Tracheostomy Care at home 3

Management of Tracheotomy Care 3

Bismillahirahmanirahim...

Physiotherapy Care for Tracheotomy.

• Must conduct a thorough assessment of patient at the start of visit
• Observe for signs of hypoxia, infection, excessive secretions, pain, etc
• Examine trach tube, any attached tubing and equipment, as well as stoma site
• Observe for redness, purulent drainage, and abnormal bleeding around the stoma – note the amount, color, consistency, and odor of secretions
• Auscultate breath sounds
• Ensure that appropriate emergency trach supplies and CPR equipment is at bedside
• Be aware of when and why the trach was inserted , how it was performed, the type and size of tube inserted
• Please note:  When a trach is inserted, the natural warming, humidification and filtering of inhaled air (from nares / mouth) is lost.  Therefor it is essential to provide an alternate form of humidification.

Tracheostomy Humidification

As mentioned previously, the nose and mouth provide warmth, moisture and filtration for the air we breath.  Having a tracheostomy tube, however, by-passes these mechanisms so humidification must be provided to keep secretions thin and to avoid mucus plugs

Types of tracheostomy humidification systems

1. Heated humidification (increased heat and water vapor inhaled) –
2. Ambient or cold water humidification
3. Heat and moisture exchangers
4. Stoma protectors
5. Heat moisture exchanger (attached to the outside of a trach tube for long-term trach patients) – looks like a t-tube attachment

Humidification examples

Mobilizing Secretions under Physio Care

• Many trach patients have acute or chronic disease that predispose to stagnation of secretions
• Frequent repositioning, deep breathing and coughing, chest physiotherapy, postural drainage, oral and parenteral hydration and supplemental humidification all help to thin and mobilize secretions
• Tubing from an external moisture source accumulates moisture and will need frequent draining – ensure the tubing is positioned LOWER than the patient to avoid aspiration risk!

Suctioning Care

• Necessary for all trach patients to remove secretions and assess for airway patency
• Acute care patients need to be assessed every two hours (teach family members)
• Routinely done 2x / day, but more often if needed – particularly a newly placed tracheostomy or when there is infection present
• Suctioning activates psychological and physiological reflexes that make the experience both uncomfortable and frightening
• Precaution– severe hypoxia, cardiac arrhythmias, and even cardiac arrest when the airway is occluded by the catheter and air is simultaneously sucked out the lungs.

Indications for Suctioning

1. Dyspnea:  Flared nostrils, chest retractions and/or prolonged wheezing
2. Noisy breathing
3. Cyanosis and clammy skin
4. Restlessness and agitation
5. Copious secretions; moist cough
6. Low oxygen saturation
7. Increased peak inspiratory pressure on mechanical ventilator

Procedure for suctioning

1. Place patient in semi-fowler’s position
2. Select appropriate sized suction catheter
3. Hyper oxygenate BEFORE each suction pass (exceptions to hyper oxygenation are children and patients with long-term tracheostomies)
4. Insert catheter to a pre-measured depth or (to point of resistance if deep suctioning)
5. Apply suction on withdrawal while slowly removing suction catheter
6. Limit suctioning to 5 seconds for pre-measured depth and 10-15 seconds for deep suctioning
7. Use suction pressure between 80 – 120 mmHg
8. Limit suctioning to 3 passes and discontinue if HR drops by 20; increases by 40, produces arrhythmias, or decreases 02 < 90%
9. It’s important to note:  suction mouth AFTER trach suctioning to remove secretions ABOVE CUFF.  DO NOT CONTAMINATE the trach be going from mouth back to trach
10. Reassess the patient’s condition after suctioning and recommence oxygen therapy as soon as possible, ideally within 10 seconds of completing suctioning.  

Tracheostomy Ties

• To lower the risk of a new trach tube accidentally dislodging, ties are usually not changed within the first 24 HOURS FOLLOWING INSERTION; thereafter, ties are generally changed daily
•  To lower the risk of accidental decannulation (the trach tube coming out) the tie changes should be performed by two people or with new ties secured BEFORE old ties are removed.
• Various ties are available on the market today such as velcro tape and twill tape.  Maintain two finger breaths between patient neck and ties for ease and comfort.

