Benefits of quitting the smoking habit

This is from an interoffice email

You can see immediate benefits to your health as soon as you stop smoking. Within 20 minutes of quitting, your heart rate and blood pressure drop. After 12 hours, carbon monoxide levels in your blood drop to normal. After 2 weeks-3 months, your circulation improves and your lung function increases. After 1-9 months, coughing and shortness of breath decrease. After 1 year, excess risk of coronary heart disease is half that of a person who smokes. After 2-5 years, stroke risk can fall to that of a non-smoker. After 5 years, risk of cancer of the mouth, throat, esophagus, and bladder are cut in half and cervical cancer risk falls to that of a non-smoker. After 10 years, the risk of dying from lung cancer is about half that of a person who smokes. After 15 years, risk of coronary heart disease is that of a non-smoker. So make it your day to quit!

Quitting is hard, and of course the best method is to never start.

Public Health Director on Ebola

This note is from Public Health director in Santa Clara County on Ebola.

**Everyday Heath on Ebola

http://www.everydayhealth.com/news/ebola-what-every-american-needs-to-know/?xid=salesnl_8690_20141029
Dr. Sanjay Gupta from Everyday Health talks about Ebola.  He says it is a deadly disease, but not very contagious.  It is hard to catch from someone else as you ha e to come in contact with their fluids.  It however only needs skin contact, no open sore. 

Halloween Safety Notes

This list is taken from the book Halloween: A True Book by Dana Meachen Rau
1. Take an adult with you and only visit houses of people you know.
2. Wearing makeup is safer than wearing a mask because it is easier for you to see.
3. If you do wear a mask, be sure the eye holes are large.  Please take it off when you have to cross the road.
4. Be sure your costume in nonflammable.  Also be sure it is bright enough to be seen in the dark.  If it isn't, wear reflective tape.
5. Be sure your costume isn't too long.  You don't want to trip on it.
6. Don't eat any candy until and adult checks through it [and takes the best pieces.]  [] is my addition.

Prevencion de Suicidio y Crisis: Folleto de Condado de Santa Clara

http://billywardlehealthasiseeit.blogspot.com/2014/10/suicide-prevention.html

**SuicideisPreventable.org

You should always be aware of where others may be coming from.  You may save a life

**Ebola: Letter from Jeff Smith, County Executive

I am taking excerpts from a letter by Jeff Smith, Santa Clara County Executive

...Please know there is no Ebola in Santa Clara County.  The risk of Ebola infection in our community is extremely low and we mean to keep it that way...

There are a few things that you should know about the current situation:  

 

Ebola only spreads from sick people and is not spread through the air or water.  The virus spreads only by contact with bodily fluids from an infected person.  It is NOT SPREAD by people who have been exposed to the disease but are not yet sick.  In essence, spread of this disease requires very close contact with an infected individual.

...Ambulance providers are now being required to begin all patient interactions by asking those who have a fever whether he or she has traveled to Sierra Leone, Liberia, or Guinea. These are the countries in West Africa where Ebola is currently spreading. 

...Staff at Santa Clara Valley Medical Center are currently screening patients for travel to the West African countries mentioned above and symptoms of a possible Ebola infection, based on Centers for Disease Control and Prevention (CDC) recommendations.  

   

REMEMBER THESE EBOLA FACTS

·         There is no Ebola in Santa Clara County or California.

·         Santa Clara County has been preparing and continues to prepare for the extremely unlikely chance that a person in Santa Clara County becomes sick with Ebola.

·         The Santa Clara County Public Health Department has provided information to medical providers and hospitals in our community so that they are informed and prepared.

·         Ebola can only be spread by contact with the bodily fluids of a person who is sick and has symptoms of the disease. The disease is ONLY spread by direct contact with a sick person’s body fluids.

**Suicide Crisis and Prevention: Pamphlet Santa Clara County

This pamphlet explains itself.  It includes prevention, intervention and postvention services.

**Stroke: Fast Action Saves Brain Cells

http://www.everydayhealth.com/stroke/stroke-treatment-every-second-counts.aspx?pos=2&xid=nl_EverydayHealthManagingDiabetes_20141010
I am paraphrasing an article from Everyday Health:
Quick action, getting to the emergency department, in the case of a stroke can save brain cells.  In other words, it saves lives and can reduce the loss of functioning.  A stroke basically means that blood cells are dying due to a problems with blood circulation.  Strokes come in two types: ischemic and hemorrhagic.  In ischemic a blood clot is stopping blood from getting to a part of the brain.  In hemorrhagic, a blood vessel has burst leaking blood into the brain.  In both cases quick action is needed.  However to act quickly you have to recognize a stroke.  This article suggests, "Signs may be subtle — someone just isn't quite normal, seems tired, confused, or uncoordinated."  I googled "signs of a stroke" and got this result:

• SUDDEN numbness or weakness of face, arm or leg - especially on one side of the body.
• SUDDEN confusion, trouble speaking or understanding.
• SUDDEN trouble seeing in one or both eyes.
• SUDDEN trouble walking, dizziness, loss of balance or coordination.
• SUDDEN severe headache with no known cause.

In the stroke caused by blood clot, there is a treatment that can eat the clot, if administered within three hours of the stroke.  The blood leakage stroke is more lethal, and causes more damage to the brain.  But again timely treatment is needed.   Strokes vary based on size and location.  Even a small stroke, in a delicate location can have big effects.  We should all be aware of stroke signs, and the need for timely action.  I know at Valley Medical Center where I work they have a stroke team, just as they have a code blue team.  This is to give treatment in a timely manner for the best results.

