“Never.

Never do we loose our loved ones.

They accompany us; they don’t disappear from our lives.

We are merely in different rooms, temporarily.”

Paulo Coelo (South American author, who has sold over 165 million books in his lifetime.)

Many look at aging as it sucks but believe or not some look at it as a privilege but how?  It’s how you look at it and how you as a child looking up to parents to mentors around you looked at aging.   Of course there are those that say “Aging sucks” I have even said that.  2. Aging is a privilege.   How is aging a privilege let me explain.  A paradox of living is that striving to age healthfully overall can lead to increased longevity, meaning you’ll have more experiences with death the older you get. As we age, so do the people around us. This is just as much a part of the “aging is a privilege” perspective as any of the rest of it.  Keep in mind those you die young miss out on those great memories or great experiences you may have had 20 to 50 years of being with that person who died.

Living longer has both joys and consequences. We will lose friends and loved ones to accidents, illnesses, and, as we reach our later years, old age—though we desperately want to know the “whys” of old age losses, seeking answers on how to avoid them.

In Stephen King’s fantasy The Green Mile, the unjustly executed main character passes some of his miraculous life-extending gifts onto a death row guard, forever changing the rest of the guard’s life. Its bittersweet conclusion leaves burning questions as well as heavy food for thought. The guard now possesses a form of near immortality—something he sees as punishment for not being able to stop the prisoner’s execution even though he knew him to be innocent. And he goes on to outlive all the people he loves.

While death I say frequently at the age I am and even before with being a RN about 40 years that its a natural part of life and an unavoidable consequence of aging, it doesn’t mean you won’t be deeply affected by it.

“There but for the grace of God go I” is often a saying on the tops of our minds as we join other mourners. But it is the very fact that we are there with others that defines our affirmation that life is indeed precious.

While you may not be able to predict how grief will affect you, having a support system in place and the skills necessary to care for your mental health will offer a foundation from which to continue this amazing thing called life.

Our unique personalities and experiences often influence how we think about death, but other factors enter into our approach to it. The culture in which we were raised can shape our beliefs and perceptions of death. How? Because the way the people around us perceive and react to grief affects our feelings as well.

Why is it that we feel differently about the loss of a person we know depending on how they left us? A sudden fatal car accident, a long-drawn-out illness, or the fact that they decided to end their own suffering—any of these conjure up feelings and opinions in us that are hard to shake—most of which were passed on to us by our parents. “She lived a long time.” “What a tragedy to see a life end that early.” “It’s too bad he didn’t take better care of himself.” “At least she is no longer in pain.” No matter what words we use to justify, judge, or comfort ourselves, the fact remains that that person is no longer around.  The key is to acceptance and to know how to deal with the emotions you’re having instead of analyzing the timing or the circumstances that led to it. In that way, you can begin to celebrate that person’s time here on Earth in the spirit of appreciation.

Some of us have cared for loved ones like myself and still am, watching the physical part of the process happen before our eyes. We may have gently washed a loved one’s face, moved them around to change their bedding, and noticed the many physical changes that took place. The thing is, fear (of the unknown) is simply a normal human reaction for both the caregiver and the one ailing.  Though I must say being a RN helped in so many ways in the acceptance of death with having religious background and still practicing to this day.

You can think you’re doing well with the losses happening around you, but don’t be surprised that you can phase in and out of the feelings you experience both now and in the future.  You may have remember something due to something you see, smell, hear, or touch.

Some say they may be “at peace” with a particular loss.  I say that especially when someone was sick and in a terminal drawn out diagnosis.  I have seen too often.   But even getting there doesn’t necessarily spell relief once it’s reached. The fact is, we won’t all experience death and dying in the same way. Our unique experiences may even change as we age and are confronted with death more often.

So, the best we can say about it is that the physical, emotional, and spiritual aspects of dying that are distressing and confusing are just plain outright normal. especially for humans since we have a heart and feelings. The thing to remember is that we are not alone. Don’t hesitate to reach out to someone you know and trust to “vent” awhile over the loss of someone you knew, whether it’s a long-distance loss or one you witnessed personally. Our friends and family often don’t know how to act around us even though they want to help.

