Tuesday, June 23, 2015


If you hear that someone has hepatitis, you may automatically think it is because of drug abuse.  You must keep an open mind because that is not always true, there are actually 5 different types of hepatitis that is possible to acquire.  Whenever a word ends with “-itis” it simply means inflammation.  Therefore hepatitis is the medical term that refers to inflammation of the cells in the liver. 

Hepatitis can be caused by a virus or toxin, or it can occur as a secondary infection with another virus that has made itself at home in your body.  Your hepatitis condition will be classified as either acute or chronic.  If your hepatitis proves to be a chronic, long-term, condition it could result in cirrhosis.  Cirrhosis is permanent scarring of the liver from persistent inflammation over time.  The most common type of hepatitis actually occurs from a virus.  Along with their routes of transmission and risk factors, the five major categories of viral hepatitis include:

Ø  Hepatitis A virus (HAV)
·      Transmitted by the fecal-oral route, which means it is spread by stool that comes into contact with mucous membranes of your mouth.  For example, this could be a worker that prepares food who does not wash his or her hands after using the bathroom.
·      Risk factors for this type include ingestion of food or water that is contaminated, or having close personal contact with an individual who is infected.
Ø  Hepatitis B virus (HBV)
·      Transmitted by blood.
·      Risk factors include engaging in unprotected sex with an infected individual, infants who are born to infected mothers, contact with infected blood, or injection drug users.
Ø  Hepatitis C virus (HCV)
·      Transmitted by blood.
·      Risk factors include drug abuse and any sexual contact.
Ø  Hepatitis D virus (HDV)
·      Transmitted as a co-infection with HBV, meaning it may also occur if the individual has hepatitis B.
·      Risk factors include being an injection drug user and having unprotected sex with infected individuals.
Ø  Hepatitis E virus (HEV)
·      Transmitted also by the fecal-oral route as mentioned above.
·      Risk factors include ingestion of contaminated food or water.

Let us now explain further how toxic and drug-induced hepatitis may also occur.  An example of drug-induced hepatitis would be overuse of acetaminophen, which is the fancy name for Tylenol that is used more frequently than it probably should be in some of us for everyday aches and pains.  Excessive and prolonged use of Tylenol could result in liver damage, or hepatitis.  Other viruses can also cause hepatitis to occur such as shingles, for example.  Overall, after exposure to a virus or toxin occurs, the liver becomes enlarged due to the inflammatory process.  Then, as the disease runs its course there will be an increase in inflammation and other tissue in the liver will begin to die off because it can’t keep up with the repairs it needs to make.  Once the disease progresses to the point where cells and tissues begin to die off, blow flow then begins to become impaired.  Following are signs and symptoms that you may experience if you have acquired a type of hepatitis:

Ø  Flu-like symptoms (feeling tired, decreased appetite, abdominal pain, joint pain)
Ø  Fever
Ø  Vomiting
Ø  Dark-colored urine
Ø  Clay-colored stool
Ø  Jaundice (yellowing of the skin/eyes)

In addition to the various signs and symptoms, a variety of laboratory tests may be performed to aid in your diagnosis and pinpoint which type of hepatitis you have.  If you contract hepatitis, your symptoms may be very vague, which may cause you to ignore them.  Or you may not have any signs or symptoms at all, which is dangerous and could cause you to be unaware of your infection and putting those around you at an unknown risk.  Total Home Health professionals are aware of how serious the hepatitis condition can be.  We hold strong beliefs that promotion of your health could lead to prevention of the condition entirely and/or prevent it from worsening or being spread to others.  There are several ways we will work as a team to promote your health to prevent this disease while we take care of you, including:

Ø  Providing you with education related to transmission and exposure to the different types of hepatitis.
Ø  Providing you with information related to appropriate vaccinations that you are recommended to receive to prevent hepatitis.
Ø  Educating you on safe and correct injection practices, including how to properly dispose of syringes in your home.
Ø  Providing education to your loved ones about the type of hepatitis that you have and how they can protect themselves.  For example, if you are incontinent and you have hepatitis A, which is spread via the fecal-oral route, those in direct care should wear personal protective equipment such as a gown, gloves, and/or goggles.
Ø  Teaching and reinforcement of proper hand hygiene techniques for prevention in the home.

