Frequently Asked Asked Questions


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Home Care

Companion care refers to a type of home care that provides non-medical assistance to seniors or individuals with disabilities. It is distinct from personal care, as personal care aides, also known as home health aides, may perform similar tasks to companion caregivers, but may also assist with activities such as bathing, dressing, and managing medication based on state regulations.

Companion care primarily aims to provide emotional support and socialization to older adults, while also offering assistance with various tasks such as:


  • Light housekeeping
  • Other household chores such as washing clothing and dishes
  • Running errands such as grocery shopping
  • Planning and scheduling appointments and social activities
  • Transportation to appointments and other activities
  • Preparing meals
  • Socialization and entertainment
  • Communicating with family members and other care team professionals
  • And more

Companions make visits on a regular basis, tailored to the unique needs of the care recipient. Generally, weekly visits are the norm, though some older adults may require more frequent visits, up to two or three times per week or even daily, to assist with tasks like meal preparation and laundry.


Scheduling may also be affected by appointments, with companions adjusting their visits to accommodate outside appointments or arranging for alternate transportation if necessary.

Older adults who live independently may often feel lonely and isolated. Companionship can help alleviate this by engaging in conversation, going for walks, playing games such as cards or board games, and simply being there to listen and talk to.


Additionally, companions can assist by providing transportation to local senior centers, healthcare and therapy appointments, and other activities. By doing so, they not only help older adults stay active and engaged but also ensure that they receive essential healthcare services.

As individuals age, living independently in their own homes can become challenging as they struggle to manage daily household tasks. This can be due to a decline in mobility or cognitive abilities resulting from conditions such as Alzheimer's disease or dementia.


Often, families turn to companion care as the initial means of assistance to enable their elderly loved ones to continue residing in their homes.

Based on the 2016 Genworth Cost of Care Study, the median cost for homemaker services, also known as companion care, is $125 per day or $3,813 per month nationwide. Costs vary by state, ranging from a median of $96 per day in Louisiana ($2,908 per month) to a median of $175 per day in North Dakota ($5,331 per month).


It's important to note that your actual costs for companion care may differ from these averages, depending on your location and the number of hours of care needed per day. The national median hourly rate for homemaker services is $20 per hour, which represents a 2.56% increase from 2015.


Genworth's cost estimates are based on 44 hours of care per week. If your loved one requires only a few hours of care per day or week, your costs may be significantly lower than the estimates provided.


Some seniors may live with family members and only require a companion's help when no one else is available, while others may be mostly independent but require assistance with certain household tasks.


To get a better idea of potential costs, assess your loved one's needs and contact your local Area Agency on Aging to learn more about companion care providers and average costs in your area.

For older adults, companionship is essential, especially for those who live alone and struggle with leaving their homes. Companions provide various beneficial services, but it is the companionship itself that is the most crucial.


They engage in conversation, take walks, play games, and offer a listening ear, providing older adults with a sense of company and a break from loneliness and isolation.


In addition, companions assist older adults with transportation to appointments and activities, ensuring they remain active and engaged while also receiving necessary healthcare services.


Older adults and people with disabilities may also face challenges with everyday tasks such as laundry and dishes. Companions assist with light housekeeping, reducing the burden and improving their care recipient's quality of life.

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Non-medical or non-skilled home care mostly focuses on companionship and personal care services that allow people to live a better quality of life at home.

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An ostomy is an artificial opening in the body that’s created during an operation.

A stoma is the opening through the skin made during ostomy surgery. This is where the contents of your bowels or bladder will empty out of.


Some stomas are flush with the skin, but most protrude slightly.


Healthy stomas are nice and red, and they are all wet to the touch.

An ostomate is someone who has an ostomy.

An ostomy bag or ostomy pouch (often called a colostomy bag, although that only applies if you actually have a colostomy) is used to collect the feces or urine that comes out of a person’s stoma.


These are nearly always made of some type of plastic, although they come in many styles and sizes.

The wafer, which is also called a baseplate, is the part of an ostomy appliance that sticks to your skin.


The flange would be the part that connects your wafer to your ostomy bag on a two-piece system; one-piece systems don’t have flanges.

Generally, there should be no pain. The only time I’ve experienced pain with my stoma was after surgery (for a few months) and when I have a blockage.


If you’re having unexplained pain, you should talk to your stoma nurse or surgeon.

  • The insertion of a gastrostomy tube is overall a safe procedure including in the paediatric population. The most common complications include abdominal pain, peristomal infection (11%) and leakage (10%)
  • A single shot of prophylactic antibiotics is effective for decreasing peristomal infection post gastrostomy tube insertion
  • Percutaneous method of gastrostomy tube insertion is overall safer than surgically inserted gastrostomy
  • Radiologically and endoscopically inserted gastrostomy tubes are equally safe
  • Radiologically inserted gastrostomy (RIG) tube insertion carries a higher morbidity and mortality in head and neck
    patients ineligible for a endoscopically inserted gastrostomy tube
  • The rates of complication with the formation of gastrostomy are estimated in the range of 8–30% depending how a complication is defined. Acute and severe complications such as perforation, serious abdominal haemorrhage or peritonitis requiring significant surgical intervention is less than 0.5
  • Free air visible on X-ray is observed in up to 38% but significant intervention is needed in less than 5%. Pneumoperitoneum is not regarded as a complication unless there is evidence of adverse consequences
  • Buried bumper syndrome, a progressive impaction of the inner bumper of the tube in the mucosa of the gastric wall, is a rare long term complication of percutaneous endoscopic gastrostomy (PEG) insertion
  • Home-made formula including blenderised, pureed and vitamised foods are not recommended in adults and paediatrics patients due to increased risk of bacterial contamination and nutritional inadequacy. Home-made formula has been shown to have a higher viscosity , higher osmolality and inconsistent and uncertain nutrient composition when compared with commercially prepared formula
  • Commercially prepared formulas are recommended for enteral tube feeding
  • Commercially prepared liquid enteral nutrition formulas should be used in preference to reconstituted powdered formulas whenever possible as it reduces the risk of contamination
  • Dilution of enteral formula may affect osmolality and delay achieving nutritional targets
  • Do not dilute or mix anything into an enteral formula as it increases the risk of bacterial contamination
  • Avoid flushing a gastrostomy tube with substances other than those prescribed, including acidic fluids (fruit juices or carbonated drinks) due to increase chance of blockages.
  • Sterile water is advised for water flushes in immune compromised patients and patients in critical care. Tap water is acceptable for use in all other patient groups

Gastrostomy site selection is based on identification of transillumination at the skin surface. Although there is limited evidence, most experts favour placement on the anterior wall in the left upper quadrant towards the antrum. This theoretically lowers the risk of reflux.

It is recommended that prior to the administration of anything via the gastrostomy tube that the external length of the tubing (markings at skin level) is checked to ensure it has not changed since initial insertion. If the tube position has changed significantly, use the other methods of confirming the position.

A gastrostomy tube should be moved in and out and rotated 24 hours post initial insertion in order to avoid adhesion.

  • A distance of 2–5mm is recommended from external flange to skin level
  • Excessive tension between the skin and the external flange should be avoided as this can increase risk of stoma site complications
  • The minimum period of time from initial insertion of a gastrostomy to commence administration of
    enteral feed is:
    • 2–4 hours in adults
    • 4–6 hours in paediatrics
  • No evidence exists to support water (sterile or non-sterile) trials prior to the administration of enteral formulae


It should be noted that most studies are done with percutaneous endoscopic gastrostomy tube insertion versus radiologically or surgically inserted gastrostomy

Patients should be positioned at greater than 30-45⁰ from horizontal during enteral feeding and for 30–60
minutes post cessation of feed.

  • Initial gastrostomy tubes should not be replaced before 30 days post insertion. In the case of accidental dislodgement, tubes should be reinserted as soon as possible under endoscopy or image guidance. Gastrostomy tract maturation usually occurs within 7–10 days or up to 30 days in compromised patients i.e. malnutrition, steroid treatment etc
  • Replacement of a gastrostomy tube with a mature tract (>30 days) can be done blindly at the bedside by an adequately trained health care professional
  • Gastrostomy tubes (initial and replacement) should be monitored and changed as deemed necessary by the treating health care professional. Programmed tube changes are not necessary i.e. elective change at fixed period of time
  • Planned change of a PEG to a low profile device in paediatric patients is recommended 6–12 weeks post
  • The gold standard to confirm the position of a gastrostomy tube is gastrograffin radio contrast study or endoscopy
  • As the gold standard is not cost effective or always practical, confirmation of replacement gastrostomy tube position in a mature stoma (>30days) should ideally be done by using all of the following methods in combination
    • Aspiration of gastric content however this may be limited as the inability to obtain an aspirate does not always indicate tube is in incorrect position
    • Flush with 30–50mLs of water and ensure no resistance/pain
    • pH testing of aspirate (where available) with universal indicator paper to ensure pH <5. This method is unreliable if the patient is on gastric acid suppression medication or continuous enteral feeding
    • Confirmation of external length (if not low profile device)
    • Rotate tube and perform in out play to ensure free movement of tube in the tract
  • If there is any concern or doubt about replacement tube position, a gastrograffin radiocontrast study must be performed. This would include if firm resistance is encountered or several attempts are required to reinsert
    the tube
  • Air insufflation to confirm tube position is unreliable and should not be used
  • A gastrostomy tube should not be removed until the tract is mature (>30 days)
  • Always confirm the method of removal with the tube manufacturer via product information or contacting the company directly
  • Gastrostomy tubes with a collapsible internal flange can be removed safely by external traction/vigorous pulling at the bedside. However in paediatric patients, these tubes are commonly removed by endoscope to reduce trauma
  • Gastrostomy tubes with a rigid internal flange should be removed via endoscopy. There is a risk of small bowel obstruction with the cut and pass method, so it should not be used
  • Gastrostomy tubes with a balloon retention device can be removed gently using external traction at the bedside once balloon deflated

Gastrostomy feeding tube introducers should not be re-inserted into the feeding tube while the tube is in the
patient due to risk of tube perforation and serious injury

  • Foley catheters are not recommended as a replacement feeding tube. They do not have an external retention device increasing risk of migration and obstruction and are not designed to withstand gastric acid
  • If the gastrostomy tube is accidentally pulled and/or partial displacement of the internal bumper is suspected in an immature stoma tract, a gastrograffin radiocontrast study or endoscopy should be performed
  • If displacement is confirmed the device will need to be removed (as per recommendations in Question 2i) and replaced with the appropriate gastrostomy tube
  • For gastrostomy tubes with a mature stoma tract, preservation of the tract is the priority by replacing the tube as soon as possible and securing with tape. If the tube is not available a Foleys catheter can be used for this purpose
  • For replacement of a gastrostomy tube with a mature stoma, a balloon gastrostomy tube can be inserted at the bedside within the recommended window of 12–24 hours (before the stoma closes). This avoids the need for further endoscopy
  • Low profile replacement gastrostomy should be considered in patients who are at high risk of inadvertent tube dislodgement
  • There is no evidence to support recommendations for the bedside confirmation of partially dislodged tubes that may require replacement
  • All patients and their carers should receive pre-discharge education from members of the multidisciplinary team (MDT), including verbal and written information, on the management of their gastrostomy feeding tube
  • It is recommended that a standard checklist is used for education of patients before discharge. Hospitals should have a local policy to facilitate safe discharge of a patient with a new gastrostomy
  • Gastrostomy tube training and information should include:
    • Tube type including how it is held in place, balloon volume where applicable, how often it needs to be changed, how it will be changed and by whom
    • Checking stoma site daily to ensure no infection/redness/gastric leakage
    • Checking tube position daily (length at skin level) to ensure tube has not migrated into stomach
    • Tube rotation and gently move in and out daily
    • Check balloon water (where applicable): if deemed necessary and/or suitable according to local policy
    • Tube flushing to avoid blockage
    • Gastrostomy tube and stoma cleaning: wash daily with warm soapy water, rinse and dry thoroughly
    • No dressing is required
    • Infection control recommendations including hand washing
    • How to prevent and recognise complications including infection, tube blockage, tube dislodgement
    • Contact details including who to contact 24 hours per day and in an emergency
    • Follow-up arrangements
    • Community support group information for paediatric patients and their families

There is no evidence regarding undertaking water trials before starting enteral feeds via a gastrostomy tube

  • The evidence for checking gastric residual volumes (GRVs) in patients with a gastrostomy tube is lacking. Most research on GRVs is conducted in mechanically ventilated patients with nasogastric feeding tubes in the critical care setting
  • Checking of GRVs in patients with a gastrostomy feeding tube in the critical care setting should be managed according to local hospital policy. There is no evidence to recommend checking GRVs in patients with a gastrostomy tube outside of the critical care setting

What exactly is urinary incontinence? It’s the involuntary loss of urine, according to the National Association for Continence (NAFC). Although incontinence can happen at any age, it’s generally more common in seniors.


As you age, changes in the body can make elderly urinary incontinence more likely. One out of two women older than 65 experience bladder leakage sometimes, according to the Urology Care Foundation.


It can be caused by typical aging, lifestyle choices, or a range of health conditions.

From not drinking enough water to childbirth to a health condition such as diabetes, there are many different reasons behind urinary incontinence.

There are six common types of urinary incontinence:


  • Urge incontinence is the most common diagnosis, often referred to as an overactive bladder. It involves an urgent need to urinate resulting in the loss of urine before arriving at the toilet.
  • Total incontinence indicates your sphincter muscle is no longer workingIt results in constant and uncontrollable bladder leakage.
  • Stress incontinence occurs when an increase in abdominal pressure overcomes the closing pressure of the bladder. You may feel abdominal pain when you cough, sneeze, laugh, climb stairs, or lift objects. Stress incontinence is more common in women due to pregnancy and childbirth. However, it can affect men who’ve had prostate cancer or surgery.
  • Overflow incontinence occurs when your bladder never completely empties. Sufferers frequently feel the need to go and often leak small amounts of urine. This condition is often caused by an obstruction in the urinary tract system, or by a bladder that either has very weak contractions or isn’t able to contract at all.
  • Functional incontinence is incontinence caused by other disabilities. Neurological disorders, stroke complications, or arthritis can prevent someone from unzipping their pants quickly enough, resulting in an accident. People with functional incontinence feel the urge to urinate but aren’t physically able to plan or carry out a trip to the bathroom.
  • Mixed incontinence is a combination of more than one type of incontinence. People with mixed incontinence — especially women — usually have a combination of stress and urge incontinence. But people with severe dementia, Parkinson’s disease, or neurological disorders — as well as people who have had strokes — can have urge and functional incontinence.

If your elderly loved one suffers from urinary incontinence, self-care can help avoid complications such as skin rashes, urine odors, and accidents.


For cleaning, use a mild soap such as Dove. Petroleum jelly or cocoa butter can protect the skin. Make sure to pat the skin dry.

Helpful incontinence care products

Having the right products on hand will provide you and your loved one some peace of mind in urgent moments and ease the stress of incontinence care. Common products include:

Absorbent briefs

Waterproof, vinyl briefs

Absorbent booster pads and liners

Disposable washcloth and wipes

Penile clamp

Washable, waterproof bed pads

Absorbent bed pads

Oxygen therapy helps people with lung diseases or breathing problems get the oxygen their bodies need to function.


