Recognize the flexibility of the writing process. Ascertain the problem. Find strengths and solutions. Think about the client “ecologically. Use the assessment as part of the therapeutic process.

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There is not necessarily a single way to write an assessment. This can cause trepidation because you will need to find your own voice, but it does allow you to write the report as you think is best for your particular case.  Include as much information as possible. Describe the client's personal appearance, whether or not the client was appropriately dressed for the weather on the day of the interview, the client's personal hygiene, ability to maintain eye contact, and the client's mental orientation (awareness of person, place, time and event). Many facilities have standardized forms that direct you to describe specific questions about the client. One example of categories for an assessment include: “presenting problem,” “problem history,” “personal history,” “substance abuse history,” “family history,” “employment and education,” and “summary treatment and recommendations.”  Another example of such categories include: “identifying information,” “referral,” “presenting problem,” “sources of data,” “general description of client,” “family composition and background,” “educational background,” “employment and vocational skills,” “religious involvement,” “ health conditions,” “psychological background,” “social, community, and recreation activities,” “basic life necessities,” “legal concerns,” “client strengths,” “clinical summary,” and “goals and recommendations.” The most basic function of the assessment is to determine what the social worker is trying to accomplish with the client. Reports are often written in a narrative form that tells the story of the client's current problems and how and when those problems initially appeared. It is important to do this in a way that would not offend the client. It is often best to refrain from using technical diagnoses, like borderline personality disorder. These can offend the client. Furthermore, they are often not as useful as detailed, specific characterizations of the individual in question. You should make an effort to ascertain the strengths and resources of the...


Recognize the good and bad in your life and examine how you’ve been affected by each. Practice mindfulness. Identify whether your inner monologue is an optimist or a pessimist. Look for the positives in your life. Remember that true optimism is different from blind optimism. Write yourself daily positive affirmations. Avoid comparing yourself to others. Work on improving your perspective in 1 or 2 areas of your life. Smile as often as you can.

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Optimism doesn’t mean you have to feel “happy” all the time. In fact, trying to force feelings of happiness during potentially traumatic experiences can be unhealthy. Instead, attune yourself to the full range of emotions in your life, accepting that the negative as well as positive feelings are a natural part of human experience. Trying to repress a certain type of emotion can cause severe emotional distress. Not focusing more on one type of emotion than the other can actually help you become more adaptive and proactive in future unexpected situations. This will increase your ability to be optimistic and resilient in the face of uncertainty.  Negative feelings can become a conditioned habit over time. Avoid blaming yourself for negative emotions and associations. Blame is unhelpful because it doesn’t look forward to how you can grow; it looks backward at what has already happened.  Instead, focus on being mindful of when these negative emotions occur. A journal could help you do this. Write down when you experience negative feelings or thoughts, then examine their contexts and explore alternative ways of responding to them.  For example, imagine that someone cuts you off in traffic. You respond by feeling angry, honking your horn, and perhaps yelling at the driver even though s/he can’t hear you. You could write in your journal what happened, how it made you feel, and what your immediate response was. Don’t judge yourself as “right” or “wrong,” just write down what happened.  Next, take a step back and think about what you’ve written. Was your response in accordance with your values and the type of person you want to be? If not, what could you have done differently? What do you think you were really responding to? For example, perhaps you weren’t really angry at the driver; maybe you had a stressful day and allowed your stress to explode on that one person. Look forward when you write these entries. Don’t use them just as a place to wallow in negative feelings. Think about what you can learn from the...


Recognize the impersonal nature of mind.