Perhaps that’s the way we all need to look at this phenomenon of the frequency of funerals we must attend as we age. Life is a precious gift, and whether your spiritual beliefs help you cope with them or not, be sure to find something that works for you.

“Losing a friend is a painful and difficult experience that many of us will face at some point in our lives if not already. Friendship is a unique and special bond that brings joy, support, and companionship into our lives. When we lose a friend, we not only grieve the loss of their presence, but also the loss of the connection and shared experiences that we had with them.   Friendship is a unique relationship that often goes beyond the boundaries of family or romantic partnerships. Friends are the people we choose to bring into our lives, and they become an integral part of our support system. When we lose a friend, it can feel like losing a piece of ourselves. The impact of losing a friend can be profound, as it disrupts our daily routines, social dynamics, and emotional well-being.  The emotions experienced when losing a friend can be intense and overwhelming. Grief is a natural response to loss, and it can manifest in various ways.  It is important to acknowledge and validate these emotions, as they are a normal part of the grieving process. 

Also if it gets heavy for you in coping with this loss whether loss of a friend or a loved one significant to you on spouse or romantic level, it is important to seek professional help if needed there is nothing wrong with professional help or counseling.  Everyone grieves at their pace and you being there with allowing them to go at that pace friend/family or professional support is always helpful.

Engaging in self-care activities is another important coping strategy for dealing with the loss of a friend. Self-care involves taking care of your physical, emotional, and mental well-being. This can include activities such as exercise, meditation, journaling, spending time in nature, or engaging in hobbies that bring you joy. Taking care of yourself during this difficult time is essential for healing and moving forward.

Connecting with others who have experienced similar loss can also be beneficial. Support groups or online communities provide a space to share your experiences, gain support from others who understand your pain, and learn from their coping strategies.

Looking at the good times and celebrating the loss is always a good step in the right direction for grieving and letting you know its not over but at a completely different positive level till you see each other again.”

Legacy Family Services (https://www.legacyfs.org/friendship-farewell-navigating-the-grief-of-losing-a-companion/)

I lost a good friend in my life, Fran Mazza. and I dedicate this article to you.  Fran I know you went through a challenge with cancer (Gleoblastoma) for about 4 plus years but you I know are in heaven, at peace, and without question in a place of beauty!  You are in a place of ecstasy that so many can and can’t relate to. Most importantly you are out of misery and no longer fighting this terrible diagnosis of cancer.  Rest in peace my friend till we meet again!  For me goodbyes are not forever; goodbyes are not an end.  It simply means you will be missed greatly but I will remember the great times I and Chris had with you and the family till we meet again. I know you are watching over family and friends right now which we need in going through this time; you were and still are a beautiful person to me.

Anyone out their who has had a loss recently I can relate to the feelings you might be experiencing and my deepest condolences to you but know you can cope with this in time.  All who pass on are in a better world and both are so much happier out of misery especially if it was fight in staying alive but maybe harder for those who could not prepare for it over some time.  Know it is us on earth in misery but it will heal in time like a wound.  The other thing to know is that individual or individuals have never left us.  They are both with old and new loved ones that they saw all the time and some rarely when they were living on earth but left years or months ago before the significant one you just lost.  They will never leave us and help us get through this rough time just like my father did in the late 1990’s when he died of cancer but never left me.  I know my deceased family and friends are so much happier, no longer ill and they are with family now  and friends they missed terribly with others that they have not seen for a long time.  Know this, those who where terribly ill are no longer fighting to stay alive or to breath to their last breath.  Instead now they are keeping a close eye on you and all loved ones they had in their life.  As long as that person in my life who left me from earth is better off I know that is for the best which overrides my misery.  My faith and being a RN over over 37 years seeing so many types of patients and some who may have passed on all types of units including oncology, burn units, all types of med surg, telemetry (cardiac), stroke, hospice and more might make it easier for me in dealing with death than some but trust me I still have feelings like everyone else in this world.  God has his reasons for taking those significant in our life to leave this world and we may not understand why but we will in time whether it be in this world or the next.   I am very thankful I had the time to see my loved ones significant in my life during my lifetime on earth and I put myself in that person’s shoes who struggled to stay alive and now is gone.  I ask myself would you want the people down here on earth hurting and in misery for a long time, if you died and I say no to myself and you probably would say the same.  So if you do agree with this apply this positive attitude for when you loose someone significant in your life it may just help you get through the struggle your going through.

