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Home care, especially for the ailing seniors, is not easy. The home caregivers need to follow a lot of set guidelines and rules for making sure that care services provided are just as needed by the patient. Whether it is treating a general patient or dressing the wound of someone who has met with an accident, there are specific processes to follow for every care process and therapy.
The same is applicable for providing Inotropic therapy, especially in a home setting. However, the rules to follow in such types of care processes seem to be more severe simply due to the complicacies involved in it, aimed for the treatment of HF or heart failure. These guidelines of Inotropic therapy are designed by different agencies and organizations such as:
· The National Institute for Health and Clinical Excellence, NICE
· The Heart Failure Society of America, HFSA
· The American College of Cardiology Foundation, ACCF and
· The American Heart Association, AHA.
These guidelines provide all of the home healthcare providers with the necessary clinical resources and therapies to use in the treatment of HF.
However, at this point, it is important and motivating to note that only the ACCF or AHA Task Force guidelines mention the use of an intravenous inotrope therapy in the home setting, though the comments are in brief and not very specific.
The AHA comments
According to this specific guideline it is stated that the decision to go with and continue with the intravenous infusions at home should not be made until all other alternative attempts are made and are proved to have failed repeatedly and substantially in achieving stability in the patient.
· This is because applying such an approach and therapy in a home setting may present a major problem to the family as well as the health care provider.
· There is also an increased risk of death of the patient that may ultimately increase due to this therapy.
Therefore, make sure that the health care provider discusses the matter with the physician and the proper clinical judgment is made with the collaboration with the patient. Remember, all possible treatment options are paramount.
The background of the therapy
It is also required by you as well as your home caregiver to know at least a little bit of the background of the Inotropic therapy before using it of the HF patient at home.
· One of the earliest intravenous inotropes used was Epinephrine and dates as early as the early 20th century.
· The inotropic therapy, however, started to be used routinely in hospitals for treating advanced diseases since the 1950s to 1960s.
· The therapy needs to be given intermittently to the patient over 72 hours and at specific intervals. However, it can also be given continuously.
The ACCF or AHA guidelines, however, do not recommend such therapy using sporadic outpatient infusions of vasoactive drugs such as positive inotropic drugs or Nesiritide. This is because these drugs have not really shown any effectiveness in improving the symptoms and may even jeopardize the survival of patients suffering from advanced HF conditions.
Use of inotropic therapy in homes
The use of inotropes for home care Philadelphia is however more recent. Ideally, this type of therapy is normally reserved for those patients on whom all other traditional therapies and care processes have failed to improve the symptoms in HF patients.
There are different indicators used for this purpose and includes:
· Higher Type B natriuretic peptide
· N-terminal pro b-type natriuretic peptide levels and
· Left ventricular ejection fraction levels that are either less than or equal to 35%.
In order to ensure better results, along with the inotropic therapy, allied patient symptomatology must also be followed by the home care nurse.
Oral inotropes, on the other hand, however, developed in the last couple of decades. These drugs have shown positive results and can immensely improve several symptoms. It is due to its special ability that includes:
· Increasing cardiac output
· Decreasing filling pressures and
· Enhancing the quality of life as seen in most of the cases.
However, the use of chronic oral inotrope has been accompanied by higher mortality rates thereby raising the concerns regarding the intravenous formulations on the whole, which ideally is the prime factor to increase mortality.
With all these diverse possibilities and concerns, the guidelines state that the patients must be fully informed about the therapy and its effects. They must also be adequately informed about the fact that although inotropic therapy may make them feel somewhat better, it still has the potential risk to shorten life expectancy, even if they survive the initial impact of the therapy and the inotropic drugs.
The cost factors
Apart from the consequences, both positive and negative, of the inotropic therapy, another thing that may raise your concerns is the cost factor associated with this therapy.
Though a bit on the higher side of the cost scale, you can still afford such treatments if it is absolutely necessary. This is because you can avail Medicaid waivers and different state funding as well, provided you qualify for it.
Therefore, check out in your area whether you can avail of such benefits in such services and care coordination. Typically, the Medicaid programs are aimed at providing help to older adults and other people with disabilities to remain independent in their homes or in their communities.
