“A pulmonary embolism (PE) is a blood clot that blocks the flow of blood to part of one lung. Many people with this condition have two or more clots in one or both lungs. Symptoms of a pulmonary embolism can vary as subtle to pronounced.  A pulmonary embolism is a serious and potentially life-threatening condition, but there are ways to help prevent it.

Because almost all pulmonary emboli originate from a DVT, and the risk factors and treatment of both are similar, doctors often use the umbrella term venous thromboembolic (VTE) disease to cover both conditions.

Thrombus occurs when a blood clot forms locally in a blood vessel and slows or blocks the flow of blood. There are two types of thrombosis: venous and arterial.

An embolus is any foreign substance that moves in your bloodstream until it blocks a blood vessel. An embolism is often caused when a thrombus or a piece of thrombus breaks off from where it formed and travels to another area of your body.

An embolism is a life-threatening condition and can cause serious complications such as stroke (clot in the brain) and pulmonary embolism (clot or blockage in the lung).

Pulmonary emboli affect about 900,000 people in the U.S. each year. They can happen to anyone at any stage of life, even very healthy people. Depending on the size of the clot and which blood vessels are blocked, a pulmonary embolism can be life-threatening.”

Harvard Health Publishing/Harvard Medical School (Pulmonary embolism: Symptoms, causes, risk factors, and treatment – Harvard Health)

Pulmonary embolism (PULL-mun-ary EM-bo-lizm), or PE, is a sudden blockage in a lung artery. The blockage usually is caused by a blood clot that travels to the lung from a vein in the leg.  The clot gets to the right side of the heart and goes into the upper chamber (atrium) down to the lower chamber (ventricles) to the pulmonary artery bringing the clot into the lungs.

A clot that forms in one part of the body and travels in the bloodstream to another part of the body is called an embolus (EM-bo-lus).

PE is a serious condition that can:

• Damage part of your lung because of a lack of blood flow to your lung tissue. This damage may lead to pulmonary hypertension (increased pressure in the pulmonary arteries).
• Cause low oxygen levels in your blood.
• Damage other organs in your body because of a lack of oxygen.

If a blood clot is large, or if there are many clots, PE can cause death.

Overview

PE most often is a complication of a condition called deep vein thrombosis (DVT). In DVT, blood clots form in the deep veins of the body—most often in the legs. These clots can break free, travel through the bloodstream to the lungs, and block an artery.

Deep vein clots are not like clots in veins close to the skin’s surface. Those clots remain in place and do not cause PE.

Outlook

The exact number of people affected by DVT and PE isn’t known. Estimates suggest these conditions affect 300,000 to 600,000 people in the United States each year.

If left untreated, about 30 percent of patients who have PE will die. Most of those who die do so within the first few hours of the event.

The good news is that a prompt diagnosis and proper treatment can save lives and help prevent the complications of PE.

Other Names for Pulmonary Embolism

• Venous thromboembolism (VTE). This term is used for both pulmonary embolism and deep vein thrombosis.

What Causes Pulmonary Embolism?

Major Causes

Pulmonary embolism (PE) usually begins as a blood clot in a deep vein of the leg. This condition is called deep vein thrombosis. The clot can break free, travel through the bloodstream to the lungs, and block an artery.

Blood clots can form in the deep veins of the legs if blood flow is restricted and slows down. This can happen if you don’t move around for long periods, such as:

• After some types of surgery
• During a long trip in a car or airplane
• If you must stay in bed for an extended time

Blood clots are more likely to develop in veins damaged from surgery or injured in other ways.

Other Causes

Rarely, an air bubble, part of a tumor, or other tissue travels to the lungs and causes PE. Also, if a large bone in the body (such as the thigh bone) breaks, fat from the bone marrow can travel through the blood. If the fat reaches the lungs, it can cause PE.

Who Is at Risk for Pulmonary Embolism?

Pulmonary embolism (PE) occurs equally in men and women. The risk increases with age. For every 10 years after age 60, the risk of having PE doubles.

Certain inherited conditions, such as factor V Leiden, increase the risk of blood clotting and PE.

Major Risk Factors

Your risk for PE is high if you have deep vein thrombosis (DVT) or a history of DVT. In DVT, blood clots form in the deep veins of the body—most often in the legs. These clots can break free, travel through the bloodstream to the lungs, and block an artery.

Your risk for PE also is high if you’ve had the condition before.

Other Risk Factors

Other factors also can increase the risk for PE, such as:

• Being bedridden or unable to move around much
• Having surgery or breaking a bone (the risk goes up in the weeks following the surgery or injury)
• Having certain diseases or conditions, such as a stroke, paralysis (an inability to move), chronic heart disease, or high blood pressure
• Smoking

People who have recently been treated for cancer or who have a central venous catheter are more likely to develop DVT, which increases their risk for PE. A central venous catheter is a tube placed in a vein to allow easy access to the bloodstream for medical treatment.  A clot can form at the end of it but usually in preventing this if not heparin bolus (ex.300 U in 5 cc of normal saline) is flushed in the catheter if not just flushing the catheter with 10cc of normal saline the prevent the clot forming every 8 hrs or 12 hrs.

Other risk factors for DVT include sitting for long periods (such as during long car or airplane rides), pregnancy and the 6-week period after pregnancy, and being overweight or obese. Women who take hormone therapy pills or birth control pills also are at increased risk for DVT.

The risk of developing blood clots increases as your number of risk factors increases.