This oxygen is supplemental (additional) to what you breathe in from the air. You may also hear the term supplemental oxygen.

You may need oxygen therapy if you have:


  • Asthma, bronchitis or emphysema.
  • Chronic obstructive pulmonary disease (COPD).
  • COVID-19.
  • Cystic fibrosis.
  • Heart failure.
  • Lung cancer or other cancers.
  • Pneumonia.
  • Pulmonary fibrosis.
  • Sleep apnea.

People who live in or visit high-altitude areas may also need supplemental oxygen, including mountain climbers. Oxygen levels in the air are lower in high-altitude locations, which can lead to altitude sickness.

Oxygen therapy gives your body the oxygen it’s not getting when you breathe in air. You might think of it as a respiratory system aid.


When you breathe through your mouth or nose, your body takes in air. Air contains 80% nitrogen and 20% oxygen. Your lungs filter oxygen from this air. They then send oxygen through blood vessels to your organs, tissues and cells.


When you have lung problems, not enough oxygen reaches your cells to keep your body and organs working as they should. You develop low blood oxygen levels (hypoxemia). Over time, hypoxemia can lead to organ damage and organ failure.


Lack of oxygen can be life-threatening.

A healthy oxygen level (also called oxygen saturation) is 95% or higher. Healthcare providers prescribe oxygen therapy when oxygen levels drop below 88%.

Providers use these tests to measure oxygen levels:


  • Pulse oximeter - This small device painlessly clips onto your finger, toe or earlobe. Sensors in the device send light beams through your skin to measure oxygen levels in capillaries (tiny blood vessels). Many providers routinely perform this test at each appointment. You can also buy a pulse oximeter (pulse ox) at drugstores to use at home.
  • Arterial blood gas test - This test uses a blood sample from an artery to measure oxygen and carbon dioxide levels in your blood. This test is the most accurate method for determining lung function.
  • Lung function tests - Pulmonary function tests like spirometry measure how well you inhale and exhale air. Some tests also measure your lungs’ ability to send oxygen into your cells.

You can’t always tell when your oxygen levels are low. When symptoms occur, you may experience:


  • Shortness of breath.
  • Bluish tint to skin, lips and nails.
  • Extreme fatigue.
  • Severe headaches.
  • Coughing or wheezing.
  • Fast pulse and heart rate.
  • Confusion.

A tracheostomy (also called a tracheotomy) is an opening surgically created through the neck into the trachea (windpipe) to allow air to fill the lungs. After creating the tracheostomy opening in the neck, surgeons insert a tube through it to provide an airway and to remove secretions from the lungs.


The person with a tracheotomy breathes through the tracheostomy tube (trach tube) rather than through the nose and mouth. A tracheostomy may be temporary or permanent.

Patients who have undergone a tracheostomy or are using a ventilator for chronic respiratory illnesses or injuries associated with breathing difficulties would benefit from our services. This includes but is not limited to MS, ALS and COPD.

It is important for tracheostomy tubes to be kept clear and clean. Taking good care of your tracheostomy and ventilator will help prevent plugs or blockages, stave off infection, and aid in breathing.

The cost of hiring a private nurse for tracheostomy will vary depending on the level of assistance you need and the total hours of care. It will also depend on the nurse’s licensure, experience, and training.

Yes, a doctor’s order is required to hire a private nurse for in-home tracheostomy and ventilator care. An assessment by a nurse does not require a doctor’s approval, but any form of care does.

A ventilator is a machine that supports your breathing. Ventilators help get oxygen into the lungs and remove carbon dioxide. It makes breathing possible for people who have lost all ability breathe on their own.

Some need ventilator care because of treatable conditions including infection or malnutrition. In these cases, patients can be weaned from their dependence on a ventilator.


Other have chronic and long-term respiratory failure that is an irreversible problem. In these cases, staff will provide compassionate care and ventilator monitoring to ensure that residents enjoy maximum quality of life.

Our Respiratory Care Unit provides critical care to residents who are ventilator dependent. Our unit has concentrator oxygen and portable ventilators. This high acuity program benefits residents suffering from neuromuscular and pulmonary diseases, head traumas and strokes.


Our goal is to aid in preserving the stability of the resident and return them to the highest level of function or independence, if possible. Our program includes:


  • Pulmonary rehabilitation
  • Ventilator care and weaning
  • Education in disease management
  • Self-care instructions
  • Individualized physical, occupational, and speech therapies
    1. Keep the wound clean: The wound should be kept clean and free from debris, dead tissue, and bacteria to prevent infection and promote healing. Nurses should use sterile or clean techniques when cleaning the wound, depending on the type and severity of the wound.


    1. Manage wound exudate: Excess wound exudate can delay healing and increase the risk of infection. Nurses should use appropriate wound dressings to manage exudate and ensure that the wound remains moist and protected.


    1. Minimize trauma: The wound should be handled gently to minimize trauma and prevent further damage. Nurses should use soft, non-adhesive dressings and avoid aggressive cleaning or debridement techniques that could harm healthy tissue.


    1. Optimize nutrition: Adequate nutrition is crucial for wound healing. Nurses should ensure that patients are receiving a balanced diet that includes sufficient protein, vitamins, and minerals to support wound healing.


    1. Manage underlying conditions: Many underlying conditions, such as diabetes or peripheral artery disease, can affect wound healing. Nurses should work with other healthcare providers to manage these conditions and ensure that patients receive appropriate medical treatment to support wound healing.


    Overall, these five rules of wound care can help nurses promote optimal wound healing outcomes and ensure that patients receive the highest quality of care.

    1. Incised wounds: These are caused by a sharp object such as a knife or razor blade and are typically long and narrow.


    1. Lacerations: These wounds are caused by blunt force trauma and are often irregular in shape. They can occur when the skin is stretched or torn.


    1. Puncture wounds: These are caused by a pointed object such as a nail or needle and are often deep and narrow.


    1. Abrasions: These are superficial wounds caused by friction, such as a skinned knee.


    1. Avulsions: These wounds occur when a portion of the skin or tissue is torn away from the body, often as a result of a traumatic injury.


    1. Burns: These wounds are caused by heat, chemicals, electricity, or radiation and can range in severity from minor to life-threatening.


    1. Pressure sores: These are caused by prolonged pressure on an area of the body, often as a result of being immobile for long periods of time.


    It's important to seek medical attention for any wound that is deep, large, or shows signs of infection, such as redness, swelling, or pus.

A chronic wound is a type of wound that fails to heal properly within the expected time frame, typically within three months. It is often caused by an underlying medical condition or disease that affects the body's ability to heal, such as diabetes, vascular disease, or immune system disorders. Chronic wounds can be painful, debilitating, and increase the risk of infection. Examples of chronic wounds include pressure ulcers, venous ulcers, diabetic ulcers, and arterial ulcers. These types of wounds require specialized treatment and management by healthcare professionals to promote healing and prevent further complications.

A wound care nurse is a healthcare professional who specializes in treating and managing wounds. These nurses have advanced training in wound assessment, wound healing, and wound care management. They work closely with patients who have acute or chronic wounds, including surgical wounds, pressure ulcers, diabetic ulcers, burns, and other types of wounds.


Wound care nurses are responsible for assessing the patient's wound, determining the appropriate treatment plan, and monitoring the wound's progress. They may use a variety of techniques to promote healing, including dressings, topical medications, debridement, and other interventions. In addition to wound care, they may also educate patients and their families on wound prevention and self-care techniques to promote healing and prevent further injury or infection.

A wound care nurse is a specialized healthcare professional who is responsible for treating and managing wounds, particularly complex or chronic wounds that require advanced care. These nurses are trained to assess, diagnose, and develop treatment plans for a wide range of wounds, including surgical incisions, pressure ulcers, diabetic ulcers, and burns.


The specific duties of a wound care nurse may vary depending on their place of work, but generally, they are responsible for:


  1. Conducting a thorough assessment of the wound, including its size, depth, location, and surrounding tissue.


  1. Developing a treatment plan based on the patient's overall health status, the severity of the wound, and any underlying medical conditions.


  1. Administering medications, dressings, and other treatments to help promote healing and prevent infection.


  1. Monitoring the wound for signs of improvement or deterioration and adjusting the treatment plan as needed.


  1. Providing education and support to patients and their families on wound care techniques, infection prevention, and self-care.


  1. Collaborating with other healthcare professionals, including physicians, physical therapists, and occupational therapists, to ensure comprehensive care for the patient.


Overall, wound care nurses play a critical role in the management and treatment of complex wounds, helping patients to heal as quickly and effectively as possible while minimizing the risk of complications.



You will need a prescription for therapy from your doctor if you would like your insurance billed. You will need a referral if your insurance plan requires one.


On your first visit, you need to bring your prescription, your referral (if needed), your insurance card(s) and a government issued identification.

  • Patient's name
  • Contact phone number
  • Physician's full name
  • Insurance company name / type of insurance

We are open Monday through Friday 8:00 A.M. to 6:00 P.M.

We do send your doctor our initial evaluation and periodic progress reports on your recovery.


If any issues arise during the duration of therapy, our office will contact your doctor directly.

Every patient’s condition is unique. We provide treatment for patients immediately after an operation to manage open or sutured wounds, control hypertrophic/raised scars, and/or to reduce swelling. We can custom fabricate orthotic devices in our office, to help prevent further injuries or correct existing conditions. We help our patients manage their pain, de-sensitize injured tissues, and implement a customized regimen of exercises tailored to each patient.

The goal of our therapists is to help patients recover the use of their hands, or other areas of the upper extremity. We get to know the unique needs of each of our patients, including any issues relating to pain.


We strongly encourage patients to engage in an open discussion with their treating therapist, with any concerns regarding pain, levels of discomfort, or treatment as a whole. We focus on goals that will aid in patient recovery, allowing us to achieve a balance between discomfort and healing.

The amount of time you spend in therapy depends entirely on your individual condition. Some of our patients require only a few visits, while other patients can require several months of therapy.


On your first visit we will evaluate your condition and outline your specific program. Recovery begins at your first visit.

Treatment sessions are tailored to each individual and may be scheduled two to three times each week.


Session duration and frequency may change over time, but this is based entirely on your specific condition and the progress you make in recovery.

On average, your first session, which includes your initial evaluation, will last 1 - 1.5 hours. Subsequent visits average 45 minutes to 1 hour. These averages may change based on the nature and severity of your condition.

We encourage each patient to be involved in every aspect of their recovery - from learning and understanding about their condition, to setting personal goals within therapy. Your home exercise program is as important as your office visits.


If questions come up during your home exercise program, please call us directly so we can provide the necessary help between therapy sessions.

A patient may be given a customized regimen of exercises to be performed each day outside of office treatment, depending on the characteristics of their condition.


Successful therapy requires measured, and often frequent, use of your hands or other areas of the upper extremity.


This portion of your therapy is discussed, and often practiced at length in your treatment sessions.

Recovery can affect your entire household, as normal activities and behaviors can be altered during the process. This being the case, many of our patients find it helpful to involve family members in their recovery.


As every condition and patient situation is different, this is entirely up to you. We are happy to discuss ways to involve your family.



All children, with and without hearing loss, develop speech sounds (called phonemes) gradually.  HERE is a chart with norms for reference.  Some sounds, like /p, b, m/, come earlier, and others, like /r, z/, come later.  


In fact, it is perfectly within normal limits for a child with intact hearing and no other issues to continue to struggle with some of the harder sounds (sh, th, etc.) and not have mastered them until around age eight.  (Here is a good book, The Late Eight, that discusses these later-developing sounds.)  


Norms vary for speakers of other languages, and some sounds are present in one language but not in another (for example, /p/ does not exist in Arabic, so even adult speakers of that language may have difficulty distinguishing /p/ from /b/ if they learn English).


Children with typical hearing learn to produce speech sounds by listening to the speech around them and experimenting with their voices (vocal play, or babble) to try to replicate them.  At first, children produce sounds by “accident” — they’re just babbling.  Slowly, they learn that these sounds can combine to make words that have meaning, and they become more accurate at imitating the adult models they hear.


For children with hearing loss, we need to give them time to make up for the hearing and vocal play opportunities they missed as babies.  Remember, even if a child is amplified early, typically hearing children develop their auditory sense twenty weeks before they’re even born, so we have some catching up to do!


In general, for children with hearing loss, I like to look at hearing age when considering the child’s speech sound production.  If a four-year-old child has just received CIs, I would not expect to hear four-year-old sounds.  Rather, I would start from the beginning.  

Though it can be tempting to jump the gun and expect the child to produce age-appropriate phonemes, it’s important to remember that speech sounds develop in sequence for a reason.  Learning early sounds first builds the basis for the production of later, more complicated sounds.  Don’t cheat your child’s brain out of a strong foundation.

First of all, it’s in extremely poor taste to comment on another person’s speech or accent unless you’re the clinician they’ve hired to help them.  I understand that this is a question many people have, but please, please don’t ask it to the person with hearing loss’s face or discuss it with others behind their back.  After all, when’s the last time you learned how to talk without hearing?


Ultimately, we only speak as well as we hear.  With good access to the sounds of speech from the beginning, and auditory verbal therapy, people with hearing loss can learn to speak naturally and without articulation errors.  When people with hearing loss do not have good access to sound or appropriate intervention, or they get started too late with either of those components, speech quality can suffer.  


But here’s a secret I’ll tell you as a Listening and Spoken Language Specialist: I don’t worry about vocal quality.  With appropriate technology and intervention in place, barring other issues, it will come.  In terms of cognitive, social, and academic success, language is more important anyway.

Auditory Verbal Therapy is specialized for children with hearing loss because it focuses on growing speech skills naturally through hearing and training parents to be their children’s first and best teachers. 


 For children with hearing loss, not just any SLP will do.

Typically hearing babies learn speech through listening, not through looking.  With appropriate hearing technology, children with hearing loss can do the same.  Learning to speak through listening leads to more natural speech production that lasts.  


HERE is more information on why lipreading (and therefore, learning to talk by looking) doesn’t work.

When a child has a consistent pattern of errors, that is, their mistakes seem to follow a “rule” (like, “I always leave off the last sound in words” or “I always make sounds from the front of my mouth like /t/ instead of the back of my mouth like /k/”), we call it a phonological process.  


For these mistakes, as with all mistakes in children with hearing loss, suspect hearing first.  If the child does not have good access to sound, the ends of words can be inaudible, or soft sounds like /t/ get missed entirely.  


Of course you wouldn’t say it if you couldn’t hear it!  Eminent Auditory Verbal Therapist and author of Speech and the Hearing Impaired Child, Dr. Daniel Ling, includes in his book a list of perception errors that are often confused with phonological processes.  

Babble is the practice that we do to come to speech on our own through a process of trial and error.  Babies are incredible little scientists, playing around with their articulators (teeth, lips, tongue, etc.) and figuring out cause and effect (“Oh!  When I do this it makes a funny sound.”  “Oh!  I made that cool sound by accident.


 I wonder how I could do it again.”  “When I say it this way, it sounds more like Mom and people understand me.  I guess that’s how I’m supposed to say it.” etc.)  Without calling it formal “practice” or anyone ever teaching the baby anything, he learns to manipulate his articulators and builds his auditory feedback loop (the ability to listen to, monitor, and change his own speech).  


