Learn How to Advocate Your Loved Ones Medical Needs

21 08 2011
Family Support at the Hospital is a Huge Plus

    If you have a loved one in urgent care, or are now experiencing serious ill-health issues yourself, it would be wise to ensure a family member or significant other advocates on your behalf should health further deteriorate. Why?  Because a well educated, informed and/or concerned family or significant other “often” can provide valuable medical information to the treating physician.

     This becomes truer if your loved one is no longer able to make decisions and provide accurate medical information to medical staff.  And in knowing ones medical history and current health profile “is” enough to save, or prolong life with the right advocacy skill sets!  Don’t think so, you will want to reassess how you view the medical services applied within the disabled and senior citizen ranks.  Why is that?  Our medical service industry is built upon quick patient turnaround.  This has mostly to do with the ever increasing costs and finite medical services-specialties, drugs and diagnosis technology resources.  So as push comes to shove, making room for another patient becomes the status quo.  It would be prudent to ensure your loved one receives the best treatment possible by advocating on their behalf.  Senior citizens don’t have the luxury of time on their side when it comes to accurate diagnosis and treatment.

    There are limits to finite human resources and what can be provided, or expected under emergency circumstances in the ER scenario.  And this is especially true if a patient intake area is under heavy demand.  Tempers often run short and emotions are less than tempered. And the patient and family member expectation for immediate medical services is high.

     This then requires the skill sets of a “cool head” and “experienced” family medical advocate to understand the situation and communicate accurate medical information on a loved one’s behalf.  I know, the typical patient expectation is that the medical staff knows best.  But even under the best case scenarios, vitals will not tell staff the entire medical history of a complex ill-health condition(s).  And this becomes even truer if the patient’s primary care physician is not available for an immediate consultation with medical emergency staff. 

     At a minimum, if you are designated as the families medical advocate for a loved one:  Ensure you have medical insurance information, a contacts list of patient doctors and specialists and a list of current medications on hand.  It would also be good to carry a current medical history transcript for the patient.  Or if you have power of attorney, simply go to the hospital’s medical records, request patient documents for the current year and ensure you highlight (yellow marker) the recent diagnosis, treatment and drug prescription listed on the medical transcripts.  Also arrange if you’re going to be out of town, or on vacation to provide an envelope with the patient’s medical transcripts and other information to an alternate family advocate as a backup plan.                       

    Contact listing and medical transcripts are good.  But it would be better if the family advocate could obtain some level of knowledge on how their loved one’s chosen HMO is organized at the emergency triage, patient holding and in-patient intake services.  Without this understanding, you’re missing pieces of the puzzle in advocating for the best possible care.  It also helps to have some customer service skill sets in talking to the doctors assessing the situation as they are now making decisions on treatment to stabilize.  In other words, if you have a choice of a family member advocate, ensure they are customer service oriented.  A bull in a china shop mentality will not help matters.

     So I put this question in front of you…  How could the emergency intake personnel know about a complex medical history simply based on the current vitals and symptoms that got the patient admitted?  The answer is simple, they can’t.  They read the vitals, treat the symptoms to stabilize and then depend on information the patient or family advocate, or primary care physician provides.  The goal of ER medical personnel is to stabilize the patient.  Until other information on the patient is received; lab work and other referred medical services are initiated while the patient waits further results processing in patient holding.

     If the seriousness of your hidden medical condition is an underlying unknown to the medical staff and treating physician, you’re “now” stable vitals will move you to a lower triage priority category while waiting on various lab results in patient holding.  A good example I know almost everyone can relate if you’ve gone through urgent care:  If you are stable, you’ve experienced hours before you are passed through the next phase of treatment.  And this delay in medical treatment for many disabled, or our senior citizens is not good for their overall health outcome!

     If you depend solely on the subjective judgment of an examining doctor, including your primary care physician, you’ll be treated by their understanding of the current symptomatic, physical examination, lab results, x-Rays, etc.  And this may not be in the patient’s or your family’s best interest.  It would behoove the family advocate, or patient learn as much about the ill-health condition(s), HMO policy’s and medical organization services; and armed with past and current medical information to become a part of the treating physicians decision making process.  Without this advocacy resource plan a loved one and/or family members may experience more pain and suffering that need not be. 

Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2011 Copyright, All rights reserved, Mirror Athlete Publishing @: www.mirrorathlete.com,  Sign up for your Free eNewsletter.

Rehabilitate Self Through Walking

9 04 2010

Marc from Mirror Athlete stops during his 10mile walk.  See  (www.daretowalk.com) and (www.mirrorathlete.com)  current stories/projects to show you how he went from being confined to bed and wheelchair after surgeries back to health.

It took him approximately 3 years to go from 1block to 18mile (best walk). Doctor’s had left him with prescriptions, handicap placard, stay off feet advicement. His mobility aids of choice : Wheelchair, walker, canes. There was no instruction on rehabilitation to get back what he had lost; other than self advocation for more physical therapy and specialist referals. In other words, it was all up to him to find the motivation, strength and applied knowledge to progress to where he is today. Marc had one knowledge based benefit most don’t have… An undergraduate degree in Exercise Science that he used to apply in order to rehabilitate himself.

Marc specializes in fitness, general health, wellness, nutrition and pain management. See his websites: Through his project hub:  At Mirror Athlete.biz 

Also you can follow mirrrorathlete or daretowalk on twitter. You can also sign up as a Face Book fan and follow Mirror Athlete Enterprises through Facebook. Please chime in on discussions if you have time to contribute.   Share your rehabilitative stories, your walking and active movement exercise activity success.  Send your video links to the Facebook discussion room under an applicable health category so we can post videos here as we do at YouTube (mirrorathlete). In this way we share and outreach to millions that are suffering in unnecessary pain. We welcome your support and success stories for the sake of others that need your inspiration and motivation. Good Health to you and your families!

Author:  Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET2009 Copyright.  All rights reserved, Mirror Athlete Publishing @: http://www.mirrorathlete.com,  Sign up for your Free eNewsletter.

Improve Fitness after Surgery-Rehabilitate Yourself

8 04 2010

 If you have just recently had surgery, experienced an injury and now are finished with your HMO rehabilitative services and want to become fit there is a post exercise mobility therapy habit that needs to be considered to ensure quality living experiences.  Many that are going through physical rehabilitation tend to gain weight, lose strength, cardiovascular endurance and suffer acute to chronic pain from inactivity.

 If you experience weight-bearing acute to chronic pain in any of your weight-bearing joints, i.e., back, neck, hip, feet, legs and have put on weight, or simply want to take control of your weight, a safe starting movement activity is the way to go.  This means to find some form of activity where you can move your body to begin increasing your fitness levels. 

 There are exercise activity routines you could participate in to rehabilitate yourself to walk, if not able to walk well.  For example, there’s extended physical therapy offered by many health insurers, to include Medicare.  If your insurance does not cover extended specialized services because you have annual limits on these services which you’ve used up, all is not lost.  The same is true if you have coverage that only includes short-term, or very limited medical services.  If you have the ability to walk, you are in a better position to rehabilitate yourself through walking movement activity.

 Now if you’re in a bad way and you need assistance to get yourself rehabilitated, don’t go it alone!  Suck up your pride, reach out and recruit a friend or family member to drive you to the nearest social security administration if you can’t do this yourself, or visit www.socialsecurity.gov online, or call by phone toll-free 1-800-772-1213 to reach a representative.  Office hours are between 7a.m. and 7 p.m. Monday through Friday.  Check into disability benefits if you can’t work.  While your there, check into the supplemental home assistance programs and other available services.

 Rehabilitation after surgery, or accident to get active with life will depend much on your ability to begin actively moving your body to receive a fitness benefit.  The disability assistance is nice because you now don’t have to worry about paying your basic living expenses.  However, a word of caution…  All too often, those with limited movement and pain begin to move even less when disability and supplemental services are provided.  This level of comfort somehow nestles within many to sit around further disabling themselves.  To develop a habit of less activity when one should be attempting to increase activity, “especially if one can walk” is detrimental and a contradiction to overall fit-healthy goals.

