Skin ulcer prevention for bed-bound patients - complete guide on choosing a low air-loss / alternating pressure air mattress

One of the most expensive aspects of caring for bed-bound patients are pressure ulcers and wound care. In those terms, they heavily affect both the families of the patients and, in the bigger picture, the economics of the healthcare system.

However, it's fair to say that the highest "cost" is the suffering of the affected patients.

The problem

There is no way of avoiding it altogether. However, the data shows a problematic trend that we want to talk about today.

It's the fact that the technology of low-air-loss and alternating pressure air mattresses has seen significant improvements over the last decade (best medical mattresses today even include both technologies working in synergy). BUT the incidence and prevalence of wound and ulcers development have not followed the significant leap in technology.

Our research shows that the two factors that play the biggest role in the disparity between the numbers are:

1. The difference in the expertise between nursing and non-nursing facilities (as reported by the study conducted in Philadelphia between 1998 and 2001, you can see it here)
2. Inadequate choice of medical mattresses, which especially goes for home settings

The bottom line is that the prevalence has not followed the technological advancements in the area of specialized mattresses. The debate about whether ALL pressure ulcers can be prevented is ongoing and is not likely to end any-time soon. With that in mind, we believe that the energy spent on debating the issue of occurrence and prevalence is (as far as the comfort of the patient goes) wasted and our efforts are better used minimizing the risks.

In the post below, we'll address some of the ways the choice can go wrong and look at some actionable tips to help those in need choose an alternating pressure mattress  to lower the risk of wound injury development.

Issue 1 - not adjusting the choice to wound staging

One of the most common mistakes you can make when choosing the right mattress is not taking the time to properly assess the risk and adjust.

It happens with people in home care if the physician is not consulted. To put it simply - people tend to think that all low air-loss and alternating pressure mattresses are created equal.

The proper way to choose a mattress is to make sure that it fits the wound staging as here defined by the NPUAP.org  - National Pressure Ulcer Advisory Panel.

Note: Don't be confused by the terminology, NPUAP changed "pressure ulcers" to " pressure injury" back in 2016.

Following the guidelines defined by NPUAP, your physician will determined what type of injury-prevention mattress is the right fit.

Once you know this, you can take it there...the part where you have more "leeway" is choosing a specific product, NOT the mattress type.

Issue 2 - specific product choice

This is where we'll get more specific and even mention some trusted brands.

Mattresses and overlays of this type are regulated by the Part 880 Section 5500 of the Code of Federal regulations about "General and personal use devices."

This, of course, doesn't mean that all low air loss and alternating pressure mattresses are created equal.

It is still fair to say that your safest bet is going with a trusted brand.

In this year's update to their guide, TheSleepStudies.com has found that that, based on statistics, the most well-trusted brands among low air loss and medical alternating pressure air mattresses are Drive Medical, Vive and Invacare.

What to look for

Now that we've looked at some specific brands, let us take a step back and analyze types of mattresses available and look into some advantages and shortcomings of each.

Choice of a bed

The systems can come as independent products (overlays of mattresses) or with a bed.

Beds used with the systems can range from classic frames (in lower risk groups) to dedicated beds (the type you'd see in a hospital). The later usually use electric profiling, which reduces the need for manual repositioning and, in turn, the overall risk of injury.

Surfaces

First things first - let's make sure we fully understand the terminology you might come across.
You might see the surface of the mattresses and overlays described as: pressure relieving, reducing or redistributing.

The only term that can be universally applied to air mattress with alternating chambers is "relieving", the latter two indicate that the surface of the mattress plays the role of distributing weight across the surface.

For low risk patients

Classic hospital beds are sufficient for low-risk patients. Foam used for hospital beds offers enough comfort as per a study conducted in 2004 - you can see it here.

Dedicated foam mattresses

If there is any risk of pressure injury development but the risk is not as high as to require dynamic mattresses (we'll get to these in a minute), mattresses made of visco-elastic foam will be superior to standard hospital beds in terms of lowering the risk of pressure skin injury.

