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Understanding: Does Your Doctor “Get” You?

Archive for the ‘Blog’ Category

Understanding: Does Your Doctor “Get” You?

Posted on: September 12th, 2016 by Mindy Ruben No Comments

Does Your Doctor “Get” You?

So I’m at a restaurant, about to order my favorite salad with a slight twist: I’ve decided to top it with grilled salmon instead of my usual grilled chicken and my husband peeks over the corner of the menu and says, “Danger, Will Robinson!”

Encompass HealthCare patients trust Doctor Ruben like Will trusts the Robot in Lost In Space

I smile wryly, content with the instant connection we have. No further words are needed. And if our ages separated us more than 7 1/2 years, I might not have “gotten” him. (more…)

I Spend 90 Days Of My Life On Hold!

Posted on: August 12th, 2016 by Mindy Ruben No Comments

Encompass HealthCare & Wound Medicine heals infections and wounds, without putting your life on hold, West Bloomfield, MichiganIf I added up all of the time I’m on hold, I bet it would total 3 months. It’s true, I’ve actually done the math!

First, let me clarify the type of phone hold we’re talking about here. You know, the kind that takes you through a maze of phone menus? (more…)

“Mom, There’s Nothing To Eat!”

Posted on: August 1st, 2016 by Mindy Ruben No Comments

“Mom, There’s Nothing To Eat In The House!”

How many times have we heard our kids say this? Still huffing and puffing from carrying in 8 or 9 plastic bags full of groceries, some of which have magically transformed into tourniquets around the ends of my fingers, I look at my kids incredulously: “Nothing in the house to eat?”

Sound familiar? Encompass HealthCare & Wound Medicine, West Bloomfield, Michigan.

“The fridge is so full, I can barely fit in anything else and the pantry is chock full of your favorites…what do you mean ‘there is nothing to eat?!'”

(more…)

Why Protein is Important for Healing Wounds

Posted on: July 11th, 2016 by Mindy Ruben No Comments

What’s protein got to do with it?

A day doesn’t go by that I’m not bombarded with information on the newest diet, the latest exercise trend, or the fastest way to get in shape. (more…)

Providing Barrier-Free Treatment for Disabled Patients

Posted on: July 8th, 2016 by Mindy Ruben No Comments

One of the most heartbreaking scenes in Forrest Gump is when Lieutenant Dan is coming to grips with the loss of his legs. Robbed of his perceived destiny of dying proudly in battle like his ancestors, and with the weight of his world collapsing down on him, an exhausted Dan Taylor sighs,”What am I going to do now?” 

For Lieutenant Dan and many newly disabled patients, the loss of mobility, independence and dignity can often be more paralyzing than the loss of sensation in their appendages. Just making it through a routine doctor’s office visit can be a most daunting and challenging experience if their office is not barrier-free.For example, most intra-office hallways are designed to allow two people to pass each other comfortably. But what if one of the people is in a wheelchair? What if both are in wheelchairs? It gets uncomfortable very quickly.”Hop up on the table” is not a problem for most patients. But for paraplegics and quadriplegics, the dynamics are not so easily orchestrated. That’s an example of an obvious physical barrier to treatment along with push/pull doors and bathrooms that are not equipped with reinforced safety bars and handles.

Designing a Facility for Patient Accessibility

Wouldn’t it be wonderful for these patients to have an outpatient medical facility designed from the ground up to accommodate wheelchair or gurney patients as fully as their free-walking counterparts? Certainly, such a facility would be much more comfortable for the disabled patient and provide him/her with a greater sense of independence and dignity.

That was the thinking behind the creation of Encompass HealthCare and Wound Medicine; an outpatient wound care facility in West Bloomfield, Michigan. Founder and Medical Director, Dr. Bruce Ruben, explains his model.