Grief is a natural response to loss. It’s the emotional suffering you feel when something or someone you love is taken away. The more significant the loss, the more intense the grief will be. You may associate grief with the death of a loved one—which is often the cause of the most intense type of grief—but any loss can cause grief, including: divorce, loss of health, loss of a job, loss of financial stability, retirement, loss of a friendship, loss of a cherished dream (ex. spouses in their own business, planning to get married that never happens, loss of a mortgage on a new home, a loss of a baby, etc…).

The more significant the loss, the more intense the grief. However, even subtle losses can lead to grief. For example, you might experience grief after moving away from home, graduating from college, changing jobs, selling your family home, or retiring from a career you loved.

Grieving is a personal and highly individual experience. How you grieve depends on many factors, including your personality and coping style, your life experience, your faith, and the nature of the loss. The grieving process takes time. Healing happens gradually; it can’t be forced or hurried—and there is no “normal” timetable for grieving.  Some people start to feel better in weeks or months. For others, the grieving process is measured in years. Whatever your grief experience, it’s important to be patient with yourself and allow the process to naturally unfold.

Dr Elisabeth Kübler-Ross pioneered methods in the support and counselling of personal trauma, grief and grieving, associated with death and dying. She also dramatically improved the understanding and practices in relation to bereavement and hospice care. This is quite aside from the validity of her theoretical work itself, on which point see the note, right.

Her ideas, notably the five stages of grief model, the model was first introduced by American Psychiatrist Elisabeth Kübler-Ross in her 1969 book, On Death and Dying, and was inspired by her work with terminally ill patients but simply a significant loss can experience these steps as well.  They are: 1.) Denial 2.) Anger 3.) Bargaining 4.) Depression 5.) Acceptance .  You go through all these steps in a loss and repeat them and not in order for all.   Contrary to popular belief, you do not have to go through each stage in order to heal.   In fact, some people resolve their grief without going through any of these stages. And if you do go through these stages of grief, you probably won’t experience them in a neat, sequential order, so don’t worry about what you “should” be feeling or which stage you’re supposed to be in.Kübler-Ross herself never intended for these stages to be a rigid framework that applies to everyone who mourns. In her last book before her death in 2004, she said of the five stages of grief: “They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grieving is as individual as our lives.”

While loss affects people in different ways, many experience the following symptoms when they’re grieving. Just remember that almost anything that you experience in the early stages of grief is normal—including feeling like you’re going crazy, feeling like you’re in a bad dream, or questioning your religious beliefs.

Symptoms of Grief:  Shock and disbelief – Right after a loss, it can be hard to accept what happened.  Sadness – Profound sadness is probably the most universally experienced.  Guilt – You may regret or feel guilty about things you did or didn’t say or do. Anger – Even if the loss was nobody’s fault, you may feel angry and resentful. If you lost a loved one, you may be angry with yourself, God, the doctors, or even the person who died for abandoning you.  You may feel injustice has been done to you.  Fear – A significant loss can trigger a host of worries and fears. You may feel anxious, helpless, or insecure. You may even have panic attacks.  You may feel fears of how do  I live without this person.  Physical Symptoms – We often think of grief as a strictly emotional process, but grief often involves physical problems, including fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia.

