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Jumat, 14 Juli 2017

Take Care Of Your Toes And Feet With Neuropathy


Today's short post from journal.diabetes.org (see link below) contains advice you really need to follow if you have neuropathy in your feet. Many articles on this subject refer to diabetic neuropathy but as we all know by now, diabetes is just one of the many forms of neuropathy that can cause you to either lose feeling, or suffer extreme feeling in your feet. Listening to a friend's recent story of having painful and infected toenail wounds from clipping too close, led me to publishing this article. It's a very common problem but one that's easy to forget. Read carefully - with the Winter coming on in the northern hemisphere, care of our feet is especially important.


How To Avoid Foot Problems If You Have Neuropathy
Ingrid Kruse, DPM CLINICAL DIABETES VOL. 18 NO. 3 Summer 2000

Inspect Your Feet Daily.
Look at your feet every day. Check for blisters, cuts, scratches, or cracks in the skin (commonly in the heel). Remember to check between your toes. A mirror can help you see the bottom of your feet, or you can ask a family member or friend to help you.

If you experience flu-like symptoms or increased blood glucose levels, be sure to check your feet. They may provide the only warning signals you will receive when a foot infection is present.

Make the daily foot inspection a regular part of your morning or evening routine, just like brushing your teeth. This simple task has kept many people with diabetes from losing their feet by helping them identify problems early on.

Wear Proper Shoes and Socks

All shoes should be comfortable at the time of purchase. Choose a shoe with a soft leather upper, or try athletic shoes for everyday wear. Do not try to "break in" uncomfortable shoes. Buy your shoes at the end of the day when your feet tend to be more swollen than in the morning.

The first time you wear your shoes, wear them only for 1 hour and only around the house. Take them off and inspect your feet for blisters or red areas. Slowly increase the wearing time, giving yourself about a week before you wear a new pair all day.

Do not wear sandals with thongs between the toes because they can rub deep gashes.

Never wear shoes without socks. Socks should be changed daily. Avoid wearing socks with holes or those that have been mended. In sporting good stores, you can find socks that have extra padding under the heel and ball of the foot for better shock-absorption.

Do not forget to check your shoes before you put them on by sliding your hand into them. Feel for nail-points and foreign objects such as keys, small toys, bird seed, or pebbles.

Practice Proper Foot Hygiene.
Wash your feet daily with mild soap, and dry them carefully, especially between the toes. Apply a moisturizing cream everywhere except between the toes. Too much moisture between toes will encourage the growth of microorganisms that can cause infection.

Trim your nails straight across with a slightly rounded edge. If you have trouble seeing, have neuropathy, or have difficulty trimming your nails yourself (because of thick fungus on your nails, for example), see a podiatrist. Avoid all types of "bathroom surgery," such as trying to fix an ingrown nail yourself or trimming your own corns and calluses. The results can be disastrous.

Do not walk barefoot—even in the house—because of danger from stepping on pins, needles, tacks, glass, or other items on the floor.

Be Mindful of Other Dangers to Your Feet.
Neuropathy can affect the set of nerves that detect heat. When these nerves are damaged, you cannot always tell when something is too hot, making burn injuries more likely. Always check bath water with your hands, or use a thermometer if you also have neuropathy in your hands.

Other heat-related problems that could cause serious burns include walking on hot pavement in the summer, using heating pads or hot water bottles to warm your feet, or putting your feet too close to radiators or space heaters in the winter.

If your feet feel cold at night, wear a pair of socks to bed. This is most likely due to neuropathy and not to poor circulation. Neuropathy can cause hot or cold sensations in your feet.

