Saturday, April 28, 2012

" An 'A-B-C-' Of Home Health Care...Part IV of IV "


 “ An ‘A-B-C ‘ Of Home Health Care: A List Of Things You NEED To Know (Which Might Just Save Your Life, Or The Life Of Someone You Love), Incomplete As It May Be…Still 



Part IV of IV



04/30/12



To my ever dearest, loyal friends, and constant readers, I remain ever grateful to you for your caring, and support; in my attempt to somehow repay that debt of absolute gratitude to you for your kindness, and love, and of accepting me as I am, it is my goal to try to prove to maybe be of some help to you; to maybe make your lives better and more secure.



I delight in your wonderful company, and even as I fully know that you have both mental and health issues, yet, you have somehow made room for me.  Never once have you been unfriendly, or unkind, nor ever wavering in your support.   You have made me feel welcome here, at MDjunction, and yet, you have never been judgmental, or censorious, which is so often so counter to those I meet in real life, that I count you among my blessings, and, many times, I cannot believe my good fortune in having stumbled-across MDJ, where I have made both wonderful, and lasting friendships, so many I hope will be long and thoroughly enjoyable.



There seems to be too frequent times, during which I am lost in pain and depression, unable to find but errant, short, or unreliable relief; I know that many of you feel the same, yet, in being my dear friends, and pausing to read my diary entries, and with your comments, and criticisms, you bring to me a singular joy I thought I had lost; it is YOU who have been as stalwart, always being ‘there’ for me, when my massed complaints would otherwise wear me down and out, and, in utter hopelessness, I would be alone, and full-given into my depression, my agoraphobia, panic, and a general fearfulness of a Future without change, without cure, without refuge, and quite without any sense of happiness.



And while I write these many diary entries to try to regain some sharpness and clarity of old, I dedicate them to YOU, my dear, sweet friends, in expectant hope that even some little bits will prove to be of help to you. It remains among my fondest hope that—in them—you may find both comfort, and direction that may further your own goals and aspirations, and the successful intervention of illness, accident, or injury in perfecting your own, ‘First Aid Kit’; which, while it may appear long, unnecessary, tedious, maybe…it is my offering to you to help keep you or a loved one safe, often until an ambulance arrives.



And when I happen to receive a hug, or PM, or diary comment that I have helped you, then, my heart is truly happy.  And I thank you for all these things, and more.



I realize that I tend to run overlong, but ask of you to stay the course, and then make up your own minds.  What matters is that I think of you so very often, and want you to be well. With ALL the happiness that you most kind hearts can hold.





And so to that end, if I may be allowed to present you with Part V of V, on;



“ An ‘A-B-C’ Of Home Health Care : A List Of Things You NEED To Know…”



My dearest friends, EVEYONE needs to assemble a fairly simple, yet fairly comprehensive First Aid Kit to have with you at home; granted, this is—for me—an ideal, wish list, some of which you might never need, but I nonetheless desire to provide you with various things that may—in fact—save lives, and that will also buy you time until ‘911’ has been called, and the ambulance arrives.



The list—as such—is not alphabetical, to lessen the chance that in doing so, potentially valuable items might  accidentally be forgotten, and unfortunately left off the list. I am also thinking as I write. Frankly, the only time an alphabetized list would come in handy, is to—at an eye-glance—tell you what you have, and possibly, what you will need.



The Container:



You will want to make a First Aid Kit that is accessible, but one not underfoot.  An empty 2-litre soda box with handles will suffice, but you want your supplies to remain dry, and free from getting wet; equally, an old suitcase can be used (just be sure that if you lock it, you will have the key on hand, which wastes valuable time!). What you don’t want, is to have your supplies jostling-about, and lose, as you want to be able to lay ready hand to whatever you may need with as little delay as possible.



After careful consideration, what I would recommend is one of those large, plastic tackle boxes that fishermen use, with the fold-out drawers.  These boxes close compactly, and can be snapped shut in the front; further, they have carrying handles on them, are fairly inexpensive, and are available in bright colors to be more quickly and easily seen.  The many fold-out compartments help keep your supplies separated, and, if the top of the box is white, you can take a magic marker, and boldly write upon it, “First Aid”.  This box should contain your first aid supplies….and nothing else.





