Posts Tagged 'chronic disease'

This day and this month

Wikipedia defines caregiver as an unpaid or paid person who helps another individual with impairment with his or her activities of daily living. Merriam-Webster defines a caregiver as a person who gives help and protection to someone (such as a child, an old person, or someone who is sick). Veterans Day is almost over and perhaps this is a good time to reflect on war injured veterans who require another individual to help them with activities of daily living.

When we think of disabilities the obvious first comes to mind – paraplegia, blindness, single or multiple amputations, maybe severe scarring. When we think further we may think about the invisible disabilities – traumatic brain injuries (blasts are the leading cause of TBI), psychological injuries, internal injuries with lasting effects. For these veterans, their war goes on. It also goes on for their caregivers. November is National Family Caregivers Month.

Family caregivers are unpaid yet they care for many, if not most, of our disabled veterans. Caregivers also care for our elderly who may have one of the dementias, such as Alzheimer’s disease, or are frail due to age. They care for our children and adolescents who may have congenital, traumatic or illness related disabilities. They sometimes care for our dying.

It’s their family responsibility you say? Maybe. But whose responsibility is it when they need care?

Caregiving is grueling work. It is physically, emotionally, and mentally exhausting. Anyone who has been responsible for a toddler for even one day knows this. But a toddler grows into a child and becomes more independent. Imagine having a toddler for all of your life. That is not to say that there aren’t rewards in caregiving. But the rewards don’t come in the form of free time or rest, things that everyone needs. These rewards are intangible and don’t really make up for disturbed sleep, postponed or forgotten social engagements, or disturbed relationships.

So today and this month and all the time, let’s thank our veterans and let’s thank the caregivers. Let’s do something for them. Are you listening Veterans Admiration? Are you listen Federal Government? Are you Listen State Government? Are you listening?


Be Aware of COPD

COPD (chronic obstructive pulmonary disease) is the third leading cause of death in the United States, behind heart disease and cancer. Lung cancer is the #1 leading cause of cancer deaths in both men and women. More on that another day.

Smoking is the primary cause of lung cancer and COPD. It is one of the causes of heart disease. This blog is not going to be a diatribe against smoking. You all know it’s bad for you. You all know you should quit or not start. Enough said. Oh, as an aside, smoking marijuana is as bad for your lungs as is tobacco. Think twice before you smoke marijuana recreationally.

Dying from lung disease is very unpleasant. Yes, I’ve seen it. I’ll spare you the graphic details. Instead I’ll tell you what happens to the lungs in COPD and let you think about it.

First, a very brief anatomy lesson (with apologies to my anatomy professors). You have two lungs, one on each side of your heart in your chest cavity. The lung on the left side has two lobes and extends further down that the right lung, in order to make room for the heart, which tilts slightly to the left. The lung on the right has three lobes and does not tilt downward, in order to make room for the liver, which is below the diaphragm. Each lobe of the lungs is further divided into segments.

As you breathe, the air travels from your nose into your trachea, basically a tube in your throat. The trachea branches left and right into the left bronchus and the right bronchus (plural: bronchi), which divide into ever smaller tubes, called bronchioles. Imagine a tree with ever smaller branches. Each bronchiole ends in an air sac called an alveolus (plural: alveoli – I am so glad I took Latin in high school). This is where the air you breathe ends up.

Your blood vessels also get smaller and smaller as they enter the lungs. The smallest blood vessels, which should be full of gaseous waste products, transfer the waste into the alveoli and pick up oxygen from the alveoli. So, if your lungs are healthy, you breathe in oxygen and breathe out waste.

COPD is actually a pair of lung diseases: emphysema and chronic bronchitis. In emphysema, the walls of the alveoli have been damaged and either the alveoli can’t contract enough to expel the waste or the walls are too thick to go through the exchange process. In chronic bronchitis (-itis at the end of a word means inflammation), the irritated bronchial tree secretes mucus, lots of mucus. Eventually there is so much mucus that the individual with chronic bronchitis can’t expel it all. This interferes with breathing.