Permission is granted to reproduce this material for nonprofit educational purposes. Written permission is required for all other purposes.

http://journal.diabetes.org/clinicaldiabetes/V18N32000/pg119.htm

Minggu, 27 November 2016

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Minggu, 21 Agustus 2016

Tips For Care Givers of People In Chronic Pain


Today's post from psychologytoday.com (see link below) follows on from yesterday's post in that it offers tips for people involved with people living with chronic pain. This time, it's a warning list for carers and supporters of chronic pain patients. Caring for people with illness is often a strenuous, thankless and stressful business and can often lead to the carer him- or herself becoming ill. It's very important then that the carer takes care of himself otherwise both people suffer from the consequences and that defeats the object. It's easy to forget that becoming a carer means giving up a part of your own independence and these 'not-to-do' hints are well-worth reading. If you're the person who is living with chronic pain it's worth reminding yourself that it's often family and friends who are being forced into the position of carer and unconsciously taking advantage of their good natures is an easy mistake to make.
 
A Not-To-Do List For Caregivers of the Chronically Ill
Published on January 23, 2014 by Toni Bernhard, J.D. in Turning Straw Into Gold
Six items that belong on a Not-To-Do List for an oft-forgotten group: caregivers

In August 2013, I posted “A Not-To-Do List for the Chronically Ill.” It led me to turn my attention to those who take care of us. In a study published in the Journal of the Royal Society of Medicine, “Quality of life: impact of chronic illness on the partner,” JRSM, v. 94 (11) Nov. 2001, the authors stated:

…the most striking research finding is a tendency for the partner’s quality of life to be worse than that of the patient.

The people who are least likely to be surprised by this finding are not just caregivers, but those who are in their care. The study focused on partners and spouses, but I'm certain that the finding would be the same when the relationship of caregiver and “cared-for” is parent/child, child/parent, sibling/sibling… or a host of other relationships.

From my own personal experience, as well as from feedback from others, I’ve learned a lot about the life of a caregiver (called “carers” in most countries other than the U.S.). If you’re a caregiver, here is my Not-To-Do list for you.

1. DO NOT shy away from sharing with others that you’ve become a caregiver.

The reluctance to tell others about this life-changing, high stress event is particularly prevalent among men. They’re likely to hide it at work. They often hide it from their friends. It’s a sad commentary on our culture that we still haven’t found a way to make men feel comfortable sharing with others that, when they’re at home, they’re taking care of a partner, a sibling, a parent, or a grown child. They’re doing the cooking and the cleaning; they’re running all the errands; they may even be providing nursing-type assistance.

The consequence of caregivers hiding their role is that people who’d be willing to help don’t even know that help is needed. Not only can this lead to caregiver burn-out, it also helps account for why caregivers have a high incidence of clinical depression. The National Family Caregiving Association found that over 60% of caregivers who provide at least 20 hours of caregiving a week suffer from depression.

If you’re a caregiver, I hope you’ll talk to others about your life. If you’re the one being cared for, encourage your caregiver to share with others the difficulties he or she is facing. No one benefits from a caregiver “going it alone.” It may take only one friend to make a significant difference in a caregiver’s life: one friend whom he or she can confide in and talk to about how stressful and difficult life has become; one friend whom he or she can ask for help and support. “Troubles shared are troubles halved” is one of those good clichés.

2. DO NOT pretend that everything is like it used to be; you need time to grieve the loss of your old life.

Many people (including myself) have written about the need for the chronically ill—including those in chronic pain—to go through the same type of grieving process that’s triggered by other life-disrupting events, such as the break-up of a relationship or the death of a loved one.
If you're a caregiver, you need time to grieve too.

The drastic change in your life can be a shock. One day you were free to go out whenever you wanted and hang out with whomever you wanted. The next day, you were tied to the house and expected to understand how to take care of someone who may need help with the most intimate of life functions. Our culture does a poor job of preparing people for this very real possibility. (An estimated 45 million people in the U.S. alone are caregivers for elderly relatives or the chronically ill.)

In addition to grieving the loss of freedom, you may be mourning the loss of the relationship you once had with the person you're caring for. In my life, except when we were at our respective jobs, my husband (also named Tony) and I used to do almost everything together. Now when he goes out, he almost always goes out alone.

This past Christmas, Tony went to a holiday party—by himself. He rarely goes to these events anymore, but the couple who were hosting it issued a special invitation to him, so he went. He saw people from our smallish town whom he hadn’t seen for years. This is the type of event that would have been fun for us to “compare notes” about afterward. Instead, when he got home, he told me who was there and how they’d all asked how I was doing (a question that, once answered, tends to be a conversation killer, even though people ask with the best of intentions).