Maintenance of the inner cannula

• The majority of trach tubes have inner cannulas that require cleaning one to three times daily unless they are disposable
• Use sterile technique to clean the reusable cannula with ½ strength hydrogen peroxide and normal saline or just NS
• Reinsert and lock back into place within a 15 minute time frame

Trach cuff pressure

• Cuff pressure (balloon) should be maintained between 20 to 20 mmHg of pressure via a manometer – should be assessed daily;
• if you don’t have a manometer measuring device – check with the patient/family – to evaluate how many cc’s of cuff pressure they have been utilizing (generally 5-8 cc) depending on trach size
• With a stethoscope placed on the neck, inflate the cuff until you no longer hear hissing; deflate the cuff in tiny increments until a slight his returns.

Possible Trach Complications

• Can arise the first few days or within several weeks; initially, the most common complications are:
• Inflammation and edema of the trachea
• Infection and abscess of stoma and/or pulmonary tree
• Bleeding associated with suctioning
• If humidity is insufficient, mucous membranes dry out and the irritation of an inserted catheter will cause small amounts of bleeding during routine suctioning
• Long-term complications from the presence of a trach are due to tracheal scarring and erosion
• Stenosis, the narrowing of the trachea from scar tissue occurs in 5 to 15% of patients
• Scarring can occur at the stoma, the cuff site, or at the point where the distal end of the tube presses on the tracheal wall – possible granuloma….
• Stenosis:  fairly common complication of trach patients, but are not usually significant enough for surgical intervention unless it narrows the airway by more than 50% 
• Ulceration and scarring:  may occur with prolonged exposure to a trach tube; treatment may be:  serial dilation; endoscopic excision; anterior cricoid split or laryngotracheoplasty (balloon open)
• Fistula formation:  may take months to develop.  The constant pressure from a poorly fitted trach tube, excessive cuff volume, and/or nasogastric feeding tube all contribute to tissue necrosis.  A fistula can develop between the trachea and the esophagus or can grow into the wall containing a major artery
• Aspiration of gastric contents:  is the consequence for one path of erosion; hemorrhage results from the other.  If your patient is coughing and choking during meals, and trach cuff inflation requires increasing amounts of air, your patient may have a tracheal-esophageal fistula.  A patient with a fistula should be NPO and evaluated for surgery
• Decannulation:  trach tubes are discontinued surgically or through a transition process of intermittent trials; the trach tube is capped or plugged for lengthening periods of time until the patient can tolerate if for 24 hours; during these times, patient should be closely observed for respiratory distress; systematic downsizing of tube may also be used for the weaning process; always assess your patient’s risk for aspiration BEFORE removing tube; patient should be NPO at least 4 hours prior to removal; once tube is removed, an occlusive dressing should be placed over the remaining stoma to form a seal so that patient can breath normally through the mouth and nose; once removed, the stoma normally closes by itself, if not, minor surgery will be done to close it; patient should be inserted to apply gentle pressure over the stoma dressing when coughing or speaking to aid in the stoma closure; dressings need to be CDI.

Home Trach Care

1. Patient and family education normally starts in hospital setting
2. Initial care may consist of:
3. Warm compress to the incision site to help relieve discomfort
4. Humidified air
5. Wearing a scarf over trach opening to keep dry and clean
6. Follow up with Dr. for any concerns or changes

Patient Instructions

Trach patient’s avoid:

1. Deep bathing water
2. Fine particles such as powders, chalk, sand, dust, mold and smoke
3. Loose fibers and fair found on fuzzy toys and pets
4. Persons with contagious illnesses
5. Cold air and wind
6. Portable suction equipment is available for travel and should be tested PRIOR to use

The sharing of this info is easy for family members and patient to understand how to learn and also understand a Tracheotomy care ,it will give some clear picture to take care and also to prevent any complication after the procedure of Tracheotomy. wallahuaklam.

Tracheotomy Care at home 2

Management Of Tracheotomy Care 2

Bismillahirahmanirahim, as i mentioned in my last post entry , here i will continue about the info regarding management of tracheotomy .

Endotracheal Tube Verses Tracheostomy Tube

A variety of tracheostomy tubes are available, depending on the patient’s specific needs.  Tracheostomy tubes vary in size, composition, number of parts, and shape.  Trach tubes may be made of metal, PVC material, or silicone and will differ accordingly in the degree of flexibility they provide.  They are either disposable or reusable.  