What Are the Signs and Symptoms of Pulmonary Embolism?

Major Signs and Symptoms

Signs and symptoms of pulmonary embolism (PE) include unexplained shortness of breath, problems breathing, chest pain, coughing, or coughing up blood. An arrhythmia (irregular heartbeat) also may suggest that you have PE.

Sometimes the only signs and symptoms are related to deep vein thrombosis (DVT). These include swelling of the leg or along a vein in the leg, pain or tenderness in the leg, a feeling of increased warmth in the area of the leg that’s swollen or tender, and red or discolored skin on the affected leg.

See your doctor right away if you have any signs or symptoms of PE or DVT. It’s also possible to have PE and not have any signs or symptoms.

Other Signs and Symptoms

Some people who have PE have feelings of anxiety or dread, light-headedness or fainting, rapid breathing, sweating, or an increased heart rate.

How Is Pulmonary Embolism Diagnosed?

Pulmonary embolism (PE) is diagnosed based on your medical history, a physical exam, and test results.

Doctors who treat patients in the emergency room often are the ones to diagnose PE with the help of a radiologist. A radiologist is a doctor who deals with x rays and other similar tests.

Medical History and Physical Exam

To diagnose PE, the doctor will ask about your medical history. He or she will want to:

• Find out your deep vein thrombosis (DVT) and PE risk factors
• See how likely it is that you could have PE
• Rule out other possible causes for your symptoms

Your doctor also will do a physical exam. During the exam, he or she will check your legs for signs of DVT. He or she also will check your blood pressure and your heart and lungs.

Diagnostic Tests

Many tests can help diagnose PE. Which tests you have will depend on how you feel when you get to the hospital, your risk factors, available testing options, and other conditions you could possibly have. You may have one or more of the following tests.

Ultrasound

Doctors can use ultrasound to look for blood clots in your legs. Ultrasound uses sound waves to check blood flow in your veins.

For this test, gel is put on the skin of your legs. A hand-held device called a transducer is moved back and forth over the affected areas. The transducer gives off ultrasound waves and detects their echoes as they bounce off the vein walls and blood cells.

A computer turns the echoes into a picture on a computer screen, allowing the doctor to see blood flow in your legs. If the doctor finds blood clots in the deep veins of your legs, he or she will recommend treatment.

DVT and PE both are treated with the same medicines.

Computed Tomography Scans

Doctors can use computed tomography (to-MOG-rah-fee) scans, or CT scans, to look for blood clots in the lungs and legs.

For this test, dye is injected into a vein in your arm. The dye makes the blood vessels in your lungs and legs show up on x-ray images. You’ll lie on a table, and an x-ray tube will rotate around you. The tube will take pictures from many angles.

This test allows doctors to detect most cases of PE. The test only takes a few minutes. Results are available shortly after the scan is done.

Lung Ventilation/Perfusion Scan

A lung ventilation/perfusion scan, or VQ scan, uses a radioactive substance to show how well oxygen and blood are flowing to all areas of your lungs. This test can help detect PE.

Pulmonary Angiography

Pulmonary angiography (an-jee-OG-rah-fee) is another test used to diagnose PE. This test isn’t available at all hospitals, and a trained specialist must do the test.

For this test, a flexible tube called a catheter is threaded through the groin (upper thigh) or arm to the blood vessels in the lungs. Dye is injected into the blood vessels through the catheter.

X-ray pictures are taken to show blood flowing through the blood vessels in the lungs. If a blood clot is found, your doctor may use the catheter to remove it or deliver medicine to dissolve it.

Blood Tests

Certain blood tests may help your doctor find out whether you’re likely to have PE.

A D-dimer test measures a substance in the blood that’s released when a blood clot breaks down. High levels of the substance may mean a clot is present. If your test is normal and you have few risk factors, PE isn’t likely.

Other blood tests check for inherited disorders that cause blood clots. Blood tests also can measure the amount of oxygen and carbon dioxide in your blood. A clot in a blood vessel in your lungs may lower the level of oxygen in your blood.

Other Tests

To rule out other possible causes of your symptoms, your doctor may use one or more of the following tests.

• Echocardiography (echo). This test uses sound waves to create a moving picture of your heart. Doctors use echo to check heart function and detect blood clots inside the heart.
• EKG (electrocardiogram). An EKG is a simple, painless test that detects and records the heart’s electrical activity.
• Chest x ray. This test creates pictures of your lungs, heart, large arteries, ribs, and diaphragm (the muscle below your lungs).
• Chest MRI (magnetic resonance imaging). This test uses radio waves and magnetic fields to create pictures of organs and structures inside the body. MRI often can provide more information than an x ray.

How Is Pulmonary Embolism Treated?

Pulmonary embolism (PE) is treated with medicines, procedures, and other therapies. The main goals of treating PE are to stop the blood clot from getting bigger and keep new clots from forming.

Treatment may include medicines to thin the blood and slow its ability to clot. If your symptoms are life threatening, your doctor may give you medicine to quickly dissolve the clot. Rarely, your doctor may use surgery or another procedure to remove the clot.

Medicines

Anticoagulants (AN-te-ko-AG-u-lants), or blood thinners, decrease your blood’s ability to clot. They’re used to stop blood clots from getting larger and prevent clots from forming. Blood thinners don’t break up blood clots that have already formed. (The body dissolves most clots with time.)

