People who get more than just blue in the winter months may find they have seasonal affective disorder, or SAD. Before self-diagnosing, it’s important to research the disorder and speak with a health care provider.
Here are some things to know about SAD.
What is it?
According to the National Institutes of Health, SAD, also called seasonal depression or seasonal mood disorder, is a type of depression that typically starts in late fall and early winter and goes away during the spring and summer.
For some it starts in the spring and summer and goes away in the fall or winter, but that’s very rare.
The cause of the disorder is not known, but researchers say those who have the disorder are found to have an imbalance of serotonin, which affects mood, and not enough vitamin D, which comes from sunlight, among other places. They also have too much melatonin, which regulates sleep, according to the NIH.
What are the symptoms?
Symptoms may include feeling sad, irritable, hopeless or worthless, having low energy, difficulty eating or sleeping, a gloomy outlook, losing interest in activities you used to enjoy and thoughts of death or suicide. According to the Mayo Clinic, symptoms specific to winter-onset SAD include oversleeping, wright gain and appetite changes, particularly craving high-carb foods. Symptoms specific to summer-onset SAD include insomnia, agitation or anxiety, loss of appetite and weight loss.
People with those symptoms and who feel depressed for days at a time should see their doctor.
Who does SAD affect?
Anyone can be affected by SAD, but it is more common in women, young people, and people who live far from the equator, in areas where there is less sunlight throughout the day. People who have bipolar disorder or major depression, as well as those with blood relatives with SAD or other forms of depression, are more likely to be at risk of the disorder.
How can it be treated?
Light therapy is typically the main treatment for SAD. According to the National Institute of Mental Health, other treatments include medication, such as selective serotonin reuptake inhibitors, and psychotherapy.
A Florida woman recently settled a medical malpractice lawsuit against a surgeon who removed her fully-functioning kidney during a 2016 spinal surgery.
Maureen Pacheco’s lawsuit against Dr. Ramon Vazquez was settled last month, according to Palm Beach County court records. The terms of the settlement were not disclosed.
Pacheco, a West Palm Beach resident, was 51 years old and suffering from back pain due to a car crash when she was scheduled to undergo anterior lumbar interbody fusion surgery in April 2016, the October 2017 lawsuit said. The surgery, which took place at Wellington Regional Medical Center, is described by the American Academy of Orthopaedic Surgeons as a “welding process,” in which problematic vertebrae in a person’s spine are fused together into one larger bone.
The term anterior meant that doctors would go in from Pacheco’s abdomen instead of her back. The academy explains on its website that an anterior procedure allows more direct access to the discs between the vertebrae, which are removed during the procedure, and offers a quicker recovery time.
Surgeons are also able to access the spine without moving nerves out of the way, but they have to move organs and blood vessels to the side to reach the spine, the website says.
Pacheco told WPTV in West Palm Beach there were no signs of what would go wrong when she prepared for the operation.
“There was no red flags or anything,” Pacheco told the news station.
Pacheco’s orthopedic surgeons that day were Dr. John Britt and Dr. Jeffrey Kugler, who was the treating physician. Vazquez, a general surgeon with staff privileges at the hospital, was assigned with opening the patient up and providing access to the surgical site so the other doctors could perform the fusion.
An administrative complaint against Vazquez filed with the state medical board by Florida Department of Health officials -- the outcome of which is still pending -- described what happened next.
“During the surgical procedure, (Vazquez) noted a pelvic mass and provided a presumptive diagnosis of a gynecologic malignancy, lymphoma and/or other metastatic disease,” the December 2017 complaint stated. “The pelvic mass was clipped, transected and removed in its entirety.”
A few days later, a hospital pathologist discovered that the mass was not cancer -- it was Pacheco’s left kidney.
It turned out that Pacheco had a “pelvic kidney,” which occurs when a person’s kidney does not ascend like it should as the organs develop in utero. The kidney remains in the pelvis instead of settling in the flank.
Read the administrative complaint against Dr. Ramon Vazquez below.
