The View from Where I Sit

Category: Dealing with Disability series

  • Let’s Work Together to Stop The Pressure!!!

    https://www.shasbah.co.uk/spina-bifida/spina-bifida-pressure-ulcers/?fbclid=IwAR1g0wzmeyBLMxAs78HfH9CZrUD0A4lf6C52TP3w-O3EMutQuLDXv1qBfMk


    MY PRESSURE ULCER JOURNEY

    I never knew what pressure ulcers were until I got one for almost all pressure points. I am currently facing possible amputation. If this happens what am I gonna do?

    24 hour support will be needed. I don’t like the idea of amputation. The problem is, I’ve been having pressure ulcers, foot x-rays and MRIs/CTIs. I’ve had a series of meetings about my right foot. I’ve got antibiotics to take. Blood sugars, protein levels, blood circulation, feet pulses and kidneys all contribute to the feet. I also got to see photos from MRI scans. I got permission to take photos of them. The heel bone is infected. I know what it’s like to be cured of pressure ulcers, but they keep returning, especially on my feet. What’s going on?

    As a result, I have chosen to join the fight against pressure ulcers.

    During my first year of college, the pressure ulcers started. When this happened, I got a social worker, carers, District Nurses from the Chelsea and Westminster Hospital in London while studying. I also have a Tissue Viability Nurse and a Podiatrist. Before the pandemic, I visited the doctor’s office for appointments. Now I get home visits.

    One day, the wound on my right foot seemed smelly to the nurse as if it’s infected so I was on antibiotics for 7 days. Sensation and movement is limited from the ankles down as a result of lower spine damage due to Spina Bifida. Pressure ulcers can also be caused by bed mattresses or wheelchairs. Bermuda has a lack of resources and a lack of information. There are no Spina Bifida clinics/specialists in Bermuda. Lived with parents. Swimming in the salt ocean in Bermuda beaches has contributed to the healing process. Before England and College, I had no pressure ulcers.

    Pressure wounds usually take 3 months to heal. My wheelchair has a ROHO Cushion with air pockets. Now my footrests have air pockets. It’s ultimately an airbag under my feet. https://www.permobil.com/en-us/products?category=SeatAndPositioning

    Podiatry and District Nurses tend to clash from time to time. District Nurses visit three times a week while Podiatry only visited once. District Nurses know how to dress my foot correctly. Which one is more important?

    Pressure Sores (also called bedsores or decubitus ulcers)
    Pressure sores, also called bedsores or decubitus ulcers, are areas of broken skin and underlying tissues that have been damaged by pressure. Pressure (such as sitting in the same position for too long) restricts blood being supplied to the area, so the tissues become deprived of oxygen and toxins build up, which causes the skin and tissue cells to die. People with Spina Bifida may not feel this damage beginning because of reduced feeling in parts of their body.

    PURSUN GROUP IN LEEDS
    Prevention is better than cure! You must have tough skin. Pay attention to pressure points. Additionally, make sure you have good quality, well-fitting shoes that do not cause red marks on your feet. You may want to ask your GP to refer you to an orthotics centre to have shoes made especially for you. The styles are much better than they used to be!

    Make sure you have a well-fitting wheelchair with a pressure-relieving/ reducing cushion. Pressure mapping in the wheelchair cushion. Always use your footplates to support your feet and stop your legs from ‘hanging down’, which is bad for the circulation. Ergonomic Assessment required.

    Feet must be elevated above the head, especially in bed, for good circulation. Check your wheelchair does not leave red marks on your legs or body. When you see a reddened area of skin, tell your GP straightaway. Don’t wait to see if it improves on its own. If left untreated they can take a lot longer to heal. If you do have a skin breakdown, make sure your health professionals look at the reasons why it happened, and don’t just apply dressings. Change your sitting position frequently throughout the day and have a chair at home to sit in other than your wheelchair. Try to spend part of each day off your bottom. Check your skin regularly for pressure sores using a mirror to see areas of your body you cannot see otherwise. Pay particular attention to areas of skin where you have little or no feeling.

