The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation1Copyright Michael Gillan Long Distance Recovery Specialisthttp://aching-legs.org/closing_the_patient_isolation_gap.html

Hospital Staff-Patients-Visitors

The patient long term stay has 3 main problems

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The isolation gap

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Lack of touch

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Lack of movement

Most people have hospital stays sometime in their lives for varying problems and periods of treatment-for the lucky ones, it is just an overnight stay and home again, for the not so lucky thestay could be a lengthy oneIt is during the lengthy stays that the patient becomes more isolated from friends and families; evenif they visit often as allowed and stay for maximum time and they are emotionally attached to thepatient, a physical gap can develop between themThe patient may miss the physical contact may not be allowed because the treatment being used orisolation may prevent this-but there may be a time when touching can be recommencedHow to bridge the gap can be difficult because the gulf between patient and visitor may havewidened after initial welcome at the start of visiting time, the middle may become an area of desolation with both parties trying to find common ground between the life they live and the sterilelife of social isolation the patient lives that others can’t relate toHospital staff; doctors, nurses, physical therapists, occupational therapists, cleaners, meal delivers,are all a substitute family the patient depends on for all their needs; other patients may become theirconfidante they tell all their fears and hopes toAs the patient improves the emotional and physical gulf that has resulted between hospital patientand family needs bridging to bring them back to a normal life in readiness for discharge and easetheir placement into life outside the ward again; this can be difficult as if the stay has been a lengthyone, they may have become institutionalised, and going home may be stressful for them

Patients are people who need touch other than that provided by hospital staff

The longer someone is in hospital and under medical treatment, the more difficult it becomes tobreak down the barriers to give them touch-being in a hospital setting even for family and othervisitors can be a daunting experience, so can place a strain on relationships and can make the patientfeel even more isolated after the visit is over

Some patients may not be going home for some time

Some patients may not be going home as their age, domestic arrangements and medical status maymake it impossible for it to be considered-they are very long term stayers with little prospect of leaving any time soonThese become even more isolated and institutionalised; they lack one of the most basic needs; thatof touch, other than that of medical staff, they are left to their own devices in their own locked inworld with the odd visitor now and again-they need another option to bridge the gap

The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation2Copyright Michael Gillan Long Distance Recovery Specialisthttp://aching-legs.org/closing_the_patient_isolation_gap.html

Lack of movement

Long term hospital stays can have other problems connected with them-lack of movement andrestricted walking areas, and if the patient is confined to bed for any length of time, there is theproblem of reduced lower leg circulation and loss of sensation of underfoot environment which canlead to loss of confidence when they stand and try to walk again

Sitting or lying down long term

Sitting or lying down for long periods also brings its hazards-by nature of their medical problems,many patients are forced to have extended bed rest, this can place them in the position of risk fromdeveloping an unwanted condition known as Deep Vein ThrombosisDeep Vein Thrombosis-blood in the veins becomes static allowing the balance between clotting andanti clotting agents in the blood to be altered and clots to form in the veins which may break awayand lodge higher up in the bodyMost modern hospitals have access to up to date drugs, pressure stockings, calf pumping systemsand modalities such as physio or physical therapists to deal with these problems, but in manycountries there may be only the financial resources to cover treatment of the initial complaint andnothing left for the ancillary therapies needed for prevention of Deep Vein ThrombosisThis leaves a gap that may be filled by

Light Manual Muscle Relaxation-the walk you havewhen you are not having a walk

Lower Leg Circulation

Blood is sent to the lower legs under pressure through the arteries and vessels called arterioles andeven smaller capillaries-as the vessel size reduces the pressure taking it there also decreasesBy the time the blood reaches the feet, all the pressure has been used, and there is none left to returnthe used blood back up the legs to the body against gravity again

Blood pumpedfrom heartthrougharteries under

pressureReaches feetPressure runsout

Calf musclesact as pumpmotorsUsed blood ismoved up thelegs throughthe veinsOn return tobody blood isrenourishedand recycled

The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation3Copyright Michael Gillan Long Distance Recovery Specialisthttp://aching-legs.org/closing_the_patient_isolation_gap.html

The Veins

Used blood is sent back to the body by a pumping system made up of the leg muscles and veinswhich have one way valves in them which prevents it going back down to the feet

There are three types of veins

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Superficial veins

act as a reservoir for blood, supplying it to the tissues as needed, theyalso carry blood from the muscle tissues to the perforating veins.

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Perforating veins

that carry blood from the superficial veins through to the deep veins.

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Deep veins

carry used blood and lymph fluid away from the legs towards the heart.

Low-pressure High pressureBlood is forced upwards Blood is resting on the valve

As muscles squeeze the vessels valves are open as they relax the valves close preventing leaksIn this way, a balance is kept between the fresh blood going into the lower legs and the old bloodleaving them on its way back to the body for refreshment and recycling again

The Calf Muscle Pump-its contribution to recovery from fatigue

To keep the lower leg circulation working, the muscles rely on having a constant supply of freshblood to the tissues to help prevent fatigue and to recover when they doWhile the effects of the pump has a great effect on the physiological condition of the body, brokendown into its various parts it is just a pump-not too sophisticated in the way it operates, except thatit is made from living tissues rather than manufactured componentsBasically the way it works is there are a series of flexible tubes (veins) to take fluid (used blood)from the lower legs back to the body against gravity-in the tubes are a series of one-way valves thatopen to let fluid pass through when the tube is squeezed by the motors (the calf muscles)When the pressure on the tube is released, the valves close again to prevent the fluid going back down to the feet againThe calf muscles ability to keep working at applying and releasing pressure the tubes-once thisstops, the fluid can’t be moved up the legs-the used fluid is allowed to just become staticSwollen ankles from lymph fluid (or water) separating from the static blood and migrating throughthe vessel walls into the tissue spaces instead of being pumped away can be the result inefficient useof calf musclesBeing a mechanically based pump, the system can be serviced or restarted using a manual system toremove some of the fluid and pressure that has built up-once started, fresh blood can more easilyenter the muscle tissues and start the recovery process