Little Things Mean a Lot

I tell this story to people asking about what we have learned over the years as patient advocates: Most of our clients have “big” diagnoses–heart failure, COPD, Alzheimer’s disease, you name it. And most of them and their families are thinking about these diagnoses, particularly when they go to the doctor. We had one gentleman client who had a number of “big” diagnoses that affected both his physical and mental state. He was also a proud man who didn’t like to complain, especially to his doctor. But the one thing that was really bothering him was a persistent ingrown toenail. Any pressure from a shoe was intensely painful. As a result, he stopped walking. He sat during the day and relied on his wheelchair, which he had formerly used only for shopping trips. Now, in an elder person, stopping walking can lead to all kinds of issues, but particularly that once people stop, they can find it impossible to start again, and often become wheelchair bound. When our gentleman saw the doctor, he went in his wheelchair and never mentioned his toe. He believed he should only talk about the “big” diagnoses because they were the important thing. Of course, when he went again with his RN patient advocate, we mentioned that he should talk to the doctor about his toe and get it looked at. The upshot was that his toe was treated, he got less irritating shoes, and got some physical therapy to get him walking again. But the lesson here is that sometimes, it’s the little things that are really the important ones. If something “small” is bothering you, it is best to get it seen to before it becomes something “big.”

Poison Ivy

You’re gonna need an ocean

Of calamine lotion

You’ll be scratchin’ like a hound

The minute you start to mess around

Poison iv-y-y-y-y, poison iv-y-y-y

      -“Poison Ivy” by The Coasters

 

Now that Spring might finally be under way, we all need to be aware of a threat in our garden that is growing more common.

Poison ivy, also known as Toxicodendron radicans, is a poisonous vine or shrub. It is commonly found in wooded areas east of the Rocky Mountains in North America.

The toxin, found in the sap of the vine, can cause an itchy rash with blisters. This rash is often mild and can be treated at home. If you have a mild case of poison ivy, be sure to gently wash the area with soapy lukewarm water. Apply calamine lotion or over the counter cortizone cream and take an antihistimine pill. Repeat the lotion and the pill as directed on the containers.

Be sure to wash your clothes and anything that might have touched the sap. Although it is generally believed that poison ivy spreads if you scratch it, the spreading actually is caused by further exposure to the sap on different areas of the body through clothes, garden tools, and even pets. Luckily, pets themselves aren’t affected by the toxin in the vine.

If you have trouble breathing or swallowing, your face becomes swollen (especially if an eye swells shut), the rash covers most of your body, or nothing can ease the itch, go to the emergency room immediately.

Due to global climate change, poison ivy is becoming more widespread in North America as well as more toxic. If you notice poison ivy in your yard, keep yourself and your pets away. If you must handle it to remove it, make sure you are wearing heavy gloves, long pants, and long sleeves. Don’t wipe your face with your gloves and be sure to wash or discard anything that touches the vine.

Don’t be “scratchin’ like a hound.” Keep away from poison ivy!

When to See Your Doctor for a Headache

Headaches are, sadly, fairly common occurrences for most people. Generally, we take an aspirin or ibuprofen and it goes away. But when is it time to seek treatment for a headache?

 

Plan a trip to your doctor if :

 -your headaches require you to take pain medication frequently or in high doses;

 – your headaches are getting progressively worse over time;

 -your headache prevents you from performing your usual daily activities.

 

Go to the emergency room right away if:

 -your headaches are accompanied by seizures, weakness, blurred vision, difficulty with speech or other neurological problems; 

 -you feel acute, severe pain, particularly with sudden onset;

 -your headache is accompanied by severe nausea;

 -your headache is the result or an injury, such as a car crash or fall.

Surgery for Back Pain? Think Twice. . .

Back pain can be an enormous obstacle to your daily life. Our spines are so central to every movement we make that any discomfort or pain can make ordinary activities unbearable.

 There are numerous causes of back pain, from muscle spasm to disc problems to bone deformities. And there are almost as many kinds of treatments, from massage and acupuncture to steroid injections to surgery.

Our little Nurse Tip blog is not big enough to provide an overview of all the treatments for back pain, but it’s important to know that according to the Mayo Clinic and recent studies, surgery helps in only a small percentage of cases and can create complications that can be even worse than the original problem.

Our advice is not to rule out surgery altogether, but to think of it as a last resort after trying every other treatment, starting with the least invasive. New studies have shown that acupuncture is very effective for treating back pain.

Have you ever received treatment for back pain? How successful was it? I am interested in hearing your story!

