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Artist Leroy LeFlore was a ship’s engineer with Exxon deep-sea tankers for 32 years before retiring, so it’s understandable that he often paints boats, seabirds, and water.
He works in oil, watercolor, and pen-and-ink, with his favorite medium “the one I’m working with at the moment. When I do oils, I love the spontaneity of composing on the fly that I can do with the medium. With watercolors, combining the drybrush method with the wet-on-wet technique, I can get precision and looseness together in the same painting. Pen and ink serves as a reset button, to get back to the basics of drawing and shading.” LeFlore, whose awards include a Best of Show in Galveston Art League juried competitions, joined the 104-year-old nonprofit organization as a way “to kick-start my art career.” He serves on its board and hangs artwork for the monthly member and juried shows. He also has joined the Plein Air Washington Artists. “I make frequent trips to Seattle for family and engage in plein air painting there.” And pending approval of his portfolio, he will become a member of the Oil Painters of America on Jan. 1, 2019, joining so he can enter its quarterly competition and compete on a national level. The 65-year-old artist sells and competes through Galveston Art League galleries at 2117A Postoffice St. in Galveston and 611 6th St. N. in Texas City. Perhaps surprisingly, however, most of LeFlore’s sales are through The Sunflower Bakery & Café, 14th Street at Postoffice in Galveston. “I’ve learned the value of selling through a popular venue such as the Sunflower Café,” he says. “The exposure is terrific, they handle the sales tax, they provide the establishment, and there’s no need to advertise due to their high volume of patrons.” LeFlore paints four to six hours per day, seven days a week. Q: When did you discover your passion for art? A: At age 6. I would draw the square-rigged ships my father used to make models of, and I remember that my friends and teachers thought they were pretty good. Of course as children, we’re encouraged when we draw. It doesn’t necessarily mean you have an innate talent. I never felt I had an innate talent. What I produce now is backed by a lifetime of just doing it. If I was talented, I would have been good from the start. When someone comments that I’m talented, I wonder then why I had to work so hard at it to get to the level I’m at now. Passion, certainly, is what drove me, but I don’t know where that came from. Q: Do family and friends encourage you? A: Family, friends, loved ones support and encourage you, but essentially it’s a solo journey. To get any good at it requires intense devotion which means the neglecting of other aspects of your life. I could never give my art that kind of devotion until I retired and my kids were grown and on their own. Q: What is your art education background? A: Self-taught. Most of what I learn I stumble upon through repetitive experimentation. When I find something that works, for example, drybrush watercolor, I get exhilarated. Then I find out that it’s a well-established and well-known technique in the art world. I work towards art that appeals to me. I try to figure out how that art was created, and experiment with getting that same effect. Q: Do you work outdoors or indoors? A: Both. I love concentrating for a few days on an ambitious studio painting but also exhilarated painting onsite and the reward it brings. Painting onsite, you own the day. Q: What are your favorite subjects? What are your challenges and your strengths? A: Landscapes appeal to me, but I will never feel fully accomplished until I master portraits, which is to say to capture a personality in an expression. Portraits are still a challenge for me. I’m not there yet. Getting the color right is something I still struggle with. Knowing when to stop, especially with watercolors is very important. My strengths are perspective and composition. Q: Briefly describe your start-to-finish process for your artwork. A: With oils, I tone the canvas with thinned color applied with a paper towel ― for instance, burnt sienna. Establish a horizon line. Using raw umber, applied thinly I paint a monochromatic composition. I use silhouettes to create accurately shaped objects. Proceed with colors. With watercolor, I start with an accurate drawing. Proceed with washes, semi dry technique, using a mister to control water, remembering to preserve white spaces where needed ― hence the need for a preliminary drawing. Avoid overworking. Q: Do you use photos as part of your artistic process? A: In the studio I use photos taken with my smartphone to jog memory and provide details. I snap pictures on the fly of scenes that inspire me. Q: Do you follow any rules when painting? A: In the enthusiasm of painting, stop occasionally and ask yourself, “What does this painting need?” Instead of always focusing on what was intended, or accuracy of the scene, look at the painting. What does it need? Q: How have you improved over the years? A: The most effective means of improving is time spent at the easel. Along with that, you have to put your work out there beside other artists’ work. That is the catalyst to impel you to strive to do better. It makes you see your art the way a casual, uncommitted observer would see it. So essentially, time at the easel and the skill level of other artists. Q: Do you also teach? A: I haven’t taught because, being self-taught, everything I did has been experimental and not methodical. But now that’s changed. I’ve developed some techniques that are effective so I’m contemplating teaching or at least demos. Q: Do you have an art goal you’re striving for? A: To be accepted into the Society of Marine Artists at the Signature membership level just on the basis of my submitted portfolio. I’ve been pursuing this for seven years and have yet to submit a portfolio because I judge my work is not quite up to the mark yet. But I’m getting closer and have joined at the entry level to receive their correspondence and news. Q: What’s the most rewarding aspect of creating art? A: To have something good to show for a day’s work.