These programs include different types such as:
· Assisted Living Waiver
· Home Care Waiver and
· Specialized Recovery Services Program.
In addition to that, there are also specific programs such as state Alzheimer's and Senior Community Service funds. This type of program is designed to provide services to older adults and people with disabilities in specific regions that include:
· Caregiver respite
· Personal care
· Adult daycare
· Transitional care and
· Evidence-based wellness programming.
All you have to do is a little bit of research to find the right type of program that will support your inotropic therapy needs and cost. If you are lucky, you can even earn tax levies by the local government that is also provided to benefit the seniors.
The best example of professional predisposition to toenail infection can be seen in runners. Training or participation in big events – both can lead to fungal infection which is most commonly known as toenail infection. The causative agent as we all know is a fungus, namely, dermatophytes.
We thought you may be interested in knowing, so...
Why are toenail more susceptible than fingernails?
- Bloodflow to our toes is less than our fingers, which makes difficult for our immune system to detect and cure the infection.
- Toenails remian inside the shoes for a long time hence provide an apt environment for the fungus to grow. The two reasons runners get this infection include excessive sweat and occluding footwear.
Now, coming to its cure...
One must remember that before treating the toenail fungus with any topical ointment or homne remedy, it is important to remove the thick layer of fungal biofilm. Only then, anything will penetrate the skin and produce relief.
Now lets run through some of the natural means of getting rid of the toenail fungus:
Apple Cider Vinegar
This amazing liquid has only one rival in terms of benefits that it provides – tea tree oil. Use it in the below given manner:
- Add some apple cider vinegar (or white vinegar) whichever you have at home into a tub full of warm water.
- The proportion to be used is 1:1. If it causes irritation, make it 2:3 and use it on alternate days rather than every day.
- One must do this at least for 3 months to get rid of the fungus.
Tea Tree Oil
The antifungal and antibacterial properties of the oil make it a perfect remedial essential oil for the infection. Use it in either of the following manners:
- Apply it directly on to the affected areas with the help of a cotton ball.
- Soak your feet in warm which has 4-5 drops of the essential oil. Let your feet in there for 15-20 minutes. Dry thouroughly.
Both the methods are equally good. Though there are organic tea tree oil wipes but they are better for cleaning nicks and cuts.
This oil should be used for its ability to disintegrate the cell membranes of the fungus.
Use it in the following manner:
- Apply a thin layer of the oil on to the affected area. Apply it 2-3 times in a day.
You will have to wash your hands in between the applications to ensure hygiene.
It is a staple product lying in our kitchen and often overlooked for its skincare benefits.
Ingredients: baking soda (one-half cup), 1/4 cup 3% hydrogen peroxide and one half cup of Epsom salt.
- Mix all the ingredients
- Add white vinegar 1/4 cup of white venegar
- Soak feet in the solution for 10 minutes
Do it two times in a day.
Oil Of Oregano
It makes for a fantastic cure for toenail fungus since it is all in one – antifungal, antibacterial, antiseptic, analgesic and antiviral.
What you need to do:
- Take two drops of oregano oil and one teaspoon of olive oil. Mix.
- Apply it on the affected part
- Let it stay there for half an hour.
- Rinse off
- Dry your feet
Do it two times in a day.
By following these methods, you can cure your toenail fungus. Try them and let us know the results.
Hi again! In Part 1 (The Puzzle of H. pylori: The Science) I explained what Helicobacter pylori is, how it invades the body, the symptoms it causes - basically, all the science stuff. Here in Part 2 of my trilogy of posts on my H. pylori experience I'm going to talk about my own personal H. pylori project i.e. my experiments with various foods and herbal remedies in my efforts to come up with my own treatment and eradicate the little pest from my body!
My personal pylori project
The core of my plan has been the rather fantastic mastic gum, a herbal remedy from a Greek pistachio tree with potent anti-pylori activity. A little goes a long way – my pot of 13g lasted me 3 weeks. I'd just like to run through some more of the details of my plan, to give you an idea of the natural products that can be used to discourage pylori.
When you chew the 'bobbles' they turn into a gum!