You can take blood thinners as either a pill, an injection, or through a needle or tube inserted into a vein (called intravenous, or IV, injection). Warfarin is given as a pill. (Coumadin^® is a common brand name for warfarin.) Heparin is given as an injection or through an IV tube; usually given as Heparin drip than when Counmadin starts within 24 hrs the drip is discontinued in the hospital and the patient stays on coumadin or some type of blood thinner as the MD prescribes.

At times, your doctor may treat you with both heparin and warfarin at the same time. Heparin acts quickly. Warfarin takes 2 to 3 days before it starts to work. Once warfarin starts to work, heparin usually is stopped.

Pregnant women usually are treated with heparin only, because warfarin is dangerous for the pregnancy.

If you have deep vein thrombosis, treatment with blood thinners usually lasts for 3 to 6 months. If you’ve had blood clots before, you may need a longer period of treatment. If you’re being treated for another illness, such as cancer, you may need to take blood thinners as long as PE risk factors are present.

The most common side effect of blood thinners is bleeding. This can happen if the medicine thins your blood too much. This side effect can be life threatening.

Sometimes the bleeding is internal, which is why people treated with blood thinners usually have routine blood tests. These tests, called PT and PTT tests, measure the blood’s ability to clot. These tests also help your doctor make sure you’re taking the right amount of medicine. Call your doctor right away if you’re bruising or bleeding easily.

Thrombin inhibitors are a newer type of blood-thinning medicine. They’re used to treat some types of blood clots in people who can’t take heparin.

Emergency Treatment

When PE is life threatening, a doctor may use treatments that remove or break up the blood clot. These treatments are given in an emergency room or hospital.

Thrombolytics (THROM-bo-LIT-iks) are medicines that can quickly dissolve a blood clot. They’re used to treat large clots that cause severe symptoms. Because thrombolytics can cause sudden bleeding, they’re used only in life-threatening situations.

Sometimes a doctor may use a catheter (a flexible tube) to reach the blood clot. The catheter is inserted into a vein in the groin (upper thigh) or arm and threaded to the clot in the lung. The doctor may use the catheter to remove the clot or deliver medicine to dissolve it.

Rarely, surgery may be needed to remove the blood clot.

Other Types of Treatment

If you can’t take medicines to thin your blood, or if the medicines don’t work, your doctor may suggest a vena cava filter. This device keeps blood clots from traveling to your lungs.

The filter is inserted inside a large vein called the inferior vena cava. (This vein carries blood from the body back to the heart). The filter catches clots before they travel to the lungs. This type of treatment can prevent PE, but it won’t stop other blood clots from forming.

Graduated compression stockings can reduce the chronic (ongoing) swelling that a blood clot in the leg may cause.

Graduated compression stockings are worn on the legs from the arch of the foot to just above or below the knee. These stockings are tight at the ankle and become looser as they go up the leg. This causes gentle compression (pressure) up the leg. The pressure keeps blood from pooling and clotting.

“Safety Support Solidarity!

Like safety, there is no one-size-fits-all definition of support for survivors. Often the most important thing you can do to support the survivors in your life is to simply be there for them, without judgement or expectation. If you are an advocate or other helping professional, you likely know this already, as supporting survivors is a huge part of your work. That said, we can all find ways to support the survivors in our lives, regardless of our profession.

What does “safety” look like to you? Freedom from violence? A roof over your head? When we say that survivors deserve safety, we mean that all survivors – and in fact, all people – deserve to live in safety and dignity, however they define it for themselves. This can include, but is not limited to:

• Physical safety: freedom from violence, safe housing, adequate food, access to medical care
• Emotional safety: trusting and respectful relationships, being able to express thoughts and feelings without judgement or ridicule, feeling a sense of belonging
• Financial safety: stability, access to finances, freedom from housing/food insecurity”

VAW net (How can I stand with survivors for Domestic Violence Awareness Month and beyond?)

“October is Domestic Violence Month—and a good time to be reminded that women are not the only victims. Men are victims too.

Domestic violence statistics updated October 2024 by the U.S. Centers for Disease Control and Prevention (CDC):

• In the United States, nearly every 1 in 2 women and more than 2 in 5 men reported experiencing intimate partner violence at some point in their lifetime.
• Every minute, 32 people experience intimate partner violence in the United States.
• 1 in 4 men in the United States has endured severe physical violence from an intimate partner.”

Psychology Today (Male Victims of Intimate Partner Violence | Psychology Today)

We live in a scary world and for reasons society inflicted on itself; regarding the thought process or how our mind works.  Domestic Violence is violent or aggressive behavior within the home, typically involving the violent abuse of a spouse or partner.

People are often confronted with feelings of disappointment, frustration and anger as they interact with government officials, co-workers, family and even fellow commuters; which is people just in society. Most can control their actions to the extent that relatively few of these interactions end in a radical action like being racist to violence.

What help build a individuals feelings to turn out in a negative result (like bullying someone to protesting to worse rioting to violence or killing) is factors.

Factors being:

• Feel powerless
• Suffer from insecurity
• Need to control others
• Enjoy the rewards they get from bullying
• YOUR CHILDHOOD UPBRINGING. Your childhood builds the foundation of how you turn out as an adult. If you have good upbringing where there are good morals, values, ethics with limitations or rules and regulations in what you can and cannot do with mommy and daddy overlooking from a distance in watching the child’s actions/interests/who they play with/what they’re doing on the computer or watching on T.V or even listening to music will help give direction for their child to be effective in society. Including, as the child shows good choices than more independence in getting older with still guidance and direction as needed. Remember your a young adult at 17 and a full fledged adult at 21 years of age to make all decisions in your life.

