Thursday, April 05, 2007
Bed rest can be hazardous to your health

By Yvonne Lyles, M.D

What do bed-ridden patients and astronauts have in common? They both get weaker from not using their anti-gravity muscles. Remember pictures of early astronauts stumbling when they first got out of the space capsule? Weightlessness had weakened their leg muscles. The same thing happens to healthy people who take to bed because of illnessÉ.they may even have difficulty walking after a week or so. It's ironic that when you go to the hospital, you're assigned to a bed. If you're sick enough, you may have no choice but to stay there, but staying in bed for prolonged periods of time can make you sicker. Besides leg muscles getting weaker from lack of use, the heart muscle also gets weaker from lack of use, resulting in cardiovascular deconditioning. It can happen surprisingly fast. Besides getting weaker, prolonged bed rest can lead to a number of other problems. The first one many people think of is blood clots, especially in the legs. This is called "Deep Venous Thrombophlebitis" (DVT) and can happen from sitting for a long time, such as with a long trip. Normally, the pumping action of leg muscles keeps blood circulating, but if you sit or lie still too long, blood tends to pool in your legs from the pull of gravity, so circulation becomes sluggish and prone to clot. Nowadays, when patients are in the hospital and confined to bed for prolonged periods, they often are given small shots of blood thinners, such as heparin, to prevent blood clots. Blood clots are especially common following major surgery, especially orthopedic or abdominal, because release of tissue factors from surgery or bone marrow also makes blood more likely to clot. Of course, heparin as a preventive measure should be avoided if there are problems with bleeding or plans to go to surgery. Special sequential pressure stockings which massage the lower legs are also used to prevent blood clots. Blood clots in the legs can be deadly. A condition called "Pulmonary Embolism" (PE) occurs when a piece of clot breaks off from the veins in the legs and goes up into the lungs, cutting off blood flow and oxygen delivery with symptoms of shortness of breath and chest pain. Sometimes it can be fatal. Another common problem that occurs with prolonged bed rest is bedsores, also known as decubitus ulcers or pressure sores. These are especially common in people with inadequate nutrition, in thin people with bony prominences, and in obese people who have trouble moving around in bed. Eggcrate mattresses can help keep pressure from being focused on one spot to avoid skin breakdown. Common sites for decubitus ulcers are over the sacrum (near the tailbone) and the lateral hips where there's skin close to bone, and on the heels when someone is continually on his back. Just a little redness of the skin in these areas can indicate the beginnings of a decubitus ulcer. The pressure from lying in one position squeezes out blood flow from the area, so the skin and underlying tissue can't stay healthy. Frequent turning in bed, and barrier creams to protect the skin help prevent pressure sores. Sometimes heel protectors to cushion the heels are used. It's also important not to drag someone across the sheets, since "sheering" can be hard on the skin too. Other complications of bed rest may not be as commonly known. Pneumonia is a common development in people who stay in bed for prolonged periods. When you're lying down, your belly pushes up on your chest, making it harder to take in a deep breath. Then the lower parts of the lungs may collapse (called atelectasis), collect mucus, and be a good breeding ground for bacteria, which causes pneumonia. A device called an Incentive Spirometer, which encourages deep breathing by showing you how much you can inhale, is used to prevent this collapse of the lower lungs, especially in patients with abdominal pain after surgery. Lying down flat on your back also makes one more prone to aspiration, which is inhaling saliva or even stomach contents into the lungs, another cause of pneumonia. It helps to keep the head of the bed elevated, and not to lay flat right after eating, to keep stomach contents from going up the esophagus where they can be inhaled.

Relay for Life Friendraiser
The Western Sussex Relay for Life committee members are busy making preparations for this year's Relay for Life. This year's event will be held on May 18, at the Mears Campus in Seaford. The Relay for Life is an overnight event that helps raise money for the American Cancer Society. If you are interested in receiving information on how to register a team or for further information, contact Mary Catherine Hopkins at 875-7308.

Take steps to end Alzheimers
Congratulations to the teams and individual walkers who participated in Memory Walk Rehoboth 2006 raising almost $100,000! On April 16, 2007, the Alzheimer's Association Delaware Valley Chapter will host an open house from 9 a.m. to 6 p.m. Individual walkers and team captains are invited to attend and register for Memory Walk Rehoboth 2007 and tour our new office at 109 North Bedford Street in Georgetown. For more information, call 854-9788.

Family Caregiver Training
The Alzheimer's Association Delaware Valley Chapter sponsors The Family Caregiver Education Series four times per year in each of Delaware's three counties. Easter Seals at 22317 N. DuPont Blvd. in Georgetown will host the training on April 26, 2007 from 8:00 a.m. until 4:00 p.m. This program includes a Medical Overview; Legal and Financial Issues, Communications, Behaviors and Activities of Daily Living and Community Resources. This training, for family caregivers, is free and lunch will be provided, but pre-registration is required. For more information or to register, call Jamie Magee, 854-9788.

Networking Groups
The Wellness Community-Delaware offers networking groups for people with cancer. Networking groups give participants, support people and their caregivers an opportunity to connect with others coping with the same type of cancer or similar issues. We offer a Breast Cancer group that meets on the second Thursday of each month at 6pm. On the third Wednesday, we offer a Prostate group at 7 p.m. and on the fourth Thursday of each month we have a Head and Neck cancer group meeting at 6:30 p.m. On the third Thursday at 4:30 p.m. at Nanticoke's Cancer Care Center we offer a General Cancer group. All of our facilitators are licensed mental health professionals. Our support groups are free of charge to those people affected by cancer and their loved ones. The Sussex facility is located in the Medical Arts Building, Suite 312 at the Beebe Health Campus on Rt. 24 in Rehoboth. Call Kaye or Lori at 645-9150 for information or to register