Tips for Decreasing the Instances of Developing Urinary Tract Infections While Using Adult Diapers to Manage Incontinence
Managing incontinence comes down to diligence and proper care of your genitals. If you do not properly cleanse your genitals after changing out your incontinence products, the urine can lead to very painful skin rashes along with other issues like a urinary tract infection. Many elderly individuals are not as diligent in changing out their incontinence products, which places them at risk for urinary tract infections. A urinary tract infection is very painful and irritating to a regular person but in the elderly, it can be very serious as they do not always remember to take the antibiotics necessary to treat the infection. If left untreated, a urinary tract infection can lead to other problems like infection of the kidneys. As a caregiver of an elderly loved one you need to focus your efforts on helping your loved one to change out their adult diapers and to wash their skin so they do not become susceptible to urinary tract infections. There are some great incontinence products on the market that you can use. Some people use sanitary wipes each time they change their incontinence products, which is a great way to remove the urine from the skin. Flushable wipes are a great option instead of using a towel or even wet toilet paper to clean the urine from the skin. Another thing you can do is to purchase the right type of incontinence products. Purchasing high-quality incontinence products will be able to help remove urine from the skin and will allow air to get in, allowing the skin to breathe. Purchase high-quality products that are made specifically for your gender. To find some quality products try LiveAnew BestFit. Here you can find incontinence products for men and incontinence products for women that are specific to your needs and the type of incontinence you are dealing with. A lot of people find that they can easily manage their condition by using a pad where others may need to opt for adult diapers or some type of incontinence product that provides additional protection. Frequently change your incontinence underwear. If you wear it too long, it will end up leading to infections. You need to make sure you change them each time they are soiled instead of waiting for them to become completely filled. When you do this, you remove the bacteria found in the urine and fecal matter that may end up leading to a painful urinary tract infection. Since you may need to frequently change your incontinence underwear you might consider using washable products instead of disposable ones. This will save you more money on your incontinence supplies as you only need to invest in them once a year or so instead of needing to make multiple purchases each month to deal with your incontinence problem. What if you are caring for a loved one that is dealing with incontinence? You may struggle to get them to frequently change their diapers as they can forget or just find it to be a hassle. Remind them of the importance of changing their diapers to prevent infections and then consider using a timer or clock that will remind them to change their diaper. Having a reminder clock is a great way to remind yourself to check up on them as well. Set the clock for every 2 hours or however frequently they seem to soil their diapers. If they have a fecal incontinence problem it is important that you make sure they change their diaper right away as the bacteria in the fecal matter can cause serious problems.
Malnutrition in the Elderly: Causes, Costs and Consequences
Put simply, malnutrition is a state of nutrition (under or overnutrition) in which a lack of protein, energy and other nutrients causes measurable adverse effects on tissue and/or body form, composition, function or clinical outcome. In this section, we will focus on undernutrition as a nutritional concern.Malnutrition can be significant if a person has:a BMI of less than 18.5 kg/m2 a BMI less than 20kg/m2 and has had unintentional weight loss greater than 5% within the last 3-6 months had unintentional weight loss greater than 10% within the last 3-6 monthsPeople are also at risk of becoming malnourished if they have eaten very little or nothing for more than 5 days and/or this pattern is likely to continue. Malnutrition is, and continues to be, a serious problem in the UK. Worryingly, more than 1 in 4 of all adults admitted for a hospital stay, to a mental unit or a care home is at risk of malnutrition, which is a staggering statistic. It is a well-documented fact that worldwide, the elderly population is increasing, and with it, the incidence of malnutrition. Malnutrition is associated with significantly increased morbidity and mortality in independently living older people, as well as in nursing home residents and hospitalised patients. [5,6] BAPEN NSW 2007 revealed a high prevalence of malnutrition amongst our elderly population: 35% in adults over 80 years of age 25 – 35% in adults 60 – 80 years 25% in adults less than 60 years of age Causes of MalnutritionThere are many causes of malnutrition. These can include: Reduced intake: Poor appetite due to illness, food aversion, nausea or pain when eating, depression, anxiety, side effects of medication or drug addiction Inability to eat: This can be due to investigations or being held nil by mouth, reduced levels of consciousness; confusion; difficulty in feeding oneself due to weakness, arthritis or other conditions such as Parkinson’s Disease, dysphagia, vomiting, painful mouth conditions, poor oral hygiene or dentition; restrictions imposed by surgery or investigations Lack of food availability: poverty; poor quality diet at home, in hospital or in care homes; problems with shopping and cooking Impaired absorption: This can be due to medical and surgical problems effecting digestion & stomach, intestine, pancreas and liver /or absorption Altered metabolism: Increased or changed metabolic demands requirements related to illness e.g. cancer; surgery, organ dysfunction, or treatment Excess losses: Vomiting; diarrhoea; nutrient fistulae; stomas; losses from nasogastric losses tube and other drains or skin exudates from burns People at risk of MalnutritionThose most vulnerable to malnutrition include: People just discharged from hospital Elderly people (16% in residential care) People with cancer and other long-term conditions People recovering from surgery Consequences of MalnutritionMalnutrition can often go undetected and when left untreated, it can have serious consequences on health, which include: Increased risk to infections Delayed wound healing Impaired respiratory function Muscle weakness and depression Costs of MalnutritionMalnutrition has been estimated to cost the NHS an incredible $12 billion each year, which is more than double the projected $5.7 billion cost that will be spent tackling obesity.This cost is based on patients who suffer from malnutrition: Needing a greater number of GP consultations Needing more frequent and more prolonged hospital admissions Having a higher rates of complications and mortality compared with nourished patients Detection of MalnutritionWith patients who you suspect are malnourished (or likely to become so), it is vital you identify the problem early so you can provide support and achieve the most effective use of resources. Although biochemical measurements can contribute to nutritional assessment, none can reliably measure nutritional risk e.g. a low serum albumin is almost always a marker of an acute phase response or fluid overload rather than a marker of malnutrition.There is therefore really no alternative to measurements of weight and height, along with other anthropometric measures in specialist circumstances. These measurements can then be used with the following questions: Has your patient been eating a normal and varied diet in the last few weeks? Has your patient experienced intentional or unintentional weight loss recently? Obesity or fluid balance changes and oedema may mask loss of lean tissue. Rapid weight loss is a concern in all patients whether obese or not Can your patient eat, swallow, digest and absorb enough food safely to meet their likely needs? Does your patient have an unusually high need for all or some nutrients? Surgical stress, trauma, infection, metabolic disease, wounds, bedsores or history of poor intake may all contribute to such a need Does any treatment, disease, physical limitation or organ dysfunction limit your patient’s ability to handle the nutrients for current or future needs? Does your patient have excessive nutrient losses through vomiting, diarrhoea, surgical drains etc? Does a global assessment of your patient suggest under nourishment? Low body weight, loose fitting clothes, fragile skin, poor wound healing, apathy, wasted muscles, poor appetite, altered taste sensation, altered bowel habit. Discussion with relatives may be important In the light of all of the above, can your patient meet all of their requirements by voluntary choice from the food available? Understanding that asking these questions take a significant amount of time and expertise, a number of screening tools have been developed to help you identify whether your patient is at risk of malnutrition. Given the high prevalence of malnutrition and lack of proper management of patients in various settings, performing a routine nutritional ‘screening’ should result in early identification of patients who might have otherwise been missed.A screening tool should therefore help establish reliable pathways of care for patients with malnutrition. Screening for malnutrition (and the risk of malnutrition) should be carried out by healthcare professionals with appropriate skills and training.