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 GALVESTON (Nov. 2018) – The stage is set for the third annual Thanksgiving Day feast at The Salvation Army’s Center of Hope on Galveston Island on Thanksgiving Day, November 22 from 12-3. The Lighthouse Charity Team is cooking turkey and ham, the centerpiece of a traditional, sit-down meal open to the entire community. Other activities scheduled are live music, miniature horses, a jump house, movies and crafts for kids and gifts for kids under 12. The event is completely free and all are welcome.
“We wanted to provide this day as a gift to our community,” says Captain Kenny Jones. “It’s not just for the down-and-out but for anyone who wants a family experience for Thanksgiving. We’ll have good music, good food and fun activities for kids. Our only goal is to thank God for his goodness toward us and share his love. We expect to serve close to 1000 people this year.” The Center of Hope is located at 601 51st Street in Galveston. Limited volunteer opportunities are available but must be registered in advance. To volunteer, visit www.salvationarmygalvestoncounty.org/our-needs and click the link to the online sign-up sheet. This event is sponsored by the Lighthouse Charity Team, Galveston Regional Chamber of Commerce, Walmart Seawall, Shipley Donuts of Galveston, United Rentals of Galveston. About The Salvation Army The Salvation Army, an evangelical part of the universal Christian church established in London in 1865, has been supporting those in need in His name without discrimination for 130 years in the United States. Nearly 30 million Americans receive assistance from The Salvation Army each year through the broadest array of social services that range from providing food for the hungry, relief for disaster victims, assistance for the disabled, outreach to the elderly and ill, clothing and shelter to the homeless and opportunities for underprivileged children. 82 cents of every dollar The Salvation Army spends is used to support those services in 5,000 communities nationwide. For more information, go to www.salvationarmyusa.org.  In Your Own WordsYour story is important to The American Legion. That is why the "In Your Own Words" forum is now available. If you have a memoir, poem, photo, video, book or link to another site, you are invited to submit it here. Submissions are carefully reviewed and may be subject to editing or rejection in some circumstances. Just enter your information, upload the image or any other elements you wish to publish, and your submission will be posted on the forum.
Please log in to enter your own words. How-to instructions for "In Your Own Words" The articles, photos, etc. in the posted publications are the sole opinions of the author/photographer. Absolutely no content within the publication is reviewed, endorsed or pre-approved by The American Legion. For questions, or assistance please click here. Categories: In Your Own Words  GALVESTON COUNTY, Texas – Quitting smoking improves your health immediately, and over the long term, at any age. But, it’s not easy. It takes hard work, time and a plan.
