Difficulty Swallowing (Dysphagia)

At some point in life you or your loved one may be stricken by difficulty swallowing, or dysphagia, as the health care professionals call it.  Noticing a difficulty in swallowing can prove to be dangerous to your health.  You may not be able to eat and drink things as you once could, and it may take longer and/or more effort to move the food or liquid from your mouth to your stomach.  Plus, there also may be pain associated with your swallowing difficulty, which can cause additional problems.  Dysphagia can range from having mild difficulty swallowing to where swallowing may be impossible in some cases. 

There are times when you could have occasional difficulty swallowing, and this could occur when you either eat too fast or neglect to chew your food thoroughly, which usually should not cause much concern.  However, persistent dysphagia should be taken seriously and may require medical treatment which will ultimately depend upon the underlying cause if one can be found.  Difficulty swallowing can arise from conditions such as suffering from a stroke or it can occur with the progression of dementia.  Dysphagia can occur no matter what your age or condition, but it is much more common in the older adult population.

Experiencing difficulty swallowing can cause an individual to become very anxious when it comes to eating or drinking for the fear of possibly choking.  Therefore, some people who experience dysphagia may simply choose not to eat or drink.  Following are some signs and symptoms to look for with dysphagia:

ü  Noticing pain while swallowing

ü  Being unable to swallow at all, or a noticeable change in ability to swallow

ü  Sensation of food getting lodged in the throat or chest behind sternum

ü  Excess salivation (drooling)

ü  Having a hoarse voice

ü  Regurgitation

ü  Frequent episodes of heartburn

ü  Unexpected weight loss

ü  Coughing when swallowing

ü  Having to cut food into small pieces or avoiding certain foods

Be alert to the above changes that may occur with dysphagia.  Generally, if an individual indeed is diagnosed with difficulty swallowing, the diet will be modified according to the severity.  Diet modifications may include having liquids thickened and/or having food served in smaller pieces, or even pureed.  Your provider will determine the severity of your condition before recommending any dietary changes.  You should make it a point to see your provider if you notice a continued pattern of difficulty swallowing, accompanied by weight loss, regurgitation, or vomiting.  The symptoms mentioned could lead to further problems if modifications are not implemented.  However, if there is a known obstruction that is interfering with your breathing, emergency help should immediately be notified.

Swallowing is a complex process and numerous conditions can interfere with it.  There are times when the cause related to the difficulty swallowing cannot be identified.  As with other health conditions there are risks that increase your chances of developing dysphagia.  These risks include aging and other certain health conditions.  As individuals age the natural aging process and the normal wear and tear on the esophagus, along with a greater risk of stroke or Parkinson’s disease, puts older adults in a higher risk category of developing swallowing difficulties.  Certain health conditions also place individuals at risk for difficulty swallowing such as neurological system disorders, like dementia.

If you or a loved one experiences chronic difficulty swallowing, many complications could arise.  These complications could include dehydration, malnutrition, and weight loss.  If one is unable to swallow efficiently, the individual most likely is not getting the adequate nourishment they need to meet the demands of their body.  Respiratory complications may also arise with difficulty swallowing.  Food or liquid that enters the airway when a person tries to swallow can lead to pneumonia or upper respiratory infections.  The best advice is to chew your food thoroughly and more slowly until the severity of your dysphagia is determined by your provider.  Also, try to eat small meals and avoid eating right before bedtime. 

Total Home Health has the program that is right for you or your loved one that is experiencing difficulty swallowing.  Our professional and compassionate staff will provide you with all the care and advice you need to acclimate yourself to any dietary modifications that you may have to adhere to in order to maintain an adequate nutritional status.  Although sometimes we are hesitant to change, most of the time change is good.  Allow Total Home Health to be a part of your changes and help you to continue to lead a productive and proud life.

Decreased Endurance

Endurance is your body’s ability to sustain extended periods of physical activity, which can be several days of low-intensity exercise, or minutes of high-intensity exertion.  Unhealthy lifestyle choices may decrease your endurance, so you can increase your stamina with a few changes to make your body healthier.  These changes include:

ü  Exercising at least four to five days per week for at least 30 to 45 minutes per session.

ü  Following a healthy diet by eating five to six small meals per day, consuming fruits, vegetables, fish, whole-grains, and legumes.

ü  Consult with a dietician if the need arises to find out how many calories you should consume each day, and then monitor your daily caloric intake.

ü  Refrain from smoking as we all know this is a horrible habit that can cause many health complications.