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Like a code or program repeatedly performs the same function, in the same way your mental conditioning runs you as a bundle of conditioned reflexes or reactions You are not even there but a mind created 'personality' or image, which interacts with other mind created images or personalities and world. It doesn't matter where you are, as long as ego is running your life, same egoic patterns will emerge in different situations or places. Ever heard of the saying "Wherever you go, there you are"?  This is one of major reasons why ego is not a personal problem. As all egos have same basic structure that is based on fear, desire, comparison, attack, defend, seeking conflict, resistance to what is etc. no matter how well disguised. In other words, Egos differ only on the surface, deep down they are all the same. On the surface, words or content or stories could be different but the underlying energy and structure is of the Ego. For example: Most people compare themselves with others using different aspects like looks, life stories, money, nationality, skills, job, even illnesses, location etc. to feel superior or inferior or balance the comparison or how dreadful their life is as compared to others. The words or aspects or things they use to compare could be different on the surface but underlying energy is of the Ego that feeds on comparison. So if you consider Ego a personal problem, that's a sign of more ego. As ego loves to personalize things and thrive on it. Once you truly see the impersonal and dysfunctional nature of mind, you naturally relinquish identification with it, become non-reactive, forgiving, tolerant and compassionate towards yourself and others. Events are not personalized or labelled as good or bad or even neutral. The 'fact of the moment' is allowed to be.


Recognize the importance of exercise to thyroid function. Take a fitness class. Reduce your stress levels. Visualize using the chakra system. Give yourself time to rest.

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Exercise for 30 minutes every day. Your exercise doesn't have to be rigorous or take place at a gym to be effective. 30 minutes of brisk walking a day can be enough to make a difference to your health. You can increase either the speed or the length of your walking if you feel that you need to intensify your exercise regimen. If you have trouble motivating yourself to exercise, try engaging in group fitness. There are some approaches to wellness, such as yoga, tai chi, and qigong, that are excellent choices to be active and also protect the thyroid gland. Exercise keeps the blood flowing. This lets the thyroid hormone reach every cell. Identify areas of stress in your life and work to reduce their effect on you. You may have to make some tough choices about obligations that you’ve agreed to in the past for the sake of your health. Learn meditation techniques like breathing, visualization, or counting breaths. Sit quietly and visualize a blue light entering your body at the site of the thyroid. Every time you breath in, the light gets brighter and more blue. As you breath out, it dims a bit. Keep this visualization in mind for as long as you can, but try it for at least 5 minutes every day. In the ancient chakra energy system, the thyroid gland is at the 5th chakra (Vishuddha) and is characterized by a blue color. Make sure you get enough sleep at night and enough down time during the day. The thyroid is very sensitive to stress because it is one of the glands that responds to stress. Because of this, your thyroid needs time to “re-boot.” Rest and relaxation gives the thyroid the time it needs.


Recognize the importance of receiving antibiotics. Do not rely on oral antibiotics prior to labor. Ask your healthcare professional about your options. Accept treatment with antibiotics during labor.

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Do not assume that because B strep is harmless in your body that it will not harm your baby. Group B strep may cause sepsis or meningitis in babies and may also cause pneumonia, all of which can be debilitating or deadly in infants. A baby that contracts group B strep may also suffer from kidney problems, gastrointestinal problems, difficulty breathing, and unstable blood pressure and/or heart rate.  Keep in mind that not all mothers who have group B strep will pass it on, but antibiotics helps to reduce the chance of passing on the infection. Make sure your pediatrician knows that you are group B strep positive during pregnancy so that the doctor can watch out for any sign or symptoms of infection in the infant. A previous course of antibiotics may reduce the B strep bacteria for a short time, but it will not protect your baby during labor. B strep can live in your body and you may carry it regardless of whether you were previously treated with antibiotics or herbal remedies.  If you tested positive for B strep prior to or during your pregnancy and followed up with a course of antibiotics, it is possible the infection may have returned prior to delivery.  If you are group B strep positive in the period just before delivery it is imperative that you receive antibiotics during delivery. Depending on the type of delivery you have, your options to avoiding passing B strep to your baby may vary.  If you have a planned surgical delivery due to particular health needs, you may not need IV antibiotics for yourself or your baby unless you naturally go into labor before the operation begins; however, some doctors will still give IV antibiotics even if you are having a caesarean section.  If you intend to deliver vaginally, you may be started on antibiotics as soon as labor begins to prevent your baby from becoming infected by coming into contact with the bacteria in vaginal fluids. If you are allergic to penicillin or another antibiotic, be sure your medical team is aware so that they can offer an alternative...


Recognize the limits of home remedies. Prepare your plantar wart before treatment. Try a salicylic acid treatment. Try duct tape. Investigate home freezing compounds. Determine if it's time for a physician's care.