Adult Diaper Brief Banks: Your Guide to Helping and Getting Help
Have you ever heard of a diaper bank? Most people have, but in regards to babies. Unfortunately, over 13 million Americans suffer from incontinence and need adult diaper briefs. And many of those who need them simply can’t afford them. Medicare and most insurances will not cover the cost of absorbent products unless the individual is living in a care facility. If they live at home, the individual often must shoulder the responsibility of cost for adult diaper briefs themselves. For many seniors and disabled individuals this means going without other necessities because their fixed income can only stretch so far. It also means wearing products too long, compromising comfort and skin health, as well as confidence, in order to make adult diaper briefs affordable. But fortunately, there are places individuals with incontinence can turn to for help with affording supplies. Adult Diaper Brief Banks are a relatively new resources, but offer aid to those who need it. The following is your guide to helping and getting help:HelpingFirst, how can you help? Diapers for adults usually cost over $100 a month. Public assistance and Medicare do not cover these costs, leaving many seniors with fixed incomes to try and figure out how to afford the products they need. There is a growing need in the US for adult diaper brief banks. The economic downturn and large senior population have contributed to this great need for adult absorbent products. And you can help by donating funds or products to diaper banks across the country. Many diaper banks have websites that accept donations as well. Another way you can help is by starting a diaper bank. There can never be too many diaper banks out there. If you do not think you can do it yourself, consider trying to convince a local organization to start one, such as a church group or local social service center. Getting HelpMost diaper banks distribute their resources using local agencies. These include agencies such as United Way, Food Banks, and religious organizations and churches. They are not distributed directly to individuals, and thus, if you need assistance, it is important to not just find the diaper bank itself, but ask which local agency manages the distribution of adult diaper briefs. It is possible to find diaper banks by doing a simple Google search. Type in "Diaper Bank" and your local area. Then call to find out if they carry adult diaper briefs, and if they do not, if they know of an agency or bank that does. They should be able to direct you where to go to get the help you need. Diaper banks are in place to help those in need. If your local diaper bank does not carry adult products and you need them, ask for them. If you can show a real need, they will likely do what they can to help fill it. You don’t have to live without absorbent products or too few, or give up something you need in order to get protection. There are alternatives, and adult diaper banks exist and can help. Find out today!
"I was in shock when I learned my cancer had been misdiagnosed for ten years and now had spread into my liver!"
Over a period of about ten years, I had been mentioning symptoms to my family practice doctor at my annual physicals – flushing and hot flashes, itching and changing bowel habits. These ‘dots’ were never connected and over this period the cancer inside my small intestines slowly spread to my liver and started growing."You have a carcinoid tumor or a Neuroendocrine Tumor (NET). The flushing and other symptoms you’ve experienced are referred to as"Carcinoid Syndrome." I learned that Carcinoids occur in about 1 of 100,000 people – it is the rarest of rare diseases, is frequently misdiagnosed and is incurable when it spreads to the liver. At first I was mad about the misdiagnosis, but then I realized misdiagnosis is almost always the case. A Mayo Oncologist said he received about 20 minutes of classroom discussion of NETs in medical school. The government classifies it as an orphan disease because it gets so little attention from the medical community, pharmaceutical companies and government. Its also sometimes referred to as the ‘looking good disease’ because many who have it, don’t show any or many outward signs of distress’ because it's so slow growing or indolent."Watch & Wait"After a liver biopsy and a 3 day scan called an OctreoScan ($8800), the diagnosis was confirmed in June 2015. My local oncologist suggested a ‘watch and wait’ strategy which I later learned is referred to as the ‘Wait and Worry’ strategy. My husband immediately went into a complete research mode and within 6-weeks we attended a patient directed conference 5 hours away where NET experts from clinics throughout the middle part of the U.S. presented. What did we learn? If you have this, you need to see a NET expert. I live in Wisconsin and there is no one who is an expert – not in the entire state. My gastroenterologist told me in no uncertain terms, "If I were you, I’d go to Mayo." (generically meaning a center of excellence for NETs). After the conference, I talked with experts in Rochester, MN, Kenner, LA and Iowa City, Iowa. There are a handful of other clinics and speciality groups in other cities, but I didn’t want to have to travel to either of the coasts, especially if surgery were involved.The first key learning was that the ‘watch and wait’ strategy my local oncologist prescribed was 100% wrong for me. Every expert told me that right off. It became clear to me that she was out of her league and didn’t have the intellectual curioscity to learn more about this disease, even when I presented her with facts from my research.One size does not fit allEach NET case is different and there is no one size fits all. In most cases there is tumor growth where it started (in my case, the ileum or end of the small intestine), the lymph nodes and the liver. They are all treated uniquely. If they’re all treated the same, you’ll go down in flames. A NET expert will devise a strategy to tackle each area. It's all about individualized care and a team approach where Oncologists, Surgeons and many other specialities work together. There are quite a few tools they can employ. Surgery to ‘get rid of it’ if it's possible is the first choice. In my case, it was possible and that is what I elected. Because I was in good physical (and mental) shape, the liver metastases were few, small and contained to only the right side of my liver, I was a good candidate for surgery. The surgeons said they could get it all (the visible part) and that I would not need monthly injections of Octreotide that cost about $10,000 each… following surgery. Earlier I mentioned "it's incurable". If it spreads to the liver, this is true. It almost always does spread to the liver because it's allowed to sit, fester and spread due to misdiagnosis. If there is any good news, is that it is usually (not always) slow growing. Where lung cancer may grow at 80% per year, a NET may only grow at 1 