“Freedom is what I was really striving for with Encompass HealthCare,” Ruben said. “I didn’t want there to be any barriers for patients to endure in order to obtain treatment. Quadriplegic and paraplegic patients have enough medical challenges in their lives. Access to the care in the first place shouldn’t be one of them,” he said.

 

Encompass HealthCare was designed with barrier-free 5-ft.-wide hallways and 48-in. tall walls

Encompass HealthCare was designed with barrier-free 5-ft.-wide hallways and 48-in. tall walls

 

Automatic Doors and 48-inch Tall Windows

Among the many amenities that are included in the Encompass HealthCare design are automated doors at both inside and outside entrances to the office. Extending from the outside entrance is a stretched awning so patients don’t have to wait in the rain, wind or snow while the automatic doors open. True, these may seem like minor conveniences to most patients, but to someone in a wheelchair or on a gurney, they mean less vulnerability, which translates into better healthcare experiences.

One unique feature built into Encompass HealthCare is 48-inch tall walls in the front treatment cubicles of the office. They lengthen the lines of sight for wheelchair patients. According to Dr. Ruben, there is an important psychology behind the design.”Shorter walls are simply less intimidating for the disabled patient than being surrounded by four, full-size walls. Forty-eight inch walls give the outer office an open and airy feeling. Wheelchair-bound patients feel more in control since they can see more of what’s going on around them,” Ruben said. “They also provide a sense of community, particularly when we’re busy.”

Removing Patient Barriers to the Health Care Facility

Encompass HealthCare is located on the ground floor inside the Lakes Medical Center and excellent handicapped parking is available right outside the office entrance. For patients who require extra assistance, wheelchairs and walkers are available just inside office’s front door. The staff is trained and ready to help get patients from their vehicles to their treatment areas close by.

Once inside, the staff is able to utilize a convenient lift system to transfer patients from their chairs or gurneys onto their treatment tables. The facility is also equipped with a full, roll-in shower and all the bathrooms are equipped with reinforced safety bars and handles.

 

This Encompass bathroom and shower is barrier-free.

This Encompass bathroom and shower is barrier-free.

 

“We have patients with urinary catheters and colostomies. Sometimes, those systems can fail and for the patient, it can be very embarrassing. But we’re all very caring and professional about it when those things happen and we’re well equipped to clean them up quickly. We always have fresh towels and scrubs to give them should the need arise,” Dr. Ruben explained.

Eliminating the barriers to the comfortable and dignified delivery of health care goes beyond providing the amenities and physical properties patients need. More important may be the psychological barriers imposed. For those, Dr. Ruben has only two suggestions that have obviously worked in his practice.

“You have to hire the right personalities to work together and the training is every day,” Ruben said. “If I had to put it in just two words, they would be ‘passion’ and ‘compassion.’

“To do what we do every day, seven days a week, passion and compassion have to be deep in your DNA. When a patient experiences that in you, all the psychological barriers come down. They know you care, that you’re on their side and that they’re not alone in their goal to heal their wound or to overcome an underlying condition preventing that wound from healing,” said Dr. Ruben.

“I think we, as providers, will always be the most powerful barrier-busting force for paraplegic and quadriplegic patients. The equipment and the layout are necessary tools. But it’s the relationships we have with our patients that, from my perspective, eliminates a great deal of the barriers for disabled patients and for healing in general.”

“Doctor’s Office, Please Hold”–Is This Patient Care?

Posted on: July 5th, 2016 by Mindy Ruben No Comments

Patients want care. They want to feel better. Most people who go to a doctor’s office have a medical malady and they are usually scared.

Going to the doctor to find out what’s wrong can be very frightening. Many of us have experienced that, entering the doctor’s office with trepidation and hoping for a nice face on the other side of the that sliding glass window to greet us with care and with pleasantness. We are so desperate for someone who’s in a good mood, that we even fake a smile through our own anxiety in hopes of eliciting a grin from the would-be assailant. For if not, this person could pose the biggest barrier between our fear and something even more powerful: hope. (more…)

Loss of Independence: A Wound That Heals With Time and Patience

Posted on: May 1st, 2016 by Mindy Ruben No Comments

Enjoy this blog about unfortunate feelings surrounding loss of independence, appearing in WoundSource and available here.

