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A Hospital-Type Environment with Hospital-Level Equipment, Without the Risks Of Being In the Hospital

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A Hospital-Type Environment with Hospital-Level Equipment, Without the Risks Of Being In the Hospital

Posted on: October 11th, 2021 by Encompass Healthcare No Comments

Encompass HealthCare & Wound Medicine in West Bloomfield, Michigan is Metro Detroit’s only full-service wound healing & infection facility, offering patients everything possible for healing under one roof. Dr. Bruce Ruben launched Encompass HealthCare to offer patients a hospital-type environment with hospital-level equipment, without the risks of being in the hospital.

Wound Care News explains why it’s safer and overall better to visit a wound-care specialist like Dr. Bruce Ruben at Encompass HealthCare than going to a hospital. This is especially true during the current Covid-19 pandemic.

If you’re one of the 6.7 million Americans living with a chronic wound, you may well be referred to a wound care specialist for treatment. In this article, we’ll explore when you should see a wound care specialist, why proper wound care is so vitally important, and how specialist treatment can reduce the risk of complications and encourage a speedy recovery.

While most primary care physicians are qualified to treat a straightforward wound, resulting from a day-to-day injury, they may not be the right person to deal with a complex or non-healing wound. In addition to the usual medical training, wound care specialists undergo a rigorous three-year wound care program and written exam. They are, therefore, uniquely qualified in the most sophisticated treatments, techniques, and technologies to help patients recover more quickly from serious wounds.

To maintain their status, wound care specialists also have to secure continuing education credits and periodically requalify for certification. As a result, a qualified wound care professional will be up to date with the latest developments and research into wound care.

During your first visit, your wound care specialist will conduct a thorough diagnostic analysis of your wound, including the cause of the wound and any issues that might be obstructing your healing. You will then be given a customized treatment plan that takes into account your case history and the type of wound, your ability to comply with particular treatments (for instance, physical therapy), and any additional treatments you might require. You will then be scheduled for a series of visits with your wound care specialists, during which your healing will be evaluated, and your treatment modified.

Not every wound needs specialist treatment. In most cases, a simple wound that results from an injury can be treated by a primary healthcare provider. More serious wounds may require treatment in the hospital, followed by recovery at home. And, of course, if you see any signs that the wound is infected, such as redness, increased pain, a bad smell, fever, or swelling, you should call your doctor immediately.

However, certain kinds of wounds are more likely to need specialist treatment. For instance, complex wounds such as vascular ulcers, diabetic ulcers, radiation wounds, various types of traumatic injury, and some post-operative wounds may benefit from treatment in a wound care center.

There are also health conditions that may make it harder for your wound to heal. These include:

  • Diabetes

  • Congestive heart failure

  • Vascular disease

  • Incontinence

  • Severe obesity

  • Renal failure

  • Nerve damage

Certain lifestyle issues may also prevent wound healing. For instance, a poor diet, excessive alcohol intake, smoking, and being inactive may also impede your recovery from a wound.

In general, if your wound has not started to heal after 2 weeks, or has not healed completely within 6 weeks, then you should consider visiting a wound care specialist.

For many patients, treatment by a wound care specialist can have a dramatic positive impact on their recovery and quality of life. The key benefits of specialized wound care treatment include:

Unlike a regular clinician, a wound care specialist has the knowledge to develop an individualized treatment based on your specific wound, health issues, clinical history, and personal preferences. They will then develop a care plan using this information, to help speed your recovery and healing.

Because the plan has been designed specifically for you, you are more likely to be able and willing to follow it. For instance, a specialist wound care professional could recommend the kinds of dressings that you will be most comfortable with, or take your current mobility into consideration when making recommendations about physical therapy. By contrast, a non-specialist might recommend a more standardized approach that could be harder for you to comply with.

The incorrect treatment of a wound can be potentially catastrophic. For instance, diabetic foot ulcers are the most common cause of diabetes-related amputations—infected or non-healing ulcers can result in the patient losing a foot or the whole lower part of the leg.

Long-term non-healing wounds are particularly prone to infection. Infections such as MRSA can enter the bloodstream via the wound, resulting in serious illnesses. In the most severe cases, infections can lead to sepsis, a potentially fatal medical condition triggered by the body’s immune response.