to 2%. So you have a little time to develop a plan. Now let me introduce the Zebra. Why the Zebra? "When you hear hoofbeats, think horses, not zebras." In the medical field, the term "zebra" is used in reference to a rare disease or condition. Doctors are taught to assume that the simplest explanation is usually the best, so as not to go around diagnosing patients with all sorts of exotic illnesses that are highly unlikely. Common diseases are what doctors should expect to encounter.But many doctors seem to forget that ‘zebras" exist, and so getting a diagnosis and getting treatment can be more difficult for sufferers of rare diseases. NET Newby ChecklistThe information below was prepared and written in its original form by Gary Murfin, a NET patient himself. I modified it a bit for my particular case. If you would like a link to Gary's 'Newby' list you can reach him at gmurfin@covad.net. I thank him for the use of his original material.Record Keeping – get copies of everything. Office visits, scans and bloodwork.Digitize your records – name them so they can be sorted in chronological sequence. A file might say 100 – CT 11/10/15. I number the record in chronological sequence like 1000, 1010, 1020, etc. It makes it easy to sort. Get a scanner or go to a print shop.Get copies of scans on CD’s. Learn how to make copies or take them to a FedEx Office store. Record visits to Doctors. I’ve never been told no. Purchase a recorder or download a free app on a smartphone. With the app on my iPhone, I can easily email the recording to family, etc. I own an app named Voice Record.Resources & Research – I have a file that’s about 100 pages long (after only 6 months). It is a bullet point summary of every event – Doctor Office visits, scans, biopsy, etc. It also contains:A list of contacts including addresses, phone, fax, email, etc. A list of medications and allergies to medicines. Clinics will ask for this information often… it's easier just to email, fax or mail a document.A spreadsheet of blood tests, and scans. What they are for and what were the results. Over 100 so far.A scan of your insurance card and driver’s licenseWebsites, List Serves, YouTube videos of presentationsLinks to relevant peer reviewed articles on Pubmed.govResources & Research Carcinoid.org Neuroendocrine Tumor Research Foundation Dr. Liu's Zebras Northwoods NETS Other NET and Carcinoid sites NETs support groups International Neuroendocrine Cancer Alliance The NET Alliance NetCancerBlog HealingNetFoundation Carcinoid Crisis — a crisis which may occur when a patient undergoes some kind of invasive procedure — like surgery. This can cause the tumors to quickly release various forms of hormones that cause the blood pressure to rise or fall causing life-threatening conditions for a patient. This can also happen when a surgeon just touches a tumor while operating. Patients who display the syndrome seem more prone to experiencing this condition. The best way to protect against this crisis is for the doctors to be prepared to counteract it with injections of Octreotide. Below is the protocol recommended by Dr. Gene Woltering, a very experienced NETS surgical oncologist. There is research indicating that the use of Octreotide prophylactically does not help. All agree that Octreotide should be on hand in the operating room.The Diagnosis - Testing/Scanning - Prior to my surgery, my first inexperienced, local oncologist ran several tests to confirm the diagnosis. Needle biopsy of one of the tumors in the liver to confirm that it was a NET.Urinalysis called the 5-HIAA where you lug around a gallon jug of urine for over a day. She should have ordered the plasma version of this test which is far less inconvenient), but was likely not aware. OctreoScan. This is a nuclear scan (uses a radioisotope tracer) that detects the presence of carcinoid tumors anywhere in the body. However, there is one caveat to using this type of scan. Not all carcinoid tumors are the same. Some have special receptors that facilitate the absorption of the radioisotope and some tumors do not have these receptors. If you have the receptors then the O-scan will work. If not, then it will not show anything. This type of scan does not show specific tumors, but rather lights up (shows bright spots) in the area or areas where neuroendocrine tumors exist (those with receptors).Because she was not experienced with carcinoids (which I didn’t realize at the time), she failed to order a Chromogranin A (CgA) test or pancreastatin (more sensitive than CgA). These are some of the best biomarkers for determining the presence of carcinoid tumor. Inter Science Institute, located in California does these tests . The web address is interscienceinstitute.com. ISI offers a free guideline manual for NETs that they will send you or your doctor for free. Just call them. The guide is considered by many to be the gold standard and is authored by a number of recognized experts -- and updated regularly. For the past few years there have been clinical trials offered in the US for a scan known as the Gallium-68 PET/CT scan. This scan has been used for years in Europe and is the Gold Standard for detecting NETS (with receptors). They are much more detailed, take significantly less time than an OctreoScan and use far less radiation. Why they are taking so long to get approved in the U.S. is anyone's guess. Where carcinoid tumors startMost carcinoid tumors start in the gastrointestinal tract to include the stomach and the appendix. The pancreatic type of neuroendocrine cancer can develop in or on the pancreas. Carcinoid seems to start almost anywhere in the gastrointestinal tract. A less common point of origin is in the lung. The development of the cancer starts with what is called the primary tumor. This is usually a small tumor that sends out seeds that go to other parts/organs of the body. The liver is the most common place to find the metastases along with the lymph nodes. My diagnosis was a primary in my ileum of the small intestine which had spread to four adjacent lymph nodes and two sections of my liver. The original scans of my liver showed 3 tumors. Upon removal, it was found one of the tumors was horseshoe shaped and two tumors came out at the same time. Ki-67 IndexThis is an important test, but can only be done on tumor tissue. The Ki-67 index is a stain test that tells the Docs how quickly (or not) your type of tumor will spread in the body. It is technically known as a Proliferation Index. The Ki-67 stain can be done even years after surgery, if that tissue was retained. Hospitals are supposed to keep cubes of the tissue from the primary tumor as well as the mets for a number of years.This test is run on resected tumor tissue, metastasized tissue and biopsy material. The test is done to determine how likely your form of carcinoid is to proliferate (grow-spread). The scale is on a 1-100 percent basis. An index of below 2% is good. The norm for most carcinoid patients is 1-2% and this means it is slow growing. The