“Empty nest syndrome refers to the distress and other complicated emotions that parents often experience when their children leave home.

Of course, people want their children to grow up and lead independent lives. However, the experience of letting go is often bittersweet or emotionally challenging. Parents may feel lonely, sad, and have some degree of grief when their children leave the nest, whether it’s to live on their own, start a college career, or pursue their own relationships. Women normally suffer more than men do, and feelings of sadness may be more pronounced among stay-at-home parents whose lives were organized around meeting the everyday needs of their children.

This empty nest syndrome that many parents of adult children experience is not a clinical disorder or diagnosis. It reflects the emotional ambivalence of a normal life transitional period.”

Psychology Today (Empty Nest Syndrome | Psychology Today)

Empty nest syndrome is not a clinical diagnosis. Instead, empty nest syndrome is a phenomenon in which parents experience feelings of sadness and loss when the last child leaves home. Empty nest syndrome usually happens in female parents aged between 40-50. When their children have to leave home e.g. for continuing their study in the college or university, parents have to stay home alone without routine activities with their children. Although parents might actively encourage their children to become independent, the experience of letting go can be painful. Parents might find it difficult to suddenly have no children at home who need their care. Parents might miss being a part of their children’s daily lives as well as the constant companionship. These changes might develop stress, anxiety and depression. It might eventually induce suicidal thought of the parents.

With reference to Kübler-Ross, Swiss-American psychiatrist, Grieving Process consists of 5 stages:

1. Denial and rejection;
2. Anger and acting against what had happened;
3. Bargaining for keeping the hopes;
4. Depression and grief; and
5. Acceptance of the loss.

If parents experience feelings of loss due to empty nest syndrome, advices that might help parents adapt to this major life change include accepting the timing, keeping in touch with children, seeking support if necessary and staying positive.

If the last child is about to leave home and parents are worried about empty nest syndrome, it is highly recommended to look for new opportunities in personal and professional life. Changing focus from taking care of children in the last 2-30 years, it is more beneficial to look after parent’s own health. Keeping busy or taking on new challenges at work or at home can help ease the sense of loss as well.

TIPS IN DEALING WITH THIS IN YOUR LIFE:

1 Time management tools can help you manage your time.

2 Space time out for a verse of the day, things you’re praying about, truths to remember, and even what to let go.

3 Make a Planner from daily to weekly to monthly in what you will be doing.

4 Like I say so many times as a RN, not to far from 40 years in this career, TAKE ONE DAY AT A TIME!

5 Remember anyone can start strong but the your goal should be “finish strong”.  Example, How many times have we said we would loose weight and started strong but ended weak loosing nothing putting the white flag up and restarting later all over again and it was just a broken record finishing with no results?  I have, but ending strong with starting strong is much better in results making you a more confident, stronger and happier as a person.

6 What ever your dreams are in wanting to accomplish but couldn’t with the kids at home due to busy now you can try to reach your goals you wanted to strive for.  Ex. Retired now, the kids left the nest, less to do at the house now but  you took a degree in art years ago, have been an artist at times in your working life but had to put it on hold since you had work elsewhere to do in paying the bills but not you can now do art work.  Just make sure that they are reachable goals and not impossible to reach in art work now.  So you don’t set your self up for failure.  You need to approach that before starting that new life goal.

Remember everything comes to an end, some things sooner than others of course, but it does not mean life is over!

Other perianal infections

Sometimes the skin glands near your anus become infected and need to be drained, like in this structural disease. Just behind the anus, abscesses can form that contain a small tuft of hair at the back of the pelvis (called a pilonidal cyst).

Sexually transmitted diseases that can affect the anus include anal warts, herpes, AIDS, chlamydia and gonorrhea.

Diverticular disease

The structural disease diverticulosis is the presence of small outpouchings (diverticula) in the muscular wall of your large intestine that form in weakened areas of the bowel. They usually occur in the sigmoid colon, the high-pressure area of the lower large intestine.

Diverticular disease is very common and occurs in 10% of people over age 40 and in 50% of people over age 60 in Western cultures. It is often caused by too little roughage (fiber) in the diet. Diverticulosis can sometimes develop/progress into diverticulitis

Complications of diverticular disease happen in about 10% of people with outpouchings. They include infection or inflammation (diverticulitis), bleeding and obstruction. Treatment of diverticulitis includes treating the constipation and sometimes antibiotics if really severe. Surgery is needed as last resort in those who have significant complications to remove the involved diseased segment of the colon.