Babble progresses through stages of increasing complexity, from cooing/gooing (those baby oohs and aahs), to reduplicated babble (strings of the same sound, like “babababa”), to variegated babble (strings of a variety of vowels and consonants, like “bagidagu”), to jargon (a mixture of babble and some true words, like “Mommy, doggie bagadu”).


Given access to sound and a supportive listening and spoken language environment, children with hearing loss can have these important foundational babble experiences, too.

To answer this question, it is important to consider the age of the child.  Even for hearing children, it is normal to go through stages of baby babble before speaking words clearly.  As discussed above, there is also a sequence of speech sound development, so young children may not “have” all of the sounds they need to speak words clearly at a young age, and substitute others instead.  


This is completely developmentally appropriate.  A child’s “first true word” is really the first consistent label-object association he makes, whether or not the word is a perfect model of adult speech.  For example, if the child consistently calls the family dog, Barney, “Baba,” and uses that word to mean only Barney and nothing else, then that’s a true word for that child.


Would anyone outside the family understand it?  Probably not.  But the child has made a crucial connection that sounds/words are used to label specific things.  As children’s articulation and language skills grow and develop, they become easier to understand.  As a general rule of thumb, we aim for a child to be 80% intelligible (understandable) to an unfamiliar listener at age three.

This question comes up all the time, but what does the research really say?  While it’s tempting to see a child with hearing loss struggling with speech despite all our best efforts and label it “apraxia” in an effort to explain/exonerate/reassure ourselves, the research shows us that childhood/developmental apraxia of speech is grossly over diagnosed, to the tune of about 75% of cases being false positives.  


Why is this?  Partially, I think it’s the human tendency to look for answers.  Another factor could be that the majority of people who work with children with hearing loss still have an under-appreciation for the importance of audition and neural pathway development and rely instead on outdated information and methodologies.

 Always suspect hearing first.  


Finally, my theory is that we may be causing some of this problem ourselves:  Apraxia is characterized by “groping” movements of the mouth (e.g. the child aims to say a sound but his articulators are all over the place, missing the mark)… this may be an imitation of the exaggerated mouth movements that some parents and professionals mistakenly use, thinking that speaking in this manner will improve the child’s understanding and articulation (it won’t, and here’s why).  


We may also be seeing difficulties in articulation in children with hearing loss when we haven’t given them adequate time for listening and vocal play experience before launching into trying to get them to imitate words.  Regardless of chronological age, we need to give some time for auditory experience first.


Yes, there are certainly children out there who truly do have apraxia, and yes, some of those children might have hearing loss.  But, given the general over-diagnosis of apraxia in general combined with the tendency I see for professionals to use “apraxia” as code for “what I’m doing isn’t working, so…”, I am extremely cautious to come to this conclusion.  


Even scarier, to me, is the fact that once people get in their heads that a child has apraxia, the next common “wisdom” seems to be that Oral Motor Therapy is the next “logical” conclusion.

Parents continue to be told that non-speech exercises, like blowing a feather, smacking the lips together, holding up a cheerio with the tongue, etc., will lead to improvements in speech production because the child’s articulators are “weak” or “uncoordinated.”  


Let’s unpack this for a minute.  First of all, if you want speech, you practice speech.  If you wanted to be a basketball player, you wouldn’t practice moving your hands in the motion of dribbling without using an actual ball and think it would improve your skills.  You’d just be waving your hand back and forth at the ground.  


Secondly, the amount of strength and flexibility required for articulation is really, really low.  We call it the “50% Rule” — that is, if 50% of a structure is intact, you should be able to produce the sound.  This is why people who have had partial glossectomies (tongue removal, usually due to cancer), or lost a few teeth, or are elderly and very weak, are still able to speak.  You’re not lifting weights with your tongue.


Thirdly, even if great strength were required for speech (and it’s not), you gain strength by working against resistance until the point of failure (basic Workout 101 skill here).  Puffing your cheeks and licking your lips isn’t doing this.


So why do NSOMEs persist and why are parents constantly being suggested that they might just be the cure for what ails their children?  Sadly, it’s all about supply and demand.  Companies and ill-informed (and/or unethical) professionals continue to make money hand over fist providing these services because parents who don’t know any better are desperate for anything to help their children.  Parents who have already been through NSOME therapy may well believe that it has helped their children, but this is an anecdote about one child, not evidence.  


Given the current literature on the subject, it’s hard if not impossible to justify the use of NSOMEs, but it’s also hard if not impossible for us as humans to admit our mistakes.  Parents, upon finding out that they’ve been taken for a ride, feel justifiably hurt and defensive — they were just trying to do their best for their child!  Professionals, whether they used these exercises purposefully or inadvertently due to lack of knowledge, need to have the integrity to acknowledge their mistake, learn more, and change their ways.  But we’re human, it doesn’t always happen.  


It’s a lot easier to continue practicing the way you have for the past twenty years (and call your anecdotes of success “evidence” to justify it), than to face the evidence the harsh light of day.  Non-Speech Oral Motor Exercises to improve speech production are just not supported by evidence, and it’s frustrating to see how they continue to persist and be promoted, even at the highest levels of our profession.

Speech acoustics is the study of the acoustic (sound) properties of speech sounds (phonemes).  This chart shows were the different speech sounds fall relative to an audiogram of human hearing.  Note that some sounds appear twice on the chart.  


Why is this?  Sounds are made up of formants, different bands of energy that together are perceived as one sound (like a chord on a piano).  Speech acoustics analyzes the properties of each sound (where does it fall in terms of pitch and loudness) and relates that to a person’s articulation abilities.


 For example, if someone has aided hearing only through 3000Hz, it makes sense that they would have difficulty producing the /f/ sound because it is inaudible to them.  Likewise, many substitution mistakes that may be heard as articulation errors can, when viewed through the lens of speech acoustics, really be traced back to an issue with the hearing device’s programming, or a change in the person’s hearing status.  Remember, we only speak as well as we hear.

Listening and Spoken Language Specialists, whether they are SLPs by training or entered the certification route from some other profession (for example, teachers of the deaf and audiologists are also eligible to apply), undergo rigorous training and an exam that requires a thorough knowledge of spoken language communication and strategies for listening and spoken language development.  


They are eminently qualified to address articulation issues in children with hearing loss, especially because they have the expertise to address them with a rich background knowledge of speech acoustics and auditory development.  Some AVTs will address articulation within their sessions, and others will discharge to a general SLP if they feel the child has appropriate auditory skills but just needs some speech skill polishing.  


My preference, and my practice pattern, is to stick with the former option.  In the relatively rare cases where a child is caught up in all other areas except articulation by the time of discharge, I prefer to continue seeing that family for these goals because 1) they still need to be addressed from a place of listening first by someone who is listening-brain-oriented and 2) I believe that parent coaching is still critical to build lasting success with any skill, including articulation.


Auditory Verbal Therapy is more than just “listening skills,” and speech and articulation are certainly within the LSLS scope of practice.

Absolutely!  While it is important to have realistic expectations given your hearing and communication history, we only speak as well as we hear, so an improvement in in your hearing status can lead to improvements in your speech.


Having greater access to sound will give you a chance to build and refine your auditory feedback loop — the ability you have to hear yourself clearly and monitor and correct your own speech.  You’ll also be able to hear others more clearly, too, giving you better models.  


Some sounds, like f, s, or th, that you’ve never heard before (or never heard clearly) in your life, should be accessible to you with a cochlear implant.  Practice and therapy are key, but you may surprise yourself and your family and friends with the changes you see.  Who said you can’t teach and old dog new tricks?

The best way to know if your child needs therapy is to arrange an assessment with a speech language pathologist.

The assessment will be conducted in either of these two ways:


1.  Brief Screening - During a brief screening, the therapist will make observations of your child’s communication skills as well as obtain  background information from you. This takes approximately one hour.

If your concerns about your child are simple (e.g. "is my child stuttering?" or "does my child have a lisp?"), this is enough time for an experienced therapist to provide you with answers based on their observations.

However, if you have multiple or complex concerns (e.g. "does my child have a language delay and how severe is it?") this type of assessment will not be enough to obtain detailed results. 


2. Comprehensive Assessment -  During a comprehensive assessment, the therapist will gather background information from you and other sources such as your child’s classroom teacher.

The therapist will then make observations of your child’s communication skills. The therapist will also administer at least one norm-referenced, standardised assessment tool. 

These tools include established 'norm scores' reflecting what is expected from children at each age.
Comprehensive assessments usually take between two to four hours, and are often administered across more than one session.


The therapist will also write a report about your child’s communicative ability across all the areas assessed. A comprehensive assessment will provide you with a holistic and detailed understanding of your child’s communication skills.

The price for speech therapy in Bangkok ranges between 3,000 – 4,000 THB per hour. Some therapists may charge slightly less if you sign up for a package with them.

You should note that the above price estimate is not the same for assessments. The price for assessment sessions will depend on what type of assessment your child will receive (i.e. a comprehensive assessment or a screening), how much time is required to complete the assessment, as well as time required to write an assessment report.

A common misconception is that speech therapy is a ‘quick fix’, when in fact, it is a process which involves several steps. These steps include an assessment, goal setting, therapy, homework and follow-up sessions.

The duration of therapy required can’t be predicted accurately because it differs for each child. For instance, I have previously worked on the same goals with two children separately; while one child required only a few months of therapy, the other required therapy for over a year.

There are many factors which contribute to the duration of the therapy process including:

·        The types of communication areas requiring therapy
·        The number of communication areas requiring therapy
·        Your child’s ability to focus during sessions
·        Your child’s awareness and response to cues provided in sessions
·        The frequency of therapy sessions
·        The consistency of home practice

As therapy is an ongoing process, home practice should also be consistently ongoing. However, it is not practical to expect parents to complete hours of daily home practice.


I usually recommend 10 minutes of daily homework. Your child will benefit more from short but frequent home practice instead of long practice sessions.

Your role in the therapy process really depends on your own personal preference. However, as a parent, you should never underestimate the impact of your involvement.

Scientific research has even shown that some interventions lead to better outcomes when delivered by parents, compared to being delivered by a therapist.

Also, because no one knows your child better than you do, a therapist will always appreciate your input.

Your role in the therapy process can include:

· Referring your child for speech therapy services.

· Expressing what areas of your child’s communication you are concerned about. The therapist can then focus on these areas during the initial assessment.

· Collaborating with the therapist to develop goals. You can inform the therapist what you would like to prioritise in therapy. This can be broad such as the general area of therapy like speech sounds instead of stuttering, or very specific such as the production of ‘s’ and ‘z’ sounds.

· Being involved in therapy sessions. You can use the session time to practice doing what the therapist is doing with your child and as an opportunity to seek feedback about this.

Asking any questions or voicing any concerns.

· Providing feedback regarding any progress which you have observed.

· Consistently completing home practice with your child.

Swallowing therapy helps to restore function of the muscles involved in swallowing. 


Improving the range of movement and strength of the muscles can increase the ability to clear food from the mouth and throat, as well as improve closure of the airway when swallowing. 


Therapy can be an integral part in achieving the ability to eat ta variety of foods and liquids as well as avoiding or reducing the use of alternative means of nutrition (feeding tubes). 


Improvement of the swallow can allow for a less restrictive diet, such as moving from thickened liquids (smoothie consistencies) back to thin liquids (i.e. water, juice). Restoring swallow function can lead to a more fulfilled lifestyle.

Yes, for any food consistency that the Speech- Language Pathologist has determined to be appropriate and safe.  

Oral-motor feeding impairments include decreased oral strength, range of motion, or coordination necessary for eating. Sensory-behavioral feeding impairments consist of deficits in oral sensitivity and avoidance behaviors. 


A child may exhibit a hyposensitive (reduced sensory) or hypersensitive (increased sensory) response to different food textures. Symptoms may include pooling of food in the mouth, poor chewing abilities, a sensitive gag reflex, or an aversion to the texture for touching or eating certain foods. 


Avoidance behaviors can range from mild (turning head) to severe (screaming, crying and refusing food).


A therapist performs cupping by placing cups on the patient’s skin that create suction. Traditionally, the suction is created by putting a flammable substance in the cup, lighting it, then extinguishing the flame and turning the cup upside down on the skin.


As the warm air in the cup cools, it creates a vacuum effect, pulling the skin and tissue into the cup and increasing blood flow to the area. Cups are left in place for three to five minutes. Some modern therapists use a pump instead of fire to create the suction, but the effect is the same.


The maximum number of cups a therapist uses is usually between five and seven. For a first-time session, three to five cups are more typical, or even just one cup if the patient wants to first see how they will respond to the treatment.  

There are two common methods used for cupping:


Dry and wet.

Dry cupping is just as described above, while wet cupping involves another step. After removing the cup, the therapist makes tiny, shallow incisions on the skin and then replaces the cup for a second round of suction.


This draws some blood to the surface. The intent is to promote healing by releasing toxins and harmful substances from the body.

Cupping may be used as a complementary therapy to treat a medical condition or to promote relaxation and stress relief. These are some of the most common ailments that cupping has been used to treat:


  • Acne and eczema
  • Blood disorders like hemophilia or anemia  
  • Varicose veins
  • Migraines
  • Allergies and related respiratory issues like asthma
  • Depression and anxiety
  • Arthritis
  • Fibromyalgia

It is also used to achieve deep tissue massage, relieve pain and promote overall well-being. 

Cupping is considered a safe treatment, but patients may experience some side effects like mild discomfort, bruising and swelling at the site where the cups were placed.


A clean environment and a therapist trained in cupping can reduce the risk of any more serious complications like burns or skin infection. 

Cupping therapy involves placing cups, most commonly made of glass, but can also be made of bamboo or earthen materials. Flammable materials, such as essential oils or paper, are placed inside the cups, they’re ignited to heat the interior of the cups.


The flame is then extinguished and the cups are placed on strategic acupoints on the body – usually on the back and/or shoulders. 

When placed on the skin, the headed cups create a vacuum effect that pulls the skin away from the body, and thus the underlying muscles and connective tissues, improves blood flow to the areas where the cups are applied, and throughout the entire body, and helps to release and circulate stagnated toxins that are trapped in the tissues.


The increased blood flow and released toxins improve oxygenation, which promotes healing, reduces inflammation, and helps relax the muscles. 

Cupping can be used to treat a wide variety of ailments. Back cupping, for example, can help to loosen tight muscles and alleviate stiffness and pain in the upper and lower back. Cupping therapy can also be used to ease neck pain, as well as chronic pain conditions, such as fibromyalgia, and a whole host of other issues.


It can relieve migraines, reduce cholesterol levels, ease coughing, bronchial congestion, and asthma, ease the symptoms of anxiety and depression, improve varicose veins, minimize cellulite and stretch marks, improve digestion and relieve constipation, and it can even be an effective remedy for thalassemia and anemia.


Some say that it can help to boost fertility, too. Of course, it also promotes relaxation, and when you’re relaxed, you feel more at-ease, so cupping can also enhance your mood. 

Not really. Of course, you will feel a suction sensation, but you shouldn’t feel any pain.


In the event that your muscles are really tight and your tissues are very stagnant, you may experience a degree of soreness; however, it should be quite slight, and it should subside.


If, for any reason, you do feel any pain, let your therapist know, and they can loosen the strength of the cups to make you more comfortable. 

Once your session is complete, your therapist will remove the cups and you will be free to get dressed and return to your regular activities.