    Massage is now advised against as recent evidence suggests that it is not beneficial for pressure areas and may be harmful.

    https://www.nursingtimes.net/clinical-archive/tissue-viability/does-massage-help-to-prevent-pressure-ulcers-15-08-2011/https://www.nursingtimes.net/clinical-archive/tissue-viability/does-massage-help-to-prevent-pressure-ulcers-15-08-2011/


    Hygiene: Access to Showering facilities instead of bathing facilities in England. District nurses clean and dress wound 3x a week maximum, in addition to personal daily showering. Skin care included Aqueous cream. No scented creams are allowed on broken skin. I shower daily but due to pressure ulcers and a PICO, I also use a LIMBO to cover my damaged foot to keep it clean and dry.

    Why does immobility cause pressure ulcers?
    Poor mobility/immobility: Patients who are unable to independently change position are at increased risk of developing a pressure ulcer, due to pressure exerted over bony body parts which results in reduced blood flow to the tissues and subsequent hypoxia.

    CURE

    I also use a Profile bed, I prefer loose clothing vs tight clothing like dresses or sweat suits. Compression socks/stockings/orthopaedic shoes/socks because sensation and movement is limited from my ankles down.

    Incontinence can also contribute to pressure ulcers. Pressure ulcers must be kept clean and dry.
    Previously during the first four months of my first year in college, I skipped meals for the sake of my studies. I was also given a Dietician who put me on a high protein diet. My meal plan looks something like this:


    Breakfast
    Mid-morning snack
    Lunch
    Mid-afternoon snack
    Dinner
    Dessert

    Why does malnutrition cause pressure ulcers?

    Unplanned weight loss is a major risk factor for malnutrition and pressure ulcer development. Suboptimal nutrition interferes with the function of the immune system, collagen synthesis, and tensile strength.

    Pressure Ulcer Prevention at Home

    • Treat your skin gently to help prevent pressure ulcers.
    • When washing, use a soft sponge or cloth.
    • Use moisturizing cream and skin protectants on your skin every day.
    • Clean and dry areas underneath your breasts and in your groin.
    • DO NOT use talc powder or strong soaps.
    • Try not to take a bath or shower every day

    https://tvs.org.uk/stop-pressure/

    https://www.shinecharity.org.uk/self-care/skin-and-tissue#Sores

    https://nhs.stopthepressure.co.uk/patients.html

    https://medicinehealth.leeds.ac.uk/leeds-institute-clinical-trials-research

    Click to access SHASBAH-news-summer-2021.pdf

    Every day has to be a STOP THE PRESSURE day when you are a person living with skin vulnerability or reduced mobility.

    LET’S WORK TOGETHER TO STOP THE PRESSURE!!!

    STOP THE PRESSURE, START THE RELIEF!!!!

    STAY TUNED FOR THE REST OF THIS SERIES ON PRESSURE ULCERS!

  • What does Independence mean to me?

    All throughout life, I’ve been encouraged and trained to be independent despite being diagnosed with Spina Bifida and Hydrocephalus at birth. Independence is important to me. This pandemic has actually caused me to live at a higher level of independence, especially, in relation to self care and health care.

    Some wheelchair users prefer their own independence because receiving help makes them feel more disabled than they already are. It’s partly about dignity and respect. Other times it can be about disability pride. Their disability pride can be fuelled by entitlement, and identity. Wheelchair accessibility is one right that wheelchair users are entitled to.

    Wheelchair inaccessibility causes one to be co-dependent. I experienced this in Bermuda. I also cannot claim benefits at all in addition to relying on family. Fortunately, wheelchair accessibility enhanced my Independent Living. I experienced this in England. Wheelchair accessibility causes one to be independent because you can access things without relying on someone. I also cannot claim benefits while living with family.

    For example, when I was eight years old, I got my first manual wheelchair. From that age, I was always encouraged to push myself instead of allowing anyone to push me. This reinforced my independence.

    Another level of independence that I’ve experienced was high school. During my first year of high school, the building was nowhere near wheelchair accessible so I required hands on support. However, while in my second year of high school, it was taken away from me. I did everything on my own without a Paraeducator, because, when I transferred to the new wheelchair accessible building, it was assumed that I no longer needed support. This wasn’t a smart move because I struggled under pressure, failed two subjects and had to do Summer School to catch up on credits. This also affected my G.P.A when I graduated. This was quite stressful and frustrating for me. I cried and complained to my parents so they met with the school to sort it it out.

