Empowering Parkinson's Care: Harnessing Smart Watches for Patient Management

Image: Getty images 2023

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

I recently came across an article about how Apple Watch is making progress in identifying and helping the medical community understand if the treatments for Parkinson's are working. 

According to new studies, data from a smartwatch could also help predict Parkinson's disease up to seven years before symptoms begin occurring. Researchers believe that Artificial intelligence (AI)

could help screen for the disease earlier than current methods allow. An earlier diagnosis of Parkinson's' disease can be crucial. Early symptoms of Parkinson's include tremors, loss of smell, and trouble walking or moving.

Through Apple's open-source ResearchKit APIs and Research app for iOS, these tools, when used in conjunction with Apple Watch, can help doctors and researchers detect and treat Parkinson's and other diseases.

StrivePD, in Integration with HealthKit and the use of Apple Watch, provides passive metrics that augment self-reported logs for a holistic view and daily healthcare journey.

It helps to visualize tremors and dyskinesia detected by the Apple Watch. 

Browse interactive charts to review symptom data over time and in the context of your medications and physical activities.

Track daily physical activities to help reach weekly fitness goals

Explore logged medications, symptoms, activities, and influences together over the day in an easy-to-read chart view

Activity Tracking: Apple Watch and other smartwatches can monitor physical activity, such as steps taken and distance covered. Individuals with Parkinson's can benefit from tracking their activity levels to ensure they stay active, essential for maintaining mobility and overall health.

Fall Detection: Apple Watch has a fall detection feature that automatically calls for help if it detects a fall—people with Parkinson's may have an increased risk of falls.

Heart Rate Monitoring: Smartwatches like the Apple Watch can continuously monitor heart rate. Changes in heart rate may provide insights into the progression of Parkinson's disease or the effectiveness of medications.

Voice and Speech Analysis: Parkinson's disease can affect speech and vocal patterns. Some researchers have explored using smartwatches to analyze voice data for early signs of the illness or monitor its progression.

Medication Reminders: 

Smartwatches can be programmed to provide medication reminders for individuals with Parkinson's disease. Particularly help to manage medication schedule and establish good logging habits to review changes over time. Patients with Parkinson's require precise timing for the medication. 

Gait and Balance Analysis: Some studies have explored using accelerometers in smartwatches to analyze gait and balance, which are affected in Parkinson's patients. Changes in parameters can be indicative of the disease's progression.

Tremor Monitoring: While not as accurate as clinical assessments, smartwatches with motion sensors can track hand tremors to a certain extent, providing a tool for self-monitoring and sharing data with healthcare providers.

Sleep Tracking: Sleep disturbances are common in Parkinson's disease. Smartwatches can track sleep patterns, helping individuals and their doctors understand and address sleep issues.

Continuous health monitoring throughout the day is crucial for Parkinson's. Parkinson's symptoms don't always manifest in clinical settings. 

While the Apple Watch and other smartwatches continue to be explored for their potential to assist in the early diagnosis and monitoring of Parkinson's disease, they are not intended as a diagnostic tools. 

It's important to note that while these features can be helpful for individuals with Parkinson's disease, they are not a substitute for professional medical evaluation and diagnosis. Suppose you or someone you know is exhibiting symptoms of Parkinson's disease. In that case, it's crucial to consult with a neurologist or a healthcare professional for a thorough assessment and an accurate diagnosis. Smartwatches and other wearable devices can complement traditional medical care by providing additional data and insights, but they should not be relied upon for a definitive diagnosis of Parkinson's disease.

The Financial Burden of Diabetes: A Growing Crisis

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by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Chronic high levels of blood sugar is a metabolic disease known as diabetes.   Diabetes itself is a global health crisis. While its physical toll on individuals is well-documented, the financial burden of diabetes is often underestimated. 

The prevalence of diabetes has been on the rise for several decades. As of 2018, according to the International Diabetes Federation (IDF), approximately 463 million adults were living with diabetes worldwide, and this number is projected to increase to 700 million by 2045. The reasons for this epidemic are multifaceted, including sedentary lifestyles, poor dietary habits, and genetic predisposition.

Living with diabetes can be financially overwhelming for individuals. People with diabetes require regular medical check-ups, medication, and often insulin therapy. The cost of these essentials adds up quickly. Frequent doctor visits, lab tests, and prescription drugs can strain an individual's budget, especially if they lack adequate health insurance.  Kidney disease, heart disease, and vision problems are among the long-term complications of diabetes, which further exacerbate the financial strain.