Coping with grief and loss is one get support.                                                        

The single most important factor in healing from loss is having the support of other people. do not grieve alone. Connecting to others will help you heal.

Here are some recommendations when finding support after a loss:

• Turn to friends and family members
• Draw comfort from your faith
• Join a support group – To find a bereavement support group in your area.
• Talk to a therapist or grief counselor – If your grief feels like too much to bear, call a mental health professional with experience in grief counseling.Face your feelings, express your feelings in a  tangible and creative way (I am writing about it in my blog for example).  Take care of your health (especially not on alcohol or drugs to numb the pain for it will be only temporary and unhealthy).  Don’t have people inform you how to feel and when you will be better.  Don’t tell yourself how you should feel.  This is YOUR grief no one elses and when its time to move on or that you have gotten over the grief you will know.  It is ok to be angry, ask why God did you do this to me, not understand why this took place,  laugh at moments of good time memories
• When you’re grieving, it’s more important than ever to take care of yourself. If you don’t care for yourself you can’t take care of others.  The stress of a major loss can quickly deplete your energy and emotional reserves.
• Don’t let anyone tell you how to feel, and don’t tell yourself how to feel either. Your grief is your own, and no one else can tell you when it’s time to “move on” or “get over it.” Let yourself feel whatever you feel without embarrassment or judgement.   It’s okay to be angry, to yell at the heavens, to cry or not to cry. It’s also okay to laugh, to find moments of joy, and to let go when you’re ready.  As time passes, these emotions should become less intense as you accept the loss and start to move forward.The sadness of losing someone you love never goes away completely, but it shouldn’t remain center stage. If the pain of the loss is so constant and severe that it keeps you from resuming your life, you may be suffering from a condition known as complicated grief .  Unable to get rid of the intense grieving loss feelings and move on with your life.  Still in intense mourning and unable to accept the death or loss you have had after a long period of time.  A loss can effect you weeks to months to a year and if you move on at that point it is therapeutically dealing with it.  Your feeling can still be present till you die but in less intensity since the occurrence of the loss.
• Contact a grief counselor or professional therapist if you:- Experiencing complicated grief, feel like life isn’t worth living, wish you had died with your loved one, blame yourself for the loss or for failing to prevent it, feel numb or disconnected from others for more than a few weeks, are having difficulty trusting others since your loss, are unable to perform your normal daily activities!

REFERENCES TO THIS ARTICLE:

1. Block SD. Grief and bereavement. http://www.uptodate.com /index. Accessed Aug. 31, 2012.
2. Dealing with the effects of trauma — A self-help guide. Substance Abuse and Mental Health Services. http://store.samhsa.gov/shin/content//SMA-3717/SMA-3717.pdf. Accessed Aug. 31, 2012.
3. Holtslander L, et al. An inner struggle for hope: Insights from the diaries of bereaved family caregivers. International Journal of Palliative Nursing. 2008;14:478.
4. Vale-Taylor P. “We will remember them”: A mixed-method study to explore which post-funeral remembrance activities are most significant and important to bereaved people living with loss, and why those particular activities are chosen. Palliative Medicine. 2009;23:537.
5. Benkel I, et al. Managing grief and relationship roles influence which forms of social support the bereaved needs. American Journal of Hospice and Palliative Medicine. 2009;26:241.
6. Reminders of trauma: Anniversaries. United States Department of Veterans Affairs. http://www.ptsd.va.gov/public/pages/anniversary-reactions.asp. Accessed Aug. 31, 2012.

      7. MAYO CLINIC 2012

“To relieve chronic pain, healthcare providers first try to identify and treat the cause. But sometimes they can’t find the source. If so, they turn to treating, or managing, the pain.

Healthcare providers treat chronic pain in many different ways. The approach depends on many factors, including:

• The type of pain you have.
• The cause of your pain, if known.
• Your age and overall health.

The best treatment plans use a variety of strategies, including medications, lifestyle changes and therapies.

