Angina

Angina…better known in society as chest pain, is a very common occurrence in today’s population.  The pain and discomfort that accompanies angina is caused when your heart muscle essentially doesn’t get enough oxygen-rich blood, which results in a lack of the adequate nutrients it needs to perform optimally.  The pain in angina may feel like pressure or a squeezing sensation in your chest…some people say it feels like an elephant is sitting on their chest, ouch!  

You may hear of other individuals who complain their pain radiating, meaning that not only is there discomfort in their chest, but it also may be felt in their shoulders, arms, neck, jaw, or back.  Pain from angina could also even feel like a bad case of indigestion too.  Due to the wide variety of areas that can cause you discomfort with angina, several tests will be completed to rule the type of angina you are experiencing, if any.  Do not automatically assume you’re having a heart attack because you may be surprised…it could just be indigestion.  Do not cause yourself more worry than it’s worth because that worrying just makes things worse.

Angina is not a disease in itself; rather it is a symptom of another underlying heart problem.  Usually, angina is a symptom of coronary heart disease.  There are several types of angina which we will elaborate on briefly to hit the high points and give you a little insight to which type of angina you or your loved one may be experiencing.  Total Home Health cares deeply about the state of your health and we believe that if you are well informed you will more likely participate in ways to prevent conditions such as this from happening to you.  Listen up!

Types of Angina

Ø  Stable Angina (Angina Pectoris)

·         Chest pain due to coronary heart disease.

·         Heart muscle lacks adequate blood supply when one or more arteries are narrowed or blocked.

·         Causes uncomfortable chest pressure, squeezing, and/or radiating pain.

·         Most likely occurs during times of physical activity or stress.

·         Can also occur at rest if your arteries are severely blocked or narrowed.

·         Pain episodes will follow a distinguishable pattern and are predictable.

·         Episodes usually lasts 5 minutes or less.

·         Pain may feel like indigestion and is relieved by rest or medication, or both.

·         May be triggered by stress, very hot/cold temperatures, eating large meals or smoking.

Ø  Unstable Angina (Acute Coronary Syndrome)

·         Chest pain is unexpected.

·         Usually occurs during rest, sleep, or with little physical exertion.

·         Commonly caused by reduced blood flow to the heart muscle.

·         Should be treated as an emergency because you could be having a heart attack.

·         Caused by blood clots that block your arteries, which results in inadequate blood flow to the heart.

·         Episodes may last longer than 5 minutes and may worsen with time.

·         Rest or medicine usually does not relieve the pain.

·         To treat, your provider will have to determine where your blockage is, and to what extent.

·         Once the blockage is determined, further specific treatment measures will be implemented.

Ø  Variant (Prinzmetal’s) Angina

·         Almost always occurs at rest, usually between midnight and early morning hours.

·         Attacks can be very painful.

·         Rare condition and usually occurs in younger individuals.

·         Pain is caused by a spasm in the coronary arteries (these arteries supply blood to your heart muscle).

·         Coronary artery spasms can occur from exposure to extreme cold temperatures, stress, medications, smoking, and use of cocaine.

·         Can be relieved by taking medication, such as nitroglycerine.

·         Spasms will occur in cycles, and this is a chronic condition that your provider will strictly follow for your health and safety.

Ø  Microvascular Angina

·         Affects the heart’s smallest coronary artery blood vessels

·         Spasms in the very small blood vessels result in reduction of adequate blood flow to the heart which leads to chest pain

·         Episodes of chest pain usually last greater than 10 minutes, and may even last longer than 30 minutes

·         May occur with shortness of breath, sleep problems, being tired, or having a lack of energy

·         Individuals usually notice this during their routine daily life and possibly during times of mental stress

·         Your provider will create an individualized plan of care to work to control and prevent symptoms of this condition once you are diagnosed.

Ultimately, all chest pain should be evaluated by a medical professional to determine whether or not your situation warrants diagnostic tests and any treatment measures.  You should not ignore episodes of angina because if left untreated it could result in a heart attack, or even death.  Never hesitate to seek out medical attention, it is better to be safe than sorry.