Some patients experience a loss of independence when faced with serious medical problems.

Some patients experience a loss of independence when faced with serious medical problems.

by Bruce E. Ruben MD

“Any natural, normal human being, when faced with any kind of loss, will go from shock all the way through acceptance.”
Elisabeth Kubler-Ross (more…)

“Really listening can tell you all you need to know about what’s wrong with that patient, and it’s never failed me yet,” says Dr. Bruce Ruben. Read Why Technology Will Never Replace Great Doctors.

Posted on: March 18th, 2016 by Mindy Ruben No Comments

“Really listening can tell you all you need to know about what’s wrong with that patient, and it’s never failed me yet,” says Dr. Bruce Ruben.

Read Why Technology Will Never Replace Great Doctors.fraid that new technology might replace great doctors? Not a chance! Read what Bruce Ruben, M.D. has to say about this in LifeZette’s article below.

(more…)

The Encompass Home is featured in the online edition of DBusiness, Detroit’s premier business magazine.

Posted on: February 23rd, 2016 by Mindy Ruben No Comments
The Encompass Home houses wound-healing patients

The Encompass Home houses wound-healing patients

The Encompass Home is featured in the online edition of DBusiness, Detroit’s premier business magazine.

The Encompass Home is Encompass HealthCare and Wound Medicine’s extended stay facility for those patients receiving infection and serious wound healing treatments. (more…)

What Are The 4 Infections And How Do We Treat Them?

Posted on: February 14th, 2016 by Mindy Ruben 1 Comment

Read my latest blog entitled “The 4 Infections You Need To Be Aware Of…(And How To Treat Them) at MD.com.

 

General Health

The 4 Infections You Need to Be Aware Of (And How to Treat Them)

Bacterial Infection

Bacterial infections are the first of 4 infections that we will discuss. Bacteria are self-sustaining, respiratory, (breathing) one-cell life forms that live on, in and throughout the human body. Hundreds of thousands of specific types live homogenously on your skin, throughout the gastrointenstinal tract and in the urogenital tract. They live within our bodies for good reason: they protect us from illness and from some diseases, rarely causing any problems.

Bacterial Infection--Encompass HealthCare & Wound Medicine, West Bloomfield, Michigan

Bacterial Infection–Encompass HealthCare & Wound Medicine, West Bloomfield, Michigan

Sometimes, however, too much of a good thing can be bad. For example, bacteria that are under our armpit are good because they consume our sweat secretions, but bad because they produce volatile fatty acids that turn into gas. That gas smells and is what we call “Body Odor .” [1] This is simply a negative by-product of this bacteria, however what becomes a serious, medical concern is when these bacteria, that normally live outside of an organ like your skin, enters into and throughthe body, invading the space in which it should not live.

An example here is when you suffer a cut or a wound. The bacteria sitting on the pre-wound’s skin surface now can enter into your body and potentially cause infection. Not every skin breach causes infection, as we have all experienced. But in some cases, a wound that is not kept clean or a person with a compromised and weakened immune system can get ill. The symptoms are redness, hot to the touch, pain at site, and sometimes fever, chills, muscle aches, and an overall feeling of malaise.

In order to properly treat serious bacterial infections, you first must determine the type, depth and the severity of the infection. Your doctor typically will swab any drainage from the site and send it off for laboratory culture to identify the specific bacterial type. S/he then prescribes the correct antibiotic that will eradicate the bacteria, returning your body to a state of health. In some cases, the antibiotic will be delivered orally and in more serious cases, intravenously (through an I.V.). This type of antibiotic prescribing is the most prudent because the physician has specific information and can match the most useful antibiotic to the bacteria. Penicillin, tetracycline, sulfa, and ciprofloxin are typical antibiotics prescribed for bacterial infections.