Pacheco’s lawyers argued in the lawsuit that Vazquez was provided with MRI images taken of their client’s spine in February 2015 and February 2016. The images showed that Pacheco had a pelvic kidney.
The MRIs also showed that the kidney was functional, the document said.
“If he would have looked at the MRIs that were given to him, he would’ve realized it,” Pacheco told WPTV.
Vazquez never confirmed what was on the images or discussed the images with Kugler and Britt before removing Pacheco’s kidney, according to the lawsuit. He also failed to biopsy the “mass” before deciding to remove it, the health department complaint stated.
Pacheco was not consulted about the removal or given options for treatment of what Vazquez thought he found, the lawsuit said.
The lawsuit stated that Kugler and Britt were negligent because they failed to exhaust all “conservative pain management options” before recommending surgery, and that they should have confirmed that Vazquez consulted with Pacheco and looked at the MRIs before opening her up.
The doctors also failed to ensure that Vazquez knew she had a pelvic kidney prior to surgery, the lawsuit said.
The Palm Beach Post reported that the medical malpractice insurers for Kugler and Britt settled the case for $250,000 per doctor.
Wellington Regional revoked Vazquez’s privileges following the incident. Hospital officials told WPTV that all necessary and appropriate steps were taken to ensure it did not happen again.
“In the 30-year history of Wellington Regional Medical Center, an incident of his nature has never occurred, before or since,” a hospital statement read.
Vazquez’s attorney, Mike Mittelmark, told the Post his client did not admit wrongdoing in settling with Pacheco.
“The case was settled on his behalf for a nominal amount due to the uncertainty of litigation and in no way did Dr. Vazquez admit liability by agreeing to this settlement,” Mittelmark told the newspaper.
Read the entire lawsuit filed by Maureen Pacheco below.
Florida law subjects a doctor to discipline for performing or trying to perform a procedure on the wrong patient, a procedure at the wrong site, a wrong procedure or an unauthorized procedure that is medically unnecessary or otherwise unrelated to the patient’s diagnosis or condition. That includes while preparing the patient, the health department’s complaint stated.
“Respondent performed a medically unnecessary procedure on (Pacheco) by removing a pelvic kidney during a lumbar fusion,” the complaint said.
The recommendation of Florida Surgeon General Celeste Philip was for Vazquez to suffer permanent revocation or suspension of his license, restriction of practice, imposition of a fine, a reprimand, probation, corrective action, refund of fees collected, remedial education “and/or any other relief the board deems appropriate.”
Pacheco’s attorney, Donald Ward III, said he didn’t expect Vazquez to lose his medical license over what happened.
“It’s unlikely that he would lose his license over something like this,” Ward told WPTV. “What is most likely is that he would face a fine and possibly be required to do some continuing medical education so that he could learn not to make the same mistake in the future.”
There were some oddities about the case, however, on top of Pacheco losing a healthy kidney.
“What is not common is for you to meet that general surgeon the morning of (surgery) and be told that if something were to happen to you, that general surgeon doesn’t carry any health insurance whatsoever,” Ward said.
Vazquez did not have malpractice insurance, which means if he is fined by the state, the fine will have to be paid out of the doctor’s own pocket, the lawyer said.
Pacheco said she harbors “no ill will” against Vazquez.
“Everyone is entitled to their livelihood, but you should have consequences when gross mistakes and negligence are made,” she told the news station. “I just wish that he learns a lesson from the consequences. It’s always in the back of my mind -- lifelong kidney transplant or dialysis.
“Now I’m always fearful.”
A female inmate at a California prison last year gouged out her own eye and ate it during a psychotic break, according to an internal report blasting the state’s prison system for inadequate care of mentally ill patients.
The report, released last week as part of an ongoing, decades-long federal lawsuit over inmate care, was written by Dr. Michael Golding, the chief psychiatrist for the California Department of Corrections and Rehabilitation. The Los Angeles Times, which reported on the document Monday, said that Golding accused prison officials of hiding the truth about the subpar mental health care they provide to those in custody.