A continued list of ‘What You Will Want To Get:

PLEASE note that to be on the ‘safe side’, regarding ANY O.T C. (over the counter) preparations that I may recommend, I will always err on the side of prudence and caution in their use; I urge you to do the same.  Not all directions to these ‘medications’ should even be followed by the directions on the box, but—rather—to be used more sparingly, enough to help you, as I’ve seen a tendency, especially in America, an attitude that, “If one pill works, two will work better and faster…and so on.”  This may pose a decided problem for you, among two more concerns: when it is time to call ‘911’, or take the ill person to a Primary physician; hence, ALL my recommendations—as may be necessary—will be as general guides, only. And then, to be used sparingly, for my conscience dictates that—in any help to you—too much of anything is never good, nor wise.



In order to save time, and to marshal my thoughts, I have ‘listed’ what you may need, with any, necessary explanation for these items as we go along.  Doubtlessly, some of the things will make more sense than others; should you have further suggestions, remarks, questions, or criticisms, I would most kindly ask you to leave them in comment section, or in PM’s, or even ‘hugs’ to me, and I will be more than happy to reply.  And if—in still natural, further doubt—I would urge you to speak to your Primary, or Pain Management Physician.  Thank you. ‘Zahc’



1)           Aspirin.     Discovered in 1890, and one of the class of drugs called ‘NSAIDs’, such as Tylenol, Motrin, Aleve, etc., which stands for, “Non-Steroidal, anti-inflammatory drug”, which means that they do not contain steroids such as cortisone, or prednisone.  Aspirin comes in many brands, and strengths, from ‘baby aspirin; to regular aspirin (326 mg. tabs); to extra-strength aspirin (500 mg. tabs); to now, ‘adult-strength’ aspirin (81-83 mg. tabs).  Aspirin is cheap, and performs a variety of uses.  It is an ‘anti-inflammatory’, to reduce swelling; an ‘analgesic’, to reduce pain; and an, ‘anti-pyretic’, to reduce elevated temperatures. 

Further, The American Heart Association recommends that—as may be tolerated, adults should take an 81-83 mg. dose, daily, to help prevent, or lessen the severity of heart attacks.  Since aspirin can upset your stomach, these adult doses should be coated (enteric coating), so that the aspirin will dissolve in the intestines, rather than in the stomach; further reading has suggested that in doubling the dose, to one in the morning, one at night, may slow the onset of Alzheimer’s disease.  And as with all, O.T.C preparations always look for the ‘sell buy’ date to ensure freshness and efficacy. To many, partially dissolved aspirin tastes very bitter.

2)           Tylenol.  An ‘NSAID’ to be used, in lieu of aspirin, for those for whom aspirin upsets their stomachs, or, who are allergic to aspirin.

3)           Imodium.  An O.T.C. preparation that is used to slow, and stop diarrhea.  However, as nasty as it is to have diarrhea, where possible, it should be allowed to continue at least two to three days, untreated, as diarrhea is the body’s way of rapidly removing toxins from the system, such as those in flu; some types of food poisoning, etc. However, you want to keep in mind two things: that unchecked diarrhea can rapidly lead to dehydration, which is why you want to continue to ‘push’ fluids and soup.  As important is: that over-use, can cause the stool to ‘concretize’ in the bowel, resulting in severe constipation, or ‘impaction’, which, if left untreated, can be life-threatening.  Constipation that lasts for more than four days should require a trip to the emergency room; and, should I not have previously mentioned it, one of the signs of an impaction is ‘fullness, the inability to express stool, except for slight diarrhea that is forced around the impaction, and out.

