During this blessed Christmas season, most of us are excited and maybe just a little frantic with preparations for family gatherings, parties and celebrations of all sorts. Sometimes in the midst of our business we forget that for many this is a sad time, a time even when depression is a huge problem. Being alone, loss of loved ones, and ill health all contribute to the problem, and a real problem it is.
Depression is a serious medical illness that must be diagnosed and treated by trained professionals. If left untreated, depression, which can last months or even years, can cause unnecessary suffering for the person and their family members, worsen other diseases, lead to disability or premature death, and result in suicide (Those over 65-years-old account for more than 25% of the nation’s suicides).
Being depressed is not a normal part of aging, and it’s impossible “to just snap out of it”. Unlike sadness, which does not impact engaging in regular activities, depression interferes with the ability to function. According to the National Institute of Mental Health, other symptoms are: sadness that lasts more than two weeks, unexplained physical pain or gastrointestinal problems, excessive worry about finances and health, difficulty with sleeping and concentrating, weight changes, no interest in personal hygiene and appearance, and withdrawal from regular, social activities.
Like other illnesses, there are various types and levels of depression. Published in Cognitive Therapy and Research, a recent study determined that late-onset depression (in people over 60) can damage the brain’s executive functions (planning and control), and can spiral into excessive rumination (uncontrolled thought patterns that are repetitive, negative and destructive). Symptoms include inattention, a decline in the working memory, rigid thinking, and no inhibition.
Depression is sometimes difficult to diagnose among the ageing. Rather than be considered weak or crazy, an older person usually describes physical pain to the physician rather than feelings of hopelessness and worthlessness, loss of interest or prolonged grief. When properly diagnosed and treated, however, more than 80% of those suffering from depression recover fully and return to normal, productive lives.
Be aware of how the older people in your life are handling the holidays. Are they having as much enjoyment as you? Are they positive and looking forward? Are they hopeful? If not, perhaps you will need to pursue diagnosis and treatment. At least, begin with a conversation about how they feel and what you can do to make this Christmas season special for them.
Saturday, November 26, 2011
Sunday, November 20, 2011
Flying in Peace
I just got back from an amazing trip to Minnesota. I adore everything about traveling except the flying. I'm not at all afraid and I never get sick, but with the exception of flying business-class abroad, there is absolutely nothing about flying that is fun.
At best, the quarters are close, cold and uncomfortable. The worst has included being plastered between two men who hadn't bathed for what smelled like a year, tolerating a reclined seat that allowed a strange man's head to be practically laying in my lap, and having to listen to a screaming baby for five hours straight while the father read his book and the mother did a crossword puzzle.
Why do parents travel with babies? They are exposing them to countless germs, extreme ear pain from the change in pressure and altitude variance, and a disruption of their schedule.
Some airlines are considering putting families at the back of the plane in a group and I say hurrah! I realize that a little distance might not create complete silence but it beats having a miserable child crying in your ear or a mom rocking the row as she jiggles and jostles in vain.
Is it discrimination? In any other circumstance, if someone was causing disruption to the peace and distress to others, they would be asked to leave or be removed from the premises. Now, I adore babies and I empathize with those who must travel with little ones, but the parents must also be sensitive to the commotion they are causing.
And what's the down side to the parents if they are all put together in one section. I see none. They will be surrounded by others who can empathize and even help. Oh yes, it might be a bit noisy, but there are repercussions for all our choices.
At best, the quarters are close, cold and uncomfortable. The worst has included being plastered between two men who hadn't bathed for what smelled like a year, tolerating a reclined seat that allowed a strange man's head to be practically laying in my lap, and having to listen to a screaming baby for five hours straight while the father read his book and the mother did a crossword puzzle.
Why do parents travel with babies? They are exposing them to countless germs, extreme ear pain from the change in pressure and altitude variance, and a disruption of their schedule.
Some airlines are considering putting families at the back of the plane in a group and I say hurrah! I realize that a little distance might not create complete silence but it beats having a miserable child crying in your ear or a mom rocking the row as she jiggles and jostles in vain.
Is it discrimination? In any other circumstance, if someone was causing disruption to the peace and distress to others, they would be asked to leave or be removed from the premises. Now, I adore babies and I empathize with those who must travel with little ones, but the parents must also be sensitive to the commotion they are causing.
