The Little Things.

“Yesterday I overheard a nursing student snark, “yeah, this is why I’m in nursing school – so I can pass trays.” And if I hadn’t been up to my eyeballs in other things to do for my patients, I would have stopped and said: You’ve already missed the point entirely.

I’m not sure why you DO think you’re here. If you hope to be a good nurse (or coworker, or person with a heart), you’re going to spend the majority of your working life doing things you SO mistakenly think are beneath you. You are going to pass trays with a smile – excitement even, when your patient finally gets to try clear liquids. You will even open the milk and butter the toast and cut the meat. You will feed full-grown adults from those trays, bite by tedious, hard-to-swallow bite. You will, at times, get your own vital signs or glucoscans, empty Foley bags and bedside commodes without thinking twice. You will reposition the same person, move the same three pillows, 27 times in one shift because they can’t get comfortable. You will not only help bathe patients, but wash and dry between the toes they can’t reach. Lotion and apply deodorant. Scratch backs. Nystatin powder skin folds. Comb hair. Carefully brush teeth and dentures. Shave an old man’s wrinkled face. Because these things make them feel more human again.

You will NOT delegate every “code brown,” and you will handle them with a mix of grace and humor so as not to humiliate someone who already feels quite small. You will change ostomy appliances and redress infected and necrotic wounds and smell smells that stay with you, and you will work hard not to show how disgusted you may feel because you will remember that this person can’t walk away from what you have only to face for a few moments.

You will fetch ice and tissues and an extra blanket and hunt down an applesauce when you know you don’t have time to. You will listen sincerely to your patient vent when you know you don’t have time to. You will hug a family member, hear them out, encourage them, bring them coffee the way they like it, answer what you may feel are “stupid” questions – twice even – when you don’t have time to.

You won’t always eat when you’re hungry or pee when you need to because there’s usually something more important to do. You’ll be aggravated by Q2 narcotic pushes, but keenly aware that the person who requires them is far more put upon.

You will navigate unbelievably messy family dramas, and you will be griped at for things you have no control over, and be talked down to, and you will remain calm and respectful (even though you’ll surely say what you really felt to your coworkers later), because you will try your best to stay mindful of the fact that while this is your everyday, it’s this patient or family’s high-stress situation, a potential tragedy in the making.

Many days you won’t feel like doing any of these things, but you’ll shelve your own feelings and do them the best you can anyway. HIPAA will prevent you from telling friends, family, and Facebook what your work is really like. They’ll guess based off what ridiculousness Gray’s Anatomy and the like make of it, and you’ll just have to haha at the poop and puke jokes. But your coworkers will get it, the way this work of nursing fills and breaks, fills and breaks your heart. Fellow nurses, doctors, NPs and PAs, CNAs and PCAs, unit clerks, phlebotomists, respiratory therapists, physical and occupational therapists, speech therapists, transport, radiology, telemetry, pharmacy techs, lab, even dietary and housekeeping — it’s a team sport. And you’re not set above the rest as captain. You will see you need each other, not just to complete the obvious tasks but to laugh and cry and laugh again about these things only someone else who’s really been there can understand.

You will see clearly that critical thinking about and careful delivery of medications are only part of the very necessary care you must provide. Blood gushing adrenaline-pumping code blue ribs breaking beneath your CPR hands moments are also part, but they’re not what it’s all about. The “little” stuff is rarely small. It’s heavy and you can’t carry it by yourself. So yes, little nursling, you are here to pass



Reposted from: Whitney Koenig

‘I want to talk!’ Waterloo students demonstrate for better mental health support

Months of waiting for counselling and the culture of high productivity has University of Waterloo students demonstrating at arts quad Thursday morning.

“I want to talk!” One student chanted. “We want to listen!” The crowd answered.

WaterlooWalkout for Mental Health was organized after a 22-year-old student in his fourth year of study died by suicide on campus on Monday.

About 200 students showed up. Some held signs. Others shared their struggles with mental health and what they believe is a lack of support on campus from counselling services.

“It seemed like they didn’t care about what I had to say,” said Iman Abbarao, who has been studying at the university for almost four years.

“The other day I told my friends that if I didn’t have family and friends in downtown Toronto, I probably would have taken my own life at some point along this journey,” she said in front of the crowd of students.