**Book Review: Suicide: The Forever Decision

Suicide: The Forever Decision: For Those Thinking about Suicide, and for Those Who Know, Love or Counsel Them; New Expanded Edition by: Paul G. Quinnett, Crossroad Publishing, New York, 1987, 2011 printing.
I have been studying this book for some time.  Mr Quinnett writes this book with the intent of engaging those considering suicide, getting them to slow down and take another look, and then presents some of the things they should consider.  He starts asking people to take a step back.  And then take another look at how they came to this point.  One of the aspects of suicidal thought, is that we often have some illogical thinking, based on some erroneous ideas.  Quinnett does a very good job of looking at some of this thinking, and refuting it.
He warns about the danger of anger, and alcohol and drugs when mixed with thoughts of suicide. He has a very good chapter on family and suicide.  We should not attempt suicide to get at our family. 
He ends with a couple other ideas to consider.  What if I don't succeed, but leave myself permanently disabled or in pain or whatever.  And also what about those who are left behind.  He describes the act of suicide like a hand grenade.  Many people get hurt from suicide, not just the person who commits the suicide. 
He ends with talking of the help that is available, although he says professional help is not always needed.  There are clergy, family and others who can provide support.  He makes a good point, suicide prevention is one of the primary functions of mental health workers.  He also makes an observation that there are many causes of death, however suicide is tragic because it is one cause of death which is preventable. 

**Movie Review: Walking Down Your Blood Sugar

This exercise video features Leslie Sansone who walks you through a two-mile aerobic walk.  The part that relates to diabetes is the pep talk she gives while you are walking.  This includes saying we do not let exercise beat us, but invigorate us.  We are only beaten when we stay on the couch.
I found the two-mile workout more than I could handle.  However, Sheri says she has a DVD with the same concept, which has one to four mile workouts.  I think I can handle the four mile.  Sheri says it is pretty mild.  her walks start slow, then build and then cool down and stretch.  That sounds good. 

**October is Domestic Violence Awareness Month

http://www.sccgov.org/sites/owp/Pages/dvam.aspx
Domestic Violence can be such a tragedy.  If not checked, the result can be death.  The cost in physical and emotional trauma is  devastating.  If we approach conversation with open hands, palms up, we can overcome the violence.  If you find yourself tensing, making a fist, it is time to time yourself out.  Get away, and come back to deal with the issue after you have calmed yourself down.

**Fetal Alcohol Syndrome

http://www.cdc.gov/ncbddd/fasd/facts.html
The effects of alcohol on a growing fetus are such that no woman pregnant, or considering pregnancy should drink alcohol.  If they are drinking alcohol, they should stop drinking until after the pregnancy so as to minimize the effects of alcohol.
The effects from alcohol vary from the most serious, fetal alcohol syndrome, and then to less severe, but still concerned symptoms such as alcohol related neurological disorders and alcohol related birth defects.  The above link gives more information on feta alcohol syndrome.  In my career doing foster care I supervised a couple children who were living with their grandmother and had fetal alcohol syndrome.  They were very difficulty with learning problems and behavioral issues.  But at the same time they were beautiful children.  That was some time ago, so they must be grown up now.

**Are Mental Health Disorders Inherited?

http://www.everydayhealth.com/specialists/emo_health/wolever/qa/are-mental-disorders-hereditary/index.aspx?pos=4&xid=nl_EverydayHealthHealthyLiving_20140924
Interesting article which reenforces what I learned in school 30 years ago.  We can inherit a predisposition to a mental disorder.  However the predisposition is triggered by environmental issues--stress or a traumatic event.  Most mental illness manifests later in life.  So the answer to the above question is yes, there is a genetic component, but that is not everything.

**Weight Loss Saboteurs

This is a list from Everyday Health of things which can sabotage weight loss.  Some of these things you would not suspect, while others make sense. 
Love of Late Night Television: Now here I have a problem.  I don't stay up late on week days, but I do on the weekend.  I don't watch television however.  I watch movies, or once in a while I get working on a project.  However the snack craving can sometimes hit on this nights.  The advise from this list is to tend towards healthy snacks, which is easier said than done.
Traveling for Work: I thought I was sunk, as I travel five hours daily.  But they are talking more about business travel, where you are away from home, and prone to eat at unhealthy restaurants, or snack as you travel by car.  I don't travel for work, but when I travel for visiting this is something to be concerned with as those gas station foods can pack on the calories fast. 
A Cardio Obsession: I have no worries here.  However the reason for this is because too much cardio breaks down muscle, not fat.  They suggest a combination exercise, one minute cardio ad then a minute at a slower pace, like running sprints between walks. 
Blasting the Air Conditioner: If we are forced to use mechanisms of our body to cool down, then we burn calories and can better control our weight.  Also a cooler environment seems to encourage you to eat more.  (Actually the opposite is what the say, we eat less when we are hot.)  I think resorting to a salad on hot days, or something very light, are defenses against heat.
A Jam Packed Fridge: An overloaded fridge not only leads to spoilage of food, it also seems to hide foods.  The vegetables in the cooler seem to be forgotten and we grab the easy fattening foods.
A Daily Diet Soda Habit: This one seems weird.  Diet sodas save calories.  However research shows those with the diet soda habit gain more weight.  Perhaps the reason is you later satisfy the sugar craving with other snacks.  I for the most part avoid sodas, except when I get the craving for rootbeer.
Constantly Multitasking:  This one also is a paradox.  You would think being more busy would lead to more calorie burn.  However it does lead to less thought taking towards our diet, and more ikely to choose unhealthy foods which put on weight.  Also exercise is one of the tasks that often is thrown out when people are busy.

