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What is a stillbirth?
If you lose a fetus at or after the 20th week of pregnancy, it's called a stillbirth. A stillbirth can occur before or during delivery and may be considered as:
Stillbirth can happen in any pregnancy. Some factors may increase the chance that one can occur. Risk factors can include if you:
In many cases, the cause remains unknown. Some causes may be preventable, but most are not.
Causes for a stillbirth may include:
Before delivery, the only way to diagnose a stillbirth is to check if the fetus's heart is beating. Your health care provider may use an ultrasound to look for the fetal heartbeat.
During your pregnancy, your provider may recommend keeping track of fetal movements. However, if you don't notice movement, it doesn't always mean a stillbirth occurred. Sometimes, especially if it's your first pregnancy, it might be difficult to notice movement. If you're pregnant and something seems unusual or is worrying you, talk to your provider.
After labor and delivery, your provider will check the baby for signs of life. These can include breathing, heartbeat, voluntary movements, and pulsations in the umbilical cord. If one or more signs of life are not present, then life-saving measures are taken. If these measures are unsuccessful, a stillbirth may be diagnosed.
How do health care providers manage a stillbirth?Care after a stillbirth depends on when it occurs. If it happens before delivery, your provider may induce (start) labor or use surgery to deliver the fetus (cesarean delivery). If it happens during labor and delivery, the placenta will still need to be removed or delivered.
No matter when it occurs, losing a pregnancy can be difficult. Counseling may help you cope with your grief. Later, if you decide to try to get pregnant again, work closely with your provider to understand any risks. Many women who have a stillbirth go on to have healthy babies.
NIH: National Institute of Child Health and Human Development
What is stress?
Stress is how your brain and body respond to a challenge or demand. When you are stressed, your body releases certain hormones. Hormones are chemicals that travel in your bloodstream and control how different parts of your body work. The hormones that are released when you are stressed make you alert and ready to act. They can raise your blood pressure, heart rate, and blood glucose (blood sugar) levels. This response is sometimes called a "fight or flight" response.
Everyone gets stressed from time to time. There are different types of stress. It can be short-term or long-term. It can be caused by something that happens once or something that keeps happening.
Not all stress is bad. In fact, it can help you survive in a dangerous situation. For example, one kind of stress is the jolt you may feel when a car pulls out in front of you while you are driving. This jolt of hormones helps you quickly hit the brakes to avoid an accident. A little short-term stress can sometimes be helpful. For example, the stress of having a deadline for school or your job may push you to get your work done on time. Once you finish it, that stress goes away.
But stress that lasts a long time can harm your health.
What causes long-term stress?Long-term stress, or chronic stress, lasts for weeks, months, or longer. As you go about your life, your body is acting as if you're being threatened.
Causes of long-term stress include:
People respond to stress in different ways. If you're stressed for a long time you may notice that you are:
When stress keeps going, your body acts as if you're always in danger. That's a lot of strain that may play a part in developing serious health problems, including:
It's possible to get used to the symptoms of stress and not even realize there's a problem. So when there's a lot of stress in your life, it's important to pay attention to how it affects you so you can do something about it.
How can I manage long-term stress?Simple things that improve your mental health may be helpful in managing long-term stress, such as:
Get help if you're having severe symptoms for 2 weeks or more, including:
Always get help right away if stress is causing you to:
Your health care provider may refer you to a mental health professional such as a psychologist or social worker.
NIH: National Institute of Mental Health
What is sudden cardiac arrest (SCA)?
Sudden cardiac arrest (SCA) is a condition in which the heart suddenly stops beating. When that happens, blood stops flowing to the brain and other vital organs. If it is not treated, SCA usually causes death within minutes. But quick treatment with a defibrillator may be lifesaving.
How is sudden cardiac arrest (SCA) different from a heart attack?A heart attack is different from an SCA. A heart attack happens when blood flow to the heart is blocked. During a heart attack, the heart usually doesn't suddenly stop beating. With an SCA, the heart stops beating.
Sometimes an SCA can happen after or during recovery from a heart attack.
What causes sudden cardiac arrest (SCA)?Your heart has an electrical system that controls the rate and rhythm of your heartbeat. An SCA can happen when the heart's electrical system is not working right and causes irregular heartbeats. Irregular heartbeats are called arrhythmias. There are different types. They may cause the heart to beat too fast, too slow, or with an irregular rhythm. Some can cause the heart to stop pumping blood to the body; this is the type that causes SCA.
Certain diseases and conditions can cause the electrical problems that lead to SCA. They include:
You are at higher risk for SCA if you:
Usually, the first sign of SCA is loss of consciousness (fainting). This happens when the heart stops beating.
Some people may have a racing heartbeat or feel dizzy or light-headed just before they faint. And sometimes people have chest pain, shortness of breath, nausea, or vomiting in the hour before they have an SCA.
How is sudden cardiac arrest (SCA) diagnosed?SCA happens without warning and requires emergency treatment. Health care providers rarely diagnose SCA with medical tests as it's happening. Instead, it is usually diagnosed after it happens. Providers do this by ruling out other causes of a person's sudden collapse.
If you are at high risk for SCA, your provider may refer you to a cardiologist, a doctor who specializes in heart diseases. The cardiologist may ask you to get various heart health tests to see how well you heart is working. He or she will work with you to decide whether you need treatment to prevent SCA.