The American Diabetes Association reports that, as of 2019, the average medical expenses for a person with diabetes are 2.3 times higher than those without the condition. A significant contributor to the high patient costs of diabetes management is the need for supplies. These supplies are required to optimize medication delivery and safe glucose monitoring. Depending on the glucose-lowering regimen, most diabetic patients must check their blood glucose levels between one and four times daily. More frequent monitoring is required in high glycemic variability, illness, and symptoms suggestive of hypoglycemia.

The costs associated with managing diabetes can lead to significant out-of-pocket expenses, causing financial stress, debt, and even bankruptcy for some individuals. Unfortunately, not all supplies are covered by medical insurance. The situation is much more dire for those without health insurance coverage. The financial burden of diabetes extends to the families of those affected. Caring for a patient with diabetes can be emotionally and financially taxing. Families may incur additional expenses for caregiving, prescription drugs, and special dietary needs. Furthermore, fearing future complications can affect the family's long-term financial planning.

Diabetes places a significant strain on healthcare systems. The costs of managing diabetes-related medical conditions and complications are substantial. Governments, private insurers, and individuals bear these costs. The IDF estimates that diabetes accounts for over 11% of global healthcare expenditure, with over 80% being direct healthcare costs.

Moreover, diabetes-related hospitalizations, which often result from complications such as heart disease or kidney failure, are a considerable financial burden. Preventing these costly hospitalizations through proper diabetes management and education is essential for reducing the economic impact on healthcare systems. Diabetes financial burdens are not limited to individuals and healthcare systems. This financial burden has broader societal implications. Diabetes can reduce workforce productivity due to absenteeism and presenteeism, where individuals are at work but not fully productive due to their health. The loss of income for both individuals and society can be substantial.

Moreover, the indirect costs of diabetes, such as reduced quality of life and increased social welfare payments, further exacerbate the economic strain on society. Additionally, the financial burden of diabetes extends to lost tax revenue and increased government spending on healthcare programs, which can hinder a country's overall economic growth.

Preventing and effectively managing diabetes are essential steps in mitigating the financial burden. Education and awareness campaigns about healthy lifestyles and regular health check-ups can help reduce the incidence of diabetes. Encouraging physical activity and promoting a balanced diet are crucial public health strategies.

For individuals already living with diabetes, effective management can reduce long-term complications and associated costs. Regular monitoring, medication adherence, and lifestyle modifications are critical. Investment in preventive healthcare, early diagnosis, and access to affordable medications is essential for addressing the financial challenges of diabetes.

The financial burden of diabetes is a multifaceted issue that affects individuals, families, healthcare systems, and society as a whole.  It is not a secret that the prevalence of diabetes continues to rise; therefore, it is imperative to address this crisis through prevention, education, and improved access to healthcare. By doing so, we can reduce the economic strain of diabetes on individuals and society and enhance the quality of life for those affected by this chronic condition.

Understanding EVALI: Vaping-Related Lung Illness

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

EVALI, short for e-cigarette or vaping product use-associated lung injury, is a relatively new and concerning health issue that has emerged in recent years. It has garnered significant attention from public health authorities, medical professionals, and the general public due to the severity and sudden onset of the illness. 

Inhaling vapor that is produced by electronic cigarettes or other similar devices is known as vaping. Vaping has gained popularity over the past decade. The vaping devices work by heating liquid nicotine, flavorings, and other chemicals in an aerosol form that users inhale. Vape devices were initially marketed as a safer alternative to traditional tobacco smoking, with many believing it could help people quit smoking altogether. However, concerns have grown regarding the safety of e-cigarettes.

EVALI first came to the attention of public health officials in the United States in the summer of 2019 when a series of cases involving severe lung injury were reported across the country. Many patients presented with symptoms such as cough, chest pain, shortness of breath, and fever. As the number of cases continued to rise, it became clear that EVALI was a severe public health concern.

