An Assessment with Julia

What should I expect?

It's understandable to be curious about what an assessment looks like, as well as what a treatment plan will look like in your time with me. I'm writing this in the hope it answers some of your questions and conveys my commitment to ensuring you're happy with my treatments. I stand behind my business — and if this doesn't answer your questions, please reach out via the Contact page.

Initial assessment

All of my patients begin with an initial assessment. My areas of expertise are Sleep Coaching, Buteyko Breathing, and Myofunctional Therapy. In our 60–90 minute full evaluation, we assess function and I ask about your day-to-day life. Where possible this is best done in person (though I'm happy to work with you via video as well). The assessment includes photographs of your facial and oral structures, videos of functions such as swallowing, and a thorough medical, dental, and sleep history. The goal is to set achievable goals, set expectations, and begin formulating a custom training plan.

Treatment

Following the assessment, our course is charted depending on several factors. Meetings are held between 1 and 4 times per week, depending on schedule and plan. I can work around your week, and weekends are available if necessary. Meetings can be in person in Manhattan or virtual — most patients opt to meet virtually. During these meetings we go over new exercises, assess functional gain (or address stopping points), and end with an open Q&A. The treatments require practice over time, facilitated by frequent touchpoints.

Meeting frequency

In the interest of full transparency, you can expect an approximate frequency depending on treatment:

• Myofunctional therapy: Phase I (intensive) — weekly for 8 weeks; Phase II (generalization) — 2–3 weeks apart; Phase III (habituation) — 3–4 weeks apart
• Buteyko breathing: once per week for the initial training; minimum 6 weeks, typically 6–12 weeks depending on progress
• Habit elimination: daily text/call check-ins for the first week (e.g. thumb sucking in children — see Thumb Sucking: A Common Bad Habit)
• Sleep issues, insomniac: weekly for 4–6 weeks
• Sleep issues, non-insomniac: weekly for 1–4 weeks

Free advice!

You made it this far, so here's some free advice to help in your daily life:

• Smile! As Phyllis Diller said: "A smile is a curve that sets everything straight."
• Be mindful of your breathing. Try to breathe through your nose, and check that your lips are closed when you breathe.
• If you catch yourself clenching your teeth when stressed, relax, spread your tongue over the roof of your mouth, close your lips, and hum your favorite tune through your nose. Humming triggers increased nitric oxide production in your sinuses, which — among other benefits — is proven to lower blood pressure.
• Before bed, limit blue light, loud music, and high-intensity training. Avoid caffeine, tobacco, and alcohol. Take a warm shower. Keep your laptop out of bed. Reserve your bed only for sleep and intimacy.
• Blow up balloons! Balloon blowing helps with throat and diaphragm muscle training.
• When at your desk, try not to cross your legs, support your feet on the floor, use a good armrest and lumbar pillow, and stand up and move at least every 30 minutes. Any position is better than the previous one.
• Get 15–30 minutes of sun a day to support vitamin D production — it improves mood, gut health, fertility, and melatonin production for better sleep.
• Fill your mind with gratitude and positive thoughts. Expressing and receiving gratitude helps release dopamine and serotonin — natural antidepressants.
• Stay healthy and happy!

Interested in learning more?

Please reach out for a no-pressure discussion of your symptoms and interest in my services. After that call, if you decide my treatments are right for you, we'd schedule the initial assessment and get started. Have a great day!