And what's the down side to the parents if they are all put together in one section. I see none. They will be surrounded by others who can empathize and even help. Oh yes, it might be a bit noisy, but there are repercussions for all our choices.
Saturday, November 12, 2011
Kidney Health in Kids
I didn’t know youngsters struggled with kidney stones until one of my students had to miss school because the pain from one was so great. As it turns out, the incidence of kidney stones is rising sharply among children (an 11 fold increase).
There are a number of reasons for why both adults and children develop this painful condition and most of it has to diet, which means it is also preventable. Factors that put us at risk is not drinking enough fluid and ingesting too much of what dehydrates us, so avoid drinking too much caffeine, eating too much salt (should take in no more than 3000 mg. per day) and protein, and eating too much oxalate found in chocolate, peanuts, spinach, tea and black pepper.
The biggest cause of kidney stones is not drinking enough decaffeinated liquid. Doctors recommend that we drink enough to make more than a half a gallon of urine. “The Institute of Medicine reported that U.S. women who appeared to be adequately hydrated consumed the equivalent of about 91 ounces of fluids each day, and men about 125 ounces -- far more than the 64 ounces in eight glasses of water --but stated that beverages other than water and the fluid in solid foods also counted toward the total. Even a slice of white bread is more than 30% water.
Doctors believe that if we wait until we’re thirsty to drink that we are already dehydrated. It is imperative to drink water constantly throughout the day especially if the weather is hot or physical activity is high, which, of course is the reason that children are prone, that and the fact that too many children live on a steady diet of colas, energy drinks and sweets. How do these bad choices impact our kidneys? Well let’s look at what the kidneys do as described by American Urological Association Foundation.
“What do the kidneys do?
Your kidneys are bean-shaped organs, each about the size of your fist. They are located near the middle of your back, just below the rib cage, one on each side of the spine. The kidneys are sophisticated trash collectors. Every day, your kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The wastes and extra water become urine, which flows to your bladder through tubes called ureters. Your bladder stores urine until you go to the bathroom.
The wastes in your blood come from the normal breakdown of active muscle and from the food you eat. Your body uses the food for energy and self-repair. After your body has taken what it needs from the food, wastes are sent to the blood. If your kidneys did not remove these wastes, they would build up in the blood and damage your body.
In addition to removing wastes, your kidneys help control blood pressure. They also help make red blood cells and keep your bones strong.
What is a kidney stone?
A kidney stone is a solid piece of material that forms in a kidney out of substances in the urine.
A stone may stay in the kidney or break loose and travel down the urinary tract. A small stone may pass all the way out of the body without causing too much pain.
A larger stone may get stuck in a ureter, the bladder, or the urethra. A problem stone can block the flow of urine and cause great pain.
Most kidney stones pass out of the body without help from a doctor. But sometimes a stone will not pass. It may even get larger. You should call a doctor if you have any of the following signs:
• extreme pain in your back or side that will not go away
• blood in your urine
• fever and chills
• vomiting
• urine that smells bad or looks cloudy
• a burning feeling when you urinate
Are all kidney stones alike?
No. Doctors have found four major types of kidney stones.
• The most common type of stone contains calcium. Calcium is a normal part of a healthy diet.
• Though calcium is a normal part of a healthy diet, that which is not used by the bones and muscles goes to the kidneys. In most people, the kidneys flush out the extra calcium with the rest of the urine. People who have calcium stones keep the calcium in their kidneys.
• The calcium that stays behind joins with other waste products to form a stone. The most common combination is called calcium oxalate.
• A struvite stone may form after an infection in the urinary system. These stones contain the mineral magnesium and the waste product ammonia.
• A uric acid stone may form when the urine contains too much acid. If you tend to form uric acid stones, you may need to cut back on the amount of meat you eat.
• Cystine stones are rare. Cystine is one of the building blocks that make up muscles, nerves, and other parts of the body. Cystine can build up in the urine to form a stone. The disease that causes cystine stones runs in families.
What can my doctor do about a problem stone?
If you have a stone that will not pass by itself, your doctor may need to take steps to get rid of it. In the past, the only way to remove a problem stone was through surgery.
Now, doctors have new ways to remove problem stones. The following sections describe a few of these methods.
