“The 10th leading cause in America is Suicide. Each year 44,965 Americans die by suicide. Know for every suicide 25 attempts. Suicide costs the US $ 69 Billion annually.”
American Foundation for Suicide Prevention
“The 10th leading cause in America is Suicide. Each year 44,965 Americans die by suicide. Know for every suicide 25 attempts. Suicide costs the US $ 69 Billion annually.”
American Foundation for Suicide Prevention
Suicide is a major public health problem and a leading cause of death in the United States. The effects of suicide go beyond the person who acts to take his or her life: it can have a lasting effect on family, friends, and communities. This fact sheet, developed by the National Institute of Mental Health (NIMH), can help you, a friend, or a family member learn about the signs and symptoms, risk factors and warning signs, and ongoing research about suicide and suicide prevention.
Suicide is when people direct violence at themselves with the intent to end their lives, and they die because of their actions. It’s best to avoid the use of terms like “committing suicide” or a “successful suicide” when referring to a death by suicide as these terms often carry negative connotations.
A suicide attempt is when people harm themselves with the intent to end their lives, but they do not die because of their actions.
Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk.
The main risk factors for suicide are:
Even among people who have risk factors for suicide, most do not attempt suicide. It remains difficult to predict who will act on suicidal thoughts.
According to the Centers for Disease Control and Prevention (CDC), men are more likely to die by suicide than women, but women are more likely to attempt suicide. Men are more likely to use more lethal methods, such as firearms or suffocation. Women are more likely than men to attempt suicide by poisoning.
Also per the CDC, certain demographic subgroups are at higher risk. For example, American Indian and Alaska Native youth and middle-aged persons have the highest rate of suicide, followed by non-Hispanic White middle-aged and older adult males. African Americans have the lowest suicide rate, while Hispanics have the second lowest rate. The exception to this is younger children. African American children under the age of 12 have a higher rate of suicide than White children. While younger preteens and teens have a lower rate of suicide than older adolescents, there has been a significant rise in the suicide rate among youth ages 10 to 14. Suicide ranks as the second leading cause of death for this age group, accounting for 425 deaths per year and surpassing the death rate for traffic accidents, which is the most common cause of death for young people.
Most people who have the risk factors for suicide will not kill themselves. However, the risk for suicidal behavior is complex. Research suggests that people who attempt suicide may react to events, think, and make decisions differently than those who do not attempt suicide. These differences happen more often if a person also has a disorder such as depression, substance abuse, anxiety, borderline personality disorder, and psychosis. Risk factors are important to keep in mind; however, someone who has warning signs of suicide may be in more danger and require immediate attention.
The behaviors listed below may be signs that someone is thinking about suicide.
Suicidal thoughts or actions are a sign of extreme distress and an alert that someone needs help. Any warning sign or symptom of suicide should not be ignored. All talk of suicide should be taken seriously and requires attention. Threatening to die by suicide is not a normal response to stress and should not be taken lightly.
Asking someone about suicide is not harmful. There is a common myth that asking someone about suicide can put the idea into their head. This is not true. Several studies examining this concern have demonstrated that asking people about suicidal thoughts and behavior does not induce or increase such thoughts and experiences. In fact, asking someone directly, “Are you thinking of killing yourself,” can be the best way to identify someone at risk for suicide.
If you or someone you know has warning signs or symptoms of suicide, particularly if there is a change in the behavior or a new behavior, get help as soon as possible.
Often, family and friends are the first to recognize the warning signs of suicide and can take the first step toward helping an at-risk individual find treatment with someone who specializes in diagnosing and treating mental health conditions. If someone is telling you that they are going to kill themselves, do not leave them alone. Do not promise anyone that you will keep their suicidal thoughts a secret. Make sure to tell a trusted friend or family member, or if you are a student, an adult with whom you feel comfortable. You can also contact the resources noted below.