As you age you may think it is normal to be unable to tote things around as easily as you did when you were younger.  You may believe that you just are not as strong as you used to be and you don’t use your muscles as much, or in the same ways as you used to.  Unfortunately, growing older is not always the reason for decreasing strength and endurance.  Low testosterone levels lead to a decreased muscle mass, which also causes a lack of endurance. 

Diminished strength does in fact come with age and the normal progression can occur more quickly if testosterone levels start to drop.  This is because testosterone is a necessary component in gaining and retaining muscle mass, and if levels are low it results in a decrease in strength and endurance.  Furthermore, a decrease in strength and endurance can lead to other issues that may occur in your body, including:

o   Weight gain.  As muscle loses mass, it will turn into fat.  The pounds may quickly add up causing one to experience social anxiety, fatigue, poor sleeping patterns, and a decreasing level of sexual satisfaction because of the extra weight causing an overall decrease in endurance.

o   Higher risk of injury.  In case you didn’t know, your muscles do more than just help you lift something that is heavy; they protect your bones and joints, and help in balance.  If you have a low muscle mass, you may begin to have trouble with balance, which could cause you to experience falls.  As you age, your bones continually become more and more fragile.  So, even a minor bump or fall could put you in an arm sling. 

o   Joint pain.  Muscles protect your bones and joints both.  Therefore, the loss of muscle mass puts you at risk for unnecessary joint pain, which could play hand in hand with causing a decrease in endurance.

o   Hopeless feelings.  As if gaining extra weight and having an increased risk for injuries was not bad enough, a declining muscle mass can ultimately lead to a decrease in endurance.  With a lack of endurance, or stamina, it can be hard for you or your loved one to complete the most simplest of tasks causing you to now feel hopeless.

If you are of the younger population, around 30 years or less, you can regain muscle mass by exercising and weight lifting.  However, extreme workouts are not recommended for older adults with testosterone deficiency that is the cause of loss of muscle mass and decreased endurance.  Your provider will most likely recommend testosterone replacement therapy if you are a part of the aging population, along with light weight exercises to safely add to your muscle mass and hopefully keep you safe and maintain your endurance.

Do not hesitate to consult your provider if you continue to notice a decrease in your endurance.  Your problem could be an easy fix, or it could require more extensive treatment.  Your provider will take into consideration your age, lifestyle habits, diet, exercise regimen, and any changes to your daily routine when deciding on the treatment plan that is right for you.

Total Home Health has a program that is right for you or your loved one if you are experiencing a decrease in endurance.  This condition can take an emotional toll on an individual due to not being able to perform as they once could.  Our empathetic and professional staff at Total Home Health will help you stick to your treatment plan in hopes of regaining or maintaining your current level of endurance, along with making you feel the best about yourself as we possibly can.

Fracture - The Basics

A fracture is the medical term for a broken bone.  Unfortunately, there are times in life when we may unexpectedly experience this painful, possibly life-altering, situation.  Fractures are common and clinicians are familiar with them, as the average personal has two during a lifetime.  Fractures occur when the physical force that is exerted on the bone is stronger than the bone itself. 

The risk of fracture depends some on your age.  Broken bones are very common in childhood, but are generally less complicated than when they occur in adults.  With age bones become more brittle, and you are more likely to suffer fractures from falls that otherwise would not have occurred when you were younger. 

There are many types of fractures, but the main categories are displaced, non-displaced, open, and closed.  Displaced and non-displaced fractures refer to the way the bone breaks.  Following are various types of fractures:

·      Displaced fracture.  The bone snaps into two or more parts and moves so that the two ends are not lined up straight. 

·      Comminuted fracture.  The bone breaks into many pieces.  

·      Non-displaced fracture.  The bone cracks either part or all the way through, but does not move and maintains its proper alignment.

·      Closed fracture.  Bone breaks but there is no puncture or open wound in the skin.

·      Open fracture.  Bone breaks through the skin.  It also may recede back into the wound and not be visible through the skin at all times.  There is also a risk of a deep bone infection.

·      Greenstick fracture.  Incomplete fracture that results in the bone being bent, instead of broken.  This occurs most often in children.

·      Transverse fracture.  The broken piece of the bone is at a right angle to the bone’s axis.

·      Oblique fracture.  The break in the bone has a curved or sloped pattern.

·      Buckled fracture.  This is also known as an impacted fracture.  The ends of the bone are driven into each other.  Commonly seen in arm fractures in children.