Iman Abbarao Waterloo mental health

Iman Abbarao, a student in her fourth year, said the only way she can get support is to leave campus and take a two-hour GO bus ride to downtown Toronto where her family is. (Flora Pan/CBC)

One after another, students recalled times when they went to counselling services but were told the next available appointment is months away. Other students spoke about abuse, sexual assault, depression and post-traumatic stress disorder.

Chelsea MacDonald, a first year student studying theatre performance, said she is angry about the state of support available for students.

“And then something like this happens, the university tells me go to counselling services. I can’t even f–ing get an appointment,” she said.

Mental health report

Matthew Grant, the university’s director of media relations, said at the rally that it was “very brave” for the students to share their experiences with mental health.

He said the mental health report being released on March 14 will have recommendations for improving student mental health on campus. There is also a town hall where the president will talk about the report and address student questions.

Currently, there are 22 full-time equivalent counselling services staff and 2 full-time equivalent psychiatrists serving 31,380 undergraduate students and 5,290 graduate students.

For comparison, at the University of Guelph, there are 16 full-time counsellors, one full-time psychiatrist and one part-time psychiatrist serving about 23,000 students.

A Wilfrid Laurier University spokesperson said for approximately 14,500 full-time equivalent students at the Waterloo campus, there are more than 30 staff, a mix of full-time and part-time physicians, nurses and counsellors, at the Student Wellness Centre who address mental health concerns.

Sundus Salame waterloo mental health walkout

Sundus Salame said the pressure to succeed academically is intense and she frequently feels like despite studying very hard, she isn’t good enough. (Flora Pan/CBC)

‘Very competitive’ culture on campus

Aside from the long wait times for counselling, students mentioned the pressure to succeed academically and getting good co-op job placements makes it very difficult.

“Somehow I have to be superhuman, or I have to have some kind of time-turner to catch up with all of these deadlines and readings,” said Sundus Salame.

“A lot of people here are pushed to just work 24/7 just to get 80 average, just because the courses are designed to just weed out anyone who does less than an excessive amount of work,” she said.

Chelsea MacDonald waterloo mental health

Chelsea MacDonald is in her first year studying theatre and performance. She lives in a one-person suite in residence and says she feels isolated. (Flora Pan/CBC)

In her speech to the crowd, MacDonald said students on campus are so wound up in the “grind for grades, grind for co-op,” that there is very little feeling of community.

Despite having friends, she said she frequently feels lonely.

“I don’t feel safe in my dorm anymore,” she said, “Because I know if I was ever, ever, at that point, how long would it take for someone to find me?”

Sarah Welton Waterloo walkout

Sarah Welton organized the walkout in a matter of days after the 22-year-old student died on campus. (Flora Pan/CBC)

Sarah Welton, who organized Thursday’s walkout, said coming to the university as a second-year student was “very alienating, very isolating.”

“I’ve heard so many people express the same sentiment over and over again,” she said.

“I don’t feel that all these reports they keep sending out are going to do enough, if they aren’t actually trying to take action and make some real concrete changes around the university.”

Reposted from:

Players from NHL, junior leagues seeking brain scans without team involvement.

More than 200 current and retired National Hockey League players have taken concerns about existing or potential brain injuries into their own hands by visiting a neurosurgeon in Kingston, Ont., for MRI brain scan procedures.

Dr. Douglas James Cook says at least 120 former and some 80 active NHL players have undergone the scans over the past two years. He said that about 50 active players combined from the Ontario Hockey League and Western Hockey League have also been tested at Queen’s University over the same time frame.

The tests have not been done with the oversight or formal participation of any of the active players’ teams, Dr. Cook said in a series of interviews with TSN.

“Some guys come because teammates tell them about it,” Dr. Cook said. “Some players bring a teammate with them and then when they come for a follow-up say, ‘Can I bring these other two players with me? I think they might be interested.’”

TSN could not independently corroborate the number of NHL players who have had the tests completed.

Dr. Cook, who operated twice on Tragically Hip lead singer Gord Downie after his brain cancer diagnosis, said the technology used to measure the flow of blood through the brain’s millions of blood vessels is new and that his methodology for analyzing the data collected is unique.

Following a brain injury, Dr. Cook said, the flow of blood can accelerate through damaged or stressed parts of the brain as the brain directs oxygen-rich blood to the affected areas. In other nearby parts of the brain, blood flow can slow if it is redirected to injured areas in need of repair.