If you have chronic pain and depression and/or anxiety, it’s important to seek treatment for your mental health condition(s) as well. Having depression or anxiety can make your chronic pain worse. For example, if you have depression, the fatigue, sleep changes and decreased activity it may cause can make your chronic pain worse.

Your healthcare provider may recommend certain medications to relieve chronic pain, including:

• Anticonvulsants (medications that prevent seizures) for nerve pain.
• Antidepressants such as tricyclic antidepressants.
• Corticosteroid.
• Muscle relaxers.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen.
• Topical products (applied to the skin) that contain pain relievers or ingredients that create soothing heat or cold.
• Opioids (narcotics). Opioids can be addictive, and you can build up a tolerance to them over time. Because of this, healthcare providers usually try other pain treatment options before prescribing opioids.
• Sedatives to help with anxiety or insomnia.
• Medical marijuana.

Other medical treatments your healthcare provider may have you try include:

• Transcutaneous electrical nerve stimulation (TENS): This procedure delivers small shocks through patches on your skin. The electrical impulses can relieve pain.
• Nerve blocks: For this treatment, your healthcare provider injects an anesthetic near the site of your pain to reduce feeling in the area. Nerve blocks can also sometimes provide diagnostic information and locate the source of your pain.
• Epidural steroid injections: This procedure is an injection of anti-inflammatory medicine — a steroid or corticosteroid — into the space around your spinal nerves known as the epidural space to treat chronic pain caused by irritation and inflammation of spinal nerve roots.

The key is through PREVENTION of pain through the following:

Four major lifestyle factors can affect your chronic pain and help minimize it. Healthcare providers sometimes call them the four pillars of chronic pain. They include:

• Stress: Stress can play a major role in chronic pain, so it’s important to try to reduce your stress as much as possible. Everyone has different techniques for managing their stress, but some techniques include meditation, mindfulness and deep breathing. Try different options until you find what works best for you.
• Exercise: Participating in low-intensity exercises, such as walking or light swimming, for 30 minutes every day may help reduce your pain. Exercise can also be a stress reliever for some people, which is important to manage when you have chronic pain.
• Diet: It’s important to eat a healthy diet to boost your overall health. Your healthcare provider may suggest trying an anti-inflammatory diet by eliminating foods that cause inflammation, such as red meat and refined carbohydrates.
• Sleep: Getting enough quality sleep is important for your overall health. A lack of sleep can cause you to gain weight, which could make your chronic pain worse. Getting quality sleep is also important for stress management.”

Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/4798-chronic-pain)

“Leading causes of death regarding Mortality:

Mortality was caused by Alzheimer’s disease and other dementias, self-harm (suicide), hypertensive heart disease, chronic kidney disease, and liver cancer have shown the largest percentage change from 2000 to 2019; this was for both male and female.”

Pan American Health Organization (https://www.paho.org/en/enlace/leading-causes-death-and-disability)

2- “Suicide is a major public health concern. Suicide is among the leading causes of death in the United States. Based on recent mortality data, suicide in some populations is on the rise according to the CDC; which states for 2021:

• Suicide was the eleventh leading cause of death overall in the United States, claiming the lives of over 48,100 people.
• Suicide was the second leading cause of death among individuals between the ages of 10-14 and 25-34 , the third leading cause of death among individuals between the ages of 15-24, and the fifth leading cause of death among individuals between the ages of 35 and 44.
• There were nearly two times as many suicides (48,183) in the United States as there were homicides (26,031).”

National Institute of Mental Health – NIH (https://www.nimh.nih.gov/health/statistics/suicide)

9- Kidney Disease

• Deaths: 48,146
• Rate: 15.1
• Age-adjusted rate: 13.2
• Percentage of total deaths: 1.8 percent

Nephritis, nephrotic syndrome, and nephrosis are all conditions, disorders, or diseases of the kidneys.

Chronic kidney disease (CKD) is a condition in which the kidneys are damaged and cannot filter blood as well as healthy kidneys. Because of this, waste from the blood remains in the body and may cause other health problems.