lower the Ki-67 index, the slower growing the tumor cells. The results of this test are now categorized into THREE Grades: Grade 1 - < 2% Grade 2 - 3 to 20% Grade 3 - > 20% This index is valuable when trying to determine if chemotherapy will work on a patient. Most chemo agents are designed to act on fast growing tumor cells, so the higher the Ki-67 index, the more likely that the cancer will respond well to chemo. Tumors that fall into Grade 3 are faster growing and therefore may be good candidates for chemotherapy. Some in the 15-20% could be treated with chemo agents as well. If you don’t have this Ki-67 test result, call your surgeon and ask him to have it run on your tissue. A similar test that is like the Ki-67 and measures cell mitotic activity is called the MIB-1 or Mitotic test. This is a proliferation index too. This is sometimes run in place of the Ki-67 depending upon the form of cancer involved. If either of these tests were done, it should be reported in your pathology report which you should have a copy of.Creating Your StrategyRemove the primary tumor. The first and most important step in dealing with a newly diagnosed carcinoid is to get the primary tumor taken out. One of the general rules about this cancer is that most of the time it takes a long time for this cancer to grow and so it is thought that most people have this cancer in their body for an average of 9.2 years before a diagnosis is made. This means that the cancer has had time to spread. The definitive work on the importance of removing the primary (if it can be found) was done by a team of Docs at Oregon Health Sciences University in Portland OR. The team was led by Dr. Rod Pommier. Here is what you might expect with this type of open surgery. Another theory is that the primary tumor sends out very small tumors (sometimes called micro-lesions) to all parts of the body via the bloodstream. This continues to happen until that primary tumor is taken out. The other part of this theory is that most people, by the time they are diagnosed, have already had their cancer metastasize (spread) to other parts of the body. When the primary tumor is in the gastrointestinal tract this usually means that the cancer spreads to nearby lymph nodes and most always to the liver. The tumors in the liver can remain quite small for a long time, but be aware that tumor size does not equate to tumor activity in terms of the release of the hormones that cause symptoms (if you have symptoms). You can have a few or even a lot of very small tumors that release a lot of bad hormones and these tumors may not show up on your scans. Another general rule for this cancer is that is it not curable. Only under certain circumstances has it been found that surgery could be a cure. This is only when the cancer has been found to not have spread. This is just a fact of life that the majority of us with this cancer must face. The bad news is we can't be cured, but the good news is that this cancer generally grows slowly and there are treatments that will slow the development of the tumors in the body. This means that usually a person has the time to what treatment could be best for them. Bottom line is that this cancer is treated like a chronic illness. You just keep controlling the tumor load, doing treatments that have good benefit but that are low risk. Interpreting test resultsWhen evaluating test results (blood, urine, etc) you have to look at two things…one is the test value in relation to the normal range and the other is the trend of the test values over time (usually at least 3 tests over time). The first thing you need to know is that normal is normal. All of these tests have a normal range. A test number at the low end of the range is considered to be the same as the test number at the high end of the normal range. If the test number falls below the lowest normal number then the result is abnormal. The same is true if the test number is higher than the highest value in the normal range. Abnormal low or abnormal high usually has a different interpretation, depending upon what is being tested.A lot of people get excited if they get a test number that is very high or very low compared to the normal range, but the real importance of the testing is the trend. If over 3 or more tests the values for one kind of test changes in one direction (by a significant enough amount) then that is an indicator of something going on. It could mean that things are getting better or things are getting worse. The best values are those that fall within the normal range. If the trend is a change within the normal range, then usually this means nothing….normal is normal. Also, there can be a trend, but the magnitude of change from one test to another may not be much, so the significance is not much either. Some people get tests done at different labs and this can cause complications in the interpretation of the test values. Each lab may have its own normal range, so you must have the normal range from each lab for each test run. If a test was done multiple times over a period of time at the same lab, then the norm range will be the same. If not, then the range may vary according to the lab and the interpretation of the test values and the trend may have a different meaning. The real question to be asked is will the test results change my treatment plan? For me the value is in knowing if there is something going on with my tumors. If the answer is yes, then it means I must be diligent in monitoring my cancer. The reality is that these kind of test results do not tell you where the activity is in the body. The other reality is that until tumors get to be of a size that they can be found on some kind of scan, they cannot be accurately treated. The only exception to this would be the case where tumor load is spread throughout the body and a "systemic" form of treatment, like Chemo or PRRT, needs to be used. Scans in UseThe CT and MRI scans done in the US have limitations in terms of the size of tumor that can be found by the scans. The Tri-phasic MRI or 4-Phase CT are the best in the US for finding lesions in the liver, but even the best do not get below 5mm. This is pretty small (0.2"), but you could have lesions in the 1-4mm range that are producing lots of hormone. The fact that your liver may still look good on an MRI or CT scan may not be good enough to declare that there are no tumors there. They may be there, but are too small to find. Morphological vs Functional scansThere are two types of scans…one is called a morphological scan and the other is a functional scan. The first type includes the MRI and the CT scans that most patients experience during the course of dealing with NETS. These scans show tumor structure, so tissue masses must be large enough to be identified by the scanner. The purpose is to determine size, volume and location of tumors. Depending upon the vascularity of the tumor, a radiologist may be able to conclude that the tumor is a NET or not. Note - MRI does not use