Total Home Health has a program that will work closely with you in regards to your needs related to you angina experience.  Our healthcare professionals are highly trained and will remain on top of your condition to keep you well informed on ways to restore your optimal health and prevent future occurrences of angina.  Plus, our skilled professionals will be alert to any changes to your health that need to be immediately reported to your provider in order to adjust your treatment plan.  Our passion is your overall optimal health and satisfaction!  We will be by your side for all your health care needs throughout your enrollment with us.

Advance Directives

In today’s healthcare world it is extremely important to allow for each and every individual to be an integral part of their own care and direct it in the route that result in the most good without causing harm.  With advance directives for medical care, this can happen.  It is a duty of the healthcare industry as a whole to present ways that protect individuals from making harmful decisions when their mind becomes impaired, or they are deemed incompetent and are unable to make their own decisions.  This brings us to the question, “What kind of medical care would you want if you were too ill or hurt to express your wishes?” 

Advance directives are legal documents that allow you to make your own decisions regarding end-of-life care ahead of time, should the time come that you are no longer competent or become a part of a critical health situation.  These documents give you a way to express your healthcare wishes to your family, friends, and medical professionals in the event that you become unable to direct your own health care and what life-sustaining or life-saving measures are used.  Advance directives will help to avoid unwanted conflict between families and friends, while also avoiding any confusion of care decisions if they are made ahead of time while you are in your right mind.  In addition, you will be at ease knowing that your healthcare wishes are in writing so that you will not have to worry about placing the burden on a loved one to make huge and tough decisions to direct your care to save or prolong your life if you become ill or injured.  Any individual over the age of 18 can prepare an advance directive.

Types of Advance Directives

·         Living Will

- Allows a competent adult to direct health care wishes if he/she were to become incompetent, such as if you were to become critically ill or unconscious.

-  This will includes whether or not you want any unusual medical procedures or lifesaving equipment used to prolong your life.

-  A good idea when creating a living will is to include instructions on the following if you were to become incompetent:

o   Use of dialysis and/or breathing machines

o   If you want all measures done for you if your breathing or heartbeat ceases

o   Tube feeding

o   Organ or tissue donation

·         Durable Power of Attorney

-  Often used in conjunction with the living will.

-  May also be referred to as a “medical power of attorney.”

  Allows you, as a competent adult, to appoint a specific person to authorize care decisions for you if you were to become incompetent.

-  Usually this will not be in effect until you are no longer competent.

·         Do Not Resuscitate (DNR)

-  This is a request not to have CPR if your heart stops beating or if you stop breathing.

-  Your provider will have to sign your DNR order and place it in your medical chart to make it official and this order will be followed by all other medical professionals.

Living wills and durable power of attorneys are legal in most states; your provider will introduce you to your options and allow you to choose what is best for you according to your health wishes and the legalities of the state in which you reside.  As far as DNR orders go, providers and hospitals in all states accept these orders. 

If you are in medical care and do not have a DNR order, such as in an emergency, you will be considered a full-code, which means that all measures will be carried out in order to save your life if you cannot deny them otherwise.  Remember also that you can change or cancel your advance directive at any time as long as you are able to think rationally enough to do so.  These changes to your advance directives will only take affect once they are signed and notarized according to the laws in your state. 

Other Important Legal Information

·         Nurses must follow your advance directive requirements unless there is a court order stating otherwise.

·         Consent is not required if a procedure is necessary to save a life during an emergency.

·         Competent individuals may decline to give consent for a procedure…even if there will be serious health consequences.

·         If a family member were to challenge the advance directive you have put into place for your medical care, there will need to be legal proof from the court system that the advance directive can be overturned and replaced with their wishes for your care.

Total Home Health knows that the process of figuring out advance directive options can be overwhelming and emotionally draining.  Our professionals are trained in this area and will provide you with all the information you need to be completely informed in order for you to make the best decision for your care now, and in the future.  We never know what may happen five minutes from now, let alone a year or two from now…so it’s a good idea to get your measures in writing now in order to be prepared and receive the care you desire in the future!  Enroll today with Total Home Health and we’ll work together to get your advance directives in writing so you’ll have one less thing to worry about!