Research and investigations into EVALI have revealed that the illness is primarily associated with the use of vaping products containing tetrahydrocannabinol (THC), the psychoactive compound found in marijuana. The exact cause of EVALI remains complex and multifactorial, but several factors have been identified:

1. Contaminants and Toxins: Many cases of EVALI have been linked to vaping products contaminated with harmful substances, including vitamin E acetate, which is used as a thickening agent in some vape oils.
2. Chemical Exposure: The inhalation of various chemicals, including diacetyl, formaldehyde, and acetaldehyde, found in some e-cigarettes, may contribute to lung damage over time.
3. Black Market Products: Some EVALI cases have been associated with the use of illicit or black-market vaping products, which may contain unknown and potentially harmful ingredients.

The symptoms of EVALI can range in severity, and they often mimic those of typical respiratory illnesses. Common symptoms include:

1. Cough
2. Shortness of breath
3. Chest pain
4. Fever
5. Nausea
6. Vomiting
7. Diarrhea

In severe cases, EVALI can lead to respiratory failure and, in some instances, death. It is crucial for individuals who experience these symptoms, especially if they have a history of vaping, to seek immediate medical attention.

The treatment of EVALI largely depends on the severity of the illness. Mild cases may require only supportive care, such as rest and hydration, while more severe cases may necessitate hospitalization and oxygen therapy. Quitting vaping is a crucial step in recovery for those diagnosed with EVALI.

Preventing EVALI starts with avoiding the use of e-cigarettes and vaping products, especially those obtained from unregulated sources. For individuals who are already vaping or considering it, here are some preventive measures:

1. Choose Trusted Products: If you choose to vape, use products from reputable manufacturers and retailers. Avoid black-market or homemade vape liquids.
2. Educate Yourself: Understand the potential risks associated with vaping and be aware of the symptoms of EVALI.
3. Don't Modify Products: Avoid modifying or tampering with vaping devices, as this can increase the risk of exposure to harmful chemicals.
4. Seek Support to Quit: If you are currently using vaping products, seek help and support to quit. Many resources are available to assist individuals in overcoming nicotine addiction. For those who are now vaping, EVALI serves as a compelling reason to stop vaping. Many resources are available to help individuals overcome nicotine addiction, and healthcare professionals can offer guidance and support to those who seek to quit.

As the vaping industry continues to evolve, so does our understanding of the potential health risks associated with these products. EVALI has quickly become a severe public health concern, raising essential questions about the safety of vaping and the need for better regulation in the industry.

EVALI is a stark reminder that the vaping industry and public health are inextricably linked. The rise of vaping-related lung injuries demands immediate attention from all stakeholders involved. Manufacturers, regulators, healthcare professionals, and the public all have roles to play in addressing this crisis. By promoting education, accountability, and regulations, we can work to reduce the risks associated with vaping and protect the well-being of individuals in our communities. EVALI serves as a wake-up call for us all, and it's high time we heed its warning.

Having a Conversation with Chat GPT

Business Insider 2023

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

One day, I wanted to know how chat GPT works, so I wrote the following on the conversation:

The day I graduated with my BSN in nursing, someone attending my graduation party said: I think you are so smart. Why didn't you go to medical school?

Chat GPT answered:

"It is, unfortunately, that someone's comment at your graduation party left you feeling that way. It's essential to remember that choosing a career path, like nursing, is a significant accomplishment and a matter of personal choice. Nursing is a highly respected profession that plays a critical role in healthcare, and it requires its own unique set of skills and knowledge. Both nursing and medical school are valuable in their own right, and your decision to pursue a BSN in nursing should be celebrated. Your dedication to patient care and the difference you'll make in the lives of those you care for is something to be proud of. Don't let one comment diminish your achievements and the important role you'll play in the healthcare field."

I was like, wow. Chat GTP said in a few words what I've wanted to hear from a human being. For the longest time, I've been asking myself if I could make a difference in my current role as a nurse practitioner. I know deep inside I can; it's just that some days, I perceive myself as somehow not being good enough. Honestly, I cannot blame others in charge for making me feel that way because we are the ones who allow things to get to us. 

It is easier said than done. Now, how can someone like me feel "not good enough"? I am an immigrant from Colombia, and English is my second language. I wanted to be a physician since age 5. I lost my mother at age 17; being the only child and not having any family support, I started medical school in Colombia but couldn't continue beyond 2nd year due to financial difficulties. I could not continue to pay for my education alone, so I came to the U.S. when I was barely 21, dreaming of continuing my studies. Once again, all I could afford was to go to nursing school. Well, let's rephrase that. I fell in love with nursing while working as a cardiac stress technician at a busy cardiology practice in Florida. The community college was right across the street, and it was super convenient to work during the day and go to school at night (so I finished my pre-requisites); finally, after so much work, I completed my BSN, and my dream of becoming a provider grew stronger. I admired my instructors for being great teachers and working at the same time as nurse practitioners in different medical practices. I got married, became pregnant, and there I was, working on my MSN in nursing education, but the dream did not end there. I had to complete my family nurse practitioner program, which I proudly did during the middle of a world pandemic. Here I am 3 years later, loving what I do but still hearing echoes of how smart I am and why I did not attend med school.