“We simplify it for players,” Dr. Cook said. “We explain that there are areas of stress in the brain after an injury and that there are changes in blood flow that we can monitor in those areas of stress.”

Dr. Cook said he’s discovered blood flow abnormalities in the brains of about one-quarter of the roughly 80 active NHL players he has examined.

“Unfortunately there are a number of them,” he said. “They just are not comfortable telling anyone about it.”

Dr. Cook said he’s talked about his testing with some NHL team owners and is hoping to meet with the NHL Players’ Association to discuss the testing. The NHL Alumni Association has also been involved in helping to build awareness of the tests, he said.

NHL Alumni Association president Glenn Healy declined to comment.

“We think this is exciting but it’s also controversial,” Dr. Cook said. “From the players’ perspective, some are concerned about what we might find out, what we might see. Some people don’t even want to know what’s going on in there. They know that they have accumulated damage and don’t necessarily want to face it. And obviously there are always concerns from the owners’ side. …  We worry the [NHL] perspective and perhaps the owners’ perspective is that this … is potentially damaging for the reputation of the league.”

The active players who have been tested include some of the NHL’s top young stars, a source told TSN. Their identities have not been made public and Dr. Cook declined to identify any players involved in the tests, citing privacy rights.

Toronto neurologist Dr. Charles Tator once taught Dr. Cook when he was in medical school at the University of Toronto and calls the 39-year-old Cook a rising star in the field of neurology.

“He was very inventive when he was working in my lab. He’s smart and well trained and he’s an expert on blood flow. … He told me about this project at least a year ago. … He’s a clever guy and has attracted their [NHL players’] interest. There is word of mouth and players encouraging their colleagues to go. That’s the way it happens.”

Dr. Tator said he has also examined NHL players in his Toronto office, but said he’s worked with far fewer players than Dr. Cook.

“Many players are capable of independent thought and they are concerned and sometimes they are pushed into seeking other opinions from their families if their families detect some alteration in behaviour,” Dr. Tator said. “Despite the best efforts of the NHL officials to play down concerns, there is concern among players’ families. They are thinking more about it. And this is escalating as time goes on.”

After finishing his residency and PhD in Toronto, Dr. Cook moved to California and worked at Stanford University, establishing himself as an expert in cerebral blood flow. In 2013 he returned to Canada and began working at Kingston General Hospital.

Using the nearby Queen’s University MRI machine costs about $600 an hour, Dr. Cook said. Players are not charged for the exams. The costs are covered with funding from Queen’s and from a family foundation whose administrators want to remain anonymous.

In Kingston, Dr. Cook said that the brain scans take about 45 minutes. Patients lie down inside the MRI machine and put on a facemask known as a rebreathing machine, which controls the amount of inhaled oxygen and carbon dioxide.

Dr. Cook said the MRI is then able to identify areas of the brain that have been damaged.

“We’re looking at the brain’s vascular physiology following injury,” Dr. Cook said. “There are patterns of impairment that are recoverable and there are patterns of impairment that set in and become more permanent. So we are using this as a technique as a way to detect concussion and also to identify the chronic syndrome that we see in older athletes as they age – issues like sclerosis, scar tissue, impaired vessel function and flow. It’s an exciting technology in a lot of ways.”

Dr. Cook said he began examining patients with suspected brain injuries four years ago and has received about $1.5 million in funding so far. After researching military personnel with a grant from the Canadian Institute for Military and Veteran Health Research, the Canadian Institutes of Health Research and the Natural Sciences and Engineering Research Council offered funding for a study of varsity football players at Queen’s.

Brain injuries and concussions are perhaps the most polarizing issue facing the NHL. On one hand, the NHL’s critics, who include nearly 200 former players who are suing the NHL, say the league has not done enough to educate and protect players from the long-term consequences of repeated head trauma. They point to NHL internal emails that show senior league officials have scorned independent medical experts who scrutinize or critique the NHL’s medical decision making.

For its part, the NHL has argued that any interested players could seek out medical journals and do their own research about the impact of brain injuries. Moreover, its officials point out that the NHL was the first pro sports league in North America to introduce baseline neurological testing for its players.

Reposted from:

Cultural Competence in Promoting End-of-Life Care for Muslim Patients.

Just a little infographic I put together last term as part of my learning plan. Cultural competence is essential in providing patient centred care.

