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

Archive for the ‘Blog’ Category

“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.

 

Dr. Ruben’s Venous Insufficiency Article

Posted on: December 15th, 2015 by Mindy Ruben No Comments

Dr. Ruben’s Venous Insufficiency Article explains this condition thoroughly in his Woundsource article here.

Venous Insufficiency: blood and other fluids can't travel up toward the heart because of faulty valves inside the vein. This is explained in Dr. Ruben's venous insufficiency article.

Venous Insufficiency: blood and other fluids can’t travel up toward the heart because of faulty valves inside the vein. This is explained in Dr. Ruben’s venous insufficiency article.

Chronic venous insufficiency (CVI) refers to a long-term condition where the veins inside the legs have lost their ability to move blood back up to the heart from the legs. This occurs because the vein walls have weakened to the point where the venous pumps are no longer sufficient enough to send blood back up, against gravity, to the heart. CVI also affects the tiny valves inside the leg veins. When these valves do not close sufficiently, blood seeps back down past the valves and pools in the lower legs.

Many treatments are available including our in-house venous ablation(more…)

Avoid Amputation At Encompass HealthCare & Watch Our Video

Posted on: December 8th, 2015 by Mindy Ruben No Comments

We avoid amputation by delivering the most sophisticated wound healing technology to our patients…all outside of a hospital, safely at our in-house wound treatment center.

At Encompass Healthcare, our patients have been able to avoid amputation because we have access to hospital-level technology without the hassles that hospitals present. Our sophisticated wound care technology includes treatments such as venous ablation, hyperbaric oxygen therapy, I.V. antibiotics, x-rays, special dressings and a home-like atmosphere that is anything but hospital-like!  (more…)

See Dr. Ruben’s Video On Refractory Osteomyelitis

Posted on: November 4th, 2015 by Mindy Ruben No Comments

Refractory osteomyelitis is a recurrent case of osteomyelitis.

This patient has recurring or refractory osteomyelitis of his lower jaw.

This patient has recurring or refractory osteomyelitis of his lower jaw.

Osteomyelitis is a fancy word for bone infection and refractory osteomyelitis can become a problem if untreated.

(more…)

Stasis Ulcer Information from Dr. Bruce Ruben

Posted on: October 7th, 2015 by Mindy Ruben No Comments

Overview of Venous Stasis Ulcers

A stasis ulcer is a breakdown of the skin (ulcer) caused by fluid build-up in the skin from poor vein function (venous insufficiency). Fluid leaks from the veins into skin tissue when the blood backs up rather than returning to the heart through the veins.

This wound is a result of venous insufficiency (venous stasis ulcer)--Encompass HealthCare and Wound Medicine, Michigan.

This wound is a result of venous insufficiency (venous stasis ulcer)–Encompass HealthCare and Wound Medicine, Michigan.

Who’s At Risk
Leg vein malfunction (venous insufficiency) affects 2–5% of Americans, and approximately half a million Americans have stasis ulcers. Women are more often affected by stasis ulcers than men.

Your risk for acquiring a stasis ulcer is greater if you:

  • Are overweight.
  • Have varicose veins.
  • Have had blood clots in your legs.
  • Had a leg injury (trauma) that might affect blood flow in your leg veins; even minor trauma may cause an ulcer.

Signs and Symptoms

Swelling of the leg, brown discoloration, or an itchy, red, rough area (stasis dermatitis) may appear before you notice an ulcer. This is often seen on the inner ankle area first, although any area on the lower leg may be affected. Varicose veins may be present. Sometimes there are hard, tender lumps under the skin near the ulcer.

The ulcer is a crater-like, irregular area of skin loss. It may be an open, easily bleeding, painful wound, or it might have a thick black scab. The level of pain varies.
Self-Care Guidelines
People with a leg ulcer should seek medical care if it is anything beyond a small scrape or cut on the surface of the skin.

If the ulcer appears minor:
Clean it with soap and water.
Apply a thin layer of petroleum jelly (Vaseline®) and a clean gauze bandage.
Avoid putting any tape or adhesive on the skin.
Avoid using topical antibiotics and other over-the-counter products, as people with leg ulcers often become allergic to these products.

When to Seek Medical Care

If you have pain, swelling, spreading red areas, fever, or any open wound that does not heal after a few days of self-care, seek medical advice.

