Hot Tub Folliculitis

If you are like me and you have hot tub folliculitis then you are reading this article because you are desperate for a cure. You want someone who has gone through the process of suffering with this condition, looked around for a hot tub folliculitis cure, and tried and tested it. Well this is what i was looking for and i am very happy to be able to help you along the way to living a folliculitis free life.

For anyone who is unsure of whether or not they have hot tub folliculitis then i can help. A few symptoms may include: A rash of that consist of several small 3-5cm red/pink bubbles around the base of a hair follicle. It can appear on any part of the body that has been in been in the water that is contaminated. Unfortunately it can take months for an ordinary rash to disappear.

Now that i am free from hut tub folliculitis, I can tell you how to prevent further attacks, and how you can treat it naturally and live folliculitis free in less than 10 days.

When it comes to preventing further attacks of hot tub folliculitis it is pretty straight forward. Avoid entering water that is not clean and that is not filled with bacteria. This may be difficult when entering Jacuzzi’s, so what you can do is make sure you maintain a ph. level of 7.

When it comes to treating your folliculitis this is where I can really help you.

If you have been searching online, like i did, then you will be getting conflicting views from people. What treatments to take? Medical or holistic? Is it Safe? I went down the harmful medicine and moisturizers route at first. After weeks of very expensive hot tub folliculitis treatment and seeing few results i was sick and tired of it.

Is it Vitiligo or Something Else find it out – Vitiligo Diagnosis

Vitiligo has taken toll of around more than 3% population all over the world. This disease has affected without any discrimination of race, ethnic group or country. The white patches that appear on the skin are the only symptoms of this skin disease.

The on time diagnosis of vitiligo has proved to be useful in order to get re-pigmentation. The diagnosis of this disease is very difficult as white patches are the only symptoms for this disease also the cause of onset and patterns in which the white patches appear are very different.

The diagnosis are carried out in two steps


The doctor can ask you question related to your medical history, in order to diagnosis the real disease, these questions may be related about:

  • Family history about Vitiligo or any other autoimmune disease like hyperthyroidism. As Vitiligo is often suspected as genetic and some other theories consider autoimmune disease as the optimistic reason of Vitiligo.

  • Your medical history for recent sunburns or skin rashes. Also the doctor may ask you for emotional or mental stress. Don’t be shy to share if have any as this is a major cause of vitiligo.

  • Skin sensitivity or other infection are also susceptible for hypo-pigmentation therefore the doctor may ask you for that as well


When the doctor is satisfied from the oral examination he may ask you to go for a skin biopsy test in order to confirm his diagnosis for vitiligo. Also a blood test may be required to check your blood cell count, thyroid function or for the presence of any other antigens, related to autoimmune disease.

10 Common Skin Problems For Dogs

If your child gets a bad rash, she’ll understand the words “Don’t itch.” (Whether she listens is a whole different story!) Unfortunately, it’s not like that with pets. They hurt, they itch, they whimper, they scratch, and before you know the situation’s worlds worse.

Dogs can be afflicted by a vast array of skin problems, including:

1. Canine atopy: allergies to seasonal pollens occurring in dogs 1-5 years old, starting in the late summer and fall. Symptoms include itching around the face and paws which might spread to the ears, armpits, elbows, and groin. Up to 75 percent of dogs diagnosed with atopy experience recurrent ear infections. Immunotherapy is the most effective treatment, sometimes in collaboration with antihistamine treatment or an essential fatty acid dietary supplement.

2. Chiggers (aka Trombiculiasis): Common skin parasites found in the central United States which cause itching and severe skin irritation around the legs, head, and abdomen. Chiggers are usually found in high numbers during the spring and fall in grassy areas. These mites look reddish-orange, and although you often won’t be able to see them, you’ll notice a small welt. Treatment involves either a couple of pyrethrin-based dips spaced a couple weeks apart, or the application of a topical anti-parasite drug.

3. Dermatitis: inflammatory allergic skin conditions, including: pyotraumatic dermatitis, which shows as a red, moist, hairless sore; acral lick dermatitis, which yields a wound that your dog will probably lick all day; contact dermatitis, caused by direct contact with an irritant, like fertilizer or bleach; and flea allergy dermatitis, caused by a sensitivity to saliva or fleas. Your vet may recommend an oral antibiotic or an injection to treat dermatitis.

4. Ear mites: tiny, crab-like parasites that live in dogs’ ear canals. They’re highly contagious and common in puppies. Although they live on the surface of the skin in the ear, they can spread to your dog’s back, neck, and tail. If you notice your dog excessively shaking his head or scratching around his ears-or if you see dark debris in his ears or notice a bad odor-mites might be to blame. Several over-the-counter medications treat them effectively.

5. Flea allergies: proteins in the flea saliva cause severe itching. A single bite can cause a reaction for 5-7 days. Injections to desensitize are not generally effective because it’s hard to collect enough flea saliva to make a serum. Consult your vet for a flea control program that won’t further irritate your dog’s skin.

6. Impetigo: An inflammatory skin condition characterized by shallow blisters that break easily. In younger animals, you’ll notice inflamed white pimples on the stomach. They’ll ooze pus, dry, and then form scabs. You can treat impetigo with daily applications of antiseptic powder, such as BFI.

7. Puppy Strangles (juvenile cellulitis): a skin irritation that affects the face, ears, and lymph nodes of puppies less than four-months old. Pimples develop and break open, and then crusts and small ulcers form. Your puppy may have difficulty eating or swallowing, and he may become depressed or develop a fever. Strangles can be treated with antibiotics.