Nov. 15 marks the Great American Smokeout, an annual effort to encourage the nearly 38 million adults in the United States who smoke cigarettes to quit. “If you’re a smoker or tobacco user, setting a date to quit is important. It’s that first step in protecting your health,” said Kathy Barroso, Galveston County Health District Chief Executive Officer. “Remember, you don’t have to stop smoking all in one day. But, taking that first step to make a positive change is vitally important to putting down tobacco for good.” Smoking remains the single largest preventable cause of death and illness in the world, according to the American Cancer Society, which sponsors the Great American Smokeout. Smoking causes more than 480,000 deaths every year and more than 16 million Americans live with a smoking-related disease. Quitting smoking is an important step toward feeling better and creating a healthier life. A good plan can help smokers get past the symptoms of withdrawal. Set a date Choose the Great American Smokeout or another quit day within the next two weeks. Tell your family and friends about your quit plan Share your quit date with the important people in your life and ask for support. A daily phone call, e-mail or text message can help you stay on course and provide moral support. Be prepared for challenges The urge to smoke is short – usually only three-five minutes – but those moments can feel intense. Even one puff can feed a craving and make it stronger. Before your quit day, write down healthy ways to cope. Drink water, exercise, listen to music or call a friend. Remove cigarettes and other tobacco Remove these items from your home, car and workplace. Throw away cigarettes, matches, lighters and ashtrays. Clean and freshen your car, home and workplace. Old cigarette odors can cause cravings. Know your options Talk to your pharmacist or doctor about quit options. Nicotine patches, gum or other approved quit medication can help with cravings. Benefits of quitting smoking includes better tasting food, normal sense of smell, teeth and fingernails stop yellowing, not being out of breath from ordinary activities and better smelling breath, hair and clothes. What happens after you quit? 20 minutes after – Your heart rate and blood pressure drop. 12 hours after – The carbon monoxide level in your blood drops to normal. Two weeks to three months after – Your circulation improves and your lung function increases. One-nine months after – Coughing and shortness of breath decreases. One year after – The excess risk of coronary heart disease is half that of someone who still smokes. Heart attack risk drops dramatically. Five years after – Your risk of cancers of the mouth, throat, esophagus and bladder is cut in half. Cervical cancer risk falls to that of a non-smoker. Your stroke risk can fall to that of a non-smoker after two-five years. 10 years after – Your risk of dying from lung cancer is about half that of a person who is still smoking. Your risk of cancer of the larynx and pancreas decreases. 15 years – Your risk of coronary heart disease is that of a non-smoker’s. For more information about the effects of tobacco use and tips to quit, visit www.gchd.org/quitsmoking. # # # Public Health Services · Coastal Health & Wellness · Emergency Medical Services · Animal Resource Center The Galveston County Health District (GCHD) is the local public health agency for Galveston County, Texas. GCHD provides services and programs that protect the everyday health and well-being of Galveston County. P.O. Box 939 La Marque, Texas 77568 • (409) 938-7221 www.gchd.org  Successful companies of all sizes readily address their insurance needs so they won’t later be caught off guard by either a baseless or valid legal claim. No matter how hard you try to provide flawless products and services to the public, there’s always a chance that a defective product or business transaction may render you liable for legal damages.
Although only certain types of companies must carry workers compensation, disability and unemployment insurance to meet federal guidelines, all businesses can benefit from protecting their company assets by purchasing basic and special types of business insurance. Fortunately, there are only six basic types of business insurance that you and your business partners must carefully review while trying to protect your company against future legal challenges. All six are set forth below with additional information. Six common types of business insurance Before reviewing the following types of insurance, be sure to thoroughly discuss the precise nature of all your business transactions with your insurance agent.