    However, it made me more self aware and helped me improve time management. Having an extra pair of hands helped me to navigate the school faster.

    The next example was during the first semester of my first year in college. I took classes without learning support for fear that I’d have to pay for it, because I was being treated as an international student instead of a home student. Before my January exams, lecturers raised concerns about my grades and overall progress. When this was realised, I was given assistance from learning support without paying for it. But I must admit, that it made me more organised and it improved my study skills and habit.

    Another aspect of independence that I learned, especially in college, is speaking up for myself while living independently. I had to move to another country to further my studies due to wheelchair accessibility issues.

    During my first year of college, meeting with the learning support department was very frustrating. Communication between my lecturers and the learning support department always seemed disconnected. The week or day before my exams, lecturers always asked me what was the learning support plan for my exams. This stressed me out because after every meeting, they assured me that they would share our discussion with the staff members. This almost never happened and I found myself repeating all of the information just to ensure my needs were met. This took away from my personal study time.

    However, all of these experiences taught me how to advocate for myself and cultivated the desire to advocate for others with disabilities.

    Unfortunately, due to struggling to balance studies, personal care and health I got help from disability services. This came in the form of a social worker, carers, district nurses, and a GP, after my first year of college. I received these services because I started losing weight and getting pressure ulcers. This means I had to rely on people more to help me cope with the demands of life. They helped me with cooking, cleaning, laundry and sometimes shopping. It helped me to set my priorities straight and enhanced my independence.

    Independence means taking ownership, taking responsibility, and taking action. It’s all part of maturity and putting on my ‘big girl panties.’ This is what independence means to me!

  • Disability Representation

    Disability Representation

    Disability has a negative connotation that extends beyond its definition, which includes impairments, activity limits, and participation restrictions. Disabled people’s attitudes and the degree of social exclusion they experience are manifested in actions that vary greatly depending on the kind of impairment and various social, community, and familial factors. The impact of an individual’s position, as well as the type and degree of his or her handicap, and, in particular, his or her gender, can be tremendous.

    People with Disabilities have been fighting for their right to be heard, both in their own lives, as well as in the greater community. This fight continues to this day, and I want to bring their voices and needs to the forefront. Having direct input in one’s life has a clear effect on overall health, well-being, and quality of life.

    People don’t come with labels.

    ‘You don’t look ill’! Just because you can’t see it doesn’t mean it isn’t there. A diagnosis should never define anyone.

    The skills of handicapped individuals are generally undervalued in society.

    Why is the wheelchair the only emblem used to represent disability?

    This gives a distorted view of disability. We need self respect and mutual respect.

    Wheelchair Privilege

    It is hard to acknowledge our own privilege because privilege is the other side of oppression. Some people are against talking about privilege because they don’t want to be framed as the aggressors or complicit in a system that gives them an advantage at the expense of others. Other critics of the word ‘privilege’ mistake it for a blanket term that suggests that, if you have a privilege, your whole life has been easy.

    Ultimately, privilege is not a concept designed to make people feel guilty or to diminish their achievements. Instead, waking up to how you may have certain privileges is an essential first step towards being able to decisively act, in small and large ways, to use your privilege and make the systems we were born into fairer. One example of this is wheelchair privilege.

    For example, some taxis are only equipped for manual wheelchairs, not electric ones. The physically impaired may be entitled to more benefits than any other disability group.

    In order to use your own privilege for good and to be a good ally you have to be aware, listen and speak up. Focus on equity instead of equality so that everyone is given what they need to be successful. https://www.hivelearning.com/site/resource/diversity-inclusion/5-main-types-of-privileges/

    What about the speech impaired?

    Just because you can’t speak doesn’t mean you don’t have anything to say. The Purple Vote Campaign in Wales is good at doing this. Advocating for yourself is important. Speak with me, not for me!

    Freedom of speech

    Article 21 – Freedom of expression and opinion, and access to information

    People with disabilities should be able to exercise the same rights to freedom of expression and information as other people and through all forms of communication of their choice. The UN Convention on the Rights of Persons with Disabilities (CRPD) also protects freedom of expression and the right to information. https://www.article19.org/resources/disability-and-information-what-are-your-rights/#:~:text=People%20with%20disabilities%20should%20be,and%20the%20right%20to%20information..