8. Ringworm: a skin disease that has the appearance of a round sore with crusts or scabs, caused by a fungus. As the disease progresses, you’ll notice more of these sores. Treatment involves cleaning the infected spots, applying a fungicide regularly, keeping lesions clean to avoid infection, and maintaining proper hygiene to avoid spreading.

9. Scabies (Sarcoptic Mange): A condition caused by mites which results in hair loss, itching, and lesions. Mites burrow in the dogs skin surface, often in the abdomen, chest, legs, and ears, storing their eggs in a trail behind them. You’ll only notice a few scabs and perhaps some hairless patches. The most effective treatment involves the application of topical solutions, like Salamectin.

10. Ticks: large parasites that attach to the skin. They’re commonly found beneath the ear flap and where hair is thin. Ticks can transmit a variety of diseases, including tick paralysis, Lyme disease, and Rocky Mountain Spotted Fever.

Now that you know some common skin problems that affect dogs you’ll be better equipped to identify them.

Alopecia Areata and Hair loss: What Does Aloe Vera Have to Do with It

A disease of unknown cause in which well-defined bald patches occur, usually on the head and other hairy parts of the body. The condition typically clears without treatment; recurrences are common. Alopecia areata is an immune system disorder where hair follicles cease making new hairs. About 2% of us experience a case of alopecia areata at some point in their lives.

Even though medical doctors have no known cure for alopecia areata, there have been some discoveries in the medical research arena of aloe. (El Zawahry M;Rashad M;Hegazy MR;Helal M;. Use of aloe in treating dermatoses. Int J Dermatol. 1973; 12: 68-73)

The Aloe vera gel, the substance from the inner leaf, has long been used for its wound healing properties and contains mainly polysaccharides consisting of acetylated mannose, glucose, galactose, and arabinose. Numerous studies have documented the effectiveness of fresh gel in healing skin or excessive x-ray irradiation or thermal burns. Fresh aloe vera gel applied to the skin was shown to be effective in alopecia, and alopecia areata. Several human clinical studies, which documented efficacy of aloe vera gel in treating psoriasis, burn wounds, and skin abrasions, have been documented. (Woodward S;. The soothing aloe vera plant. Delicious. 1997; 68-71)

Even though medical wisdom says that there is no cure alopecia, there is medical research stating that they have seen much improvement to alopecia in regards to aloe vera. Alopecia is not life treating, but it can be annoying. Remember alopecia is nothing to lose your hair about.

Acid Reflux And Coffee – Do They Go Hand In Hand?

An alarming number of American citizens suffer from heartburn, gastro esophageal reflux disease, ulcers and acid reflux. Foods that contain citrus, spices and dietary fats are great contributors to these ailments.

What many don’t know is the negative effects regarding existing acid reflux and coffee. Caffeine is, also, a contributor toward the increased sufferings of acid reflux as it’s known to aggravate these existing conditions by promoting hyperacidity within the stomach and digestive tracts.

Some people experience occurrences of acid reflux so infrequently that they might forget the last time and incident happened. Other people, though, suffer from acid reflux much more frequently, even having acid indigestion more than once a day!

It’s common for those suffering for acid reflux to depend solely on antacids and medications to relieve such an ailment. Many of these people, though, don’t realize that a slight change in diet can produce the same results, such as reducing the amounts of coffee they drink.

Acid reflux is the occurrence of acid from the stomach is forced up into the esophagus, generally known as heartburn. This only occurs, though, when the esophageal sphincter weakens. The esophageal sphincter is a encircling muscle between the esophagus and the stomach. Studies have proven that there exists a very close association with the ingestion of caffeine, especially in high quantities, and the negative effects of heartburn.

Most people that hear the word caffeine automatically associate the term with coffee. What remains unknown to a lot of people, though, is that caffeine is also present in such tasty delights as cocoa, tea, aerated beverages and chocolate.

People might reduce their coffee intake, but continue normal ingestion of the others. This, of course, only helps slightly. As acid reflux worsens, it becomes what is known as gastro esophageal reflux disease, or GERD.

The common ailments associated with GERD are as follows. Chest pain, bleeding, stricture of the esophagus, Barrett’s esophagus, swallowing complications and choking. Now, the inability to decrease caffeine intake is not the only way to increase the harmful effects of acid reflux, becoming GERD, but consuming alcoholic beverages and pregnancy have been known to be as equal a culprit.

Caffeinated products tend to increase the process that empties gastric acid from the body which, after time, damages the tissue of the intestines. Obviously, then, to reduce this process, the sufferer must decrease their consumption of caffeine in order to, hopefully, reverse this unwelcome ailment.

As in anything, though, unless a person is addicted to such things and must seek professional assistance in order to decrease this unnecessary intake, it’s best to just cut caffeine from the diet altogether.

Begin by altering your diet. Substitute caffeinated products with non-caffeinated products. Acid reflux and coffee can prove to be a painful combination. Soy is an excellent substitute. Herbal coffees also make for great alternatives.

Not only can you decrease, or reverse, the negative effects of acid reflux by removing caffeine from your diet, but you’ll also notice a substantial decrease from chronic stress, adrenaline exhaustion and any other ailments that are associated with caffeine. There’s nothing to lose but ailments, themselves.

Alvin Hopkinson is a leading health researcher in the area of natural remedies and acid reflux cure. Discover how you can get rid of your acid reflux for good using proven home remedies, all without using harmful medications or drugs. Visit his site now at

What Type of Grass Do I Need in Atlanta, GA?