**Documentary Review: The Incredible Human Machine

The Incredibla Human Machine, National Geographic, 2007.
This is an incredible look at the human body.  It looks at each of the major systems, and describes the importance of that system, usually i more than one way.
It starts with skin.  Skin not only keeps us together, it is also a cooking mechanism.  The individual cells expand when we are hot, which allows for increased cooling.  Also the secret sweat, which encourages evaporation and cools us.  If not for tyhe cooling properties of skin, we would all be sunk.
It then takes a look at each of our senses.  Eyes are the gateway.  The retina of the eye is so thin, yet it had thousands of individual cells receiving images.  In similar fashion, the ear receives myriads of waves, some traveling very fast, which are interpreted by three tiny bones.  The ear also plays an important role in balance and helping us know where we are at.
It is incredible how many taste buds are on the tongue, and if we accidentally burn them off new ones are formed in a couple of weeks.  Touch and smell also play important parts.  Pain is a mechanism to warn us, and is a good teacher.
The digestive system is so intricate as well.  Food gets to the stomach very quickly, and then is slowed down to allow for absorption of minerals and vitamins that we need.  The stomach first slows food down, and then the intestines.  Food slowly escapes through he intestine wall, where the liver is waiting to finish the absorption process. 
Oxygen also enters the body, and is distributed through the lungs to the blood stream.    Sound is made as air is passed over the voice box.  The voice box is two membranes that vibrate and knock against each other at an incredibly rapid rate.  They shows Steve Tyler's voice box, and studied this through a concert.  There were over a million such collisions in one concert.
Our bodies house over 70 miles of blood vessels which carry minerals and oxygen to every cell of the body.  This entire 70 mile system is controlled by one 10 ounce pump called the heart. 
The muscular system was presented in great detail.  Over 200 different muscles make it possible to walk; Back and stomach muscles so we don't fall over backwards or forwards, and then all the leg muscles.  We are an incredibly complex machine. 
Our system of bones can withstand great pressure.  They give us shape.  However bones would not work without joints, and joints would not work without ligaments.  It is all so complex.
Our nervous system and our brains are also a marvel.  We use such a little percent of our capacity.  But we are able to expand our minds.  Just now data is beginning to develop with regards to mapping the brain.  Each individual is distinct, and places in the brain for certain functions can vary  Some of these area, we are just touching the surface of understanding.
In many areas the give glimpses of new advances, sight, heart surgery, brain surgery, joint restorarion, are just a few of the advances we glimpse. 
This movie is truly amazing.  It is impossible to describe the entire system.  However, my conclusion after watching this is :There is a God."  How could such a complex system come together randomly.  We were created in God's image.

**Santa Clara Valley Medical Center: Your Health: Diabetes

https://www.youtube.com/watch?v=nrGhAEwkv0o&list=UUEBqPBM4kLVhTH4Auzp3PSw
There are a series of informational videos produced by the hospital where I work, Valley Medical Center in San Jose, CA.  In this video Dr. Tyler Aguinaldo and Carrie Wickware RN explain how diabetes works, and some of the risks from diabetes.  They explain that in type I diabetes or juvenile diabetes our body doesn't produce insulin.  However in type II diabetes the body produces insulin, but does not use it correctly.  Common symptoms of diabetes are frequent thirst and urination.  Other symptoms may be tingling in the hands, blurred vision, fatigue and weight loss.  Slow-healing sores and frequent infections can also point to diabetes.  However most people with diabetes do not have symptoms, and are identified through blood tests. 
People with type I diabetes are insulin dependent.  However with type II diabetes, exercise, weight loss and diet viable treatment options.  Medications are also available.  However, sometimes insulin is also needed.
Education can be the best tool to handle diabetes.  How to check blood levels/  How your diet effects blood sugar?  How to use exercise to lower sugar levels?  Lifestyle changes can prevent and have a big impact on previously diagnosed diabetes.

**Santa Clara County Suicide Prevention Week

**Preventing Falls When You Are Older

Sept 23 is Fall Prevention Day
http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html
Falls among older adults is the leading cause of fatal and non fatal injuries.  One in three older adults fall yearly.  However not all are reported to a doctor.  Falls cause over 20,000 fatalities a year.  They are also responsible for almost half traumatic brain injury among older adults.  They also cause significant injury due to broken bones.

Exercise and nutrition (including calcium and vitamin D) can help prevent falls.  Also being aware, and perhaps decluttering your home to prevent hazards.  Also adding grab bars, by the tub, by the toilet etc can be helpful. 

Out family has experience with falls.  Mom has fallen several times.  She has broken her neck and her hip, and banged up her face very badly on occasion. 

**My3: Suicide Prevention App

http://www.my3app.org/

**American Foundation for Suicide Prevention

Here is a link to a page with ideas for suicide prevention.  You can help save a life.
http://www.afsp.org/preventing-suicide/warning-signs-and-risk-factors

**Spanish Language Crisis Line in the Bay Area

The county of San Francisco has agreed to have Spanish speaking crisis counselors available on their crisis line afternoons and evenings 1-9.  Other lines may have to use interpretive services.

**Book Review: Diabetes: Chicken Soup for the Soul: Healthy Living Series

This is a  book of many stories, interspersed with practical advise about diabetes from Dr, Byron Hoogwerf of the Cleveland Clinic.  Jack Canfield and Mark Victor Hansen edit the stories.   I think the most important thing I get from this book is motivation, and realization that diabetes is really a disease I need to worry about, and take care of.  I don't want to be dependent on pills forever.
The stories are repetitive, and tell the story of diabetes from several different angles.  As someone growing up with juvenile diabetes,and the parents or siblings of someone with juvenile diabetes.  
Also as being told as an adult that you have type II diabetes, and the consequences, life changes and what this means.  The doctor explains some of the things to be aware of in terms of taking care of you health when you have diabetes.
I enjoyed this book, but more than the practical information, I enjoyed the motivational stories presented.