Another important point; to improve fitness levels and overall health does not mean your disability benefits will end.  All too often, fear in “not meeting” and maintaining the social disability expectation prevents many from ever improving their fitness levels.  A lifestyle dependent on disability support often promotes meeting the disability expectation for fear of losing needed supplemental disability services.  This primarily occurs because if people appear to become more fit, there is fear that these services may go away.  And of course this is not true.  Why?  Because the injuries, illness and disease that put you into this ill-health condition have been substantiated by medical professionals and most likely will be with you a lifetime.  You should not fear if you improve certain aspects of your fitness levels for better quality living experiences your benefits will be cut off.

 My message for those that find themselves in this situation, you can have better quality life experiences if you can find a way to get yourself busy in life through a walking activity.  Especially if you can pain manage this activity.  And if you can do this, you will also be able to travel a little more, visit family members, go to a ballgame, maybe even do other activities; like ballroom dance, walk the dogs, sit for periods of time and write that book you’ve always dreamed about.  The list goes on.  Through walking many ailments can be pain alleviated and fitness levels increased.  Of course, keep what I’m telling you in perspective.  Your quality living improvements are relative to your health condition(s), physical and mental limitations.  Never the less, you will experience more feel good endorphins if you begin moving your body.  This will also improve mood, motivation to do more with your time in a day, boost self-worth and reduce dosages on pain medications daily.

 The cost to you to walk is nothing, other than your time, effort and motivation commitment toward improved mobility.  Through daily physical movement activities fitness levels will increase.  This will positively impact mood disposition.  This is important why?  Increased fitness levels contribute to healthy heart, lungs, metabolism, lean body, body strength, reduced body fat, weight control, pain alleviation, better physical endurance, excellent circulatory properties, reduced depression and other ill-health prevention, etc.  A combination of healthy habits, such as daily activity exercise movement and balanced nutrition are two of the ageless body prevention formulas.   This combination instills “proven” ageless fountain of youth methods centurions have known about for years and apply daily to enjoy quality living experiences for life.  To know this information is a “powerful mind-body motivator” for those that are in daily need of rehabilitative strategies to improve overall fitness and health.

 But in order to begin movement exercise activity safely; if you’ve been a couch potato, post surgery patient, or are in some form of physical rehabilitative condition, overweight, etc., you must first develop a fitness activity exercise plan and include your primary care physician and/or specialists to discuss a physical fitness program to ensure it is right for you. 

 Remember we’re all different in age, have various fitness goals, pain issues, disease, life circumstances, etc.   For example, I didn’t use a gym for many years while I worked to rehabilitate my body after surgeries.  I simply walked around the house, short stints with mobility aids in/outside the house, did PT exercises in bed the best I could until my body got stronger.  After I was able to crutch my way around the neighborhood an 1/8 of mile I incorporated other activity.  I’m not telling you to base your exercise mobility routine like mine; I’m simply providing what worked for me as an example.  I also had 4 physician specialists I coordinated with to assure my plan was not going to be detrimental to my overall health.  I know making appointments with specialists to compare notes is an additional burden.  However, it is a necessary part of any rehabilitative effort to ensure when customizing a fitness mobility exercise program it is done safely with your specialist(s) in the loop.

 Even with an undergraduate degree in Exercise Science, although I’m well versed in fitness activity and the effects on mind and body, I’m not a doctor.  There are many aspects of illness and disease pain pathologies, medications and effect’s on the “encompassing being” I cannot safely forecast when incorporating a daily movement activity to improve overall fitness and health during a rehabilitative scenario.  This is why you need to include your primary care physician at the least before you undertake a daily exercise mobility fitness activity.  But one thing for sure that is consistent in achieving good health, that’s daily movement activity.

 One must get back up on their feet one way or the other and move forward to become more fit.  The best way I know how to do this is achieve a goal to walk without mobility aids if possible.  This may not ever be physically possible for some.  The key is movement activity.  So when I mention walk, if you cannot do this without a mobility aid, simply increase your daily movement activity using a cane, wheelchair, walker, etc. 