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Although treatments at home are effective, they will usually take many months to be effective. If you want your warts to disappear faster, it's best to seek the care of your doctor. Permanent eradication may still take a long time, even when  warts are treated by a doctor. Plantar warts will often disappear on their own and will not leave a scar; however, this can take several months to happen. The warts may be painful and it will be difficult to walk in the meantime. Soften the top of the wart by soaking your foot in warm water for several minutes. Then take the excess skin off the top with a pumice stone or nail file. Be sure that you don't use this stone or file for anything else, ever, as you can transfer the virus to other areas of the body. Removing the top layer of dead skin will help the product to go deeper into the wart. There are a variety of topical (on the skin) over-the-counter products, such as Compound W, that treat plantar warts using salicylic acid. Treatments come as liquid, gel or patches. Follow the directions on the package to successfully remove your plantar wart. Salicylic acid treatments are not painful but it can take several weeks for full results to appear. Duct tape should be cut to the size of the wart and placed over the top of it for up to six days. On the seventh day, remove the tape, soak the foot for five minutes in warm water to soften the dead skin on the top, and then use a pumice stone or nail file to buff off the top layers of the wart. Replace the duct tape for another six days.  Do not use the pumice stone or nail file for any other purpose. This process can take several weeks to see results. It is not known why this process is thought to work, but many have good results using this method. The freezing process works to close off the blood supply to the wart. There are over-the-counter medications you can use at home to freeze the wart, including Compound W Freeze Off and Dr. Scholl's Freeze Away. Follow the directions on the product you are using. Freezing at home...


Recognize the meow. Understand what the meow is about. Pay attention to nonverbal cues.

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Cats can make as many as 16 different meows. Paying attention to the different sounds can help you better communicate with your cat.  A short meow is typically a greeting. Multiple meows signal excitement A mid-pitch meow is a request, likely for food. A deep “Mrow” is usually a complaint. A high pitch “Rroww!” is an indication of anger or pain. A long drawn out “mrrroww” is usually a demand. In nature, cats only meow as kittens to get attention for their mothers. When they realize you do not respond to their other signals, they learn to meow. Often the meow is a way to communicate something the cat wants, but it can have other meanings as well.  Most frequently your cat’s meow is trying to articulate a request. A meow often means that they want food, attention, or to be allowed into a room. A meow can also signal distress. Cats vocalize when they are in heat, lonely, stressed, angry, or in pain. They also become more vocal when they get older. Other times a meow is a simple greeting similar to a “hello.” Some of the most important ways that cats communicate are through body language.  Cats, for example, have a complex language of signals that they make with their tails.  When a cat looks you in the eyes and makes a long, slow blink, they are showing affection. This is sometimes compared to a kiss. A cat approaching you with their tail in the air is a greeting that suggests your cat is happy to see you. This has been compared to a handshake.  If the fur on your cats hair is standing up, this is a sign that they are angry or afraid. When your cat's tail is low, or between their legs, they are insecure or anxious. A tail thrashing back and forth is a sign that your cat is angry. The faster they move it back and forth, the angrier they are.


Recognize the musical staff. Memorize the notes of each line in the staff using the acronym "Every Good Boy Does Fine. Memorize the spaces between the lines using the acronym "FACE. Use lines above and below the basic staff, known as ledger lines, to get higher and lower notes. Read the key signatures, made of sharp, flat, and natural signs, to know what key the song is in. Use time signatures to determine the rhythm of the song. Use the vertical bars in the staff to find the end of each measure. Recognize the different types of notes.