Select Age Groups | ||||||||
---|---|---|---|---|---|---|---|---|
Rank | 10-14 | 15-24 | 25-34 | 35-44 | 45-54 | 55-64 | All Ages | |
1 | Unintentional Injury 847 |
Unintentional Injury 13,895 |
Unintentional Injury 23,984 |
Unintentional Injury 20,975 |
Malignant Neoplasms 41,291 |
Malignant Neoplasms 116,364 |
Heart Disease 635,260 |
|
2 | Suicide 436 |
Suicide 5,723 |
Suicide 7,366 |
Malignant Neoplasms 10,903 |
Heart Disease 34,027 |
Heart Disease 78,610 |
Malignant Neoplasms 598,038 |
|
3 | Malignant Neoplasms 431 |
Homicide 5,172 |
Homicide 5,376 |
Heart Disease 10,477 |
Unintentional Injury 23,377 |
Unintentional Injury 21,860 |
Unintentional Injury 161,374 |
|
4 | Homicide 147 |
Malignant Neoplasms 1,431 |
Malignant Neoplasms 3,791 |
Suicide 7,030 |
Suicide 8,437 |
CLRD 17,810 |
“Sigmund Freud used to refer to depression as anger turned inward. While many people may regard this as an overly simplistic approach to the most common mental health disorder in the world, there is no doubt that anger plays a significant role in depression.”
Depression Vs. Anger — What does it all mean and What do I do?
Getting the blues or down in the dumps now and than in one thing but staying in the blues or down in the dumps just sinking deeper over a long period of time can be diagnosed as clinical depression. Clinical depression presents many forms and symptoms. It is not something just to be brushed off, assuming it will rectify itself in a while. One of the most common symptoms noted when a person suffers from clinical depression is anger. Whether it’s uncontrollable anger toward oneself or outward aggression toward others, it’s clinically proven that depression and anger run hand in hand.
Do you find yourself feeling angry more often than usual, or more often than not, depression could be to blame. Anger is a common symptom of depression, which can lurk beneath the surface of any man, woman, or child as well.
Depressive disorders come in many different types, but each type has its own unique symptoms and treatments. Major depression, the most common type of a depressive disorder, is characterized by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime. Mental health professionals use this checklist of specific symptoms to determine whether major depression exists or not. Depression is also rated by your diagnosing physician or mental health professional in terms of its severity — mild, moderate, or severe. Severe depression is the most serious type. A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives. Another type of depression is experienced as a part of bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees
Risk Factors
Numerous risk factors can lead to feelings of depression and anger in an individual. Some of these risk factors include but are not limited to: loneliness, financial strain, unemployment, alcohol or drug abuse, marital or family problems, or lack of a social support network. Depression and anger can also be influenced by childhood trauma, or it can be hereditary.
Symptoms
Anger manifested with depression is no ordinary anger. It can be all-consuming feelings of anger and hatred against one’s self, others or the situation that is causing the depression. One of the first signs of depression in a teenager may be a sudden onset of uncontrollable anger. In turn, constant feelings of anger can also trigger a response of depression. Also noted with depression are a tendency to turn away from family and friends, poor performance at work or school, lack of motivation, feelings of guilt, insomnia and hopelessness
Symptoms of Depression
Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.
Depression
“Dog lovers know how much warmth and comfort their canine companions add to their lives. But they might not know that a growing body of evidence suggests that having a dog may help improve heart health.”
Harvard Medical School – Harvard Health Publishing (www.health.harvard.edu)
“When kidneys fail, your body may have difficulty filtering your blood and keeping your body chemically balanced. Dialysis is a treatment process that cleans the body of unwanted toxins, waste products and excess fluids.”
Fresenius Kidney Care (freseniuskidneycare.com)
PERITONEAL DIALYSIS VERSUS HEMODIALYSIS
There is not always a simple easy answer for a patient that has chronic renal disease regarding which choice or option of dialysis that is best for him or her ; so let’s investigate the options & know you can always change the choice of dialysis you initially go on. But remember you are going from a tube placed in your circulatory system to a tube now in your abdomen or visa versa (depending on what your first choice of dialysis was) and that both tubes take time to be ideally ready and final for dialysis after inserted. So definitely take consideration in your choice both for your body and time it takes to allow the tube (especially in hemodialysis) in getting at its optimal level or state in being used:
Advantages | Limitations | |
Peritoneal Dialysis | ·Flexible lifestyle and independence.