1. BEING AN ADULT.   This includes accepting the turn outs of how a situation finally results; before the final result if you did everything you could legally try to reach your hope of a turn out and did reach it great, it makes you a stronger person. Now let’s say you didn’t than acceptance is necessary of what the result turned out as which also makes you a stronger person with being an asset in the community. Than your next step whether it be alone or in society overall move on without being an insult to the community where it effects the society in a negative way (like killing 2 innocent police officers just for wearing the color blue in uniform, prejudice=a radical action).   Being able to allow acceptance in your life which doesn’t always turn out the way you want it to helps you move on in life making you less out to be radical in your behavior. Take the riots (which they call protesting a radical approach from Missouri to New York) and see what their results turned out to be. Stopping people from getting to a destination point who had nothing to do with what the protestors were protesting about, to damage of property of innocent people’s business to the worse DEATH. Like this radical move did anything productive for humans in society. It obviously didn’t.

First let’s look at what turns anger into action?

The answer to this is mostly cognitive control or to use a less technical term, self-control.   University of Michigan professor of social psychology, Richard Nisbett, the world’s greatest authority on intelligence, plainly said that he’d rather have his son being high in self-control than intelligence, one year ago. Self-control is the key to a well-functioning life, because our brain makes us easily [susceptible] to all sorts of influences. Watching a movie showing violent acts predisposes us to act violently. Even just listening to violent rhetoric makes us prone or more inclined to be violent. Ironically, the same mirror neurons that make us empathic make us also very vulnerable to all sorts of influences. This is why control mechanisms are so important. If you think about it, there must be control mechanisms for mirror neurons. Mirror neurons are cells that fire when you grab a cup of coffee (to give you an example) as well as when you see someone else grabbing a cup of coffee. So, how come you don’t imitate all the time? The idea is that there are systems in the brain that help us by imitating only “internally”—they dampen the activity of mirror neurons when we simply watch, so that we can still have the sort of “inner imitation” that allows us to empathize with others, without any overt imitation. The key issue is the balance of power between these control mechanisms that we call top-down—because they are all like executives that control from the top down to the employees—and bottom-up mechanisms, in the opposite direction, like mirror neurons. This is whereby perception—watching somebody making an action—influences decisions—making the same action ourselves.

Neuroscience uncovered why people behave so violently looking into the Virginia Tech Massacre in 2007 with many other like incidents also which were still a small percentage of people. What happens in these individuals is that their cognitive control mechanisms are deranged. Mind you, these individuals are not out-of-control, enraged people. They just use their cognitive control mechanisms in the service of a disturbed goal. There are probably a multitude of factors at play here. The subject is exposed to influences that lead him or her to violent acts—including, unfortunately, not only the violent political rhetoric but also the media coverage of similar acts, as we are doing here. A variety of issues, especially mental health problems that lead to social isolation, lead the subject to a mental state that alters his or her ability to exercise cognitive control in a healthy manner. Again also childhood plays a big role.   The cognitive control capacities of the subject get somewhat redirected—we don’t quite understand how—toward goals and activities that are violent in a very specific way. Not the violent outburst of somebody who has “lost it” in a bar, punching people right and left. The violence is channeled in a very specific plan, with a very specific target—generally fed by the media (like take the protesting that has gone on from Missouri to New York for a month or more with media showing every news flash each day)through some sort of rhetoric, political or otherwise—with very specific tools, in the Giffords case, a 9-millimeter Glock.

Now lets look at what are the signs of a person who is disturbed enough to take some form of action to killing.   The signs are quite visible, although difficult to interpret without a context—and unfortunately they unfold very quickly , and people can rarely witness them before the action is taken (which happened with Brinsley in New York killing officers in Brooklyn on duty just doing their job), . The action itself is a sign, a desperate form of communication from a disturbed individual (Brinsley did put on the internet a warning the day it was going to be done, Sat 12/20/14. Unfortunately, nobody was chatting with the guy when he left his final messages on Internet before getting into action. But I bet that if somebody was communicating with him before the act and saw those signs and read those messages on social network he was using, that person could have done something, could have engaged him in a sort of conversation that might have redirected his deranged plans. Indeed, by connecting with the subject, that person might have redirected some of the activity of mirror neurons toward a truly empathic behavior, rather than in the service of the deranged imitative violence leading to action.

Now we have Ukraine vs Israel War with now Former President Trump having attempted assassinations not once but THREE times because people did not agree to want him as President of the U.S.  What is this world coming to.

My readers I could go on with more examples of people killing but I am sure you listen to the news or read it somehow but I tell you this information not to persecute a person, not even a race or politician but to LEARN HOW THE BRAIN WORKS.   Most importantly to PARENTS bring your children up AS A CHILD not as an adult until they reach adulthood with giving good direction and guidance as their primary mentor. You the parents make our next generation who are now children and even for future parents learn so they will have a more productive working society. For now the society in America works as a   nonproductive unit of people to all races, creeds, genders, sex preferences, & nationalities of all kinds. Especially in being compared to the 1980’s; yes they had their problems but not like today’s with people treating each other with more respect even if things didn’t go their way. Our nation didn’t go off the deep end  where  it was allowing us to have freedom of everything without limitations or better rules/regulations legally in place not followed which we are paying a good price for today for allowing this behaviour and will take a very long time to fix. Remember when someone or now a group of people get hurt you can forgive but healing is like a wound it takes time to heal. Example: Look at Hitler, people who haven’t forgiven him, those that did have not forgotten it and they shouldn’t since he caused such a disaster to the human race. Protesting can be effective where its peaceful, quiet, and not bothering other people in the area who aren’t involved. Look at Missouri and New York City this past 15  years, MUCH DAMAGE due to not thinking first but acting out first.