    States Parties shall take all appropriate measures to ensure that persons with disabilities can exercise the right to freedom of expression and opinion, including the freedom to seek, receive and impart information and ideas on an equal basis with others and through all forms of communication of their choice, as defined in article 2 of the present Convention, including by:

    a) Providing information intended for the general public to persons with disabilities in accessible formats and technologies appropriate to different kinds of disabilities in a timely manner and without additional cost;

    b) Accepting and facilitating the use of sign languages, Braille, augmentative and alternative communication, and all other accessible means, modes and formats of communication of their choice by persons with disabilities in official interactions;

    c) Urging private entities that provide services to the general public, including through the Internet, to provide information and services in accessible and usable formats for persons with disabilities;

    d) Encouraging the mass media, including providers of information through the Internet, to make their services accessible to persons with disabilities;

    e) Recognizing and promoting the use of sign languages. https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities/article-21-freedom-of-expression-and-opinion-and-access-to-information.html.

    The colour purple is used to represent the disabled community because it means royalty, status and importance.

    Purple Tuesday and the Purple Pound are business initiatives to improve customer service for people with disabilities.

    Paralympic Games is a global sports competition for people with disabilities. It is a modified version of the Olympics for people with disabilities. Highlighting abilities and maximising potential.

    International Day of People with Disabilities showcases wheelchair access, history of disability in education, disabled icons, disabled political figures and celebrates diversity. Celebrated on 3rd December every year, the International Day of Persons with Disabilities aims to promote an understanding of disability issues and to mobilise support for the dignity, rights, and well-being of persons with disabilities. Each year the day focuses on a different issue.

    Advocacy

    Advocacy includes speaking up on other people’s behalf. This could also cover unemployment amongst people with disabilities.

    ‘Disability equals diversity not disadvantage.’

    We should be accepted without having to ‘fit in’.


    Tips for Advocacy

    • Be Persistent
    • Build Effective Coalitions

    Self-Advocacy Skills

    • Be assertive vs Aggressive
    • Be direct
    • Be intentional
    • Be accurate
    • Healthcare
    • Relocating
    • Emotional Needs- Social Isolation

    Advocacy usually includes petitions, protests, lobbying, placards, propaganda, elections, party politics, and pressure groups. Being an advocate makes you an agent of change.

    The importance of rejecting society’s toxic value system

    It’s about dignity. This is important especially when fighting microaggressions. https://www.bustle.com/articles/186060-13-microaggressions-people-with-disabilities-face-on-a-daily-basis.

    At the heart of it, representation matters because people matter. Disabled persons exist in every nation and community across the world. It is essential that we respect human rights for all humans no matter their abilities or disabilities.

  • Encouraging Advocacy!

    People with Disabilities have been fighting for their right to be heard, both in their own lives, as well as in the greater community. This fight continues to this day and I want to bring their voices and needs to the forefront. Having direct input in one’s life has a clear effect on overall health, well-being, and quality of life. Learn how you can have an impact on the enhancement of individual lives, and the community, as a whole.

    What does being an ally and reducing ableism look like?

    Being an ally looks like fighting against bullies, creating awareness, being assertive, and getting your point across effectively. It’s one way of ‘amplifying community voices’. State their case like it is your case.

    While interviewing a disabled substitute teacher she said, ‘I think it is important to be able to speak up and explain our physical challenges to co-workers and others around us. As a substitute teacher, I just talk to my students and co-workers about my challenges and explain what my life is like as someone who uses crutches. I have found that people are much less likely to have “ableist” opinions if I share my story first.’

    That is what reducing ableism looks like.

    How do we get there?

    Don’t be a sceptic!

    Ask questions. Never assume.

    Think before you speak.

    Don’t judge by appearances.

    Be friendly.

    Get social workers, carers, nurses, doctors and family involved.

    http://linktr.ee/disabilityreframed

    Your Self Advocacy Toolkit

    Self Advocacy is helping you to speak up for yourself and your rights. Sometimes you just have to make them listen! http://www.advonet.org.uk/.