Shock Waves
Your doctor can use a machine to send shock waves directly to the kidney stone. The shock waves break a large stone into small stones that will pass through your urinary system with your urine. The full name for this method is extracorporeal shock wave lithotripsy. Doctors often call it ESWL for short. Lithotripsy is a Greek word that means stone crushing.
Two types of shock wave machines exist. With one machine, you sit in a tub of water. With most newer machines, you lie on a table. A health technician will use ultrasound or x-ray images to direct the sound waves to the stone.
Tunnel Surgery
In tunnel surgery, the doctor makes a small cut into the patient's back and makes a narrow tunnel through the skin to the stone inside the kidney. With a special instrument that goes through the tunnel, the doctor can find the stone and remove it. The technical name for this method is percutaneous nephrolithotomy.
Ureteroscope
A ureteroscope looks like a long wire. The doctor inserts it into the patient's urethra, passes it up through the bladder, and directs it to the ureter where the stone is located. The ureteroscope has a camera that allows the doctor to see the stone. A cage is used to catch the stone and pull it out, or the doctor may destroy it with a device inserted through the ureteroscope.
Ask your doctor which method is right for you.
How will my doctor find out what kind of stone I have?
The best way for your doctor to find out what kind of stone you have is to test the stone itself. If you know that you are passing a stone, try to catch it in a strainer.
Your doctor may ask for a urine sample or take blood to find out what caused your stone. You may need to collect your urine for a 24-hour period. These tests will help your doctor find ways for you to avoid stones in the future.
Why do I need to know the kind of stone?
The therapy your doctor gives you depends on the type of stone you have. For example, a medicine that helps prevent calcium stones will not work if you have a struvite stone. The diet changes that help prevent uric acid stones may not work to prevent calcium stones. Therefore, careful analysis of the stone will help guide your treatment.
Points to Remember
•Most stones will pass out of the body without a doctor's help.
•See your doctor if you have severe pain in your back or side that will not go away.
•See your doctor if you have blood in your urine-urine will appear pink.
•When you pass a stone, try to catch it in a strainer to show your doctor.
•Drink lots of water to prevent more kidney stones from forming.
•Talk with your doctor about other ways to avoid more stones.
For More Information, contact:
American Urological Association Foundation
1000 Corporate Boulevard, Suite 410
Linthicum, MD 21090
Phone: 1-866-RING-AUA (746-4282)
Email: patienteducation@auafoundation.org
Internet: www.auafoundation.org
www.UrologyHealth.org
There are a number of reasons for why both adults and children develop this painful condition and most of it has to diet, which means it is also preventable. Factors that put us at risk is not drinking enough fluid and ingesting too much of what dehydrates us, so avoid drinking too much caffeine, eating too much salt (should take in no more than 3000 mg. per day) and protein, and eating too much oxalate found in chocolate, peanuts, spinach, tea and black pepper.
The biggest cause of kidney stones is not drinking enough decaffeinated liquid. Doctors recommend that we drink enough to make more than a half a gallon of urine. “The Institute of Medicine reported that U.S. women who appeared to be adequately hydrated consumed the equivalent of about 91 ounces of fluids each day, and men about 125 ounces -- far more than the 64 ounces in eight glasses of water --but stated that beverages other than water and the fluid in solid foods also counted toward the total. Even a slice of white bread is more than 30% water.
Doctors believe that if we wait until we’re thirsty to drink that we are already dehydrated. It is imperative to drink water constantly throughout the day especially if the weather is hot or physical activity is high, which, of course is the reason that children are prone, that and the fact that too many children live on a steady diet of colas, energy drinks and sweets. How do these bad choices impact our kidneys? Well let’s look at what the kidneys do as described by American Urological Association Foundation.
“What do the kidneys do?
Your kidneys are bean-shaped organs, each about the size of your fist. They are located near the middle of your back, just below the rib cage, one on each side of the spine. The kidneys are sophisticated trash collectors. Every day, your kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The wastes and extra water become urine, which flows to your bladder through tubes called ureters. Your bladder stores urine until you go to the bathroom.
The wastes in your blood come from the normal breakdown of active muscle and from the food you eat. Your body uses the food for energy and self-repair. After your body has taken what it needs from the food, wastes are sent to the blood. If your kidneys did not remove these wastes, they would build up in the blood and damage your body.
In addition to removing wastes, your kidneys help control blood pressure. They also help make red blood cells and keep your bones strong.