Cuffed Tracheostomy Tube

Consists of three parts:

1. Outer cannula with an inflatable cuff and pilot tube
2. An inner cannula
3. An obturator

• Cuff trach tubes are generally used for patients who have swallowing difficulties or who are receiving mechanical ventilation. 
• Disposable and reusable trach tubes are both available – and can be custom made if needed.
• The outer cannula has an inflated cuff that keeps the airway open.  When inflated, this tube seals the airway and prevents aspiration of oral or gastric secretions.  The cuff directs air through but not around the tube.  It is commonly used when mechanical ventilation is required, to provide a closed airway system.
• The inner cannula of the cuffed tube has a universal adaptor to use with a ventilator and other respiratory equipment.  The inner cannulas can be removed, cleaned, and reinserted, unless it is disposable.  The inner cannula fits inside the outer cannula.  It has a lock to keep it from being coughed out, and is easy to remove for cleaning. 
• The obturator has a rounded tip for smoothly inserting the outer tube and avoiding trauma to the tracheal wall.  It is important to keep the obturator near the beside in case of an emergency.  It is used to insert the tracheostomy tube.  
• The cuffed tube with disposable inner cannula is used to obtain a closed circuit for ventilation; cuff should be inflated when using with ventilator – just enough to allow for minimal airleak; should be deflated when/if a patient uses a speaking valve; cuff pressure needs to be checked twice daily; inner cannula is disposable.  The same aforementioned items pertain to a cuffed tube with reusable inner cannula with the exception that the inner cannula is NOT disposable – it can be reused when cleaned properly and thoroughly.

Cuffless tubes

1. Rarely used in acute care settings
2. More suitable for long term ventilation
3. Cuffless tube is usually double-lumen – patient must have effective cough and gag reflex to prevent aspiration risk

• Non-cuffed or (cuffless) trach tubes are used to maintain a patient’s airway when a ventilator is not needed. 
• Also used for patients who are ready for decannulation.  Patient may be able to eat and may be able to talk without a speaking valve

Fenestrated Tube

• Have an opening on the posterior wall of outer cannula – allows for air flow through the upper airway and trach opening;
• Allows patient to speak and produce a more productive cough
• Often used during weaning process

Used for ventilated patients who are not able to tolerate the speaking valve; there is a high risk for granuloma formation at the site of the fenestration (hole).  There is a higher risk for aspiration of secretions; it may be difficult to ventilate the patient adequately

Communication and Tracheostomies

Some trach tubes  are designed to allow patients to speak

Patients being weaned off trach tubes may have either a cuffless, fenestrated tube or a trach button that does not extend into the trachea enough to restrict airflow past the larynx

For long-term Trach patients

Speaking is possible with these options:

A fenestrated inner cannula inside a cuffed outer cannula – allows for speech when cuff is deflated (some tubes expand on inspiration and deflate on expiration versus manually deflated cuffs)

A tracheostomy speaking valve is a device that attaches to the trach tube – it contains a diaphragm that opens on inspiration and closes on expiration so that air is exhaled through the vocal cords and upper airway – the cuff must be COMPLETELY deflated during speaking valve to allow for exhalation through the upper airway

A speaking trach tube forces air or oxygen from an outside source to flow across the vocal cords, independent of the airflow within a closed system created by a cuffed trach tube.  The patient has control over this air line with a thumb port. 

will continue to Management Tracheotomy 3, wallahuaklam.

Tracheotomy Care at home 1

Management of tracheostomy care 1

Bismillahirahmanirahim , The term “tracheotomy” refers to the incision (otomy = opening) to provide an airway and allow for removal of secretions from lungs.  Breathing is accomplished through the tracheostomy rather than through the nose and mouth.  A tracheostomy can either be temporary or permanent.

What is Tracheostomy Facts ?

Tracheotomy is a surgical procedure that creates an opening in the cervical trachea (windpipe) allowing direct access to the breathing tube – rarely done as an emergency – secondary to oral or nasal intubation which is must faster and less complicated when managing respiratory arrest.

Why is a Tracheostomy performed?

• To bypass obstruction
• To maintain an open airway
• To remove secretions more easily
• To oxygenate and/or provide mechanical ventilation on a long-term basis

 Types of patients requiring tracheostomies?

• A comatose patient
• A patient with cancer of the larynx or neck
• Blockage of airway
• Inability to swallow or cough
• A burn patient with inhalation damage
• A COPD patient on mechanical ventilation
• A pediatric patient with a congenital airway obstruction
• ALS patients
• Plegic patients

Tracheostomy Anatomy

The tracheostomy can be performed in the OR or at bedside under moderate sedation.  The tracheostomy is usually formed between the second and third or third and fourth tracheal cartilages.