An estimated 10 percent of adults in the U.S. – more than 20 million people – are thought to have CKD to some degree. The chances of developing CKD increase with age, especially after the age of 50, and the condition is most common among adults older than 70.

Awareness and understanding about kidney disease is critically low, with an estimated 26 million Americans having chronic kidney disease. Among those with severe (stage 4) kidney disease, fewer than half realize that they have damaged kidneys.

Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include: Nausea/ Vomiting/Loss of appetite/Fatigue and weakness/Sleep problems/Changes in how much you urinate/Decreased mental sharpness/Muscle twitches and cramps/Swelling of feet and ankles/Persistent itching/Chest pain, if fluid builds up around the lining of the heart/Shortness of breath, if fluid builds up in the lungs/High blood pressure (hypertension) that’s difficult to control.

Remember, signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.

In how to help prevent this condition:

• Lose weight if you are overweight.
• Get active. Physical activity helps control blood sugar levels.
• Quit smoking.
• Getting a checkup? Make sure to get your kidneys checked too.
• Take medications as directed.
• Keep your blood pressure below 140/90, or ask your doctor what the best blood pressure target is for you.
• If you have diabetes, stay in your target blood sugar range as much as possible.
• Stay in your target cholesterol range.
• Eat foods lower in salt.
• Eat more fruits and vegetables.

10. Suicide

Suicide is a Leading Cause of Death in the United States. According to the Centers for Disease Control and Prevention (CDC) WISQARS Leading Causes of Death Reports, in 2016: Suicide was the tenth leading cause of death overall in the United States, claiming the lives of nearly 45,000 people.

Suicide was the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death among individuals between the ages of 35 and 54.  There were more than twice as many suicides (44,965) in the United States as there were homicides (19,362).

American facts on statistics with suicide in the U.S.:

• The annual age-adjusted suicide rate is 13.42 per 100,000 individuals.
• Men die by suicide 3.53x more often than women.
• On average, there are 123 suicides per day.
• White males accounted for 7 of 10 suicides in 2016.
• Firearms account for 51% of all suicides in 2016.
• The rate of suicide is highest in middle age — white men in particular.

We have a rising toll of suicides in our world today. This is an extremely disturbing fact, the tenth-leading cause of death. The suicide rate has gone up nearly 30% in the past 18 years in the U.S. This is a complicated issue without simple causes or solutions. We have internet bullying. We have loneliness and isolation. We have families in dissolution. We have a preponderance of psychiatric treatments that ignore the heart and soul of what it is to be human. Life is difficult, and requires struggle and resilience and caring to carry on.

There’s no single cause for suicide. Suicide most often occurs when stressors and health issues converge to create an experience of hopelessness and despair. Depression is the most common condition associated with suicide, and it is often undiagnosed or untreated. Conditions like depression, anxiety and substance problems, especially when unaddressed, increase risk for suicide. Yet it’s important to note that most people who actively manage their mental health conditions go on to engage in life.

Something to look out for when concerned that a person may be suicidal is a change in behavior or the presence of entirely new behaviors. This is of sharpest concern if the new or changed behavior is related to a painful event, loss, or change. Most people who take their lives exhibit one or more warning signs, either through what they say or what they do.

What to do if somone appears suicidal:

1- Contact emergency services immediately if someone is about to commit suicide. You need emergency responders, especially first-aid, to be there as soon as humanly possible. If you need to be with someone and they won’t let you call, try to get someone else to call. If someone is on a bridge, holding a weapon, or otherwise threatening their own life, your first move needs to be to 911. You should never try and handle this on your own.

• Mental health professionals, such as therapists or counselors, should be notified as soon as possible.
• If someone is adamant that you don’t call the police, call the National Suicide Hotline at 1-800-273-TALK (8255).