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You know you have written music when you see five lines, capped off on the ends. On the far left will be a "clef" (a italicized "G" or "C" shape), a set of numbers, like 44{\displaystyle {\frac {4}{4}}}, and a set of hashes or flats denoting the key. Together, these elements make up a musical staff.  Guitar is also written as "tablature," a unique music-writing system for guitar. Tabs resembles traditional musical staffs but have six lines instead of five, no clef, and often say "Tab" on the far left side. Guitar music is always written in "treble clef." This means the symbol on the far left is always a cursive G, with the bottom looping around the second-lowest line of the staff. " Each line in the staff signifies a note, like an A, an E, etc. When there is a note symbol on the line, you play that note -- but you have to know which line is which note. Starting from the bottom, the notes are E - G - B - D - F, or the acronym "Every Good Boy Does Fine" " The spaces in between the lines also denote notes, meaning that the staff, in total, covers nine different notes (not counting sharps and flats, which will be covered later). From the bottom up, the spaces signify the notes F - A - C - E, or "FACE." Including the spaces, the final staff from looks like:  F E D C B A G F E If you see small little lines above and below the staff, these are simply to extend the range of the sheet music beyond the five lines on the staff. Each line has a note above and below, and you need to memorize it as you move forward. For now, however, just work on the basics. The key signature is between the staff and the time signature. It will be made up of some combination of three signals -- ♯, ♭, ♮ -- lined up on the staff. You'll need to memorize key signatures to know them -- the one in the video above is the key of D. However, they still give useful information if you don't know the key: Depending on what line the symbol fall on, you adjust that note. In the example above, there is a sharp on the F line, and one on the C space. This...


Recognize the nature of your illness. Identify the cause. Accept that your alters are real, at least for the time being. Expect to experience amnesia. Know that you will experience fugue states. Understand that depression is common in people with DID. Be aware that anxiety is also common in people with DID. Look for other mental health symptoms. Watch for auditory hallucinations.

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You are a single, whole individual with different identities. Each separate identity (or “alter”) is your own, even if you feel that you have no control over them. Recognizing this basic fact will give you a sense of personal identity and help you learn how to manage your condition. DID is most common in women, and it is almost always connected to childhood trauma, often in the form of brutal and sustained abuse. As painful and difficult as the process might be, understanding the cause of your dissociation may help you heal. Others may tell you that your alters don’t exist, that you created them yourself. This is not true, as you did nothing on purpose to create these alternates or your disorder, otherwise, they wouldn't be considered involved in mental health issues. Instead, they are referred as your alter egos, i.e. you made up your own "personalities". Alter egos and DID are both very different. Alters are not independent people. However, if you are living with DID, these alters feel very real. For the time being, it may be best to acknowledge their apparent reality and learn to cope with their existence. If you have DID, you may have two kinds of amnesia. First, you may have forgotten or blocked out painful or traumatic life experiences; recall that many people with Dissociative Identity Disorder had such experiences as children. Second, you may develop amnesia and a sense of “lost time” whenever one of your alters takes over your consciousness. Because one of your alters may take over at any given time, you may find yourself away from home, unsure of where you are or how you got there. This is called a “dissociative fugue.” If you have Dissociative Identity Disorder, you may also experience symptoms of depression: disturbed sleep and appetite, persistent sadness, and, in some cases, suicidal thoughts. If you have Dissociative Identity Disorder, you may also experience symptoms of anxiety. You may notice that you feel very worried or panicked, sometimes without understanding why. In addition to amnesia,...


Recognize the need for medication. Ask you doctor about thiazide diuretics. Take calcium channel blockers. Try Angiotensin-converting enzyme (ACE) inhibitors. Use beta blockers and alpha blockers.

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Frequently, lifestyle changes are not enough to reduce blood pressure to healthy levels. In many cases, prescription medications must be used. In this situation, the most effect anti-hypertensive regimen is a combination of both lifestyle changes and medication. Sometimes more than one type of medication is necessary. There are several types of medication that can be used as initial drug therapy. This medication, such as chlorthalidone and hydrochlorothiazide, are believed to work initially by reducing fluid volume, and secondarily by causing the relaxation of your blood vessels. They are taken once daily. Possible side effects of this medication include low potassium, which can lead to muscle weakness and irregular heart beat, as well as low sodium, which can lead to dizziness, vomiting, and fatigue. These medications, which are sometimes called amlodipine, nicardipine, nifedipine, verapamil, or diltiazem, are are potent vasodilators. They work by relaxing the muscle in the wall of your blood vessels. These are generally taken 1-3 times daily. Possible side effects include swelling in the lower extremities and decreased heart rate. ACE inhibitors and Angiotensin II receptor blockers (ARBs) are types of medications that inhibit a hormone called Angiotensin II, which results in a narrowing of blood vessels. It also helps increase fluid retention. They are generally taken 1-3 times daily.  Major side effects include low blood pressure and a lower pulse, which can cause dizziness and fainting. They also cause elevated potassium, which can cause muscle weakness, irregular heart beat, and cough. Up to 20% of patients taking an ACE inhibitor will develop a dry, hacking cough, generally within 1-2 weeks of starting the medication. ACE inhibitors and ARBs work well for younger patients ranging from 22-51 years old. These medications may be used if you do not respond to other medications. These work by blocking signals from nerves and hormones in the body that cause the narrowing of blood vessels. They are taken 1-3...


