today.  Give me a call to discuss your system and what is involved and what your cost would be to upgrade your Difra VNG system.   I think you will be impressed with the results.

Feel free to contact me at 260.804.4041 or email [email protected]

Dan Scherer

CEO, Secure Health, Inc.

260.804.4041 / [email protected]

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Always Be Networking

May 31, 2021
| No Comments
| Categories: Management, Uncategorized

Always Be Networking

The Importance of Networking In-Person and Online

Many of us become involved in all aspects of running our clinical practice or small business that it's easy to overlook consciously and continually building your network. Networking is a business basic and so important to ingrain into your mindset no matter where you are. Always be thinking about who can benefit from your services and vice versa. Maybe you'll meet someone who can provide insight for a business need of your own.

Social gatherings, business events, neighbors, friends, friends-of-friends, community leaders and your own family can lead to personal interactions with others who have shared common interests. As Mark McCormack famously said, "All things being equal, people will do business with a friend; all things being unequal, people will still do business with a friend." The sweeping changes of the pandemic have resulted in more online meetings; however, face-to-face interactions very much still matter. 

The obvious benefits of online interactions via professional groups such as LinkedIn and others are the 24/7 availability to reach others with common interests, as well as creating your profile to showcase and summarize your expertise in a succinct manner. Introverts, especially, can benefit from a solid online presence. But, the key is to seek out appropriate groups and keep your online presence updated, then actively participate in the professional groups, which is easier said than done. It takes a fair investment of time to regularly share and read articles of relevance with your peers via professional networks.

Suggestions for networking in person and online include the following:

--Attend different types of events
--Meet people through other people
--Introduce yourself when appropriate
--Be genuine
--Don't take up too much time
--Let the other person speak
--Present a success story
--Keep updated business cards with you at all times
--Leverage social media on a regular basis
--Follow up, follow through

"Your network is your net worth"
--Porter Gale

May you all have a prosperous and healthy 2021.  Feel free to contact Secure Health at 260.804.4041 or email [email protected]

Lana Scherer

Secure Health, Inc.

260.804.4041 / [email protected]

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Repairs Procedure and Shipping Instructions

January 30, 2021
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| Categories: Management, Uncategorized

PROPER PACKING & SHIPPING INSTRUCTIONS

In the event a repair is needed on your VNG or caloric devices, please follow these packing and shipping instructions

On occasion, you may need your Difra device sent to us to be repaired.  When this is necessary, first follow the instructions for return authorization and where to send your device then look under the heading Warranty & Repair Return Protocol.

I am writing this shipping guide because we receive a fair amount of poorly packed devices when they arrive at our office. Do not simply throw your caloric irrigator into a box, tape it up, and ship it.  There is a very high probability of extensive damage if you do.  A relatively low cost repair can now cost several thousands of dollars because the package was not properly prepared for shipping. Yes, this has happened more often than anyone would believe. 

If you don't have a proper box and packing materials or you are not comfortable and do not have time to do the packing yourself, take the device to your local UPS, Fed EX, or PakMail location and let the professionals prepare and ship.  Yes, it costs more, but it is highly probable it will get delivered without any additional damage.  It can be money well spent.

Box 

When packaging your device make certain to use a sturdy cardboard box large enough to allow plenty of packing material surrounding every surface of the device.  Don't cram the device in a box that does not allow for a fair amount of packing material.

Packing Material

Proper packing material can be any of the following; packing peanuts, bubble packing, cushioning paper, air pillows or a combination of all.  The rule is, make sure the device is packed so it does not jostle around and the box does not collapse or crush, potentially causing more damage to your device.

Shipping Tape

Make sure to use enough SHIPPING tape to seal your box. Do not use your office or desk tape dispenser.  I promise you, that will not arrive without problems. Tape every seam with multiple strips of shipping tape, including the bottom of the box. We have received packages with the bottom of the box falling apart because no one bothered to put an extra layer of tape on it.

Shipping Insurance

Secure Health, Inc. is not responsible for shipping damages.  We highly recommend insuring your package for replacement value. It costs slightly more to ship, but in the event, it is lost or damage occurs, you can at least recover your losses with little or no out-of-pocket expense.

Shipping Services

Which service do you choose?  My suggestion is either UPS or Fed Ex for several reasons. First and foremost is the quality tracking services.  You can follow the delivery right to the destination plus have a delivery receipt showing when it was delivered and who signed for it.  USPS offers very good service, but based on past experience, personally, I most comfortable with either UPS or Fed Ex.  

Best practices for shipping a VNG or caloric irrigator

How to Pack Your Difra VNG Device 

We recommend you keep the molded plastic Difra travel case in which your VNG was shipped to you.  This offers the best protection for shipping your VNG. The internal space is tailored to the VNG mask and other components allowing them to well protected during shipping.  I highly recommend putting the mask in the Difra case with any other components we request, then put the Difra travel case in a sturdy cardboard box with shipping padding for the safest, most effective way to ship without damage.

