Taking a quick departure from injection site management to update on Tartoos product development! Our fingers are crossed that our inventory and e-commerce site will be up by the end of February with the completed Tartoos product ready for purchase! As we are committed to offering the most well refined products for chronic disease management; Visual Medical would love to hear your stories of empowering strategies used in daily health management. A continuous, strong, open dialogue is needed to help support other's in our community, please share your journey with us! The comment box at the end of this post can be utilized or email directly at rj@myvisualmedical.com.
Wednesday, January 30, 2013
Wednesday, January 16, 2013
Why injection site managment?
In my different vocational roles, I have had the privilege of working along side clinical educators who have instructed on a variety of health related issues. However, I credit one education experience as being the catalyst for why I have a particular interest in injection site management.
As staff escorted a family who had a newly diagnosed little one with Type I diabetes to our education room, I gathered my materials for what would be presented to them in our session. I heaved the 100 plus page family education binder onto the table and started surveying the scene.. Syringes, alcohol wipes, anatomical charts, blood glucose meter, monitoring strips and insulin pens littered the table where this family would learn in all its complexity what it really takes to now care for their child. Tired, the parents listened to another 2 hours of instruction and diligently practiced pulling up syringes of saline to mimic insulin administration. Holding the syringes up to the lights, the parents would squint, examine them for microscopic differences in dosage, look to the educators for a nod of approval and practice over again and again to make sure it was emblazoned into their memory. Rote learning was used to teach the importance of technique, selecting an injection site, pinching the skin, cleaning and making sure to choose a different site for the next injection. Over and over this sequence was preformed; however, one concept was routinely highlighted as unclear. How to ensure that injection sites were adequately rotated was never fully realized and understood. You see, the teaching tools for this consisted of anatomical charts with grid - like patterns (Figure 1). Frankly, it is a confusing display in my opinion as the image is not to individual scale of the child and does not offer any real world systematic approach. The best suggestion offered to the parents was to use imagination: "Pretend there's a clock or calendar on your child's abdomen, place injection's at 12,1,2," and so on. As I was trying hard to remember if I had fed the dog that morning, I wondered if I would be able to execute this if my child needed this level of care.
(Figure 1)
My thoughts drifted back to when Carter received his autism spectrum diagnosis. The expectations that were placed on the level of care he would need included, speech, occupational and physical therapies, accommodations at school, medication to control his neurological ticks, anxiety and ADHD, home behavior interventions, and so on. It was assumed by the medical staff who cared for him that Carter's needs were the only priority issues in our family. Important? Yes! VERY, but not ONLY. It had to be taken into consideration that our family was complex, with many needs and different dynamics.
Focusing my attention back to our session, my ear caught yet another parent asking, "How do we keep track of where this injection was placed?"- I knew then, this was not a lack of understanding on part of our clientele- it was on us, who were utilizing methods and tools to teach that were not effective.
As staff escorted a family who had a newly diagnosed little one with Type I diabetes to our education room, I gathered my materials for what would be presented to them in our session. I heaved the 100 plus page family education binder onto the table and started surveying the scene.. Syringes, alcohol wipes, anatomical charts, blood glucose meter, monitoring strips and insulin pens littered the table where this family would learn in all its complexity what it really takes to now care for their child. Tired, the parents listened to another 2 hours of instruction and diligently practiced pulling up syringes of saline to mimic insulin administration. Holding the syringes up to the lights, the parents would squint, examine them for microscopic differences in dosage, look to the educators for a nod of approval and practice over again and again to make sure it was emblazoned into their memory. Rote learning was used to teach the importance of technique, selecting an injection site, pinching the skin, cleaning and making sure to choose a different site for the next injection. Over and over this sequence was preformed; however, one concept was routinely highlighted as unclear. How to ensure that injection sites were adequately rotated was never fully realized and understood. You see, the teaching tools for this consisted of anatomical charts with grid - like patterns (Figure 1). Frankly, it is a confusing display in my opinion as the image is not to individual scale of the child and does not offer any real world systematic approach. The best suggestion offered to the parents was to use imagination: "Pretend there's a clock or calendar on your child's abdomen, place injection's at 12,1,2," and so on. As I was trying hard to remember if I had fed the dog that morning, I wondered if I would be able to execute this if my child needed this level of care.
My thoughts drifted back to when Carter received his autism spectrum diagnosis. The expectations that were placed on the level of care he would need included, speech, occupational and physical therapies, accommodations at school, medication to control his neurological ticks, anxiety and ADHD, home behavior interventions, and so on. It was assumed by the medical staff who cared for him that Carter's needs were the only priority issues in our family. Important? Yes! VERY, but not ONLY. It had to be taken into consideration that our family was complex, with many needs and different dynamics.