·      Pathologic fracture.  Caused by a disease that weakens the bones, such as cancer.

·      Stress fracture.  This is noted by a hairline crack in the bone.

The severity of a fracture will depend upon its location and the damage that is done to the bone itself, along with the tissue that surrounds it.  Serious fractures obviously will have more dangerous complications if they are not treated immediately.  Possible complications include damage to blood vessels or nerves and infection of the bone or the surrounding tissues.  Recovery time from a fracture varies and depends on the age and the health of the individual that is involved.  A minor fracture in a child may heal within a few weeks, whereas a serious fracture in an older adult may take many months to heal.

The treatment plan will depend upon the type of fracture that is experienced by the individual.  Total Home Health has a program that is right for you and any type of fracture that you may be diagnosed with.  Our highly qualified, professional, and compassionate staff is experienced in caring for individuals with fractures on a daily basis.  When you enroll with Total Home Health, we will be with you for each step of your journey and provide you with the highest quality of treatment so that your fracture may heal as quickly and as efficiently as possible.  Enroll today!

Lumbago

For those of you who are unfamiliar with the term “lumbago,” it refers to low back pain.  The two terms are often used interchangeably.  Lumbago is something that can be experienced at any age; however it tends to worsen with advancing age.  The underlying causes of lumbago can be complex and are not always completely apparent just by looking at someone.  At Total Home Health we firmly believe that the client is the only one that can describe their pain.  Therefore, with Total Home Health we will focus totally on your description of the pain you are experiencing, and will always take your complaints seriously in order to keep you as comfortable as possible while maintaining your independence.

Lumbago, or low back pain, is caused by damage to a muscle (strain) or ligament (sprain).  Commonly lumbago is caused by improper lifting, poor posture, lack of regular physical activity, fractures, a ruptured disk, or arthritis.  Often the only symptom will be pain in the affected area, which is why it may not be evident to others that you are experiencing lumbago.  Generally, lumbago occurs in the back, hip, leg, tailbone, or muscle and bone.  Also, leg numbness or muscle spasms can accompany the lumbago, depending on what part of the body is affected.  If your pain becomes chronic, or lasts more than three months, and you or your loved one observes that it is interfering with the activities you complete on a daily basis, you should definitely contact your provider for more treatment options.  Plus, if your pain has occurred from an acute injury such as from heavy lifting or sports, you should contact your provider if it does not get better within 72 hours.

Clients who experience lumbago most often complain of anything ranging from a dull ache to a stabbing or shooting pain sensation in the affected area.  The pain may make it increasingly hard to stand up straight or move like they once considered normal.  Severe back pain could warrant immediate medical attention and you should not hesitate to contact your provider, especially if you experience a loss in bowel or bladder control, have leg weakness, fever, and/or pain when coughing or urinating.

The good thing about lumbago is that there is a great chance that it will resolve on its own and it can usually be treated at home without medical attention.  Use of a heating pad or taking a warm bath may provide temporary pain relief.  Rest is a good thing too, although you probably may not feel like getting out of bed.  However, if the culprit for you lumbago is from a muscle strain, physicians generally recommend that you should return to your normal activities as soon as possible to maintain your muscle tone and flexibility.  The longer you stay in bed and avoid moving the muscle, the greater the chance will be that the pain will worsen.

There are several treatment options for lumbago which depend upon the underlying causes of your pain and your current health condition.  Your provider will determine which option would be the best for you.  Treatment options include, but are not limited to:

·      Rest

·      Heating pad

·      Warm bath

·      Chiropractor manipulation

·      Massage

·      Acupuncture

·      Yoga

·      Medication

·      Injections

·      Surgery

·      Physical therapy

There are also basic rules to follow to prevent lumbago from happening to you or someone you love, which include:

·      Maintaining a healthy weight for your body type.

·      Engaging in regular physical activity.

·      Always lift with your legs, never your back.

Total Home Health has a program that is right for you and your lumbago experience.  Our staff will be your go to person for advice related to prevention and treatment of any low back pain that you may encounter during your care.  Our experienced nurses will be your advocate during your treatment process, and will help to provide services such as education regarding pain medication and also how to correctly manage your medication.  Physical therapy staff will also be available for you when you are enrolled with Total Home Health.  The physical therapy staff is experienced in evaluating your situation to determine what exercise regimen will be the best for you if your level of lumbago is interfering with your daily activities.  Ultimately, our goal is to maintain your level of lumbago at a tolerable level so that you may continue to go about your daily activities and remain in good spirits all at the same time.