If you cannot locate your Difra travel case, then you will need a sturdy cardboard box large enough to contain the mask and other components.  Wrap the goggles heavily in bubble wrapping, not peanuts. 

With a NysStar II, the binocular mask you need to be certain the molded eye cover is installed and secured.  This helps protect the glass mirror.  You do not want this mirror to get broken since your replacement cost is $1,000.  Wrap the entire mask with bubble wrap. It's best not to skimp on the bubble wrapping to make sure we receive your VNG without further damage.  All of your other components need to be wrapped as well.  Fill in any space in the box with shipping material, securely tape the box shut with shipping tape and now you are ready to ship your device.

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A Goal without Action is just a Dream

December 31, 2020
| No Comments
| Categories: Management

A GOAL WITHOUT ACTION IS JUST A DREAM

Goals are great but what actions are needed to reach your goals?

This is a great time of year to reflect on where you were in the past year on both a professional level and personal level.  Where did we fall short in our goals and what steps or adjustments are needed in the coming year to reach your new goals? There are hundreds of books that address goal setting.  Search "goal-setting books" and you will find all you want on the subject. They all have one common thread, goals need to be specific, realistic and contain a plan of action.  So my intent here is to not rewrite the books or introduce you to the latest goal-setting fad, but to simply break down the tried and true steps needed for successful goal setting.

Goals need systems, procedures, and action

The first action step in successful goal setting is to honestly evaluate your past year. Did you set goals? If so, have you taken the time to measure them? An evaluation plan needs to candidly analyze:

  • Were the goals realistic?

  • Where did you end up compared to your goals: ahead, behind, or even?

  • Why did you reach your goal or not?

  • What factors contributed to reaching or not reaching your goals? Economic? Personnel? Lack of capital? Poor planning?

  • What did you do well?

  • What improvements are needed to do better this year?

Now that you have honestly completed your evaluation of last year, it's now time to establish your new goals using the results from last year, plus consider all influencing criteria that need consideration for setting your goals this year. Influencing criteria is trying to predict or evaluate operational changes from last year to this year. For example, changes in the economy, legislative or regulatory changes, personal or personnel changes, capital needs versus capital available, marketing or sales strength, product or service trends, where you are and where you want to be, plus so much more.  Any or all of these influencing criteria will have a positive or negative effect on your goals and must be factored into your goals and action plan.

Now you are ready to state your coming year's goal. Do not make blanket statements such as, "I am going to make a million dollars this year." More than likely, you will never achieve that goal. Unless you are incredibly lucky, it's just not enough to make any kind of blanket statement and expect to reach the stated goal.

Goal-setting is not what you say, it's what you say and then do. If you simply state you want to make a million dollars this year, you will fail. That is not a goal, but a dream. Don't just dream! Instead, plan out in detail exactly how you will make a million dollars, or whatever your number is, with the resources you have available to you or that you can acquire.

If your goal is to make a million dollars this coming year and you made nine hundred thousand last year, your goals will be far more different than if you earned fifty thousand last year. To be successful in your goal setting, it's imperative to consider all aspects, have a firm grasp on the complete picture and be honest with yourself. Keep asking yourself, "Is this realistic and am I up for the challenge?"

Plan the Work, Work the Plan

Your plan of action is the precise steps you need to take to make your goal a reality. It's the 'systems and procedures' portion of the goal setting. If your goal is to create or improve your systems and procedures, start there. Systems and procedures are essential to accomplishing your goals. If you don't have organized systems that you abide by, how can anyone else follow them?

Everyone in your sphere has to be all-in on your vision and action plan for the future. That requires you to instruct, train, coach, ask questions and motivate everyone to be on the ride with you.

Regular communication is essential to attaining goals. Ask your team questions and as well as their input on various systems or procedures. How can we be more efficient? What changes need to be addressed? What value does each person bring to implementing the action plan? What do we do well? What needs more of our attention? If you are successful in motivating everyone to have the same vision, it will be far easier to reach your goals. Everyone has to clearly understand your goals, systems, procedures and action plan to be operating at the peak performance to reach your goals.

Goals are a work-in-progress.  Constantly re-evaluate your goals and make adjustments.

I like to evaluate my progress on a monthly basis. I know many who do this on a quarterly basis. The important point is, don't put all this work into building a goal and action plan and not revisit the plan on a regular basis.  If you need to make adjustments, it's far easier to do so more frequently when such things as influencing criterion affect your goals.

The facts are situations, commodities and conditions change all the time. So, learn to 'adjust and adapt' how we do things. Goals are a work-in-progress. Events that can and will impact your goals will occur, but don't give up.  Don't become so rigid in your goal and action plan that you cannot or will not make adjustments. The end result is what matters so don't get caught up in minor changes in your journey. Adjust and adapt effectively and you will get there.

May you all have a prosperous and healthy 2021.  Feel free to contact me at 260.804.4041 or email [email protected]

Dan Scherer

CEO, Secure Health, Inc.

260.804.4041 / [email protected]

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