Abscess

Ever wonder what that red, painful, and warm spot was that popped up under your arm?  Most likely it was an abscess.  An abscess is best described as a mass that is tender and surrounded by redness…ranging from pink to deep red.  Due to their characteristics, abscesses are generally easy to feel just by touching.  The abscess takes on a mass-shape because the middle is full of pus and debris that has collected and deposited itself there.  You may think of an abscess like an extra large pimple…more serious and painful of course. 

Any part of your body is pretty much fair game to an abscess; they are known to pop up just about anywhere.  Frequently though an abscess is found in your armpits, areas around your anus and/or vagina, at the base of your spine, around a tooth, and in your groin.  No matter where an abscess is…it will be a nuisance.  Have you ever heard of someone complain of having an infected hair?  Well, an infected hair occurs when there is inflammation around a hair follicle which can also ultimately lead to development of an abscess or a boil.  If you are unsure whether or not you have an abscess or a boil, do not hesitate to seek medical attention because it will make a difference with your treatment plan.

At this point you’re probably wondering, “What causes an abscess so I can prevent this from happening to me?”  Keep in mind that abscesses are caused when germs get under or into the skin or into your glands.  When the germs enter uncharted territory, an inflammatory response is sparked that causes your body’s defenses to try to kill off these germs.  When your body’s defenses take over, the inside of the abscess liquefies and ends up containing dead cells, bacteria, and other debris.  The area will grow until it reaches a big enough size to house all of what is deposited there creating an abscess.  The abscess will then create tension under the skin and more inflammation of the surrounding areas making it a painful nuisance that generally requires medical attention.

Causes of an Abscess

-  Obstruction of oil or sweat glands

-  Inflammation of hair follicles

-  Minor breaks in the skin

-  Skin punctures

-  Exposure to dirty environments

-  Poor circulation

-  Poor hygiene

-  Exposure to skin infections

Symptoms & Characteristics of an Abscess

-  Painful mass

-  Red, warm & tender to touch

-  May come to a head as they grow

-  May spontaneously rupture

-  Will worsen without care

-  Infection can spread to other tissues

-  Infection can spread into the bloodstream

-  Fever if infection spreads into deeper tissues

Total Home Health would like to encourage you to always maintain good hygiene practices to avoid allowing any unwanted germs to set in and result in an abscess.  Once the germs choose their route and set in, they build up and create a pocket of debris and pus within the abscess.  Treatment of an abscess will usually require more than just antibiotic medications, because it just won’t be enough.  Once your provider assesses your abscess, your treatment regimen will be created.  Do not hesitate to seek out medical attention, because if left untreated an abscess could cause an infection throughout your whole body.  A good point to remember also is that if your immune system is already weak in the first place, you may get abscesses more often and they could be more severe than normal.  Here are some more tips extended to you from Total Home Health.

When to Seek Medical Treatment

-  Sore area that is larger than a half-inch across, especially on the face

-  If a sore continues to enlarge or becomes increasingly painful

-  Sore is on or near your rectal or groin area

-  Your fever reaches 101.5F or higher and you know you have a sore area

-  You notice a red streak extending away from the sore area

The size and the extent of the abscess that you experience will of course determine what treatment plan will be the best for you.  Sometimes an abscess will open and drain spontaneously, but keep an open mind because an abscess could also require a procedure that requires an incision to be made and the debris drained.  During this procedure you provider will make a small incision in the abscess and allow for it to expel the debris and pus so that it may resolve more quickly.  After the abscess is drained, there is usually immediate pain relief, which is good news.  Sometimes you may be required to keep your abscess packed with gauze and change it regularly until the area closes itself and/or shows signs of improvement.

Sound complicated?  No worries because Total Home Health has a program that is right for you.  Our professional staff is aware of just how much of a nuisance having an abscess can be.  We will ensure your treatment regimen is carried out on a regular basis so that your abscess resolves as quickly as possible.  We will also implement measures to incorporate into your lifestyle that will work to prevent further abscesses from occurring while you make the most of your daily life.  Enroll today and let us help you make positive changes in your life!