Working with a wound specialist is the best way to make sure that your wound receives the most effective treatment. A customized wound care program will be designed to approach your wound healing from multiple angles, such as increasing your circulation, reducing pain, and creating the best environment to promote recovery.

Wound care centers have access to the latest wound care treatments and technologies that may not be available in a primary healthcare facility. Advanced treatments that may be helpful in treating non-healing or complex wounds include:

  • Wound Vac Therapy

Vacuum-assisted wound closure, also known as Wound Vac treatment, involves using a vacuum pump to create negative pressure to seal a foam bandage over an open wound. The pressure pulls the edges of the wound together, promoting healing by reducing swelling, stimulating tissue growth, and preventing infections.

  • Ultrasound

Ultrasound treatment uses sound waves to encourage healing, reduce inflammation and pain, and increase circulation and soft tissue mobility.

  • Growth Factor Therapy

Growth factors are chemicals naturally secreted in the body that encourage cell growth. Growth factor therapy involves applying growth factors directly to the wound to promote the growth of wound-healing cells.

In general, wound care specialists take a more proactive, aggressive approach to wound treatment, based on the latest medical findings. For non-healing wounds, frequent debridement (removal of dead tissue) and more active medical interventions may reduce the time to heal and improve the patient’s comfort level.

Perhaps one of the most important roles of the wound specialist is to educate both the patient and their family about how to care for the wound and manage the process of healing. For those with chronic or severe wounds, recovery can be a slow and grueling process. A wound care specialist can offer advice about managing the emotional aspects of recovery, making the best lifestyle choices to promote healing, understanding your wound and how to care for it as it heals, and transitioning safely and easily to self-care.

Above all, our staff treats everyone like family. That’s the Encompass difference!

How Telemedicine Might Be Enhancing the American Healthcare System

Posted on: February 24th, 2021 by Encompass Healthcare No Comments

Since the start of technology being so mobile and active in our everyday lives, the American healthcare system has utilized it to enhance the patient experience. Mandy medical offices use tablets instead of clipboards and paper to check patients in, medical records are now kept in online databases instead of paper charts, patients check doctor’s websites for the hours and available services rather than making a phone call or stopping by. The use of technology in medicine started small, yes. But now we’re looking at an almost industry-wide embrace of technology for the safety of patients and staff! And this shift even has its own catchy name, telemedicine!

 

Chances are, you’ve heard the term telemedicine. Especially since the start of the COVID-19 pandemic. It has become a very common term, describing the use of technology, phone calls, instant messaging, image sharing, or video calls to deliver medical consultation and care. It isn’t a tough concept to understand, but it’s changing the way we handle patient care.

 

Telemedicine is increasing the accessibility of physicians, specialists, and other healthcare professionals. Patients with disabilities, susceptible immune systems, or remote locations probably benefit the most from these technological advances, but in total, it seems to be improving the availability of care for all patients! Patients can now receive test results and imagery quicker than ever. The lab results or scans can be saved and sent via digital file and then interpreted by a medical physician over a phone call to the patient. Patient portals make medical records, bills, and past treatments accessible to patients 24/7.

 

One more recently popular addition to telemedicine is video conferencing between providers and patients. Patients who can’t make it into the office or hospital can video chat with their doctors, allowing them to feel more like they’re speaking face-to-face and allowing for more engagement than a phone call. During the COVID-19 pandemic, this feature has been very helpful for many physicians, healthcare providers, and especially for patients trying to limit exposure and risk. Patients who had tested positive for the virus were often asked to stay home and conduct their follow up appointments through telemedicine if they did not have to be hospitalized. Other patients who might have still been healthy, felt safer staying home than traveling to a doctors office where there might have been an opportunity for infection or exposure. Either way, providers offering telemedicine are helping mitigate risk.

 

Overall, we’ve found telemedicine to have a lot of positive changes, but in case you’re playing devil’s advocate, here’s a pros and cons list.