Recognize the onset of the aura phase. Take your preventative migraine medication, if you have it. Rest and get away from your triggers. Use an over-the counter (OTC) pain reliever if needed. Place a cold compress on your head for additional pain relief. Massage your scalp

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Ocular migraines are characterized by visual problems, known as the “aura.” You may have trouble seeing, experience zig-zag lights that aren’t really there, “see stars,” or have other visual effects. These may or may not be accompanied by pain. Part of treatment is learning to recognize the particular symptoms that accompany your ocular migraines. The aura phase usually takes place in the 10-60 minute window before the ocular migraine begins. Your doctor may have prescribed you a medication (usually a triptan or ergot derivative) to take whenever you start to have a migraine. If so, take this as soon as you experience the onset of the aura. Doing so may stop the headache, nausea, or other symptoms that may follow the aura phase.  These prescriptions are available in a variety of forms: pills, dissolving tablets, sprays, or shots. Make sure to follow your doctor’s dosing instructions. You should not use these medications if you are pregnant or have certain types of heart disease or uncontrolled high blood pressure. Discuss your medical history with your doctor before using migraine medication. Even if you aren’t experiencing pain or headache, find a quiet, dark place where you can close your eyes and rest as soon as you begin to experience ocular symptoms. If you know you have specific migraine triggers (such as specific sounds, smells, or staring at a screen too long), resting away from these will also help treat the migraine. Even if you can’t lie down, try moving away from bright sunlight or harsh lighting as well as noisy situations. Mild migraine pain can be stopped or at least reduced with a standard dose of aspirin, acetaminophen, or a non-steroidal anti-inflammatory (NSAID), such as ibuprofen or naproxen sodium. Follow the package instructions and do not take more than the maximum recommended dose.  You can also take specially formulated OTC migraine pain relievers, which may combine several medications (typically aspirin, acetaminophen, and caffeine). If you are taking any other medications, talk to a...


Recognize the possible causes of hoarding. Know the negative effects of hoarding. Remember that a hoarding disorder may not completely go away.

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Hoarding affects 2-5% of people above the age of 18.  Hoarding is associated with, “alcohol dependence; paranoid, schizotypal, avoidant, and obsessive-compulsive personality disorder traits; insecurity from home break-ins and excessive physical discipline before 16 years of age; and parental psychopathology.” Hoarding behaviors can also be a result of the individual wanting to hold onto items that remind her of individuals who have passed away, or to keep special memories from the past alive. Hoarding behaviors also tend to run in families, especially for women. Individuals with Hoarding Disorder may have brain abnormalities that result in difficulty identifying the emotional worth of an object, having normal emotional reactions and regulating emotions while making a decision (whether to buy, save, or throw out an object). People who compulsively hoard may be more likely to: be evicted or threatened to be evicted, be overweight, miss work, and have medical and mental health concerns. Like many types of illnesses, the goal is to learn how to manage the disorder, not expect it to go away and never come back. Your loved one may always have the temptation to hoard. Your role as a friend or family member is to help the one who hoards balance that temptation with all the benefits that come from keeping the impulse in check.


Recognize the presence of a traumatic event. Understand exposure. Note changes in functioning. Confront repeated exposure. Confirm that the changes do not result from drug, alcohol, or medication use.