Always talk about every reasonable type of harm that your business might suffer. Also, make sure you’ve chosen the best type of partnership or corporate structure to further protect your personal and business assets. Once you fully understand all the risks your company might face, find a highly respected business insurance broker. Always ask trusted business peers for their recommendations for this type of agent. Finally, speak with your Houston business law attorney about all the specific types of insurance required by the state of Texas for a company like yours. And be sure to address all the federal government’s insurance requirements. Keep in touch with your insurance agent and lawyer throughout each year so they can each readily update you about new legal or policy requirements that may affect your current coverage during the upcoming year. Please feel free to contact a Murray Lobb lawyer so we can talk with you about the legal aspects of obtaining adequate insurance coverage for all your business needs. CATEGORIESBUSINESS, BUSINESS LAW, INSURANCE, LIABILITY, MURRAY LOBBTAGS#BUSINESSINSURANCE, #BUSINESSLAW, #BUSINESSLAWYERS, #BUSINESSOWNERS, #COMMERCIALPROPERTY, #HOUSTONATTORNEYS, #HOUSTONBUSINESSES, #HOUSTONPROFESSIONALS, #INSURANCE, #KNOWLEDGEISPOWER, #LIABILITY, #MURRAYLOBBATTORNEYS, #OWNER, #PROFESSIONAL, #SMALLBUSINESS, #TEXASBUSINESSES, #TEXASPROFESSIONALS, #TEXASSTRONG, BUSINESS, HOUSTON, MURRAY-LOBB, OPTIONS Previous PostPREVIOUSPurchasing a Texas Franchise or Company Already in BusinessRECENT POSTS
 GALVESTON COUNTY, Texas – The Galveston County Animal Resource Center (ARC) is happy to host a low-cost pet vaccination clinic on Wednesday, Nov. 14. The event, open to residents of any city, will also include pet microchipping and county registration.
Low-Cost Vet Vaccinations Low-cost vaccinations, flea control and heartworm testing and treatment services through ARC range from $15 for a rabies vaccine for both dogs and cats to $60 for the dog package and $45 for the cat package. Specific pricing is online at www.gchd.org/arc. Microchips and Registration Microchips are available for all cats and dogs, regardless of jurisdiction, for just $20 each. County regulation requires pet owners who live in the municipalities served by the ARC (Bayou Vista, Hitchcock, Kemah, La Marque, Texas City, Tiki Island and unincorporated Galveston County) to register their pets. There is no registration fee for pets that are already microchipped. Registration for pets that are not microchipped is $20 and includes a microchip. The fee is $15 for pet owners age 65 and older. Location The event will take place at ARC, located at 3412 25th Avenue North (Loop 197 North) in Texas City from noon-3 p.m. on Wednesday, Nov. 14. Appointments are not needed. Cash, check and major credit cards are accepted. For more information, call the ARC at 409-948-2485. WHAT: Low-Cost Pet Vaccinations and Registration WHEN: Wednesday, Nov. 14 from noon- 3 p.m. WHERE: Galveston County Animal Resource Center, 3412 25th Avenue North (Loop 197 North), Texas City About the Galveston County Animal Resource Center The largest, most modern and best-equipped animal shelter in Galveston County, the Animal Resource Center (ARC) provides animal services to Bayou Vista, Hitchcock, Kemah, La Marque, Texas City, Tiki Island and unincorporated Galveston County. Learn more at www.arcpets.org or by calling (409) 948-2485. # # # Public Health Services · Coastal Health & Wellness · Emergency Medical Services · Animal Resource Center The Galveston County Health District (GCHD) is the local public health agency for Galveston County, Texas. GCHD provides services and programs that protect the everyday health and well-being of Galveston County. P.O. Box 939 La Marque, Texas 77568 • (409) 938-7221  Urgent message: It is common for patients with injuries to the upper extremity due to falls on outstretched hands to present to urgent care. As such, evaluation, appropriate imaging, and initial treatment should all be within a clinic’s capabilities.
