History and Facts

Lyme disease is the most common tick-born illness in North America and Europe, according to the Mayo Clinic.  Lyme is caused by a spirochete (spiral-shaped) bacterium called Borrelia burgdorferi and is found in deer ticks. The disease is transmitted to humans by an infected tick bite (not all deer ticks carry the bacteria, however).

The Lyme Disease Association states, “deer ticks feed once in each stage: larva, nymph and adult.  Each time they feed they can pass the disease to whatever animal they feed upon.”  Deer ticks can survive for two years even through freezing temperatures and can be active anytime of the year when temperatures are above freezing.

Prevention

Prevention is the best policy.  When you are in wooded or grassy areas, wear long pants and shirts with sleeves, tuck your pants into your socks and wear shoes.  Do the best you can to stay on a trail because ticks are most abundant in low brush and tall grass.  Use a bug spray with DEET to deter ticks (watch labels – DEET is not safe for everyone).  Clean up brush, leaves and garbage in your yard to minimize habitat for ticks and animals that ticks live on.  Also, keep woodpiles in sunny areas to help the wood stay dry; ticks need humidity to live.

When you return to your home after being in an area with ticks, check yourself, children and pets for ticks.  Be careful to check in hair, body creases and the bellybutton.  Wash your clothing right away.  Shower using a washcloth to scrub your skin.  This will help remove ticks that are not attached to your skin that may have been missed on visual inspection.  Deer ticks range in size from less than 2mm or the size of the poppy seed to the size of a sesame seed.

You can see this picture and read more about deer ticks on the MN Department of Health website.

The tick removal tips listed below are provided by the Centers for Disease Control:

1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
2. Pull upward with steady, even pressure.  Don’t twist or jerk the tick – this can cause the mouth-parts to break off and remain in the skin.  If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water. 

This is the only safe way to remove a tick and it is important to remove the tick as soon as possible to minimize the risk of being infected with Lyme disease. 

Signs and Symptoms

Early signs and symptoms can start a few days to a few weeks after the infectious tick bite.  One sign is a red bull’s eye rash.  According to the Lyme Disease Association, less than 50% of people will get a rash.  Other early symptoms include fatigue, chills, fever, diarrhea, headache, muscle and joint aches, swollen lymph nodes and stiff neck.  It is very important to get treatment in the early stage of Lyme disease because it is much easier to treat.  The bacteria that causes Lyme disease is spiral-shaped so it can burrow into any area of the body, making it difficult to eliminate. 

Symptoms by body system according to Lyme Disease Association:

• Heart/Lungs: chest pain or rib soreness, shortness of breath, heart palpitations, or heart murmur.
• Stomach/Intestines: nausea or vomiting, difficulty eating, change in bowel function (constipation, diarrhea), abdominal cramping, irritable bladder or bladder dysfunction.
• Musculoskeletal: joint/muscle pain in feet, swelling in toes, balls of feet, ankle pain, burning in feet, shin splints, joint pain and /or swelling, stiffness of the joints, neck or back, muscle pain or cramps that may migrate, neck creaks and cracks, neck stiffness and TMJ.
• Neurological: twitching of the face, eyelids or other muscles, headache, tingling, numbness, burning or stabbing sensations, facial paralysis (Bell’s palsy), dizziness, poor balance, increased motion sickness, light-headedness, wooziness, difficulty walking, tremor, confusion, difficulty in thinking or with concentration or reading, forgetfulness, poor short term memory, disorientation (getting lost, going to wrong place), difficulty with speech, double or blurry vision, eye pain, blindness, increased sensitivity to light or sound, ringing in ears, seizures, and low blood pressure. 
• Neuropsychiatric: mood swings, violent outbursts, irritability, depression, disturbed sleep (too much, too little, early awakening), personality changes, obsessive compulsive disorder, paranoia, panic anxiety attack and hallucinations.
• Reproductive: testicular pain/pelvic pain, menstrual irregularity, milk production (lactation), sexual dysfunction, loss of libido.
• Other: fever, sweats, or chills, weight changes (loss or gain), fatigue, hair loss, swollen glands, sore throat, difficulty swallowing, swelling around the eyes.

Testing/diagnosis

Blood testing is done to screen for Lyme disease and it takes several days to get the results.  Unfortunately, the testing can result in false positive or false negative depending on the reference source.  Lyme literate doctors believe that patients should be diagnosed by symptoms and not testing alone.  Lyme disease has been known to be misdiagnosed as: Lupus, Fibromyalgia, RA, Chronic fatigue, MS, ALS, Parkinson’s disease and depression. 

Treatment

Lyme disease is treated with antibiotic therapy.  Doxycycline given orally, twice per day for 10-30 days, is the most common treatment for early stage Lyme disease.

Be your own advocate!  Seek a second or third opinion if you feel that your symptoms return after treatment and your doctor does not feel they should re-treat you or your doctor does not want to treat your current symptoms.  There are doctors who specialize in Lyme disease called Lyme literate doctors.  The medical community is divided on whether or not it is a chronic condition and if long term antibiotics are beneficial, therefore, treatments vary depending on your doctor.