Overlays

Dedicated overlays are usually made of fibre or foam (one piece or chunks). On the higher end of risk scale, the physician might recommend a fluidized overlay or mattress.

Non-dynamic fluid filling might be a good choice if access to power (electricity) is limited.

Dynamic systems

This is where low-air-loss and alternating pressure medical mattresses belong. The "dynamic" refers to the fact that these mattresses alternate the pressure in the air-filled cells.

We mentioned a few brands tested and recommended by TheSleepStudies.com above.

Final thoughts

The choice of the right mattress or overlay for pressure relief is sensitive and it has a long-term, both in terms of comfort of the affected patient and, in the big picture, the economics of the healthcare system.

It is not a choice that can be rushed or made randomly.

Sources:

NPUAP.org

National Center for Biotechnology Information

TheSleepStudies.com

Onlinelibrary.wiley.com

This is a guest blog entry.

3 Advancements in Mesothelioma Diagnosis that You Should Know About

Mesothelioma is a rare form of cancer. But in the US in 2017 it’s estimated that at least 13% of all cancers will be considered rare forms of the disease. That means mesothelioma is a big problem. The various forms of the disease are currently without a cure.  There are 4 types which are pleural, peritoneal, pericardial and testicular.

www.survivingmesothelioma.com offers an in depth peritoneal resource, as well as sources for the other 3 types.

In the next few years,’ mesothelioma is going to become a bigger problem because the latency period is more than 20 years. And we only stopped using asbestos 30 years ago.

That’s why these advancements in mesothelioma diagnosis are so important.

Mesothelioma Breath Test

A brand new breath test is changing the way that people are diagnosed with mesothelioma for the first time. Belgian scientists tested the breaths of different people for evidence of volatile organic compounds.

They discovered that sufferers of mesothelioma have certain volatile organic compounds in their breath that healthy people don’t. This simple breath test is cost effective, easily distributed to healthcare centers, and takes mere minutes to administer.

With more research, this new test could offer suitable screening for mesothelioma that has been lacking up to now.

Rosetta Mesothelioma Test

The Rosetta Mesothelioma Test is a brand new diagnostic test that has gone into use in some private clinics. It addresses the issue of doctors misdiagnosing mesothelioma as another form of cancer.

Sadly, this is a common problem that leads to the wrong treatment being given. By the time the mistake is found the cancer has already spread and the patient has little hope of surviving.

The way this test works is it takes a genetic sample from the patient and checks the microRNA inside the tumor. Someone who has a tumor will have different amounts of microRNA depending on the type of cancer.

This will give doctors a better chance of detecting mesothelioma early.

Selected Reaction Monitoring

Selected Reaction Monitoring is a non-invasive blood test that can provide doctors with the tools they need to determine whether someone is suffering from mesothelioma.

It was developed by researchers in Switzerland. The way it works is that it can discover biomarkers within the tumor cells that have made it into the person’s circulatory system. It searches for the biomarkers, which comes from proteins. The information feedback will help to discover whether a person is suffering from mesothelioma.

Last Word – How Far Advanced are these Diagnostic Tests?

It’s important to understand that these diagnostic tests are in the early stages of their development. They have been tested on mesothelioma patients, but it will take a lot more studies before they start to be used across the world.

However, they offer hope. They provide hope that mesothelioma sufferers will be able to be diagnosed with the correct illness early. The earlier that a diagnosis can be made the better the chance of a patient surviving in the long-term.

The longer it takes for a patient to be diagnosed the more likely it is that the cancer will spread to other organs and become nearly impossible to treat.

Do you believe these mesothelioma diagnostic advancements will change the playing field?
 
This is a guest blog entry.

Parkinson's Disease and Tips for Patient Care

Parkinson’s disease is a progressive neurodegenerative disorder that affects the brain, leading to shaking, stiffness, and movement difficulties that worsen over time. Currently, there is no known cure for Parkinson’s disease.