Take A Stand is a call to action meant to bring attention to the issue of domestic violence for Domestic Violence Awareness Month (DVAM) and throughout the year.  By taking a stand we intend to remind the nation that there are still countless people–victims and survivors, their children and families, their friends and family, their communities–impacted by domestic violence.  We, all of us, should not stop until society has zero tolerance for domestic violence and until all victims and survivors can be heard.

Take A Stand is a call to action meant to bring attention to the issue of domestic violence for Domestic Violence Awareness Month (DVAM) and throughout the year.  By taking a stand we intend to remind the nation that there are still countless people–victims and survivors, their children and families, their friends and family, their communities–impacted by domestic violence.  We, all of us, should not stop until society has zero tolerance for domestic violence and until all victims and survivors can be heard.

Taking a stand against domestic violence means speaking up when we see or hear behaviors that contribute to a culture where violence lives. This could mean trying to stop violence before it starts by promoting healthy relationships and attitudes, supporting survivors of violence when they come forward, or intervening if you see someone acting violently toward another person. Before you intervene in a situation, think about your personal safety, the safety of others, your relationship with the people involved, and what your options are for intervening.

Strategies on how to take a stand:

1) Refocus the Conversation

This is the least direct approach to intervening as a bystander, by refocusing the conversation away from the offensive comment or person.  The goal is to not give an audience to the comment or person by changing the situation.  This approach can work especially well if you are uncomfortable confronting the offender directly for any reason, like someone in a position of power.  You could ask for the time, ask for directions, make a joke, tell a story, or even spill your drink.  If the comment is toward a specific person, you could take a more direct approach and verbally support the target without addressing the offender.

2) Engage Others in Intervention

In this approach, the goal is to use the situation to promote a new positive perspective for all the bystanders. You can do this by asking the group a question that challenges the idea you think is problematic without directly refuting it.  For example, if a friend or family member makes a victim blaming comment about someone returning to a relationship where there is domestic violence, you could say, “I know it’s easy to ask why victims go back when we hear about domestic violence, but maybe a better question would be why someone would think it’s okay to harm or control someone they love.”

3) A Direct Confrontation

In this case, the bystander approaches the person who made the offending comment and explains why what they said is a problem, or how the comment made the bystander feel. You could choose to confront the situation right away or wait for a moment of privacy with this person. It could also be good to seek the support of another friend, especially if you worry that your approach will not be taken seriously.

Your goal is to make whoever you’re approaching consider, even briefly, why their behavior is problematic with the hope of influencing future behavior.

“An estimated 2.5% of adults worldwide have ADHD and 4.4% of adults in the U.S. have ADHD. More than half of those who have ADHD also have other behavioral health and mood disorder diagnoses like depression or anxiety.

“When adult ADHD is not attended to, with either therapy or medicine, it results in the adult leaving a trail of incompletions in their path, and leaving things incomplete can cause some people to get anxious or depressed,“ says Dr. Manos. “Many times, adults with ADHD can be diagnosed with a depressive disorder or anxiety disorder because of that very thing.”

For this reason, it’s important to get the diagnosis for adult ADHD correct and identify any underlying causes to provide the best course of treatment. When diagnosing ADHD, doctors look at 18 different symptoms — nine inattentive symptoms and nine hyperactivity symptoms.

Diagnosing ADHD is a 3-step process. When diagnosing an adult for ADHD, a doctor looks for:

• Symptoms of ADHD that are problematic to a person’s life.
• External factors that could be causing the behavior in question.
• The presence of another mental health disorder.”

Cleveland Clinic (18 Symptoms That Could Indicate Adult ADHD)

What is Attention Deficit Hyperactivity Disorder (ADHD)?

Attention deficit hyperactivity disorder (ADHD) is one of the most well-recognized childhood developmental problems. This condition is characterized by inattention, hyperactivity and impulsiveness. It is now known that these symptoms continue into adulthood for about 60% of children with ADHD. That translates into 4% of the U.S. adult population, or 8 million adults. However, few adults are identified or treated for adult ADHD.

ADHD in Adults

Adults with ADHD may have difficulty following directions, remembering information, concentrating, organizing tasks, or completing work within time limits. If these difficulties are not managed appropriately, they can cause associated behavioral, emotional, social, vocational, and academic problems.

Adult ADHD Statistics

• ADHD afflicts approximately 3% to 10% of school-aged children and an estimated 60% of those will continue to have symptoms that affect their functioning as adults.
• Prevalence rates for ADHD in adults are not as well determined as rates for children, but fall in the 4% to 5% range.
• ADHD affects males at higher rate than females in childhood, but this ratio seems to even out by adulthood.

Common Behaviors and Problems of Adult ADHD

The following behaviors and problems may stem directly from ADHD or may be the result of related adjustment difficulties:

• Anxiety
• Chronic boredom
• Chronic lateness and forgetfulness
• Depression
• Difficulty concentrating when reading
• Difficulty controlling anger
• Employment problems
• Impulsiveness
• Low frustration tolerance
• Low self-esteem
• Mood swings
• Poor organization skills or messy (clutters in the office or in the house)
• Procrastination
• Relationship problems
• Substance abuse or addiction

These behaviors may be mild to severe and can vary with the situation or be present all of the time. Some adults with ADHD may be able to concentrate if they are interested in or excited about what they are doing. Others may have difficulty focusing under any circumstances. Some adults look for stimulation, but others avoid it. In addition, adults with ADHD can be withdrawn and antisocial, or they can be overly social, going from one relationship to the next.