At first, you’ll see red marks where the cups where, and those marks will turn into reddish-purplish circular spots. The color will progressively decrease each day. On average, it takes about 7 to 10 days for the skin to return to normal. Make sure you stay well-hydrated after your session by drinking plenty of water.


Doing so will help to maintain circulation; plus, drinking plenty of water is always good for you, even when you aren’t cupping. 

If you’re an athlete and you’re making cupping a part of your training routine, scheduling an appointment for a session within about 24 hours of a serious workout is highly recommended, as you’ll want to give yourself a full day to recover from the therapy before you start working out or participating in your sport again. 

It depends on your specific needs and goals. If, for example, you’re an athlete and you’re actively training, frequent sessions may be your best bet; however, if you’re interested in detoxing and want to promote relaxation, once a month may do you well.


Speak with your therapist about your objectives and they will be able to advise you about the ideal frequency of sessions. 

As with all types of treatments – including natural therapies – cupping therapy may not be suitable for everyone. Generally, it is considered safe for the vast majority of healthy adults; however, for some individuals, it isn’t recommended.


For instance, those who have blood disorders, such as hemophilia, and cancer patients should avoid cupping. Cupping should also be avoided by those with heart disease or kidney disease or kidney failure.


Additionally, if you’re pregnant or you think you could be pregnant, cupping is not recommended. 

There are many different types of therapy cups that are used in cupping:


  1. Glass
  2. Plastic
  3. Bamboo
  4. Silicone
  5. Ceramic

Traditionally, bamboo and glass cups are used. Glass therapy cups have the greatest suction and ability to stay fixed on the body.

Typically, patients will feel some level of discomfort, but it is short-lived. 


If one does not feel the treatment at all, it is not yet working.

We go to great lengths to ensure safety. Results Physical Therapists have all passed their necessary board exams, and have an exhaustive understanding of anatomy.


In fact, Results physical therapists have four times more training and education than the national average for all physical therapists. We apply OSHA standards, use personal protective high-quality equipment, and proudly hold to the highest standards of safety.

There may be some soreness immediately after treatment in the area of the body that was dry needled. This is normal, although does not always occur. Occasionally, soreness develops a few hours later, or even the next day.


The soreness may vary depending on the area of the body that was treated, and also varies person-to-person, but typically it feels like you have had an intense workout at the gym. Occasionally patients will experience some bruising with this soreness.


A patient may also feel tired, nauseous, emotional,  and/or somewhat “out of it” after treatment. This is a normal response that only lasts an hour or two after treatment.

To decrease any chance of soreness following your appointment you should increase your water intake, soak in a hot bath or hot tub if possible, and/or use a heating pad on the muscle.

Results charges $40 per dry needling session, which is in addition to the cost of the appointment.


Insurance may cover dry needling in some instances, but typically it is an out-of-pocket expense.

No. Working out, stretching and massaging can all be done based on your comfort level.

We do not typically use dry needling at a patient’s first appointment unless they fit a classic “trigger point” presentation. We may introduce a patient to dry needling at an initial appointment, educating on the procedure, benefits, risks and side effects; and then use the procedure on subsequent visits. 


Results' dry needling patients average 2-3 sessions, and will not use more than 5-6 except in rare circumstances.


Often we will use dry needling once or twice per week out of 2-3 visits.


Not at this time. We only recommend dry needling as a part of a comprehensive physical therapy treatment program.


Dry needling is based on traditional, studied and tested practices of Western Medicine to restore normal muscle function. Traditional acupuncture practitioners’ follow Eastern Medicine's key principle of holistic treatment, and base their practice on "normalizing the energy imbalance," or Chi, in the body to cure syndromes.


Results prescribes dry needling within medically-proven and measurable parameters, in accordance with our advanced training in musculoskeletal function. Results therapists that perform dry needling therapy have successfully passed regulated board exams, and have a thorough knowledge of a patient's condition based on in-depth and ongoing assessments and treatment.

No. Each needle is discarded after use, consistent with medically approved standards and practices.

Graston Technique is an instrument-assisted soft tissue mobilization treatment. It’s widely known to be very effective in detecting and treating scar tissue.


Scar tissue, incidentally, causes pain and limits range of motion, both of which could prevent you from going about your normal activities.

This innovative technique, which is based on the works of an orthopedic surgeon named Dr. James Cyriax, makes use of six core tools. These tools are made from stainless steel in concave and convex shapes.


But don’t worry about the stainless steel part because the tools aren’t sharp but rather have round edges.


The technique uses cross-friction massage and re-introduces small degrees of trauma to the affected area. This increases blood flow, which begins and supports the healing process.

The practitioner will use the Graston tools to run over and “catch” on fibrotic tissue, identifying the area of restriction. The tool is then used to break up the scar tissue so that the body can absorb it.


Now some patients have reported some form of minor discomfort during this treatment and some bruising may also occur after the procedure.

The Graston treatment is generally given for a period of four to five weeks. Patients get two treatments every week.


But according to the Graston site, patients usually experience results by the third or fourth treatment.


Graston can treat acute and chronic conditions such as carpal tunnel syndrome (CTS), Achilles tendonitis, cervical strain, fibromyalgia, illiotibial band syndrome, knee pain, plantar fasciitis or foot pain, shin splints, trigger points, tennis and golfer’s elbow, and post fracture pain.


Graston reduces overall time of treatment. It cuts down on having to take anti-inflammatory medication. It’s known to resolve chronic conditions that once were thought to be permanent. And it supports speedier recovery or rehabilitation. For more information about this innovative treatment, ask your specialist today.


Now and then, you’ll hear about some newfangled treatment for pain. Naturally, this bodes well for you if you happen to be suffering from carpal tunnel syndrome (CTS) because of your job or shoulder pain from playing a rough football game.


Any opportunity that allows you to get relief from the physical suffering is certainly good news. And that opportunity could possibly come from Graston.


If you’re unfamiliar with Graston, you may be wondering about several things: what is it exactly or how is it done. So here are just five of the most frequently asked questions about this innovative treatment.

Kinesiology tape (k tape or kinesiotape) can be used for many and various injuries and complaints. It accelerates the self-healing ability of the body, provides support, stability and allows full range of motion.


Kinesiology tape is an elastic cotton tape with an hypoallergenic, acrylic adhesive layer. It has been designed to mimic the skin in terms of elasticity and thickness.


The kinetic tape is made of high quality materials, adheres to the skin for 3 to 7 days and is water resistant Kinesiology tape can be used throughout the entire healing process. Kinesiotape is successfully being applied to athletes when treating sports injuries.

• High quality cotton materials
• No additional medications used in manufacture
• Elastic therapeutic tape with a stretch ability of 130 to 140% (attributes similar to the human skin)
• Air and water permeable but resistant to water (showering, swimming)
• 100% hypoallergenic acrylic adhesive layer, arranged according to a wave pattern and activated under the influence of body heat
• CureTape® can adheres for several days
• Kinesiology taping is actively treating patients 24 hours a day

The elasticity of kinesiology tape has been designed to mirror the elasticity of the skin. Applied correctly, kinesiotape mimics the elasticity of the skin therefore influencing various subcutaneous structures.


In the hands of a trained skillful therapist differing techniques can be used to correct and adapt physiological structures, such as microcirculation, neuroreceptors, lymph vessels and the fascia.

Because kinesiology tape can be applied in a number of ways and due the fact that a variety of physiological structures can be influenced, the Medical Taping Concept has numerous fields of application.


Once the clinician has assessed whether the deficit in the muscles ability is length or strength related, specific muscular taping can be used to normalize muscle function. Joint function can be corrected or stabilized by using techniques that work more on connective tissue.


Specific lymph taping can stimulate lymphatic function to reduce oedema and haematomas. Through a segmental approach taping can be used to influence internal organs and both the sympathetic and parasympathetic nervous system

Multiple taping techniques combined simutaniously in a therapists daily practice frequenty bear the best results in normalizing a patients biomechanics.


Other possible indications for taping would include: complaints due to overload, deviations in posture, sports injuries, menstruation problems, growing pains and bone contusions to name a few.

Within a range of CureTape®, for example CureTape® Punch, the base of the kinesiotape is identical but only a different dye bath is used to create the various colours of kinesiotape. The hypoallergenic adhesive properties used in CureTape® Sports enable this tape to endure longer but the base tape is the same.


Originally, the colours were chosen on the principles of ‘Colour therapy’. When applying coloured kinesiology tape, an aesthetic choice is often made in practice. Sometimes a therapist may use a certain colour for structural taping to support a joint and then a different colour to strap a muscle or simply you may use a ‘beige’ colour to tape with more discretely.

No pharmaceutical properties have been embedded in kinesiology tape. The positive effects achieved by using kinesiology tape are largely the result of Thysols R & D testing and the skillfull application of kinesiology tape to the patient.

Yes, kinesiology tape can get wet. CureTape® kinesiotape has been designed to be water-resistant so showering, swimming and bathing can continue as normal. The cotton in kinesiology tape does absorb some water so after showering or swimming it is advisable to ‘dab’ dry kinesiology tape with a towel.


The way kinesiology tape adheres to the skin happens as body heat stimulates the adhesive hypoallergenic material in kinesiology tape to become tacky and affix to the skin. Therefore it is not recommended to use a heater or hair dryer to dry kinesiology tape as this may cause a skin reaction. Sunbaking or using a sunbed with kinesiology tape are also better avoided.

Kinesiology tape does not adhere well to greasy or oily substances such as body creams, lotions or massage oil.


The use of cream rinse can also reduce the adhesive strength of kinesiology tape in shoulder or neck applications. Generally for best application the skin must be cleaned and degreased before taping.


Good practice would direct the therapist to place a small test patch of tape on the inner forearm to test for reactions to sensitive skin although reactions are rare.


Another option for very sensitive or thin skin is to use 3M’s Cavilon spray beforehand. This spray creates a protective film on the skin, preventing skin reactions. This film layer is slightly sticky, so that kinesiology tape will stick even better.

For best effects kinesiology tape should adhere directly to the skin. If there is too much hair, kinesiology tape will lie on the hair which can hinder or limit potential results. Removal of kinesiology tape from hairy bodies also obviously can generate some discomfort.


If the patient or therapist can shave or trim the area to be treated prior to application would prove sensible.


In some cases care would be taken not to remove too much hair to avoid folliculitis or wounds. In this case a trimmer would be recommended.

Kinesiology tape is not sterile and therefore cannot be applied over damaged skin. It is highly recommended to tape adjacent to the wound to accelerate and promote wound healing.

You can only tape scars after the wound is closed and able to take the load of tensioned tape.

Post radiotherapy sufficient time must have elapsed for the skin to recover before applying tape. According to the protocol, the first six weeks after the end of the radiation taping should not occur. Each patients healing rates will differ so clinical discretion must be used to determine when it is safe to apply tape.

Yes, CureTape® Classic (medical tape) and associated Thysol kinesiology tapes (CureTape® Sports, CureTape® Punch and CureTape® Art) are made of hypoallergenic material. CureTape® is made of high quality cotton, through which latex-free elastic fibers are woven.


A 100% acrylic adhesive layer is used, which is also well tolerated by people with a allergies to elastic plasters. The adhesive layer is woven in a wave pattern, so that the skin can breathe and body fluid can pass through kinesiology tape.

Occasionally skin irritations and allergies can occur in practice and are often due too:


  • Technique errors, such as too much stretch on kinesiology tape or skin folds stuck to kinesiology tape;
  • Sometimes due to the patients medications e.g., blood thinners;
  • The incorrect removal of tape
  • Sometimes we perceive there is a problem when there is not. E.g., kinesiology tape has a normalizing effect on the blood flow so if a reddening of the skin is observed it may not be due to irritation.
    Occasionally a sympathetic overreaction of the body can occur;
  • In all cases if there is any doubt please remove kinesiology tape!

Kinesiology tape should be removed calmly and carefully, to prevent skin irritations or skin damage, kinesiology tape is not a band aid.


Effective removing kinesiotape:

  • Determine the direction the hair is growing. Soak kinesiology tape well with a food grade cooking oil before removal process. Support /pin the skin adjacent to where you wish to start removing tape. Pull slowly but firmly in the direction of hair growth (away from the area of skin you are supporting/pinning and parallel to the skin (you will need to reposition your support/pin hand as tape is removed).


  • For more vulnerable skin or children: rub kinesiology tape with (baby) oil, let the oil drain well. This will easily release kinesiology tape.


  • Another useful tool is Sterilium. Let it soak in for a short time so that the adhesive layer has a chance to soften or dissolve before removing kinesiology tape.
    Use of irritants is not recommended if there is a lymph problem.

For a positive result, it is necessary fully understand your condition and the technique of kinesiology taping that best applies to the condition.

Improper use can cause a counterproductive effect or even create a new problem! We recommend that you only tape yourself after a thorough explanation and good instructions from a therapist with sufficient taping experience.


If in doubt you should always contact a physician who has sufficient knowledge of the Kinesiology Taping Concept.

Kinesiology tape may remain in place as long as it adheres. On average, a tape will last for 4 to 6 days. Applications with a hand or foot may release more rapidly which is also the case for oily skinned patients.


Kinesiology tape absorbs the skin heat and adheres optimally after about half an hour. Dressing for the first time must therefore be done carefully to prevent the ends from coming loose. Once kinesiology tape has reached skin temperature, the vulnerability when dressing or undressing declines.


Tip: after applying kinesiotape, rub kinesiology tape with talcum powder. The talcum powder adheres to the edges of the kinesiotape so that kinesiology tape does not stick to the clothes.

Some kinesiotaping techniques, as with massages, are highly beneficial during pregnancy, yet also some techniques may stimulate body function.


So it is always recommended during pregnancy to err on the side of caution and seek professional advice prior to pregnancy kinesiology taping.

Manual therapy is a primary modality of physical therapy. It is a skilled application of hands-on techniques by skilled clinicians to manipulate soft tissue, joints, and nerves.


Manual therapy is important for multiple body systems, because hands-on manipulation can be very effective to decrease pain and tissue tension, improve quality of movement, and guide a patient through their exercises.

For example, let’s say you are having stiffness in your hip. During your sessions in the clinic, your therapist may employ manual therapy techniques like joint and soft tissue mobilization and/or massage to improve your range of motion and decrease stiffness and discomfort when you walk. 


Your therapist will assign exercises and stretches that you can complete independently, but manual therapy techniques applied by a skilled therapist can take your treatment to the next level.


Unfortunately, not every physical therapist will use manual therapy in your treatment - application depends on your sensitivity, your stage in the healing process, and the potential benefits of the technique. 

Manual therapy has many benefits, including reduced pain, reducing stress and strain, increasing joint mobility and soft tissue health, increased blood flow, and reduced inflammation.


Along with appropriate exercise progression, the addition of manual therapy to your treatment is a great way to ensure that you return to what you love faster. Your joints and tissues are designed to function as a balanced system, and when dysfunction occurs, manual therapy can be a great way to begin restoring normal movement patterns.


Let’s use headaches as an example. During your evaluation, your therapist may identify areas of joint & tissue stiffness and associated areas of weakness. Based on their findings, the therapist would apply manual techniques to your spine to restore movement and decrease pain.


Additionally, your therapist would apply manual exercise progressions to promote strength and stability in weakened areas. Your therapist can give you stretches to do all day long, but when the stretches are combined with manual techniques, you should have a quicker response and decreased headaches. 