radiation, the CT does. The second type of scan (functional) is able to find active tumors through the use of radioactive tracers that may be absorbed into the tumor. This kind of scan looks at the whole body and if tumors are large enough or have the right receptors or the right cellular metabolism they can be detected on the scan. For NETS, the Octreotide Scan can be done in the US. A relatively new scan for the US, that is currently in clinical trials here, is the Gallium-68 PET/CT. Another type of scan that can be used for faster growing tumors is the FDG-PET scan. It uses a tracer attached to glucose. Fast growing tumor cells consume the glucose and thereby absorb the tracer and the tumor shows up. There are other scans, some actually more effective than the Ga-68, but they are not offered in the US.Sando LAR and Somatuline Depot / Sub Q Octreotide - Octreotide comes in two forms…a short acting form that is given by subcutaneous shot and a long acting formula called Sandostatin LAR which is given as an Intramuscular shot. At present the company making the LAR is Novartis. The short acting is made by a variety of companies. For many years the Sando LAR formulation was prescribed for NETS patients to control the syndrome symptoms. In early 2009, a study, called the PROMID Study, was released by Novartis. This study showed that the medication could slow tumor growth for some patients with certain characteristics, in addition to stopping symptoms. This finding got many Docs to start prescribing this med to slow tumor growth for patients who had no symptoms. Another drug also on the market to stop syndrome symptoms is Lanreotide. This drug is made by Ipsen Pharma. As of 2015, this drug comes in only one formulation — a long acting formula called Somatuline Depot that is given as a subcutaneous shot. In July of 2014, Ipsen did a press release announcing the results of a study called CLARINET. The results of this study showed that Lanreotide in the long acting form (Somatuline Depot), like Sandostatin LAR, could slow tumor growth. For both drugs, there are side effects that can potentially affect patients. One is to pre-dispose a person for Type II diabetes since the med can influence blood glucose levels. Another possible side effect is to cause the gallbladder to produce gallstones. This typically leads to resection of the gallbladder which is a standard of care currently when NET surgery is performed.The timing of treatments. The first objective first after diagnosis is to remove the primary tumor. My first oncologist prescribed a ‘wait and worry’ strategy. That instinctively, did not sound right to me. The type of surgery performed depends on the location of the primary. Depending on the location of any metastases, a doctor may choose to reduce a patient’s tumor load by taking metastases out of the liver or in areas of the mesentery at the time of primary resection. There can be an order to the treatments in that doing one treatment might preclude the use of another type of treatment. That is why it is important to seek out a NET expert and develop a strategy that addresses the primary, lymph nodes and other metastases You don't necessarily treat them all the same, if you do, you can go down in flames (Dr. Gene Woltering). In my particular case, my primary was in the distal ileum with metastases to four of 22 lymph nodes and 3 small metastases to the liver, all on the right side (which is a good thing). Add to this my age (62) and general health (no diabetes, not a smoker, not overweight, etc.) made me an excellent candidate for surgery. Because the tumor had metastasized to my liver, the odds of it recurring sometime in the future is high - but it could be 10 to 20 years. By then there will be new developments. I studied this disease until I knew it much better than my original, local oncologist (and certainly my Family Practice doctor). Keep in mind that the typical F.P. doctor might only see one person with a NET during their entire career. I went to a patient directed seminar on NETs with presentations by a range of NET experts from various clinics throughout the midwest. I arranged a meeting with three of them to get opinions. After meeting with and talking to two and getting the same answer, I decided on the clinic that was closest to home - a four hour car ride. Both the Oncologist and Surgeon are recognized experts. The surgeon had done more liver surgeries than any other doctor at Mayo. The Five Es — it is well-known in the NETS community that there are a number of things that can trigger the syndrome. Epinephrine – or Epi: It is extremely dangerous for us as it can precipitate a carcinoid crisis. Novocaine as used by most dentists can come in two forms…one with Epi and one that is "plain" with no Epi. When talking to your dentist make sure he is using the plain form. There are "caines" without epinephrine (like Mepivacaine). Make sure your dentist and others know that you cannot tolerate Epinephrine. If you have a medical ID bracelet or necklace, NO EPI should be prominently displayed on that. Ethanol (Alcohol): Hardly any carcinoid patients can tolerate wine or beer. That is because those contain amines. They set off flushing, hot flashes, etc. On the other hand, many people can still drink "hard liquor". That is, rum, vodka, gin, bourbon, etc. Some people cannot tolerate any of these. If you drink, you may have to discover your own level. Exercise: The trick here is not to overdo. If not used to a particular exercise regime, take it slowly and work up your tolerance. Lots of carcinoid patients are regulars at gyms, walk, run, ski, etc. Mostly because that is something they have always done and so are used to it. But when starting something new or taking it to a higher level, increase the activity slowly. Eating: Large meals are difficult for most of us, especially those who have had gastrointestinal surgeries. Please do read through the section on Nutrition on the Carcinoid Foundation website. There is a list of "forbidden foods" - which does not mean you have to avoid them exactly. Some can indulge in those foods and some cannot. For instance, sauerkraut is on the forbidden list but some eat it frequently and have no problem. Here again, it is a case of testing out things. Most of us cannot eat an entire "regular" meal. You might want to eat six small meals instead of three big ones. You may want to "graze" instead, e.g. eat a little bit many times through the day. Emotions: Stress! It is difficult to avoid all stress - at work, family conflicts, worry. Learn meditation (transcendental - prayer - whatever form helps you). Take time off and get a massage, sit by the ocean, lake, river, and relax.The 'Newby' information above was prepared and written in its original form by Gary Murfin, a NET patient himself living near Seattle. I modified it a bit for my particular case. If you would like a link to Gary's 'Newby' list you can reach him at gmurfin@covad.net. I thank him for the use of his original material.