Colon polyps and cancer

Each year, 130,000 Americans are diagnosed with colorectal cancer, the second most common form of cancer in the United States. Fortunately, with advances in early detection and treatment, colorectal cancer is one of the most curable forms of the disease. By using a variety of screening tests, it is possible to prevent, detect and treat the disease long before symptoms appear.

The importance of screening

Almost all colorectal cancers begin as polyps, benign (non-cancerous) growths in the tissues lining your colon and rectum. Cancer develops when these polyps grow and abnormal cells develop and start to invade surrounding tissue. Removal of polyps can prevent the development of colorectal cancer. Almost all precancerous polyps can be removed painlessly using a flexible lighted tube called a colonoscope. If not caught in the early stages, colorectal cancer can spread throughout the body. More advanced cancer requires more complicated surgical techniques.

Most early forms of colorectal cancer do not cause symptoms, which makes screening especially important. When symptoms do occur, the cancer might already be quite advanced. Symptoms include blood on or mixed in with the stool, a change in normal bowel habits, narrowing of the stool, abdominal pain, weight loss, or constant tiredness.

Most cases of colorectal cancer are detected in one of four ways:

• By screening people at average risk for colorectal cancer beginning at age 45.
• By screening people at higher risk for colorectal cancer (for example, those with a family history or a personal history of colon polyps or cancer).
• By investigating the bowel in patients with symptoms.
• A chance finding at a routine check-up.

Early detection is the best chance for a cure.

Colitis

There are several types of colitis, which are conditions that cause an inflammation of the bowel. These include:

• Infectious colitis.
• Ulcerative colitis (cause unknown).
• Crohn’s disease (cause unknown).
• Ischemic colitis (caused by not enough blood going to the colon).
• Radiation colitis (after radiotherapy).

Colitis causes diarrhea, rectal bleeding, abdominal cramps and urgency (frequent and immediate need to empty the bowels). Treatment depends on the diagnosis, which is made by colonoscopy and biopsy.

Prevention:

Can gastrointestinal diseases be prevented?

Many diseases of the colon and rectum can be prevented or minimized by maintaining a healthy lifestyle, practicing good bowel habits and getting screened for cancer.

A colonoscopy is recommended for average-risk patients at age 45. If you have a family history of colorectal cancer or polyps, a colonoscopy may be recommended at a younger age. Typically, a colonoscopy is recommended 10 years younger than the affected family member. (For example, if your brother was diagnosed with colorectal cancer or polyps at age 45, you should begin screening at age 35.)

If you have symptoms of colorectal cancer you should consult your healthcare provider right away. Common symptoms include:

• A change in normal bowel habits.
• Blood on or in the stool that is either bright or dark.
• Unusual abdominal or gas pains.
• Very narrow stool.
• A feeling that the bowel has not emptied completely after passing stool.
• Unexplained weight loss.
• Fatigue.
• Anemia (low blood count).

Other types of gastrointestinal diseases

There are many other gastrointestinal diseases. Some are discussed, but others are not covered here. Other functional and structural diseases include peptic ulcer disease, gastritis, gastroenteritis, celiac disease, Crohn’s disease, gallstones, fecal incontinence, lactose intolerance, Hirschsprung disease, abdominal adhesions, Barrett’s esophagus, appendicitis, indigestion (dyspepsia), intestinal pseudo-obstruction, pancreatitis, short bowel syndrome, Whipple’s disease, Zollinger-Ellison syndrome, malabsorption syndromes and hepatitis.

“The digestive system is a complicated and diverse part of the body. It extends from the mouth to the rectum.

• The primary function of the digestive system is to eliminate waste and assist the body in absorbing essential nutrients and minerals.
• Studies report that the gut plays a crucial role in immunity.

Every one of us has experienced digestive issues, such as stomach pain, indigestion, or discomfort, at some point in our lives for various reasons.

The medical community classifies all diseases that affect the GI tract as digestive diseases. Unfortunately, more than 85 percent of all adult Americans have some form of intestinal disorder.

The best chance for a cure is always early detection. Many GI disturbances and disorders can be avoided or reduced by leading a healthy lifestyle and undergoing regular screening as recommended.”

Medicine Net (What Are 13 Common Diseases of the Digestive System?)

“What is the home Epley maneuver?

The home Epley maneuver is a type of exercise help that helps to treat the symptoms of benign paroxysmal positional vertigo (BPPV). You can do this exercise at home.

BPPV is caused by a problem in your inner ear. Your semicircular canals are found inside your ear. They detect motion and send this information to your brain. The utricle is a nearby part of the ear. It contains calcium crystals (canaliths) that help it detect movement.