Manual therapy is great for joints that are not moving or muscles that are extremely tight. For example, a hip flexor release is a common technique that loosens the muscle that runs from the front of the spine/pelvis down the thigh, or the hip flexor.


This muscle may tighten while sitting for long periods of time, which can result in back pain. In order to get the most out of stretching the muscle, your therapist needs to manually release the muscle through soft tissue mobilization/massaging. 


Manual therapy can also be very effective in treating shoulder pain. There are many conditions that can cause pain or reduced function in your shoulder, especially poor posture or overuse. Exercises can get you a long way, but manual joint & soft tissue techniques are needed to restore full range of motion. 

Because manual therapy by a physical therapist involves a hands-on approach, many could confuse it with chiropractic care or massage therapy. But there are some critical differences between each practice. 


Both physical therapists and chiropractors must attain clinical doctorates in their respective fields and must be licensed to practice by their governing boards.


While physical therapists perform manual therapy techniques with the goal of establishing pain-free movement, chiropractors perform spinal adjustments primarily to treat underlying medical conditions and restore spinal alignment. 


1. Chiropractors -  focus on issues stemming from spinal imbalances, such as back pain, neck pain, and headaches, and they may use specialized equipment in their practice. Physical therapists’ treatment expertise lies in restoring functional movement, decreasing pain, and preventing injury through manual techniques and prescribed exercises. They can practice in a hospital, in a hospice care setting, or in an outpatient clinic.


2.Massage therapists - typically require a license from most states to practice, which requires a certain amount of clinical hours and an associated degree from an accredited massage therapy school, but there is no prior college degree required. Both massage therapists and physical therapists manipulate soft tissues and muscles, but the primary goal of a massage therapist is relaxation. Physical therapists, through their advanced education and clinical training, are licensed to use hands-on interventions in order to rehabilitate an injury or medical diagnosis. 

 Manual therapy can be an essential component of many physical therapy treatments, it may not be right for every patient. Medical conditions that require improving stability might need a treatment that does not involve manual therapy, such as joint hypermobility.


Other conditions such as osteoporosis might not benefit from manual therapy due to lower bone density and the inherent risk of fracture. There are many other conditions that your therapist should be aware of before applying manual techniques.


Techniques are always applied with the intent of reducing pain and improving function. Treatments can range from gentle soft tissue mobilization/massage to reduce swelling, to increased pressure on specific joint structures to improve range of motion. If any technique is painful, your therapist should be able to adjust it so that you are not in any discomfort.

For example, if you have shoulder pain and loss of range of motion, your therapist may begin with gentle soft tissue techniques/massage to reduce pain and relax the shoulder muscles. Then, they might follow with a joint mobilization technique to improve range of motion and shoulder function.


Your therapist should always be monitoring your tolerance to any technique. If you cannot relax during the treatment, your therapist will move toward a less painful technique. 


On rare occasions, some patients are not as comfortable with being touched. Whether it is part of your personality or personal preference, your therapist will work with you and make sure you are comfortable while still getting the best possible treatment. 

At EW Motion Therapy, all of our therapists are trained in manual therapy techniques, so we can incorporate them into your treatment and help you feel better.


If you have more questions about manual therapy, fill out the Request an Appointment form on our website, and a member of our staff will contact you with the next steps. 

Of course, all patients have the right to choose where they attend physical therapy.

We work diligently to coordinate our services with all medical doctors and other healthcare professionals.

A quick no-cost assessment will be able to determine if PT is right for you. If PT is not appropriate, we will not waste your valuable time or insurance expenses.


However, we pride ourselves on helping our patients achieve their maximum function and pain reduction. So if we can help, we will be more than happy to assist you.

Normally, we can accommodate same-day or next-day appointments.

This would have to be addressed with your surgeon, but research shows that a patient’s preoperative status directly affects their postoperative outcome.


The therapists at Elite Physical Therapy can help you reach your optimal pre-op status.

Although a home program does not replace an active physical therapy program, you can stop by for a free assessment and an exercise program can be provided.

Yes, we do. Workers’ Compensation and no-fault claims involve a lot of paperwork, and many PT practices do not want to be hassled with the extra work.


The staff at Elite Physical Therapy is highly trained in dealing with these types of claims and has a close relationship with many of the insurance claims adjusters, which helps expedite your claim.

Generally, ice is used for most injuries. If your injury is new, you should ice it three to ten times per day for 15 minutes each time, depending on the amount of inflammation.


Hot packs can be used for arthritic conditions only. Do not exceed 15 minutes three times per day.

Yes, we do. Elite PT is an area leader in postsurgical rehabilitation.


We treat a variety of orthopedic surgeries, including ankle reconstruction, knee replacement/ACL and ligament tears, hip replacements, open reduction of fractures, back and neck fusions, discectomies, laminectomies and disc replacements, rotator cuff and labrum tears and ulnar nerve and medial nerve (carpal tunnel syndrome) releases.


With state-of-the-art equipment and some of the most highly trained PTs in the area, you will receive top-notch postoperative care at Elite Physical Therapy.

Come on in. We carry a large supply of bracing for ankles, knees, backs, necks, shoulders, elbows, wrists and hands.

Yes, we can. In fact, Elite Physical Therapy specializes in treating youth athletes ages 7 to 21. Our Return to Play program was designed to address this common need in young athletes.


Sometimes the injury can be corrected with a simple brace or taping; other times a more active treatment plan is needed. With our help, your child will be back on the field as quickly as possible, without sacrificing safety or risking further injury.

As a matter of fact, Elite Physical Therapy is the only facility in the area to have a structured program for preseason strength and conditioning. We are also the only facility that specializes in athletic training. Our Step Your Game Up program is a six-week sport-specific strength and conditioning program designed to increase athletic performance.


A trained and licensed physical therapist can assess an athlete’s physical need like no other professional can. Chad Cardillo (PT and owner of Elite PT) is certified by the American Sports Medicine Institute to train and treat youth athletes. We have the tools to unlock your child’s athletic potential!

Our Elite Athletic Assessment is designed to evaluate persons of all ages and abilities who wish to partake in athletic or other physical activities. This assessment can identify any orthopedic condition, muscle or postural imbalances and level of conditioning that may need improvement.


It will provide our specialists with the information they need to develop a program that will help you in your desired sport or activity. This service is not available at any health club or other PT facility.

Commonly Treated Conditions Include:


  • Knee Replacements
  • Hip Replacements
  • Rotator Cuff Repairs
  • ACL Reconstructions
  • Shoulder Arthroscopy

Therapy is at its core a type of preventative care. The primary goal of this type of care is to prepare the body as much as possible for the demanding aspects of surgery. 


To give an example of how pre-surgical physical therapy would be highly beneficial, consider the prospect of a reconstructive knee surgery. If you knew you were going to have this surgery, a physical therapist may prescribe a few months of physical therapy highly focused on maximizing the strength and flexibility of the knee.


This would help ensure the knee has a high baseline of health before it is operated on and must recover.

Once a surgery has been concluded, ideally a patient will already have a schedule of appointments ready to begin the post-surgical phase of rehabilitation.


If the pre-surgical phase of physical therapy has been completed, it would be doubly wise to begin post-surgical as soon as possible to hit the ground running to take advantage of the strong foundation built beforehand.


Post-Surgical physical therapy can maximize the chances of a successful recovery and positive health outcomes through:


  • Assisting muscles re-strengthen
  • Making sure that the joints achieve a proper range of motion
  • Alleviating post-surgical discomfort by re-establishing circulation in the affected body parts
  • Re-training muscles that may have been unusable prior to surgery
  • Preventing the buildup of scar tissue that may inhibit recovery

The purpose of pre-operative physical therapy is to get a patient more ready for surgery. Of course, this can mean meeting a large number of needs. The better physically and mentally prepared you are for an operation, the better your outcome will be.


If you're going in for any surgery that will require post-operative physical therapy, pre-operative PT will benefit you. Partial and total joint replacements, stress fractures, tendinitis surgery, and meniscus repairs are a few examples of these types of operations.


Physical therapy as part of pre-operative care can make joints more flexible, meaning it'll be easier to return to regular movement after surgery. It can also improve circulation at the targeted area of the body, which goes a long way in the healing process.

Post-operative physical therapy aims to get a patient who's undergone surgery healed and back to their regular level of functioning. A physical therapist will help a patient who needs post-operative PT to cope with pain, rebuild muscle and joint strength and stability, and overall assist in their recovery.


JAG-ONE PT specializes in physical therapy care following total hip and knee replacements, arthroscopic repairs, bone fracture repairs, and surgery for intervertebral disc issues, among many others. Our physical therapists understand that following your surgery, you want and need to be mobile.


We'll come up with a customized plan for your needs that may include isometric exercises, gait training with assistive devices, assistance in standing, sitting, and movement, and other interventions that may be right for you.



Vitamin B12 is a key nutrient for the body to produce Red Blood Cells and maintenance of your central nervous system.  By administering B12 IV, it can have immediate effect in the body without having to be absorbed through the gut.


By infusing it directly into the blood circulation, cells are able to utilize B12 for cellular maintenance.


Vitamin B12 booster shots & vitamin injections enhances the rate of you feeling reenergized. Set up a consultation today and we'll schedule with you at your convenience.

B12 is a key nutrient for the body to produce Red Blood Cells and maintenance of your central nervous system.  


By administering B12 IV, it can be utilized by body quickly and without having to be absorbed through the gut.  IV B12 can also help the client experience an increase in energy and metabolism.

Yes. It is often used to fortify the body as one of the nutrients in a Vitamin infusion.

Anywhere from 45-60 minutes depending on volume and IV placement.

B12 as an add-on to an infusion can be $10. 

B12 shots are absorbed after injection for 5-10 days. How long it lasts in the body varies and depends on the deficiency.

Frequency depends on what your goals are. Weight loss can require injections twice a week, whereas general wellness can be once a month.  


If treating B12 deficiency, injections can be administered once a week for 4 weeks followed by once a month. 

Having more energy and feeling good!

B12 being infused is extremely safe. Shots and IV infusions carry a small risk for adverse issues, but the risks are not associated with B12.


The risks are associated with the IV insertion, existing medical issues, and administration of the infusion.

When using B12 injections for weight loss, a patient can safely receive 1 or 2 injections per week.


When working with a medical professional, B12 can be paired with other injectable nutrients to maximize metabolism and energy production.

B12 absorption in the gut can be affected by certain medications. B12 injections bypass the gut and get superior absorption for use.  


In short, there are no medication reactions to note.

B12 can certainly help in losing weight by boosting metabolism and energy levels.

Feeling worse after a B12 injection is exceedingly rare.  


Potentially you may not feel any effect from a B12 injection, but that is usually because of an inability to convert B12 into a usable form.


LIVation specifically uses Methyl cobalamin, which is a usable B12 that the body can start using immediately.

Depending on dosing, $25-35.

Intravenous (IV) vitamin therapy (also known as intravenous micronutrient therapy and hydration therapy) is a way to give high concentrations of vitamins and minerals directly into the bloodstream, allowing rapid absorption of higher doses of the vitamins and minerals than if the person got them through food or supplements.


  • These liquids are delivered through a small tube inserted into a vein.

  • The infusions typically take 20 minutes to an hour, depending on the volume of the cocktail and the size of the person's veins.

  • IV vitamin therapy is touted by many celebrities and is available at many IV bars, drip bars, and IV lounges.


The Myers' cocktail is a popular formula among complementary and alternative medicine providers for IV vitamin therapy.



  • The Myers' formula consists of high doses of B vitamins, vitamin C, and minerals (magnesium and calcium) mixed with sterile water.


  • Dr. John Myers developed and administered the first IV vitamin treatments in Baltimore in the 1970s.


  • Any vitamin or mineral can be infused intravenously, and some doctors who administer the infusion have changed the amounts of the vitamins in the Myers' cocktail (this is called the modified Myers' cocktail). Some doctors have also individualized doses for frail, older people and children.
IV vitamin therapy is supposedly best used for people who cannot get enough vitamins and minerals because they cannot eat enough food or an illness prevents them from absorbing nutrients.
However, in contrast, some advocates claim that IV vitamin therapy can enhance wellness even in people who do not have vitamin (or mineral) deficiencies.
Clinics and companies offering the Myers' cocktail and other high-dose IV vitamin formulations claim that these infusions can do the following:
  • Treat dehydration after extreme exercise or too much alcohol intake
  • Boost the immune system (although what this means or how this could be done is not clear)
  • Increase levels of energy and reduce fatigue
  • Relieve stress, anxiety, and depression
  • Eliminate toxins from the body
  • Make skin healthier
  • Treat hangovers and headaches
  • Treat asthma, allergies, chronic sinusitis, high blood pressure, fibromyalgia, diabetes, heart disease, acute muscle spasms, and Parkinson disease
  • Treat migraine and tension headaches
Sellers of IV vitamin therapy also claim that infusions are better than dietary sources of the vitamins because
  • The infusions can be given to people with various food sensitivities.
  • Large amounts of vitamins and minerals are delivered directly into the bloodstream, so they have a more direct path into the cells and mitochondria, where they allegedly have beneficial effects.

Very few studies have tested the effectiveness of the Myers' cocktail or any other form of high-dose IV vitamin therapy in people who do not have a vitamin or mineral deficiency. (Also, no published evidence so far has shown that this therapy is effective for any serious illness or chronic disease.)


Thus, evidence is mostly anecdotal, meaning that it is limited to people's personal remembrances. Anecdotal evidence is generally not considered strong evidence.


  • Injections of individual vitamins or minerals are evidence-based treatments for people with deficiencies of these nutrients or to manage the side effects of certain drugs.

  • But evidence also shows that the best way to obtain needed vitamins, minerals, and other nutrients is through the diet, with only occasional exceptions (for example, sometimes iron or vitamin B12).

  • The few studies that have been done were small, did not include a placebo group, or showed that the infusions were not more effective than placebo.

In 2018, the US Federal Trade Commission (FTC) charged a company marketing and selling the Myers' cocktail and other IV vitamin and mineral infusions of making "deceptive and unsupported health claims" about the ability of these infusions to treat such diseases as cancer, multiple sclerosis, diabetes, fibromyalgia, and heart failure.


  • The FTC argued that these health treatment and efficacy claims were false or not supported by competent and reliable scientific evidence.

As with any IV treatment, IV vitamin therapy can make the body more vulnerable to infection and can cause blood clots, and burning sensations at the injection site.


  • In people with abnormalities in blood levels of magnesium or potassium (for example, caused by kidney disease, use of diuretics or excessive use of alcohol) infusions containing magnesium (or, less commonly, potassium) can cause problems such as abnormal heart rhythms or muscle weakness.

  • In people with heart conditions or high blood pressure, a high-dose vitamin infusion could lead to fluid overload, which could temporarily, but occasionally permanently damage the kidneys, brain, and/or heart.

  • If the infusion is administered too quickly, it can lower blood pressure (probably due to the magnesium), which can lead to light-headedness and fainting.

  • According to a few study reports, infusions of the Myers' cocktail or another combination of vitamins and minerals can lead to symptoms of depression, insomnia, and upset stomach.

  • Excess amounts of vitamins and minerals can be harmful. For example, large IV doses of thiamine, a B vitamin, can cause anaphylaxis, a potentially life-threatening allergic reaction. Also, high doses of vitamin B6 may cause damage to peripheral nerves (peripheral neuropathy).