What type of Grass do I need? In Metro Atlanta, GA, we have predominantly 5 types of turf grass in our landscape: Bermuda, Thin Blade Zyosia, Thick Blade Zyosia, Fescue, and Centidpede. We do see a little Saint Augustine in the southern suburbs. This article will help homeowners and those in lawn care and landscape maintenance determine the proper turf grass for a homesite, based upon the amount of sunlight and available water.

Bermuda is the most common and most economical turfgrass. While it is ideal for home builders, it is not a good long term solution for most homes in Atlanta. Bermuda is a warm season grass that needs full sun for 7 to 8 hours during the day. As your landscape develops you may run into issues with areas of grass starting to thin because of increased shade on your turf. Bermuda is also very drought resistant and resilient. Bermuda will go completely dormant in the winter. It enters dormancy early than Zyosia and will start to green up later than zyosia. Bermuda can be installed year around. However, winter kill can be a problem if severe cold or snow occurs after it has begun to green up in the spring. This was seen in 2009 when we had a late snow fall on April 15th. The northern facing slopes and areas where snow was piled up (ie. the snowman from the children), we had severe winter kill. This is why it is recommended not to fertilize any of the warm season grasses until they are 50% green. Early fertilization can push a warm season grass out of dormacy early, which may lead to winter kill. Bermusa can be aerated once the bermuda grass is 50% green. Aerating and scalping in the early spring are two landscape maintenance practices that will help reduce turf fungus in warm season grasses. Bermuda can be cut very short up to less than a half inch. Bermuda grows rapidly and needs to be cut at least weekly and if possible every 4 to 5 days in the growing season. Letting the grass grow to seed head is not recommended as you then no longer cutting blades of grass but you are cutting stems of the seed head. This will rapidly dull your blades. Most common hybrid of Bermuda is Tiftway 419. There are some new Bermuda hybrids that are shade tolerant one that I have heard very good results about is TifGrand.

Thin Blade Zyosia is the most ideal turfgrass for Atlanta and the most beautiful. This zyosia is a warm season grass that needs about 4 to 5 hours of sunlight during the day. It is moderately drought resistant. It does not go completely dormant in the winter although the exposed blades of grass are brown. The root system is still green. Some people will spray roundup on dormant Bermuda to kill weeds and especially poa annua. Do not do this on Zyosia as you will kill the zyosia. Zyosia enters dormancy later than bermuda and begins to green up early in the spring. However, it is slow to becoming fully green until May. In Atlanta, Thin Blade Zyosia should only be installed from 15 April until 1 September. The root system of the thin blade zyosia can be damaged by cold temperature. For this reason, thin blade zyosia must be fully rooted before freezing temperatures occur. The most common hybirds are Emerald and Zeon Zyosia.

Thick Blade Zyosia is very similar to the thin blade zyosia, except it needs about 5 to 6 hours of sunlight. It is also moderately drought resistant. Thick Blade Zyosia follows the same dormacy patterns as the thin blade, but does a better job in reach fully green in the spring. Thick Blade Zyosia can be installed year around but it is recommended to avoid installation when coming in or out of transition. Most common hybrid is Meyer Zyosia. Aeration of any type of zyosia is recommended anytime the turf is 50% green. Aeration and scalping in early spring will reduce the amount of fungus. One of the other benefits of the zyosia is it is a very thick grass that will choke out weeds and other turfgrasses like Bermuda. Zyosia can be cut very short at half inch and it is not recommended to let the grass grow to a seed head between cuttings.

Fescue is a cool season grass and is the most difficult to grow in Atlanta. It needs only 4 to 5 hours of sunlight but it does not tolerate full sun or heat very well. It is not drought resistant and needs deep watering a couple of times a week. While it is lush and green from Fall to Spring, the high temperatures of summer turn it brown. In the summer it is not water it needs but it needs more shade and cool temperatures. Fescue is high maintenance and requires yearly aeration, over-seeding, and liming. It should never be fertilize after mid May as this will led to turf fungus. Fescue needs to be cut high at about 3 to 4 inches. Fescue does work well in large tree canopy covered areas.

Centipede is a warm season turfgrass that is very aggressive, disease resistant, and slow growing. It needs 6 to 7 hours of sunlight and is moderately drought resistant. It has very little nitrogen requirement and very low maintenance. You can mow it every 2 to 3 weeks during the growing season. However, I feel it is not the most attractive grass, and definitely not comfortable to walk on barefooted.

Saint Augustine is another warm season grass that can work in the southern suburbs of Atlanta. It is shade tolerant and moderately drought resistant. It needs only 4 hours of sunlight, however it is not that common of a grass in the Atlanta Landscape and it is only seen in the South Metro Atlanta area. It is not very adaptable to the cold winter temperatures, and in severe winter there maybe areas of winter kill. Thus, very few people know how to properly maintain this grass in the Atlanta Market.

How Long Does an Air Purifier Need to Clean a Room?

Have you heard it said, “A woman’s work is never done?” Your air purifier is never done either. There are six basic reasons why you need to clean your air continuously. Understanding each will help you get the clean air results you want.

Once in a While is Never Enough

The most common misconception about air cleaning is the belief it is a single task that once done is finished until another day. Air cleaning is not like vacuuming the floor, washing the dishes or the clothes. Using an air purifier for a few hours doesn’t finish the job of air cleaning.

The reason is simple. Indoor air is in a constant state of change. Particles, gases and microorganisms are constantly introduced by such things as foot traffic, coughing and sneezing, normal shedding of skin (dander) by humans as well as pets, your central heating and air system and other activities.

