Monday, November 24, 2014

How Do You (TRY HARD to) Prevent Teen Suicide ?

Philadelphia Inquirer, Sunday, November 23, 2014, HEALTH section, Front Page, Page G1:



Gallery: Awareness key to preventing teen suicide




Awareness key to preventing teen suicide

VAL B. MINA / Sacramento Bee
Why young people take their lives remains a mystery. Even known risk factors - such as a history of suicide attempts, a family history of suicide or mental illness, substance abuse, recent stress, and easy access to lethal methods - can't always explain such a tragedy. Nor does having risk factors mean someone will commit suicide.
But one thing is clear: Prevention methods, including greater awareness by teachers, parents, and friends, can help reduce suicidal behaviors.
The Pennsylvania Child Death Review team investigates the circumstances around a child's death and what factors might have prevented it. Of the deaths reviewed in 2011, local teams found 86 percent of suicide deaths were preventable, says Erich Batra, co-chair of the Pennsylvania Youth Suicide Prevention Initiative and medical director of the review team.
Suicide is now the third-leading cause of death among teenagers in Pennsylvania and fourth in New Jersey. (It's second nationally.) The 2013 Youth Risk Behaviors Survey shows that 17 percent of respondents considered suicide in the preceding 12 months, 13.6 percent had developed a plan, and 8 percent reported trying to take their own lives.
In response, Pennsylvania recently enacted a law, sponsored by State Rep. Frank Farina (D., Lackawanna), requiring school personnel to be trained in suicide prevention and mental health awareness and requiring school districts to develop policies on youth suicide. Other components include a suggested curriculum for students to raise prevention awareness and understand mental-health issues more broadly. Implementation will begin in the 2015-16 school year.
"A lot of people came together to make this bill a reality," says Batra. "It's amazing how many people suicide has touched. Everyone has a story."
Online materials for schools on prevention, intervention, and postvention (dealing with the effects of a death) are available free or at low cost.
"We needed to increase awareness," says Batra. "The goal was not to make teachers into mental-health counselors, but to make people aware of the need to refer students who might be having trouble to a trained counselor.
"We feel like you need three elements. You need policy so people know the infrastructure: who does what when something happens. The staff needs to be trained to know policies and procedures for answering children's questions. And students need to understand that when they notice a friend in trouble, some secrets should be shared."
Eleven years ago, a 15-year-old male student in Joe Vulopas' high school English class at Cocalico High School in Lancaster County committed suicide. After hearing the news, Vulopas - the last teacher to talk with the student - headed back to his classroom to stare at the student's desk and reconsider what he might have missed or done.
"If you had talked to me about depression then, I would have had no idea," says Vulopas, who testified in hearings for the suicide-prevention initiative.
Today, besides teaching English, Vulopas serves as executive director of Aevidum/"I've Got Your Back," a club started by Cocalico students in response to the young man's death. Aevidum has 75 chapters in high schools across the state, with plans to expand into high schools and colleges in Philadelphia.
Serving students in kindergarten through 12th grade, the group uses original songs, videos, and public-service campaigns to spread its message of openness, connectivity, and sensitivity in dealing with suicide and depression.
"Factors which lead a young person to take their life are never simple," says Batra. "Sometimes changes that occur are part of normal adolescence, like changing friendships or withdrawal, which can make factors for suicide tougher to pinpoint."
There are also misconceptions. Batra says people may draw a direct link between bullying and suicide, but although both the bullied and those who bully are at a higher risk for suicide, "there is little research on an exact cause-and-effect relationship."
To protect students at risk, Batra says, all members of the school community need to be on alert. "Behavior that might not be noticed by a teacher might be noticed on a school bus or playground," he says.
Suicide-prevention awareness can also be tied into school shootings, which often involve not only homicides, but also suicides.
"The person often has mental illness and knows that they're not going to survive the episode," says Batra. "From Sandy Hook to Columbine, it goes back to promoting a culture of tolerance and acceptance in the schools."
The next steps include meetings with the Pennsylvania Department of Education to work out a model policy on suicide prevention for schools. Teachers can now receive training through an online program developed by the Society for Prevention of Teen Suicide and receive ACT 48 credits, all at no cost to school districts.
"Suicide is not only the death of an individual," Batra says. "It affects the family and the school at such a raw level. Anything we can do to help we need to do it."


RESOURCES FOR SUICIDE PREVENTION

The American Foundation for Suicide Prevention www.afsp.org
The Society for the Prevention of Teen Suicide parent video www.sptsusa.org
Aevidum/"I've Got Your Back" http://aevidum.com

Friday, November 21, 2014

Surviving Congestive Heart Failure/AFIB in Your 50s !!




November 21, 2014

Well today things are looking a bit better.  Recently I had an echocardiogram (pictures of my heart; they look a lot like a baby sonogram believe it or not).  My heart doctors have determined from the echo that I can now stop wearing my portable defibrillator and that I don't need currently to have a defibrillator installed into my body.  My heart is at about 45% of operating capacity now.  Apparently in a healthy person the heart operates at 80%.  When I entered the hospital in July my heart was at 20% or a bit less.    45% is considered a vast improvement and the thinking is that my heart will continue to improve.  Occasionally my heart feels a bit queer but that is considered OK.  I feel no pain.