    In part, this is about listening to the voices of those with Disability & Chronic Illness, as they are the experts of their experiences. https://linktr.ee/ashleekelly_iammeblog?fbclid=IwAR0K_licUZMa4YuRqfTXOinH4Dn6UhBspGseLR8X1ftMd_ZUCEEKwkbHBcQ

    Self Advocacy in Goal Setting

    Effectively address self advocacy in learning or therapy programmes. Self advocacy is a learned skill.

    Unintentional Ways to Discourage Advocacy

    Bribing is one way to discourage self advocacy in childhood. Masking is another way to discourage self advocacy in adolescents. This includes:

    • Loss of identity
    • Suicidal thoughts
    • Stress and Anxiety
    • Hand controlling techniques. This makes them feel helpless. This raises concerns about consent. According to statistics, persons with disabilities are more vulnerable to victimisation than people without disabilities. Self Advocacy is a Life Saving Skill.
    • Don’t Panic

    How can we support self advocacy?

    • No means No!- Respect the No.
    • Pulling their hand away.
    • Shaking their head. Non verbal cues.
    • Communication is key. Sign language also works.
    • Follow their passions.
    • Strengths based approach. Instead of asking, ‘What’s Wrong’ ask ‘What’s working Already?’
    • Make space for them to be a decision maker.

    Include goals focussed on:

    • Boundaries
    • Emotional Regulation
    • Preferences

    Set up meetings for accountability when promises are made. This includes the education system. This includes integration in the mainstream education system instead of special schools. Special schools still have their place in society but integration is better for the sake of fairness and inclusion.

    It’s all about Empowering Yourself. I remember as a College student complaining to the directorate of college about discrimination. The learning support department didn’t seem very efficient to me. IEP meetings can also be a pain. This also encourages disability representation.

    Speak with Me Not for Me!

    I agree with this video because some people think we’re irrelevant and treat us like we’re invisible. Especially us wheelchair users. https://www.youtube.com/watch?v=sGxVz2jijK8.

    Support Self Advocacy for Loved Ones.

    Individuals with intellectual disabilities deserve a seat at the table! Just because someone can’t talk doesn’t mean they don’t have anything to say. Freedom of speech or expression shouldn’t be a challenge. Advocacy includes speaking up on other people’s behalf. This could also cover unemployment amongst people with disabilities.

    This may include:

    • Behavioural Support Plans
    • Person Centred Passports

    The service that supports you

    This should include a Recruitment Policy, Culture and Structure of an Organisation, and Consultation Process.

    There should also be a Partnership Board co-chaired by someone with a disability. It helps to change policy.

    Seniors and Self Advocacy

    Encouraging seniors to think about their needs and wants to advocate! This includes refugees.

    It raises consciousness and helps to organise seniors and local communities. Goals of advocacy should effect change in attitudes, policies, services and actions.

    Their needs may include welfare, they may want to work beyond retirement age or become an entrepreneur. Access to healthcare.

    Seniors can be or feel marginalised.

    Self Advocacy Skills

    • Be assertive vs Aggressive
    • Be direct
    • Be intentional
    • Be accurate
    • Healthcare

    Relocating

    Emotional Needs- Social Isolation

    Tips for Advocacy

    • Be Persistent
    • Build Effective Coalitions

    Advocacy also includes petitions, protests, lobbying, placards, propaganda, elections, party politics, and pressure groups. Being an advocate makes you an agent of change.

  • Hygiene and Amputation

    With foot deformities and insensate feet, Spina Bifida patients are at risk of foot skin breakdown, pressure ulcers, and osteomyelitis. Rarely, pressure ulcers progress to squamous cell carcinoma. Spina Bifida patients may require limb amputation for osteomyelitis, foot ulcers, and squamous cell carcinoma. There is concern that transtibial amputations would have poor functional outcomes in Spina Bifida patients because of lower-extremity weakness.

    However, there is no available literature on transtibial amputation outcomes in this population. More distal calcanectomy and Symes amputations have been successful in restoring ambulation in lower-level Spina Bifida patients. https://journals.lww.com/ajpmr/Fulltext/2015/11000/From_Wheelchair_to_Cane__Elective_Transtibial.10.aspx

    Foot Care for Amputees

    LOOK
    Check your feet every day for any changes and use a hand mirror to see underneath your feet.


    PROTECT
    Wear correct fitting shoes and never go barefoot


    PREVENT
    Don’t allow problems to occur – wash and dry your feet properly every day.