Six Facts About Getting Healthy Air

Most likely you want specific health benefits like allergy or asthma relief. What do you need to know to make certain your air purifier delivers those health benefits? Consider the following six issues:

  • Your personal sensitivity
  • Dilution of pollutants
  • Dispersion of pollutants
  • Reintroduction of pollutants
  • Air changes per hour (ACH)
  • Efficiency level of your air purifier

How Do These Points Relate To Your Air Cleaning Effort?

Each person has their own “tipping point.” Personal health and environmental factors make this a moving target. Certain allergens may provoke a reaction today but not tomorrow. It depends upon your total load of irritants and physical stresses.

The goal of air cleaning is to progressively dilute contaminants with clean air, keeping them below the threshold at which you react.

Why do I talk about dilution of contaminants and not total elimination? Because particles and gases do not stand still for an air purifier to capture them one by one. Normal particle motion disperses them equally throughout your room air.

This means clean air exiting your air purifier is almost immediately recontaminated by the untreated air. You can’t hold clean air on one side of the room while cleaning the air on the other side.

This is why your air purifier should run continuously. Constant treatment reduces pollutants and keeps them at a low level.

Countering air cleaning is the reintroduction of new pollutants. Reintroduction is like a leak in a boat. In time the boat sinks. Your air quality will sink also if you don’t stay ahead of the reintroduction rate for new pollutants.

Just as the boat needs steady bailing to stay afloat your room air needs continuous cleaning to stay healthy.

This is where ACH, or air changes per hour, comes into play. ACH indicates how fast you can bail your room air of contaminants.

ACH is determined by dividing the cubic feet of cleaned air your air purifier can deliver in one hour by the cubic feet of the room. Say your room is 12 x 15 with an eight foot ceiling. That’s 1440 cubic feet (12 x 15 x 8). Say your air purifier is rated to deliver as much as 165 cubic feet per minute (165 CFM) or 9900 cubic feet over an hour. Dividing 9900 by 1440 reveals your air purifier can deliver 6.8 air changes per hour in this room.

That air purifier would be an excellent choice for that room. Most experts agree that 6 ACH is needed for those with severe respiratory problems. At least 4 ACH is recommended for typical allergy relief. In any case, never less than 2 ACH for any benefit at all and then only with the most efficient air purifier.

Which brings us to the issue of efficiency. Not all the air passing through an air purifier may be cleaned. Some may bypass the filter or the machine simply can’t remove 100% of the particles passing through.

The lower the total system efficiency the more times the air needs to pass through the air purifier to achieve the same cleaning result as a higher efficiency unit. This is why I recommend using only air cleaners with proven high system efficiency. It does the job effectively with fewer ACH and thus lower fan speeds and less noise.

Putting It All Together

So, how long does an air purifier need to clean a room? Initially and with a good ACH of 4 to 6, about an hour or so to reach a point yielding good allergy relief. Of course, give your body more time to relieve itself of its allergen load. Just remember that you never really finish the job of air cleaning. You should run your air purifier continuously to maintain the healthiest possible air.

I also recommend you use the most effective and efficient air purifiers you can. Two excellent resources that stringently test and prove the value of any air cleaner they offer are achoo! and Both sites also offer good educational information about air cleaning and allergy control.

Know About Helicobacter Pylori Gastritis

The H pylori bacteria cause helicobacter pylori gastritis. Generally this infection does not have any symptoms, so the body does not realize that the infection has already occurred. The disease remains centralized in the gastric area and persists for quite long if there no treatment are carried out to cure the helicobacter pylori gastritis.

The helicobacter pylori get into the body through food or fluid intake. It can also occur if a contaminated utensil is used. Since this infection increases with age, it is diagnosed mostly in older people. It can also be seen in young people who live in underdeveloped countries where the living space is small and the sanitation is poor. Not only the underdeveloped countries, people diagnosed with h pylori bacteria are also found in developed countries like theUnited StatesandUnited Kingdom.


The helicobacter pylori are one kind of fragile bacteria that is most commonly found inside the protective mucous lining or cover of the stomach. The helicobacter pylori have long threads that stick out from their end and attach themselves with the underlying cells of the stomach. The mucous layer that guards the stomach cells from various acids also guards the helicobacter pylori bacteria. But unlike some other bacteria that attack the stomach cells, the helicobacter pylori do not attack the stomach cells. The infection from these bacteria is quite real which does not even make the body to react. When this happen the white blood cells move towards the affected area and the body produces antibodies of helicobacter pylori.  

The most common symptoms of this infection are nausea, discomfort, bloating and even vomiting. The person may also get affected by ulcers in his upper abdomen areas which generally occur an hour after the meal is taken. It can also occur at the night time. General home remedies of these symptoms include milk, antacids or other medications which reduces the acidity for the time being. But even after a diagnosis with endoscopy or x-ray if no ulcer is found the doctor treats it as non-ulcer dyspepsia.                    

If there are helicobacter pylori bacteria then ulcers are found in the stomach in 40% of the total patients as examined by the researchers across the globe. Peptic ulcer is the most common ulcer that is found in these cases. While peptic ulcer can be treated, there is a long way to go in researching for the right kind of treatment for helicobacter pylori.

9 Health Benefits of Ashwagandha the Super Adaptogen

Ashwagandha is an adaptogen, which is a medicinal herb that helps the body adapt to stress and exerts a normalizing effect upon bodily functions.

Ashwagandha means horse’s smell in Sanskrit; the reference meaning, horse like attributes of physical strength and endurance.