“If you are thinking about suicide pick up the phone and call someone who can help you:

• Crisis Call Center
  Phone: (800) 273-8255
• Hopeline Network
  Phone: (800) 422-HOPE (1-800-422-4673)
• National Runaway Safeline
  Phone: (800) RUNAWAY (1-800-786-2929)
• National Suicide Prevention Hotline
  Phone: (800) 273-TALK (1-800-273-8255)
• Befrienders Worldwide
  Resources and numbers by states and countries
• Boys Town Hotline
  Phone: (800) 448-3000
• The Trevor Project
  Phone: (866) 488-7386
• Veterans Crisis Line
  Phone: (800) 273-8255 Press 1
• The Samaritans
  Phone (In the UK and ROI): 116 123

“The top global causes of death, in order of total number of lives lost, are associated with two broad topics: cardiovascular (ischaemic heart disease, stroke) and respiratory (COVID-19, chronic obstructive pulmonary disease, lower respiratory infections).   Lower respiratory infections remained the world’s most deadly communicable disease other than COVID-19, ranked as the fifth leading cause of death. However, the number of deaths has gone down substantially: in 2021 it claimed 2.5 million lives, 370 000 fewer than in 2000.

The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. Prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries.  Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.  Between 2000 and 2019, there was a 3% increase in diabetes mortality rates by age.  In 2019, diabetes and kidney disease due to diabetes caused an estimated 2 million deaths.  A healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes.  Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.

World Health Organization – WHO

(https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death2-https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

2=https://www.who.int/news-room/fact-sheets/detail/diabetes)

7: Diabetes (diabetes mellitus)

• Deaths: 73,831
• Males: 38,324
• Females: 35,507
• Rate: 23.7
• Age-adjusted rate: 21.6
• Percentage of total deaths: 2.93%.

Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When a person has diabetes, the body either does not make enough insulin or cannot use insulin as well as it should. This causes sugar to build up in the blood.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations.

Type 1 diabetes, which was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, may account for about 5% of all diagnosed cases of diabetes.

Type 2 diabetes, which was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, may account for about 90-95% of all diagnosed cases of diabetes.

The estimated costs of diabetes in the US in 2012 was $245 billion. Direct medical costs accounted for $176 billion of that total and indirect costs such as disability, work loss and premature death accounted for $69 billion.

Warning signs and symptoms of diabetes

People who think they might have diabetes must visit a physician for diagnosis. They may have some or none of the following symptoms:

• Frequent urination
• Excessive thirst
• Unexplained weight loss
• Extreme hunger
• Sudden vision changes
• Tingling or numbness in hands or feet
• Feeling very tired much of the time
• Very dry skin
• Sores that are slow to heal
• More infections than usual.

Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1 diabetes.

Can diabetes be prevented?

Researchers are making progress in identifying the exact genetics and “triggers” that predispose some individuals to develop type 1 diabetes, but prevention remains elusive.

A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. Type 2 diabetes is associated with obesity.

There is no known way to prevent type 1 diabetes. Several clinical trials for preventing type 1 diabetes are currently in progress with additional studies being planned.

The Diabetes Prevention Program (DPP), a large prevention study of people at high risk for diabetes, showed that lifestyle intervention that resulted in weight loss and increased physical activity in this population can prevent or delay type 2 diabetes and in some cases return blood glucose levels to within the normal range. Other international studies have shown similar results.

Recent developments on diabetes from MNT news

Diabetes rates in the US ‘leveling off’

A new study from the CDC finds that between 2008 and 2012, diabetes prevalence and incidence rates plateaued, possibly because of slowing obesity rates.

Could a single injection stop diabetes?

Researchers who gave mice with type 2 diabetes the growth factor FGF1, found it reversed diabetes and kept blood glucose within a safe range for 2 days with just one injection.

8: Influenza and pneumonia

• Deaths: 53,826
• Males: 25,401
• Females: 28,425
• Rate: 17.3
• Age-adjusted rate: 15.7
• Percentage of total deaths: 2.13%.

Influenza accounts for 1,532 deaths annually and pneumonia 52,294.