    SEEK
    If you notice any changes immediately seek medical advice from a foot care professional


    DO
    Have an annual foot check from a podiatrist.

    For more information, you can search http://www.limbs4life.org.

  • Leg Elevation Rules

    Elevating legs occasionally

    Rest– Immediately rest the affected area as much as possible. Experts recommend 24 to 48 hours of no weight-bearing activities. Continued use of a moderate or severely sprained ankle can delay healing, increase pain, or even worsen the injury. With a mild sprain, activity is generally tolerated after 24 to 48 hours of rest.
    Ice– To help reduce pain and swelling during the first 48 hours after injury, ice the area 20 minutes at a time every 4 hours, using an ice pack covered in a towel. If you don’t have an ice pack handy, an alternative would be to use a bag of frozen peas, corn, or other veggies. Try not to ice the injury for more than 20 minutes at a time, as it may actually cause further tissue damage.

    In the majority of studies, researchers found icing was effective in numbing muscle soreness, but observed — for up to 15 minutes after ice treatment — significantly reduced:

    • Muscle strength
    • Power
    • Fine motor coordination


    Compression– Using an elastic medical bandage, wrap the area to help decrease swelling and internal bleeding (if present). The wrap should be snug, but make sure you have proper circulation. Some signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling. If you think you need to use the wrap for more than 48 to 72 hours, you may have a more serious issue that requires prompt medical attention.


    Elevating your limbs and Exercise! Raise the injured body part above heart level so that gravity can move fluids away from the injured area.

  • The frequency of lymphoedema in an adult Spina Bifida population

    The Fight Against Pressure Ulcers

    Lymphoedema


    Lymphoedema is a swelling often of your legs which is due to fluid collecting in the tissues under the skin. This can leave you prone to cellulitis and skin breakdown, and can interfere with independence as your legs get heavy and difficult to move. Ask your GP to arrange treatment with pressure stockings or appliances, which are very effective.

    The National Lymphedema Network (lymphnet.org) defines lymphedema as “an accumulation of lymphatic fluid in the interstitial tissue that causes swelling, most often in the arms and/or legs, and occasionally in other parts of the body. Lymphedema can develop when lymphatic vessels are missing or impaired or when lymph vessels are damaged or lymph nodes removed.

    Feet
    It is suggested that you see a podiatrist/chiropodist regularly to have your toenails cut and hard skin removed if you have loss of feeling or poor circulation in your feet. Use a foot-softening cream on your feet and moisturiser on your legs to prevent cracking as bacteria can enter this way. If your skin is very dry, use aqueous cream instead of soap when bathing. Dry carefully between your toes and treat athlete’s foot straight away. Creams and sprays are available from pharmacies and larger supermarkets.

    There have been very few studies to date documenting the occurrence of lymphedema in the Spina Bifida population, despite a case series in 2001 that suggested that the occurrence may be higher than in the general population. A total of 240 electronic medical records from the Adult Spina Bifida Clinic from January 2005 to August 2008 were retrospectively reviewed.

    This is why incontinence/ moisture management, movement, and sensation are important for Spina Bifida patients.

    10 Methods to tackle swollen feet

    1. Drink 8 to 10 glasses of water per day
      Though it might seem counterintuitive, getting enough fluids actually helps reduce swelling. When your body isn’t hydrated enough, it holds onto the fluid it does have. This contributes to swelling.
    2. Buy compression socks
      Compression socks can be found at a drug or grocery store or even bought online. Start with compression socks that are between 12 to 15 mm or 15 to 20 mm of mercury.

    They come in a variety of weights and compressions, so it might be best to start off with lighter-weight socks and then find the kind that provides the most relief.

    1. Soak in a cool Epsom salt bath for about 15 to 20 minutes
      Epsom salt (magnesium sulfate) may not only help with muscle pain. It may also reduce swelling and inflammation. The theory is that Epsom salt draws out toxins and increases relaxation.

    Just make sure to get Epsom salts marked with the USP designation. This means that it meets standards set forth by the U.S. Food and Drug Administration and is safe to use.