Michael Bartuseck, MSN, ARNP, FNP-C, EP-C Introduction Urgent cares centers play an integral role in providing care for patients who have sustained injuries due to falls on outstretched hands (FOOSH). While complex anatomy of the wrist, hand, and elbow often lead to confusion and misdiagnosis of FOOSH injuries, the high prevalence of these injuries makes it is imperative for urgent care providers to be proficient in diagnosis and management. Adequate treatment, follow-up, and patient education are essential to minimize risk for long-term complications. Such complications include avascular necrosis of scaphoid, scapholunate advance collapse (SLAC), and scaphoid non-advanced collapse (SNAC) wrist, as well as avascular necrosis and chronic pain. These can lead to significant morbidity and decreased quality of life. In this article, we provide a simple and concise approach to evaluation, assessment, and treatment of common FOOSH injuries in the urgent care setting. Anatomical Overview While elbows and hands may be affected, FOOSH injuries typically impact the wrist, which is relatively complex and composed of eight carpal bones and the distal radius and ulna. Joining these bones are multiple ligaments and cartilaginous components. Our focus will be directed most at the proximal carpal row (scaphoid, lunate, triquetral), specifically the scaphoid. Scaphoid The scaphoid presents diagnostic challenges and can be difficult to treat, at least partly due to the fact that its vascular supply limits its ability to heal after injury. The main blood supply is retrograde, with the more proximal 70% to 80% supplied by the dorsal scaphoid branches entering along the dorsal ridge.1,2 This slow flow of blood supply makes the scaphoid prone to osteonecrosis after injury, especially of the proximal pole, which has been reported to occur in 13% to 50% of such patients regardless of treatment.2,3 Medical History Medical history taking is greatly enhanced with attentive listening followed by focused questions to help guide examination; this is certainly never truer than when examining a patient for FOOSH injury. In such situations, history should focus on the following:
Examination, Diagnosis, and Management When examining a FOOSH injury (or any orthopedic injury), palpate with a purpose. It is inherent in our role as urgent care clinicians to distinguish among injuries which need immediate stabilization, injuries which need immediate consultation, and injuries that need prompt, but not immediate follow-up. It is important to consider all differentials, as it is common for more than one injury to be present after a FOOSH (Table 1; Table 2 shows examination techniques to consider). Scaphoid Fracture Scaphoid fractures are challenging to diagnose and treat. Patients who report radial-sided wrist pain that is either acute, subacute, or now chronic should be assessed as follows to help guide the clinician to diagnosis:
Management for confirmed fracture via diagnostic imaging, or even suspicion with history and examination findings as listed above, should be treated as a fracture until proven otherwise. Acute scaphoid injuries are often occult on first radiologic imaging and require further investigation in a week with an orthopedic specialist for repeat imaging. In the interim, the patient should be placed into a thumb spica splint (or short arm splint if no thumb spica is available). It is imperative to explain the reasoning for splinting even without clear diagnosis to the patient. The explanation will help the patient understand the risk for detrimental outcomes if the scaphoid fracture is not treated properly. Those adverse effects include: avascular necrosis, osteoarthritis, chronic pain, decreased range of motion, and need for surgery. Follow-up examination with either repeat x-ray or advanced imaging with MRI or CT scan will be required. Source: Wikimedia Commons contributors. Distal Radius Fracture Colles fractures are the most common type of distal radius fracture. They usually present with obvious deformity. Some however, may be more subtle and require further investigation. Palpation over the dorsal aspect of the distal radius will elicit significant pain. There will be pain with range of motion of the wrist, and it is likely the patient will decline to perform motion. Diagnostic imaging will be required. Splinting with wrist control or Colles splint is effective with prompt follow-up to an orthopedic specialist. If displacement is present, closed reduction with splinting should be performed (presuming the provider is experienced with closed reduction technique). Postreduction imaging should be obtained. Red flag: it is imperative to assess the neurovascular components distal to the fracture. If there is any compromise, ED evaluation should be initiated. Assess for motion of the thumb as the extensor tendon (extensor pollicis longus) can be ruptured due to fracture fragments.2 Radial Styloid Fracture Fractures of the radial styloid will