 To achieve more movement activity requires daily exercise activity.  This is certainly possible and applicable to all of those using mobility aids.  I’ve got to tell you, I got the best workouts using wheel chairs and crutches.  It takes much conditioning to get into shape to hall your body weight around.  I know this from personal experience.  I challenge any walker to keep up with an avid mobility challenged person that’s conditioned to do so daily.  A word of caution with mobility walk aids.  I did suffer torn rotor cuffs and neck strains because of my aggressive competitive nature to excel in all I do.  So beware, you can hurt yourself while increasing your fitness levels through exercise with crutches and wheel chairs.  To get conditioned with these mobility devices takes the body time to build up strength, postural balance, muscle toning coordination and cardiovascular endurance.  These things are true in training for any form of physical task specific activity.  And with this said, there are correct ways to train for increased activity and wrong ways.  I’ve learned within my rehabilitative experiences, I need to better pace myself and not train for a marathon right out the gate.  After all I’m no longer in peak condition as I once was many moons ago.

 Take one step at a time, one block at a time, and one mile at a time.  Do what you can daily.  Put no time lines, or distances on yourself.  The mind-body will tell you each day what it’s capable of doing.  If you have the ability to walk you’re much further ahead in becoming more fit and healthy.  Move around, or walk daily regardless of mood, etc.  Do your in home physical therapy in bed, flexibility, range of motion exercises, walk in place, move up and down stairs if possible.  The key is to move more daily, work to reach 10-15min/day exercise activity at a minimum before increasing movement walking activity outdoors.  Be consistent at daily movement.  Don’t miss a day.  This is important if you want to improve your fitness level activity circumstances.  If you use a walker, wheelchair, or cane get out and move forward/move daily.  Build up walking endurance with a walking mobility aid if necessary to achieve goal distances of 100ft for example.  Physical therapy exercises will vary for each individual and will not be covered here.  However, if you need ideals on how to warm up and exercise before walking activities research the following:  Use the library, Internet, magazines, primary care HMO home PT exercise book, relevant rehabilitative subscription information/self-help recommendations for your conditions, etc. 

 There are many self-help books and free HMO pamphlets available.   I personally like Pilates and plank exercises for core strengthening exercises after passive and active warm-ups like, hot shower and range of motion stretching exercises.  I also do these slow stretch exercises while I watch the morning news, or evening shows and in-between writing my daily articles.  My slow stretch exercises include seated reach for toes and hold, standing slow stretch side bends, neck rotation/side tilts and squatted back stretches holding from 10’s of seconds to minutes at any time within the day’s activities.  I then go on my daily walk (active warm up and conditioning) and incorporate Pilate’s stretches and body part light strength training at the local fitness center.  I do manage pain daily by knowledge of working around pain threshold trigger points during activity and certain prescribed medications.  Check out books and literature on Pilates and core strength exercise examples.  There are thousands of exercise examples.

 Other tips:  Consider “not taking” your car to the store for daily staples once you can walk half a mile total distances assisted mobility device or not.  Make your fitness goal each day to walk to a market that’s near.  Make a goal to walk and shop for your evening meals, or drive to and walk the mall for example “a safe environment as you rehabilitate through movement activity.”  Get a small backpack “once able to walk small distances;” carry healthy produce, products to the car, home etc. 

 Never carry more in weight than the weight you lose.  For example, I personally never carry more than 5 lbs in bags, one for each arm, greater than 1 mile.  That’s .5 mile one way.  This has more to do with my chronic back-neck problems than weight lost.  So you need to factor in acute-chronic pain triggers under load.  In other words when starting a shop & walk activity program, you don’t hall extra weight until you lose weight, or alleviate pain significantly.  Just like you won’t move your body by walking without a cane, or walker after injury, or surgery until your body was conditioned to do so. An unconditioned body to walk without crutches, walker, cane, or wheel chair adds more body weight to weakened weight-bearing joints.  To do so when the mind-body is not ready will risk secondary weight-bearing injuries to body compromising overall health.