Sometimes these crystals detach from the utricle and end up inside the semicircular canals. When these crystals move inside the canals, they may send incorrect signals to your brain about your position. This can make you feel like the world is spinning. This is called vertigo.

Dr. John Epley designed a series of movements to dislodge the crystals from the semicircular canals. These movements bring the crystals back to the utricle, where they belong. This treats the symptoms of vertigo.

The original Epley maneuver was designed to be done with a healthcare provider. The home Epley maneuver is similar. These are a series of movements that you can do without help, in your own home.”

John Hopkins Medicine (Home Epley Maneuver | Johns Hopkins Medicine)

Surgical Procedures for Vestibular Dysfunction When is surgery necessary? 

When medical treatment isn’t effective in controlling vertigo and other symptoms caused by vestibular system dysfunction, surgery may be considered. The type of surgery performed depends upon each individual’s diagnosis and physical condition. Surgical procedures for peripheral vestibular disorders are either corrective or destructive. The goal of corrective surgery is to repair or stabilize inner ear function. The goal of destructive surgery is to stop the production of sensory information or prevent its transmission from the inner ear to the brain.  The types of surgeries used if non-invasive treatments are not successful are possibly: 

Labyrinthectomy:

A labyrinthectomy is a destructive procedure used for Ménière’s disease. The balance end organs are removed so that the brain no longer receives signals from the parts of the inner ear that sense gravity and motion changes. The hearing organ (cochlea) is also sacrificed with this procedure.

Vestibular nerve section:

A vestibular nerve section is a destructive procedure used for Ménière’s disease. The vestibular branch of the vestibulo-cochlear nerve is cut in one ear to stop the flow of balance information from that ear to the brain. The brain can then compensate for the loss by using only the opposite ear to maintain balance.

Chemical labyrinthectomy:

A chemical labyrinthectomy is also known as transtympanic or intratympanic treatment or gentamicin infusion. This is a destructive procedure used for Ménière’s disease. An antibiotic called gentamicin is introduced into the middle ear and absorbed via the round window. The drug destroys the vestibular hair cells so that they cannot send signals to the brain.

Endolymphatic sac decompression:

Endolymphatic sac decompression is a stabilizing procedure sometimes used for Ménière’s disease or secondary endolymphatic hydrops to relieve endolymphatic pressure in the cochlea and vestibular system. A variety of techniques exist. One method involves allowing the sac to decompress by removing the mastoid bone surrounding it. Other methods involve inserting a shunt (a tube or strip) into the endolymphatic sac so that, theoretically, excess fluid can drain out into the mastoid cavity or other location. The effectiveness of decompression techniques in controlling vertigo remains in doubt.

Oval or round window plugging:

If the exercises described above are ineffective in controlling symptoms, symptoms have persisted for a year or longer,  and the diagnosis is very clear, a surgical procedure called “posterior canal plugging” may be recommended. Canal plugging blocks most of the posterior canal’s function without affecting the functions of the other canals or parts of the ear. This procedure poses a substantial risk to hearing — ranging from 3-20%, but is effective in about 85-90% of individuals who have had no response to any other treatment (Shaia et al, 2006; Ahmed et al, 2012). The risk of the surgery to hearing derives from inadvertent breaking into the endolymphatic compartment while attempting to open the bony labyrinth with a drill. Sensibly, canal plugging for BPPV (note the first letter stands for “benign”) is rarely undertaken these days due to the risk to hearing.

Alternatives to plugging:

Singular nerve section is the main alternative. Dr Gacek (Syracuse, New York) has written extensively about singular nerve section (Gacek et al, 1995). Interestingly, Dr. Gacek is the only surgeon who has published any results with this procedure post 1993 (Leveque et al, 2007). Singular nerve section is very difficult because it can be hard to find the nerve.

Dr. Anthony (Houston, Texas), advocates laser assisted posterior canal plugging.  It seems to us that these procedures, which require unusual amounts of surgical skill, have little advantage over a conventional canal plugging procedure.  Oval or round window plugging is a stabilizing procedure sometimes used for repair of perilymph fistulas. Openings in the oval and/or round windows are patched with tissue taken from the external ear or from behind the ear so that perilymph fluid does not leak through the fistulas.

 Pneumatic equalization (PE) tubes:

Pneumatic equalization (PE) is a stabilizing procedure sometimes used for treating perilymph fistulas. A tube is inserted through the tympanic membrane (eardrum) with one end in the ear canal and the other in the middle ear, to equalize the air pressure on the two sides of the eardrum.