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PTSD occurs after a traumatic event. A traumatic event is something that deeply impacts someone such as a brush with death, violence, or serious injury. The event can have actually happened or may have been threatened (such as being threatened by a gun or threatened with violence).  Some events may be experienced as more traumatic to some than to others. For instance, living through a natural disaster may be experienced as traumatic by one person but not by another. Someone may experience a close encounter with death or witness someone else almost die, like a friend or sister. A traumatic event can include war, natural disasters, car or plane crashes, terrorist attacks, violence such as rape, kidnapping, mugging, or assault, sudden death of a loved one, or childhood neglect. An event doesn’t have to happen to you for it to be traumatic. You may experience an event directly, or you may witness an event, such as violence in your home. You may also experience the event indirectly, such as hearing something that happened to a relative or friend.  While you may not have experienced being mugged, you may feel traumatized after hearing that your sister recently was mugged. For the trauma to be considered indirect, the outcome of the event was either violent or accidental. An accidental trauma could include learning that your sibling was burned severely by boiling water or was severely injured at work in a sort of “freak accident”. As a result of the traumatic event, the person may not approach life in the same way. Social, professional, school, or home function may change. The person may experience a decrease in functioning in more than one environment. The distress from the trauma causes significant changes to the person’s functioning. A person’s school grades may dramatically decrease, work productivity may change, or a once very clean person may suddenly be unable to take care of his or her house or personal needs. People may experience repeated or extreme exposure to aversive details of the event after it...


Recognize the purpose of an anemometer. Gather your supplies. Place the cardboard strips on top of each other to form a plus sign. Attach 4 cups to the ends of the cardboard pieces. Place the pushpin through the center of the cardboard pieces. Set up the fan a few feet away from the anemometer.

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An anemometer helps weather scientists to measure wind speed. This instrument rotates at the same speed as the wind and provides a direct measurement of the speed of the wind. Wind speeds are typically measured using the Beaufort Wind Scale, with a 0-12 scale based on visual cues. You can learn to identify calm, gentle, moderate, and strong breezes with your homemade anemometer. To make an anemometer, you will need the following supplies:  4 plastic cups of the same color, such as Dixie or Solo cups 1 plastic cup of a different color 2 long strips of stiff cardboard A pen A pencil with an eraser on one end A ruler A stapler A push pin A watch with a second hand or timer A small fan A calculator Then, use the stapler to staple them together. Staple them in the center of the plus sign so they hold their shape. Use the different colored cup as one of the 4 cups. Staple the cups onto the cardboard so they are on their sides, facing the same direction in relation to the cardboard pieces. Then, push the eraser part of the pencil into the pin sticking out of the center of the cardboard pieces.  Use the scissors to poke a small hole in the bottom of the remaining cup. Slide the pencil into this cup. The anemometer should now stand upright, supported by the pencil in the cup. There should be 4 cups on the ends of the cardboard pieces, all on their sides and facing the same way. Then, turn it on at low speed. Use the stopwatch to count the number of rotations that occur in 15 seconds. Multiply this number by 4 to determine the number of rotations per minute.  Use the different colored cup as a marker for 1 rotation, where 1 rotation is every time the different colored cup comes all the way around. This will help you to count the rotations accurately. You can also test the anemometer outside to get an air pressure reading. Make a chart that has 2 columns, 1 for the time interval and 1 for the number of spins. You can then record the time interval and the number of spins within that time interval.


Recognize the purpose of the hook. Use the active voice. Address the main plot. Focus on character and action, rather than theme. Read the hook out loud and revise it.

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The hook for your book is different from a synopsis or a plot summary in that it should not reveal the entire plot of the book or provide too much detail about your book. Instead, the hook should capture what your book is about in 1 to 2 sentences total and entice readers at the same time.  Your hook should grab your reader’s attention in 30 seconds and act like the elevator pitch for your book. Having a strong hook in your book proposal or in the marketing material for your book can make it seem more attractive to an editor or a literary agent. Your hook should also explain how your book is different from the other books that are currently available. If you are writing in a specific genre, the hook should also tell your reader how and why your book is different from the other books published in that genre. You should always use the active voice in your hook as well as active verbs so your hook feels immediate and engaging. Avoid the passive voice and passive verbs as this can make your hook seem dull, stale, and not all that memorable to readers. Most hooks for a book are written in the present tense, rather than the past tense, to make the hook feel more active to the reader. You should try to always use the present tense to describe the action in the book. Your hook should also include the main plot or the issue at stake in the story. Try to address the main conflict or crisis in a few words, using bold and descriptive sentences. Do not try to explain the crisis. Instead, simply describe it.  You should use engaging nouns in your hook to describe the main plot. Avoid too many adjectives or adverbs. You want the hook to be descriptive, but not long-winded or too full of descriptors. When in doubt, simple is better for the hook. Make sure you do not reveal the ending of the book in the hook, only the main plot. The ending of the book should be included in your synopsis of the book, not in the hook. It may be tempting to simply describe the main themes of the book. But this can end up sounding too generic and...