As healthcare providers we need to be aware of our patient’s backgrounds as it often has a direct influence on promoting well-being in our patients. It can relate to why our patient isn’t eating, thinking at a deeper level maybe the patient or the GI system is not used to the food being served at the bedside. Perhaps as a nurse, it is important to advocate for our patients in obtaining the foods they are accustomed to (ex. rice).

I think sometimes in healthcare we fail to recognize things that are quite important to our patients. Part of what inspired me to create this learning plan was having had the opportunity to sit in the nurse’s lounge on my first shift and overhearing the nurses talk about a particular patient who was at the end of their life. They were not quite sure how to fulfill this patients personal and religious wishes and could not understand why the patient’s family refused to remove him from life sustaining measures, even after multiple family meetings were held.

Having not understood where these issues stemmed from, I decided to do a bit of research into the patient’s faith and quickly discovered that removing the patient off of life-support would be considered suicide under Islamic faith.

While we can’t be expected to know everything as nurses, we should do our due diligence in researching things, particularly in regards to religious backgrounds. Religion is a huge part in many of our patients lives, and being able to incorporate or understand particular aspects is vital in promoting health and well-being.

Anyways, just some food for thought 🙂



We’re Working Nurses to Death.

By: Jason Silverstein

Nurses do the work that neither hospitals nor patients could live without, which comes at an ever-increasing physical and emotional cost, as they are expected to aid sicker patients for longer hours with less support.

Otherwise, nursing could easily be the best job in the United States—the Bureau of Labor Statistics estimates more than 400,000 new jobs will be created by 2024. In five states, the average pay clears $85,000, with nursing jobs in California crossing into six figures.

Those numbers are no surprise to those who are aware of how much older the nation’s old are, and how much sicker they are, too: By 2030, there will be 70 million people over the age of 65, of which an estimated 14 million will have Alzheimer’s and more than 50 million will have at least two chronic health conditions.

But just as the need for nurses is increasing, so too is the price for devoting one’s life to the direct care of strangers. Nearly a quarter of hospital and nursing home nurses aren’t satisfied with their jobs, according to one study, and more than a third feel burned out. “Burnout is an occupational hazard in nursing,” says Jeanne Geiger-Brown, dean at Stevenson University’s School of Nursing and Health Professions. “It is hard to generate a lot of caring about other people, because you are so depleted yourself.”

Burnout, of course, is caused by overwork, but what causes overwork is more complicated and reveals how the cost-cutting priorities of hospitals force their nurses to pay an emotional tax.

“What’s causing the overwork is the increased acuity of patients,” says Susan Letvak, a professor at the University of North Carolina at Greensboro School of Nursing. “You are only in a hospital if you are so acutely sick that you can barely move. The minute you can move, you are kicked out the door.”

“The push is to get everybody out of the hospital as fast as we can,” echoes Bernadette Melnyk, dean of the College of Nursing at the Ohio State University and the university’s Chief Wellness Officer. Melnyk and her colleagues recently published a paper that shows depression among nurses is associated with both burnout and medical errors.

Getting people out of the hospital “quicker and sicker,” as a few Harvard health policy researchers explain, is a response, in part, to Medicare’s prospective payment system, which pays a fixed amount for a diagnosis no matter the length of stay, and the need for open hospital beds. If that formula seems designed to create higher rates of readmission, well…yeah. Even so, there’s also a financial incentive to avoid having people readmitted.

How does the quicker and sicker approach add up for nurses? Physically, it means the shifts themselves are much harder, especially since shifts are often twelve hours to begin with, which itself is a risk factor for burnout and mistakes in a place where patient alarms are constantly sounding. “It’s not healthy for the nurses, it’s not safe for the patients,” Melnyk says.

Emotionally, the quicker and sicker model means the long hours are engineered to be less fulfilling. “It’s not very satisfying to just put bandaids on people who are really quite ill,” Geiger-Brown says.

When the hospital is successful at turfing patients to home or anywhere else, you might expect nurses to benefit somewhat: Fewer patients on a given day could mean a slower shift and a chance for a break. But that’s not how it often plays out.

“Minimum is maximum staffing,” Letvak says. “We don’t have any easy days anymore. If the [patient load] is low, which happens all the time, they send the nurses home, instead of them having a light afternoon. How few do we need? That’s all that you’re getting. Every time you are at work, it is a bad day. There really isn’t a chance of having a lighter day anymore.”