“This group has created a biased and inaccurately positive picture of what is actually a troubled system of care,” Golding wrote in the report, which was obtained through federal court documents.
The Associated Press reported that U.S. District Judge Kimberly Mueller, who made the 161-page report public Oct. 31, is considering appointing a special investigator to look into Golding’s claims.
Golding, who wrote the report based on his own visits to prisons across California, alleged that officials lied to Mueller and attorneys in the case about how often inmates were seen by psychiatrists, boasting in 2017 and 2018 that inmates were seen on time by their doctors at least 90 percent of the time. Golding said the actual percentage of on-time appointments was less than 46 percent.
The chief psychiatrist wrote that inmates were denied appointments in confidential offices, instead being seen by a psychiatrist in the prison yard or through a crack in a solid metal door, where other inmates could hear the details of their conversation.
The corrections department also has a “resetting-the-clock” strategy in which a mental health patient’s psychiatric care is “reset” each time he or she is transferred from one facility to another, Golding wrote in the report. The strategy was used to “deem as compliant appointments occurring later than the maximum interval” permitted, he alleged.
“They reset the clock every time a patient is transferred, irrespective of when the patient last saw a psychiatrist,” the report states. “A…patient transferred more than once might not have another psychiatry appointment for eight months.”
The maximum amount of time the federal court allows a patient to wait to be seen is three months, the report said.
Golding wrote that the Department of Corrections and Rehabilitation has a “broken system” because information is not accurately reported and “reliable commonsensical action” is not taken.
“I have documented that patients are not getting to appointments on schedule and in confidential spaces, that appropriate consultation is not occurring, and worse, appropriate medical decision-making by psychiatric physicians has been overridden,” he wrote.
The lack of a proper medical decision was part of the problem for the woman who removed and ate her eye at the California Institution for Women in Chino, the report alleged. Golding wrote that the woman, who he identified as Patient X, presented “relatively well” when she entered the prison system, but she stopped taking the anti-psychotic medication she had been prescribed on the outside.
“Arguably, in situations like this, longer transitions for patients at higher levels of care should be insisted upon when medication from the community is discontinued, even if the patient appears to have the legal right to discontinue medication because of presenting in a logical way,” Golding wrote.
The patient was well for as long as the medication stayed in her system, but eventually, those positive effects wore off and she “did not stay well,” the report stated. Four hours before the April 20, 2017, incident, she was evaluated by a psychiatrist and found to be “gravely disabled,” so the psychiatrist wrote orders for her to be taken to the licensed psychiatric crisis bed unit.
“These admission orders were being followed, except for the order for the patient to go to a crisis bed,” Golding wrote.
Instead, the patient was being monitored in an unlicensed setting that was more like an urgent care facility and, although she was on one-to-one suicide watch as ordered, she was not placed in a “strong gown” because she refused to comply with that order.
Documentation indicated she was actively psychotic at the time of admission, the report said.
“Documentation from the one-to-one observer noted ‘screaming’ every 15 minutes for most of the four-hour period,” Golding’s report said.
Golding wrote that staff members did not contact the psychiatrist on call and the woman did not receive any medication during those four hours. The woman, who was lying face-up on the floor, then touched her left eye for several seconds before removing it from her head.
“The alarm was sounded and two correctional officers entered the cell,” the report stated. “The (inmate patient) was asked to relinquish the eye, however, she put the eye in her mouth and ingested it.”
Golding alleged that multiple psychiatrists who subsequently heard about the incident agreed medication should have been forced on the woman to keep her out of harm’s way. State prison psychologists who evaluated how staff handled the incident, however, determined the failure to contact the psychiatrist on call was not the root cause of the woman’s self-harm.
A psychiatrist, who is a medical doctor, has the ability to prescribe medications, while a psychologist does not. Golding wrote in his report that psychiatrists in the prison system routinely report to psychologists, who make the majority of decisions about system-wide care.
The psychologist in the woman’s case made the decision not to contact the psychiatrist on call, Golding wrote.