School-Related Impairments Linked to Adult ADHD

Adults with ADHD may have:

• Had a history of poorer educational performance and been underachievers
• Had more frequent school disciplinary actions
• Had to repeat a grade
• Dropped out of school more often

Work-Related Impairments Linked to Adult ADHD

Adults with ADHD are more likely to:

• Change employers frequently and perform poorly
• Have less job satisfaction and fewer occupational achievements, independent of psychiatric status

Social-Related Impairments Linked to Adult ADHD

Adults with ADHD are more likely to:

• Have a lower socioeconomic status
• Have driving violations such as being cited for speeding, having their license suspended, and being involved in more crashes
• Rate themselves and others as using poorer driving habits
• Use illegal substances more frequently
• Smoke cigarettes
• Self-report psychological maladjustment more often

When ADHD enters the bedroom, distraction, wandering thoughts, and a lack of desire usually aren’t far behind. In fact, sexual boredom is one of the biggest complaints among ADHD couples, and a major reason behind their high divorce rate. Unfortunately, even when couples are sexually active, ADHD symptoms can interfere with emotional and sexual intimacy, leaving one or both partners feeling unconnected, alone, and sexually frustrated or unsatisfied.

Looking at ADHD & when intimacy just doesn’t jive.

Hurt feelings, confusion, and resentment can build and fester when one or both partners feel emotionally and/or sexually unsatisfied. If misinformation or misunderstanding is the main culprit, a marriage counselor or sex therapist can help the non-ADHD spouse understand how the disorder affects sexual desire and performance.

For instance, many ADHD partners are too hyperactive to relax and get in the mood. Instead of shutting out the world and focusing on their partner, they’re distracted by their racing thoughts. Others are distracted by loud music, even if it’s romantic. Instead of focusing on their partner, they may start singing along or talking about how much they loved the last concert.

How to Improve Sexual Intimacy

Provided there aren’t emotional distractions or barriers interfering with intimacy, it’s possible to overcome distractions that may prevent an ADHD spouse from being able to focus on, respond to, or enjoy sexual intimacy.

The following are some strategies for turning up the heat in your ADHD marriage or relationship.

• Talk openly about what turns your ADHD spouse on — and off. If she’s super-sensitive to scented oils or lotions, finds music more distracting than romantic, or can’t stand your scratchy beard, get rid of it.
• Be open to new experiences. ADHD adults love novelty, so don’t be afraid to introduce something new to ward off ADHD boredom. Make sure you’re both comfortable with it before trying anything. If your ADHD spouse isn’t comfortable with it, it’s likely to become yet another ADHD distraction.
• Practice being in the moment. To help your hyperactive partner stay in the now, try doing yoga, tai chi, meditation, deep breathing exercises, or massage as a couple. Then move the relaxed togetherness into the bedroom.
• Let go of libido-killers. When ADHD symptoms make your ADHD spouse unreliable, it may force you into assuming the role of parent. Once the child/parent pattern becomes the norm in a relationship, romance and sexuality between partners usually declines. If you and your partner are trapped in this pattern, work with a therapist to rebalance your relationship so you’re both equal partners.
• Make a date. If conflicting schedules are preventing you and your partner from having fun together, playing together, or hooking up, make a date and put it on the calendar. Then commit to it.

Lasting Happiness and Love

While ADHD poses disadvantages in a relationship, it also has many advantages. Opposites often attract, so if you’re the steady, reliable, and dependable type who could use a jolt of spontaneity, impulsivity, novelty, and excitement, an ADHD spouse may be just what the doctor ordered. On the other hand, if you’re an ADHD adult who has trouble balancing his checkbook, matching his socks, or remembering to feed the dog, a non-ADHD spouse could be the gift from heaven you’ve been searching for.

While it may take some effort, it’s possible for an ADHD relationship to have a happy and permanent ending. An ADHD spouse needs to take responsibility for his disorder rather than use it as an excuse for his problems.

In addition, the non-ADHD spouse needs to remember that she’s married to someone who’s wired a little differently than most people. While an ADHD marriage may not always run like clockwork, it could be a lot more lively and fun.

Treatment for ADHD or ADD in adults:

• Individual Therapy
• ADD Coaching
• Medication
• ADHD/ADD centers
• Neurofeedback Training for ADD/ADHD

“An estimated 7 million (11.4%) U.S. children aged 3–17 years have ever been diagnosed with ADHD, according to a national survey of parents using data from 2022.

Estimated on sex, race and ethnicity the following was stated by CDC:

• Boys (15%) were more likely to be diagnosed with ADHD than girls (8%).
• Black children and White children were more often diagnosed with ADHD (both 12%) than Asian children (4%). American Indian/Alaska Native children (10%) were also more often diagnosed with ADHD than Asian children.
• Approximately 6% of Native Hawaiian/Pacific Islander children were diagnosed with ADHD.
• Overall, non-Hispanic children (12%) were diagnosed with ADHD more often than Hispanic children (10%).