4)           Laxatives.  These, too, should be used with prudence; pain medication can often be very constipating. So ‘stool softeners’ (generic name: docusate sodium, or docusate potassium), gently help to encourage the production of stool.  These—too—should be used, with caution, as the ‘docusate sodium’ contains salt, for those who have hypertension.  Perhaps, the powdered versions mixed with either water, or fruit juice, taken daily, should provide necessary bulk, and ease of passing stool.  Plus, the too-frequent use of laxatives may contribute to one becoming, ‘laxative dependent’, especially in the elderly, where normal bowel motion may be lost, until one cannot go to the bathroom without laxatives.

5)           Oil of Clove, or ground, powdered Clove.  This is an absolute, non-habit forming, nor potentially dangerous Godsend for tooth and/or gum pain.

While nothing—of course—will take the place of regular, dental hygiene, or visits to the dentist, often, toothaches occur at all the wrong times, and can be severe, and these days, few can afford to visit a dentist regularly, or at all.

Add a little water to the ground cloves to make a paste that will adhere better to teeth and gums, or directly apply the oil to the toothache with—of course—washed hands, or with a palette made or a tongue depressor; rub it thoroughly into the top of the tooth that hurts, and massage it into the sides, and gums.  Since it is a ‘natural’ product, without noted side-effects, it can be used repeatedly to buy you time, or to just temporarily eliminate toothache pain, which can be so severe, it can be applied as often as you may need.

While this is a wonderful approach, it does NOT replace dentist visits in case of abscess, or infection.  It is—however—safe-enough to use in moderation on small children who may be ‘teething’.

6)           ‘Burn Cream’, or—where possible—silver sulphathiazide cream, in the treatment of minor burns, to help reduce the pain, and encourage healing.  Please note that severe burns ( ones that cause blistering, or lack of pain sensation, or ones that cover larger areas of skin, should immediately necessitate a call to ‘911’, and an ambulance trip to an emergency room, or nearest burn center).

7)           Flashlights.  For the ‘Home First Aid Kit’, I would recommend having two: one regular one for illumination in dark settings, and one, ‘pen light’, smaller flashlight that may be held in the ‘on’ position in the mouth, to free-up use of both your hands.  Always keep on hand a pack of fresh, unopened, and unused batteries.

8)           Thermometers.  For years, we have become accustomed to the old, triangular, glass thermometer which contains mercury, and requires keeping sterile in alcohol, or with alcohol-based wipes; these must be ‘shaken down’, by several, quick, ‘whip’ motions, while holding the top.  These came in two types: blue at top for oral thermometers, and red, for anal use.

These thermometers can break easily, especially when attempting to ‘take’ the temperature of one who is ill, and may have chills.  In addition, old, glass thermometers contain mercury, which is very poisonous.  I would not recommend their use.  Instead, I would suggest that you purchase a plastic, disposable, digital thermometer (along with end-covering sleeves, to help keep them sterile), that is light-weight, and ‘beeps’ when the correct temperature is arrived at.  Since the end of a digital thermometer is lightly weighted, it still may prove difficult to keep it in the mouth of those who are ill, children, and the elderly, or those who lack the teeth to hold it in their mouths.  There are two, other ways in which a temperature may be reached, and these you need to know.  First, in babies, the temperature should be taken rectally.  To the value that you receive, deduce one point.  Thus, if your young child (or, grandchild’s rectal temperature is, say, 103.0, deduce one point, to make it now, 102.0, a proper reading.  For those who simply cannot keep a thermometer in the mouth, any value—there obtained—will be useless.  Instead—where possible—place the thermometer securely under the arm pit, and make sure the thermometer is held tightly there; this is referred to as an ‘axillary temperature’, whose value you will need to add one point.  While ‘oral’ temperatures are supposed to be more accurate, what good is it if the person cannot keep it in the mouth, under the tongue.  However, should you use either of these alternative ways, and subsequently need to report them, always designate whether taken rectally, or axillary

9)             Every Home First Kit should have a bottle of peroxide; allow to dribble over wounds, or apply—carefully—with sterile cotton balls, before bandaging.

10)   One bag of sterile, cotton balls.

11)   One package of sterile Q-tips, to use in dabbing ointment to a wound; NEVER use them in your ears to clean them, as you will probably compact the wax that is there, which may lead to ear pain, or ear ache, or infection!