Recognize the risk factors. Check for trauma. Diagnose pain due to infection. Look for orchitis. Check for sexually transmitted infections (STIs). Look for signs of epididymo-orchitis. Have lab tests done.

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There are some common risk factors for both bacteria and viral infections that cause testicular pain. These risk factors include:  Sexual activity Strenuous physical activity, such as frequent bicycle or motorcycle riding Prolonged sitting, such as frequent travel or truck driving History of prostate or urinary tract infection Benign enlarged prostate or prostate surgery, typical in older men Anatomic defects such as a posterior urethral meatus, which occur in prepubescent boys Testicular pain from trauma, called testicular torsion, includes pain of the testicles and of the epididymis, which is the tube that runs on the underside of the testicles. To evaluate this, it requires a meticulous physical exam. If you have experienced any testicular trauma at all, especially testicular torsion caused by a twisting of the testicles, have it checked because it is a testicle-threatening problem.  Your doctor may check your Cremasteric reflex, which is absent in cases of trauma. This is done by running a reflex hammer along the inner thigh, which will cause the testicle to rise up protectively into the scrotal sac in healthy testicles.  Testicular torsion usually represents itself as an abrupt pain. Age plays a major factor in the determination of infection. Infectious causes of testicular pain include bacterial infection of the testicles and epididymis. This is due to bacteria that make their way up from the rectum, usually in men older than 35 and younger than 14. For young men between 15 and 35, the most common reason for infections of the testicles are sexually transmitted bacteria, such as Chlamydia and Gonorrhea. You will have pain when the area is touched during examination. Your doctor may check to see if elevating the testicles will ease your pain, which is referred to as Prehn’s sign.  Treatment of the infection will help with pain relief and combat any worsening of the infection and potential sepsis. The Cremasteric reflex will still occur with pain due to infections. Orchitis is due to viral infection, which...


Recognize the signs and symptoms of a potential pulmonary embolism. Seek treatment if you have signs of an already-present DVT (deep venous thrombosis). Consider your risk factors.

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If you notice these signs and symptoms, it is important to go to the Emergency Room immediately. Seeing a doctor for prompt diagnosis and treatment is key. (It is also important to understand, however, that half of people with a pulmonary embolism present with no symptoms.) Symptoms to look out for include:  Shortness of breath and/or rapid respiratory rate Sudden onset chest pain (often a sharp, localized chest pain that gets worse when you take a breath) A fast heart rate Coughing and/or "hemoptysis" (coughing up blood) A DVT (deep vein thrombosis), that normally occurs in one of your legs, is often the precursor to developing a PE (pulmonary embolism). It is for this reason that, if you notice signs and symptoms of a DVT (a blood clot in your leg), it is also key that you seek medical treatment immediately. The therapy for both DVT and PE are not identical, but they are similar, so if you seek treatment for your DVT it will both treat the problem and also prevent a future PE from developing. Signs and symptoms of a DVT include:   Leg pain over the calf or lower thigh, often on one side, but it is possible to have DVTs in both legs Swelling over the affected area, sometimes accompanied with a feeling of tightness on the leg Skin redness or changes in skin color over the affected area Warmth over the skin over the affected area Certain risk factors may increase your likelihood of developing a pulmonary embolism. In addition to recognizing signs and symptoms, there are risk factors that make you more susceptible to developing a pulmonary embolism. These include:  Being pregnant Having kidney problems Being overweight or obese Having cancer Being immobilized (either from surgery, disability, or other conditions leading to bedrest) Having heart failure Smoking Having a previous history of blood clots Taking certain medications (such as birth control pills and/or other hormone replacement therapy, erythropoietin, thalidomide, and tamoxifen)


Recognize the signs and symptoms of angina. Understand the risk factors for angina. Know how angina is diagnosed.