During treatment, patients can experience a reaction (Jarisch-Herxheimer) that causes them to feel worse even though the bacteria are dying.  The reason is because dying bacteria release toxins into the body faster than the body can eliminate them.  This reaction is also common in the treatment of syphilis, another spirochete bacterium. 

When people are being treated for chronic Lyme disease and are on antibiotics for months or years at a time, the patient goes in and out of remission and can eventually be cured. 

On a personal note: I have been witness to what long-term antibiotic treatment can do and it has been positive.    

Under our Skin is a documentary about Lyme disease. If you have a few minutes, watch the trailor!

The author of this blog is Divine Home Care RN Case Manager for our Little Falls branch, Kristin Woodford

What is the PCA program?

The personal care assistance (PCA) program provides services for people of all ages who need help with day-to-day tasks to allow them to be more independent at home and in community settings. A PCA (personal care assistant) is a trained individual who helps with those daily tasks including hands-on personal cares, household chores and community involvement. ADLs or Activities of Daily Living involve personal cares such as:

• Eating
• Medications
• Bathing
• Dressing
• Range of motion exercises
• Transfers
• Toileting

IADLs or Instrumental Activities of Daily Living include things like:

• Shopping
• Laundry
• Meal preparation
• Housekeeping

Who is eligible for the PCA program?

An individual must meet all of the following criteria to be eligible for PCA services:

• Eligible to receive Medical Assistance or MinnesotaCare Expanded
• Able to make your own medical decisions or have someone else who can
• Require services that are prescribed by your physician

Click here for a more complete list of requirements.

How many hours of service can a client receive?

The Department of Human Services (DHS) decides if an individual qualifies for personal care assistance services. DHS does an assessment, which determines their needs and what services are appropriate. This assessment allows DHS to authorize a certain number of hours of PCA services that individual may receive each week. After approval by their physician, this evaluation is sent back to DHS where the final decision is made about eligibility. These services are usually approved for one year at a time.

How can I become a PCA?

There are a few qualifications that must be met for someone to become a personal care assistant for Divine Home Care:

• Must pass a background study with the state of Minnesota
• Have at least one year experience working in care giving (there are some exceptions to this)
• Complete an eight hour training given by Divine Home Care

Besides meeting these basic qualifications, we are always looking to employ people who are caring and compassionate. If you are interested in becoming a PCA and would like to be a part of Divine Home Care, click on “Careers” at the top of the page to learn more.

The author of this blog post is Divine Home Care Staffing Coordinator for our Willmar office, Alexis Alle.

Spring is officially here! This is such an exciting time of year for me – I love to watch everything turn green and beautiful again, get the grill out, sit on the deck and take the dog for long walks. The fresh air and sunshine just do wonders for my mood. However, millions of people may disagree with me. These people would be those suffering from springtime allergies.

Allergies can affect people at all times of the year, but pollinating trees are the main cause of springtime allergies. Pollen is released by the trees and carried to other trees of the same kind to fertilize new seeds. According to the Asthma and Allergy Foundation of America, “Pollen travels best on warm, dry, breezy days.” The trees that are triggering your allergies right could be:

• Ash
• Beech
• Birch
• Cedar
• Cottonwood
• Box elder
• Elm
• Hickory
• Maple
• Oak

 Also commonly called hay fever, springtime allergies can bring on a number of symptoms that cause people to be just plain miserable: sneezing, congestion, runny nose, wheezing, coughing, itchy nose and throat, swollen, watery, itchy eyes. Some people with severe allergies may even experience asthma attacks. But how do you know if you are fighting a cold or suffering from allergies? Well, if you seem to get this “cold” around the same time every year and it seems to linger for quite some time, chances are, your symptoms are caused by allergies. Also, your itchy eyes, nose and throat are a good indication that you have allergies rather than a cold. The only way to be 100% sure is to be tested by a doctor. This is especially important if you experience more severe symptoms that could become a serious problem.

But wait – there IS good news – you don’t have to suffer! One of the most important steps to getting relief is attempting to reduce your exposure to your allergy triggers in the first place.

• Stay inside as much as possible on dry, windy days.
• If you have to do things outdoors like mow and pull weeds, remove the clothes you have worn outside and shower off to rinse the pollen from your skin and hair.
• Even though it makes your laundry smell wonderfully fresh, don’t hang anything outside to dry. Pollen can actually stick to fabrics.
• Use air conditioning rather than opening your windows – especially on those windy days.
• Use a dehumidifier to keep the air dry inside your house.

If trying to limit your exposure isn’t doing the trick, there are many over-the-counter medications that you can take to help relieve symptoms; medications such as Claritin, Zyrtec, Sudafed and Benadryl (which may cause drowsiness). However, nonprescription drugs may still not do it for you and then you may need to move on to prescription medication. These could include oral medication, nasal sprays or allergy shots. According to Consumer Reports, most people who see a doctor for their allergies end up feeling much better either because the doctor prescribed an effective medication or the doctor was able to help them choose the appropriate over-the-counter drug.