Fungal Infections

The second type of infection is a fungal infection. Living in a similar manner to bacteria, we all have fungi that live in and on the body sites. Generally, they are not a problem unless one of two conditions is present:

  1. Someone has a compromised or weakened immune system (called immunocompromised;)
  2. A blockage exists where it should not.
Example of a fungal infection, Encompass HealthCare & Wound Medicine, West Bloomfield, Michigan

Example of a fungal infection, Encompass HealthCare & Wound Medicine, West Bloomfield, Michigan

When kept in delicate balance, fungi do not cause illness. However, when out of balance, infection can occur. Someone who has AIDS, for example, might develop pneumonia because the fungi that live homeostatically inside

the lungs can overgrow, impair air exchange in the lung, and cause florid pneumonia. Because this person’s system is compromised, it is unable to maintain that healthy balance.

Recurrent sinus infections with bacteria or fungi are often the result of pendulous blocking polyps or allergy provoking mucosal swelling which block the normal sinus drainage into the stomach of infectious debris.

Again, treatment for these types of fungal infections must be cultured and then treated with the proper agent. Fluconizole and Nystatin are common antifungal medicines.

Parasitic Infections

The third type of infection is a parasitic infection. This is where the parasite uses your body and is a life form itself. It can live on its own and/or “rent”space in your body. A common parasite is Giardia Lambia and it is usually found in fresh water systems such as lakes and rivers. Ingestion of infected water is the primary way this parasite infects humans. Over 50% of our lakes, river streams and creeks are infected with Girardia Lambia and it is even finding its way into urban areas’ drinking water.[2] This parasite is commonly found in the gastrointestinal tracts of deer and bears and it finds its way into the water through fecal contamination.

Giaradia Lambia parasite, a parasitic infection that can be treated at Encompass HealthCare and Wound Medicine, West Bloomfield, Michigan

Giaradia Lambia parasite, a parasitic infection that can be treated at Encompass HealthCare and Wound Medicine, West Bloomfield, Michigan

Another example of a parasite is Malaria. Malaria is a disease caused by a parasite transmitted by infected mosquitoes. In 2013 an estimated 198 million cases of malaria occurred worldwide and 500,000 people died, mostly children in the African Region. [3]

Parasites are treated with anti-parasitics. Examples here are oral pills like Metronidazole (Flagyl), which is the most commonly used antibiotic for a giardia infection, and I.V. Quinine, which is one of several treatments available for Malaria.

Viral Infections

The fourth type of infection is a virus. Viruses are different than all the others mentioned thus far because they require a life form in order to reproduce themselves. In essence, they use your body’s machinery in order to survive. Examples here include the common cold, Chicken Pox and Herpes. What is interesting about viruses is how they work: they take your own DNA and make template of your body’s cells. They then take that DNA template and form RNA viral genes. These genes use the cellular machinery to make hundreds of thousands of protein and carbohydrate capsules before inserting the RNA back in this shell and then breaking and killing the cell to move on to the next. This is how it grows and this is why it spreads.

4

Treatments here are self-limiting, usually requiring nothing but fluids and rest in order to get better. Viruses do cause serious diseases, however, in humans such as AIDS, Influenza pneumonia, and Hepatitis. For these and others, antiviral agents are the remedy. Acyclovir and Oseltamivir are two common, antiviral medicines.

In short, infections of all kinds typically present in the same fashion with similar symptoms: fever, chills, muscle aches, and general malaise. It is only through thorough medical evaluation that one can determine the underlying problem and thus, its treatment. It is important that you have a good doctor who you trust and who has extensive experience. It is in this way that he or she can get rid of what’s bugging you.

 Sources

[1] Cheryl Power, senior lecturer in microbiology at the University of Melbourne, Body and Soul.

[2] Content copyright 2016. HUMAWORM

[3] CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.

 

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