-Time commitment: usually less than 10 hrs per week -Time allotment: as per patient convenience -No needles -Simple techniques: easy learning -Continuous therapy: minimal fluctuation of symptoms -Once a month clinic, so no need to travel repeatedly -Easy personal travel, pack bags and go -Can use APD: connect at night and go to sleep |
Limitations are you need to weave this into lifestyle
-Abdominal catheter -Does have passive sugar intake, so need to watch for weight gain -Needs storage space of around half a closet (supplies) |
Home Hemodialysis | -Flexible lifestyle and independence
-Time commitment: based on therapy ~ 22 hours a week -Time allotment: at patient convenience -5-6 times a week so less symptomatic fluctuations -Much higher freedom in dietary and fluid intake -May eliminate the need for BP and some of the other medications -Easy to travel with, pack and go.. |
-Needs a caregiver at least for the duration of dialysis 5-6 times a week
-Higher commitment compared to hemodialysis -Need to weave into lifestyle -Needs storage space of around half a closet -Does need AVF creation and needle access |
In Center Hemodialysis | -Dialysis done at clinic by dialysis technicians and nurses |
-Rigid schedule, limited flexibility -Time commitment: ~20 hours a week -Time allotment: no flexibility, as per dialysis unit -Need prior authorization and arrangement for travel -Cannot travel to region not having dialysis clinic -Significant fluctuation of symptoms -Does need AVF creation and needle access -Need transportation arrangements |
More than 1/2 a million patients in USA suffer from stage V CKD commonly referred to as Renal Failure (or End Stage Renal Disease (ESRD)) with nearly similar number of patients suffering with the pre-dialysis, stage IV CKD. The management of ESRD involves either replacement of the lost kidney function through the kidney transplantation, or clearing body of the accumulating toxins through maintenance dialysis. Unfortunately, kidney transplantation is not a viable option for a majority of ESRD patients due to a limited availability of donor organs, further compounded by the fact that many of the dialysis patients are medically unsuitable for transplantation. Thus, maintenance dialysis forms mainstay of the treatment for this large majority of the ESRD patients.
It is uniformly agreed that no single type of dialysis (home Vs In-center dialysis, or Hemo Vs peritoneal dialysis) is superior to others in terms of hard clinical endpoints e.g. mortality or cardiovascular deaths. However, home dialysis modalities (both PD and HHD) provide significant advantages in multiple outcome parameters important to the management of patients with ESRD namely quality of life, freedom of travel, greater liberty from dietary restrictions, preservation of residual kidney function etc.
Historically, analyses of various patient cohorts in US have consistently revealed that; a privileged patient cohort more frequently chooses a home dialysis. This in many circumstances have been reflected by higher use of peritoneal dialysis in patients that are Caucasians, patients with higher education, patient under the care of nephrologists during the pre-ESRD period, patients receiving pre-dialysis education etc. In fact, nearly half of the patients when provided with a comprehensive pre-dialysis education (CPE) opt for home dialysis. Additionally both individual kidney physician surveys and recommendations of various professional medical societies now recommend a higher utilization of home dialysis. Despite these, only a minority of ESRD patients in US are on Home dialysis modalities. Lack of patient awareness due to lack of pre-dialysis education and scarcity of medical experts performing the home dialysis therapies are the two principle reasons for this underutilization of Home dialysis therapies.
Considering these facts, University of Florida and DCI have established a specialized clinic and education set up where a comprehensive pre-dialysis education (CPE) will be provided to the patients with stage IV (pre-dialysis) CKD along with their multispecialty care for various ailments of CKD. This clinic will put a special emphasis on the comprehensive care of CKD patients with special attention towards their dietary needs, their social and pharmacological concerns and their awareness and needs for decision making for their eventual dialysis or transplant therapies.
In conclusion of renal failure and if you are chronic, it’s not always easy to decide which type of treatment is best for you. Your decision depends on your medical condition, lifestyle, and personal likes and dislikes.
**Discuss the pros and cons of each with your health care team. If you start one form of treatment and decide you’d like to try another, talk it over with your doctor. The key is to learn as much as you can about your choices. With that knowledge, you and your doctor will choose a treatment that suits you best.**
I hope this article help you in some small way or more in dealing with your chronic renal failure. Know your not alone and have many sites and places in giving you direction and support!