Percutaneous dilatational tracheostomy (PCT or PDT) is done at the patient’s bedside, usually in the ICU setting.  The procedure generally takes 15 minutes or less…bedside procedure (1/4 of patients) are contraindicated in a quarter of the patients – mostly due to anatomical irregularities or coagulation problems.

Landmark Of tracheostomy ?

Definition of Terms in Tracheostomy.

• Decannulation:  Removal of a tracheostomy tube
• HME:  Heat, moisture exchange (have pictorial)
• Humidification:  the mechanical process of increasing the water vapor content of an inspired gas
• Stoma:  a permanent opening between the surface of the body and an underlying organ (trachea and anterior surface of neck)
• Tracheal suctioning:  a means to clear the airway of secretions or mucus through the application of a negative pressure via a suction catheter

Temporary Tracheostomy versus Permanent Laryngectomy

Temporary:  THE UPPER AIRWAY WILL REMAIN PATENT IF THE TRACH TUBE WERE TO BE DISLODGED

Permanent:  THE LARYNX  IS REMOVED AND AN ARTIFICAL TRACHEOSTOMY IS CREATED – NO CONNECTION BETWEEN THE PATIENT’S UPPER AIRWAY AND THE TRACHEA ITSELF

Risks or complication of tracheostomy .

• Medication reaction
• Uncontrollable bleeding
• Respiratory problems
• Possibility of cardiac arrest
• Pneumothorax
• SC and/or mediastinal emphysema
• Tracheo-oesophageal fistula (development of a small connection between trachea and esophagus)
• Infection

Post procedural trach care:

The first days following tracheostomy are especially uncomfortable for the patient.  Namely – adjusting to the trauma of surgery, pain of a fresh incision, presence of a foreign object in the trachea, and the inability to communicate through speech. 

Patients commonly report choking sensations – generally takes one to three days to adapt to breathing through a trach tube

Potential Complications with Long-term Tracheostomy

• Thinning (erosion) of the trachea (trachemalacia)
• Development of granulation of tissue (bump formation in trachea
• Narrowing or collapse of the airway above the site of tracheostomy
• Once tracheostomy tube is removed, the opening may not close on its own
• Dysphagia; airway obstruction from secretions;
• Tracheal ischemia and necrosis

Higher risk for PCs exist for the following patient population:  children (newborns, infants); smokers; ETOH abusers; DM; immunocompromised patients; persons with chronic disease or respiratory infections; persons taking steroids or cortisone

Continued Assessment/SE after tracheostomy placement

• Subcutaneous emphysema (SCE) around stoma – air escapes into the tracheostomy incision creating SCE; generally of no clinical consequence – but can be palpated around the stoma site
• Excessive manipulation of the trach tube during coughing or suctioning can break improperly secured ties and dislodge the tube – (within the first 48 hours the freshly created stoma has a potential to close shut, constituting a medical emergency) – to minimize this risk, trach ties are not usually changed for 24 hours 
• First tube change is generally done by a physician after approximately one week (should have detailed Dr’s orders to always have a spare trach tube on hand – size should be indicated

Insha Allah  , in next blog entry i will continue another info regarding a tracheostomy  Care , its important for us to understand regarding a tracheostomy care for easy to manage and also give some info on that matters. wallahuaklam.

Poison Food can kill slowly

Common food that can kill you slowly 

Bismillahirahmanirahim , human have a naturally instinct to eat when get hungry ,so the explaination is simple, When we wanted to eat, our goal is of course to overcome hunger, getting pleasure on the tongue and nutrition for the body. For survival and optimal health we know that the body requires the right combination of protein, healthy fats, whole grains, dietary fiber, minerals, and vitamins; But many food 'popular' that actually toxic, containing addictive substances that can kill you slowly without you noticing in your life.
We understand, these foods do not necessarily pose a hazard effects directly but took a long time to finally make the body become weak, susceptible to disease and could eventually die from it. Foods such as these do not need to eat, let alone to get it can cause cancer in future.

So beware of the following 10 foods that science has now slowly proved that could kill you without you know.

1.Alcohol

If you drink this one is certainly all agree that this is healthy. Alcoholic drinks full of calories, this could be the cause of weight gain, poor skin health, and has a relationship with depression. These drinks can cause dehydration because of fluid secreted by the body and  its proving in research that can lead to liver damage if consumed too frequently.