Go see your doctor to determine the best way to manage your symptoms. Don’t let springtime allergies prevent you from enjoying the fresh air and sunshine.

April is National Autism Awareness Month. The Autism Society defines autism as, “a complex developmental disability that typically appears during the first three years of life and affects a person’s ability to communicate and interact with others.” The national symbol for Autism Awareness is a ribbon made out of puzzle pieces, signifying the complexity of the autism spectrum. The different colors and shapes represent the diversity of the people and families living with the condition.

Statistics say autism currently affects around 1 million Americans. According to the Center for Disease Control, the number of U.S. cases of autism has grown to 1 in 88 children, a 78% increase since a 2007 report and 23% increase since the last report in 2009. Another interesting fact - studies show that boys are three to four times more likely to develop autism than girls. To try and put these numbers in perspective, Autism Speaks states that autism affects more children than those affected by diabetes, AIDS, cancer, Cerebral palsy, cystic fibrosis, muscular dystrophy and Down syndrome, combined! Health officials attribute the increase largely to more awareness of early signs and better diagnosis of cases through various screenings and evaluations.

Symptoms almost always start before a child is 3 years old. Diagnosing autism is done by observing and evaluating behaviors. This generally involves a team of professionals including a pediatrician, a psychologist, a speech and language pathologist and an occupational therapist. There is no blood or biologic test used to make a diagnosis. Some signs of autism include: a delay in talking or not speaking at all, not responding to his or her own name, repeatitive and overused behaviors, unusual sensitivity to light sound and touch, and/or becoming very upset when routines change. These are just a handful of possible symptoms.

There are no two people alike with autism. Individuals can have many different kinds of behaviors, from mild to severe. Many children with autism prefer to play alone and do not make eye contact with other people. Kids with autism may also have other problems including: below normal intelligence, depression, anxiety and epilepsy.

Autism tends to run in families, which has led some experts to believe it may be something that you inherit. Scientists are trying to find out exactly which genes may be responsible for passing down autism in families. Other studies are looking at whether autism can be caused by other medical problems or by something in your child’s surroundings. Some think that childhood vaccines cause autism, however, studies have not proven this to be true. It is important that your child receives all necessary childhood vaccines. They help keep him/her from getting serious diseases that can cause harm or even death.

There is no cure for autism – but there are interventions that involve behavioral training and/or medication. Behavioral training rewards good behavior to teach children social skills and ways to better communicate as well as how to help themselves as they grow older. With early treatment, alot of children with autism are able to learn to interact and communicate better with others.  Treatment can include speech, physical and occupational therapy, parent and family involvement and a team of teachers.

Exactly what type of treatment your child needs depends on the symptoms, which are different for each child and may change over time. Because people with autism are so different, something that helps one person may not help another.  It is important to work with a group of people who have your child’s best interests at heart in order for them to receive the best education possible.

The goal of National Autism Awareness Month is to increase awareness of the disorder and promote early intervention and appropriate treatments in the hopes that people with autism and their families will lead full, complete lives.

The author of this blog is Divine Home Care RN Case Manager for our Litchfield branch, Crystal Lawver.

Caring for a client who wants to remain at home takes a team of people working together to help make that happen. This post highlights the role of an Independent Living Skills (ILS) staff and the importance he/she has at Divine Home Care.

The job of an ILS staff is to help a person develop and maintain the skills necessary to participate and become integrated in the community he or she lives in, as well as live independently at home. ILS staff work on tasks specific to individual needs in the client’s home or community to help develop these skills. ILS workers offer assistance and supervision for their client, however, training is the primary service provided. Below is a list of skills that ILS staff help different clients with:

• Personal hygiene
• Communicating effectively
• Reducing and eliminating inappropriate or disruptive behavior
• Sensory/motor development
• Socialization
• Money management
• Meal preparation
• Household tasks like laundry and cleaning

All of the ILS employees at Divine Home Care work under close supervision of the Independent Living Skills Director and each client’s RN Case Manager. The ILS Director and staff, case managers and county social workers all work closely to ensure that the needs of the client are being met.

The main objective of an ILS employee is to teach and train clients how to perform tasks and develop skills to live an independent life. Independent Living Skills staff must have general knowledge of disabilities and chronic illnesses that affect the ability of a person to live independently. Good human relation skills are also important in order to relate to clients with both compassion and professionalism.

There are also qualifications that must be met for someone to become an ILS worker for Divine Home Care:

• Must pass a background study with the state of Minnesota.
• Complete five hours of classroom training in recognizing the symptoms and effects of certain disabilities and health conditions.
• 20 hours of classroom instruction in providing supervision of, training to and assistance with ILS training services.

Besides meeting these basic qualifications, Divine Home Care is always looking to employ people who are caring and compassionate. If you are interested in becoming an Independent Living Skills staff and would like to be a part of Divine Home Care, click on “Careers” at the top of the page to learn more!

The author of this blog post is Divine Home Care Office Manager for our Litchfield branch, Christy Krueger.