Total Home Health has a program that you will undoubtedly find suits your needs related to hepatitis.  You may feel like an outcast and hopeless when you are diagnosed, but Total Home Health will make you feel like you belong all day, every day.  Our nursing professionals will work closely in conjunction with other professionals on your health care team to always provide you with the most safe and effective care no matter what!

Irritable Bowel Syndrome (IBS)

When nature calls…sometimes we have to run!  It is a horrible feeling to be in the middle of an important family function or a meeting and sense that you must immediately head for the bathroom.  Missing out on important events in your life can be such a nuisance and in this case it is included in what medical professionals refer to as irritable bowel syndrome, or IBS. 

IBS is a disorder of the gastrointestinal system (your stomach and your intestines), that causes changes in bowel habits.  These changes can include long-term diarrhea, constipation, and/or abdominal pain.  The severity of IBS that you or your loved one may experience depends upon what is causing it.  Generally food intolerances, such as to dairy products, will make the symptoms of the condition worse.  For IBS it is good to work toward prevention of flare-ups and promotion of your own health and bowel habits.  With Total Home Health we offer you some ways to do just that, and here are a few of them!

o   Avoid foods that contain dairy, eggs, and wheat.
o   Avoid alcoholic and caffeinated beverages.
o   Drink 2 to 3 liters of fluid per day.
o   Increase your daily amount of fiber.

Total Home Health has a program that will fit all your needs related to your IBS condition.  Our team of professionals are well-educated on what exactly your condition involves, including how to work toward its prevention.  Your optimal health is our greatest goal and we will work toward prevention of your IBS in order for you to fully take part in every minute of what is important to you.  Risk factors are also apparent with IBS and they include:

o   Female gender
o   Stress
o   Eating large meals that have a large amount of fat
o   Consuming caffeine
o   Consumption of alcohol

Generally if you or your loved one goes through an episode of IBS there will be complaints of various signs and symptoms which can include the following:

o   Cramping pain in the abdomen
o   Abdominal pain from changes in bowel patterns
o   Nausea when eating or when having a bowel movement
o   Anorexia
o   Bloating in the abdomen
o   Belching
o   Diarrhea
o   Constipation

Your specific IBS condition will be directly related to how your body functions.  IBS does not necessarily mean you’ll just have diarrhea, your bowels can be irritated just the same with long-term constipation.  Several different laboratory tests may be performed in diagnosis of IBS, however the condition is generally difficult to diagnose with laboratory tests alone.  Diagnosis is based more on individual descriptions of any changes to bowel patterns, abdominal discomfort, feelings of incomplete passage of stool with bowel movement, and/or the presence of mucus in stool. 

Nursing professionals with Total Home Health will always focus on you and you only!  The professionals assigned to your treatment plan will talk with you about ways to reduce the stressors in your life that could play a part in causing your IBS.  Also, we will educate you about the importance of limiting the intake of food or drink that could be irritating to your stomach and intestines, while working to encourage an increase in your dietary fiber intake at the same time.  In addition to all this, our professionals will work to help you create a food log, and also a record of your bowel patterns in order to refine your diet even more to prevent flare-ups of IBS.

We do realize that diet and lifestyle changes may be easier said than done, and they may not take effect as quickly or as ideally as you may wish.  If this is the case and your IBS continues to persist, treatment with medications may be recommended for you.  Your provider will determine what treatment will be best for your IBS.  Your provider will then always work in conjunction with our nursing professionals to provide continuous and attentive treatment throughout the course of your IBS, to make any adjustments that are needed as quickly as possible to prevent any worsening.  The professionals at Total Home Health are ready to take the plunge with you, no pun intended, and work to promote your health while preventing flare-ups of IBS.  Let’s get started today!

Gastroesophageal Reflux Disease (GERD)

We all love to eat…right?  Well, sometimes after we eat that big meal or too much of something that just doesn’t sit right we get that unwelcomed heartburn feeling.  It is very uncomfortable and we can feel the burning sensation all the way up into our throat.  This “heartburn” is actually medically referred to as gastroesophageal reflux disease, or GERD, which is a disorder the affects the esophagus. 