2.Artificial sweeteners

Aspartame is an extreme toxic to the body and is associated with high blood pressure, type 2 diabetes and heart disease. There are over 90 different health conditions affected by aspartame such as loss of vision, seizures, anxiety and depression. Instead of better than sugar, aspartame as an artificial sweetener often used recorded much worse than sugar. Do not worry! You can enjoy fresh sweet healthy drink that is found in fruit or vegetable juice and tea with natural sweeteners such as stevia leaf or honey to add sweetness and micro nutrients.

3.Simple carbohydrates

Refined carbohydrates such as white bread, flour and pasta have little nutritional value and break down into simple sugars quickly. This causes insulin spikes reactions and accidents that can lead to chronic fatigue, weight gain, heart disease, high blood pressure and diabetes type 2. Replace it with complex carbohydrates found in whole grains, fruits are healthier



4.Sugar

Not as sweet sweetness impact. Did you know that refined white sugar turned out to be toxic and lead to weight gain, heart disease, anxiety and type 2 diabetes if taken continuously without regard to a healthy dose. When the heart is polluted with fructose, it can turn into fat and insulin resistance spike in the body leading to diabetes type 2. In fact, there is also a relationship between high insulin produced and breast and colon cancer. Unfortunately, the sugar contained in millions of food products and be a tricky thing to avoid completely. Always read food labels to be consumed!
the choice is  in your hand

5.Cow's milk

Milk is full of saturated fat and contain Bovine Growth Hormone. Cow's milk is known to cause an inflammatory response associated with cancer, allergies and asthma. Milk also interfere with the absorption of nutrients, arthritis and migraine. As an alternative, use organic milk and goat's milk because it does not have the extra hormones and easier to digest. Some experts have stated that cow milk was never really intended to be consumed by humans since been known to lead to some health problems.

6.Potato chips

Acrylamide is a chemical used in many industrial processes such as dyes, paper, plastics, and adhesives. Acrylamide is a substance formed from frying, heating to a high temperature or bake certain plant foods like potatoes and grains with certain amino acids and have been found to cause cancer in laboratory rats. The World Health Organization classifies acrylamide as a "human carcinogen". This substance is contained in chips and French fries were delicious dry it


7.Fast food

Mass production of fast food like instant noodles and fast-food eateries that usually come from outside, was not healthy. Excessive Eating fast food can cause permanent liver damage. Red meat, salt, saturated fat, sugar, preserves all of the compounds to produce a fast food unhealthy that often causes headaches, nausea, vomiting and addiction. It comes easily to take but can cause heavily impact after take.




8.Trans fats

Foods rich in trans fats, most to high-tech food that adds hydrogen molecules to keep vegetable oils solid at room temperature, for example, can be found in processed foods that are fried and packaged. Trans fats increase the lifespan of food (durable), but reduces human life by increasing LDL cholesterol and increase the risk of heart disease and stroke.






9.Bacon

Preserved meat such as bacon and hot dogs are loaded with sodium, nitrate and other bio-toxin. Diligently consume 'meat products' is preserved can increase the risk of colorectal cancer by 21% and can lead to heart disease. One study found that people who ate more than 160 g of meat like this has a chance of 44% more likely to die prematurely of cardiovascular disease or cancer than those who did not.



10.Canned Soup

It's loaded with sodium, sugar and preservatives. Canned soup has been so successful because it looks healthy and practical. Make own soup with fresh ingredients if you really want to eat healthy.





Its easy to make , easy to take and easy the disease to come , the type of food in my blog here its more to make us clear and understand the impact on our health , so as i am say the choice of your health and life is in your hand. wallahuakalam.

Danger Heat in older people

Thermoregulation Heat in older people

Bismillahirahmanirahim , when become older the human body will start to lose of all their humanity control ,one of the function will be detotriate is temperature control .

INTRODUCTION

•        Humans are homoeothermic.

•        Only during prolonged heavy exercise ,illness, or extremes condition of heat and cold do body deviate outside the normal range of 36.1 to 37.8 c.

•        The transfer of body heat is done by conduction, convection, radiation, evaporation.

CONTROL OF HEAT EXCHANGE

•        Done by hypothalamus.

•        Sensory receptors called thermo receptor, detect changes in your body temperature and relay this information to hypothalamus.

•        Hypothalamus has a predetermined temperature or set point, that it tries to maintain.