  • The safety of IV vitamin therapy in pregnant and breastfeeding women has not been studied.

Which drugs interact with IV vitamin treatments depends on which vitamins and minerals are infused and their doses. A few examples of interactions are listed below:


  • Intravenous vitamin B6 can lead to poorer responses to drugs taken to stimulate the production of blood cells (for example, erythropoietin, epoetin alfa, and darbepoetin alfa), often used in people with chronic kidney disease or cancer.

  • Magnesium may interact with antihypertensive, resulting in low blood pressure.

  • Ceftriaxone, an injected treatment for certain bacterial infections, could bind together with infused calcium in the blood, so this combination could damage the kidneys, lungs, or gallbladder.

  • Supports the metabolism
  • Decreases soreness and muscle aches
  • Promotes an efficient consumption of energy
  • Improves cellular repair
  • Decreases muscle cramps
  • Decreases oxidative stress within the body
  • Replenishes your electrolyte level
  • Quickly restores the fluids and vitamins you lose during an intense workout
  • The reduction of oxidative stress
  • Effective and fast rehydration
  • A faster recovery
  • A decrease in inflammation
  • Decreases both aches and muscle soreness

High level athletes almost always experience a depletion in both macro- and micro-nutrients because of the intense physical exercise necessary. The micro-nutrients are especially important to replace.


This process can be extremely tricky. Micro-nutrients are crucial co-factors for the production of energy. Every time you experience an intense workout, your muscles produce energy in the form of ATP. Your body creates the level of energy required for an intense workout by using enormous stores of micro-nutrients. Once your body has depleted the stores of micro-nutrients, your will feel fatigued and sore.


If you have been exercising hard, your recovery can be extremely difficult. To understand the way this process functions, your must first understand the formation of ATP during exercise and your energy metabolism.

Weight Loss Vitamin IV Therapy is known to offer a great effect to increase growth hormone (GH) secretion and hence enhances muscle growth in appropriate progress.


Moreover, it is also suitable for people who seek to increase exercise performance and benefit from a shorter recovery period.

Vitamin IV therapy at our affiliated wellness center focuses on delivering essential nutrients to the body by the IV drip method.


For this option which focuses on weight loss, the intensive ingredients will help to improve insulin and thyroid function, as well as citric acid cycle metabolism, in which these are known to target fat burn for energy.

1. Consultation and examination of body condition
2. Drip will be carefully inserted into your arm while you sit on a comfortable couch
3. The drip will be removed around after 180 mins

· Manages weight loss
· Boosts immune system
· Improves insulin and thyroid function
· Increases growth hormone secretion
· Enhances muscle growth
· Aids in exercise performance and body recovery

· Maintenance sessions may be required for the ideal effect

No. You can proceed with your usual daily activities right after the procedure.

It is recommended to get it once a week, but this largely depends on individuals' needs.


Basically, you might need another treatment if you feel that the effects have gradually decrease. It is highly recommended that you get 5 sessions for the best results.

The effects will last longer if you practice excellent dietary intake, regular exercise as well as good skincare regimen that includes appropriate amount of sunscreen application.

The hydration benefits of Beauty Blend are invaluable. By providing hydration and nutrients through mobile IV therapy, we can help improve your appearance confidence.


After all, when your body is more hydrated, you just feel better! Of course, when you feel better, you look better, so if you’ve been craving a boost, Beauty Blend is the solution.

Hydreight is proud to offer a number of services include:


  • Energy Boosting

  • Immune Support

  • Athlete Recovery

  • Hangover/Detox

  • Fat Burner-Lipo

  • Myer’s

  • Migraine

  • Prenatal

Your body needs an optimal balance of vitamins and minerals during weight loss to support healthy, long-lasting change. IV fluids contain those essential nutrients in an effective delivery system. The fluids are infused into the bloodstream for maximum absorption, compared to oral supplements that need to be digested first before they start to work. 


You also need to stay hydrated when you’re trying to drop pounds. Dehydration, or an inadequate amount of fluid in the body, makes you feel run down, and it’s harder to eat right and exercise when you don’t have enough energy. IV hydration supports weight loss with fluids your body needs to thrive.


Finally, IV drips are customizable, depending on your health goals. Supplement your IV fluids with methionine inositol choline (MIC), enzymes that may target fatty deposits, or l-carnitine, which can encourage muscle mass growth. Weight-loss infusions give your body the sustenance and support it needs in combination with healthy lifestyle habits.

IV therapy offers benefits that can enhance your weight loss efforts in the following ways: 


  • Supports Changes to Your Body Composition

This is where it may help to add MIC and l-carnitine to your IV drip. Your body looks leaner and more fit when muscle mass increases while body fat decreases. These two IV supplements may help you achieve that goal, according to research. 


  • Supplies Energy

A good IV for weight loss infusion contains B vitamins for enhanced energy levels. The popular Myers’ Cocktail, for instance, has vitamin B12 and B Complex vitamins (the latter is a combination of B1, B2, B3, B5, B6, B7, B9, and B12 vitamins). This increase in energy makes it easier to take the necessary steps toward weight loss through doing physical activity and eating healthy foods. 


  • Helps with Post-Workout Recovery

You may be feeling serious muscle aches if you’re just starting an exercise regimen for weight loss. It’s important to keep moving, so don’t let tired muscles get you down. Weight loss infusions deliver hydration and nutrients that replace lost fluids from sweating and helps muscle tissue heal and rebuild so you continue getting stronger. 


  • Promotes Healthy Tissues and Cells

Losing weight takes a lot out of your body, and IV fluids help restore what your body needs to function at its best. Antioxidants, vitamins and minerals support cellular health, but it’s not just what’s in the fluid, but the fluid itself. A normal saline solution contains sodium chloride that adds electrolytes to your body and delivers fluids to your cells.

It’s important to understand that IV therapy isn’t a weight-loss cure. If you want to move the needle on the scale or achieve fat burning, IV drips can’t do that on their own.


They’re intended to be one of the many planks in the foundation you’re building for a healthy lifestyle. 

Achieve your weight loss goals by combining metabolism drips with other habits:


  • Eat a diet rich in produce, lean meats, whole grains and fiber-rich foods. Limit sugar, trans fats and processed foods. Consult with a dietitian or consult the U.S. Dietary Guidelines for Americans if you need help with planning healthy meals.
  • Track your portions. Portion control helps curb the number of calories you consume each day. When you eat a meal, at least half the plate should consist of produce.
  • Drink plenty of water (add sliced fruit for flavor) and avoid sodas, juices and other calorie-laden beverages.
  • Burn more calories than you eat with regular exercise. Aim for a minimum of 150 minutes of moderate exercise per week or 75 minutes of intense activity. 
  • Get between seven and nine hours of sleep each night. Studies have shown high-quality sleep can help with successful weight loss and obesity prevention. 
  • Watch out for emotional eating. Keep a food diary noting what you ate and how you felt when you were eating. If you see a pattern of turning toward sugary snacks when you’re sad or stressed, create a new habit to cope with the emotion like going for a walk or calling a friend. 

Vitamin IV therapy and IV infusions allow various critical nutrients to be administered to the body intravenously. When vitamins and other essential nutrients are delivered directly into the bloodstream, they bypass the digestive system, where many nutrients get lost and are not absorbed.


With IV infusion and vitamin injections, nutrients and minerals can go to work, instantly replenishing and revitalizing your body and organs from the inside out.


When nutrients are able to bypass the digestive system in this way, you can be assured that you are receiving the nutrients your body needs, no essential vitamins or minerals are being overlooked in your diet, and that your body and organs are properly absorbing the vitamins and minerals you need.


This method is especially beneficial for people experiencing digestive complications or irregularities, who may struggle with the natural absorption of certain nutrients and vitamins. While it is always important to choose foods rich in nutrients, it does not always mean that those vitamins and minerals are reaching your body to the fullest.


Additionally, vitamin IV therapy allows larger quantities of vitamins to enter your system than can be safely tolerated orally. The “concentration gradient” allows these vitamins and nutrients to be absorbed rapidly and efficiently and to transfer nutrients directly into your cells, yielding optimal results.

All IV infusion therapy and vitamin injections are administered from the comfort of our office here at French Radiance Esthetics. The exact length of an IV therapy session varies depending on the type of infusion selected by each patient, as well as how many injections are administered. Vitamin injections can usually be administered fairly quickly, but infusion therapy usually takes a little more time.


You may feel a slight pinching sensation caused by the needle around the site of the injection, but you should not feel any irritation or negative effects after the injection is complete and should be able to walk out of the office and go about your day feeling great.


Everyone will feel the effects of IV infusion therapy a little differently. What you experience after a treatment will depend on the specific drip chosen and your specific body composition.


However, nearly everyone enjoys the benefits of IV infusion therapy almost right away, as your body is able to absorb the nutrients immediately. You may need to schedule several sessions to create a longer-lasting effect and more thoroughly cleanse and treat the body.

IV therapy has many benefits to its users. There are no known risks involved with the body’s ability to absorb a high concentration of vitamins and nutrients. However, there are a few minor risks associated with the needle injection itself.


Some of these risks and side-effects are comparable to those of having blood drawn for a lab test or having an IV administered during a hospital procedure.


As with any similar procedure, there is a small risk that a vein wall could be perforated or ruptured by the needle due to vascular fragility. This can result in fluid leakage to the surrounding area and may temporarily cause slight swelling or bruising around the site of the injection; you may also experience a slight burning sensation surrounding the needle, which will dissipate when the IV is moved to another vein.


If you have small or hard-to-locate veins or have experienced any previous difficulty with other intravenous injections or getting blood drawn, you may not be a good candidate for IV infusion.

There are countless health benefits and reasons to think about having B12 injections. B12 is a vitamin responsible for maintaining healthy nerve and blood cells. It helps make DNA and genetic material in all cells, prevents certain types of anemia, and helps maintain productive energy levels.

Vitamin B12 can also benefit other areas, including:


  • Beauty
  • Energy
  • Metabolism
  • Immunity
  • Recovery

The French Radiance Esthetic Pure Hydration infusion is beneficial to everyone. This infusion is especially popular amongst professional athletes when refueling after a competition.


It is a great option for restoring hydration and jump-starting muscle recovery after a grueling athletic event, triathlon, or an extra intense workout. Pure Hydration is also helpful in treating headaches, dizziness, dry skin, exhaustion, and hangovers, by supplying your body with the fluids and electrolytes needed to restore balance.

Building and supporting a healthy immune system is crucial to staying healthy. Our special immune-boosting IV vitamin C therapy infusion is filled with the perfect blend of vitamins to help fend off cold and flu symptoms during flu season, fight fatigue, speed up recovery time, and maintain good immune health.

The Well-being infusion is a carefully blended vitamin cocktail intended to give you more energy, support overall well-being and health, and generate good internal balance.

The Well-being infusion drip is a special blend of magnesium, zinc, and Dexpanthenol,


which together help:


  • Reduce fatigue.
  • Promote muscle recovery.
  • Improve the quality of sleep.
  • Contribute to metabolism.
  • Strengthen bones.
  • Repair skin and keeps it supple.

V Glow is a vitamin infusion carefully blended specifically for women who are pregnant or nursing. This infusion has a high concentration of the vitamins and nutrients most active in supporting a healthy pregnancy and a healthy baby.


This infusion will also promote healthy skin, hair, and nails to make you glow with radiance.

Many people have often wondered, do IV drips work for hangovers?


The answer is a resounding YES. 


Have you ever woken up after a long night of celebrating and felt so thirsty that no amount of water could quench it?


A night of fun and drinks, no matter how enjoyable, can be rough on the body. Alcohol has a severely dehydrating effect, which commonly leads to nausea, vomiting, dizziness, and headaches—in other words, a hangover. Rehydrating and detoxifying your body with this rehydration infusion therapy tonic will allow you to bounce back more quickly and reclaim the day!

This special vitamin blend improves your body’s metabolic function and increases fat burning. Skinny Me infusion also supports the liver by providing coenzymes that help it break down fats more quickly and efficiently.

This is a special formula invented by Baltimore Physician John Myer. This nutrient-dense cocktail consists of vitamins B and C, along with other essential nutrients. This cocktail is often used to treat a variety of conditions, including asthma, chronic fatigue syndrome, and fibromyalgia.


Myer’s Cocktail is an effective way to quickly give your body critical nutrients and hydration to promote general health and well-being.


  • Quick infusion (usually 2–10 min)
  • Simple method for patient to learn
  • Minimal impact on ADLs
  • Ideal for once-daily dosing
  • No extra supplies required (extensions, IV poles, batteries, etc)
  • May have compliance issues if dosing multiple times per day
  • Unable to use this method in pediatric population
  • Excludes several common medications such as carbapenem antibiotics
  • Portable
  • Minimal impact on ADLs
  • No extra supplies required (extensions, IV poles, batteries, etc)
  • Has fixed rates to eliminate the need for preprogramming
  • Not suitable for extended infusions (not commercially available for extended infusion times of 3–4 h per dose. This differs from a continuous infusion where the patient continuously receives the medication at a steady rate and a bag change is required every 24 h.
  • Single-dose containers, which may require multiple interactions with venous access throughout the day
  • If not a compounded medication pursuant to USP <797>, no refrigeration is required
  • Air removal not necessary as the medication is infused via gravity
  • High degree of variability in infusion time
    • The medication frequently infuses slower than the corresponding rate on the dial
    • This may require triaging with home infusion company, VNA, or both
  • If multiple bags are required per day, the patient will be significantly impacted
  • Unable to use this method in pediatric population
  • Portable
  • Multidose bags infuse over 24-h period
  • Ideal for medications that require multiple doses throughout the day (eg, penicillins)
  • May run into pump alarm issues that will warrant nursing intervention or a replacement pump
  • Majority of patients do not want to be hooked up to a pump 24 h per day
  • Not to be infused through a peripheral IV
  • If not a compounded medication pursuant to USP <797>, no refrigeration is required
  • Rapid infusion rates for high-volume bags
    • Depending on the model of the stationary pump, possible rates of 800–1000 mL/h
  • More accurate delivery time than gravity infusions
  • Not portable—patient immobile throughout infusion
  • Very heavy and difficult to lift and position on the pole
  • Air sensor alarm may halt infusion, requiring intervention by the home infusion company and/or the VNA
  • Not to be infused through a peripheral IV

Iron-deficiency anemia occurs when the blood doesn’t make enough healthy red blood cells. This, in turn, affects the amount of oxygen received throughout your body.


It’s caused by not consuming enough iron through your diet, an inability to absorb iron, pregnancy, or losing large amounts of blood.


Common symptoms of the condition include:


  • Shortness of breath
  • Fatigue
  • Dizziness
  • Lightheadedness
  • Headaches
  • Nails that are prone to breakage
  • Weakness

Infusion therapy delivers iron directly into your bloodstream. This means you get faster, more effective results — which is preferred to treat people with severe iron deficiencies.


It’s also an ideal alternative for people who cannot take oral medications or for people whose digestive system is failing to absorb iron. Additionally, it’s the best way to increase iron levels to avoid complications from a blood transfusion.


Soon after starting a transfusion, you’ll feel like you can breathe easier, as well as experience increased energy levels. Benefits may last for several months.