In the United States, approximately 1 million people have the disease. This record continues to climb as 60,000 more are being diagnosed every year, leading to $25 billion in annual medical costs. Worldwide, around 10 million people have to deal with Parkinson’s disease in their everyday life.

The Nature of Parkinson’s Disease

Parkinson’s disease is characterized by a gradual degeneration and death of your nerve cells, or neurons, in the brain area that controls body movement. These neurons are important because they produce dopamine, a chemical that sends signals to other neurons.

When the brain cells that produce dopamine die, the dopamine levels also decrease. This leads to the manifestations of the disease such as stiffness, shaking that is out of one’s control, and balance and coordination difficulties that make it hard to walk. The exact reason why these neurons die is still unknown.

In the earlier stage of the disease, the symptoms usually manifest on one side of the body. As the disease progresses, the symptoms become generalized.

Risk Factors for Parkinson’s Disease

The development of Parkinson’s disease is being linked to genetics. However, only around 10% of cases are believed to be due to certain genes. Individuals with no family history also develop the disease. Old age is also a risk factor but there are also cases of Parkinson’s in the younger population.

Environmental factors are also associated with Parkinson’s such as exposure to certain herbicides and pesticides, drinking well water, living in rural areas, and living near quarries and industrial plants. Research has shown that exposure to pesticides and fungicides can increase your likelihood of having Parkinson’s disease by as much as 80%. The longer your exposure to these chemicals, the higher the risk. Interestingly, studies have found an inverse relationship between Parkinson’s disease risk and caffeine intake, although the underlying biochemical rationale behind this relationship is not fully understood.

Signs and Symptoms of Parkinson’s Disease

The common physical signs of Parkinson’s disease are tremors, bradykinesia, and dystonia.

• Tremors. Patients commonly manifest with tremors in the early stage of the disease. They usually describe it as nervousness or shakiness and it gets worse when the person is experiencing a high level of stress, fatigue, or anxiety. It is initially experienced unilaterally, in one upper extremity, before becoming generalized. Some patients have resting tremors that occur when they are at rest that disappear upon movement. Tremors are often initially observed when the person is eating.

• Bradykinesia. People with Parkinson’s move slower. This slowness of body movement is known as bradykinesia. Every patient describes bradykinesia differently. Some describe it as weakness while others report a loss of dexterity (or the skill in doing tasks). Some patients experience body-aches when doing actions repeatedly. Due to bradykinesia, patients with Parkinson’s find it hard to do fine motor activities such as using eating utensils and writing.
   
• Dystonia. This symptom is common in patients who develop Parkinson’s disease before they reach 40 years old (early-onset Parkinson’s disease). Dystonia is characterized by muscle spasms, causing involuntary foot inversion (turning in) or flexion (turning down). It is often accompanied by leg cramps. Due to this, people with Parkinson’s can have gait problems and might find it hard to walk.

Living With Parkinson’s Disease

Although there is no available cure for the disease, it is still important to address safety issues and emotional and social problems that a Parkinson’s disease patient might be having.

• Patients must undergo routine medical checkups. Encourage them to verbalize the symptom that they are having trouble managing. Some medications can help alleviate the symptoms to help the patient live a more comfortable life.

• Reduce the sources of stress. Stress can exacerbate symptoms like tremors. Make the house as calming and refreshing as possible to prevent agitation and anxiety.
   
• Parkinson’s disease has no specific dietary restrictions and recommendations. A healthy and balanced diet is generally preferred. Increasing the amount of high-fiber foods in the diet can help relieve constipation. Utensils for individuals with Parkinson's can make eating easier and more comfortable. Ensure patients are adequately hydrated by drinking lots of water and caffeine-free beverages, which can lessen muscle cramping.
   
• People with Parkinson’s disease can still benefit from exercise and physical activities. Doing activities like walking, cycling, dancing, strength training, and even swimming has been shown to improve body coordination, mobility, and balance in patients with Parkinson’s disease.
   