 When you’re strong enough to walk  1/8 mile one way for a total of ½ mile without walking aids you are then ready to begin a 3-5 day fitness activity program.  Even if mobility aids will be with you for life, you can still work toward customized fitness mobility assisted 3-5 day walking program.  The fit-healthy body results will still be experienced, i.e., cardiovascular, muscular, postural, mental function and pain alleviation benefits in varying degrees.  Regardless when you apply more activity in life, this equates to better quality living and health body-mind experiences

  Please look for the following article at the home site to get on a 3-5 day activity exercise program that’s right for you after you complete your rehabilitative mobility exercise activity goals.   The article you’ll want to search for to progress to the next activity level, “How to Exercise and Increase Fitness Levels.” Try various combinations of exercise activity, break up the fitness conditioning patterns and don’t go into any activity program at full intensity unless trained to do so.  Good things in life come to those that take the time to do it right while balancing all life activities and this includes achieving fitness goals after surgery, rehabilitation and/or disability.

Author:  Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET2010 Copyright.  All rights reserved, Mirror Athlete Publishing @: http://www.mirrorathlete.com,  Sign up for your Free eNewsletter

Bout With Gout

19 06 2009

The most common signs of gout are sudden (acute) redness and inflammation around joints with intense pain.  Most often the first joint that is attacked with arthritis like symptoms is the big toe with intense pain and throbbing, also swollen beyond belief and reddened.  This experience is so painful one can hardly stand to have a bed sheet touch the toe.  The same condition can occur in many other joints such as feet, ankles, knees, fingers, hands, elbows and wrists.  Bursa sacs which are fluid protective cushions around body joints to protect joint tissues are breached by elevated uric acid forming crystals transported by the blood circulation and deposited within targeted joints.  Although there is much similarity in osteoarthritis and rheumatoid arthritis (RA) the difference is RA afflicts up to several joints at a time, where gout usually impacts one joint at a time and typically starts in the feet.  Gout may also lead to a chronic bursitis (swollen bursa sacs) a condition where surgery may be required.  Uric acid crystals can also put you at risk for kidney stone problems.

Cause:  Purines are a part of our biology and introduced into the body through diet.  The by-product of Purines is uric acid.  Purines are part of human tissue and found in many Purine-Rich foods:  Beer, beverages, organ meat (liver, hearts, and kidneys), asparagus, yeast, sardines, anchovies, herring, fish, sweetbreads, smelt, and mussels.  Diets which are high in purines and protein have long have been suspected of causing gout.  By raising blood stream uric acid, painful crystals lodge within certain joints of our body creating acute pain.  Gout is considered one of the most painful forms of Rheumatic conditions and afflicts an estimated 840 out of 100,000 people in this US.  Gout accounts for approximately 5% of all cases of arthritis.  Symptoms:  Pain, swelling and tenderness, with limited movement within one or more joints; on and off pain mostly during the night time.  Increasing pain can last for hours and up to a week(s).  After periods of acute pain, the skin areas around the joint pain may peel, appear dry and become itchy.  Other symptoms: Fever or skin that looks infected with a red-purple in skin tone color.

  • Recommendations:
    -Feel for nodules (tophi) on ears, hands, or elbows – Hard uric acid crystals form under skin.
    -If you had surgery, or recovered from illness thereafter gout signs-symptoms.  See doctor.
    -Determine uric acid levels in bloodstream through blood test if you suspect you have gout.
    -Avoid alcohol, Drink Plenty of water. Exercise, maintain Ideal Body Weight.
    -Coffee and Tea is not a problem.
    -Avoid eating Purine-Rich foods and proteins.  Choose Tofu over meat products for example.
    – Gout Balanced Diet:  30% cals from fat (10% animal), 15% Low in Protein (soy, lean meat, poultry), and high in complex carbs (fruits, vegetables, whole grain)  “American Medical Assoc.”
     – Do not participate in extreme dieting as this form of weight loss increases uric acid levels.
    -Reduce uric acid & inflammation by consuming dark berries; blackberries, cherries, raspberries and blueberry (ruby-red type combinations) (see our affiliated purity products within our MAE Wellness Store).
    -Anti-inflammatory foods:  Flax, salmon, nuts, olive oil.  Vit C and Folic acid may benefit.
    -Few supplements increase hyperuricemia risk, such as Vitamin A.

Issue “Recognize Personality Disorder”  Author:  Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2009 Copyright.  All rights reserved, Mirror Athlete Publishing @: http://www.mirrorathlete.com,  Sign up for your Free eNewsletter.