Focusing my attention back to our session, my ear caught yet another parent asking, "How do we keep track of where this injection was placed?"- I knew then, this was not a lack of understanding on part of our clientele- it was on us, who were utilizing methods and tools to teach that were not effective.
Thursday, January 10, 2013
Injection Therapy
As I will be talking a lot about the management of injectable medication issues in my next few blogs, I thought I would quickly define some terminology that is used on the LaunchRock site and that helps further define and clarify the clinical need for Visual Medical's Tartoos!
Quick Tutorial:
(Scar tissue accumulation due to lack of injection site rotation,
this gentleman only injected immediately to the left and right of his naval for
30 plus years)
Quick Tutorial:
Injection
site-
place on the body where an injection is given
Injection
site rotation- Choosing a different area of the body each and
every time an injection is given- with some medications (insulin, blood
thinners), it is recommended that you rotate within the same general area of
the body such as the abdomen, due to faster absorption rates
Disinfection
of the injection site- Cleaning the skin before an injection is given
to prevent infection
(Infection of injection site)
Lipohypertrophy- Scar
tissue accumulation from repeatedly injecting and over use of one particular
injection site
(Scar tissue accumulation due to lack of injection site rotation,
this gentleman only injected immediately to the left and right of his naval for
30 plus years)
Although injection therapies have been proven to be highly
effective in disease management when administered correctly; consistent care (rotation
and disinfection) of the injection site is often compromised due to the
challenges of injection site management and remembering where the last
injection was placed on the body. With no way of knowing where the patient last
injected, overuse of injection sites can easily happen leading to an irregular
build-up of scar tissue called lipohypertrophy. Scar tissue accumulation
(lipohypertrophy) occurs when patients repeatedly inject into the same site on
the body. As skin tissue thickens, critical medication absorption decreases in
an upwards of 25%, compromising medication efficacy leading to poor disease
management, increases in hospitalization and mortality.[1]
Among Type 1 Diabetics alone, lipohypertrophy occurs up to 48.8% in the patient population and in 28% of Type 2 Diabetics.[2]
[1] Johansson et al., (2005). Impaired absorption of
insulin as part from lipohypertrophic injection sites.
Diabetes
Care, 28, 2025-2027. doi:10.2337/diacare.28.8.2025
[2]Vadar B.,
Kizilei S., (2007). Incidence of lipohypertrophy in diabetic patients a study
of influencing factors.
Diabetes Research and Clinical Practice,77, 231-236.doi:10.1016/j.diabres.2006.12.023
Wednesday, January 9, 2013
 Our Story
My brothers and I. Aaron (middle), Luke (right) and Alex.
Visual Medical was inspired
by many brave individuals who have managed severe, chronic illness with
tremendous perseverance and unbelievable grace. It is our mission to
discover and develop products through medically sound approaches
for disease management incorporating the importance of:
I now have three beautiful boys of my own, of whom my oldest, Carter, is on the autism spectrum. In addtion to social delays, his physical health has also presented challenges, struggling with asthma, neurological tics, Graves disease and other rheumatologic issues. He is brilliantly smart, funny and a very important part of our family, though his care takes careful thought and consideration. Our lives became more complicated 2 years ago upon the diagnosis of my husband’s stage 4 lymphoma. During his treatment, I tried my hardest to keep on top of his care, however sometimes the enormity of our situation was lost on people and medical staff would become impatient when we were late for an appointment or would misstep in some other minor issue. I wished there was a way for them to gain insight into the complexity or our lives and understand we were doing the best we could. Having 10 years of experience in the healthcare field has brought a unique understanding to the medical diagnoses of my loved ones. I knew the medical community could do better, when my husband's complicated lab and chemo schedule involved running with our little ones for hours at a time, or when Carter received his autism diagnosis - being abruptly presented with a handbook and sent on my way. There was room to try harder, empathize more and dig deeper to provide better, more holistic care. Inspired by my parents, brothers, son, husband and patients I have cared for over the years. I want to make chronic disease management easier. In the crazy of everyday life, I want families to feel successful and competent when taking care of themselves or a loved one and maybe have some fun while doing it. In the next few days I will be posting images of our first product offering TARTOOS. Visual Medical has a goal to keep this product at no or minimal cost to the patients who would utilize it. In order for this to happen-interest has to be sparked! We are hoping by the power of social media our story will be shared and we can create a fire under our little business. We have set a goal of having 20,000 individuals register on our LaunchRock site. Registration only will present us with documented interest for our product, your information will not be shared, no obligation or purchases required. Once you have visited http://tartoos.launchrock.com/ please fill in the required fields and repost on Facebook, Twitter, LinkedIn and Pinterest! Rachael jacquesrachael1@gmail.com rj@myvisualmedical.com
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