Yet nurses should have the lightest days possible—like air traffic controllers, they do a job in which we accept no room for mistakes. Suppose you know that the ideal number of patients for a nurse is four—would you want to be number five?

While it may seem like a water is wet revelation to say nurses should care for fewer patients rather than get sent home, take a look at the work of Linda Aiken and her colleagues at the University of Pennsylvania. They have shown just how many lives are on the line when nurses are overworked. Give a nurse just one patient beyond four and the chances of that patient dying shoot up 7 percent and the chances of that nurse getting burned out climbs an astonishing 23 percent.

Overworking nurses extinguishes their lifesaving impact. Aiken and her team have shown elsewhere that every ten percent increase in the proportion of nurses with bachelor’s degrees lowers the risk of death for patients by five percent. A study by a different group found that a 10 percent increase in registered nursing staff saves five lives for every 1,000 people discharged. (If five saved lives doesn’t sound like a lot, try replacing “five” with five names of your loved ones.)

And while nurses care for a sicker and older population in an environment that is a burnout and depression generator, they may avoid mental health care for themselves, fearing that a hospital concerned first-and-foremost with the bottom line will use a mental health diagnosis against them.

“Think about the legalities,” says Letvak, who teaches on law and policy. “If a nurse made an error and something were to come out that they had depression, and then you can see the research that links depression and errors, that nurse just exposed herself to potential liability.”

Reposted from:

Strategies to calm the anxious brain.

This is part of a series looking at micro skills – changes that employees can make to improve their health and life at work and at home, and employers can make to improve the workplace. The Globe and Mail and Morneau Shepell have created the Employee Recommended Workplace Award to honour companies that put the health and well-being of their employees first. Read about the 2017 winners of the award at

Does your mind sometimes create thoughts – ones that make you anxious or worried – that you’d rather not have?

When our unconscious brain provides a random thought like this – if we’re not aware – we can become overly focused on these thoughts that can negatively impact our mental health.

This micro skill introduces a concept called cognitive defusion – a strategy we can use when we need to become untangled from our thoughts.

By learning how to defuse unwanted thoughts we can remove their power over us. Those thoughts can be as simple as our mind telling us there’s a difference between what we have and what we want. The thought is nothing more than a warning light. What we do with this thought defines our thinking and emotions.


When an automatic, unwanted, negative thought comes to the top of your mind, doesn’t feel good, and is distracting, the first step is not to fight it or hide from it. Acknowledge it as being present and a source of information. By “thanking our mind” for this thought without fighting it or judging we position ourselves to defuse its intensity, allowing us to use the information for some healthy action.


Dr. William Glasser, author of choice theory, suggested that we may not have 100 per cent control over our thinking, but we have 100 per cent control over our actions. Where our body goes, our mind follows. By changing our focus from troublesome thoughts to an action we enjoy, or by giving our mind an opportunity to engage in something we find interesting, we can leave the negative thought at the curb and take control of our thinking. This is not hiding from the negative thought; it’s moving past it. There may be nothing to do now, and there’s no value in focusing on negativity that’s distracting.


Persistent, negative thoughts that refocused attention doesn’t curb may require more action. Negative thoughts can be like weeds; they can multiply and take over our mind.

Cognitive defusing is about helping gain perspective so that we don’t give negative thoughts power to grow. “See thoughts as what they are, not what they say they are,” advises Steven Hayes, a professor at the Department of Psychology at the University of Nevada. Meaning a thought is just a thought – nothing more less.

Accept thoughts by name without any judgment – If negative thoughts are hanging around after you’ve engaged in an activity to re-direct them, this is fine. Stop for a moment and acknowledge the thought by name, like you would when meeting a new person. For example, “So it seems there’s anxiety, because I’m having thoughts that are due to my concerns about money and work.”

Redirect your mind – Take charge of your mind. Unhelpful thoughts are projections of some past or future concern that aren’t happening right now, so re-direct your mind in a non-judgmental way to something more positive. For example, “I get that this thought is providing me information and isn’t as helpful as it could be. Thanks for the anxiety, but I think I’d rather be calm.”

Focus on the now – We live in the now, not the future. Take a deep breath, focus on the now, and recognize that the unhealthy thought has no connection with what’s happening in the present; it’s just a thought. Practice focusing on the now, accept the thought and redirect your focus “since this isn’t happening now and there’s no danger, I’ll focus on getting my planned work done, then get to the gym for a good workout.”