Ashwagandha has a surprising number of health promoting benefits and there have been over 200 studies documenting these numerous benefits.

1: Energy and Stamina

Ashwagandha provides a steady level of healthy energy and endurance, eliminating fatigue.

2: Adrenal System

Chronic stress seems to be a constant in a lot of people’s lives. When you are stressed, your body produces higher levels of cortisol which can fatigue your adrenal glands, which also tends to disrupt hormone balances. This leads to symptoms of fatigue, irritability, weight gain and sweet or salty food cravings. Ashwagandha helps to balance cortisol production supporting health adrenal function.

3: Thyroid Hormones

Whether you are suffering from hypothyroidism (under active thyroid or elevated TSH and decreased T4) or hyperthyroidism (thyroid over produces T4, T3, or both), Ashwagandha regulates and balances healthy thyroid hormone production.

4: Anti-Aging

Ashwagandha destroys free radicals which cause damage to your skin. It also increases DHEA and Estrogen levels which helps to increase collagen production that maintains your skins youthful appearance.

5: Mood stabilizer

Ashwagandha also has the amazing ability to decrease anxiety and reduce symptoms of depression. In fact Ashwagandha generally has a calming effect and elevates your mood.

6: Brain Health

Ashwagandha greatly improves brain health by reducing the build-up of amyloid plaques in the brain that cause degenerative diseases such as Dementia, Alzheimer’s, Parkinson’s and Huntington’s Disease. It also stimulates the re-growth of damaged brain cells helping to reduce the symptoms of these degenerative diseases. Ashwagandha also improves the production of acetylcholine which improves cognitive abilities such as memory and learning.

7: Diabetes

Ashwagandha helps improve the symptoms of diabetes by lowering after meal and fasting blood sugar levels and improving insulin sensitivity.

8: Cancer Prevention

Ashwagandha helps to block the growth of cancer cells (breast, lung, central nervous system and colon) due to immune boosting and antioxidant properties. It increases the production of white blood cells which makes the body better able to fight cancer and also the effects of chemotherapy.

9: Reduces Pain and Stiffness in the Joints

As Ashwagandha is a powerful antioxidant, it greatly reduces inflammation in the body, thereby reducing joint pain and stiffness.

Recommended Dosage: 500-1000 mgs twice daily

How to Talk To a Depressed Person

It is very frustrating to talk to a depressed person, because they see everything in a negative manner. They are driven by silly fears, standing far away from good and seeing only the bad in the world.

Talking in a supportive tone is the best way to resolve a large percentage of problems. But it is very difficult to indulge in a happy conversation with a depressed person. The communication will differ according to the situation and what the people involved feel comfortable with. If it is so hard to determine whether your approach is right or wrong, use a neutral tone of voice. Any wrong thing that has a wrong tone can send the depressed person screaming or yelling.

If your words are in keeping with his feelings, it can be of great value to the depressed. By and large you have to be understanding and empathize with him. This will create a bond of trust between the two of you and the depressed person will open up his mind before you. If the depressive tells you that his life is a failure and everything is hopeless, you can suggest some ideas to him that will bring him off his way of thinking, thereby making him feel better.

Sometimes it is very difficult for you to know what to say or do when a person is clinically depressed. There are some boosting words that express your support to the depressed person. “I love you,” “you are my friend and important to me” and “I am with you” are among them. Whatever you say or do must provide physical and emotional support to the depressed loved one.

Reinforcing the mental strength of a person by suggesting mental models, giving more constructive autosuggestions, using positive metaphors, guiding the person to confront situations are among the methods you can use to improve the condition of your depressed loved one.

Role of chest physiotherapy in post surgical and bed ridden patients


Chest physiotherapy plays a vital role to play not only in medical or surgical chest conditions but also in surgical procedures involving spine. Pelvis, extremities, and abdomen.

Chest physiotherapy plays a significant role in the prevention of the common postoperative complications or, in reducing the degree of severity when these complications occur. It is also instrumental in early returns of a patient to his preoperative status.


1. To help remove secretion

Percussion: Cupped hands rhythmically applied to the thorax. Precaution include: Rib fracture, costo condritis. Hemoptysis, blood coagulation problems, dysrthymias, pain, severe dyspnea, pneumothorax and increased bronchospasm.

 Shaking: Following inspiration, a bouncing of the rib cage.

Vibration: Isometric co- contraction of the arms applied to the thorax, usually used in conjunctions with shaking, percussion and postural drainage positioning.

2. To help clear the airway

Cough: Forcefully expelling air following a deep inhalation and closing of the glottis to expel mucus.

Forced expiration technique: One or two forced expirations with relatively low lung volumes, the glottis in not closed. Ideal for patients used with COPD.

Huffing: Similar to a cough with an open glottis. Patient may say HA, Ha during expiration.

Assisted coughing: Similar to a Heimlich maneuver done during expiration.

3. To improve gas exchange and increase lung volume:

Three breathing exercises technique are useful:

  • Diaphragmatic breathing
  • Segmental breathing
  • Pursed lip breathing.






The approach of a physiotherapist should be basically be problem oriented to prevent or minimize the expected complications following surgery.

Early identification of the patients who are at the risk of developing complications is of primary importance. This is done by preoperative observations and assessment of various parameters in relation to the patient’s condition, planned surgical procedure and the patient’s physical work requirements for the job as well as for the hobbies.