What is a kidney stone?
A kidney stone is a solid piece of material that forms in a kidney out of substances in the urine.
A stone may stay in the kidney or break loose and travel down the urinary tract. A small stone may pass all the way out of the body without causing too much pain.
A larger stone may get stuck in a ureter, the bladder, or the urethra. A problem stone can block the flow of urine and cause great pain.
Most kidney stones pass out of the body without help from a doctor. But sometimes a stone will not pass. It may even get larger. You should call a doctor if you have any of the following signs:
• extreme pain in your back or side that will not go away
• blood in your urine
• fever and chills
• vomiting
• urine that smells bad or looks cloudy
• a burning feeling when you urinate
Are all kidney stones alike?
No. Doctors have found four major types of kidney stones.
• The most common type of stone contains calcium. Calcium is a normal part of a healthy diet.
• Though calcium is a normal part of a healthy diet, that which is not used by the bones and muscles goes to the kidneys. In most people, the kidneys flush out the extra calcium with the rest of the urine. People who have calcium stones keep the calcium in their kidneys.
• The calcium that stays behind joins with other waste products to form a stone. The most common combination is called calcium oxalate.
• A struvite stone may form after an infection in the urinary system. These stones contain the mineral magnesium and the waste product ammonia.
• A uric acid stone may form when the urine contains too much acid. If you tend to form uric acid stones, you may need to cut back on the amount of meat you eat.
• Cystine stones are rare. Cystine is one of the building blocks that make up muscles, nerves, and other parts of the body. Cystine can build up in the urine to form a stone. The disease that causes cystine stones runs in families.
What can my doctor do about a problem stone?
If you have a stone that will not pass by itself, your doctor may need to take steps to get rid of it. In the past, the only way to remove a problem stone was through surgery.
Now, doctors have new ways to remove problem stones. The following sections describe a few of these methods.
Shock Waves
Your doctor can use a machine to send shock waves directly to the kidney stone. The shock waves break a large stone into small stones that will pass through your urinary system with your urine. The full name for this method is extracorporeal shock wave lithotripsy. Doctors often call it ESWL for short. Lithotripsy is a Greek word that means stone crushing.
Two types of shock wave machines exist. With one machine, you sit in a tub of water. With most newer machines, you lie on a table. A health technician will use ultrasound or x-ray images to direct the sound waves to the stone.
Tunnel Surgery
In tunnel surgery, the doctor makes a small cut into the patient's back and makes a narrow tunnel through the skin to the stone inside the kidney. With a special instrument that goes through the tunnel, the doctor can find the stone and remove it. The technical name for this method is percutaneous nephrolithotomy.
Ureteroscope
A ureteroscope looks like a long wire. The doctor inserts it into the patient's urethra, passes it up through the bladder, and directs it to the ureter where the stone is located. The ureteroscope has a camera that allows the doctor to see the stone. A cage is used to catch the stone and pull it out, or the doctor may destroy it with a device inserted through the ureteroscope.
Ask your doctor which method is right for you.
How will my doctor find out what kind of stone I have?
The best way for your doctor to find out what kind of stone you have is to test the stone itself. If you know that you are passing a stone, try to catch it in a strainer.
Your doctor may ask for a urine sample or take blood to find out what caused your stone. You may need to collect your urine for a 24-hour period. These tests will help your doctor find ways for you to avoid stones in the future.
Why do I need to know the kind of stone?
The therapy your doctor gives you depends on the type of stone you have. For example, a medicine that helps prevent calcium stones will not work if you have a struvite stone. The diet changes that help prevent uric acid stones may not work to prevent calcium stones. Therefore, careful analysis of the stone will help guide your treatment.
Points to Remember
•Most stones will pass out of the body without a doctor's help.
•See your doctor if you have severe pain in your back or side that will not go away.
•See your doctor if you have blood in your urine-urine will appear pink.
•When you pass a stone, try to catch it in a strainer to show your doctor.
•Drink lots of water to prevent more kidney stones from forming.
•Talk with your doctor about other ways to avoid more stones.
For More Information, contact:
American Urological Association Foundation
1000 Corporate Boulevard, Suite 410
Linthicum, MD 21090
Phone: 1-866-RING-AUA (746-4282)
Email: patienteducation@auafoundation.org
Internet: www.auafoundation.org
www.UrologyHealth.org
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