Caregivers and Social Security Disability Benefits
Acting as caregiver for someone with a debilitating condition or illness often comes with certain level of stress. Not only does caretaking require time and energy, but it also requires financial stability. When money is tight, caring for a sick or elderly individual can seem impossible. Fortunately, the Social Security Administration offers disability benefits to individuals who cannot work due to disability or illness. As a caregiver, these funds can be used to take care of medical bills, costs associated with living arrangements, or even things like food. Social Security Disability benefits may be the lifeline you need to provide a comfortable life for your loved one. Preparing for the Application For someone unfamiliar with the Social Security Disability application process, the task can seem daunting. To ensure the best possible outcome, it is important to be thoroughly prepared prior to filing your loved ones disability claim. The following information will give you a general overview of the application process and will help you get started. Step 1: Determine which program fits the needs of your loved one. The Social Security Administration (SSA) runs two separate benefit programs that each have their own eligibility requirements. It is important to learn about these programs so that you know which one best suits your loved ones needs. The first program—Social Security Disability Insurance (SSDI)—is funded by Social Security taxes that workers pay into the system. Therefore, eligibility is based on an applicant’s work history. To qualify for SSDI the individual that you care for must have earned a certain amount of what the SSA refers to as, "work credits". The second benefit program is called Supplemental Security Income (SSI). Eligibility for SSI is based on an applicant’s finances—not on his or her work credits. This is a needs-based program, meaning that those with limited income and financial resources can qualify for SSI. SSI is often a good option for young people and other individuals who haven’t earned enough work credits to qualify for SSDI. Step 2: Collect necessary records and documentation. The SSA requires that a large amount of documentation be submitted along with an applicant’s initial application. It is important that you collect this documentation prior to submitting your loved one’s claim. Giving yourself enough time to collect this information will prevent you from making a mistake and will save you from unnecessary stress. You will first need to collect medical records. These records are vital to receiving disability benefits because they serve as proof of your loved one’s illness or condition. It is recommended that you work closely with your loved one’s doctor or doctors to collect this information. These records may include documentation of the applicant’s diagnosis, treatments, response to treatments, hospitalizations, and medical tests. You should also ask the treating physician to supply an official statement detailing how your loved one’s condition prevents him or her from working. You may also need to collect records pertaining to your loved one’s work history and finances. If he or she is applying for SSI, you will need to gather proof of income and assets. If you find that you are having a hard time collecting any of this information, it may be in your best interest to retain the services of an attorney or advocate. A legal profession will be able to relieve you of this duty and will make sure that your loved one’s application includes the necessary paperwork. Step 3: Initiate the application process. Once you and your loved one are ready to begin the application process, you can do so online at the SSA’s website or in person at your local Social Security office. To complete the initial application, you will be asked to complete and submit a number of forms. These forms include the Adult Disability Checklist, the Adult Disability Report and an authorization to release medical information. The applicant will have to sign the forms giving permission to the SSA to obtain medical records from the applicant’s treating physicians. Make sure you submit all of the applicant’s medical documentation and any written statements from treating physicians along with the application for benefits. After you have submitted the application, you should receive a response within three to six months depending on where you live and the volume of claims being handled by your local Social Security office. Receiving a Decision Once you receive the SSA’s determination letter, you will be notified of the applicant’s approval or denial. If the applicant was denied benefits, it is important that you don’t give up. After an applicant is denied, they have the option to appeal the decision. Please note that nearly 70 percent of disability claims are denied during the initial stage of the application process. In the appeal phase nearly two-thirds of applicants are awarded benefits. Although it can be difficult to apply for disability benefits on another person’s behalf, keep in mind that these programs are here to help you. Helping your loved one apply for disability benefits can help you provide them with a more comfortable life. To learn more about disability benefits visit Social Security Disability Help.