    1. Elevate your feet, preferably above your heart
      Prop your feet on cushions, pillows, or even things like phone books, when you sleep. If you’re looking to reduce foot swelling while pregnant, try elevating your feet several times a day as well. Aim for about 20 minutes at a time, even on an ottoman or a chair.

    Try to avoid standing for long periods of time and stay off your feet when you can.

    1. Get moving!
      If you sit or stand in one area for a long period of time (like at work), this can lead to swollen feet. Try to move a little bit each hour, even if it’s a walk to the break room, a walk around the block at lunch, flexing your knees and ankles, or a lap around the office.
    2. Magnesium supplements can be helpful for some people
      If you retain water, you might have a magnesium deficiency. Eating foods high in magnesium can help. Magnesium-rich foods. Trusted Source to add to your diet include:
    • almonds
    • tofu
    • cashews
    • spinach
    • dark chocolate
    • broccoli
    • avocados
    • Taking 200 to 400 milligrams of magnesium daily might help with the swelling. But before you take any kind of supplement, ask your doctor. Magnesium supplements aren’t right for everyone, especially if you have a kidney or heart condition.
    1. Make some dietary changes
      Reducing your sodium intake can help decrease swelling in your body, including in your feet. Opt for low-sodium versions of your favourite foods, and try to refrain from adding salt to meals.
    2. Lose weight if you’re overweight
      Being overweight can cause reduced blood circulation, leading to swelling of the lower extremities. It can also lead to extra strain on the feet, causing pain when walking. This can result in being more sedentary — which can also cause fluid buildup in the feet.

    Losing weight can help ease the strain on your feet and possibly reduce foot swelling as well. Talk with your doctor about whether you need to lose weight and healthy ways to go about doing so.

    1. Massage your feet
      Massage can be great for swollen feet and can also promote relaxation. Massage (or have someone massage them for you!) your feet toward your heart with firm strokes and some pressure. This can help move the fluid out of the area and reduce swelling.
    2. Increase your intake of potassium-rich foods
      A potassium deficiency can contribute to high blood pressure and water retention. If you have no dietary restrictions, consider eating foods containing potassium. Some potassium-rich foods. Trusted Source include:
    • sweet potatoes
    • white beans
    • bananas
    • salmon
    • pistachios
    • chicken
    • Try drinking orange juice or low-fat milk instead of soda, too. If you have any medical conditions, especially kidney issues, talk with your doctor before adding lots of potassium to your diet.

    How long should I elevate my feet to reduce swelling?


    The more the swelling and the longer there has been swelling, the longer and more frequently your need to elevate your legs. Start with 20 minutes twice a day. This might do the trick. If not, go to 30 minutes or even an hour.

    LET’S WORK TOGETHER TO STOP THE PRESSURE!!!

    https://www.shinecharity.org.uk/self-care/skin-and-tissue

    https://mobilitymgmt.com/Articles/2011/06/01/Lymphedema.aspx

  • PICOs and Pressure Ulcers

    Technology

    PICO is a canister-free, single-use, negative pressure wound therapy system consisting of a sterile pump and multi-layered adhesive dressings. Each dressing has 4 layers: a silicone adhesive wound contact layer, which is designed to minimise pain and damage during peel-back and to reduce lateral tension; an airlock layer for even distribution of pressure; an absorbent layer to remove exudate and bacteria from the wound; and a top film layer, which acts as a physical barrier and allows moisture to evaporate. The pump is operated by 2 AA batteries and delivers a continuous negative pressure of 80 mmHg to a sealed wound. Once activated, using a push button, the battery drives the pump for up to 7 days and LEDs provide alerts for low-battery status and pressure leaks.

    Standard PICO dressings come in 8 sizes: 10×20 cm, 10×30 cm, 10×40 cm, 15×15 cm, 15×20 cm, 15×30 cm, 20×20 cm and 25×25 cm. Multisite PICO dressings come in 2 sizes: small (15×20 cm) and large (20×25 cm).

    The latest version of the technology is the PICO7 system. This differs from the version of PICO notified to NICE by having an improved pump to minimise leakage and an integrated belt clip to allow for easier transport. The PICO7 pump contains a magnet and it should be positioned at least 10 cm (4 inches) away from other medical devices that could be affected by magnetic interference.