 

Pros:

  1. Immobile patients, patients with disabilities and those with great distance from healthcare providers can receive care more easily.
  2. Patients can easily contact providers for emergent situations.
  3. Diagnosis and Treatment Plans can be carried out quicker.
  4. Providers can keep their patients and staff members safer by keeping contagious patients at home while they receive care.
  5. Enables patients to have rehabilitation and treatment in their own home.
  6. Patients enjoy their privacy at home and get care at their convenience.

 

Cons:

  1. Smaller facilities and practices may not be able to keep up with technological advances even though they’re providing excellent care for their patients.
  2. Some patients may not feel comfortable using technology or may not have access to the necessary devices.
  3. Providers in some states may have issues billing insurances for telemedicine consults.
  4. Possible care delays, since life-saving care or laboratory tests, cannot be taken digitally.

 

If you or someone you know has participated in telemedicine, either as the patient or the provider, let us know. We’re interested in how things are turning out and how all parties are adjusting to this new phase in healthcare.

 

If you have questions about what services are available at Encompass HealthCare & Wound Medicine, you should contact our front desk or visit our website.

What You Need to Know About Coronavirus

Posted on: February 5th, 2020 by Encompass Healthcare

Coronavirus continues to dominate the news as the epidemic spreads throughout China and the Centers for Disease Control and Prevention (CDC) has confirmed cases in the United States. The first diagnosis of this novel (new) coronavirus named 2019-nCoV was in Wuhan, Hubei Province, China, and many nations have put restrictions in place for travel to and from China.

The confirmed cases in the United States currently are limited to Washington, California, Arizona and Illinois; however, the CDC is investigating potential cases in several other states, so more confirmations may be forthcoming.

On January 30, 2020, the CDC confirmed the first person-to-person transmission of the new coronavirus, between a husband and wife in Illinois. Subsequently, the World Health Organization (WHO) has declared the new coronavirus an international public health emergency, only the sixth time it’s done so. The CDC currently advises travelers to avoid all nonessential travel to China.

Here’s what you need to know about the 2019 novel coronavirus.

1. The 2019 novel coronavirus spreads from person to person, though not necessarily through actual contact. The CDC continues to research exactly how 2019-nCoV spreads, but does say it spreads from person to person. At this time, that doesn’t necessarily mean actual contact. With the previous outbreaks of similar conditions MERS and SARS, it was believed those viruses spread person to person when an infected person coughed or sneezed and virus particles were transmitted to others, much like how influenza and other respiratory viruses spread.

2. Symptoms range from mild to severe. The common cold is also spread by a coronavirus. For some patients, coronavirus symptoms mimic those of a common cold, while others experience the same symptoms that accompany a severe respiratory infection. These include runny nose, fever, cough, sore throat, and shortness of breath. In some cases, the symptoms are so severe they require hospitalization and have resulted in death. Right now, the CDC believes symptoms can appear within two days or wait as long as 14 days after exposure.

3. Treatment options are limited to addressing the symptoms.
As research into 2019-nCoV continues, there is no specific antiviral treatment available or recommended to fight the virus at this time. Instead, patients infected with the virus should receive appropriate treatment to help relieve symptoms, as well as restrict any activity outside the home and avoid crowded areas in order to prevent transmission.

4. There is no vaccine for 2019-nCoV infection. Because there currently is no vaccine to protect against 2019-nCoV, the best prevention against the virus is to avoid exposure. In addition, to help prevent the spread of this and other viruses, the CDC recommends washing your hands often using soap and water for at least 20 seconds. Alcohol-based hand sanitizer can be used when soap and water are not available.

Also, always use a tissue to cover your cough or sneeze, and immediately discard the tissue. If you are sick, stay at home until you are well. Do not touch your eyes, nose and mouth with unwashed hands. Avoid close contact with anyone else who is sick, and keep washing your hands.

While many stores are selling out of protective face masks, the CDC does not recommend them for coronavirus prevention. Instead, officials emphasize hand washing as more effective protection from this and any other virus.

5. The source of 2019 novel coronavirus is linked to animals, but not confirmed as the cause. Because many patients in the Wuhan, China, outbreak were linked to a large seafood and animal market, it’s possible the virus originated in an animal source. However, that cannot be confirmed until the results of analysis of the virus’ genetic tree become available. Other coronavirus that originated from animals include SARS (civet cats) and MERS (camels).