Both emphysema and chronic bronchitis progress slowly. But the end is an inability to breath, either because oxygen and waste can’t be exchanged or because there is an obstruction preventing breathing. Breathing is not only necessary for life. It is also necessary to perform the everyday tasks of life: eating, standing, dressing, brushing your teeth, even smiling and, of course, laughing.

There is no cure for COPD. The severity of the symptoms can wax and wane. It is not reversible. But life style changes and medications can make you feel better. Consult with your healthcare provider. Don’t smoke.

For more information:

I was just thinking.

An article in this week’s Science Times (NY Times, October 27, 2015) got me thinking. Do you know how your school system treats disabled students? Do you care? You should. Anyone of any age at any time can become disabled. You or a loved one can develop a chronic physical or mental “disease” or incur trauma with long-lasting consequences. A loved one can be born with a congenital condition. Imagine your child or grandchild develops a chronic but manageable illness. Then imagine that her school system refuses to allow her attendance because of it, whether she is attempting enrollment for the first time or has been an exemplary student for ten years.

Impossible! No, it is not. This is a situation that children with Type 1 diabetes face in many schools, public or private. The main reason given is that there is no one qualified to monitor blood sugar and give insulin or glucagon (for very low blood sugar) if necessary.

Type 1 diabetes was formerly known as juvenile or insulin-dependent diabetes. Type 2 diabetes was formerly known as adult onset or non-insulin dependent diabetes. However, the names were somewhat confusing because insulin-dependent diabetes can have its onset in adults and children can develop non-insulin dependent diabetes. It’s much easier to remember that in Type 1 diabetes the individual makes little or no insulin naturally in the pancreas. In Type 2 diabetes the pancreas makes insulin but the individual’s body is resistant to it and needs medication to help with the process.

So, what makes an individual qualified to test the blood for sugar levels and, if necessary, give insulin or glucagon (both injected)? Some school systems maintain (as does The American Nurses’ Association) that only a licensed nurse is qualified. Other school systems are willing to accept as qualified an adult volunteer who has been trained by a health professional. Some school systems, without a licensed nurse on staff, will not accept the volunteers or have no one willing to volunteer. Some schools say that a parent (or parent-designated adult) must come into the school to monitor the child. Other schools simply transfer the child to another school or, if a private school, simply say the child cannot attend.

Back to my thinking. If schools can do this when a child is newly diagnosed with diabetes (please read the Times article for the full story), what stops them from doing this when a child becomes disabled due to an accident? Is the problem the blood monitoring (aka, a “finger stick”) or the injection or the worry about a lawsuit? What happens to a newly disabled child who must have assistance with eating or who must have assistance to expel urine? What happens to any child who no longer fits the picture of “normal”?  What about the Americans with Disabilities Act?

I don’t know the answers to my questions, either in my school system or in any other. I’ve realized that this is a gap in my knowledge as a citizen. An even worse gap is that I don’t know where to find the answers. It’s election season. Maybe I should find out.

Diabetes: Part VI – Summary

Diabetes, both Type 1 and Type 2, is a chronic disease that affects your whole body and, quite possibly, your mind.


Diabetes affects your weight (Diabetes: Part II).


Diabetes affects your skin (Diabetes: Part III).


Diabetes affects your nerves (Diabetes: Part IV).


Diabetes affects your heart (Diabetes: Part V).


Diabetes also affects your kidneys, your teeth, your sight and has been related to sleep apnea (More Than Just a Relationship Breaker).


In the United States, the economic cost of diabetes is $174 billion a year.


In 2006 diabetes was the seventh leading cause of death in the United States. People with diabetes have twice the risk of dying a people of similar age who do not have diabetes.


It’s estimated that 23.6 million people (or 7.8% of the population) have diabetes. In addition, data extrapolation suggests that at least 57 million American adults had prediabetes in 2007.


Prediabetes is a condition in which individuals have fasting blood sugar levels higher than normal (100 mg/dL), but not high enough to be classified as diabetes (200 mg/dL). People with prediabetes have an increased risk of developing type 2 diabetes, heart disease, and stroke.




Diabetes is a serious disease. Get checked for it. Prevent it or postpone it by leading a healthy lifestyle.