He further wrote that the psychologist did not have admitting privileges to the crisis bed unit and that “despite this horrendous event,” the state licensing board was never informed of what happened because the inmate was being held in an unlicensed facility instead of where she should have been.
“The tragedy is that any competent psychiatric physician or general medical physician would have medicated the patient, and likely the patient’s eye would still be in her head had that happened,” Golding wrote.
A Department of Corrections and Rehabilitation spokeswoman denied Golding’s allegations in a statement issued Friday, the Times reported.
“The department strongly disagrees with this individual’s allegations and looks forward to a fair and thorough review and hearing of all the facts,” press secretary Vicky Waters said. “We have worked closely with lawyers representing prisoners, as well as the court appointment monitors, for many years to improve the mental health of inmates, and our dedicated and well-trained staff will continue to provide appropriate care and treatment.”
Michael Bien, the attorney for California prisoners receiving mental health care, told the Times that the report could throw off the headway made in recent years in improving the programs offered by the prisons. Bien said he had been poised to accept a proposal that would have slashed psychiatric staffing in the facilities by 20 percent, but the agreement has been nixed since Goldberg’s report was released.
“The bigger impact is we felt we were ticking off the last couple of issues before we could end the case,” Bien told the Times. “Now I have to go back and check all those assumptions. The most serious thing is the allegation that misrepresentations were made to the court. That really forces all of us to question what’s been going on.”
No matter who you want to win and whether you’re watching all the coverage alone or with hundreds of political allies, the midterm elections can be stressful.
But there is a secret strategy for avoiding some or all of the attendant anxiety pre- and post-Election Day.
Here are a few tips from two Atlanta-area women who help people reduce stress and seek wellness as part of their jobs:1. If you're feeling frantic, walk, run or kickbox to shake out the nerves.
This advice comes from registered yoga teacher and mindful movement educator Caroline Gebhard of Yoga Alliance.
"I am seeing a lot of election-related stress and anxiety and people overdoing it," she said. "Add the holiday season fast approaching, and it's a perfect storm for feeling frantic and compulsive."2. Do this simple exercise.
Personal life coach and nutritionist Ashley Brooke Harbour said she often teaches people this tension-relieving exercise that could help with stress:
"Stand about three feet from the wall, reaching out with both arms, lean at an angle into the wall and press with all your might!" she said. "Keep your feet locked on the floor so your Achilles tendons get a really good stretch. The further you stretch and harder your press, the more tension you'll release!"
"You'll only increase your stress by zoning out on social media and staying addicted to the drama," said Gebhardt. "Instead, tune back into your physical needs, which will pay off mentally and emotionally. Practice noticing the sensations and energetic needs in your body. If you're feeling foggy or desperate, like you want to avoid it all, be gentle with yourself but make an effort to move. Try a yoga class online, get outside and take a 20-minute brisk walk, dance around your house."
Most important, according to Gebhardt, is to remind yourself you've got a body, mind and spirit that need consistent movement and care.
"This applies no matter who takes office," she said.4. Reach out to mental health professionals.
"They can help support you during this stressful time," said Gebhardt. "If you're feeling like you can function normally, it's also an important time to carve out supportive self-care through friends and family who share your perspective. Believe me, you are not alone with these feelings. The term 'national nervous breakdown' is real."
While hypertension medication can help lower blood pressure levels, it might also increase your risk of lung cancer, according to a new report.
Researchers from McGill University in Canada recently conducted a study, published in The British Medical Journal, to determine the link between lung cancer and angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), two types of pharmaceutical drugs used to treat hypertension.
While both types of drugs lower blood pressure, they target different proteins and can have different side effects. Common ACEIs include lisinopril, benazepril and enalapril, and common ARBs include azilsartan, candesartan and eprosartan mesylate.
For the study, the authors examined the health records of 992,000 adults in the United Kingdom who were prescribed blood pressure drugs from 1995 to 2015. They were followed for more than six years, and the analysts considered their age, sex, weight, smoking status and other factors that could influence the findings.