Estimates nationally of children 3-17 y/o ever diagnosed and those who have receiving ADHD treatment are:

• National estimates among U.S. children aged 3–17 years who have ever been diagnosed with ADHD vary from 6% to 16% across states.
• Estimates for receiving any ADHD treatment among children with current ADHD vary from 58% to 92% across states.”

Center for Disease Control and Prevention – CDC (Data and Statistics on ADHD | Attention-Deficit / Hyperactivity Disorder (ADHD) | CDC)

“Primary liver cancer occurs in adults in two forms—hepatocellular carcinoma and cholangiocarcinoma (bile duct cancer). Hepatocellular carcinoma is the most common type of adult primary liver cancer. It is relatively rare in the United States. However, the incidence of liver cancer is rising, principally in relation to the spread of hepatitis C .

The liver is one of the largest organs in the body. It filters harmful substances from the blood, produces bile that helps in the digestion of fats, and stores sugar that the body uses for energy.

The National Cancer Institute estimated that 42,240 new cases of liver cancer and intrahepatic bile duct cancer are expected to be diagnosed in the United States in 2025. Approximately 30,090 people are estimated to die from these cancers. The five-year relative survival rate is 22%.

Having hepatitis B, hepatitis C, or cirrhosis are significant risk factors for adult primary liver cancer. It is more common in men than women. In the United States, liver cancer is also more common among American Indians/Alaska Natives and Hispanics than among other population groups.”

American Association for Cancer Research – AACR (Liver Cancer Awareness Month | AACR)

The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can’t feel the liver, because it’s protected by the rib cage.

The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food.

The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other functions.

The liver is a vital organ of vertebrates and some other animals. In the human it is located in the upper right quadrant of the abdomen, below the diaphragm. The liver has a wide range of functions, including detoxification of various metabolites, protein synthesis, and the production of biochemicals necessary for digestion.

The liver is a gland and plays a major role in metabolism with numerous functions in the human body, including regulation of glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification.^[3] It is an accessory digestive gland and produces bile, an alkaline compound which aids in digestion via the emulsification of lipids. The gallbladder, a small pouch that sits just under the liver, stores bile produced by the liver^. The liver’s highly specialized tissue consisting of mostly hepatocytes regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions Estimates regarding the organ’s total number of functions vary, but textbooks generally cite it being around 500.

Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common.

Not all cancers that affect the liver are considered liver cancer. Cancer that begins in another area of the body — such as the colon, lung or breast — and then spreads to the liver is called metastatic cancer rather than liver cancer.

Most people don’t have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include:

• Losing weight without trying
• Loss of appetite
• Upper abdominal pain
• Nausea and vomiting
• General weakness and fatigue
• Abdominal swelling
• Yellow discoloration of your skin and the whites of your eyes (jaundice)
• White, chalky stools

It’s not clear what causes most cases of liver cancer. But in some cases, the cause is known. For instance, chronic infection with certain hepatitis viruses can cause liver cancer.

Liver cancer occurs when liver cells develop changes (mutations) in their DNA — the material that provides instructions for every chemical process in your body. DNA mutations cause changes in these instructions. One result is that cells may begin to grow out of control and eventually form a tumor — a mass of cancerous cells.

Factors that increase the risk of primary liver cancer include:

• Chronic infection with HBV or HCV. Chronic infection with the hepatitis B virus (HBV) or hepatitis C virus (HCV) increases your risk of liver cancer.
• Cirrhosis. This progressive and irreversible condition causes scar tissue to form in your liver and increases your chances of developing liver cancer.
• Certain inherited liver diseases. Liver diseases that can increase the risk of liver cancer include hemochromatosis and Wilson’s disease.
• Diabetes. People with this blood sugar disorder have a greater risk of liver cancer than those who don’t have diabetes.
• Nonalcoholic fatty liver disease. An accumulation of fat in the liver increases the risk of liver cancer.
• Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops such as corn and peanuts can become contaminated with aflatoxins, which can end up in foods made of these products. In the United States, safety regulations limit aflatoxin contamination. Aflatoxin contamination is more common in certain parts of Africa and Asia.
• Excessive alcohol consumption. Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase your risk of liver cancer.

MOST IMPORTANT is PREVENTION:

Reduce your risk of cirrhosis

Cirrhosis is scarring of the liver, and it increases the risk of liver cancer. You can reduce your risk of cirrhosis if you:

• Drink alcohol in moderation, if at all. If you choose to drink alcohol, limit the amount you drink. For women, this means no more than one drink a day. For men, this means no more than two drinks a day.
• Maintain a healthy weight. If your current weight is healthy, work to maintain it by choosing a healthy diet and exercising most days of the week. If you need to lose weight, reduce the number of calories you eat each day and increase the amount of exercise you do. Aim to lose weight slowly — 1 or 2 pounds (0.5 to 1 kilograms) each week.
• Use caution with chemicals. Follow instructions on chemicals you use at home or at work.

Get vaccinated against hepatitis B

You can reduce your risk of hepatitis B by receiving the hepatitis B vaccine, which provides more than 90 percent protection for both adults and children. The vaccine can be given to almost anyone, including infants, older adults and those with compromised immune systems.

Take measures to prevent hepatitis C

No vaccine for hepatitis C exists, but you can reduce your risk of infection.