In subjective assessment evaluation it is important to know the duration, severity, pattern, and the factors associated with the following when present:

  • Dyspnoea or breathlessness
  • Orthopnea or breathlessness while lying flat
  • Paroxysmal or nocturnal dyspnoea
  • Cough
  • Sputum and haemoptysis
  • Types of chest pain, pleuritic, tracheitic, musculoskeletal, angina or pericarditis.
  • The chief disturbing factors as expressed by the patient.


 It is vital to record other relevant information about the symptoms, past and present, medical history, clinical and laboratory, investigations and also physiotherapeutic evaluation.

  • Respiratory rate : normal adult 12-16 b/min)
  • Chest expansion: normal adult 3.5 cm
  • Breath sound
  • Auscultation with stethoscope during inspiration is useful in detecting the sputum retention the opening of the alveoli and small airways during inspiration produces a sharp crackling sound or continuous musical sound. These added breath sounds indicate the alveolar narrowing and mucus retention. Its detachment and elimination. It can be correlated with the other signs of retention.
  • Forced vital capacity
  • Forced expiratory volume in one second: Measurement of FVC and FEV1 can be done by spirometry. The ratio of FEV1 and FVC provides a direct measure of the degree of airway obstruction. The ratio of less than 75% is graded as mild less than 60% graded as moderate and less than 40% is graded as severe.
  • Peak expiratory flow



  • Values of arterial blood gases

Normal adult values

PH= 7.35-7.456

PaO2= 80-100 mmHg

PaCO2= 35-45 mm Hg

HCO3 = 22-26 mmHg

Base excess = -2 to + 2

  • Flow volume curves
  • Chest radiograph
  • Strength and endurance of the muscles of respiration
  • Pattern of respiration including the efficiency of diaphragm or the degree of substitution by the accessory muscles of respiration
  • Range of body temperature ( normal adult 36.5-37.5 f)
  • Heart rate
  • Blood pressure
  • Body weight
  • Exercise tolerance tested by 6 minute walk test

Besides this observation of finger tips for clubbing, color of eyes, cyanosis, jugular venous pressure and peripheral edema provides important clues.

After assessment the physiotherapy has two basic functions:

  1. Preoperative guidance and training
  2. Postoperative management.


  1. Preoperative guidance and training: After evaluation and planning of a type of surgical procedure the physiotherapist must apprise the patient about the detrimental effects of general anesthesia. The patient should be made aware of the process to minimize the ensuing complications, during immediate and late postoperative phases. Ideally sessions on the sequentially progressive postsurgical therapeutic regime should be taught during this preoperative period.
  2. Post operative physiotherapy management: The basic function of physiotherapy is firstly to improve breathing control by training of normal tidal breathing, making it relaxed and least exerting and secondly the elimination of the postsurgical secretions. This is achieved by:


  • Positioning of the patient

To increase functional residual capacity as well as preventing lung collapse, upright erect posture should be assumed as early as feasible. Whenever possible ambulation should be resumed at the earliest possible opportunity. It could be assisted and well supported.

  • Teaching and practicing active cycles of breathing technique: The basic technique of the chest physiotherapy also known as active cycles of breathing technique (ACBT).

Components of ACBT

  • Breathing control or normal relaxed breathing
  • Thoracic expansion technique or inspiratory control technique
  • Forced expiration technique or expiratory control technique.

Breathing control technique: It is a technique of relaxed smooth, normal tidal breathing, primarily using the lower chest. Former known as diaphragmatic breathing technique, it is actually accomplished by coordinated activity of the abdominals, external and internal oblique muscles, the scalene muscles and the diaphragm.


  • Improves inspiratory control
  • Minimize the work of breathing
  • Helps to relieve breathlessness at rest and on exertion
  • Facilitates return of the normal patterns of breathing
  • Improves ventilation of the bases of the lungs preventing collapse, hyperventilation and fatigue.


The patient is positioned in a relaxed sitting with back head and shoulder fully supported and the abdominal wall fully relaxed. It can be given even in the high side lying position. Hands are placed on the anterior costal margins. The patient is taught to breathe out as quietly as possible sinking down the lower ribs and the abdomen without any force. It must be remembered that forced or prolonged expiration will increase work of breathing and may even increase air flow obstruction. Passage of air through the nose allows the air to be warm, humidified and filtered before it reaches the upper airway. During this phase of inspiration the abdomen should bulge out to its fullest extent. A careful watch is needed to ensure that the upper chest and the accessory muscles are not over used as this may result in early fatigue due to increased oxygen consumption due to the excessive work of the accessory muscles of respiration.


It is a technique of deep breathing with efforts and emphasis on active inspiration as against relaxed effortless technique of breathing control.


  • Assists in loosening of excessive bronchial secretion
  • Facilitates the movements of secretions
  • Assists in the re- expansion of the lung tissue
  • Improves lung volume and mobilize the thoracic cage, promoting air flow through the collateral ventilator channels, thus getting air exactly behind bronchial secretions
  • Prevents collapse of the lung tissues


After deep inspiration with maximum expansion of the thoracic cage, air is held for 3 seconds like in pranayama. This is followed by relaxed passive expiration. As it is followed by relaxed passive expiration. As it is a tiring procedure, there should be a pause for relaxation after 4 to 5 breaths.

The patient may feel dizzy owing to hyperventilation. Ideally every 4 to 5 expansion exercises should be followed by a pause for relaxation by repeating breathing control technique.

This technique is given in half lying position with the knees slightly flexed over a pillow or in the sitting on an upright chair or stool.

The technique is especially important during early postoperative phase to [prevent lung collapse, facilitate mobilization of secretions and decrease atelectasis.