**National Strategy for Suicide Prevention: Goals and Objectives 2001

I am looking at some National goals 12 years after the fact.  The goals and objectives were redone in 2012.

Goal #1  Promote awareness that suicide is a public health problem that is preventable.

One of the objectives for this goal is increase the number of public service campaigns.  Outside of the mental health community, I am not sure how effective we have been in this area.

 

Goal 2: Develop Broad-based Support for Suicide Prevention

One objective here is to increase public/private collaboration.  Another objective is to integrate suicide prevention in professional and other groups.  I know it is a big part of education and licensure for social workers and other help professions.

Goal 3: Develop and Implement Strategies to Reduce the Stigma Associated with Being a Consumer of Mental Health, Substance Abuse, and Suicide Prevention Services.

There has been a slow push for parity with medical insurances with regards to treatment of behavioral health being equal to physical health.  The only great push in this area that I have noticed was the discourse of Elder Holland at the last conference of the Church of Jesus Christ of Latter-day Saints.

http://billywardlefamily.blogspot.com/2013/10/jeffrey-r-holland-speaks-of-compassion.html

Goal 4: Develop and Implement Community-Based Suicide Prevention Programs  As a result of this goal we now have a national suicide hotline, which is actually answered locally in most cases.  Many of the local hotlines have gone through a national certification to be included.  1-800-273-2855

Goal 5:  Promote Efforts to Reduce Access to Lethal Means and Methods of Self-Harm This objective could be alarming to gun rights advocates, but reduced access does not necessarily mean gun control.  This area should include better safety measures, and ways to keep guns safe.  Also included are proper disposal of medications and manufacturing cars in such a way as to make carbon monoxide poisoning more difficult.

Goal 6: Implement Training for Recognition of At-Risk Behavior and Delivery of Effective Treatment

  There is a campaign among the professional community to recognize at-risk signs.  This is spilling over into the population in general.

Goal 7: Develop and Promote Effective Clinical and Professional Practices 

Goal 8:  Increase Access to and Community Linkages with Mental Health and Substance Abuse Services  This is a tricky area which is influenced by budgets, and most often budget cuts recently.

Goal 9: Improve Reporting and Portrayals of Suicidal Behavior, Mental Illness, and Substance Abuse in the Entertainment and News Media  I do not know how to judge the media, but for myself I have seen no change

Goal 10: Promote and Support Research on Suicide and Suicide Prevention

This is an area which is slowly developing

Goal 11: Improve and Expand Surveillance Systems

This sounds scary, but I th ink they are hoping for better reporting of suicide so numbers will be more accurate.  This includes investigation of all deaths which may be attributable to suicide or other violent causes.

The biggest judge of the effectiveness of what we are doing would be by adecrease in suicides.  However the opposite has been true, a slight increase.  You can argue the increase could have been more, or that we are more aware of and report suicide more often, but the bottom line is to this point there has not been a decrease in suicides. 

**Fiction to Get You Through Tough Times

This is a book mark from Reachout.com.  It suggests children's books which give a greater understanding of various maladies.  This list was compiled in 2011.  The themes is mentions are: abuse, bullying, depression, eating disorder, helping, manic depression, obsessive compulsive disorder, schizophrenia, self harm and suicide.  I cannot recommend any of the books because I have not yet read them.

**CANS: Child and Adolescent Needs and Strengths

CANS Training

I attended CANS Training at EMQ Families First in Campbell.  CANS stands for Child and Adolescent Needs and Strengths.   It is a comprehensive multisystem assessment for children.  It is “communimetric” in that it facilitates communication between children, parents and therapist, as well as between therapists as a way be on the same page in communicating.  This provides a set of different area for which a score determines the course in therapy.  Basically for need items, a score of 0 indicates no action, 1 indicates something to keep an eye on, 2 calls for action, and 3 for immediate action or intensive action.  Strengths are scored differently with 0 indicating a centerpiece strength, 1 a useful strength, 2 an identified strength, and 3 no identified strength in that area. 
The scaling is done in six different area.  Only Youth strengths use the alternative scoring mechanism.  These areas are: Life Domain functioning; Youth’s Strengths; Acculturation; Caregiver’s Needs and Strengths; Youths Behavior/Emotional needs; and Youth’s risk Behaviors.  Each area has a series of questions to define what might be a need or a strength in each particular area.  Additional there are individualized assessment modules.  These modules are only completed based on a response to previous question.  These modules include: developmental Needs; Trauma; Substance use Disorder; Violence; Youth Emotional/Behavioral risks; Resiliency Factors; Sexually Aggressive Behavior; Runaway; Juvenile Justice; Fire Setting.
I liked this module because you could go quickly from an identified need to formulating a plan to address that need.  This way counseling could be goals oriented and a child and parent could actually see progress being made. 

**Violence Against Women

What would be the improvement in the health and quality of life of our women, if we did away with violence towards them.  It is important to remember: Women are not property, they do not belong to you.  There is no excuse for being violent.  If you feel the need to control, then you need to take a look at yourself, and see where you are on the continuum of violence, and take a few steps back.