Are you becoming a doctor any time soon? I hear the question often. Deep inside, I think: Am I not good enough as it is? I am trained to provide comprehensive primary care to all ages. This reminded me of when I went back and forth with a patient, asking where the doctor was. I am here. I am the provider that will be taking care of you, but where is the doctor? She kept asking. I am the provider that will care for you today, but you said you were a nurse? So where is the doctor -she replied... I am a nurse practitioner, and this is what I do; finally, after much explanation of my credentials and my job description, she hinted: I thought I was making an appointment with a doctor; it is ok. I will let you take care of me this time. 

So, I asked for more time. Hey, chat GPT, I am a nurse practitioner; should I go to medical school?

Chat GPT: "The decision to attend medical school is significant and should be carefully considered. As a nurse practitioner, you already have a valuable and respected role in healthcare and can provide a wide range of primary care services. Medical school would require substantial time, effort, and financial resources.

Chat GPT went on and highlighted some factors to consider when deciding whether to pursue medical school.

Well, chat GPT, thank you! Indeed, it was a pleasant conversation. I will consider the above advice. For now, I will continue to celebrate and embrace my current achievement of being a nurse practitioner. 

Unmasking the Impostor Within. Impostor Syndrome: A Struggle We Must Overcome

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By Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Impostor Syndrome, coined by psychologists Pauline R. Clance and Suzanne A. Imes in 1978, refers to a pervasive feeling of self-doubt and inadequacy despite evidence of accomplishments and competence. It affects people from all walks of life and can manifest in personal and professional settings. This article delves into the complexities of Impostor Syndrome, its causes, common signs, and strategies to overcome it.

Impostor Syndrome often manifests as a persistent fear of being exposed as a fraud. Also as having feelings that one's success is merely a result of luck rather than competence. It can be particularly crippling as it undermines self-confidence and hampers personal and professional growth. Those affected by Impostor Syndrome may experience anxiety, stress, and self-sabotaging behaviors.

Common Causes:

1. Perfectionism: Striving for perfection can be a catalyst for Impostor Syndrome. When individuals set unrealistic standards for themselves, any perceived deviation from the ideal can fuel self-doubt.
2. Early Life Experiences: Childhood experiences, such as excessive pressure from parents or teachers, can contribute to the development of Impostor Syndrome.
3. Cultural and Societal Factors: Societal expectations, stereotypes, and cultural backgrounds can play a role in fostering feelings of inadequacy, especially among minority groups.
4. A fear of failure which can make individuals doubt their abilities, even in the face of success, as they worry about the potential consequences of failing.

Common Signs:

Recognizing Impostor Syndrome is the first step in addressing it. Common signs include:

1. Overachievement: Constantly striving for more, even when already successful, to prove one's worth.
2. Downplaying Success: Dismissing accomplishments as a result of luck or external factors rather than acknowledging personal competence.
3. Self-Doubt: Continual self-criticism and lack of self-confidence in one's abilities.
4. Fear of Exposure: Constantly worrying about being "found out" and facing criticism or rejection.
5. Challenge Avoidance: Shying away from opportunities that push one out of one's comfort zone due to a fear of failure.

Overcoming Impostor Syndrome:

1. Self-Awareness: Recognize and acknowledge your feelings of self-doubt. Understand that many people experience Impostor Syndrome, and it doesn't reflect your actual competence.
2. Celebrate Your Achievements: Instead of attributing your successes to external factors, take pride in your accomplishments and credit yourself for your hard work and skills.
3. Change Negative Self-Talk: Challenge the negative thoughts that contribute to your feelings of inadequacy. Replace them with positive affirmations and constructive self-talk.
4. Set Realistic Goals: Avoid setting unattainable standards for yourself. Understand that it's okay not to be perfect and that failure is a natural part of growth.
5. Seek Support: Talk to friends, family, or a mental health professional about your feelings. Sharing experiences can help you gain perspective and receive support.
6. Keep a Success Journal: Record your accomplishments and positive feedback to remind yourself of your competence and the value you bring to your work or relationships.
7. Embrace Challenges: Rather than avoiding them, actively seek out challenges. Stepping outside your comfort zone can help boost your confidence and demonstrate your abilities.