Treatments Your Physician May Prescribe
In addition to a thorough exam, your physician may test to evaluate how well your veins are working.

Treatment may consist of:

  • Procedures to reduce leg swelling.
  • Medication for any dermatitis or infection that is present.
  • Special wound dressings.
  • Pentoxifylline to aid healing.
  • Surgery if other medical treatment fails.
  • Compression hose to prevent the ulcer from coming back.
  • Most ulcers heal within 1–4 months, but about 25% will still be present after a year.

Trusted Links
MedlinePlus: Leg Injuries and Disorders
MedlinePlus: Vascular Diseases

References

Bolognia, Jean L., ed. Dermatology, pp.1635. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed. pp.21. New York: McGraw-Hill, 2003.

 

Source: SkinSight.com

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Inky and Pocket

Posted on: November 24th, 2014 by Mindy Ruben No Comments

Inky and Pocket, the WoundDogs at Encompass HealthCare, are members of the beloved staff at the outpatient wound care center. Here, they take time out from napping to tell us about their work and their life at Encompass.

INKY & POCKET: No? You sure? Seriously? Positive? Absolutely sure? Second chance? Once more? Not right now, but later? Maybe?

POCKET: No worries. We’ll keep an eye out in case you drop something.

INKY: It’s what we do. After all, we’re dogs, first.

POCKET: WoundDogs, that’s our family business. We’ve been doing wound care for ‘bout four years now.

INKY:  ‘Bout 28 years.

POCKET: ‘Bout 28 years in dog years.

(Inky is startled by a sound coming from the kitchen)

INKY:  Hey, I just heard the fridge door open. Be right back!

Inky taking a break.

Inky taking a break.

POCKET: Anyway, we’re quite critical to the operation here at Encompass HealthCare. See, Inky and I give the place atmosphere. We put the patients in a good space to heal, h-e-a-l, not the “heel” like “sit down.” It’s aesthetics. We add that “je ne sais quoi” that you won’t find in any other wound care facility.

INKY: False alarm. Doc was just putting his lunch in there.

POCKET: I was just going over what we do here.

INKY: You tell ‘em the French thing?

POCKET: Yes. We provide the “je ne sais quoi.”

A Blue Picardy Spaniel

A Blue Picardy Spaniel

INKY: That certain something. I’m a darn-near-perfect Blue Picardy Spaniel.

POCKET: And I’m a slightly non-traditional Cavalier King Charles Spaniel…

INKY:  …On account of he’s just black and white without the telltale classic brown accents.

POCKET & INKY: But we don’t judge.

INKY:  We’re not here to judge.

POCKET:  Basically, we’re here to look good…

INKY:  Not get in the way…

POCKET:  …and be cute…

INKY:  …Because if a patient seems a little down…

POCKET:  …Or they’re about to drop some food…

INKY:  …Then, we go into F.C.M.: Full-Cute Mode. I sit real pretty with a “you’re the most important person living” expression on my face.

Pocket always seems to be on break.

Pocket always seems to be on break.

POCKET:  And I generally roll onto my back, wag my tail and show you my goods.

INKY: And that’s it.

POCKET: And I can make myself look exactly like the Lady dog in The Lady and the Tramp.

INKY: Except that she’s brown and tan and you’re all black and white.

POCKET: Jeesh! Why can’t you ever let that go?

INKY: What?

POCKET: You never miss a chance to point out my non-traditional coloring. Am I cute?

This is what Pocket thinks he looks like.

This is what Pocket thinks he looks like.

INKY: You’re adorable.

POCKET: Then let’s leave it at that.

(The interview is interrupted by a sound in the kitchen)

INKY & POCKET: FRIDGE!!

(Both dogs high tail it to the kitchen. (Pun intended.)

POCKET:  We were so close.

INKY:  So close to that sliced turkey.

POCKET: But it wasn’t to be. But what is meant to be is that we are WoundDogs. Make no mistake about it. Our job is all about you. Our patients love us and we love them back.

INKY: Along with whatever they might happen to be eating.

POCKET: That’s a ditto.

INKY: So if you come to Encompass HealthCare and Wound Medicine, make sure you say, “hello.”

POCKET: Yeah, because we want to make you feel at home.

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