If the medical term sounds foreign to you, you may be surprised that this condition is far more common. In Singapore and around the world, the incidence of phlebitis stands at about 31% from intravenous (IV) catheter use. Given its high occurrence, it is important to know what this condition is all about.

What is Phlebitis?

Phlebitis is a vein inflammation and often occurs in a person’s legs. The veins are blood vessels in the human body responsible for carrying blood from the limbs and organs toward the heart.

A person can feel inconvenienced by phlebitis, which can be due to damage to his vein wall. Another reason this body complication happens is a blood clot blocking a vein that results in inflammation, and this disease is also referred to as thrombophlebitis.

There are two types of phlebitis – superficial phlebitis and deep vein phlebitis. 

Superficial phlebitis

Superficial thrombophlebitis is often caused by damage to the inner lining of the vein. This can happen from injections, catheters, or trauma. The damage allows blood cells and other substances to leak out of the blood vessels and into the surrounding tissue. This causes inflammation and pain.

In some cases, superficial thrombophlebitis is caused by a blood clot that forms in a vein that’s already narrowed or blocked. This is more likely to happen if you have varicose veins.

This condition is typically not serious. Nevertheless, patients should not merely dismiss this disorder because it can lead to bloodstream infections, wounds on the skin, and infection of the surrounding skin.

People with superficial phlebitis experience symptoms such as a visible red “streaking” on their skin along the vein, redness, swelling, and tenderness. Additionally, they may feel the warmth on the affected area or notice a cord or rope-like structure they can feel through their skin if the inflamed vein is near their skin’s surface.

Superficial thrombophlebitis is treated with over-the-counter pain relievers, warm compresses, and elevation of the affected leg. In some cases, your doctor might prescribe anticoagulant medication to help prevent deep vein thrombosis (DVT). Surgery is rarely needed.

Deep vein phlebitis

Deep vein phlebitis is the inflammation of a larger and deeper vein within a muscle, like that found in the legs. It results in a person feeling warmth in the affected limb. 

The discomfort may be more noticeable when walking or flexing the foot. Furthermore, if the inflamed vein is deep, a patient may complain that his thigh or calf hurts. Besides this pain in the affected area, skin discolouration and swelling are also among the deep vein phlebitis indicators. As blood clots usually cause deep vein phlebitis, they can have very serious consequences.

After all, the blood clot may break off and head towards a person’s lungs. This disease, also known as pulmonary embolism, is serious and life-threatening.

Pulmonary embolism patients usually feel the discomforts of chest pain, unexplained shortness of breath, pain when breathing deeply, and rapid breathing. Moreover, they may cough up blood, have fast heart rates, and feel lightheaded or as though they will pass out. Pulmonary embolism is a medical or healthcare emergency that needs calling the local emergency services for immediate medical treatment.

Risk Factors

Phlebitis is common among certain groups of people. The following are those who have increased risk:

• Pregnant women
• Obese or overweight people
• People with a history of blood clotting disorders
• Smokers
• Alcohol drinkers
• People with varicose veins
• Elderly individuals aged 60 years or older
• Cancer patients undergoing treatments
• People who sit or are inactive for long periods of time
• Women taking hormone therapy or birth control pills

These people are more likely to experience deep vein or superficial phlebitis. When phlebitis pain strikes, they should seek their physicians’ attention immediately.

Treatment Options

For the most part, phlebitis pain should not worry patients. This condition may involve basic medical treatment by a doctor or self-care home treatment, depending on whether the patient has superficial or deep vein phlebitis. Among the ways to heal phlebitis at home is by keeping the leg raised while resting to prevent the swelling and by applying a warm compress to the inflamed area. 

Patients also have the choice to take nonsteroidal anti-inflammatory drugs or NSAIDs. However, phlebitis patients taking a blood thinner should not take NSAIDs unless their physician prescribed these medicines. 

Deep vein phlebitis patients, on the other hand, typically require urgent care. Doctors may prescribe medications like anticoagulant blood-thinning medicines and thrombolytics, and also perform medical procedures like thrombectomy, varicose vein treatment, and vena cava filter use to resolve deep vein phlebitis. 

Phlebitis Care Right at Home

If you are experiencing pain or discomfort from superficial phlebitis, you may have trouble moving around and may need extra support. If you’re providing care for a loved one at home who has phlebitis, you will need to learn to manage their condition and keep them comfortable. With proper care, most people with phlebitis will recover completely.