typically present in a fashion similar to a fracture of the scaphoid or distal radius. Management is similar to the distal radius fracture, with splinting and orthopedic referral. Red flag: With radial styloid fractures, also assess the scaphoid. Radial styloid fracture often present with obvious or occult scaphoid pathology. Palpation over the distal radius will elicit pain; thumb motion will also be very painful. Treat as a combination of scaphoid and radial styloid until proven otherwise. Radial Head Fracture Radial head fractures often occur with FOOSH injuries. Patients will complain of wrist pain, as well as elbow pain, and be hesitant to perform range of motion. However, pain with supination and pronation at the elbow is imperative for diagnosis. Palpation at the lateral aspect of the elbow will elicit pain; you also may feel crepitus at the radial head with supination pronation. X-rays should be ordered, with a minimum of two views (AP and lateral). Radial head fractures can be difficult to recognize on x-ray. Assess for a sail sign or effusion on the image. A positive fat pad sign aids in diagnosis, as well. If image is inconclusive, but exam is consistent, treat until proven otherwise. Management should include intensive patient education. Compression wrapping for comfort and stability may be used along with a sling. Please note, early light motion is imperative for these patients, as elbow contracture and stiffness are very common after injury, possibly leading to long-term complications. These patients need to be seen by an orthopedic specialist as soon as possible to begin management. Be aware that if displacement or step-off of the radial head is present, this may require surgical intervention, and motion could worsen alignment if not managed meticulously. Red flags: Patient follow-up is imperative, as elbow stiffness from too little movement and displacement from too much movement/lifting are common, both leading to long-term complications. In addition, remember to assess the elbow, as well, after a FOOSH. Scapholunate Tear Scapholunate (IOSL) injuries can occur solely or in combination with other injuries. They are often diagnosed as a simple sprain. They then continue to cause pain or discomfort in patients, causing them to seek further treatment later in life—at which point surgery to improve symptoms due to SLAC wrist or other irreversible damage will be a likely option. Tears to the scapholunate ligament alter the stability and kinematics of the wrist, causing excess stress and weakness to surrounding structures.9 SLAC and SNAC wrist are possible complications which could lead to painful osteoarthritis. Surgery is often required to reduce pain and improve function of the wrist for these patients.10 Exam findings for scapholunate tears include snuff box tenderness, dorsal wrist tenderness, visible edema, and decreased extension of the wrist. Palpation to the dorsal aspect of the wrist at the location of the scapholunate ligament often yields great discomfort. Watson’s test, which is used to assess ligament integrity, is helpful in diagnosis. Weakness of the injured wrist is often present in comparison to contralateral wrist.11 Diagnostic imaging is helpful in determining severity of a confirmed or suspected IOSL tear. Obtain standard views with consideration of closed fist view, as this view will exacerbate an IOSL tear with a widening of the joint spacing in the AP view. Management for scapholunate injury should take into account the commonality of other wrist injuries being possible. Recommendation of a wrist control splint with avoidance of lifting or exacerbating activities and early referral to an orthopedic hand specialist is imperative to avoid long-term complications. Red flag: It is important to assess contralateral extremity in all cases of FOOSH injuries, as there may be ligament laxity that is normal for that patient. Identifying “normal” ROM for them, as well as grip strength and other findings, such as obtaining imaging bilaterally, can be helpful. Avascular necrosis to the lunate can also occur after scapholunate injury known as Kienböck’s disease. Distal Radioulnar Joint DRUJ consists of the articular between the distal radius and the ulna, which is boney in nature, and the triangular fibrocartilage complex (TFCC), which consists of cartilage, ligaments, and other soft tissue stabilizers. Patients with DRUJ injuries will typically complain of ulnar-sided wrist pain after a FOOSH. Often, the patient will complain of pain when lifting objects, along with clicking or a feeling of instability, and when pushing. Special examinations for ulnar-sided wrist pain include the piano key sign, grind test, and tabletop testing.12 There will be pain when the patient supinates, as injury at the TFCC can cause abnormal ulnar head motion. The patient may also have clicking and subluxation of the overlying dorsal extensor carpi ulnar tendon (ECU) as the ulna displaces dorsally in some DRUJ injuries. The TFCC is