• Know the health status of any sexual partner. Don’t engage in unprotected sex unless you’re certain your partner isn’t infected with HBV, HCV or any other sexually transmitted infection. If you don’t know the health status of your partner, use a condom every time you have sexual intercourse.
• Don’t use intravenous (IV) drugs, but if you do, use a clean needle. Reduce your risk of HCV by not injecting illegal drugs. But if that isn’t an option for you, make sure any needle you use is sterile, and don’t share it. Contaminated drug paraphernalia is a common cause of hepatitis C infection. Take advantage of needle-exchange programs in your community and consider seeking help for your drug use.
• Seek safe, clean shops when getting a piercing or tattoo. Needles that may not be properly sterilized can spread the hepatitis C virus. Before getting a piercing or tattoo, check out the shops in your area and ask staff members about their safety practices. If employees at a shop refuse to answer your questions or don’t take your questions seriously, take that as a sign that the facility isn’t right for you.

Ask your doctor about liver cancer screening

For the general population, screening for liver cancer hasn’t been proved to reduce the risk of dying of liver cancer, so it isn’t generally recommended. The American Association for the Study of Liver Diseases recommends liver cancer screening for those thought to have a high risk, including people who have:

• Hepatitis B and one or more of the following apply: are Asian or African, have liver cirrhosis, or have a family history of liver cancer
• Hepatitis C infection and liver cirrhosis
• Liver cirrhosis from other causes, such as an autoimmune disease, excessive alcohol use, nonalcoholic fatty liver disease and inherited hemochromatosis
• Primary biliary cirrhosis

Discuss the pros and cons of screening with your doctor. Together you can decide whether screening is right for you based on your risk. Screening typically involves an ultrasound exam every six months.

Diagnosing liver cancer

Tests and procedures used to diagnose liver cancer include:

• Blood tests. Blood tests may reveal liver function abnormalities.
• Imaging tests. Your doctor may recommend imaging tests, such as an ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI).
• Removing a sample of liver tissue for testing. Your doctor may recommend removing a piece of liver tissue for laboratory testing in order to make a definitive diagnosis of liver cancer.

  During a liver biopsy, your doctor inserts a thin needle through your skin and into your liver to obtain a tissue sample. In the lab, doctors examine the tissue under a microscope to look for cancer cells. Liver biopsy carries a risk of bleeding, bruising and infection.

Determining the extent of the liver cancer

Once liver cancer is diagnosed, your doctor will work to determine the extent (stage) of the cancer. Staging tests help determine the size and location of cancer and whether it has spread. Imaging tests used to stage liver cancer include CTs, MRIs and bone scans.

There are different methods of staging liver cancer. One method uses Roman numerals I through IV, and another uses letters A through D. Your doctor uses your cancer’s stage to determine your treatment options and your prognosis. Stage IV and stage D indicate the most advanced liver cancer with the worst prognosis.

Treatment

Treatments for primary liver cancer depend on the extent (stage) of the disease as well as your age, overall health and personal preferences.

Surgery

Operations used to treat liver cancer include:

• Surgery to remove the tumor. In certain situations, your doctor may recommend an operation to remove the liver cancer and a small portion of healthy liver tissue that surrounds it if your tumor is small and your liver function is good.Whether this is an option for you also depends on the location of your cancer within the liver, how well your liver functions and your overall health.
• Liver transplant surgery. During liver transplant surgery, your diseased liver is removed and replaced with a healthy liver from a donor. Liver transplant surgery is only an option for a small percentage of people with early-stage liver cancer.

Localized treatments

Localized treatments for liver cancer are those that are administered directly to the cancer cells or the area surrounding the cancer cells. Localized treatment options for liver cancer include:

• Heating cancer cells. In a procedure called radiofrequency ablation, electric current is used to heat and destroy cancer cells. Using an ultrasound or CT scan as a guide, your surgeon inserts one or more thin needles into small incisions in your abdomen. When the needles reach the tumor, they’re heated with an electric current, destroying the cancer cells.
• Freezing cancer cells. Cryoablation uses extreme cold to destroy cancer cells. During the procedure, your doctor places an instrument (cryoprobe) containing liquid nitrogen directly onto liver tumors. Ultrasound images are used to guide the cryoprobe and monitor the freezing of the cells.
• Injecting alcohol into the tumor. During alcohol injection, pure alcohol is injected directly into tumors, either through the skin or during an operation. Alcohol causes the tumor cells to die.
• Injecting chemotherapy drugs into the liver. Chemoembolization is a type of chemotherapy treatment that supplies strong anti-cancer drugs directly to the liver.
• Placing beads filled with radiation in the liver. Tiny spheres that contain radiation may be placed directly in the liver where they can deliver radiation directly to the tumor.

Radiation therapy

This treatment uses high-powered energy from sources such as X-rays and protons to destroy cancer cells and shrink tumors. Doctors carefully direct the energy to the liver, while sparing the surrounding healthy tissue.

During external beam radiation therapy treatment, you lie on a table and a machine directs the energy beams at a precise point on your body.

A specialized type of radiation therapy, called stereotactic radiosurgery, involves focusing many beams of radiation simultaneously at one point in your body.

Targeted drug therapy

Targeted drugs work by interfering with specific abnormalities within a tumor. They have been shown to slow or stop advanced hepatocellular carcinoma from progressing for a few months longer than with no treatment.

More studies are needed to understand how targeted therapies, such as the drug sorafenib (Nexavar), may be used to control advanced liver cancer.

Supportive (palliative) care

Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy.

When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.

Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.

What you can do in being preparred to see your doctor:

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, as well as any vitamins or supplements, that you’re taking.
• Consider taking a family member or friend along. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.