**Book Review: The Sugar Blockers Diet

The Sugar Blockers Diet: Eat Great; Lose Weight: A Doctor’s 7-Step Plan to Lose Weight, Lower Blood Sugar and Beat Diabetes—While Eating the Carbs You Love, Rob Thompson with the Editors of Prevention 2012.
This is wwat I gleaned from the Sugar Blocker Diet.  Good stuff to eat that will help black the sugar rush in your blood stream when you eat too much starch, like too much potato, rice, bread, corn etc.

Sugar Blockers: Fruit: Apricot, Avocado, Black Berries, Grapefruit, papaya, peach, pear (not quite ripe), raspberries, strawberries and water melon.

Vegetables: sprouts, artichoke, asparagus, broccoli, cabbage, carrot, cauliflower, celery, collard greens, cucumber, dandelion greens, lettuce, mushrooms, onions, peppers, scallions, spinach, tomatoes, water chestnuts, beans, peas,

Other: beans (not all the way done) best is lentils (navy and pinto also good) but all good; nuts, chia seeds best, almond, sunflower seeds hazelnuts; bran; flaxseds; Fiber supplements; Metformin.

Other ideas, fat ½ hour before meal can cause system to digest more slowly, cheese or nuts;

Cinnamon

Vinegar and pickles will create better enzyme balance

Protein with Carbs

Exercise right after eating (20 minute walk) will allow cells to absorb carbs without insulin

Strength based exercise.
One other tid-bit, Metformin can cause diarrhea as a side effect.  I take this medication so something to watch for.

**Documentary Review: Diabetes: Understanding Your Condition

These are a few ideas from Mayo Clinic.  Take control of your illness and keep it in check so you don't have any of the severe complications.  Complications of diabetes can be minimized by good diabetes care: exercise and look at health holistically.
Some of these long term effects are eye problems, retinopathy is when the blood vessels break, and nerve damage.  Neuropothy is when you feel numb. 

**What Would You Do if You Knew that I Want to Commit Suicide

This is the front, and an inside page to this pamphlet in Spanish. What would you do if you knew I was thinking of suicide?  This pamphlet answers this question with three answers.
1) First recognize the signs.  The pamphlet explains that recognizing signs of suicide can be difficult.  If you have a sense something is wrong, go with your feelings.
This our clues to look for:
Talking about suicide or wanting to die
Feeling without hope, desperate or trapped
Giving away possessions
Rage or anger
Increase in consumption of alcohol or drugs
Distancing self from others
Feeling anxious or agitated
Change in sleep pattern
Sudden changes in humor
Feeling useless

2)  Second is to communicate, to talk; to ask "Are you thinking of suicide"  This pamphlet suggests starting the conversation.  Mention the things you have observed, the things that are worrying you.  Ask are you thinking of suicide, listen.

3) Look for help.  This pamphlet suggests
911 for emergency situations,
  for advice and direction
http://elsuicidioesprevenible.org/
The national hotline is

1 (800) 273 8255

**ReachOut.Com

This website offers information and experiences about depression, self harm, mental illness, suicide and a host of other related issues.  It also offers an open forum as well as a place to reach out for help.

**Pamphlet Summary: Older Adults and Depression

Older Adults and Depression is a pamphlet produced by the National Institute for Mental Health.

This pamphlet discusses depression and older adults.  It says depression is not a normal part of again.  Symptoms which may indicate one is depressed include: feeling sad or empty; feeling hopeless, irritable, anxious or guilty; loss of interest in favorite activities; feeling very tired; not being able to concentrate or remember details; not being able to sleep, or sleeping too much, aches or pains, headaches, cramps, digestive problems, overeating or not wanting to eat. 
Depression can be caused by several factors including genes, brain chemistry and stress. 
In terms of treatment for depression, the first step is to talk to your doctor.  it is important to remember you can just “snap out of it.”  Treatment choices include medications or psychotherapy.  One should remember medications can take some time to work, and they may also have side effects which should be discussed with your doctor.  ECT is sometimes used for severe depression which is difficult to treat with conventional methods. 
If you have a loved one who is experiencing depression offer support and understanding, talk the the person, DO not ignore talk of suicide.  You can invite the person for a walk or other activity.  Assure them that with time, treat can help to lift depression. 
If you are depressed, some things to remember include: break up large tasks into smaller; spend time with people, friends and loved ones; stick to your treatment plan; do not make important life choices until you feel better.
National Suicide Prevention hotline is 1-800-273-8255.  Santa Clara County Suicide and Crisis line is 1-855-278-4204.

**Panic Disorder: When Fear Overwhelms

This is a free pamphlet from the National Institute for Mental Health.  It starts with a series of questions:  Do you sometimes have sudden attacks of fear that last for several minutes?  Do you feel like you are having a heart attack or can’t breathe?  Do these attacks occur at unpredictable times causing you to worry about the possibility of having another one at any time?

Panic disorder is manifested by sudden attacks of fear, with associated physical symptoms such as racing heart, feeling you are having a heart attack, sweating, breathing problems, weakness or dizziness, hot or cold chills, tingly numb hands, chest pain or stomach pain.  Panic disorder includes fear of places where attack have occurred, and intense worry about the next attack and feeling out of control. 

Panic disorder is generally treated with psychotherapy or medications or both.  Cognitive behavioral therapy is especially useful.  Medications used include anti-anxiety medications which give quick relief but generally should not be used over long periods of time.  Antidepressant medication is also used.  There is a warning on antidepressant medication as for some people it can increase the risk of suicide. 

A common descriptor for panic disorder is fear—the attack is terrifying and then you have fear of the next attack, and fear of having a possible physical condition.