The maneuvers of chest clapping, shaki8ng and vibrations are contraindicated or done very carefully in patients with-

  • Osteoporosis of ribs
  • Metastatic deposits affecting the ribs or vertebral column
  • Haemoptysis
  • Acute pleuritic pain
  • A active pulmonary infections e.g. tuberculosis



  • Recent severe haemptysis
  • Hypertension
  • Cerebral oedema
  • Aortic and cerebral aneurysms
  • Acute asthma emphysema or dysponea


The excessive bronchial secretion is eliminated by this technique of forceful expiration. It is a combination of one or two forceful expiration followed by intermittent periods of breathing control to prevent possible occurrence or sudden increase in the bronchial spasm. The important part of the clearance mechanism by huff or cough is the airways towards the mouth.

To mobilize the secretion huffing or coughing is initiated from the mid lung volume i.e. following a medium size inspiration. Air is squeezed out forcefully by using abdominals and the chest wall with mouth open. A rapid flow of the secretions results when a forced expiratory effort is made with coughing against a closed glottis which raises intrathoracic pressure. Then when the glottis opens abruptly there occurs a large pressure gradient between the alveolar pressure and the upper tracheal pressure, resulting in a rapid flow of secretions.


To produce effective elimination of secretion by huff or cough, it is mandatory to take a deep breath before coughing. Strong contractions in the abdominal muscles are needed to produce effective cough. A continuous huff down the same lung volume or a series of huff and cough without intermittent inspirations could be used.

ACBT done in gravity assisted positions is also an alternative method of clearing secretions

If the cause of reduced lung volume happens to be atelectasis or lobar collapse due to retained secretions a patient may fail to respond ACBT technique. it may be necessary to adopt measures like antibiotic, oxygen therapy or mechanical adjustments like periodic continuous positive airway pressure (PCPAP) , intermittent positive pressure breathing (IIPB), positive expiratory pressure mask (PEP).  Incentive spirometry may be considered along with the ACBT in gravity assisted positions.          





Problems With Charts and Handouts? Advice to Avoid the Dilemma

The first thing that every speaker needs to know about problems with charts and handouts is that they never have to be a problem.

That’s because a speaker’s presentation shouldn’t be prepared in such a way that they are essential for effectively delivering his remarks, but only compliment what he is sharing. Thus, a speaker should remember that he can do without them when absolutely necessary.


But there are still considerations that a speaker should remember when it comes to problems with charts and handouts, both as it relates to their preparation and assuring that they will in fact be available.


How can problems with charts and handouts occur before a speaker even leaves for his speaking engagement? Simply put, the situation may be troublesome because of material that has no relevance, is difficult to interpret, filled with errors, etc.


Among the considerations that have to be remembered in assuring charts and handouts are a plus to a presentation, rather than distracting from it are:

· Making sure that charts are easy to understand by using large lettering, neutral colors and placing them in a location where they can be easily viewed by an audience

· Charts should also be easy to interpret based on a speaker’s comments, rather an audience expected to draw conclusions solely from information in the charts

· Handouts should be easy to read, neat in appearance, and free of grammatical or spelling errors

· A speaker should also make sure that his handouts are not wrinkled, dirty or contain any other blemishes that may be distracting


Problems with charts and handouts also includes making sure they are available. There’s nothing wrong with the aids when they enhance a speaker’s comments but, as mentioned earlier, they should never be intended to fill gaps.


But charts and handouts also cannot be effective if a speaker is unable to access the information. That’s why avoiding problems with charts and handouts include taking proactive precautions that include:

· When possible, always taking the material with you to assure they reach their destination

· In situations in which charts and handouts must be mailed, a speaker should have all tracking information to determine their location if they have not arrived on time

· A speaker should make the material is placed in the right location if someone assists in unloading it


Regardless of how a speaker is traveling, he should also carry a draft of his handouts with him at all times. This allows him to make additional copies of handouts if needed, along with new ones if those he had planned to use are not delivered, lost or damaged.

Solutions to Lessen Feet Swelling on the Seniors

Inflammation of the feet is a medical condition which is seen in many seniors. In some cases the degree of swelling is determined by the position of the feet, in case it is elevated it completely disappear. The swelling that happens wouldn’t normally demand further interventions except if it seem serious, continuous, reddened, very painful or with other symptoms like chest pain, breathlessness and bluish discoloration of the skin. Thus, as a way to manage feet swelling in the aging adults, the health care providers just like in Senior homes decatur should know what must be referred and what proper medical management to be rendered utilizing quick steps to alleviate this condition.

The reason why older people are more prone to develop feet swelling, is that there is build up of fluids within the ankle region caused by numerous mechanisms. Hence, localized trauma which gives rise to an inflammatory reaction and secondary to fluid leak in the involved area, gravitational effect as in the case of continuous standing and hanging the feet down, inadequate back flow of the blood pooling in the feet due to venous incompetence, obstruction to blood flow and a failure in the pumping mechanism are some of the root cause that could bring about feet swelling. When considering these factors, it is obvious that they could vary from mild to more severe problems and for that reason, one of the first things that the care providers must do prior to handling a feet swelling is to know the main cause that can make the feet swell. Hence, let us now see a few of the great tips that must be followed by caregivers to handle feet swelling on their patients such as in Senior homes decatur.

First, you have to be aware of possible root cause. This isn’t always evident in all cases of feet swelling despite the fact that one may presume to be related to long distance traveling or any such event which made an individual to hang his or her feet down or kept them immobile for a long time. Localized skin changes or pain may show a possible localized trauma, bite or a secondary infection in which case the swelling is probably to be present only on one or both ankles. In case the elderly person complains about other signs and symptoms like shortness of breath and chest pain, it may be due to malfunction in the pumping mechanism or due to a heart failure and will need extensive medical check up before it gets more serious.