the most commonly injured structure within the DRUJ, and responsible for most of its stability. Imaging is needed to rule out fractures, as well as assess the DRUJ joint spacing. Injuries to the triquetrum may be present, most notably as avulsion fractures. The triquetral avulsion fracture is best seen laterally in the x-ray. Patients with associated fractures and gross amount of instability and pain should be referred to orthopedic surgery promptly. Most ulnar styloid and triquetral avulsion fractures can be managed conservatively with splinting/casting. Concomitant soft tissue TFCC injuries are likely, as well. Patients with confirmed DRUJ pathology should be placed into a splint and referred to a specialist. Those without should have prompt follow-up with a primary care provider for reevaluation and possible advanced imaging and referral. Red flag: DRUJ instability and ulnar-sided wrist pain are complex even for seasoned hand surgeons. Obtaining radiographs, assuring no obvious fracture or instability, will get the ball rolling in diagnosis. This is the essential role for the urgent care provider in patients with ulnar-sided wrist pain. Most of these issues will need advanced imaging if the patient continues to have symptoms. Hook of Hamate Patients who suffer numbing or tingling after a FOOSH injury along the small and fourth digit should raise suspicion for fracture of the hook of hamate. Body-of-hamate fractures are uncommon. This projection off of the hamate is in close relation to the ulnar nerve and is often fractured with FOOSH, or in sports that involve bats, sticks, or clubs. The patient will complain of ulnar-sided wrist or hand pain, weakened grip, and pain with flexion of the fifth and fourth digits in wrist ulnar deviation (hamate pull test).13 Examination will require compression of Guyon’s canal, which will elicit pain and sometimes tingling. This area is volar on the ulnar aspect of the palm and represents the area of the hook of hamate. X-ray imaging must encompass a carpal view. This makes the hook of hamate visible and easier to diagnose. Patients should be splinted and sent for reevaluation with primary care for possible advanced imaging if still symptomatic. Red flag: Provider must obtain carpal view for accurate assessment of the hook of hamate. Synovitis Synovitis is inflammation of the synovial lining of a joint or of the surrounding structure of a tendon or tendinous junction. A patient may present to urgent care with painful swelling of the wrist or hand, which limits motion. Synovitis can sometimes result from FOOSH episodes or from no trauma at all. It is important to investigate potential causes of synovitis, as they are numerous. Patients who display a synovitis may have underlying arthritic or autoimmune disorders. Obtaining thorough history, as well as imaging in these patients, is helpful, as you can assess for acute injury such as fracture and for new or existing arthritis and, in some instances, infection. Extensor tenosynovitis has a hallmark “V” pattern as swelling occurs following anatomy of extensor wrist tendon sheath. Splinting with anti-inflammatory management is appropriate with no other pathological findings, with referral to PCP for continued management. When there is flexor tenosynovitis, it commonly occurs with infection and often affects a hand or finger. Patient will be present with swelling, erythema, and decreased range of motion. The finger will be held in slight flexion, have a gross amount of swelling, and be painful along the flexor tendon. Passive extension also will elicit severe pain. Infective flexor tenosynovitis is an emergency. Prompt recognition and referral to the ED are paramount. Synovitis presentation should immediately raise red flags as to the underlying cause of the inflammation. Rule out infection immediately, then proceed with examination. Red flag: Provider must recognize infection of flexor tendon sheath, as if not treated promptly this can lead to tendon rupture, skin or tendon necrosis, and loss of digit if severe enough. Cellulitis Patients can sometimes develop infection of the skin post FOOSH injury. Those most susceptible include the elderly or immunocompromised, as well as those who have a FOOSH in areas that may be contaminated. Patients should be examined to rule out combined musculoskeletal injury coexisting with infection. Imaging may be needed to rule out boney trauma, as well as to rule out any foreign body if wounds are present. Antibiotic treatment should then be initiated as deemed necessary, assuming no other pathology is found. Red flag: FOOSH injuries can also accompany puncture wounds. Imaging may show foreign body. Good history taking can help decipher possible foreign body presentation. References
 (StatePoint) ‘Tis the season of friends, family and entertaining! If you’re planning on hosting guests -- whether for an entire week of family fun or a one-night celebration -- now’s the time to get your home in the holiday spirit.