After analyzing the results, they found that those who used ACEIs had a 14 percent increased risk of lung cancer compared to those on ARBs. They noticed the association after five years of use and said the risk increased the longer the patients were on the medication. In fact, those who took it for 10 years had a 31 percent increased chance of a diagnosis.
“In this large, population based study, the use of ACEIs was associated with an elevated risk of lung cancer overall, along with evidence of a duration-response relation,” the team wrote. “Although the magnitudes of the observed estimates are modest, these small relative effects could translate into large absolute numbers of patients at risk for lung cancer, so these findings need to be replicated in other settings.”
The scientists noted ACEIs do not cause lung cancer, and they do not yet understand the relationship between the illness and the pills. However, they hypothesize that socioeconomic differences, diet and family history of lung cancer may have affected their findings. They also acknowledged previous research that suggested ACEIs may cause the accumulation of chemicals that have been discovered in lung cancer tissue.
They now hope to continue their investigations and advise people to express their concerns about potential blood pressure medication risks with their physicians.
“Additional studies,” they concluded, “with long term follow-up, are needed to investigate the effects of these drugs on incidence of lung cancer.”
Public libraries and YMCAs across the United States soon will be equipped with a a nasal spray that works to counteract the effects of opioid overdoses, Time reported.
Emergent BioSolutions, which this month completed its acquisition of Narcan maker Adapt Pharma, will provide a free kit that includes educational materials and two doses of the naxalone nasal spray,.
They are being offered to the country’s 16,568 public libraries and 2,700 YMCAs, according to a statement Wednesday. It will supplement the Narcan in Schools program, in which four free doses of Narcan have been offered to each U.S. high school, Time reported.
“These two programs reflect our commitment to educating the public about the potential risks of opioids and the critical role of naloxone during an opioid overdose emergency and reinforce our mission –- to protect and enhance life,” Emergent Senior Vice President Doug White, head of the company’s devices business unit, said in a statement.
A New York infant dubbed the “Miracle Baby” has finally gone home, 104 days after being born premature at 1 pound, 4 ounces, WABC reported.
Hanna Bella Rodriguez was born July 11 at Nassau University Medical Center, the smallest child ever born at the Long Island facility in East Meadow. She was discharged Monday and weighed 5 pounds, 5 ounces, the television station reported.
Hannah was born 13 weeks premature and was the size of an adult hand when she was delivered by an emergency C-section, WABC reported. She was due Oct. 5.
“Let’s not forget that NUMC is a safety net hospital, but they have the smarts, they have the capacity, they’ve got the staff to work miracles,” Nassau County Executive Laura Curran said during a news conference Monday.
“This is a proud moment for us as a pediatric department in the hospital to care for the needs of the community,” said Krishan Kumar, the chief of the pediatrics department at the hospital. “Look at this little girl. She is a miracle girl.”
"There's many patients around the gestational age that don't make it," NUMC John Riggs told WABC. “They don't survive, or have some serious problems."
The baby’s mother, Jennifer Pena, said she was grateful to the hospital staff helping Hannah survive after doctors discovered the child’s heartbeat rate was decreasing.
“I was so scared but they helped me a lot. I was crying a lot in the surgery room but they held my hand and said everything is for your baby,” Pena told WNBC.
“I never lost my faith. She’s always going to be my beautiful baby and I love her,” Pena told WCBS.
Update 5:31 p.m. EDT Oct. 29: In a tweet, the Kansas City Police Department said it has recovered the inflatable colon that was stolen earlier this month. The department said a tip led officers to a vacant house in Kansas City, where the 10-foot, 150-pound inflatable replica of a colon was found.
No one in custody yet and the investigation is continuing, police said.
Update 12:01 a.m. EDT Oct. 27: Salix Pharmaceuticals, based out of Bridgewater, New Jersey, said its employees raised the funds needed to replace the inflatable colon that had been stolen.
In a statement, Salix senior vice president Mark McKenna said the vote was unanimous by employees to donate the necessary funds.