**Dr. David Mee-Lee Dual Diagnosis from Dynamic Health: Powerful Strategies for Healthy Living!

David Wright interviewed Dr. David Mee-Lee about dual diagnosis services.  This is treatment for people with co-occurring substance us and mental health problems.  Dr. Mee-Lee consults with Santa Clara County departments of Alcohol and Drugs as well as Mental Health.  As such I have had the opportunity to attend his trainings as well as sit in consultation of cases with him.  He is a pioneer of motivation interviewing, and he works with the call center on being able to figure out what people would like to get from mental health.  “You start at the door they open and where they let you in rather than telling them they have to work on a problem they don’t think they have.  Work on what they’re there for and from that point move to how their substance use and their mental health problems have been shooting themselves in the foot, preventing them from getting what they really want. 

This article is best when it talks about rehabilitation of mental health and substance abuse problems.  “Recover doesn’t necessarily mean they’re cured when you’re talking about a chronic illness—no more than if somebody with diabetes  or hypertension or asthma. … A person suffering from a mental illness as well as a substance problem won’t be able to be cured in the sense that they will never have a mental health problem or substance problem again.  They can recover, meaning they can live beyond just the fact that they have alcoholism or a mental illness.  They can have goals and aspirations and be empowered to have hope to change their life in terms of their relationships, in terms of productivity in the community, and reaching their dreams and aspirations. … Recover really means stabilizing their mental health and substance problem, but then living and growing to have an identity beyond just their illness.”

Dr. Mee-Lee concludes with advice for family and community.  The first is to realize that mental illness is not unusual.  There is “nothing bizarre or weird about…having substance problems or mental health issues.  The second point he makes is that there is help for mental illness.  Getting treatment sooner rather than later leads to a better result. 

**Depression and High School Students

NIMH Pamphlet Depression and High School Students

Depression can occur during adolescence, a time of personal change.  Depression is a common mental illness typically marked by sad or anxious feelings.  It is common to feels sad sometimes for a day or two, but this usually passes quickly.  Depression lasts for a long time, and interferes with day-to-day activities.

Depression symptoms include feeling: Sad, Anxious, Empty, Hopeless, Guilty, Worthless, Helpless, Irritable or Restless.  In addition there may be these symptoms: Loss of interest in activities you enjoy, Lack of energy, Problems concentrating or remember things, Problems falling asleep or staying asleep or sleeping too much, Loss of appetite or eating too much, Thoughts of suicide or suicide attempts and Aches, pains, headaches, cramps or digestive problems that do not go away.  One thing to note about adolescent depression (not mentioned in the flier) is that irritability is more common in teens than adults.  Adults more likely have depressed mood. 

If you suspect you might have depression it would be good to talk to your doctor or your parent could talk to a mental health professional.  The number in Santa Clara County is 1-800-704-0900.  Depression can respond to medications, psychotherapy or both.  Things you can do on your own to fight depression are: Give treatment a fair chance, attend appointments and give medications time to help, Engage in mild exercise, Participate in activities you enjoy, Break up large projects into smaller tasks, Spend time with friends and family, Expect your mood to improve gradually, Positive thinking will replace negative thoughts as depression improves.

If there is a crisis (you are are thinking or suicide, or someone you know is talking of suicide) you may call 911 for help, go to nearest emergency room, or talk advantage of 24-hour crisis lines: Santa Clara County  1/855/278/4204 and national 1-800-273-8255.

**Bipolar Disorder in Children and Teens

This is a summary of a pamphlet published by National Institute of Mental Health to inform parents of this illness. Bipolar dx also known as manic depressive dx is marked by unusual mood changes, extreme “ups” and extreme “downs called mania and depression.  It is not the same as normal ups and downs which is common for every kid.  Bipolar symptoms are more powerful.  Bipolar illness makes it difficult to do school work or to get along with friends and family.  Bipolar disorder can be dangerous as sometimes young people with this disorder try to hurt themselves or attempt suicide.  People with bipolar disorder should get treatment. 

In terms of diagnosing bipolar disorder there are no brain scans or blood tests.  However a thorough examination including questions about mood, energy sleep and behavior help to diagnose bipolar disorder.  Bipolar is marked by depressions and manias.  Someone having a manic episode may:  Feel very happy or act silly; have a short temper; Talk really fast about a lot of different things; Have trouble sleeping but not feel tired; have trouble staying focused; Talk and think about sex more often; Do risky things.  This is contrasted against depressive episodes.  Someone having a depressive episode may: Feel very sad; Complain about pain, stomachaches, headaches; Sleep too little or too much; Feel guilty or worthless; Eat too little or too much; Have little energy or no interest in regular activities; Think about death or suicide.

The important thing for a parent is to watch for any sign of suicidal thinking.  These signs should always be taken seriously.  In Santa Clara County the crisis line for children and teens is 408-379-9085.  The Suicide and Crisis line is 1-855-278-4204

**My Experience with Tinnitus

I have been living with tinnitus for the past six or seven years now.  I first developed it when I had bad allergies, and a stuffed eustachian tube putting pressure on my ear.  I hate that, and was steaming my ear frequently, trying to get it to go away.  This was the same year mom came to California after breaking her neck.  Anyway the tinnitus started about the same time the stuffed ears went away.  I concluded it must have been related.  However the ear doctor did not agree, and says it was the consequence of loud noises, Del Monte when I was young, and loud music when I was older. 

When it first developed it drove me crazy.  It triggered great anxiety.  I received a blessing from Brother Rod Tueller.  The tinnitus didn't go away after, but my ability to live with it has increased.  I hardly notice it any more, except when I get too tired, or when it changes tones which happens every once in a while.  If I listen for it, it is there.  But if I am busy doing something, I don't even realize it is there.  It still bothers me I really don't have silence any more.  However if I don't think about it, I'm OK.