Some people do not experience side effects. Those who do may feel any of the following:


  • Itchiness
  • Burning sensation at the site of the injection
  • Headache
  • Temporary changes in the taste of food and drinks
  • Increased heart rate

In rare instances, a person may experience iron toxicity. Symptoms of this complication include anaphylactic shock, severe low blood pressure, and loss of consciousness.

Your doctor will give you specific instructions for preparing for your first iron infusion treatment.


Some basic things you can do to prepare on the day of your infusion include:


  • eat your breakfast and lunch, as there is no need to fast for an iron infusion
  • take your regular medications
  • be prepared to have a small IV drip put in your arm or hand
  • know how to call for help during your infusion in case you have an adverse reaction

You may feel nervous about your iron infusion. You can help reduce any anxieties by talking about the procedure with your doctor first. They can recommend ways to help you stay comfortable and relaxed during the procedure.

An iron infusion usually takes place at a hospital or hemodialysis center. A doctor or other healthcare provider, such as a nurse, will use a needle to insert a small tube into a vein.


This small tube is known as a catheter. It’s usually put into a vein in your arm or hand. Then, the healthcare provider will remove the needle, leaving the catheter in your vein.


The catheter is attached to a long tube, which is connected to an IV bag of the iron. The iron has been diluted with a saline solution. This solution is either pumped into your vein or uses gravity to slowly drip down the tube and into your vein.

An iron infusion can take up to 3 or 4 hours. You should expect to remain seated for this time. In some cases, the infusion may take a little longer, depending on the level of treatment your doctor thinks you need. The slow infusion rate helps prevent complications.


It often takes several iron infusions to bring the body’s iron levels up to the appropriate levels. You will receive iron infusions over the course of one or a few weeks for your treatments. Iron infusions take time and can be more expensive than other types of anemia treatments.

A rare but serious complication from iron infusions is iron toxicity. The symptoms of iron toxicity may come on quickly, which can cause anaphylactic shock. Or they may come on slowly over time. Iron toxicity that develops over time leads to too much iron in the body’s tissues.


The test dose and the slow infusion rate are both done to prevent this complication. The test dose is also important if you have a history of multiple drug allergies. Your doctor will use the test dose to monitor you for any reactions.


These reactions can include:


  • anaphylaxis
  • shock
  • severe hypotension (low blood pressure)
  • collapse
  • loss of consciousness

Iron infusions - involve delivering a dose of iron through the vein with an IV drip. Iron injections involve injecting iron into a muscle with a needle. The injection is usually done into the buttocks. Iron infusions may take up to several hours, whereas iron injections deliver a whole dose immediately.


Iron injection -tend to be less painful than iron injections. Injections can also cause intramuscular bleeding and orange discoloration. Because of these possible complications, doctors often favor iron infusions over iron injections as treatment for iron deficiency anemia.

A pregnant woman’s need for iron increases as her fetus develops. As the fetus absorbs iron from her body, the mother’s iron levels may drop, resulting in anemia. For that reason, doctors sometimes order iron infusions for pregnant women.


Infusions are often preferred over oral iron supplements because taking it by mouth can cause gastrointestinal side effects.


However, iron infusions are usually reserved for the second or third trimester of pregnancy. It’s not yet known if it is safe to administer iron infusions during the first trimester.

An iron infusion is a way to increase the body’s iron levels quickly. It’s a more immediate treatment than supplements or dietary changes. This can be very helpful in situations where anemia is severe.


The physical benefits of an iron infusion include increased energy and easier breathing. You should start feeling these benefits a few weeks after your final infusion treatment. How long these benefits last depends on the cause of your iron deficiency anemia and whether or not you’re using any other therapies to increase your iron levels.


For example, regular blood loss, such as through menstruation, may lead to a chronic drop in iron levels. Depending on your situation, the benefits of an iron infusion may last anywhere from several months to a few years.

IV fluids are liquids injected into a person’s veins through an IV (intravenous) tube.

They prevent or treat dehydration and electrolyte imbalances.

Water is essential to every cell in our bodies. In fact, our bodies are made up of about 60% water.


When you don’t have enough water in your body, that’s called dehydration. A person needs IV fluids when they become dangerously dehydrated.


Serious dehydration may occur when you:


  • Are sick (vomiting and diarrhea).
  • Exercise too much or spend too much time in the heat without drinking enough.
  • Have a serious injury or burns.
  • Have surgery, especially when you’re asleep for a long time or are unable to eat or drink.

When you are dehydrated, it can affect:


  • Balance of important minerals (electrolytes) in the body.
  • Cognitive (mental) performance.
  • Energy level.
  • Gastrointestinal function (your ability to digest food and create pee and poop).
  • Headache frequency and intensity.
  • Many organs, including the kidneys, heart and brain.
  • Physical performance.
  • Skin health.

Signs of severe dehydration include:

  • Dizziness.
  • Dry eyes (no tears).
  • Dry lips and tongue.
  • Dry, wrinkly or blotchy skin.
  • Fatigue (feeling tired).
  • Fast breathing.
  • Hands and feet that are cool to the touch or blotchy looking.
  • Less pee than usual (fewer than four times per day).
  • Pee that is dark yellow and smells strong.

There are different kinds of IV fluids. Your healthcare provider will decide which type is right for you, depending on why you need them.


Crystalloid solutions - These are the most common types of IV fluid. They contain small dissolved molecules that pass easily from the bloodstream into tissues and cells.

Examples include normal saline, which is salt in water, and D5W, which is dextrose (sugar) in water. Another example is lactated Ringer’s, which contains sodium, chloride, potassium, calcium and lactate. It’s used for aggressive fluid replacement.


Colloids - These are large molecules that can’t easily pass through cell membranes and are more likely to stay in the blood vessels. Examples include albumin and hetastarch.

If you need IV fluids, a healthcare provider will:


  • Decide the type of IV fluid you need.
  • Determine the amount of fluid you need and how quickly. This is based on many factors, including your weight, age and medical conditions.
  • Disinfect (clean) the skin where the IV will go, usually on the inside of the elbow or on top of the hand.
  • Tie an elastic band (tourniquet) around your arm to make blood fill the veins.
  • Examine the veins to find the exact insertion site.
  • Slide a sterile needle into the vein, which may pinch. The needle will have a small plastic tube at the other end.
  • Remove the tourniquet.
  • Place a small plastic attachment onto the tube.
  • Test the tube to make sure a little bit of fluid can go in.
  • Tape the IV needle to your arm so that it stays in place.
  • Attach the small tube to a longer tube, and then attach it to a bag of fluids.
  • Hang the bag from a hook on a tall stand (called an IV stand).
  • Turn on a machine that will pump the fluid into the IV line.
  • Check your IV line regularly and monitor the amount of fluid entering your body.

The IV also may be used to deliver medications or nutrition.

IV fluids can make you feel better very quickly. But your healthcare providers will determine when you can stop receiving intravenous fluids.

IV rehydration is a common, simple and safe procedure that can make you feel better quickly and help save your life if you are seriously ill.

But rare complications can occur, including:


  • Air embolism: An air embolism, or gas embolism, occurs when an IV pushes too much air into the vein. It’s rare but can have serious consequences, including possible death.
  • Collapsed vein: Sometimes, the vein collapses when the needle is inserted or when an IV is in place for a long period of time. If this happens, your healthcare provider will try to find another vein to use. There are many other veins to take over for the collapsed vein.
  • Fluid overload: If too much fluid is given too quickly, you can experience headache, high blood pressure and trouble breathing. This usually resolves quickly with an adjustment to fluid levels. But it can be dangerous.
  • Hematoma: A hematoma occurs when blood leaks from the blood vessel into nearby tissues. It looks like a bad bruise and usually goes away in a few weeks.
  • Infection: If the area is not clean when the needle is inserted, infection may occur. Your healthcare provider can usually treat infections with antibiotics.
  • Infiltration: If the needle moves or gets dislodged, fluids can enter tissues around the vein. This may cause stinging and bruising, but it’s typically easy to resolve.
  • Phlebitis: Phlebitis occurs when the vein becomes swollen because of the IV. It’s one of the more common complications, but it’s usually easily treatable by removing the IV, applying a warm compress and elevating the arm.

Many people don’t need recovery time or have any restrictions after receiving IV fluids.


However, you may need other treatments or additional rest depending on the reason you needed rehydration in the first place.

For example, if you had vomiting or diarrhea due to infection, you might need to take medicines afterward. If you had surgery, you might have certain restrictions while you heal.

Ask your healthcare provider about your recovery and restrictions.

Immunoglobulin (IG) replacement therapy is a blood-based treatment. The immunoglobulin contains antibodies which will help fight infection.


You have been recommended this treatment because your doctors have found that your immune system (or your child’s immune system) is not making antibodies. Immunoglobulin can be given intravenously or subcutaneously.

Intravenous immunoglobulin (IVIG) has been in use since the 1970s and involves giving immunoglobulin straight into the circulation system by a needle in a vein. Quite large amounts of immunoglobulin can be given this way and for this reason, treatment is only needed every three weeks or so, with each treatment lasting between two and four hours.


If you have side effects with IVIG it is usually because it is being given too quickly. Initially you would have treatment in hospital, but most people can be trained to have it at home.


Subcutaneous immunoglobulin (SCIG) has been developed more recently than IVIG, with new immunoglobulin preparations being produced extensively for subcutaneous use by 2005. In SCIG, immunoglobulin is delivered by a needle into the fatty tissues under the skin, where it enters the circulation slowly over a few days.


There isn’t much room under the skin, so the dose of immunoglobulin given is smaller than with IVIG. For this reason, SCIG is usually given every week. Nearly everybody on SCIG learns how to have treatment at home, with each session lasting up to about two hours.

Your immunology team will give you the information to help you decide which treatment you will have. 

You might want to consider the following factors:


  • If you have really ‘bad’ veins, then IVIG is not be your best option
  • If you want to take ownership of your illness, then SCIG may be the best choice because you will probably learn how to have home therapy faster. 
  • Infusion-related side-effects are more common with IVIG than SCIG and can be related to the volume and rate of infusion.

Your immunology centre will be able to offer you either treatment depending on these factors and your personal choice. Across the UK about 60 per cent of people with immune deficiency are on IVIG.

Immunoglobulin is made from donated blood plasma. During manufacture everything except a type of immunoglobulin called IgG is removed from the plasma. IgG is very good at fighting bacteria and viruses.


IgG has other effects too, so it isn’t just used for people with immune deficiency. You might hear about immunoglobulin being used in some people with other immune (autoimmune) problems.

Immune deficient patients are at a greater risk of infection than others. Clinical trials have shown that for people with immune deficiency, immunoglobulin treatments result in fewer infections, and those infections that do occur tend to be less serious.


There is also evidence that people with immune deficiency are more likely to enjoy good health over many years if they receive immunoglobulin correctly. Finally, your wellbeing and your energy levels are likely to be better if you are on immunoglobulin.


Please note that it may take several months before you feel these benefits.

Your immunologist will only recommend starting immunoglobulin if you have had tests which confirm it is the right treatment for you. In cases of severe immune deficiency, only a couple of blood tests are required before the doctor will recommend immunoglobulin.


Fortunately, most people have mild immune deficiency and in this situation the doctor might try other treatments before immunoglobulin. For example, the immunologist might try giving you vaccines and checking how well you respond. This 'vaccine challenge' can take several weeks, as you have to have the vaccine, wait a few weeks before the blood tests and then get the results. 


Your immunologist might suggest taking regular antibiotics for a few months and seeing how well these protect you from infection. This can be done whilst you are waiting the results of a vaccine challenge.

Most people do not have reactions to immunoglobulins. This is why it is safe to go on to home therapy.


The reactions that do sometimes happen include rashes, temperature, shivering or itching. You can also get a headache with immunoglobulin, although this tends to happen the next day.


When reactions do happen, there is usually one of two factors responsible:


  • Immunoglobulin is given too fast for the individual concerned. This is most likely to happen with IVIG because a larger dose is being given. If you have a reaction during an infusion, the first thing to do is slow the infusion right down and consider stopping it if the symptoms do not improve rapidly. Once recovered, you should record the details of the reaction in order to inform your clinical immunology team.
  • Immunoglobulin is given at a time when there is an infection. If you have a cold or a chest infection on the day of your infusion, you are more likely to have a reaction. Immunology teams will help you recognise the symptoms of infection, so that you can delay your infusion by a couple of days if necessary. Because immunoglobulin treatment takes a few months to reduce the risk of infections, this is most likely to happen when you have just started immunoglobulin.

Immunoglobulin is made from blood donations. Several thousand blood donations are pooled in the process. For these reasons there is always a possibility of catching an infection from one of the blood donors.


No one has ever caught HIV or hepatitis B from immunoglobulin therapy. In the 1990s, a small number of people caught hepatitis C from immunoglobulin. These days, blood donors are selected very carefully and the manufacturing process contains steps to remove viruses and bacteria.


There have been no cases of infection being spread from person to person by immunoglobulin since the 1990s.


There are two theoretical risks from immunoglobulin. The first is from prion infection. Prions cause BSE (mad cow disease) and variant CJD, mainly in the UK. Prions have been spread from person to person by blood transfusions but never by immunoglobulin.


The other risk is of new infections that start to affect humans, either because of global climate change or change in behavior (e.g. feeding sheep to cows, in the case of BSE). One example of this is a virus that affected people in New York and entered the blood supply there.

The first step the manufacturers take is to get to know the blood donors really well.  Manufacturers insist that their donors donate regularly. 


Each time a donor attends the blood centre they are asked a lot of questions, ranging from their sex lives to any recent travel. They then donate the blood as well as having a series of blood tests to make sure they don’t have an infection. The blood is not released for processing until the blood tests have come back negative. 


The second step is that the plasma is treated in a few different ways to get rid of infection. Depending on the manufacturer, the plasma will get a combination of heat treatment (pasteurisation), addition of solvent detergent, and nano-filtration with or without UV light treatment.


Donor centres and immunoglobulin manufacturers have very high standards for minimizing the risk of infection getting into the immunoglobulin supply. Donor centers and manufacturers are inspected regularly and will be closed down if there is any hint of a problem.

The exact protocol for follow-up varies between centres and will also vary depending on your particular situation. You could expect to be seen at least two or three times a year.


Sometimes follow-up will be done by a specialist trainee doctor or a specially trained nurse if it is a recognized teaching center. You might be asked to bring along the details of your infusions, including the number of batches and possibly a diary of any infections you have had.


You might expect to be assessed from the following points of view:


Is the treatment working?


  • Are you still having infections?
  • Have you had to have antibiotics, take days off work or even go into hospital?
  • Are you getting the correct amount of immunoglobulin (checked by doing a blood test)?
  • Are your lungs healthy? You might have breathing tests or a CT scan of your lungs.


Are there any problems?


  • Have you had any reactions? What caused them?
  • A blood sample may be taken for liver tests and a sample frozen in case it needs testing for infection at a later date.
  • You might be offered a technique review if you are on home therapy.


Has anything else changed?


  • Have you had any other complications of immune deficiency?
  • Are there any new treatments or tests that should be considered?
  • Do you still understand why you are on immunoglobulin and what the possible risks are?

Immunoglobulin is manufactured in batches. Several thousand donations of plasma are pooled in each batch.