“Preparing a home for the holidays doesn’t have to require adding extensive decorations or undergoing a total remodel to update favorite spaces,” says Jennifer Kis, director of marketing communications for Progress Lighting. “Small changes through lighting can create a festive and comfortable environment with minimal effort and investment.” Here are three easy tips to try: Update Entryways and Foyers. Your entryway is your opportunity to make an exceptional first impression and set the tone for the rest of the interior. Add drama to your foyer with a grouping of striking, oversized pendant lights in lieu of a traditional chandelier. Pay Attention to Shared Spaces. Popular spaces where friends and family are likely to gather most during the holidays include great rooms, living rooms and dining areas. A large statement chandelier in a common living space creates a focal point and also ensures there is enough illumination for card games, movies and coffee and cocoa by the fireside. Illuminate Walkways to Enhance Curb Appeal. Simple outdoor lighting techniques can improve a home’s appearance and also offer functional features during the holidays and beyond. Added illumination will improve safety and enhance security, while bringing a new bold look to the front of your home. To create instant curb appeal, hang a large lantern on either side of your front door, or install a post lantern at the front of your walkway. For more design inspiration and to view on-trend lighting collections, visit progresslighting.com. In a few easy steps, you can light up your home for a warm and welcoming holiday season.  Home health care is clinical medical care provided by an registered nurse, occupational therapist, physical therapist or other skilled medical professionals, and is often prescribed as part of a care plan following a hospitalization. HOME HEALTH SERVICES Home health care services include:
Situations in which home health is prescribed include:
HOME CARE Home care is provided by caregivers, usually called home care aides or “Angels”, who are trained to understand the nuances of senior care. Home care aides can help older adults with activities of daily living, or just offer some friendly companionship. Unlike home health, home care is classified as personal care or companion care and is considered “unskilled” or “non-clinical.” WHEN TO USE HOME CARE You might consider hiring a home care aide for older adults who:
HOME CARE SERVICES Services provided by home care aides may include:
  GALVESTON COUNTY, Texas – Each year, 1.5 million Americans are diagnosed with diabetes.
Diabetes is one of the leading causes of disability and death in the United States with one in 10 Americans having the disease and another 84 million adults – that’s one in three – at high risk for developing type 2 diabetes. November marks National Diabetes Month, a time to raise awareness and encourage healthy living. “Although there isn’t yet a cure for diabetes, a healthy lifestyle as recommended by your doctor can reduce its impact on your life,” said Dr. Philip Keiser, Galveston County local health authority. “Everyday actions like eating a healthy diet, being physically active and taking prescribed medications help you stay on track.” This year’s theme is “Everyday Reality.” From what they’ll wear and eat to how they’ll take care of themselves, this year’s theme highlights the day-to-day impact diabetes makes on nearly every decision. There are three main types of diabetes – type 1, type 2 and gestational. Type 1 accounts for roughly 5 percent of all diagnosed cases in adults and can develop at any age. There is no known way to prevent type 1 diabetes. Roughly 95 percent of adults who have diabetes have type 2, which can often be delayed or prevented with lifestyle changes. Type 2 affects a body’s ability to use insulin well and makes it unable to regulate blood sugar levels. Risk factors include:
Uncontrolled, diabetes can cause blindness, nerve damage, kidney disease and other health problems. “The sooner you find out if you have diabetes, the sooner you can start making health changes that will benefit you now and in the future,” Keiser said. Symptoms include:
Early detection and treatment of diabetes can decrease the risk of developing the complications of diabetes. Diabetes can be managed by working with a health professional, eating healthy and staying active. # # # Public Health Services · Coastal Health & Wellness · Emergency Medical Services · Animal Resource Center The Galveston County Health District (GCHD) is the local public health agency for Galveston County, Texas. GCHD provides services and programs that protect the everyday health and well-being of Galveston County. P.O. Box 939 La Marque, Texas 77568 • (409) 938-7221 www.gchd.org |