By practicing cognitive defusion you can learn to look at negative thoughts as not being bad, just words and images in your mind that you can shape, process and release. The benefit is that this micro skill can teach you how to accept negative thoughts as information only; they don’t need to dictate your actions or feelings.

Bill Howatt is the chief research and development officer of work force productivity with Morneau Shepell in Toronto and creator of an online Pathway to Coping course offered through the University of New Brunswick.

This series supports The Globe and Mail and Morneau Shepell’s Employee Recommended Workplace Award.

This award recognizes employers who have the healthiest, most engaged and most productive employees. It promotes a two-way accountability model where an employer can support employees to have a positive workplace experience.

You can find all the stories in this series at this

Human antidepressants building up in brains of fish in Niagara River.

Researchers studying fish from the Niagara River have found that human antidepressants and remnants of these drugs are building up in the fishes’ brains.

The concentration of human drugs was discovered by scientists from University at Buffalo, Buffalo State and two Thai universities, Ramkhamhaeng University and Khon Kaen University.

Active ingredients and metabolized remnants of Zoloft, Celexa, Prozac and Sarafem — drugs that have seen a sharp spike in prescriptions in North America — were found in 10 fish species.

Diana Aga, professor of chemistry at University at Buffalo, says these drugs are found in human urine and are not stripped out by wastewater treatment.

Could affect fish behaviour

“It is a threat to biodiversity, and we should be very concerned,” Aga said in a release from the university.

Niagara Falls Park Bridges

Fish in the Niagara River show concentrations of antidepressants in their brains higher than levels in the river itself. (David Duprey/The Associated Press)

“These drugs could affect fish behaviour. We didn’t look at behaviour in our study, but other research teams have shown that antidepressants can affect the feeding behaviour of fish or their survival instincts. Some fish won’t acknowledge the presence of predators as much.”

The Niagara River, which carries water from Lake Erie to Lake Ontario, is already under stress, with reports this summer of untreated wastewater released into the river.

‘Fish are receiving this cocktail of drugs 24 hours a day, and we are now finding these drugs in their brains’– Diana Aga, study author

The research, published in the journal Environmental Science & Technology, found levels of antidepressants in fish brains that were several times higher than levels in the river itself, indicating that the chemicals are accumulating over time.

The study set out to look for a variety of pharmaceutical and personal care product chemicals in the organs and muscles of 10 fish species: smallmouth bass, largemouth bass, rudd, rock bass, white bass, white perch, walleye, bowfin, steelhead and yellow perch.

Antidepressants stood out as the major problem.

Rock bass had high concentrations

The rock bass had the highest concentrations of antidepressants, but several fish had a medley of drugs in their bodies.

Aga said she did not believe the chemicals were a threat to humans, as people do not usually eat fish brains. However, she was concerned about the health of fish species who are continually subjected to an influx of chemicals, as well as the delicate balance among species.

Aga said wastewater treatment plants have not kept up with the times in attempting to remove drugs from their effluent.

Between 1999-2002 and 2011-14, the number of U.S. residents using antidepressants rose by 65 per cent,  according to the National Center for Health Statistics.

Wastewater treatment focuses on killing disease-causing bacteria and on extracting solid matter but not on removing chemicals that might be found in human urine, Aga said.

“These plants are focused on removing nitrogen, phosphorus, and dissolved organic carbon but there are so many other chemicals that are not prioritized that impact our environment,” she said. “As a result, wildlife is exposed to all of these chemicals. Fish are receiving this cocktail of drugs 24 hours a day, and we are now finding these drugs in their brains.”

Spotting Addiction.

COLUMBUS, Ohio — A former Ohio State University football player whose NFL career fell apart because of a painkiller addiction says he wants to become a college coach and help others avoid similar pitfalls now that he’s clean and has a degree.

Shane Olivea told The Columbus Dispatch he was high every day following his rookie year with the San Diego Chargers.

“At my height on Vicodin, I would take 125 a day,” said Olivea, who was briefly a Giant in 2008. “It got to the point I would take a pile of 15 Vicodin and would have to take them with chocolate milk. If I did it with water or Gatorade, I’d throw it up.”

Olivea said he obtained the pills from his own sources, including one in Mexico. He parked at an Arby’s restaurant and paid a cab driver he knew $100 to go to a Tijuana “pharmacy.”

“You could buy anything you want if you had cash,” Olivea said. “I’d go buy a couple hundred Vicodin, or by then I’d progressed to Oxycontin.”