PHYSIOLOGICAL FACTORS

•        Skin receptors and circulatory response.

•        Reduced autonomic nervous system function.

•        Medications.

•        Post surgical considerations.

•        Other physiological factors like ingestion of food, alcohol, muscle atrophy.

HYPERTHERMIA

•        Internal core temperature exceed the normal range.

•        Caused by infection, brain lesions, environmental conditions, or heavy exercises.

•        In older adults, the fever response is often diminished or absent.

HOW TO AVOID HYPERTHERMIA

•        Wear loose-fitting, light clothing during periods of high heat and humidity.

•        Take cool baths or showers during periods of high heat and humidity.

•        Drink adequate amount of fluids, even when not thirsty.

•        Use air conditioning or fans to cool and circulate the air.

•        Avoid excessive exercise during peak temperature of the day, especially when humidity is high.

•        Avoid working in direct sunlight on hot days.

HYPOTHERMIA

•        Hypothermia is a core body temperature < 35° C. Symptoms progress from shivering to lethargy to confusion, coma, and death.

•        Risk factors for hypothermia in the elderly include reduced physical activity, immobility, dementia, under nutrition, many other common disorders, and many commonly used drugs.

•        Elderly patients may not recognize that they are cold and may not shiver. Symptoms may be nonspecific, and the diagnosis is easily missed.

•        Environmental factors that increase loss of body heat include being exposed to cold ambient temperatures or wind chill, lying on a cold surface, being wet, and wearing thin or porous clothing.

•        Many age-related physiologic changes, including a diminished perception of cold, predispose elderly people to hypothermia.

•        Decreased responsiveness to endogenous catecholamine reduces the vasoconstrictor and shivering responses to cold.

•        A decrease in lean body mass reduces the efficiency of shivering for producing heat.

•        Reduced physical activity and caloric intake lower the metabolic rate, decreasing endogenous heat production.

•        Other common risk factors in the elderly include certain drugs (e.g., alcohol, antidepressants, barbiturates, benzodiazepines, opioids, phenothiazines, reserpine) and disorders that decrease heat production, increase heat loss, impair thermoregulation, or reduce physical activity.

HOW TO AVOID HYPOTHERMIA

•        Wear several layers of loose-fitting clothing and a hat.

•        Stay dry.

•        Maintain an adequate, balanced diet.

•        Drink ,adequate amount of fluids but limit alcohol.

•        Humans are homoeothermic.

•        Only during prolonged heavy exercise ,illness, or extremes condition of heat and cold do body deviate outside the normal range of 36.1 to 37.8 c.

•        The transfer of body heat is done by conduction, convection, radiation, evaporation.

CLINICAL CONSIDERATIONS

•        The safe and effective use of exercise, heat, cold, or hydrotherapy require throughout assessment of individual’s condition, medical history, and ability to withstand thermal or cryogenic stress.

•        Vitals signs should be monitored along with skin temperature, sensation, color, sweat rate, and rate of perceived exertion. 

          The conclusion is Heat-related changes can become serious if preventative steps are not taken. It is important to realize that older people are at particular risk of hyperthermia. Many people die of heat stroke each year; most are over 50 years of age. With good, sound judgment and knowledge of preventive measures the summer can remain safe and enjoyable for everyone. wallahuaklam.

Trigger Finger problem

Trigger Finger 

Bismillahirahmanirahim , one of the common problem that will affected in either of our finger is called Trigger finger. As we understand the Trigger finger is a condition that causes stiff fingers in the same position. This disease mainly affects the layer of tissue around the fingers is called tendon. Tendons are thick fibrous tissue associated with skeletal muscle.

The Facts of Trigger Finger that we must know.

• ·         Also known as stenosing tenosynovitis
• ·         Finger that becomes 'locked' after it has been bent (flexed)
• ·         It is difficult to straighten out without pulling on it by the other hand
• ·         May hear a click when it is pulled straight
• ·         This clicking may be worse in the morning
• ·         Mild pain and/or a small swelling at the base of the affected finger
• ·         Trigger finger most commonly affects your little finger, ring finger or thumb
• ·         It is actually more common in the right hand

Causes:

A tendon is a strong tissue that attaches a muscle to a bone. In this case the tendon comes from a muscle in the forearm. It passes through the palm and attaches to the finger bone. The muscle pulling on this tendon bends (flexes) the finger towards the palm.