How To Keep An Elderly Person In Bed At Night
Keeping an elderly person in their bed at night is a very important part of senior safety. Night time falls are common, and can lead to serious injury, hospital time, as well as many other problems. Proper night time care, and a few precautions can help keep an elderly person in their bed at night, and create a safer environment when they do get out of bed. Here’s what you should know: Eliminate the need to get up: The absolute best way to keep an elderly person in their bed at night is to eliminate the need to get up. Many elderly get out of bed to use the bathroom, get drinks, or simply because they can’t sleep, are uncomfortable, or are bored. Find ways to circumvent these things, and prevent the need to get up all together. Bathroom needs: The need to use the bathroom during the night is one of the top reasons elderly persons leave their bed at night. Help your elderly loved one stay in bed by providing bathroom assist products. Overnight adult diapers, bed pans, under pads, urinals, and other products can decrease the need to get out of bed, and thus reduce the risk of slips, falls, and other nighttime hazards. Drinks, food, medication: Eliminate the need to leave the bed for kitchen items, including drinks, food, and medication by using a bedside organizer, or bed stand. Include a water bottle, any needed medications, pain killers, etc., as well as a few snack items. It is also wise to put books, a reading light, and other entertainment options nearby as well. Having these items in arm’s reach helps keep seniors in bed, rather than walking around in the dark. Discomfort and boredom: Often seniors struggle to sleep, wake very early in the morning, or stay up late into the night. Being able to adjust themselves, sit up and read in bed, etc. can very useful, and protect them. Often when seniors first wake, it is easy for them to lose balance and fall. Providing tools like a BedCaddie, which is designed to help seniors adjust themselves in bed by pulling themselves up the ladder like tiers to a sitting position, can help make time spend in bed more comfortable, and eliminate the need to exit the bed. Safety rails: Safety rails can also help to keep an elderly person in bed at night, as they protect them from falling out of bed during the night, and can help them support themselves so that when they do leave the bed, be it day or night, they have something to hold on to as they climb in and out of bed. This extra support is great for helping maintain balance when groggy, or in the dark. It is also important to recognize that sometimes, despite precautions, there will be a need to get out of bed. Thus, in order to make it safer if they do get out of bed, consider the following: Clear clutter, and make sure there is a clear path to bathroom, kitchen, etc. Use light, night lights and motion sensor lights can help a lot. Make movement safe with non skid mats, lit walking paths, motion sensor lights, bed rails, and more. Make sure they have secure footing with slipper socks, or socks with traction built in. Be careful with furniture placement. The CareGiver Partnership offers 500 items for senior care and care giving, as well as a staff of knowledgeable product specialists that can help you find the best products for your unique needs. To contact a product specialist call 800-985-1353 M-F 9-4 Central.
Best Adult Diapers For Fecal Incontinence
Between 6% and 15% of the population suffers from bowel incontinence. This is a frustrating, potentially embarrassing, and difficult to manage problem. Loss of bowel control, whether severe or only partial can greatly interfere with day to day living and tasks, social, and work life, and more. Therefore, finding the best adult diapers for managing bowel incontinence is a must. Here’s what you should consider: 1. Understand the severity of your fecal incontinence. The best way to do this is to talk to your physician. Despite the potentially embarrassing nature of this discussion, it is something you really should do. Fecal incontinence is not as uncommon as you may think; women are more likely to experience it as men, and often the severity and risk goes up as you age. Knowing your severity will help you understand your options, and find the products that are right for you. 2. Start on a treatment plan. Strengthening pelvic muscles and other treatments can help you regain control over your bowels. The cause of bowel incontinence must be addressed, and a treatment plan created. This may include changes to diet, exercise, and lifestyle. However, it takes time to get the bowels back to functioning properly, and if there is extensive sphincter damage, it may not be 100% reversible, or may require something more invasive, such as surgery. Thus, finding the right products for management is crucial to living with bowel incontinence. 3. Choose the best adult diapers for your bowel incontinence, and know what other products may also be helpful. When it comes to adult diapers you have a number of brand options including: Tranquility Prevail Attends Each of these brands offers a unique combination of comfort, protection and ease of use. Select the best options for your individual needs. In addition to adult diapers, consider purchasing bedpads to help protect mattresses, furniture, and the like from leaks; wipes to help keep the skin clean and healthy; and other skin care products to insure that you do not develop rashes, lesions, or other skin discomforts. Adult diapers for bowel incontinence will give you a great management option to utilize in order to main dignity while you treat the cause, strengthen the pelvic muscles, and work to gain more control over your bowels. To find the best adult diapers for bowel incontinence, check out the wide selection offered by LiveAnew. When in doubt, call a product specialist, at 1-800-411-3008 M-F 9-4 Central. These nice ladies can help you find the right size, and selection of products for bowel incontinence, and can assist you with fast ordering and zippy delivery.
Are Incontinence Supplies Tax-Deductible?
As the costs of medical care and supplies continue to rise, consumers benefit from researching ways to be reimbursed for as many of these expenses as possible. For those with incontinence, there are several areas worth checking into to help defray the costs of supplies. Expenses for incontinence supplies may be tax-deductible if you can show they’re needed to relieve the effects of a specific disease, according to U.S. Internal Revenue Service guidelines. Start by seeing your doctor, who may diagnose you with medical incontinence and may be able to advise you on seeking reimbursement based on your health and financial situation. Ask your doctor for a letter that explains your medical need for incontinence products, then consider the following options.Your health insurance planWhile many private insurance plans do not cover incontinence supplies, you may be reimbursed through a health savings account (HSA) or a flexible spending account (FSA). With an HSA, funds contributed to the account are not subject to federal income tax at the time of deposit, and funds roll over and accumulate year to year if not used. With an FSA, an employee sets aside a portion of earnings, which are not subject to payroll taxes, to pay for qualified expenses; funds deposited into an FSA must be used within the calendar year. With both types of accounts, receipts are submitted to a plan administrator and participants receive reimbursement checks.MedicareMedicare is a health insurance program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with end-stage renal disease. Medicare programs include hospital insurance, medical insurance and prescription drug coverage. To see if you may be eligible for benefits, use the Medicare Eligibility Tool. MedicaidMedicaid is health insurance that helps many people who can’t afford medical care pay for some or all of their medical bills. If you are a U.S. citizen with limited income and you qualify for Medicaid because of age or disability, Medicaid may send payments directly to your health care providers. Visit Medicaid for information on qualifications and to find a program in your state. County offices for the agingCheck your telephone book’s county government section for aging and disability resource centers. These county offices may be able to direct you to resources to help you receive reimbursement. Diaper banksSome areas offers diaper banks, where products are donated by organizations or individuals, then given to people who cannot afford them. Although many diaper banks focus on newborns, some include incontinence supplies for adults. Check your phone book or look online to see if your city or state offers this service. Your local senior center may be able to help you find resources as well.Outside the United StatesFor information on resources for citizens in countries other than the United States, visit your country’s government website.Finding the Right Incontinence ProductConsumers buying incontinence products the first time can easily be confused which product, brand, style, size or absorbency to purchase. And once the package is opened, they can’t be returned, so mistakes can be costly. Here are some helpful resources to help you avoid this problem: Explanation of types (pull-ons, adjustable underwear, briefs, undergarments and more) Incontinence Product Finder (quickly and easily sort though nearly 500 choices)