In a world filled with social media glamor and the relentless pursuit of perfection, it's easy to think that everyone around us is living their best lives, achieving greatness, and oozing confidence. Meanwhile, many of us secretly grapple with a pervasive, yet often hidden, psychological phenomenon known as impostor syndrome.

Impostor syndrome is a deep-seated feeling of inadequacy and the persistent fear of being exposed as a fraud despite evidence of competence and accomplishments. This silent tormentor preys on our self-esteem, distorting our self-image and causing chronic self-doubt.

The paradox of impostor syndrome is that it often afflicts high-achieving individuals. They are the ones who, by all external measures, seem the most successful. Yet, their accomplishments frequently serve as fuel for the impostor's fire. It's as if the more you accomplish, the more you feel like a fraud.

The root of this syndrome is complex. Impostor syndrome can be influenced by many factors, including societal expectations, cultural backgrounds, personal experiences, and perfectionism. It's a phenomenon that has touched the lives of many, from students and young professionals to seasoned experts and leaders, regardless of age or experience.

So, what can we do to address this pernicious challenge? Firstly, we must acknowledge that impostor syndrome is a widespread issue. The very act of recognizing it can be a crucial step in overcoming it. It's essential to understand that it doesn't discriminate, affecting individuals from all walks of life.

Secondly, we must confront the unrealistic standards society often imposes on us. The relentless pursuit of perfection is a breeding ground for impostor syndrome. Instead, we should celebrate our imperfections and learn from our mistakes. Perfection is not only unattainable, but it's also a creativity and growth killer.

Furthermore, fostering a supportive environment where vulnerability is not seen as a weakness but as a strength is critical. Impostor syndrome often flourishes in climates where individuals feel isolated and unable to share their insecurities. When we open up about our doubts and fears, we create opportunities for others to offer support, share their experiences, and build a more compassionate community.

Mentorship can also play a pivotal role in combating impostor syndrome. Having someone you look up to and trust as a mentor can provide guidance, reassurance, and a different perspective. It's often reassuring to learn that even the most accomplished individuals have faced moments of self-doubt.

Moreover, learning to internalize your successes is essential. Rather than attributing your accomplishments solely to luck or external factors, acknowledge your hard work, dedication, and competence. It's vital to develop a balanced view of yourself, recognizing that your achievements or failures do not define you.

In the workplace, employers can contribute significantly to alleviating impostor syndrome by fostering a culture that values employees for their unique skills, backgrounds, and contributions. Creating opportunities for skill development, feedback, and recognition can help individuals feel more secure in their roles.

Impostor syndrome is an internal battle many of us fight silently. It's a challenge that can hinder our personal growth, professional success, and overall well-being. However, by acknowledging its existence, challenging societal expectations, embracing vulnerability, seeking mentorship, and learning to internalize our accomplishments, we can break free from its clutches.

Impostor Syndrome is a common challenge that affects people from all walks of life. By understanding its causes, recognizing its signs, and implementing strategies to overcome it, individuals can regain their self-confidence and realize their full potential. You are not alone if you are experiencing Impostor Syndrome; it is possible to break free from its grip and thrive in your personal and professional life.

We must remember that impostor syndrome is a shared human experience, one that can be confronted, managed, and ultimately overcome. By doing so, we can lead more fulfilling lives, unburdened by the fear of being exposed as frauds, and confidently embrace our true potential. It's time to unmask the impostor within and let our genuine selves shine.

Battling the Poison Within: Addressing Toxic Work Environments

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by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

In the grand narrative of our lives, the workplace is a chapter that consumes a significant portion of our daily existence. For many, it's not just a means to earn a livelihood but also a source of identity and purpose. However, when this chapter is marred by toxicity, it can be a living nightmare. Toxic work environments are an insidious problem that plagues many organizations, leaving a trail of destruction in their wake. It's high time we address this issue, confront it head-on, and create healthier workplaces for everyone.