• Since Parkinson’s sufferers have balance and coordination problems, make sure that the house is free from tripping and slipping hazards like uneven flooring, trailing wires, and broken furniture. 

Using a bed rail in the bedroom and grab bars in the bathroom can also help prevent injuries secondary to falls.

Overall, the care for patients with Parkinson’s largely focuses on delaying the progression of the signs and symptoms and improving the quality of life.

This is a guest blog entry.

Your Guide to Assembling the Perfect First Aid Kit

A good first aid kit is just like a smoke alarm or a spare tire. You may not always need it, but when you do it really needs to function! Sure, everybody recognizes a first aid kid should have some bandages, a pair of scissors, and some topical ointment. But what really goes into assembling a truly first class first aid kit? Let’s look now.

A good kit is versatile

The best first aid kid will always be as universal as possible. While each kit should be a little tailored to some unique needs (more on that to follow), ultimately a good kit is one anybody can use. Whether it’s used to treat someone who is 7 foot tall and 200 pounds, or 4 foot tall and 50 pounds, or any combination in between, a kit should be versatile.

Further, while certain kits will cater to the specific needs of certain pursuits - such as camping, sailing, or mountain climbing - ultimately each should come with the ability to treat an injury and minimize its pain. Beyond this, it should also provide a temporary solution for the injured person if it’s a serious injury that requires further medical attention.

A good kit is a little overstocked

Depending on your needs, it’s often ideal to have 1 first aid kid per person. This can be particularly important for big adventures like a camping trip or an overseas holiday. Obviously, this is not always practical, and won’t always be necessary.

Nonetheless, it is always useful to play the ‘what if?’ game a little. What if 2 people get injured at once? What if someone needs a second round of ointment or bandages? By packing a little extra you’ll increase the odds dramatically of your first aid kit having too little when the need arises.

A good kit meets your needs and environment

Packing a first aid kit also requires some reflection on your needs and environment. A 300 piece first aid kit will offer more supplies than a compact one, but it’s ultimately about what you need.

It’s really great if your first aid kid has some vinegar to apply on a jellyfish sting. But a jellyfish sting is unlikely to occur if you’re taking an afternoon walk through the forest in the winter. Similarly, poison ivy may be nasty, but you won’t encounter it if you’re swimming in California this summer.

It is great to have a versatile first aid kid, and to overstock it a little on essential supplies. That’s why it is important to be conservative when including any extras you don’t need. Speaking of….

A good kit minimizes perishables where possible

Certain medical supplies will only last for so long.  This is just a fact of life and it is totally OK if your first aid kit needs fresh supplies now and then. Nonetheless, it’s important to avoid stocking your kit with goods that expire quicker than others. Examples of this can be spray on sunscreen, liquid bandages, and similar goods.

Even if the expiration date seems a long time when you first buy it, time really flies when you're kit goes unused. Supplies that expire quicker are fine for small uses day by day such as when working around the home, gardening, or playing sport, but are not good to keep in a first aid kid. Always look to buy supplies for your kit with the longest possibly expiration date.

But a first aid kid won’t replace the need for medical attention

It’s fantastic if you’re first aid kit is versatile and a little overstocked. It is not good if it's trying to replicate the emergency department of your local ER. Overstocking your first aid kid can cause a number of problems.

If your kit is really overstocked, it can be harder to do routine checks that ensure your kit’s equipment works, and its perishable supplies are in-date. It can also mean it takes longer in an emergency to locate the supplies you need. For someone injured and in pain, that extra time taken could mean their condition will worsen, and treatment will become more difficult.

[Conclusion]

We’ve shown here the principles that’ll help you when choosing the best first aid kit.

There may be some variables depending on your particular needs, but there are two golden rules: it’s vital to actually have and carry a first aid kit. Do these 2 things, follow the principles above, and you’ll be prepared to meet any first aid situation that arises.

