The Calf Muscle Pump-Why Older Patients should have Exercises and Socialization1Copyright Michael Gillan Long Distance Recovery Specialisthttp://aching-legs.org/closing_the_patient_isolation_gap.html

Patients Need Socialization-and Exercise

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

I am doing voluntary work in a hospital and they are just starting a program for exercise forpatients-I joined the first class as an active participant, and saw from the inside the problems thesepeople experience in a modern hospital, and can only speculate on how bad it must be in a lessforward or less well equipped and staffed oneI am not involved in a professional capacity; it should be understood that I am not criticizing thehard worked staff or the people in charge of the hospital or their methods, but just making acomment on patients and the view from their side of the coin, (I could be one of them myself)I wander from ward to ward just talking to patients who are feeling overwhelmed by their stay inhospital however long or short the time may beMost are making an unplanned hospital stay, and their first feelings are shock at finding themselvesthere suddenly removed from their usual surroundings, comforts, friends and other familiar territoryand routines they have become used toThey are plunged into a medical world where the day consists of being, poked, prodded, discussed,having procedures done, washed, bathed, fed, sharing a room with total strangers who snore,snuffle, moan with pain and discomfort who rely on pumps that tick and beep all hours of the dayand nightA hospital is really not a place for sick people to rest and get better; it is too busy and verythreatening for the older ones who have problems relating to all the confusion around them-this canbe even more uncomfortable when the patient is deaf, or when they are sight affectedIf a television is available to pass the time, they not be able to see it, or even hear it as the sound hasto be kept low enough so that other patients are not disturbed, and they may not even be able to readbooks or newspapers that may or may not be supplied by friends or the hospital volunteers (if any)When you are an older patient, you may not get too many friends or family visiting because theymay live too far away, or your friends find the prospect of visiting too daunting or impossible asthey are in your age group and have medical problems of their ownThe only thing you have to mark the passing of the days, are basically mealtimes, breakfast dinnerand tea, so the days and time can hang heavily, and the isolation between your other life and thisone increasesThe world outside is somewhere on another planet (it might as well be) as you are totally isolatedfrom it (if lucky, you might have a good view from a window if your eyesight is good enough to seeit-so the main things missing from your life are stimulation, movement and companyWhen you are really sick, none of these matter anyway, but as you improve, they become moreimportant to your recovery

The Calf Muscle Pump-Why Older Patients should have Exercises and Socialization2Copyright Michael Gillan Long Distance Recovery Specialisthttp://aching-legs.org/closing_the_patient_isolation_gap.html

Lack of touch

Lack of touch is a problem for many patients; they may get medical touch from doctors, and nurseswhen they are being examined, having observations done, or assisted with their daily needs, butbecause of the workload they are dealing with, this touch is minimalAlso in this modern age of nursing, infection control, political correctness through accusations of sexual harassment, and threat of lawsuits through what can be perceived as ‘inappropriate’ touch isa worry for nursing staff and others involved in patient care giving

Lack of movement

Other than trips to x-ray, ultra sound, and other departments, the older patient in the modernhospital is usually confined to their bed or bedspace surrounding them unless they are mobileenough to take themselves a walk around the hospital-the modern hospital though is so big,impersonal and busy that it is easy to become disorientated and get lostIf they are not ambulant they just sit an wait for time to pass-slowlyLack of movement can lead to many problems, it reduces any mobility that may have been there if they were able, it can lead to wasting muscles, even more isolation, and of course the risk of deepvein thrombosis from lying in bed affecting circulation

Moving and exercise groups

The hospital I do volunteer work has introduced movement and exercise groups to give patientswho can’t do physical therapies because of the conditions they have some form of therapeuticactivity during their stayThese groups are run and supervised by the physical therapy department at the hospital and costvery little to run except for the time needed to get the patients to the group and back to the wardagain-it is also cost effective as the therapists can give a whole group of people some attention theymay not have worked withIt also means that they can give more individual time to those patients who need more intensivework in their bed areaThe sessions also have side benefits attached to them, they give them something to look forward toother than meals-they get up, showered and engaged in getting ready to go to the group, they canhave a change of scenery from the ward, they can work at their own pace and within theirmovement capacityIt also gets the brain working as they have to start thinking for themselves as each exercise isexplained to them what they are required to do, and they have to start to relate to legs feet and armswhich may not have been used for some timeSocial interaction with a wide range of people (other patients) not connected with them medically isalso included in the group situation as they are seated in a circle facing each other, and laughter and jokes are quite frequent during the working time of approximately 20 minutesA further benefit to the patients is that the simple leg activity also affects their leg circulation bymoving the calf muscles during the exercises

Leg Movement is good for patients because it works the calf muscle pump

The Calf Muscle Pump-Why Older Patients should have Exercises and Socialization3Copyright Michael Gillan Long Distance Recovery Specialisthttp://aching-legs.org/closing_the_patient_isolation_gap.html

The Calf Muscle Pump

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

The Calf Muscle Pump and the muscles that are its motors

The calf muscle pump is responsible for circulation in the lower legs-another name for it is the

peripheral heart

because it is outside the bodyIts main purpose is to move used blood from the lower legs back to the body for refreshment withoxygen and other elements that the muscles need to maintain an optimum environment for efficientworking of the musclesOld blood and fluid is taken out of the lower legs through the veins, fresh blood is supplied to themuscles through the arteries