Jaga-Me offers both telemedicine and home caregiving services. As a professional healthcare provider, phlebitis patients will be able to connect with trained doctors to diagnose and treat their condition. Our care aides can also provide nursing and respite care support, no matter where they are in Singapore.

Contact us to seek help for phlebitis and a wide range of other medical conditions today.

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Often a hefty but underappreciated role, the stress a caregiver may face is a real problem. In a nationwide survey of caregivers for people with mental health issues, it was found that three in four needed temporary separation from the person they were caring for. With the ageing population in Singapore and the rise in chronic diseases abound, this role has become even more vital.

Signs of Caregiver Stress

Taking care of another person can be demanding both physically and emotionally, and it’s important to be aware of the signs of caregiver stress and burnout.

Caregiver stress can manifest in many different ways. Some common signs include feeling overwhelmed or constantly anxious, difficulty sleeping, changes in appetite, irritability or mood swings, and feeling isolated or lonely.

Common Challenges by Caregivers

It’s no secret that being a caregiver can be stressful. After all, you’re responsible for another person’s well-being and often have to put their needs before your own.

Here are five everyday struggles of caregivers in Singapore and how to manage them:

1. Financial stress

Caregiving can be costly, especially if you have to give up your job to do it full-time. In addition to daily expenses, you may also need to pay for routine medical check-ups or even private transportation to the hospital. 

If financial stress is getting to you, there are a few things you can do. First, try to create a budget and stick to it as much as possible. You can also look into government grants and financial assistance programmes. For example, the ElderShield programme provides up to $400 monthly payouts up to 72 months for eligible senior citizens in Singapore.

2. Emotional stress

Caring for a loved one can be emotionally draining. You may feel guilty, resentful, or even angry at times. It’s important to find ways to deal with these emotions so they don’t take over your life. If you are a caregiver for a palliative patient, you may even be struggling to accept and move past a terminal diagnosis.

One way to overcome this is to talk to someone who understands what you’re going through. You can also join a support group or participate in counseling or therapy sessions.

3. Time management stress

Caregivers often have a lot on their plate, which can make it difficult to find time for themselves. If you’re struggling to juggle everything, it’s important to take a step back and assess your priorities.

Try to delegate tasks whenever possible and make use of respite care services. This will give you some much-needed time to rest and recharge.

4. Physical stress

Caregiving can be physically demanding, especially if you’re caring for someone with a disability or chronic illness. Some patients may require round-the-clock care or have issues carrying out activities of daily living (ADL) such as eating or toileting.

It’s important to take care of yourself so you don’t end up getting sick as well. Make sure to get enough sleep, eat healthy meals, and exercise regularly. You can even do a health screening at the comfort of your own home to ensure that your health is in good condition.

5. Relationship stress

Being the primary caregiver can put stress on your relationships, both personal and professional. For example, family members of dementia patients may be shocked to learn that they no longer recognise them or struggle with basic tasks. These things can add up and strain relationships further.

If you’re starting to feel overwhelmed, it’s important to communicate with your loved ones and set boundaries. It may also be helpful to join a support group or seek counseling. This will give you an outlet to express your feelings and learn how to deal with them effectively.

Get Caregiving Help Today

The best way to care for someone else is to first care for yourself. As much as it is important to tend to the needs of your loved one, you should also find time for yourself, even if it is just for a few minutes each day. You can also sign up for a caregiver training course to arm yourself with the tools and resources to make your job easier.

Jaga-Me provides a wide range of services for both caregivers and patients in Singapore. Whether it is providing professional cancer care at your home or ad-hoc respite care so you can go out to catch a breather, our licensed nurses or trained caregivers will be able to help alleviate your stress and burden.

Contact us to find out how our services in Singapore can help you and your family today.

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At Jaga-Me, we believe in empowering caregivers to care for their loved ones. In this article, we will be sharing tips from Jaga-Me nurses on performing tube feeding care at home. If you still do not feel confident, our expert nurses can also perform feeding tube insertion services at home.

How often should I change the feeding tube? 

*Do check the manufacturer’s note for exact recommendations.

Hygiene should always be a top priority when performing feeding tube care at home. Syringes should be washed with water (do not boil) and thoroughly dried after each use. They should be changed every 2-3 days, and more frequently if there are visible marks in the syringe.