A tendon sheath is like a tunnel that covers and protects parts of a tendon. Normally, the tendon slides easily in and out of the sheath as you bend and straighten the finger. In trigger finger the tendon can slide out of the sheath when you bend your finger. However, it cannot easily slide back in due to the swelling. The finger then remains bent (flexed) unless you pull it straight with your other hand.

Treatment Of Trigger Finger.

Mild cases.

 Mild cases of trigger finger can be overcome with a splint, which is installed in the finger up to six weeks. Finger splint keeping the straight position during the healing process, which means that the movement of the hands will be a little limited. The aim is to provide a period of rest so that joint pain can recover and the inflammation is reduced. It also keeps the somewhat crooked fingers, when the patient is unconscious, for example asleep. Using a splint also help reduce the pain caused by trigger finger, especially early morning when the pain peaked. Once the inflammation heal, physio or Dr will recommend exercise finger to help patients restore mobility diseased joints in full. Although the condition is mild, the patient is also advised to reduce repetitive gripping motions for 3-4 weeks.

Severe cases.

In severe cases, patients have three treatment options: injectable steroid, release per cutaneous and surgical. Treatment with injected steroids are used directly on the sore tendon sheath to reduce inflammation in the section. This treatment is usually done because it is simple and caused little pain. However, this is only recommended if the patient does not suffer from diabetes. For those who have diabetes, the success rate decreased from 90% to 50%. Sometimes, the patient is injected for a second time in order to achieve the desired results.

What can we understand of the Treatment.

In some cases, patients requiring the per cutaneous release of trigger finger, a procedure in which a needle is used to remove the finger snaps. Per cutaneous release the most effective use of the index finger, middle, and sweet.

In more severe cases, surgery may be necessary, for example in rare situations. However, surgery is only used as a last resort if the finger is locked do not respond to other disposal techniques. To treat trigger finger surgery, an incision is made at the base of the fingers are sore, through the incision, orthopedic surgeons will cut the sheath that is narrow, so the tendon can be shifted back easily. This action is only performed in the operating room with a local anesthetic, but it can be done in clinic only.

The conclusion is the Trigger finger is a condition that is painful, but it need not be a permanent condition. Existing techniques for treating trigger finger to help ensure that patients do not need to live in constant pain and finger movements can normally be restored. Its Important to us to understand what is the sign and the best of treatment we can use on that situation . Wallahuaklam.

Manfaat Kunyit Hitam kepada kesihatan

Kelebihan dan Manfaat Kunyit Hitam.

Bismillahirahmanirahim , lama dah saya tak update kan blog saya ini , dengan kesuntukan masa, kesibukan bekerja menyebabkan saya terlupa saya ada blog yang perlu sentiasa diupdatekan.
hari ini saya nak menceritakan tentang manfaat dan juga satu rahsia khazanah herba yang dilakukan oleh penyelidik Mardi ,iaitu Kunyit Hitam atau Black Ginger.

Mari kita kenali sikit apa kah itu herba yang amat bermanfaat pada tubuh badan manusia ini.

KUNYIT HITAM

Nama saintifik: Kaemprefria parviflora
Famili : Zingerberraceae
Nama Biasa : KUNYIT HITAM
Nama Lain : Kali Haldi,Black Turmeric, Black Zedoary
Taburan kawasan tumbuh : Kawasan TROPIKA
Negara Asal : INDIA / THAILAND
Kategori : Rempah Herba

Tanaman Kunyit Hitam adalah merupakan sejenis kunyit yang saat ini jarang kita temui, khasiat kunyit hitam mempunyai khasiat perubatan yang sangat mujarab dan belum diperluaskan lagi kegunaannya dalam kehidupan harian  untuk mengenali tumbuhan ini ia bentuk Kunyit Hitam sama seperti kunyit biasa tetapi rizom nya atau isi dalamnya yang berwarna hitam gelap jika sudah cukup matang. Jika masih muda warna nya ungu gelap. Tulang daun nya di sebelah belakang berwarna hitam, jika masih muda maka warna akarnya menjadi coklat jernih.

Apakah Cara Pembiakan dan Penjagaan Kunyit Hitam?