Always do a Comparison of dialysis methods : Hemodialysis and Peritoneal dialysis: |
What is usually involved | HEMODIALYSIS
|
PERITONEAL DIALYSIS
|
Advantages |
|
|
Disadvantages |
|
|
” “Transplant tourists” are traveling to established destinations to obtain readily accessible organs for transplantation, available from the poor of that destination country who sell mostly kidneys, but in some instances, a lobe of the liver or a cornea. These practices have been well known for more than a decade.”
“Whether you’re ready or not, cold and flu season is right around the corner. But fortunately, you don’t have to settle for the inevitable. With a small amount of preparation and prevention, you can be ready. There are no guarantees when it comes to colds and the flu. The vaccine for the flu is great for prevention.”
Inter-mountain Healthcare
Winter is now around, so is the flu! While many people look forward to the cold weather for skiing and other outdoor activities, others heads have gone indoors until spring, cutting down on their opportunities for the exercise they need. Staying indoors with someone who has the flu you keep inhaling that air which will prone you in getting the flu as opposed to getting outside. Remember in a hospital your put on Droplet precaution, in a isolated room and droplet means you can catch the Flu within arm’s length of the pt; so you wear a mask when visiting the patient with the flu in a hospital.
So get outside in warmer or when the temp gets colder. Whether it’s spending an afternoon at the local sled hill with the kids or skiing down the Alps, you can help your clients and patients – not to mention yourself – maintain an active lifestyle in the wintertime while it still lasts.
Shoveling snow, building a snowman or going on a deep-snow hike all increase a person’s heart rate, oxygen consumption and energy expenditure. Skiing, snowboarding or ice skating strengthen the musculoskeletal system and improve balance and skill. Cross-country skiing, with its whole-body challenge, improves cardiovascular fitness and muscular endurance. And all winter sports connect us with the elements: wind, snow and, for some, the sublime beauty of the mountains.
Participating in winter activities may increase energy and fluid needs, especially if the person is engaging in vigorous and demanding activities. High altitude and cold temperatures can also increase energy expenditures — as much as two- or three-fold if you’re shivering. With winter activities, it is easy to forget to stay hydrated and fueled all day, so it’s imperative to take breaks to fuel up.
Exercising in the cold and at altitude exacerbates fluid loss in the body. A significant amount of fluid is lost through increased respiration and the body’s need to humidify dry, cold mountain air. In addition, cold-induced diuresis will lead to increased urinary volume and fluid loss. And cold reduces the body’s thirst response, making it a challenge to maintain fluid balance in the cold. However, dehydration in the cold has serious consequences; it impairs thermo-regulation and increases the risk of hypothermia.
With this in mind, it is best to begin exercise well-hydrated with water breaks (3 to 8 ounces) every 15 to 20 minutes if going out on the slopes for less than 60 minutes. For any time longer than an hour, consider recommending a sports beverage.
Altitude may increase the body’s need for vitamins and minerals. Adequate iron stores are necessary to increase red cell mass if exposure to altitude occurs on a regular basis. In other words, iron depletion interferes with the positive adaptation of the blood’s oxygen carrying capacity that typically occurs in response to exercise at altitude. Furthermore, altitude exposure increases the generation of reactive oxygen species. However, it remains debatable whether antioxidants such as vitamin E and C are needed in higher amounts to protect cells from damage when participating in exercise at altitude.
This topic is largely understudied in winter sports, and may be more concerning for elite athletes training at altitude. A balanced diet including a hearty vegetable soup with herbs and spices, a handful of nuts, an orange and a cup of green tea may be plenty to protect the cells from occasional winter outings.
Engaging in any type of cold-weather sports, especially at higher elevations, requires appropriate preparation in terms of clothing, shelter and the foods and fluids a person consumes before, during and after the activity. Recommend that your clients and patients take breaks throughout the day and listen to their bodies to ensure that they are feeling well and ready for another round of winter activity. Staying active outside can possibly help with keeping the Flu away especially if your exposed to someone in the house with the flu your not breathing the same air in the house which will prone you to getting the flu as opposed to staying active outdoors. Best thing in prevention of the flu is the vaccine but always check with your doctor.