The second thing is, always keeping the feet raised will inevitably minimize the swelling to a certain degree and would alleviate the pain caused by inflammation. Massage the feet and do a hot compress as correctly simply because it can give rise to certain amount of relief particularly in the event the swelling is caused by long term immobility. But, it should not be done if such manipulation gives rise to pain or discomfort to the elderly person.

Occasionally, the sufferers doctor will prescribe a tablet to expel excess fluids in the body that will almost always have an influence on the inflamed feet. However, such medications needs to be utilized with doctor’s advice as it can give rise to complications if consumed continuously. That’s the reason it is advised that elderly care facility needs to have regular physical evaluation much like in
decatur senior homes.

Last but not least, using pain killers and anti-inflammatory agents. These drugs would assist to lessen any kind of inflammatory reaction in the feet as well as alleviate any pains that are related to this condition. Consequently, an over the counter pain killer would be adequate in most instances for minor to moderate cases of feet swelling with the aging adults.

Resveratrol Side Effects – 4 Adverse Reactions You Need to Know About

Resveratrol is an ingredient that has been found within the skins of red grapes, specifically in glasses of wine.

There are many benefits that have emerged about resveratrol that have mad people jump on the bandwagon for supplements and multivitamins containing resveratrol.

Utilizing this ingredient will allow you to feel and look a little bit longer, but make sure that you are aware of the resveratrol side effects before you get started!

1. Joint Pain

As you get older you may notice that your joint simply are not what it used to be, but when you are taking resveratrol you may experience joint pain a little bit early. On the other hand, when dealing with resveratrol side effects such as this one, you can take a multivitamin along with the resveratrol or you can take a lower dosage so that the inflammation that causes the swelling goes down significantly.

2. Insomnia

Most patients that have used resveratrol in the past have complained of one of the major resveratrol side effects as not being able to sleep. There are a number of factors that can cause insomnia and resveratrol is only a contributing factor. If you are dealing with a lot of stress, then that can definitely become the root of your insomnia. Drink green tea along with the resveratrol this will help to clear your mind and allow you to get the good night’s rest that you deserve.

3. Anxiety

Another one of the major resveratrol side effects is anxiety and anxiety attacks. Again this is a side effect that you can tackle when you take resveratrol in a multivitamin. This side effect will actually go away after a week or two of steady use so you should have no other troubles. If anxiety does continue try to find a supplement that helps to calm the mind such as St. Johns Wort.

4. Possible Reactions to Other Medications

Blood thinning seems to be one of the biggest resveratrol side effects that people who are on other medications experience. It is important to know what you are taking and how resveratrol can affect it prior to taking your daily dosage. There are also other reactions that you can experience when you do not use the right combination of resveratrol and vitamins.

How to Take Resveratrol Properly

Taking resveratrol and reaping the health benefits is not that hard. You can find a high quality supplement, but the health benefits tend to be stronger when you take it in a multivitamin that blends different nutrients together with resveratrol.

Electric Blankets – Nightmares or Dreamsleep?

I grew up just south of Stanthorpe, and while it’s a beautiful place, and I fully recommend a visit there, let me tell you, in Winter it can get quite cold!

I was a bit of wussy little kid (now I’m a wussy adult) and while I don’t mind the weather being cold, I personally don’t like being cold. So I had an electric blanket. Sometimes I’d “forget” to turn it off, and still be toasty warm and reluctant to put my toes out into the -5 mornings…

So I know the appeal of an electric blanket, and how nice it is for something else to be keeping you warm on those quite chilly nights. However, it isn’t really good for you.

The major reason electric blankets aren’t good for you is the obvious one: it’s a fire risk. Because they’re folded / rolled up half the year, and on a bed with bodies lying on top and getting wrinkled for part of the year, the wiring can be put under a fair amount of stress. With age, the insulation around the wires can become brittle or broken, which can result in shocks to the sleeper, or short-circuits and potential fires.

The second best way to minimise risk of fires or shocks from an electric blanket is to have it checked every year, before you use it, by a qualified electrician. He or she will check the visible wiring and connections, and test the voltage and current, which will indicate whether there’s a short circuit, and advise you accordingly. If in ANY doubt, throw it out!!

The next major reason you should reduce electric blanket use is because it can generate a high electrical and electromagnetic field, in which you’re sleeping. Or trying to. The body communicates electrically, and high electrical or electromagnetic fields can cause insomnia, restless or non-restful sleep, that “jumping” feeling you sometimes get in muscles, anxiety and sometimes nightmares.

Of course, the second best way to reduce these risks is to switch off the electric blanket before you get in bed, or at least within five minutes of getting in. This can also prevent waking in the middle of the night in a hot sweat… something I have done many times as a forgetful child!

You’ll note I’ve said these options are second best. That’s because the best option is obviously not to use an electric blanket at all.

What other options are there? Well, there’s always that lovely standby, the hot water bottle. These are awesome, cheap, you can get really cute and cosy covers for them, and they have the added bonus that you can use them as a COLD water bottle in summer.

I personally have a second (cheap) quilt, which I use as an underblanket, under my bottom sheet. That has the benefit of reflecting heat back at me as soon as I get into bed. A nice warm shower right before bed to warm up the skin, hop into bed, and away you go! You can also get sheepskin or woolen underlays which do something similar.

How do you keep warm? I’d love to hear your thoughts on this one!