Very occasionally there are problems with some batches. For example, recently one batch of immunoglobulin caused some people to get an itchy rash.


Because it was possible to see which batch was causing the rash, replacement immunoglobulin could be sent out quickly.

The tests you had before starting immunoglobulin were designed to check whether you would need immunoglobulin for life. However, sometimes immunoglobulin is recommended for people whose immune deficiency may only be temporary.


This can happen in small babies or when the immune system had been damaged by medications, for example. It’s also possible you were given immunoglobulin for a condition that is no longer regarded as needing immunoglobulin.


In these situations there are blood tests that can be done to check how well your immune system is working.


If you do stop immunoglobulin, your immunology team will monitor you closely.

There are about half a dozen immunoglobulin manufacturers and the different IVIG and SCIG products available vary slightly.


However, each manufacturer must follow international standards on product safety.


The blood donor centers and manufacturing plants of all the different companies are inspected from time to time.

In the past, supplies of immunoglobulin from different manufacturers have been withdrawn from time to time.


This has happened because, for example, a batch of immunoglobulin has caused a reaction, such as an itchy rash. Another problem is that immunoglobulin is being used to treat many more different diseases, not just immune deficiency.


Immunoglobulin costs more in some countries, so manufacturers make a greater profit in different parts of the world.


In the past, there have been occasions when supplies of an immunoglobulin product became very low. People on an affected product had to switch to a different one at very short notice.


For these reasons, the UK Government has taken steps to ensure we have a good supply of immunoglobulin at a national level.


These steps include negotiating immunoglobulin prices and supplies with the manufacturer.


The Department of Health also runs a scheme to make sure that if a crisis develops, immunoglobulin is reserved for patients who really need it, particularly people with immune deficiency.

Your immunology team will be accredited as a home therapy training center and will not allow you to go onto home therapy until you are safe.


 You might have to do a short exam! Once you are on immunoglobulin at home, your team will want to do an assessment every so often.


Your assessment will happen either at home, or at the hospital.

Your immunology team will give you contact details which you can use if a problem arises at home; for example, if you think you have an infection and you want advice about delaying immunoglobulin treatment. 


Some immunology centres offer this service during office hours only. This means you might want to plan your infusions for during the week until you have some confidence.


You can also call your immunology centre if you have other concerns that might be to do with immune deficiency.

Commonly treated chronic inflammatory disorders with infusion therapies: 


  • Ankylosing spondylitis
  • Crohn’s disease

  • Juvenile idiopathic arthritis

  • Plaque psoriasis

  • Psoriatic arthritis

  • Rheumatoid arthritis

  • Ulcerative colitis

  • Uveitis

Antifungals are medicines that kill or stop the growth of fungi (the plural of fungus) that cause infections.


They are also called antimycotic agents.

Fungal infections can affect the:

  • Circulatory system.
  • Respiratory system.
  • Skin and nails.

Fungi grow as yeasts, molds or a combination of both. They reproduce through very tiny spores. These spores can exist in soil or become airborne.


You can also have naturally occurring fungi, like Candida yeast, in your body. Fungi live on your skin, inside your digestive system and vagina (part of the female reproductive system).

Anyone can get a fungal infection. Most fungi cause no problems or the infections are easily treatable.


People who have compromised immune systems are more likely to develop serious fungal infections. These infections are called opportunistic infections.


They can be life-threatening for people who have:


  • AIDS.
  • Autoimmune diseases like lupus.
  • Cancer.
  • Organ transplants.
  • Stem cell (bone marrow) transplants.

Antifungals treat these types of fungal skin infections:


  • Athlete’s foot, jock itch and ringworm.
  • Dandruff (seborrheic dermatitis).
  • Fingernail infection or toenail fungus.
  • Thrush and esophageal candidiasis (yeast infection in the mouth, throat or esophagus).
  • Vaginitis and vaginal yeast infection.

Antifungals also treat more dangerous fungal infections like:


  • Aspergillosis, pneumocystis pneumonia and Valley fever (lung infections).
  • Candidemia (blood infection).
  • Meningitis (brain infection).
  • Ocular histoplasmosis syndrome (eye infection).
  • Rhinosinusitis (sinus infection).

Antifungal medicines can kill a fungus. Or they may stop it from multiplying or growing.

There are several classes of antifungal medications and different types of medicines. Your healthcare provider will select the best prescription medicine.


Or they may guide you to an effective over-the-counter (OTC) treatment. Options include:


  • Azoles (fluconazole or Diflucan®), synthetic (human-made) antifungals that keep fungi from growing.
  • Echinocandins (micafungin or Mycamine®), newer semi-synthetic antifungals that attack and damage the fungus wall.
  • Polyenes (nystatin or Bio-Statin®), organic (naturally occurring) antifungal treatments that destroy the fungus cell.

There are OTC and prescription antifungal medicines. Talk to your healthcare provider about what treatment to use.


Antifungals come in different forms, including:


  • Injections (shots) or IV.
  • Oral pills or liquids.
  • Topical (skin) creams, ointments, gels and sprays.
  • Vaginal suppositories.

Treatment length varies depending on the fungal infection. Some fungal skin infections like ringworm clear up in a few weeks.


But it can take months or years to clear up some fungal nail, blood and lung infections.

Side effects from antifungals vary. Results depend on the type of drug, dosage (strength) and fungus. You may experience:


  • Abdominal pain, upset stomach and diarrhea.
  • Itchy skin, burning sensation or skin rash.

Rarely, an antifungal drug may cause serious problems like:


  • Liver damage (jaundice).
  • Severe allergic reactions like anaphylaxis.
  • Severe allergic skin reactions, such as blisters and peeling skin.

Medication safety depends on the antifungal drug. Breastfeeding infants who develop thrush (an oral yeast infection) can get antifungal mouth drops.


Their moms also need treatment, typically with an antifungal skin cream. Your healthcare provider can determine whether it’s OK for you or your child to take an antifungal medicine.

Antifungal resistance means a fungus no longer responds to treatment. This response makes the fungal infection harder to treat.


Some fungi are naturally resistant to certain antifungals. Fungi may also develop resistance when you use antifungal medicine for a long time. Skipping doses, stopping treatment too soon or receiving a too-low dose can also lead to antifungal resistance.


A note from Cleveland Clinic


Antifungal medications treat fungal infections that affect the skin, nails, lungs and other organs. Some fungal infections clear up in a few weeks. Others may need months of treatment.


Taking antifungal medicines for an extended period or failing to complete the prescribed treatment may lead to antifungal resistance.

Intravenous therapy (or IV care) is used to help maintain the right fluid balance, to monitor drug effectiveness, to treat infection, and to relieve pain. IV therapy consists of using liquids that are introduced directly into a vein.


The treatment can be intermittent or continuous and is the fastest method for delivering pharmaceuticals to a patient.


Some of the therapies that can be administered via IV are:


  • Nutritional therapy
  • Parenteral nutrition management (TPN/PPN)
  • Pain management
  • Hydration management
  • Anti-viral therapy
  • Anti-fungal therapy

Intravenous or IV infusion therapy may be needed for patients who require help maintaining the right fluid balance, monitoring drug effectiveness, treating infection, or relieving pain.

Generations at Applewood has experienced staff that ensure you receive compassionate care. Our highly trained nurses work closely with our patients’ physicians to speed recovery and maximize comfort.


Our program includes:


  • Individualized care plans
  • Trained staff available 24 hours a day, 7 days a week
  • Intravenous (IV) services
  • Medication administration
  • Assistance with activities of daily living


Hospice care is ideal if you or a loved one is terminally ill, and the doctor believes your situation may take a dire turn in six months or less. The elderly use hospice care the most, but you can also opt for the service if you do not want to undergo treatment.


For instance, some cancer patients prefer not to undergo the rigors of chemotherapy and surgery. You can receive hospice care in your preferred setting, such as in a nursing home, hospital, hospice facility, or in your own home.


At-home hospice patients tend to have a more satisfying experience because they are with their loved ones in a setting they find comforting.

A popular misunderstanding about hospice care is that a location is a hospice itself. Hospice is not really a physical position, but a concept of holistic treatment that focuses not only on offering support to terminally ill patients, but also to caregivers, family, and friends of the patient comfort and respect.


While hospice care can be given at an inpatient facility if the situation of your loved one requires it, most hospice care is given anywhere your loved one is comfortable.

A hospice programme offers hospice care. The team of health care practitioners from the hospice service will collaborate with the primary caregiver (usually a family member) of the patient to provide support and care 24 hours each day, 7 days per week.

Hospice care supports you and your relatives in your final days to help with the transition from illness treatment to living life as completely as possible.


It can include the following: Medical visits for checkups at your home, Home health assistants to assist with washing and other regular care needs, special medical equipment required to keep you comfortable, such as a hospital bed, oxygen, walker or wheelchair. It also involves social work, dpiritual support chaplains and medications to help sustain your comfort.


Physical therapy, diet therapy, counselling, massage as well as art or music therapy are all common in the hospice experience.

Hospice volunteers are a special group of people that give of their time and talents to help patients and their families.


They are available to visit with you and help run errands. They can also assist with daily activities and may read, sing, write letters, or just reminisce with you and your loved ones.


Their support enhances the quality of life for patients and helps relieve some of the demands that are often placed on caregivers.

Yes. Hospice services typically can be provided wherever the patient calls home. In addition to the standard services provided by the nursing home or alternate care facility, residents will receive specialized visits from hospice nurses, hospice aides, chaplains, social workers and volunteers.

In hospice care, we believe that emotional and spiritual pain are just as real as physical pain. Hospice nurses and doctors use the most effective medications and devices to relieve pain and other symptoms.


They are joined by specialists who are trained in physical therapy, music therapy, art therapy, massage therapy and nutritional counseling to help maintain patient comfort.


Finally, various counselors, including clergy, help with emotional and spiritual support for patients and and bereavement support for family members and caregivers.

Very high. Using a combination of medications, counseling and therapies, most people can attain an acceptable level of comfort to improve quality of life during end-of-life care.

Usually not. In hospice, our goal is to help people live as actively as possible, free of pain or discomfort.

Yes. Hospice provides continuing support for caregivers and families for up to 13 months following the loss of a loved one.


We also sponsor bereavement support groups, conduct memorial services and provide support for anyone in the community who has experienced the loss of a friend or loved one.

Home health care helps people recover from an illness or injury and become as self-sufficient as possible.


Visits typically decrease as the patient’s condition improves. Hospice care keeps patients comfortable as symptoms of their terminal illness worsen. Services typically increase over time to meet the needs of the patient.

Hospice and palliative care both focus on quality of life and relief of uncomfortable symptoms. The difference is that palliative care may begin earlier (e.g., at diagnosis) and take place at the same time as curative treatment.


Hospice care begins after curative treatment stops, to improve comfort and quality of life as the patient nears the end of their life. Hospice care provides all the services palliative care does, but palliative care does not typically include all the services that hospice care provides.

Hospice is a type of specialized care for people who have terminal illness that is no longer responding to medical treatment or intervention.


Rather than trying to cure the disease, we focus on pain and symptom management, emotional and spiritual support, and help for families and caregivers.

In most cases, a family member serves as the patient’s primary caregiver and helps make decisions for their loved one.


The hospice care team, working together with the caregiver, develops a plan to provide treatment, pain and symptom management, emotional and spiritual support, personal care and specialized services for both the patient and family.


Hospice staff is available 24 hours a day, 7 days a week to help meet your needs.

Patients should consider hospice when medical treatments can no longer cure their disease or when the burden of treating symptoms outweighs the benefits of treatment.


Although end-of-life care can be difficult to discuss, talking about hospice early on allows you to make educated decisions and understand a loved one’s wishes before a crisis occurs.


If you're unsure whether hospice care is the right choice for you or a loved one, our “Is Hospice the Answer” quiz may help. You can also call your local Amedisys care center for a free assessment to see if it’s time to consider hospice care.

Yes. Hospice services are 100% covered by Medicare Part A.


They are also covered by Medicaid in most states, as well as many other private or managed care insurances. 

Some of the benefits of Amedisys hospice care include:


  • Specially trained team of caring hospice professionals
  • Care provided wherever the patient calls home
  • 100% of hospice costs covered by Medicare
  • 24/7 accessibility if needed
  • Focus on comfort and quality of life
  • Assistance with daily tasks and personal care
  • Emotional and spiritual support
  • Paid medications, equipment and supplies related to the terminal illness
  • Bereavement support and respite care for family members
  • Research shows patients on hospice can live longer than patients who do not receive hospice care

You’ll receive intermittent visits from a team of people with expertise in different fields.


Your hospice team may include a physician, nurse, social worker, chaplain, bereavement counselor, hospice aide and volunteers.

The hospice care team works with patients and caregivers to determine the frequency and type of hospice services needed.


The number of in-home hospice service visits typically increases as the patient’s illness progresses and their needs increase.

Yes. At Amedisys, hospice care is available seven days a week, 24 hours a day, all year long.


We have hospice team members on call and can respond within minutes, if needed.

Yes. You can keep your personal physician while receiving hospice care.


Hospice reinforces the relationship between primary care physician and patient, and considers this bond to be a high priority.

Many, but not all, doctors are familiar with hospice. If your doctor doesn’t know about hospice care, contact us. We can share information about hospice services and hospice eligibility requirements and help you decide on next steps.


Information is also available from the National Hospice and Palliative Care Organization and the Centers for Medicare and Medicaid Services Hospice Center.

Anyone can make a referral for hospice care. Feel free to speak with your doctor, minister or a trusted friend when making this decision.


You can also contact us to learn more about in-home hospice services and arrange a meeting in your home to discuss our hospice program. We also provide care in local hospitals and some extended stay facilities.

Once you’ve expressed an interest in learning more about hospice care, one of our team members will contact you to discuss your needs and help determine your eligibility.


Next, we’ll contact your doctor to discuss your decision and receive authorization to begin providing the in-home hospice services you’ve chosen.


Finally, you’ll sign forms that are similar to the ones that you would sign before receiving any other special medical services.

Once a referral for hospice care is made, we will contact you within a few hours to schedule the first visit at a time that’s convenient for you.


A hospice care team member typically visits the patient within 24 hours. In some situations, it may be possible for hospice services to start sooner.

It depends on the patient’s specific needs, but Medicare covers six months of hospice care initially.


Care can last longer than six months if a doctor certifies that the patient continues to meet hospice eligibility requirements.

Sometimes with the extra attention that hospice care provides, a patient’s health improves.


If a patient’s condition improves or the disease goes into remission, the patient can be discharged from hospice care and returned to regular medical treatment.


Likewise, should the patient need to return to hospice in the future, these services can be resumed if the patient is eligible.

No. Your hospice care team will help you determine what you need and then assist you in obtaining any special equipment or making any changes in your home.

There’s no set number. One of the first things hospice will do is help you determine the amount of care you need.


In addition, hospice staff will make regular visits to your home. We’re available to answer questions, provide support and teach caregivers how to care for their loved one.

It’s never easy to provide end-of-life care for a loved one. Nights can be especially difficult and sometimes seem very long.


However, the hospice care team is available 24 hours a day to speak with or visit you if needed. We can teach you what you need to know to care for your loved one. We also provide resources and bereavement support for caregivers and family members.

No. It is usually not necessary for someone to be with the patient all the time.


However, we do recommend continual end-of-life care and monitoring in the later stages of hospice.

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