This is a guest blog entry.

Is Your Tap Water Good Enough To Drink?

In most modern countries the water which comes out of your tap has been collected and then processed through a treatment works before being piped to your home.

Treatment can include a large filtration system to remove debris and a smaller filter system to remove microscopic debris and bugs. The water will also have chemicals added to it to kill any bacteria, effectively making it safe to drink.

If this is the case then you might think that answers the question. However, there is a good reason why many homes have an undersink water filter fitted.

There are several reasons to be concerned regarding the water coming from your tap:

          •    Contamination

In 1998 the Sydney water board announced there were dangerous parasites in the water and that it was not safe for consumption. This was a testimony to their testing abilities as the parasites were noticed and the warning issued before anyone became ill.

However, it highlights the fact that contamination can infiltrate the treatment plant and result in unsafe water arriving at your home. It is possible you could become ill before the issue is supported by the water board.

          •    Pipe Work

There are thousands of miles of pipe work laid across the country which moves the water from the treatment works to your home. Unfortunately, the water is tested at the treatment works. Any break in these pipes which has allowed microbes or bugs into your water is unlikely to be spotted. This means you don’t actually know what you will be drinking.

Pipes also perish over time, leaching chemicals and other substances into your water supply. This might be in tiny amounts which will not affect you until the toxin has built up in your system.

          •    Chemicals

The main chemical which is added to water is chlorine. Unfortunately this has now been linked with some health issues including birth defects and miscarriages. While this is a result of high consumption levels over a long period of time, it is impossible to say just how much chlorine is dangerous to you and how much is in the water you are drinking.

The Answer

The question of is tap water safe to drink cannot be answered with a simple yes or no. There are many variables which can affect the quality of the water coming out of your tap.

To ensure your safety it is best to look at one of these solutions:

          1.    Bottled Water

This can be an expensive way of ensuring your water is safe to drink as you will need to purchase a significant amount of water every week. The average person uses 1 gallon per day for drinking, washing and cooking!

          2.    Fit a Filter

If you add a filter into your main line you will simply need to replace the cartridge periodically. This will ensure your water is always clean and ready to drink from the tap. Not only will this give you peace of mind, it is very convenient!

This is a guest blog entry.

Six Common Liposuction Myths Finally Busted

Cosmetic procedures are becoming a lot more popular these days, which has caused a few problems. When more people begin discussing a subject, myths magically appear out of thin air. There are lots when it comes to liposuction.

This doesn't bode well for anyone considering it in the future. They'll be basing decisions on a few false truths. I think it's time we finally set the record straight. Let's bust a few common liposuction myths once and for all.

Myth 1. Liposuction Is Only for Women

There is a certain stigma attached to liposuction when it comes to men. It's long been considered something only women can enjoy for many years. Luckily, a quick look at the numbers shows attitudes are changing.

One big liposuction benefit is attracting men in droves. Once you've had liposuction your muscles will look a lot more defined. Why spend months in the gym when you can get the same results with a quick procedure?

Myth 2. It's a Great Weight Loss Tool

Liposuction can help you lose fat in stubborn areas around the body, but it's not a great weight loss tool. After you've recovered from your procedure you will still have to hit the gym.

Fat cells in other parts of your body will always find ways to pick up the slack. When you stop exercising you'll end up with problems somewhere else. Think of liposuction as a supplement to working out.

Myth 3. A Tummy Tuck Isn't the Same Thing

Even though a tummy tuck sounds like a fancy name for liposuction it's not the same thing. It's easy to get confused because they're usually carried out at the same time. Tummy tucks have to do with loose skin.

If you have lots of loose skin around your abdominal area, tummy tucks will remove it and tighten everything up. Liposuction comes into play when there is also a significant amount of body fat.

Myth 4. You're Too Old for Liposuction

When you have a medical procedure carried out your chronological age doesn't come into the equation. It's got more to do with your physiological age. That means if you're in good health liposuction isn't dangerous.