6. Speak to your doctor if you recently traveled to Wuhan, China, or other affected areas. If you returned from Wuhan, China, or other affected areas, or you think you came in contact with someone who could be infected, do not wait for symptoms to appear. Call your healthcare provider right away, and he or she will coordinate with your local public health department and the CDC to see if you should be tested.

For the most recent information about 2019 novel coronavirus, check the CDC website for updates, including the number of confirmed cases and advice for travelers.

What Will the Opioid Crisis Look Like in Five Years?

Posted on: November 20th, 2019 by Encompass Healthcare No Comments

As an Infectious Disease physician, Dr. Bruce E. Ruben is always learning more about how current issues affect his patients’ healthcare. This article by Jirka Taylor and Peter Reuter originally appeared in the Concord Monitor in New Hampshire last week. Dr. Ruben found this commentary on what the opioid crisis will look like in five years to be a fascinating look at this world-wide problem and thinks his patients should read it too.

Few people had ever heard of fentanyl five years ago. By 2018 this synthetic opioid was implicated in more than 30,000 fatal overdoses in the United States. The next stage of the fast-changing opioid crisis may well depend on how the illegal drug markets morph in the years to come.

In the corners of Europe that have been dealing with fentanyl as long or longer than the United States, each illegal market for opioids took distinct turns. In some, heroin disappeared. In others, opioid nasal sprays arrived. Online sales became the norm. Any of these things could happen here.

What Will the Opioid Crisis Look Like in Five Years?

It’s Estonia where heroin practically disappeared. In the early 2000s, the Taliban’s prohibition on growing poppies in Afghanistan had a ripple effect in Europe constricting the heroin supply. Fentanyl smuggled from or through Russia took its place. Today, tiny Estonia (population about 1.3 million) has the only “mature” fentanyl market in the world.

The replacement of heroin with fentanyl in its drug market was devastating: By 2012, Estonia had one of the highest per capita rates of fatal overdoses in the world. Two other observations, however, offer a bit more reassurance. First, fentanyl does not seem to attract new users: The number of opioid users in Estonia began declining in the 1990s and has continued on that trend. Second, although fentanyl is much cheaper than heroin to produce and ship, drug traffickers do not appear to have lowered street prices, also limiting its spread.

Nearby Latvia underwent a different shift, essentially skipping the fentanyl stage. Stronger variations of the fentanyl molecule, called analogs, started appearing in large quantities around 2014. Until very recently, the most common was carfentanil. One gram of pure carfentanil represents thousands of lethal doses for those without opioid tolerance.

Despite this dangerous potency, Latvian health statistics don’t show a substantial increase in overdose deaths. This suggests that Latvian users and dealers have found comparatively safer ways of consuming synthetic opioids and that overdose death levels don’t inevitably have to skyrocket like they did in Estonia. (Some certainly go unrecorded, but the undercount would have to be enormous for Latvia’s fatal overdose rate to approach Estonia’s.)

Sweden, unlike every other country, developed parallel opioid markets: one for heroin and another for fentanyl analogs. Around 2014, dealers started selling fentanyl analogs online, offering direct-mail delivery. After a period of experimentation, these online dealers settled on an analog nasal spray—a popular alternative for people who preferred not to inject drugs.

Some, though not all, of these facets—the disappearance of heroin, direct online sales, nasal sprays, potent analogs—have begun to pop up in distinct pockets of the United States. None have become widespread in North America yet—but there is no reason why they couldn’t.

Sweden, Latvia and Estonia are, to be sure, much smaller than the United States. But it is useful to think of them as equivalent to a city or small state with a comparatively concentrated supply chain. That also shows us regions just a few hundred miles apart might be affected by fentanyl in completely different ways. The areas of North America that have suffered the most in the opioid crisis—New England, the Midwest, Appalachia, British Columbia—are likely to confront fentanyl in localized ways as well. That will have ramifications for prevention, provision of treatment and other services, and law enforcement efforts.