But that has been the case since it was determined that I had Congestive Heart Failure (CHF) in July.  Again to me CHF is a terrible old-fashioned phrase that should be updated, made new and improved.  CHF as a phrase scared me (almost to death ! ha-ha!).  I heard the word "failure" and I thought of death, my death.  CHF made me think of very unhealthy old people, not me.  Being "only" in my 50s I felt I was too young to die.  When my heart was doing crazy things in late July I felt nothing.  I felt no pain or discomfort in my heart.  (Other than not being able to walk, breath or talk.)  They can do wonders these days with CHF, things they could not do even 5 years ago.

When my heart rate was racing upward to crazy high levels or dropping precipitously to too slow beats I felt nothing.  This atrial fibrillation or afib or abnormal heart rhythms is something they addressed when they did an ablation on me to stop/cut off/"kill" the flow of some extra electrical currents I had flowing in my heart.  The ablation has been successful.  In the hospital my afib caused the monitors attached to me to go haywire and caused alarms to literally go off several times.  When this happened 2 doctors and 3 to 4 nurses came running into my room a number of times expecting to find me unconscious and about to die, or perhaps already dead.  Instead I was always awake and I always felt nothing, no pain or discomfort, in fact I felt well.?!  Go figure.  Strange but true.

The other issue with my heart was the viral infection that had been sitting in my heart dormant for about a couple of years per the doctors' estimation, from some cold I had fought off a couple of years ago.  They determined this from a cardiac MRI they did in the hospital.  It was terrible!!!!!!!!!  I had weights on my chest and all sorts of monitors and I was in the machine for two and 1/2 hours (2 1/2).  It was very claustrophobic and difficult.  I wouldn't wish it on my worst enemy.  I chickened out twice (with all the stuff on my chest they couldn't get me into the machine properly two times; both times they got me into the machine for a couple of minutes and then had to take me out because the fit was not right.  Each of these times I said no more I give up and I physically climbed to a sitting position.)  The third time was the charm!  Frankly the only thing that got me through it besides a great nurse was thinking about all of you, my family, each and every one of you separately and together, and Pressler, Winn and Amy.

So there you are just some thoughts for you guys.  Love ME

Monday, November 17, 2014

It Takes A Village To Help Elderly Remain Independent




Philadelphia Inquirer, Friday, November 14, 2014


It can take a village to help remain independent

By Neville E. Strumpf






























The statistics are startling:
Soon, 25 percent of the U.S. population will be over 65, and 70 percent of us will need care of some kind either in our homes or in an institution.
These statistics, which were aired during a segment on the realities of aging on CBS Sunday Morning last month, should serve as a wake-up call to all of us. Putting our heads in the sand and hoping for the best are not viable strategies. Fortunately, those of us who live in and love the opportunities in Philadelphia have options.
The Sunday Morning feature put the spotlight on Beacon Hill Village in Boston, the first in what is now a national movement to help elderly people stay in their own homes but provide access to assistance as needed. The "village" movement began in 2001, with the group in Boston, but now boasts more than 140 villages across the country, with 100 more under development.
Philadelphia currently has three such villages. The largest and oldest of them is Penn's Village, where I serve on the advisory council. It offers neighbor-to-neighbor volunteer services in an area that stretches from Washington to Girard Avenue, and from river to river.
Other villages that have been established in the area include the East Falls and Mutual Mount Airy communities in Philadelphia, and the Brandywine Village Network in Delaware.
Time and again, the village network proves itself a boon to members who find it difficult to get around as easily as they once did. Hundreds of men and women in our neighborhoods already embrace Penn's Village in a variety of capacities - whether receiving services or acting as volunteers or serving on committees.
What do villages do? Primarily, they open the doors to a number of opportunities to invest in your neighborhood. Nearly everyone can benefit in some capacity.
At Penn's Village, members - we call them villagers - receive services such as transportation to medical appointments or grocery shopping, training on mobile phones or tablets, and carefully vetted lists of local service providers. If you need a ceiling light bulb changed, a volunteer will climb a ladder to do that for you. Or he'll put together that lamp you ordered through the mail. Members pay annual dues, and the volunteer-provided services are free.
In many ways, these villages are ageless. Men and women within the community frequently find they play changing roles. Many of our members have served as volunteers at some point but then later found that they could use the same kind of help they once provided.
There is a power to these grassroots organizations that tailor their services to local needs. They help all of us make a reality of the dream to stay in our own homes, and as independent as possible, as we age.
We are lucky to have a variety of such organizations in our area. I encourage adults of all ages to learn more about the services offered to them, or to loved ones, without delay. Help, and peace of mind, are available.

Neville E. Strumpf is a retired professor at the University of Pennsylvania School of Nursing, past director of the gerontology nurse practitioner program, and founding director of the gerontology research center. strumpf@nursing.upenn.edu