Home Safety Hazards: 10 Places to Look for Potential Dangers
As we move toward our senior years, we need to take steps to protect ourselves from our homes where injuries can occur. Something that may not have been dangerous in the past like your bed can now be one of the worst potential hazards in your home. Here is a list of 10 potential dangers that are prevalent in your home and what you can do to prevent serious accidents and injuries from occurring. The bathroom. This is perhaps one of the most well-known places for injuries. Slips in a wet bathtub or falling off a toilet can break a hip, an arm, or a leg. To prevent serious injuries from occurring in the bathroom, you should install safety bars in the bathtub along with raised toilet seats with safety bars. Also included with safety bars in the bathtub, you might consider purchasing a seated chair so you don’t have to try and stand the entire time you are in the tub. A showerhead with a hose will allow you to cleanse your body without standing or needing to hold onto a support bar the entire time. To find nice shower seats and raised toilet seats with support bars, visit: http://www.caregiverpartnership.com/category/2. A textured bathmat is another wise purchase to prevent falls in the tub. Falls in the home are one of the scariest things for seniors. Scatter rugs in the home can easily cause you to lose your footing and fall down, possibly causing you to break some bones. Always wear a safety device to contact emergency responders in case you have an accident and you are unable to get up. You should use non-skid rugs and floor cleaners to prevent falls on slippery surfaces. Vision problems. The older we get, the worse our vision will get. When you are walking through your home, it can be difficult to see in poor lighting and you can run right into a large piece of furniture if you are not careful. Use bright lights to keep your home well-lit so you can see around dark corners. Bright lights will also help you when you are in the bathroom and kitchen and you are focused on cooking and washing. The stairs are one of the biggest dangers in the home. Make sure your stairs have safety railings installed so you can hold them as you go up and down. Your strength will start to fade as you get older and it may be wise to install a seated chair lift that will move you up and down the stairs. Keep the stairs clean and free of clutter to prevent tripping and falls down the stairs. Your bed is another safety hazard in the home as you can roll right out of bed if you are not careful. Purchase a safety railing that will keep you from falling out of bed and can also help you climb in and out of bed during the night and in the morning. A safety harness will strap you down into bed so you do not need to worry about rolling around and falling out of bed as well. Rearrange the furniture in your home to move it out of high traffic areas. Since you may be hard of hearing, push your chairs and couches closer together so you can be in close proximity with your loved ones and you will be able to hear what they are saying. If you still have problems hearing, consider using a hearing aid or amplifier. Here is a great hearing aid device: http://www.caregiverpartnership.com/landing/nexear. Walking around your home can get tedious and it may be quite painful for your joints and legs. A nice transport chair will allow you to easily get around your home and you will not need to deal with pain anymore. Use ramps on the stairs so you can easily move from room to room. Remove cords from dragging all over the floor as you can trip and fall on them and they can be hard to push the wheels of your transport chair over. Reduce the water temperature in your home to prevent scalding. This is also a safety concern for children, not just elderly individuals. Remove clutter from your home as it can be a hazard. You can easily trip and fall over a sock or cord that is in the way. Stretching your muscles to reach cups and things that are high up can be painful. Instead of using a stool, you may try using a reaching device that will grab onto anything you need that is up high or down low.
5 Ways to Treat Incontinence After Prostate Cancer Surgery
Prostate cancer is the second most common cancer among men, second only to skin cancer. The great news is, it often can be treated successfully. More than 2 million men in the U.S. count themselves as prostate cancer survivors, according to the American Cancer Society. Although men with early prostate cancer often have no symptoms, more advanced cancer cases sometimes problems urinating or holding in urine, erectile dysfunction, blood in the urine, weakness or numbness in the legs or feet, or pain in the spine, hips, ribs or other bones.When cancer has not spread to other organs, surgery is often used to treat it, and up to half of men will experience bladder leakage following prostate surgery. Incontinence following prostate surgery, while often temporary, can disrupt a man’s quality of life and cause anxiety, isolation and embarrassment. Learning to live with urinary incontinence often is a multifaceted approach. There is no one right way to deal with it — the key is to find the best approach for each individual. That may mean a combination of using the right absorbent products, strengthening exercises, bladder retraining and medication.A urologist may prescribe any combination of the following treatments:1. Absorbent products come in an array of styles and absorbencies to fit every lifestyle. Active men who want something as close to regular underwear as possible can choose from washable, reusable briefs or premium disposable briefs like look and feel like cloth underwear. Those who need more absorbency can choose from guards, undergarments, underwear, adult diapers and more.Try the LiveAnew BestFit Helper2. Kegel exercises, when performed regularly, tone and strengthen the muscles responsible for holding in urine. Starting Kegels before a radical prostatectomy may result in quicker recovery of bladder control. Kegels are performed by tightening only the pelvic muscles, while keeping abdominal, thigh and buttock muscles relaxed. A doctor will prescribe the correct number of frequency, sets and repetitions.3. Bladder retraining, or learning to urinate on a set schedule, can be an effective treatment once pain is under control. A health care provider will develop a bladder retraining program that may include keeping a diary and working up to going longer periods between voiding.4. Medication may be prescribed based on an individual’s type of incontinence. A man with stress incontinence — the most common type following prostate surgery and characterized by leakage when coughing, sneezing, laughing or exercising — may be prescribed decongestants to tighten the urethra muscles. One with urge incontinence — when an overactive bladder contracts without warning — may be treated with anticholinergic drugs that block messages to bladder nerves and prevent spasms.5. In cases where incontinence persists longer than 18 months, treatment options may include collagen injections, a catheter or surgery.