Despite the variations, there is an overarching commonality to the European cases, too: Once a synthetic opioid like fentanyl becomes dominant, it stays that way. The United States should prepare for fentanyl and other synthetic opioids as a lasting phenomenon, and learning from other countries’ experiences is an important part of that effort.

Jirka Taylor is a policy analyst at the nonpartisan, nonprofit RAND Corporation. Peter Reuter is a professor in the School of Public Policy and Department of Criminology at the University of Maryland. Both are authors of “The Future of Fentanyl and Other Synthetic Opioids.”

 

The Mayo Clinic on the Effects of Hyperbaric Oxygen Treatment

Posted on: November 6th, 2019 by Encompass Healthcare No Comments

Overview

Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room or tube. Hyperbaric oxygen therapy is a well-established treatment for decompression sickness, a hazard of scuba diving. Other conditions treated with hyperbaric oxygen therapy include serious infections, bubbles of air in your blood vessels, and wounds that won’t heal as a result of diabetes or radiation injury.

hyperbaric-oxygen-therapy-chamber-west bloomfield-michigan

In a hyperbaric oxygen therapy chamber, the air pressure is increased to three times higher than normal air pressure. Under these conditions, your lungs can gather more oxygen than would be possible breathing pure oxygen at normal air pressure.

Your blood carries this oxygen throughout your body. This helps fight bacteria and stimulate the release of substances called growth factors and stem cells, which promote healing.

Why it’s done

Your body’s tissues need an adequate supply of oxygen to function. When tissue is injured, it requires even more oxygen to survive. Hyperbaric oxygen therapy increases the amount of oxygen your blood can carry. An increase in blood oxygen temporarily restores normal levels of blood gases and tissue function to promote healing and fight infection.

Hyperbaric oxygen therapy is used to treat several medical conditions. And medical institutions use it in different ways. Your doctor may suggest hyperbaric oxygen therapy if you have one of the following conditions:

  • Anemia, severe
  • Brain abscess
  • Bubbles of air in your blood vessels (arterial gas embolism)
  • Burn
  • Decompression sickness
  • Carbon monoxide poisoning
  • Crushing injury
  • Deafness, sudden
  • Gangrene
  • Infection of skin or bone that causes tissue death
  • Nonhealing wounds, such as a diabetic foot ulcer
  • Radiation injury
  • Skin graft or skin flap at risk of tissue death
  • Vision loss, sudden and painless

The evidence is insufficient to support claims that hyperbaric oxygen therapy can effectively treat the following conditions:

  • AIDS/HIV
  • Allergies
  • Alzheimer’s disease
  • Arthritis
  • Asthma
  • Autism
  • Bell’s palsy
  • Brain injury
  • Cancer
  • Cerebral palsy
  • Chronic fatigue syndrome
  • Cirrhosis
  • Depression
  • Fibromyalgia
  • Gastrointestinal ulcers
  • Heart disease
  • Heatstroke
  • Hepatitis
  • Migraine
  • Multiple sclerosis
  • Parkinson’s disease
  • Spinal cord injury
  • Sports injury
  • Stroke

Risks

Hyperbaric oxygen therapy is generally a safe procedure. Complications are rare. But this treatment does carry some risk.

Potential risks include:

  • Temporary nearsightedness (myopia) caused by temporary eye lens changes
  • Middle ear injuries, including leaking fluid and eardrum rupture, due to increased air pressure
  • Lung collapse caused by air pressure changes (barotrauma)
  • Seizures as a result of too much oxygen (oxygen toxicity) in your central nervous system
  • In certain circumstances, fire — due to the oxygen-rich environment of the treatment chamber

How you prepare

Pure oxygen can cause fire if a spark or flame ignites a source of fuel. Because of this, you can’t take items such as lighters or battery-powered devices into the hyperbaric oxygen therapy chamber. In addition, to limit sources of excess fuel, you may need to remove hair and skincare products that are petroleum-based and potentially a fire hazard. Ask a member of your health care team for specific instructions before your first hyperbaric oxygen therapy session.

What you can expect

During hyperbaric oxygen therapy

Hyperbaric oxygen therapy typically is performed as an outpatient procedure and doesn’t require hospitalization. If you’re already hospitalized and require hyperbaric oxygen therapy, you’ll remain in the hospital for therapy. Or you’ll be transported to a hyperbaric oxygen facility that’s separate from the hospital.