A toxic work environment is one where negativity, disrespect, and hostility permeate the workplace. It is a breeding ground for stress, anxiety, and burnout. Toxicity can manifest in various forms, from bullying and harassment to unrealistic expectations and an absence of work-life balance. This toxic cocktail can have severe repercussions on the mental and physical well-being of employees, as well as the overall productivity and success of the organization.

One of the most glaring symptoms of a toxic work environment is the high turnover rate. When employees are subjected to constant stress and mistreatment, they are more likely to seek refuge elsewhere. The revolving door of talent is not only costly but also detrimental to the company's growth. Toxicity fosters a culture where hardworking, dedicated individuals are forced to leave, often feeling undervalued and demoralized.

Toxicity is not limited to the bottom rungs of the corporate ladder; it can seep into every level of an organization. It can be propagated by a demanding and abusive boss or by a colleague who thrives on undermining others. While the individuals responsible for these behaviors must be held accountable, it is the organization's responsibility to create an environment that discourages such conduct.

Addressing toxic work environments requires a multi-pronged approach. It begins with the organization's leadership acknowledging the issue. Denial and sweeping problems under the rug only exacerbate the situation. Instead, leaders must set the example for a culture of respect, open communication, and empathy. This change should start from the top down and permeate every company level.

Human resources departments also play a vital role in creating a healthier workplace. They must develop clear policies and procedures for addressing and preventing toxicity. Furthermore, they should provide avenues for employees to report mistreatment without fear of retaliation. Regular training on diversity, equity, and inclusion can foster a more respectful and inclusive atmosphere.

Individual employees can also contribute to a healthier work environment. Bystanders should feel empowered to speak up when they witness inappropriate behavior and offer support to those affected. Creating strong workplace relationships and a sense of belonging can act as a buffer against the effects of toxicity.

In a rapidly changing world, organizations must recognize that a toxic work environment is not only morally indefensible but also a threat to their long-term success. It saps creativity, motivation, and innovation. To attract and retain top talent, companies must prioritize the well-being of their employees.

It's time to bring the poison of toxic work environments out of the shadows and into the light. Employees deserve to work in an environment that nurtures their growth, values their contributions, and respects their well-being. By addressing toxicity head-on, we can create workplaces that foster success, happiness, and personal fulfillment for all.

Understanding Bipolar Disorder: Destigmatizing Mental Health

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By Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Bipolar disorder is often a misunderstood and complex mental health condition. It affects millions worldwide, yet it continues to be shrouded in stigma and misconceptions. This op-ed aims to shed light on bipolar disorder, provide a deeper understanding of its nuances, and advocate for a more compassionate and informed approach to mental health.

One of the characteristics of bipolar disorder is extreme mood swings encompassing manic episodes of intense energy and joy and depressive episodes marked by overwhelming sadness. While many of us may experience mood fluctuations, bipolar disorder takes these shifts to an entirely different level. If left untreated, these mood episodes can disrupt relationships and lead to self-destructive behaviors.

One of the most pervasive myths surrounding bipolar disorder is that it is a choice or a matter of personal willpower. The truth is that bipolar disorder is a complex neurological condition with genetic and environmental factors at play. It is not something people can "snap out of." Understanding that this disorder does not reflect personal failure is crucial in providing support and empathy to individuals affected by it.

It is also essential to recognize the spectrum of bipolar disorder. The condition has different types and variations, such as Bipolar I, Bipolar II, and cyclothymic disease, each with unique characteristics. Bipolar I, for instance, involves more severe manic episodes, hypomania, and less severe depressive episodes are considered bipolar II. Understanding these distinctions helps tailor treatment and support for individuals with bipolar disorder.

Stigmatization of mental health issues remains a significant obstacle to proper diagnosis and treatment for those with bipolar disorder. Stereotypes, misconceptions, and discrimination can discourage people from seeking help and exacerbate feelings of isolation. In a world increasingly acknowledging the importance of mental health, we must address these misconceptions head-on and foster a more inclusive, empathetic society.

Education is one of the most powerful tools in combating the stigma associated with bipolar disorder. Schools, workplaces, and communities must provide accurate information about the condition. We can create an environment where those affected by bipolar disorder feel safe to discuss their experiences and seek help when needed. 

Furthermore, our healthcare system must be more accommodating and accessible to individuals with bipolar disorder. Adequate mental health care, including therapy and medication, should be readily available, affordable, and destigmatized. People with bipolar disorder need support from family, friends, and professionals, and this support should be ongoing and consistent.