The esophagus is a tube within our neck that is made of smooth muscle that leads from the throat, all the way to the stomach.  During meals or at snack time when you swallow your food or drink, it travels down your esophagus and into your stomach where the digestion process begins.  If you are diagnosed with a disorder of your esophagus, keep in mind that any part of it can be affected. 

Ideally, there are two sphincters of the esophagus, simply named the upper and lower esophageal sphincters, which work to prevent your food and fluids that you swallow from coming back up into your throat, or esophagus which can cause GERD.  In a healthy adult the esophagus muscles work by simultaneously squeezing and pushing food and fluids down toward your stomach.  While in the meantime the lower sphincter of your esophagus should be relaxed to allow the food and fluids to smoothly pass into the stomach for good and not return.  This now brings us to the point where we can better focus on the big question, “What exactly is GERD and how will I be cared for by Total Home Health?”

To describe this condition in more simple terms, GERD is a common condition that occurs when contents of the stomach flow back up into the esophagus.  Keep in mind that the acids in the stomach are very strong because when they are in full force they are responsible for breaking down the food and drink that you consume into nutrients that are shared and/or stored by your body.  Therefore, when these stomach contents decide to flow backwards and enter your esophagus after they have already been in the stomach, they can be very acidic and irritating to your esophageal tissue.  The irritation causes the esophagus to have to work that much harder to get rid of them if they come back up, which increases the time the acidic contents remain in your esophagus causing that much more damage the tissues.

So how do I know if I am experiencing GERD?  Following are signs and symptoms that you or your loved one may complain of:

ü  Indigestion after eating food that just does not agree, such as something spicy.
ü  Pain that radiates to the neck, jaw, or back that makes you feel like you could be having a heart attack.
ü  Pain that worsens with bending, straining, or lying down.
ü  Pain that always seems to occur after eating and may persist from 20 minutes to 2 hours.
ü  Irritation in your throat (persistent cough), a bitter taste in your mouth (from the stomach contents coming back up), or an increase in salivation.
ü  An increase in flatus (gas) and/or burping.
ü  Pain that is almost immediately relieved by drinking water, sitting upright, or if you take an antacid.
If you notice the same signs and symptoms as mentioned above are familiar to you, and that they occur up to four to five times per week in a consistent pattern, you will most likely be diagnosed with GERD.  Primarily, the treatment for GERD consists of making changes in your diet and lifestyle habits.  However, if your symptoms persists or do not improve with changes you have made to your habits, medications may also be prescribed.  As a last resort, surgery is also an option.  You should seek treatment for your GERD because if it is left untreated for an extended period of time it can lead to inflammation, breakdown of the esophageal tissue, and other complications, including cancer of the esophagus.

This condition can affect almost anyone, but there are definitely some specific factors that put you more at risk, these include but are not limited to the following:

ü  Being overweight
ü  Advancing age (delays in body functions)
ü  Sleep apnea
ü  Eating an excessive amount of fatty foods, fried foods, chocolate, caffeine, peppermint, spicy foods, tomatoes, alcohol, citrus fruits
ü  Increased pressure on the stomach from things such as being overweight, or tight clothing
ü  Specific medications may result in GERD, which your provider will discuss with you
ü  Stress
ü  Weakness and/or prolonged inactivity
ü  Lying flat

Depending on your health condition and the severity of your signs and symptoms, your provider will determine which diagnostic procedure will be the best for you to either rule out GERD, or diagnose you with it.  You will be well informed and educated thoroughly regarding which procedure is chosen for you and how your GERD symptoms will be treated if you do have GERD.  Do not delay if you find yourself having symptoms of this condition, more prompt treatment will result in better outcomes for you.

Total Home Health has a program that is just right for you and your experience with GERD.  Having this condition could cause you to avoid eating altogether if interventions are not taken.  Our nursing professionals will help you better understand your condition and take steps in the right direction to see that you do not have to totally avoid the foods you once loved, but rather consume them in moderation.  At Total Home Health we understand the simple pleasure that comes from eating and drinking what you enjoy, so we will do all we can to help you make positive lifestyle changes to avoid any of the extra treatment or further complications of GERD.  Life is short and should be enjoyed, so make the most out of yours with our Total Home Health professionals by your side, and enroll today!