Depending on the type of medical institution you go to and the reason for treatment, you may receive hyperbaric oxygen therapy in one of two settings:

  • A unit designed for 1 person. In an individual (monoplace) unit, you lie down on a table that slides into a clear plastic tube.
  • A room designed to accommodate several people. In a multiperson hyperbaric oxygen room — which usually looks like a large hospital room — you may sit or lie down. You may receive oxygen through a mask over your face or a lightweight, clear hood placed over your head.

During hyperbaric oxygen therapy, the air pressure in the room is about two to three times normal air pressure. The increased air pressure will create a temporary feeling of fullness in your ears — similar to what you might feel in an airplane or at a high elevation. You can relieve that feeling by yawning or swallowing.

For most conditions, therapy lasts approximately two hours. Members of your health care team will monitor you and the therapy unit throughout your treatment.

After hyperbaric oxygen therapy

You may feel somewhat tired or hungry following your treatment. This doesn’t limit normal activities.

Results

To benefit from hyperbaric oxygen therapy, you’ll likely need more than one session. The number of sessions depends on your medical condition. Some conditions, such as carbon monoxide poisoning, might be treated in three visits. Others, such as nonhealing wounds, may require 20 to 40 treatments.

Hyperbaric oxygen therapy alone can often effectively treat decompression sickness, arterial gas embolism and severe carbon monoxide poisoning.

To effectively treat other conditions, hyperbaric oxygen therapy is used as part of a comprehensive treatment plan and administered with other therapies and drugs that fit your individual needs.

 

Contact Encompass Healthcare today to schedule a consultation with Dr. Bruce Ruben

Why Self-Care is So Important

Posted on: May 22nd, 2018 by Encompass Healthcare No Comments
At Encompass HealthCare and Wound Medicine, we know how important both self-care and the role of caretaker is to our patients. On a daily basis, we salute those men and women who take care of our patients by driving them to doctor’s visits at Encompass, ensuring they are eating properly, doling out their medication and advocating for them. Whether the caregiver is a hired professional, a family member or a friend, we recognize the sacrifice these individuals are making on behalf of another soul.

What Defines Self-Care?

This month, however, we want to focus our blog post on another issue that is of utmost concern for our patients at Encompass. The role of self-care in your daily health regimen. After all, no one cares about you more than yourself. You might rely on a caregiver for some daily functions and tasks, but there are many ways that you can provide self-care management to ensure a healthy lifestyle for yourself that is free from disease, infections and wounds.
Some tips for self-care include living a healthy life by trying to only eat healthy foods, get enough sleep, exercise regularly and take only the doctor’s prescribed doses of your medicines. Regardless of your age, it’s important to manage stress and go for regular medical check-ups.
Additionally, one of the most important aspects of self-care that Dr. Bruce Ruben at Encompass HealthCare encourages is to practice good hygiene. Good hygiene is important for social, medical, and psychological reasons in that it not only reduces the risk of illness, but it also improves the way others view you and how you view yourself. Dealing with infectious disease, Dr. Ruben cannot stress enough the importance of good hygiene on a regular basis as a key principle in self-care for his patients.

Social Interaction is Self-Care

Believe it or not, another aspect of self-care is social interaction. Studies have shown that individuals who live sociable lives live longer. See friends and family members to build your sense of belonging. You can also join a variety of different support groups to make new friends. Encompass HealthCare can recommend some local support groups and social clubs to help keep you active and involved.Self-care is important value at Encompass HealthCare & Wound Medicine, West Bloomfield, Michigan
Finally, hobbies are an integral part of healthy self-care. Try to do something you enjoy every day, whether it be exercising, dancing, going to a movie, taking a walk, watching a favorite TV show, working in the garden, painting or reading. You should also find ways to relax, like meditation, yoga, getting a massage, taking a bath or walking on a local path.
It is our strong desire at Encompass HealthCare and Wound Medicine that our patients live long and healthy lives. We know you can’t do that on your own. It takes a village of caretakers, support team and physicians. However, self-care management is also a very critical component of your healthy life.

“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…)

 

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