Pretending that everything is like it used to be doesn’t work: caregivers need time to mourn the loss of their old life and to adjust to their new one.

3. DO NOT attempt to be Super Caregiver.

Let yourself have “bad” days when, even though you’re doing what needs to be done for the person you care for, your heart isn’t in it and you wish you were free of the obligation and the burden. Don’t feel guilty if resentment arises now and then. Like everyone else in this life, you’re going to have good days and bad days.

On the flip side, don’t feel guilty when you have a good time. Be on the alert for that Super Caregiver mentality that has you thinking you’re not an adequate caregiver unless you’re giving the person in your care 100% of your attention and unless you’re sure never to have more fun than he or she is having.

Speaking personally, I want Tony to have a good time. It makes me feel less bad about the drastic change in his life and about the responsibilities he’s had to take on. As an added bonus, it makes me happy to know he’s having fun. Buddhists call this mudita—feeling joy for other people who are happy. It’s a practice to cultivate, and a wonderful side-effect of mudita is that feeling happy for Tony often boomerangs, meaning it comes back at me so that I begin to feel happy myself, as if I’m having a good time through him.

A few weeks ago, he took our granddaughter, Cam, to see the Harlem Globetrotters. When I was growing up, my dad took me to see the Globetrotters whenever they came to town, so it would have been a treat for me to take Cam. But I couldn’t, so Tony did. My choice was to be envious and resentful—or to be happy for Tony. I chose the latter. And so, throughout the afternoon, I imagined the two of them in their seats—Tony pointing out a dribbling sleight-of-hand that Cam might have missed, both of them laughing at the Globetrotters' antics just as I had. The result was that I felt joy myself, especially knowing that my caregiver was having a good time.

4. DO NOT be reluctant to share your challenges and difficulties with the person in your care.

Of course, every relationship is different, but sharing your struggles with the person you’re caring for can make the two of you closer, despite the many changes in your lives together.

Many caregivers are reluctant to share their difficulties for fear of making the person in their care feel worse. But sharing your struggles and even your sorrows can make the “cared for” person feel as if he or she is giving you emotional support. As a result, not only will you get that support, but the person you’re caring for will feel as if he or she is contributing to the well-being of the relationship. In addition, there may be important issues, such as financial constraints, that badly need to be talked about in order to avoid harder times down the road.

5. DO NOT become isolated yourself even if the person you care for is housebound.


Caregivers are often as isolated as the person they’re taking care of. If this is the case for you, consider asking someone to step in for part of a day so you can do something for yourself. Many communities have programs that provide this kind of support. In my town, there’s an organization called Citizens Who Care. They have a program called Time Off for Caregivers. Volunteers visit people’s houses for the specific purpose of allowing a caregiver to go out for a while.

There are also online support groups for caregivers that can go a long way toward easing isolation. Here are two organizations that can help: Family Caregiver Alliance, http://www.caregiver.org/caregiver/jsp/home.jsp, and Empowering Caregivers, http://www.care-givers.com/. Connecting with others in this way benefits both you and the person you’re caring for, because it puts you in touch with others who understand the challenges you’re facing. Not only can this uplift your spirits and renew your commitment, it can also provide valuable information that will make it easier for you to carry out your responsibilities.

6. DO NOT neglect your own health.

You can’t be an effective a caregiver if you don’t care for yourself physically and emotionally. Ignoring your own physical and mental health can negatively impact both you and the person you’re caring for.

Caring for yourself is part of being a good caregiver for another.

© 2014 Toni Bernhard www.tonibernhard.com

Thank you for reading my work. My most recent book is titled How to Wake Up: A Buddhist-Inspired Guide to Navigating Joy and Sorrow.

I'm also the author of the award-winning How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and their Caregivers.

http://www.psychologytoday.com/blog/turning-straw-gold/201401/not-do-list-caregivers-the-chronically-ill