Health – it’s about prevention.


Today is American Diabetes Alert Day.

Is Your Heart Failing You?

Heart failure. It doesn’t mean someone has died. But it does mean that someone’s heart is no longer working correctly. The heart is weak and not able to pump the way it should. There is no cure. Health failure is a chronic, but manageable, condition.


When the left side of the heart is not pumping well the individual suffers from left-sided failure. The symptoms include:

  • Shortness of breath.
  • Persistent cough or wheezing.


When the right side of the heart is not pumping well it is called right-sided failure. Right sided failure often follows left sided failure. The symptoms of right sided failure include:

  • Swelling of the feet, legs and the abdomen.


Symptoms common to both left and right failure are:

  • Fatigue.
  • Loss of appetite and/or nausea.
  • Confusion or impaired thinking.
  • Increased heart rate.


Any disease that causes the heart to work harder than normal may, if it’s left untreated, lead to heart failure. Diseases that often lead to heart failure include:

  • High Blood pressure.
  • Coronary artery disease.
  • Diabetes.
  • Severe lung disease.
  • Structural defects in the heart.


The incidence of heart failure increases with age. African Americans have a much higher rate of heart failure than other Americans.

NY Times


If you have one of the conditions listed above, manage your disease according to your healthcare provider’s recommendations. Prevent or postpone heart failure. Your heart is in your hands.


For more about heart failure see:


The American Heart Organization

Medline Plus

Take A Quiz

Quick quiz (only one answer needed):


  • Which chronic disease affects one in nine Americans?
  • Which chronic disease causes high blood pressure and, in turn, is caused by high blood pressure?
  • Which high blood pressure related end-stage disease is 4.2 times more likely to affect African Americans than to affect Caucasians?
  • Which chronic disease affects children and adolescents as well as adults?


Answer: Chronic Kidney Disease


Chronic Kidney Disease (CKD) is the 9th leading cause of death among Americans. Many people don’t know that they have CKD until it is well advanced. Kidney failure is the end result (or end-stage) of CKD. Kidney failure requires dialysis or kidney transplant. But early detection of CKD can prevent the occurrence of kidney failure.


Quick anatomy and physiology of the urinary system (J structure and function of the kidney/bladder system)


The kidneys (there are normally two) are fist sized organs that are located in the back of your body just below the rib cage. One kidney is on the right of your spinal column and the other on the left. All the blood in your body runs through the kidneys because it is the job of the kidneys to filter out the impurities from the blood.


Each kidney is connected to your urinary bladder by way of a small tube called a ureter. Your bladder stores the product of the kidneys, urine. Urine leaves your body by way of a tube called a urethra.


Inside the kidneys there is a complex filtration system. The parts of the system are called nephrons. There are as many as one million nephrons in each kidney. Each nephron contains a very tiny structure made of blood vessels. This structure is called a glomerulus.


Your blood flows through the glomerulus where it is filtered. The chemical composition of the resulting fluid is adjusted according to your body’s’ needs as it passes from the glomerulus to the nephron. The adjusted fluid moves from the nephron to the larger kidney, from the kidney to the bladder (it is now urine) and out the body.


As you can see, this is a complex system. Any problem along the way can result in illness and disease. If the problem is not (or can not) be corrected, chronic kidney disease results.


Some common causes of CKD are: diabetes, high blood pressure, defects in the structure of the kidneys and infection.


Tests for chronic kidney disease are:

  • Blood Pressure Measurement.
  • Blood test for creatinine.
  • Urine test for protein.


You are at increased risk of developing kidney disease if you:

  • Are older.
  • Have diabetes.
  • Have high blood pressure.
  • Have a family member who has CKD.
  • Are an African American, Hispanic American, Asians and Pacific Islander or American Indian.


See your healthcare provider. Find out if you are at risk. Get treated if you are.


Health – it’s about prevention.


Today is World Kidney Day


March is National Kidney Month  


To find out more about kidney disease:

The National Kidney Foundation

The National Institutes of Health

Mary Lou Bernardo, PhD, MSN


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