Pokok Kunyit Hitam @ black Ginger

Walaupun cara Pembiakan dan penanaman sama dengan kunyit biasa, namun Kunyit Hitam ini memerlukan Penjagaan yang rapi dan sangat rumit. Tanah nya mesti bercampur dengan pasir dan memerlukan tanah yang lembab dan air yang cukup tetapi jangan terlalu banyak air. Kunyit Hitam ini bercambah dalam masa yang sangat lama dan kadang kala selama 3 bulan baru bercambah dan hidup ini mengakibatkan penghasilan kunyit ini memakan masa yang agak lama.

Alhamdulillah hasil dari pada penyelidikan Dengan Pihak Mardi Malaysia ektrak Black Ginger ini telah di inovasikan didalam bentuk minuman dan juga Kapsul yang memudahkan masyarakat mengambilnya sebagai salah satu pemakanan tambahan yang baik dan menambahkan kesihatan badan.

apa yang saya ingin kongsikan disini manfaat serta kebaikan kunyit hitam ini amat tinggi nilainya dalam bahagian kesihatan ,

COFFEE BLACK GINGER 

• Produk pertama yang dihasilkan dengan extrak black ginger yang tulen 
• Antara produk penyelidikan yang dilakukan dengan kerjasama MARDI iaitu badan kerajaan yang terbukti dengan hasil kajian kajian pemakanan kesihatan yang bertaraf antarabangsa.
• Coffee Black G mengunakan 100% original arabica coffee , 
• tiada pengunaan Coffee sintetik yang diketahui memberi kesan buruk pada tubuh badan ,
• Tiada campuran bahan kimia mahupun toksin ,100% herba yang disahkan oleh MARDI.
• Apa yang palin penting bagi penggemar kopi ialah rasa yang sedap , enak dan segar setelah meminumnya serta tidak pahit.
• Kepekatan yang cukup untuk secawan tanpa perlu menambahkan susu atau Gula.

Manfaat serta Khasiat Coffee Black Ginger.

Harga Ditawarkan RM55
Dengan Pos Penghantaran
15 Sachet

• Kajian dan penyelidikan membuktikan salah satu agen anti Cancer dan tumour kerana merupakan tumbuhan yang melawan sel Kanser 
• Membantu meningkatkan tenaga harian dan mengurangan rasa lesu serta rasa penat serta memulihkan tenaga tanpa memberi kesan kepada jantung dan tubuh badan.
• Membantu melancarkan sistem pencernaan dalam tubuh badan.
• membantu meningkatkan keupayaan penyembuhan pada tisu tisu otot yang cedera dengan melancarkan sistem pengaliran darah dalam tubuh badan manusia.
• Terbukti membantu meningkatkan paras hormon level yang baik dimana ianya membantu bagi para wanita yang mempunyai haid yang tak teratur.
• membantu meningkatkan kesihatan dalaman lelaki dan juga Wanita.
• Black ginger bersifat anti plasmodial dimana ianya meningkatkan kesihatan imuniti dalam mencegah virus yang disebarkan oleh nyamuk iaitu aedes dan malaria.
• Bersifat anti Fungal bagi meningkatkan keupayaan badan bagi melawan jangkitan kulat , terutama mencegah keputihan bagi kaum wanita.
• Meningkatkan aktiviti otak dengan membantu mencegah penyakit parkinson, nyanyuk dan Alzheimer .
• Kajian di Amerika menunjukkan Black Ginger boleh mengawal penyakit kulit psoarisis kerana bersifat anti inflamasi
• melawaskan pembuangan air kecil dan mengelakkan penyakit batu karang.

Harga Ditawarkan RM 25.00
Pek Percubaan
Dengan Pos Penghantaran
5 sachet.

Para Pengemar Kopi
Berminat mencuba dan merasai Manfaat khazanah Herba ini anda boleh Whatapp saya (Aril )di no -016-7486142

Selalunya kopi yang ditawarkan didalam pasaran mengandungi bahan bahan sintetik dan juga bahan kimia yang boleh memudaratkan pengguna , tetapi sekali lagi saya tegaskan kopi Black G 100% selamat dan tidak memberi kesan negatif kepada pengguna malah mendapat manfaat yang baik hasil dari pada penyelidikan yang teliti dari pihak MARDI .Sebagai salah seorang penggemar kopi pilihan saya dalam meminum black G coffee memberikan kebaikan yang menyeluruh terutama ianya meningkatkan keupayaan sistem imuniti kesihatan saya yang bekerja pada persekitaran yang terdedah kepada kuman dan juga bakteria.InshaAllah segala kebaikan dan juga manfaat adalah datang dengan izin ALLAH .