What are the treatments for sudden cardiac arrest (SCA)?SCA is an emergency. A person having SCA needs to be treated with a defibrillator right away. A defibrillator is a device sends an electric shock to the heart. The electric shock can restore a normal rhythm to a heart that's stopped beating. To work well, it needs to be done within minutes of the SCA.
Most police officers, emergency medical technicians, and other first responders are trained and equipped to use a defibrillator. Call 9-1-1 right away if someone has signs or symptoms of SCA. The sooner you call for help, the sooner lifesaving treatment can begin.
What should I do if I think that someone has had an SCA?Many public places such as schools, businesses, and airports have automated external defibrillators (AEDs). AEDs are special defibrillators that untrained people can use if they think that someone has had SCA. AEDS are programmed to give an electric shock if they detect a dangerous arrhythmia. This prevents giving a shock to someone who may have fainted but isn't having SCA.
If you see someone who you think has had SCA, you should give cardiopulmonary resuscitation (CPR) until defibrillation can be done.
People who are at risk for SCA may want to consider having an AED at home. Ask your cardiologist to help you decide whether having an AED in your home might help you.
What are the treatments after surviving sudden cardiac arrest (SCA)?If you survive SCA, you'll likely be admitted to a hospital for ongoing care and treatment. In the hospital, your medical team will closely watch your heart. They may give you medicines to try to reduce the risk of another SCA.
They will also try to find out what caused your SCA. If you're diagnosed with coronary artery disease, you may have an angioplasty or coronary artery bypass surgery. These procedures help restore blood flow through narrowed or blocked coronary arteries.
Often, people who have had SCA get a device called an implantable cardioverter defibrillator (ICD). This small device is surgically placed under the skin in your chest or abdomen. An ICD uses electric pulses or shocks to help control dangerous arrhythmias.
Can sudden cardiac arrest (SCA) be prevented?You may be able to lower your risk of SCA by following a heart-healthy lifestyle. If you have coronary artery disease or another heart disease, treating that disease can also lower your risk of SCA. If you have had an SCA, getting an implantable cardioverter defibrillator (ICD) can lower your chance of having another SCA.
NIH: National Heart, Lung, and Blood Institute
There are many reasons to have surgery. Some operations can relieve or prevent pain. Others can reduce a symptom of a problem or improve some body function. Some surgeries are done to find a problem. For example, a surgeon may do a biopsy, which involves removing a piece of tissue to examine under a microscope. Some surgeries, like heart surgery, can save your life.
Some operations that once needed large incisions (cuts in the body) can now be done using much smaller cuts. This is called laparoscopic surgery. Surgeons insert a thin tube with a camera to see, and use small tools to do the surgery.
After surgery there can be a risk of complications, including infection, too much bleeding, reaction to anesthesia, or accidental injury. There is almost always some pain with surgery.
Agency for Healthcare Research and Quality
What is depression in teens?
Depression in teens (ages 13-17) is a serious medical illness. It's more than just a feeling of being sad or "blue" for a few days. It is an intense feeling of sadness, hopelessness, and anger or frustration that lasts much longer. These feelings make it hard for you to function normally and do your usual activities. You may also have trouble focusing and have no motivation or energy. Depression can make you feel like it is hard to enjoy life or even get through the day.
What causes depression in teens?Many factors may play a role in depression, including:
Depression can happen at any age, but often begins in the teens or early adulthood. Certain teens are at higher risk of depression, such as those who:
If you have depression, you have one or more of these symptoms most of the time:
You also may also have other symptoms, such as:
If you think you might be depressed, tell someone that you trust, such as your:
The next step is to see your doctor for a checkup. Your doctor can first make sure that you do not have another health problem that is causing your depression. To do this, you may have a physical exam and lab tests.
If you don't have another health problem, you will get a psychological evaluation. Your doctor may do it, or you may be referred to a mental health professional to get one. You may be asked about things such as:
Effective treatments for depression in teens include talk therapy, or a combination of talk therapy and medicines:
Talk therapy
Talk therapy, also called psychotherapy or counseling, can help you understand and manage your moods and feelings. It involves going to see a therapist, such as a psychiatrist, a psychologist, a social worker, or counselor. You can talk out your emotions to someone who understands and supports you. You can also learn how to stop thinking negatively and start to look at the positives in life. This will help you build confidence and feel better about yourself.
There are many different types of talk therapy. Certain types have been shown to help teens deal with depression, including:
Medicines
In some cases, your doctor will suggest medicines along with talk therapy. There are a few antidepressants that have been widely studied and proven to help teens. If you are taking medicine for depression, it is important to see your doctor regularly.
It is also important to know that it will take some time for you to get relief from antidepressants:
In some cases, teenagers may have an increase in suicidal thoughts or behavior when taking antidepressants. This risk is higher in the first few weeks after starting the medicine and when the dose is changed. Make sure to tell your parents or guardian if you start feeling worse or have thoughts of hurting yourself.
You should not stop taking the antidepressants on your own. You need to work with your doctor to slowly and safely decrease the dose before you stop.
Programs for severe depression
Some teens who have severe depression or are at risk of hurting themselves may need more intensive treatment. They may go into a psychiatric hospital or do a day program. Both offer counseling, group discussions, and activities with mental health professionals and other patients. Day programs may be full-day or half-day, and they often last for several weeks.
If you are thinking about hospice, palliative care, or home health, please do not hesitate to contact us. We will be happy to answer any questions and even visit your home for a free consultation.
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