Obviously those who exercise on a regular basis will have a body much younger than their date of birth. The only real problem with older people is the fact there is less elasticity in their skin.

Myth 5. Your Cellulite Will Disappear

Women used to think liposuction got rid of cellulite, which was one of the reasons it was so popular. It does kind of make sense when you think about it. Sadly, we now know it's a myth that won't disappear.

There are a few treatments you can opt for if you're desperate to get rid of cellulite. Combine any with liposuction for even better results. Just don't think a miracle is going to happen when your fat is sucked out.

Myth 6. It's Ideal for Maximum Fat Loss

Do you want them to take out as much fat as possible during your liposuction procedure? Common sense says yes, but it's actually the wrong answer. It's not designed for maximum fat loss.

Liposuction is supposed to sculpt your body so you look great. This doesn't have anything to do with a specific amount of fat. Your surgeon will know the perfect amount to extract from your body.

Liposuction Can Easily Change Your Life

When you undergo liposuction it can change your life for the better, so it's important to dispel any myths surrounding it. You can't decide whether or not to try it if you don't know the facts.

This is a guest blog entry.

Cold and allergy season is here! What to do with winter upon us

We stand at the threshold between autumn and winter, which can be a time fraught with illness and allergic responses. Not only are many of the plant-born allergens present, as many common irritants bloom and seed before winter, but the sudden change in weather can fuel the spread of the common cold.

While those suffering from allergies often have their regimen well in hand, how can we better combat the passage of the rhinovirus and shorten the duration of a cold if we succumb? In the article below, we’ll discuss cold medications and cold and allergy palliative measures to help you stay healthy and resilient this winter.

Know the Enemy

Several viruses cause colds, formally known as coronaviruses or rhinoviruses. Many lack this basic understanding and believe that once caught that a cold can be “cured” by various methods. This belief is patently false. To date, there is no vaccine for any form of the common cold. Some individuals believe that antibiotics are effective. However, due to the nature of broad-spectrum antibiotics, the result is often to compound the illness; unnecessary antibiotics weaken your body’s ability to repel additional infections and fight existing viral incursions.

So, you might wonder what use many OTC medications are if they don’t cure the disease. The good news is that, while that’s true, what you can do is bolster your body’s natural ability to fight the cold virus and shorten the duration of the cold. This is the purpose of many of the over the counter cold medicines currently available. For very young individuals suffering from colds, be wary about what remedies you apply, since some OTC medicines can cause dangerous side effects in children.

An Ounce of Prevention

Of course, if you can, improve your chances of deflecting the cold viruses to which you are exposed. Wash your hands frequently or use alcohol-based hand sanitizers. Avoid touching your face during the day, since the human fingertip picks up more contaminants and particulate matter than any other part of your body.

Stay hydrated. The drying impacts of central heating and sudden temperature changes when transitioning from indoor to outdoor activities render your mucous membranes—sinus, throat, and eyes—vulnerable to infection. And take plenty of vitamin D, since less sunlight and more clothing naturally lower our body’s ability to produce this essential vitamin, which is responsible for respiratory health, among other things.

Of course, if you do succumb to a cold, there are measures and OTC cold medications that can shorten your illness. Most medical professionals recommend hydration with broth, tea, water, and juice paired with plenty of restorative sleep. Rest is the ultimate weapon against disease.

Zinc and magnesium are two substances that will also help shorten the duration of symptoms and can be found in remedies from lozenges to nasal swabs. Throat sprays and lozenges are great ways to soothe sore throats, and saline will alleviate congestion when applied through the nostril.

If you suffer from frequent respiratory illness, it might be a good idea to focus on boosting your immune system with preventative measures. However, for most of us, cold medications and therapeutic strategies can alleviate the worst impacts of these viruses. During cold and allergy season, it’s important to know what can work and what just won’t suffice to ameliorate the agony of the common cold.

This is a guest blog entry.