Olivea said he spent nearly $584,000 on painkillers. He began to withdraw from teammates and his relationship with coaches and management suffered. He was benched late in the 2007 season and his weight rose to nearly 390 pounds.

Olivea’s parents worried after he became reluctant to respond to them, too. His mother organized an intervention, and the Long Island native in April 2008 checked into a drug addiction treatment center in California. He said doctors there told him he was lucky to be alive.

“They both looked at me and said, ‘We’ve never seen anybody living with that amount of opioids in you. You’re literally a walking miracle,’” Olivea said. “That was a punch to the gut.”

After being released by the Chargers, Olivea signed with the Giants while in rehab. He was released again after hurting his back.

Olivea re-enrolled in Ohio State in 2015, and graduated in December, at age 35, with a degree in sport industry.

He said he has a couple of job leads. And though he hasn’t coached before, he said his playing experience makes him think he’d do well on and off the field, including helping others thinking of turning to pain pills.

“If you got it, you can spot it,” Olivea said. “I can spot an addict in a public setting. I know the behavior. I know the tendencies. I know what he’s going to do. I’ll be able to notice somebody going down that slippery path and maybe catch them.”

Reposted from:

Biological Changes Could Be Underlying Factor For Higher Rates of Psychosis in Immigrants.

A new study could explain how migrating to another country increases a person’s risk of developing schizophrenia, by altering brain chemistry.

Immigrants had higher levels of the brain chemical dopamine than non-immigrants in the study, conducted by the Centre for Addiction and Mental Health (CAMH) in Toronto and the Institute of Psychiatry, Psychology and Neuroscience, King’s College, London. Abnormal dopamine levels are linked to symptoms of schizophrenia. Dopamine is also connected to the body’s stress response.

The study was published in the January issue of Schizophrenia Bulletin.

“Schizophrenia is still a rare diagnosis,” says Dr. Romina Mizrahi, a senior author and Clinician Scientist in the Campbell Family Mental Health Research Institute at CAMH. “But if we can understand the factors that increase the risk of this serious illness among immigrants, we can develop strategies such as social supports to mitigate this risk.”

As Canada’s population and workforce will decline without migration, a set number of immigrants are accepted into the country each year. While it’s not feasible to offer stress supports to all newcomers, the approach of identifying those at highest risk and offering evidence-based interventions to prevent schizophrenia is one that Dr. Mizrahi applies to her work with youth, as Head of the Youth Psychosis Prevention Clinic and Research Program.

The current study involved a type of brain imaging called positron emission tomography (PET), and applied two different approaches to examining dopamine levels.

In Toronto, 56 study participants were given a mild stress test to see its effect on dopamine release. People with schizophrenia, and those at high risk, release more dopamine with this test when compared to a matched healthy group of participants. Among the 25 immigrants in the study, dopamine release was higher than 31 non-immigrant participants. This increase was related to participants’ experiences of social stress, such as work overload, social pressures or social isolation.

The London researchers showed that the synthesis of dopamine was higher in immigrants. This increase was related to the severity of symptoms among those considered at high risk of developing schizophrenia, and did not occur among non-immigrants at high risk. In total, 32 immigrants and 44 non-immigrants were involved in this part of the study.

Dr. Mizrahi emphasizes that not everyone with high dopamine levels will develop schizophrenia, nor will the vast majority of migrants.

Yet it is well-established through population studies in Canada, the U.K. and Western Europe that the risk of developing schizophrenia is higher in immigrants and their children than non-immigrants. Stress – particularly related to perceived discrimination, social isolation and urban living – is believed to increase this risk. The role of stress also appears to be supported by the current findings on brain dopamine levels.

“This is a first step in integrating social science and biological research,” says Dr. Mizrahi. “A next step would be to help regulate stress among higher risk immigrants through social support programs, and see if this reduces dopamine in the brain and prevents psychosis.”

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Neo-Liberalism And It’s Impact on Mental Illness.

What greater indictment of a system could there be than an epidemic of mental illness? Yet plagues of anxiety, stress, depression, social phobia, eating disorders, self-harm and loneliness now strike people down all over the world. The latest, catastrophic figures for children’s mental health in England reflect a global crisis.