Canal partitioning (canal plugging):

Canal partitioning is a stabilizing procedure sometimes used for treating BPPV or superior semicircular canal dehiscence. The problematic semicircular canal is partitioned or plugged with small bone chips and human fibrinogen glue to stop the movement of endolymph and foreign particles within the canal so that it no longer sends false signals to the brain.

Microvascular decompression:

Microvascular decompression is performed to relieve abnormal pressure of the vascular loop (blood vessel) on the vestibulo-cochlear nerve.

Stapedectomy:

Stapedectomy is a stabilizing procedure sometimes used for otosclerosis. It is accomplished by replacing the stapes bone with a prosthesis.

Acoustic neuroma (vestibular schwannoma): 

This procedure involves the removal of a noncancerous tumor that grows from the tissue of the vestibular branch of the vestibulo-cochlear nerve.

Cholesteatoma removal:

This procedure involves the removal of a skin growth that starts in the middle ear and that can secrete enzymes that destroy bone and surrounding structures.

Ultrasound surgery:

Ultrasound is applied to the ear to destroy the balance end organs so that the brain no longer receives signals from the parts of the ear that sense gravity and motion changes. Cochlear dialysis Cochlear dialysis is a stabilizing procedure sometimes used to promote movement of excess fluid out of the inner ear by filling the scala tympani with a chemical solution.

Thanks to NYU Medical Hospital in Manhattan, NY you can Click here to download the “Surgery for Peripheral Vestibular Disorders” publication. – See more at: http://vestibular.org/understanding-vestibular-disorders/treatment/vestibular-surgery#sthash.GDeNWxjl.dpuf.

If you have this problem and need a great hospital than let us look at the ranking of hospitals:

Of all 180 hospitals in the New York, New York metropolitan area, the 53 listed below are the top-ranking. This metro area, also called NYC, includes Long Island, Westchester County, and northern New Jersey. I know if I had a problem that I could not get rid of immediately with a antibiotic simple cure I would next want to go to the best if my county’s hospital couldn’t remove the problem completely. So here through “US News and World Report” via the internet they show the following information on the best hospitals in NYC and Northern NJ: (Look below or to the next page)

These are their rankings on Columbia Presbyterian and NYU, NATIONALLY, in the following categories:

Starting with the best is Columbia Presbyterian in NY, for those in NY, as your #1 choice:

Adult Specialties

This hospital was among 144 facilities—roughly 3 percent of the 4,743 analyzed for the latest Best Hospitals rankings—to be ranked in even one of the 16 specialties 2024.

COLUMBIA PRESBYTERIAN RATINGS:

NYU HOSPITAL RATINGS:

• #50 in Cancer
• #11 in Cardiology & Heart Surgery
• #22 in Diabetes & Endocrinology
• #21 in Ear, Nose & Throat
• #26 in Gastroenterology & GI Surgery
• #8 in Geriatrics
• #38 in Nephrology

• #8 in Neurology & Neurosurgery************************ Impressive for neuro surgery of the ear.
• #4 in Orthopedics
• #33 in Pulmonology
• #9 in Rehabilitation
• #6 in Rheumatology
• #12 in Urology

Gynecology

For further checking of hospitals go to http://health.usnews.com/best-hospitals/area/ny/new-york-presbyterian-university-hospital-of-columbia-and-cornell-6210024 since hospitals do change yearly in their scores and this is the most recent.

“Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder. BPPV isn’t a sign of a serious problem, and it usually disappears on its own within a few days of the first episode. (It could take several weeks for some people.) However, the symptoms of BPPV can be very frightening and may be dangerous, especially in adults over the age of 65. The unsteadiness of BPPV can lead to falls, which are a leading cause of fractures.

Benign paroxysmal positional vertigo is the most common inner ear disorder. In fact, approximately 20% of people who are evaluated for dizziness are diagnosed with BPPV.  BPPV usually goes away on its own. However, until it’s successfully treated, it can come back. In some cases, months — or even years — go by before another episode occurs.  BPPV is almost always triggered by a change in your head’s position. Some people may notice symptoms when lying down or sitting up in bed. Others might notice symptoms when they tilt their head back or to the side. These symptoms often worsen with age due to normal wear and tear of the inner ear structures.”

Cleveland Clinic (Benign Paroxysmal Positional Vertigo (BPPV): Treatment, Symptoms & Causes)

“Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you’re spinning or that the inside of your head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in your head’s position. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

Although BPPV can be bothersome, it’s rarely serious except when it increases the chance of falls. You can receive effective treatment for BPPV depending on the intensity!”

MAYO CLINIC (Benign paroxysmal positional vertigo (BPPV) – Symptoms and causes – Mayo Clinic)