The only worry is the doctor says it may portend hearing loss, which may be progressive.  I hope not, but Sheri worries my hearing is getting worse. I have a hard time hearing something from the other room, but if people get my attention I hear fine.  I also hear fine on the phone.  So I'm good for a few more years yet.

**Magazine Article: The Fight to Take Back Beauty

I came across an article in the Utah State University magazine (my alma mater) about twin sisters, who have taken on a big fight.  They discovered that the majority of women are self obsessed with their body image.  50 percent of women are severely dissatisfied with their appearance and another 34 percent generally dissatisfied.  That means 84 percent of women are dissatisfied with their appearance.
The fight they have taken on, is to redefine beauty.  Dissatisfaction comes from the way our society looks at beauty, and defines beauty.  We can do more.  I want to share the link to their website in case anyone wants to join them in this fight.
http://www.beautyredefined.net/
There goal is to help women get past body image and "Develop body image resilience and to move beyond body shame and fixation on appearance to much more important concerns."

**Anybody Hear of these new Condiments?

https://www.yahoo.com/beauty/the-new-condiments-90371539823.html
These new suggested condiments reportedly can add flavor, and health benefits.  As I look at the list, there are a few I would like to try.
Flax seed is reported to get rid of belly fat.  I have way too much belly fat.  Flax seed was also recommended in another article I read about snacks.  Flax seed absorption is greatly improved if they are ground.  They can also be used by stirring them into food. They go well in oatmeal, soups and smoothies.
Chia Seeds come from Mexico.  They have a nutty taste.  You can sprinkle them on foods like oatmeal, rice, salad, cereal and baked goods.
Hemp seeds are the edible part of the hemp plant.  They are similar to sesame seeds and again can be added to most foods.
Wheat germ is general removed form flower, but is the part of what with the most vitamins.  Again you can add it to just about anything.

**HOPE

I was attending a mental health conference five years ago when this quote was presented:

There is no medicine like hope,
No incentive so great
And no tonic so powerful
As expectation of something tomorrow.
Orison Swett Marden

**Snacks that Lower Cholesterol

http://www.everydayhealth.com/heart-specialist/cholesterol-snacks.aspx?pos=1&xid=nl_EverydayHealthDietandNutrition_20140709
This is an article from Everyday Health.  For the most part, these are pretty common snacks.  Each has its own method of helping lower cholesterol.  Apples have plenty of antioxidants; but the good stuff is in the peel, so eat the peel.
Nuts and seeds, particularly sunflower seed, pumpkin seeds, sesame seeds, flax seeds, almonds, and pine nuts.  But don't overdo if you are trying to lose weight.   One ounce per day.
Oat Bran.  It is true what the boxes of Cheerios and Quaker say, these are heart healthy snacks.  Some how, oatmeal can block the absorption of cholesterol in you stomach.
Finally grapefruit is good for lowering cholesterol.  Just be careful as grapefruit can hinder the absorption of some medicines.

**The Starfish

The Starfish

I first heard this story from W Mitchell at an Amway conference.  It made an impression with me then and I still like it.  I hope to make a difference to the one.
The Starfish

There was a young man walking down a deserted beach just before dawn.  In the distance he saw a frail old man.  As he approached the old man, he saw him picking up stranded starfish and throwing them back into the sea.  The starfish had been washed ashore by a storm.  The young man gazed in wonder as the old man again and again threw the small starfish from the sand to the water.  He asked him, “Why do you spend so much energy doing what seems to be a waste of time?”  The old man explained that the stranded starfish would die if left in the morning sun.  “But there must be thousands of beaches and millions of starfish,” exclaimed the young man, “How can your effort make any difference?”  The old man looked down at the small starfish in his hand and as he threw it to safety in the sea said…… “It makes a difference to this one.”
 Adapted from Loren Eiseley

**Love Yourself: Bernie Siegel: Dynamic Health: Powerful Strategies for Healthy Living

I post my baby picture here for a reason.  Dr. Bernie Siegel tells a story of a phenomena that happens over and over.  He often talks to people, and holds up a baby, and everybody will ooh and aah and say how precious, how adorable.  He will then hold up an audience member, often a high school student, and every one will laugh and make fun, even the person being held up or asked to stand up.  And so the question, what changed in fifteen, sixteen years.  "Why were you a gorgeous baby, and now you're laughing at yourself?"... "So I really do tell people to get out their baby pictures and take a look at them.  I try to communicate to them that they're a child of God--to feel that they are divine rather than to tell them to do this, don't do that, it's not good for you, but to get them to love themselves so they then do what is good for them."
So I have posted my baby picture.  I am a child of God.  I am of divine worth.  I remember a saying our seminary teacher had in his office. "You are a child of God, and God doesn't make no junk."  When I feel down, I hope to see my baby picture, and remember my royal heritage.
Dr Siegel is a surgeon, and practices in the cancer field.  He began to realize hope and a lot to do with survival.  He and his wife established a program called ECaP (Exceptional Cancer Patients).  He talks of the importance of having love.  By this he means to love and be loved.  But he also is talking about having something you love, a passion.  He says it is funny, but now matter how ill you are, when you lose yourself in something you love, it seems to go away, you don't worry about the pain for awhile.  In my case, I don't hear my tinnitus.
Hope is important.  It improves your immune system.  It extends life.

**Doctor-Patient Relationship: Valley Medical Center: Health Shorts

http://www.scvmc.org/patients/health/Pages/yourhealth.aspx
This is a website dedicated to the doctor-patient relationship.  There are a couple of short videos featuring Dr. Jeff Arnold, Chief medical officer at Valley Medical Center.  Questions are an important part of the relationship.  The web page includes about thirty questions you might want to ask your doctor.  It also includes about fifteen questions to ask if surgery is being considered.  The more the patient is involved in care, the more positive will be the results. 