Influenza (flu) is a highly contagious viral infection that is one of the most severe illnesses of the winter season. The reason influenza is more prevalent in the winter is not known; however, data suggest the virus survives and is transmitted better in cold temperatures. Influenza is spread easily from person to person, usually when an infected person coughs or sneezes.

Influenza and pneumonia are the eighth leading cause of death in the US with around 53,826 deaths each year.

A person can have the flu more than once because the virus that causes the disease may belong to different strains of one of three different influenza virus families: A, B or C. Type A viruses tend to have a greater effect on adults, while type B viruses are a greater problem in children.

Influenza can be complicated by pneumonia, which is a serious infection or inflammation of the lungs. The air sacs fill with pus and other liquid, blocking oxygen from reaching the bloodstream. If there is too little oxygen in the blood, the body’s cells cannot work properly, which can lead to death.

Pneumonia can have over 30 different causes, including various chemicals, bacteria, viruses, mycoplasmas and other infectious agents such as pneumocystis (fungi).

Together, pneumonia and influenza cost the US economy more than $40.2 billion in 2005. This figure includes more than $6 billion due to indirect costs (such as time lost from work) and $34.2 billion due to direct costs (such as medical expenses).

Warning signs and symptoms of influenza and pneumonia

Signs and symptoms of influenza include:

• Fever
• Headache
• Cough
• Chills
• Sore throat
• Nasal congestion
• Muscle aches
• Loss of appetite
• Malaise.

Signs and symptoms of pneumonia include:

• Fever
• Wheezing
• Cough
• Chills
• Rapid breathing
• Chest pains
• Loss of appetite
• Malaise
• Feeling of weakness or ill health.

Can influenza and pneumonia be prevented?

We basically know what pneumonia is right?  If not, on problem it is this:  Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus or mucus (color-yellow to green), fatigue, sweating, fever, chills, nausea or vomiting and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.  Treatment is antibiotics.

Most important, methods of prevention with influenza and pneumonia include:

• Flu shot every year to prevent seasonal influenza
• Vaccination against pneumococcal pneumonia if you are at high risk of getting this type of pneumonia
• Wash hands frequently, especially after blowing nose, going to the bathroom, diapering, and before eating or preparing foods
• Do not smoke. Tobacco damages the lungs’ ability to fight off infection, and smokers have been found to be at a higher risk of getting pneumonia.
• Since pneumonia often follows respiratory infections, be aware of any symptoms that linger for more than a few days
• Good health habits – a healthy diet, rest, regular exercise, etc. – help prevent viruses and respiratory illnesses
• Hib vaccine prevents pneumonia in children from Haemophilus influenzae type B
• A drug called Synagis (palivizumab) can be given to some children younger than 24 months to prevent pneumonia caused by respiratory syncytial virus
• With cancer or HIV patients, a doctor should be consulted about additional ways to prevent pneumonia and other infections.

Recent developments on influenza and pneumonia from MNT news

Goji berries protect against the flu in new study

A study in older mice suggests that, when coupled with the flu vaccine, goji berries offer extra protection against the flu by boosting the immune system and diminishing symptoms.

New vaccine protects against staph-induced pneumonia

A vaccine that targeted surface proteins increased disease severity, whereas one that targeted toxins secreted by the bacteria protected against staph-induced pneumonia.

“This article describes the public health impact of Alzheimer’s disease, including prevalence and incidence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report examines the patient journey from awareness of cognitive changes to potential treatment with drugs that change the underlying biology of Alzheimer’s. An estimated 6.7 million Americans age 65 and older are living with Alzheimer’s dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, and Alzheimer’s disease was officially listed as the sixth-leading cause of death in the United States. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer’s was the seventh-leading cause of death. Alzheimer’s remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated by the COVID-19 pandemic in 2020 and 2021. More than 11 million family members and other unpaid caregivers provided an estimated 18 billion hours of care to people with Alzheimer’s or other dementias in 2022. ”

Alzheimer’s Association(https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13016)