From Grandma’s Medicine Chest: Epsom Salt

Today we have another entry from “Grandma’s Medicine Chest.” These are “old fashioned” remedies that still work for modern ailments.

This time, I’ll be discussing epsom salt, also known as magnesium sulfate.

Both magnesium and sulfate perform important functions in the body. Magnesium keeps the enzymes in your body running smoothly while sulfate plays a role in the formation of brain tissue and joint proteins, and it can strengthen the walls of the digestive tract.

Bathing with epsom salt causes the body to absorb magnesium sulfate. It also loosens sore and stiff muscles. One way to treat a sprain is to soak the area in a warm epsom salt bath for 10-15 minutes, three times per day.

Magnesium sulfate also helps keep skin soft and can help heal sores or wounds on the skin. Be sure to rinse the salt off your body after bathing, because the residue will dry your skin. You can also include baking soda in your epsom bath to further moisturize your skin. If you like, you can add a couple of drops of an essential oil, such as lavender or lemon balm to your bath.

Epsom salt can also be used orally or as an enema to treat constipation. But be careful–ingesting too much epsom salt can dangerous or even fatal. Our nurses recommend Miralax for gentle treatment of constipation.

Also be aware that epsom salt baths also have laxative properties. After all, you are ingesting the salt through your skin. While occasional baths don’t generally cause you to take in enough to result in diarrhea, consistent soaking can have an effect on your digestion.

Do you remember your mother or grandmother talking about it? Did you ever wonder what it was? What other “home remedies” have worked for you?

Does George H.W. Bush Need A Nurse?

Watching the dedication of the George W. Bush presidential library yesterday, I was struck by the sight of “Bush 41” in a wheelchair. It seems that he has been having trouble with mobility for some time, although he was walking four years ago when President Obama was first in the White House.

Of course, as an ex-President, George H.W. Bush receives the finest healthcare the US has to offer. But I hope he also has the advice of a medical professional who looks at the whole picture. An RN patient advocate can look at the intersection of medical issues, lifestyle, and medications see provide truly independent council. Doctors don’t always hear about these nuances, and they are not in the home. Other advisers may have their own agendas. But an independent patient advocate works only for their client.

And even the powerful, the wealthy, and the famous can suffer when some vital issue isn’t seen. It’s especially important to pay attention to any decline in activities of daily living, such as mobility. Often, if the issue is understood promptly at least some mobility may be maintained.

Everybody–even a former President–needs a nurse!

Does Nelson Mandela Need a Nurse?

He would if he were in the U.S.

Nelson Mandela in 200

You may have heard that former South African president Nelson Mandela was admitted to the hospital to treat a chronic lung infection. This is the second time he has been admitted this year.

Hospitals are dangerous places. They are full of infectious germs and high-tech machines and tests. In the U.S., it’s common practice to treat a 94-year-old patient the same way a 45-year-old is treated, with the same tests and procedures.

But many elderly people do not benefit from this kind of overzealous treatment. Performing a cancer biopsy on a 90-year-old can cause more problems than it solves by harming the integrity of fragile skin and disrupting the body’s processes. And if cancer is found, then what? If this person is in fragile health, it they aren’t good candidates for either surgery or chemotherapy.

Nelson Mandela is in the hospital to get antibiotic infusions, and there may be a reason why he cannot get them in his home. But at 94, it may be preferable to the patient and his family to keep the patient comfortable, even if that means his life may not be prolonged.

We can’t make the clinical decision for President Mandela, but when our loved ones are faced with this kind of medical decision, working with an R.N. patient advocate can help us understand the risks, as well as the benefits, of treatment.

New article about health advocates

Last Sunday, Parade magazine had a great article about the benefits of hiring a patient advocate. It’s great to hear about other people whose lives have been improved by having someone look at their health issues from a professional point of view.

http://www.parade.com/health/stay-healthy/2011/06/12-health-advocate.html

Guiding Lights

We had such a great time at the Guiding Lights grand opening event!  Lots of good food and conversation, plus a musician!  I’m so happy to be involved with the country’s first caregiver’s support center.  I think they’re going to do amazing things!

If you’re a caregiver, check out their website:  www.guidinglightsnc.org

Nurse Tip of the Month–October 2010

Check Your Shoe Size

The next time you shop for shoes, remember to get your size checked. Many of us keep buying the same size shoes for decades, but our feet change over time. Wearing shoes that are too small can cause circulation and pain problems, while wearing shoes that are too large can be a fall hazard. Always be sure to buy comfortable, well-fitting shoes.