As we all know, our heart is one of the most vital organs housed within our body.  It must function without error within us at all times in order for us to maintain life.  Of course it works in conjunction with all of our other organs, but if one organ becomes compromised, so will the others.  Heart problems are familiar to some of us and they can occur in individuals of any age.  Some of us develop heart problems as we go about our lives and age, whereas others are born with them. 

Installation of a pacemaker may be an option recommended for you at some point in your life as a result of various heart issues.  An artificial pacemaker is a battery-powered device that stimulates the heart with an electrical current when the natural pacemaker of the heart fails to maintain the appropriate rhythm.  Pacemakers may be temporary or permanent depending upon what your condition warrants.  It is interesting and good to know as well just what pacemakers are made of.  Parts of a pacemaker include:

ü  The pulse generator.  This area houses the battery and the control center of the pacemaker so that it knows when to fire to maintain an acceptable heart rhythm.
ü  The electrodes.  These are wires that actually attach to your heart muscle on one end and then connect to the pulse generator on the other end.

If you have a temporary pacemaker placed, there are 3 possible options that your provider had to research to decide which one was the most appropriate for your condition.  The energy sources of a temporary pacemaker is provided by an external battery pack.  Following are simple descriptions related to temporary pacemakers.

ü  External pacemaker
o   Pacing energy is delivered externally through the muscles in the chest wall to the heart via two electrode patches that are placed on the skin.
o   This type requires a larger amount of electricity in order to maintain heart rhythm, which may be quite painful for individuals when the pacemaker fires.
ü  Epicardial pacemaker
o   Leads of the pacemaker are attached directly to the heart during open-heart surgery.  The wires then extend out through the chest incision, and may be attached to an external impulse generator if needed.
o   Most commonly used during, and immediately after open-heart surgery.
ü  Endocardial pacemaker
o   Pacing wires for this type are threaded through a large central vein of your body and lodged directly into the wall of the right ventricle, right atrium, or both chambers of the heart.  Placement of wires will be based on your needs.

Permanent pacemakers actually contain an internal pacing unit.  These types may also be recommended for you by your provider depending upon what your specific condition warrants.  Following is basic information related to reasons why you may be more of a candidate for a permanent pacemaker.

ü  Permanent pacemakers are intended for chronic or recurrent abnormal heart rhythms that are due to malfunction of a certain area within your heart.
ü  Permanent pacemakers can be programmed to pace the atria, ventricle, or both heart chambers.
ü  The pacemaker mode will be discussed with you by your provider with placement.

There are several symptoms that may warrant your provider to recommend placement of a pacemaker.  You may see symptoms in yourself or your loved one such as dizziness, complaints of a racing heart, chest pain, chest pressure, increased anxiety, feeling tired, experiencing nausea, and having difficulty breathing.  From a clinical standpoint healthcare professionals with Total Home Health may notice signs such as individuals having a heart rate that is either too fast or too slow, having an abnormal rhythm if an EKG is done, shortness of breath, restlessness, low blood pressure, vomiting, and sweating. 

If you have a pacemaker you have probably already been educated on just about everything that you have read, but hopefully you have learned something too!  Anyway, if you do not yet have your pacemaker the procedure for its placement will depend solely on which one is chosen for you.  You will be educated on all of the risks and benefits of the procedure, complications of what could occur once you get your pacemaker, and anything else that your provider feels is important.  Plus, any questions or concerns that you may have will be answered by your health care professional before the procedure takes place.

Total Home Health has a program that is suitable for all your needs once you have a pacemaker.  Our nurses will bring our fantastic services to your home to tend to all your needs that may have become put on hold due to having a pacemaker placed.  Our nursing staff are always attentive to even the slightest changes to your condition, and will report any abnormal findings to the provider immediately in order to keep you in the best possible health.  Don’t forget our staff will always treat you as one of our own, so never hesitate to ask any questions or express concerns, we will be here for you 24/7/365.  Enroll today and we’ll see to it that you have the best possible pacemaker experience.