“There’s nothing better than making a difference in the health care community,” McKenna said. “This is what motivates us every single day.”
Original report: This might be a little tough to digest.
A 10-foot, 150-pound inflatable colon used to teach about the dangers of colon cancer was stolen from the University of Kansas Cancer Center, KMBC reported.
The colon, valued at $4,000, was stolen from the bed of a parked pickup truck in Kansas City, KMBC reported. It was in Kansas City for a walk/run event scheduled for Saturday in Swope Park, the St. Louis Post-Dispatch reported.
“Colorectal cancer screening is the most powerful weapon we have against colorectal cancer,” John Ashcraft, surgical oncologist at the University of Kansas Cancer Center, said in a news release Friday. “Colon cancer is a tough subject for many to talk about and the giant, 150-pound, 10-foot-long inflatable colon is a great conversation starter.”
The Cancer Coalition ships the inflatable item across the country for walkers and runners to see and learn about the progression of colon cancer in a unique way, according to a news release.
A doctor who raised concerns that he might have been drunk while working at a Kentucky hospital has been suspended by the state’s medical licensing board, the Lexington Herald-Leader reported.
The Kentucky Board of Medical Licensure released an emergency suspension order against Thomas Paul Splan on Friday, the newspaper reported.
Splan lives in Virginia, but was working temporarily at the Appalachian Regional Healthcare hospital in Hazard on April 6 when the incident allegedly happened, according to the suspension order.
According to a complaint filed with the board, a hospital administrator received a telephone call from staff members, who said they were concerned that Splan was impaired.
The staff members said Splan’s eyes were red, he could barely stand and he fell asleep in mid-conversation, WYMT reported. A test showed Splan's blood alcohol level was .187 percent, authorities told the television station. The legal limit in Kentucky is .08 percent.
During an evaluation at a facility in Virginia, Splan, whose specialty is internal medicine, said he’d been treated for alcohol dependence, the Herald-Leader reported. Splan said he had been sober since Feb. 23, 2011, before drinking alcohol on a flight from Richmond, Virginia, to Lexington on March 31, according to the emergency order.
Splan said he began working the Hazard hospital on April 2. According to the suspension order, Splan would work from 6 a.m. to 8 a.m. and then return to his motel, where he would drink, the Herald-Leader reported.
According to the suspension order, Splan said he drank nearly a fifth of alcohol every day, stopping about midnight before his shift early on April 6. He said he felt tired and “fairly hung over” that morning but did not feel intoxicated, the newspaper reported.
Hospital officials fired Splan, the Herald-Leader reported.
Splan told the Kentucky Board of Medical Licensure that he has not had a drink since April 6 and has had no issues in the Virginia hospital where he works, WYMT reported.
A British woman who delayed chemotherapy so she could save her unborn baby’s life died Sunday after a nearly five-year battle with ovarian cancer, the Daily Mail reported.
“It is with an utterly broken heart that I have to tell you all that my beautiful warrior lost her battle early this morning,” Sproates wrote on Facebook. “We fought so hard but we just couldn’t do it anymore — I am one very proud but devastated mum right now — Sleep tight Gemma — My world will never be the same again.”
Doctors gave Nuttall the option to terminate the pregnancy to receive chemotherapy for her tumor, but she decided to delay treatment until she gave birth to her daughter, Penelope by emergency C-section in March 2014, The Sun reported.
Penelope is now 4.
After the child was born, Nuttall underwent chemotherapy and radiation treatments. Doctors found cervical cancer and were able to remove the tumor, and Nuttall spent the next two years cancer-free, People reported. But in April 2016 she was diagnosed with cancer of the brain and lung, the magazine reported.
Actress Kate Winslet stepped in, and with the help of “Titanic” co-star Leonardo DiCaprio, auctioned three dinners with “Jack and Rose” and raised $1.35 million in early 2018.
Winslet said Nuttall’s death was “tragically sad” and called her “a beacon of strength,” the Daily Mail reported.
“My heart breaks for her mum and daughter,” Winslet told the newspaper.
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