12)   Traditional, metal boxes of band aids usually offer different sizes, many of which you may never, ever have a use for.  Look—instead—for a box of band aids that are at least 3/4ths inches wide, or one inch wide.  Those tiny lengths, and little, round spot band aids are useless, do not cover the wound, and never stay in place.  If—for example—one has a fairly simple finger cut, drape one band aid over the wound, and secure it in place, by wrapping another one around it.  Band aids should be changed regularly, about every day, or, every other day.  We all have had experience with band aids that have been left on too long; the skin—beneath—is always super white, mottled with blue, and feels odd to the touch.  While you want the wound to heal, you do not want to compromise the blood circulation in the fingertip, or, indeed, anywhere else on the surface of the body.

13)    Blood Pressure Cuffs.  For general ease of use, portability, and convenience, I would fully recommend a Velcro, wrist blood pressure cuff; these are fairly inexpensive, and are very accurate.  And, they stay in place, better, being held in place by Velcro.

So many accidents happen at home, many of which go way beyond any treatment that little, rusted, box of band aids in your medicine cabinet can provide.



Dressing equipment (bandaging), and other needed supplies:

14)   At least two boxes of gauze pads, 4 inches X 4 inches.  Use it to apply to wounds; but please keep in mind that plain gauze can sometimes stick to an open wound, and so;

15)   At least two boxes of “Telfa”, 4 X 4 inch pads; these do not stick to wounds.

16)   Several, packaged lengths of elastic, netting, often called ‘Curlex’.  This is used to wind-around a wound, to help keep the pads in place; they also promote air to reach the wound, to help in healing.  Always remember that dressings should be changed every day, and kept as dirt-free as possible.

17)   Now, you will need some kind of tape to use to secure the Curlex; basically, there are two types: A) Paper tape, and; B) Cloth tape.  While cloth tape may prove to better hold a dressing shut, you will need a set of scissors to cut it, as it is difficult to tear into desired lengths.  Paper tape is much easier to tear, but may require more of it to be effective.  Also, some individuals are allergic to paper tape, so it would be most wise to keep both kinds on hand.

18)   Where possible, it is always best to first wipe the wound or affected area to remove from it any dirt present.  Then use a couple sterile, gauze pads to clean the wound with peroxide, stop the bleeding, and apply with clean Q-tip, antibiotic cream, and bandage gently.

19)   Remember, please, to always keep your First Aid Kit in some semblance of order, so you won’t have to repeatedly dig-around, or look for the supplies that you may need, which wastes time, is frustrating, and postpones intervention and treatment.



My friends, this series has been of some difficulty to write, as I knew it would run long, yet, I did not want to miss more than I probably did miss.



One often thinks something as prosaic as a ‘First Aid Kit’ to be of little importance, or use, in day-to-day living.  From past experience, I feel quite the contrary, that your home First Aid Kit—when equipped, and maintained properly, is nothing less than your first line of defense, in the treatment of even simple wounds, to conditions that will require you telephone ‘911’ to summon an ambulance to your home.



It is at least a partial measure of my love and regard for you that you and yours be kept as well, and as safe as possible. Those were my only motives.  And in wracking my poor and tired brain to point of headache, I have tried to share with you things that I had experienced over the years. I still think the points are valid, and may prove to be of some possible help to you, whenever you most need it.  Remember—always—that you are special and unique to all the world.



As always—my most dear, and treasured friends—I wish so much for you days of much lessened, or of ‘no pain’; quiet, contemplative days, recalling dreams; afternoons, surrounded by both friends, and family members who love and care for you; happiness unbounded; pantries full, with no thought of need, or want; peaceful evenings, leading to nights of natural tiredness—looking forward to climbing into a cool and crisp bed; and blissful and untroubled sleep combining comfort, and pleasant dreams, protected—ever—by gentle angels, ‘to lead thee to thy wondrous rest’.



Please always know I love you dearly,



‘Zahc’/Charles

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