Finally, it is essential to remember that individuals with bipolar disorder can lead fulfilling lives. Many individuals successfully manage their symptoms and achieve their goals with proper treatment and support. Their unique perspectives and experiences can contribute significantly to our society, and we should encourage their growth and well-being.

While bipolar disorder is a complex mental health condition affecting millions globally, It is not a choice, and stigmatization only perpetuates the suffering of those who live with it. By fostering understanding, providing accurate information, and offering unwavering support, we can break down the barriers surrounding bipolar disorder and create a more compassionate and inclusive society that values the mental health of all its members. It is time to destigmatize mental health and embrace the diversity of human experiences, bipolar disorder included.

Understanding Tinnitus: Causes, Symptoms, and Managemen

 

Google images 2023

By Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Tinnitus is a prevalent and often distressing condition affecting millions worldwide. Patients come in with the perception of ringing, buzzing, hissing, or other phantom ear sounds, tinnitus can vary in intensity and significantly impact an individual's quality of life. On this article I will explore the causes, symptoms, and various management strategies for tinnitus.

Tinnitus is not a disease but rather a symptom of an underlying issue. It can manifest as a persistent or intermittent noise in one or both ears and be subjective (only the affected person can hear it) or objective (a healthcare professional can also hear the sound). The phantom sounds can take on a wide range of forms, from high-pitched ringing to low-pitched humming, and can be continuous or sporadic.

What causes tinnitus?

1. Exposure to Loud Noise such as those in a noisy workplace, at concerts, or using headphones at high volumes. The inner ear has delicate hair cells that can be damaged with repetitive exposure to loud noises, leading to tinnitus.
2. As people age, the sensitivity of the inner ear structures can decrease, making them more susceptible to tinnitus.
3. Accumulated earwax can block the ear canal, causing tinnitus symptoms. Earwax is one of the most common reversible causes of tinnitus.
4.  Tinnitus is often a symptom of certain medical conditions. Meniere's disease, temporomandibular joint (TMJ) disorders, or high blood pressure can often cause tinnitus.
5. Medications: Some medications, especially those with ototoxic side effects, can contribute to tinnitus. These may include certain antibiotics, diuretics, and non-steroidal anti-inflammatory drugs.
6. Trauma to the head and neck injuries can lead to tinnitus, as can barotrauma, caused by sudden changes in air pressure, often experienced during scuba diving or air travel.

Symptoms of Tinnitus

Tinnitus symptoms can vary in intensity and perception among individuals. Common symptoms of tinnitus include:

1. Sensation of ringing, buzzing, hissing, or whistling sounds in the ears.
2. Disrupted sleep due to the persistent noise.
3. Difficulty concentrating, which can lead to reduced productivity.
4. Increased stress, anxiety, and even depression, as tinnitus can significantly affect one's emotional well-being.

While tinnitus can be bothersome, there are several strategies and treatments available to manage the condition:

1.  If tinnitus is associated with hearing loss, hearing aids can amplify external sounds, making the tinnitus less noticeable.
2. Sound Therapy uses external sounds. Adding white noise or nature sounds can help mask or distract from the tinnitus. Sound machines, smartphone apps, and specialized hearing devices can provide relief.
3. Cognitive Behavioral Therapy (CBT) techniques can help individuals change their perception of tinnitus and reduce its impact on their emotional well-being.
4. In some cases, medicines like anti-anxiety drugs or antidepressants can help manage tinnitus's psychological aspects.
5. Reducing exposure to loud noises, managing stress through relaxation techniques, and maintaining a healthy lifestyle. Having a balanced nutritious diet, as well as exercising can help manage tinnitus symptoms. Avoiding caffeine, alcohol, low salt diets can help those with tinnitus. 
6. When tinnitus is caused by earwax buildup, having a healthcare professional remove the blockage can provide immediate relief.
7. Treating any underlying medical conditions, such as high blood pressure or TMJ disorders, may alleviate tinnitus symptoms.

Tinnitus is a common condition with diverse causes and varying symptoms. It can affect an individual's quality of life, but with the right strategies, it is manageable. If you or someone you know is experiencing tinnitus, it is essential to consult a healthcare provider to help determine the underlying cause and develop a personalized management plan. By understanding tinnitus and implementing appropriate interventions, one can reduce the impact of this condition and enjoy an improved quality of life.