**Eight Kitchen Gadgets that Help Cut Weight

http://www.everydayhealth.com/weight-loss-pictures/kitchen-gadgets-to-help-you-lose-weight.aspx?pos=1&xid=nl_EverydayHealthManagingDiabetes_20140706#/slide-1

This is a link to an article from Everyday Health.  We only have a couple of the gadgets mentioned:
Smaller dishes equal smaller portions, less calories.  We have smaller plates.
Lemon squeezer, we have this.  I love to squeeze lemons and freeze the juice.
Citrus Zester.  This is like a grater for your citrus peels.  The grated peels can be used for adding flavor to your meals in a way with less calories than oils, and less negative effect than salt.
Vegetable steamer: Steaming is a healthy way to cook food without added fats.
Slow Cooker: This is another tool we have.  Slow cooking helps to cook meets in their own juisces rather than adding calories or fat.  It is also a simple way to cook healthy food.
Oil Mister: Spraying on oil to avoid over using oil is a good idea.
Kitchen scale: Portion control cannot really be don without a scale, and is so important for portion control.
Immersion Blender: I would really like one of these.  This is a whipper/ beater you can put in your drink.
Salad spinner:  A spinner can make salad making easier, and consequently more likely.  Also a dry salad holds dressing better so you can use less.
All good ideas.  I would really like a citrus zester next.

**Taking Care of My Health

State of Welllness: Wellness Works winter 2014

This county provided pamphlet starts with a review of the health of county workers.  It is not very flattering, but good to know I am not alone.  55 percent of the county in general, and 56 percent of county worker are either overweight or obese.  I must admit I would like to get down to just being overweight.  51 percent of county workers have high blood pressure or are borderline, 44 percent are stressed or very stressed.  I have to say with regards to stress, it is stressful doing more with less, which seems to be the trend.

So some answers:

Eat right.  They suggest enjoying your good by eating more slowly, and eating less.  Prepare portions visually by using smaller plates, have of plate should be fruits and vegetables; leafy colored vegetables over starchy ones (my favorite is potatoes which didn’t make the list).  Make half your grains whole grains—watch the bread and the rice.  Eat less processed food, ingredients list should be short and sweet, avoid sugary drinks and make sure to include dairy.

Get physical activity:

“Exercise is absolutely essential to a healthy lifestyle.  Try to get in at least 150 minutes moderate physical activity each week; more if weight loss is the goal.”

Smart goals

These are goals that are attainable and time bound.  They are specific identifying actions to reach the goal; measurable, how much how long etc.; attainable, outcome is within reach; relevant, start small and make sure you have skills, resources to achieve goal; and time-bound, have an end date.

March into May, the county is sponsoring an exercise program which they do every year, to get people more active and to measure their activity.

**Folic Acid and Birth Defects

This is an article by the public health depeartment of California.  I put it here because this is something I did not know, the relationship between folic acid and the prevention of birth defects, but which is important to know.  Especially since it is recommended to take folic acid for a month before pregnancy, while most people don't visit the MD until several months after becoming pregnant.

https://draft.blogger.com/blogger.g?blogID=6805706512913964474#editor/target=post;postID=4351013393326151496

Folic Acid Awareness Week is January 5 - 11, 2014

Updated January 3, 2014

Folic acid is a B-vitamin that is necessary for proper cell growth. If taken before and during early pregnancy from multi-vitamins or fortified foods, folic acid can prevent some forms of serious birth defects of the brain and spine by 50% to 70%. Every woman needs folic acid every day, whether she’s planning to get pregnant or not, for the healthy new cells the body makes daily.

The CDC recommends that women who could possibly become pregnant should take 400 micrograms of synthetic folic acid daily at least one month before getting pregnant from:

• Fortified foods like grains, pastas or breakfast cereals
• Daily multi-vitamin
• Eating a variety of foods as part of a healthy diet

The easiest way to be sure to get the recommended daily amount of folic acid is to take a multi-vitamin every day.

Multivitamins and folic acid pills can be found at most local pharmacy, grocery, or discount stores. Check the label to be sure it contains 100% of the daily value (DV) of folic acid, which is 400 micrograms (mcg).

**Schizophrenia: Drug Free Options?

Are there drug free treatments or drug free options for schizophrenia.  Dr. Ed Zimney says no.
www.everydayhealth.com/schizophrenia/specialists/is-drug-free-schizophrenia-treatment-possible.aspx?pos=4&xid=nl_EverydayHealthHealthyLiving_20140324
He compares schizophrenia to insulin dependent diabetes, which can be very scary if someone neglects to take insulin, and so would it be scary if someone stops taking medications for schizophrenia.  The reason is that without medications, there is the likelihood that relapse will occur, if not in a week, it will in a month or two.  With each relapse, the base line functioning goes down, and Dr. Zimney points out that brain cells can be killed, which will never come back.
Medications, even with their side effects, is the only treatment for schizophrenia which has been shown to be effective.
That said, rehab options and case management options are an important part of treament.  (My addition.)

**Mental Health Stigma

Mental Health Stigma can be costly.  It often prevents people who could really benefit from treatment, from actually getting the treatment they need because they are worried what others might say.  This can lead to hospitalization, untreated mental health symptoms which can be very uncomfortable, more costly treatments, and sometimes even death. May we be considerate of others, and show respect for all people.

This flyer is from Maryland Mental Hygiene Association