There are plenty of secondary reasons for this distress, but it seems to me that the underlying cause is everywhere the same: human beings, the ultrasocial mammals, whose brains are wired to respond to other people, are being peeled apart.Economic and technological change play a major role, but so does ideology. Though our wellbeing is inextricably linked to the lives of others, everywhere we are told that we will prosper through competitive self-interest and extreme individualism.

In Britain, men who have spent their entire lives in quadrangles – at school, at college, at the bar, in parliament – instruct us to stand on our own two feet. The education system becomes more brutally competitive by the year. Employment is a fight to the near-death with a multitude of other desperate people chasing ever fewer jobs. The modern overseers of the poor ascribe individual blame to economic circumstance. Endless competitions on television feed impossible aspirations as real opportunities contract.

Consumerism fills the social void. But far from curing the disease of isolation, it intensifies social comparison to the point at which, having consumed all else, we start to prey upon ourselves. Social media brings us together and drives us apart, allowing us precisely to quantify our social standing, and to see that other people have more friends and followers than we do.

As Rhiannon Lucy Cosslett has brilliantly documented, girls and young women routinely alter the photos they post to make themselves look smoother and slimmer. Some phones, using their “beauty” settings, do it for you without asking; now you can become your own thinspiration. Welcome to the post-Hobbesian dystopia: a war of everyone against

Is it any wonder, in these lonely inner worlds, in which touching has been replaced by retouching, that young women are drowning in mental distress? recent survey in England suggests that one in four women between 16 and 24 have harmed themselves, and one in eight now suffer from post-traumatic stress disorder. Anxiety, depression, phobias or obsessive compulsive disorder affect 26% of women in this age group. This is what a public health crisis looks like.

If social rupture is not treated as seriously as broken limbs, it is because we cannot see it. But neuroscientists can. A series of fascinating papers suggest that social pain and physical pain are processed by the same neural circuits. This might explain why, in many languages, it is hard to describe the impact of breaking social bonds without the words we use to denote physical pain and injury. In both humans and other social mammalssocial contact reduces physical pain. This is why we hug our children when they hurt themselves: affection is a powerful analgesic. Opioids relieve both physical agony and the distress of separation. Perhaps this explains the link between social isolation and drug addiction.

Experiments summarised in the journal Physiology & Behaviour last month suggest that, given a choice of physical pain or isolation, social mammals will choose the former. Capuchin monkeys starved of both food and contact for 22 hours will rejoin their companions before eating. Children who experience emotional neglect, according to some findings, suffer worse mental health consequences than children suffering both emotional neglect and physical abuse: hideous as it is, violence involves attention and contact. Self-harm is often used as an attempt to alleviate distress: another indication that physical pain is not as bad as emotional pain. As the prison system knows only too well, one of the most effective forms of torture is solitary confinement.

It is not hard to see what the evolutionary reasons for social pain might be. Survival among social mammals is greatly enhanced when they are strongly bonded with the rest of the pack. It is the isolated and marginalised animals that are most likely to be picked off by predators, or to starve. Just as physical pain protects us from physical injury, emotional pain protects us from social injury. It drives us to reconnect. But many people find this almost impossible.

It’s unsurprising that social isolation is strongly associated with depression, suicide, anxiety, insomnia, fear and the perception of threat. It’s more surprising to discover the range of physical illnesses it causes or exacerbates. Dementia, high blood pressure, heart disease, strokes, lowered resistance to viruses, even accidents are more common among chronically lonely people. Loneliness has a comparable impact on physical health to smoking 15 cigarettes a day: it appears to raise the risk of early death by 26%. This is partly because it enhances production of the stress hormone cortisol, which suppresses the immune system.

Studies in both animals and humans suggest a reason for comfort eating: isolation reduces impulse control, leading to obesity. As those at the bottom of the socioeconomic ladder are the most likely to suffer from loneliness, might this provide one of the explanations for the strong link between low economic status and obesity?

Anyone can see that something far more important than most of the issues we fret about has gone wrong. So why are we engaging in this world-eating, self-consuming frenzy of environmental destruction and social dislocation, if all it produces is unbearable pain? Should this question not burn the lips of everyone in public life?

There are some wonderful charities doing what they can to fight this tide, some of which I am going to be working with as part of my loneliness project. But for every person they reach, several others are swept past.

This does not require a policy response. It requires something much bigger: the reappraisal of an entire worldview. Of all the fantasies human beings entertain, the idea that we can go it alone is the most absurd and perhaps the most dangerous. We stand together or we fall apart.

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