Most people seem to recommend cycling on/off, but the length of your on/off periods doesn't seem too critical. Personally I've been doing 3 weeks on, then anything from 2 weeks upwards off. As well as the mastic, I've been making a point of eating as many other anti-pylori foods and herbs as I can manage such as: brassicas (especially Brussels sprouts and flower sprouts), cranberries, triphala and lemon balm. So far I've done two rounds of treatment, building up the dose of all of these products gradually. I've found that combining 250mg of mastic with ½ teaspoon of triphala and taking this first thing in the morning seems to have the most powerful effect, judging from the die-off. I'm also trying to have as many stomach soothing foods as possible including: carrot, fennel and green juices, unripe plantain powder, cherries, persimmon smoothies, chia seeds and coconut. This apparently is important to repair the damage that pylori has done to the stomach lining. Judging from my symptoms of gastric irritation, my lining has indeed been left in a pretty ravaged state.
Some of my anti-pylori agents – brassica veg (Brussels and flower sprouts) and home-dried cranberries. Functional and fun!
Killing off the pylori overgrowth and repairing the stomach lining can be a fairly long-term project. Dr. Yasko says it may take months or years to address and also that once you've eradicated the pylori, symptoms can persist for perhaps 6 months afterwards. Obviously, this can make tracking progress a bit tricky, but I'm guessing it's wise to keep up with some kind of pylori control measures until you're feeling sure things are in a better state of balance. Some people say that the mastic also kills good bacteria, but instinctively, I feel comfortable with taking a low dose (500-750mg per day) and reassured that it's a daily part of the diet for many people in Greece and the Middle East.
Herbal helpers – mastic gum and triphala (an Ayurvedic remedy comprised of three sour fruits)
What happened next?
Some very wild die-off in the first few days which lessened as time went on, though even at the start, I felt remarkably better in between all the die-off. My symptoms included: severe nausea and reflux, the worst episodes of facial, arm and leg twitching and shaking I've ever experienced, feeling very fed up, bladder problems, especially bad delayed stomach emptying and more of a saliva shortage than usual. Plus a lot of episodes of the smelly sweating. And nope – I could not tell you what the connection might be with all of this!
On the plus side, I felt: improved energy, calmer, happier mood, significantly less burping and 'stomach squelching'. And once the dust had settled: generally smoother digestion, less irritable bladder symptoms and fewer twitching and sweating attacks. I have been so excited to start getting a sense in the past few months of what 'normal' feels like, when I've been having pretty extreme difficulties for the past 10 years! Improvements in the digestive department have been less pronounced so far than the general energy boost, though from Dr Yasko's info, that would be usual for the stomach to be catching up later. For now, I think my system is just relieved not to be permanently overwhelmed with ammonia.
I was hoping to try and add in some other herbs to alternate, but unfortunately my experiments with rosehips and broccoli sprouts haven't been a success. The others I've tried also haven't seemed to have such potent effects as the mastic, so I suspect I'll go back to this star-performing herb. As I'm sure you'll notice, this is really a make-it-up-as-I-go-along approach!
In the third and final part of 'The Puzzle of H. pylori' I'll look at the connection between H. pylori and environmental Illness (EI).
You can also find more info on the best blenders for smoothies on Wife Knows.
Whether you suffer from chronic fatigue syndrome (CFS/ME), fibromyalgia, multiple chemical sensitivity, irritable bowel syndrome (IBS), or any other illness which we cover on The Environmental Illness Resource, the treatment options available from conventional medicine are extremely limited or totally non-existent.
When I was diagnosed with ME/CFS in 1990 at the age of 11 I was given two treatment options by my doctor and various hospital specialists.....psychiatric treatment and 'graded exercise'. To cut a long story short, the psychiatric 'treatment' involved a grumpy old man suggesting that the only things wrong with me were that I didn't want to go to school and I had problems at home. Neither of these suggestions was even close to the truth, I loved school and was deeply upset about having to miss days because I was too ill. I also had a very happy home life and have a fantastic family. This is besides the fact that if I had problems at home AND wanted to avoid school, surely I would not have spent the days I had off school....at home in bed!