    Innovative aspects

    PICO differs from conventional negative pressure wound dressings in that it:

    • has no separate canister
    • is portable and disposable
    • has a proprietary dressing layer that is designed to allow even distribution of negative pressure across the incision and zone of injury.

    The Purpose behind the PICO

    PICO is intended for surgical incisions with low or moderate levels of exudate. This guidance focuses on the use of PICO dressings for closed surgical incisions. PICO dressings can be applied by healthcare professionals including surgeons and tissue viability nurses for people in a range of care settings. Training is needed to place the dressings correctly. My District Nurses are the only ones that can dress, undress and re-dress my wounds.

    Costs

    Standard PICO dressings are available in 8 different sizes. Each pack includes a single-use pump and 2 dressings. The list prices for PICO dressings range from £127.06 to £145.68 (including VAT).
    https://www.smith-nephew.com/key-products/advanced-wound-management/pico/.

    LET’S WORK TOGETHER TO STOP THE PRESSURE!!!

  • The Fight Against Pressure Ulcers!!!

    MORE TIPS

    Skin Checks
    Surfaces- Beware of pressure on pelvic bones depending on how you sit.
    Keep Moving
    Increased Moisture Management because increased moisture could imply or result in heart failure.
    Nutrition

    STOP THE PRESSURE!!!

    http://www.legsmatter.org.

  • Understanding and making a difference to tackling Disability Hate Crime

    Hate Crime vs General Crime

    Any crime can be prosecuted as a hate crime if the offender has either demonstrated hostility based on race, religion, disability, sexual orientation or transgender identity
    Or

    been motivated by hostility based on race, religion, disability, sexual orientation or transgender identity
    Someone can be a victim of more than one type of hate crime.

    These crimes are covered by legislation (Crime and Disorder Act 1998 and section 66 of the Sentencing Act 2020) which allows prosecutors to apply for an uplift in sentence for those convicted of a hate crime.

    The reason for failed investigation is ineffective reporting.

    Be more specific. Provide more details.

    victim vs perpetrator- responsibility falls on the victim

    Victims are seen as vulnerable and insignificant not equal. https://bradfordforeveryone.co.uk/

    It’s the first day of Hate Crime Awareness Week and we are encouraging victims of hate crime to speak out.

    What is being done to fight this?

    Monday, 11th October

    Bradford District’s Hate Crime Strategy 2021-24 Launch Event

    The event will bring together key partnership organisations, groups identified as one of the 5 ‘Protected characteristic’ groups, community and faith representatives.

    Tuesday, 12th October

    Hate Crime Conference

    Hate Crime Awareness Week is week of actions to encourage local authorities, key partners and communities affected by hate crime to work together to tackle local hate crime.

    Wednesday, 13th October

    Coffee and Cake Morning

    The Equity Centre is a Hate Crime Reporting Centre, however this event provides people with a chance to meet others over a hot drink and some cake/biscuits.

    Eastern European Community Hate Crime Awareness

    Several of the Districts main organisations working in the hate crime space such as Bradford Council, Bradford Hate Crime Alliance, West Yorkshire Police and Victims Support will be there to explain their roles, explain what is hate crime, where and how it can be reported and Q&A session

    Thursday, 14th October

    Hate Crime Question Time

    The Panelists will explain what type of hate crime-related work they are undertaking and will answer questions from the online audience.

    Hate Crime Awareness event for the Bradford African Community

    Several of the Districts main organisations working in the hate crime space such as Bradford Council, Bradford Hate Crime Alliance, West Yorkshire Police and Victims Support will be there to explain their roles, explain what is hate crime, where and how it can be reported and Q&A session.

    Friday, 15th October

    Make Sure It Adds Up – Bradford District Anti Rumour Strategy

    A chance to learn more about the Bradford For Everyone campaign to reduce rumours and increase critical thinking with the aim to reduce hate crime overall. Find out more about our online resources and forthcoming pledge.

    Saturday, 16th October

    Bradford City Football Club

    BCFC have invited 30 members from the ‘emerging communities’ to attend the match, take the Root Out Racism banner onto the pitch before the game, players will be supporting the hate crime awareness week in the days leading up to the game.
    For more information on reporting hate crime check out this website at: https://www.cps.gov.uk/crime-info/hate-crime.

    Being different is not a crime. Victimisation is prejudice!