Tube Feeding Checklist

1. Check that the micropore securing the tube is intact and has not shifted.
2. Measure the exposed length of the tube. It should be the same as the exposed length when the feeding tube was first inserted. Some tubes have numeric markings for reference.
3. Check the pH of the gastric content (aspirate).
   • Using an alcohol swab, clean the exterior of the spigot (cover of the exposed end of the feeding tube).
   • While kinking the tube, remove the spigot and clean the opening of the tube with an alcohol swab.
   • Insert the syringe (with plunger) into the opening of the tube. Release the kink.
   • Pull the plunger back gently till some gastric content is seen (usually colorless or green-yellow color).
   • If no gastric content can be seen, lean the patient to the left. Wait for 5 minutes and reattempt to collect gastric content. If there is no gastric content again, pump 10ml of air and try again. If there is still no gastric content, put 10ml of cool boiled water into the syringe and through the feeding tube. Wait for 5 minutes and attempt again. If this last attempt is unsuccessful, contact your home care nurse.
   • Observe the gastric content. The color should be colorless or yellow-green with some mucus strands. Semi-digested milk curds can be seen as well.
   • Pour the gastric content over a pH paper and compare the result to a pH chart. It should be between pH 1-6. *check the recommended pH range with your doctor, as your loved one may be taking some medication that could affect the pH of his gastric content*
   • You may feed your loved one if the pH is between 1-6 and the appearance of the gastric content is normal.

Frequently Asked Questions about Feeding Tube Care at Home

How do I check if the tube is still in place?

You can measure the exposed length of the feeding tube, and check that the micropore tape has not shifted.

What should I do if the tube has been displaced?

We recommend a trained nurse to assess the situation in person. Do not attempt to re-insert the feeding tube on your own.

How do I maintain the oral and nasal hygiene of the patient?

Carrying out feeding tube care at home doesn’t just involve changing and handling the tube. It also means maintaining your loved one’s oral and nasal hygiene to avoid debris, liquid, or plaque build up that can lead to health issues.

• If your loved one is able to brush their teeth, allow them to do so twice a day
• If they are unable to brush their teeth, use a toothette to clean the gums, teeth and tongue. Dip the toothette with sodium bicarbonate or oral gargle solution.
• Using a damp cotton bud, gently clean the exterior of the nose with the feeding tube.

How often should I replace the micropore tape?

The micropore tape should be replaced once a day, when cleaning your loved one’s face. Using a warm cloth, gently loosen the micropore tape. Remove the tape from the face and from the tube. Reattach a new micropore tape.

Why is the milk not flowing down during the feeding?

It is most likely that the tube is stuck with milk or medicine. You may reposition your loved one to the left and observe if the milk flows. If it does not, contact your home care nurse for replacement of the feeding tube. Do not use the syringe and plunger to attempt to force through the obstruction as you could cause significant discomfort to your loved one.

Expert tips from a Jaga-Me Nurse

Our Jaga-Me nurse has these expert tips to share to help you safely and easily carry out feeding tube care at home:

• To prevent the exposed length of the feeding tube from flopping around, you may use a claw-shaped hair clip to clip the end of the tube to your loved one’s shirt.
• Excess milk can be stored in the fridge for up to 24 hours (it helps to label the can/packet of milk with the opening date & time). Sit the can of milk in a bowl of warm water for 10 minutes to warm the milk. Check the temperature of the milk against your inner wrist before feeding your loved one.
• Encourage your loved one to practise swallowing while feeding through the feeding tube. This helps them to maintain their swallowing muscles.
• Always mix the milk powder with water and sieve it to prevent clumping.

Expert Opinion on Feeding Tube Care at Home

• We recommend families to have at least one extra NG Tube in the event of an emergency.
• During feeding and 1 hour after feeding, position your loved one at, minimum, a 45-degree angle. This prevents milk from potentially flowing into their lungs.
• The maximum amount that can be fed each time is 400ml. Allow adequate time between each feed for the body to digest the milk.
• To ensure that the tube is free from milk/medicine clogs, flush the feeding tube with 20 – 30ml of water after each feed.
• Check with your pharmacist if the medication your loved one requires can be pounded into powder. Do not mix medicine with the milk. Instead, mix it with water.

How can I get more expert support?

You can contact Jaga-Me for medical assistance regarding feeding tube care at home. Alternatively, you can seek advice from your JagaPro in person when you engage Jaga-Me’s Home Care Services.

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