7 May, 2020

Taking care of your leg health during a pandemic

Yvette Mier's advice on staying healthy during Covid-19 pandemic. She is a a well-respected nurse with over 25 years of experience in wound care and chapter author in the Wound, Ostomy, Continence Nursing Society (WOCN) textbook, “Core Curriculum for Wound Management.”

Most of us would like to pull the covers over our head and have someone wake us when the coronavirus pandemic is over. The constant news updates, social media bursts and even conversations with family and friends can make anyone uneasy or even fearful. It is understandable to feel overwhelmed. 

I challenge everyone to shift their thinking toward ways to protect your own health to lessen the risk that you will have medical emergency while our health care systems are overwhelmed with the coronavirus. For many of us, this means controlling what we can control. Our intentional physical and mental health practices have a direct impact on our overall health. A healthy body and mind have a stronger immune system to fight the corona virus; it’s that simple. 

If you have chronic health disease such as diabetes, high blood pressure, kidney disease, chronic blood clots or congestive heart failure, follow your prescribed physician protocols for medication, nutrition and exercise. Over 50% of patients with chronic disease neither take their medications as prescribed nor follow physician advice for diet and exercise. 

If you have chronic venous disease, chronic edema or if you have been told you are at risk for these problems due to genetics, medical history of blood clots / DVT (deep vein thrombosis), lifestyle or body habitus, it is important to maintain your leg health. Wearing your prescribed compression garments, walking 30-60 minutes daily, foot pump exercises, and elevating legs above the heart for 30 minutes 3 times daily is imperative to prevent complications associated with venous disease. Uncontrolled edema in lower legs places you at risk for new or recurrent blood clots, skin infection known as cellulitis or spontaneous ulcers known as venous ulcers. 

As a community, a nation and a world, we must support each other during this pandemic. We may not be able to physically come within 6 feet of each other due to the need for “social distancing”, but we can still communicate and be there for each other. Human connection is a basic need for mental health. Frequent phone calls, text messages, social media, video conferencing, email or even the old-fashioned written letter are all great ways to maintain family, friend and community relationships. I encourage you to balance your communications about the coronavirus pandemic with some shared laughs, movie or book recommendations and maybe most importantly positive encouragement about what you are doing to promote your own health and immune system with the hopes that you will encourage someone else to do the same. 

We’re all in this together; let’s all do our best to stay healthy together!

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My tips for promoting leg health huring the Covid-19 pandemic 

1. Wear your prescribed compression socks, stockings or wrap. Compression should be applied before you get out of bed in the morning and removed at bedtime, unless you are wearing a night garment.

2. Pamper your skin. Gentle skin care is a frequently overlooked component of leg health. When bathing, use a non-perfumed, liquid soap to help maintain the natural pH of the skin. At bedtime, apply a therapeutic moisturizer to your legs and feet. Let the moisturizer absorb into your skin overnight. These simple choices decrease the likelihood of skin breakdown with minor trauma. Moist, supple skin is harder to injure than dry, brittle skin.

3. Call a friend with legs positioned above your heart. Medically therapeutic elevation occurs when the legs are above the heart. A visual cue is to draw an imaginary line from your nose to your toes. Your toes should be at or above your nose.

4. Take a walk. Walk for 30 minutes to an hour. This does not have to be a brisk walk; a leisurely stroll is just as effective and allows you to stop and smell the roses! You can even walk around the house if you cannot get outside.

5. Inventory your compression socks, stockings and inspect your wrap. A single pair of compression socks, when cared for as instructed, is therapeutic for 6 months of daily use and washing. Develop a way to mark or organize your garments so they are removed from rotation once they are no longer therapeutic.

6. Read that book on your shelf that you’ve always wanted to read but haven’t had the time. In-between chapters, alternate exercising each leg by writing the alphabet in the air with your great toe acting as an imaginary pen. It’s harder than it seems!

7. Struggle with compression sock application and removal and would like a little help? Consider using a donning aid. Donning aids like rubber gloves, foot slips or other donning tools can help. You can find donning aids online if stores are closed. What previously took 5 minutes of struggling can literally be accomplished in seconds. You could also consider a inelastic wrap garment.

8. Exercise your calf muscles specifically. It is the contraction of the calf muscles that act in conjunction with your compression garments to promote venous return. Calf pump exercises include pretending to pump on a gas pedal, circling the feet, standing up and raising up onto your toes, and marching in place to name a few easy exercises. 

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Yvette Mier, BSN / RN / CWON, a well-respected nurse with over 25 years of experience in wound care and chapter author in the Wound, Ostomy, Continence Nursing Society (WOCN) textbook, "Core Curriculum for Wound Management." She presents regularly at national wound care conferences and is passionate about leg. She lives works in the Atlanta area.

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