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During an angina attack, the patient suffers pain that is normally experienced in the chest behind the sternum but can also be felt in the neck, jaw, throat, back, left shoulder, abdomen, left wrist and left arm.  The pain can be described as knife-like or stabbing and is often accompanied by sweating and breathlessness. However, angina may also be experienced as sensations of pressure, heaviness, squeezing, burning, or choking.  An angina attack should usually only last for about one or two minutes. However, if the chest pain persists for more than ten minutes and is not relieved by rest, it is possible that you are experiencing a heart attack. If this happens, you should seek medical assistance, There are several common risk factors which may indicate that a person is more prone to angina. These include:  High blood pressure Being overweight High cholesterol Not getting enough exercise Diagnostic tests used to detect angina include the following:   Graded exercise stress testing: This is the most widely used test for the evaluation of patients presenting with chest pain. It can be performed alone or in conjunction with an echocardiography or a myocardial perfusion scintigraphy.  Coronary artery calcium scoring by fast CT: The primary fast CT methods for this application are electron-beam CT and Multidetector CT.


Recognize the signs of an impending panic attack. Practice deep breathing. Try progressive muscle relaxation. Meditate. Try to minimize worrying.

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Persistent fear is an underlying aspect of having PTSD. Excessive stress or fear can cause panic attacks, and panic attacks often co-occur with PTSD. These may last anywhere from five minutes to an hour or more. Sometimes, you may begin to feel extremely panicky without any obvious signs. Each time you respond in positive ways to your anxiety or panic, you will be working toward making it happen less often. Practice will make it easier to cope. Common signs of a panic attack include:  Pain in your chest Difficulty breathing or feeling short of breath Sweating Choking sensations Trembling or shaking Nausea Dizziness, light-headedness or faintness Chills or feeling hot Numbness or tingling Derealization (feelings like you're not real) or depersonalization (feeling like you're outside yourself) Fear of losing control or "going nuts" Fear of dying A general sense of doom This technique can be useful in reducing anxiety, fear, and even bothersome aches and pains. The mind, body and breath are all interrelated, so taking a few minutes to engage in purposeful breathing can offer a wide range of benefits such as lowering the blood pressure, relaxing the muscles, and increasing energy levels. Typical deep breathing consists of inhaling for 5 to 8 counts, briefly holding the breath, and then exhaling for 5 to 8 counts. This serves to flip the switch on your "fight or flight" response and transform you into a calmer state. Another technique found to be effective at reducing anxiety involves a gradual and systematic tightening and releasing of each muscle group. This method can ease stress and help with conditions beyond anxiety like insomnia and chronic pain. Progressive muscle relaxation also makes use of deep breathing for even greater impact. Start at the tips of your feet and slowly move up through the body. While inhaling for 5 to 10 counts, contract the muscles of the feet, and hold. As you exhale, suddenly release the tension of those muscles, taking notice of how they feel after the tension has been let go. This...


Recognize the signs of flirting. Recognize the signs that she wants to kiss. Recognize that she may talk about the things she secretly wants. Keep in mind that extra niceness can be a sign of insecurity. Ask what she's thinking if you can't figure it out.

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Girls tend to flirt when they want to deepen their relationship with you, or capture your attention. Keep an eye on her body language. Common signs she likes you include...  Playing with her hair Making excuses to touch you Trying to get your attention Facing you and leaning towards you Smiling at you Making prolonged eye contact, or looking at you a lot Seeming pleased when you pay attention to her Girls may not ask for a kiss directly, but instead hint at it and hope you'll catch on. She may act coy, or be awkward about it, or take a more assertive approach. A girl may signal that she wants to kiss by...   Getting her face close to yours Smiling at you Biting or licking her lip Making eye contact (or trying to, but acting shy) Touching your face Looking excited when you start moving in for a kiss Since girls may be afraid to ask for what they want outright, they may talk about something they want in the hopes that you'll notice and do it for them.   If she gushes about a romantic gesture that her friend's boyfriend did, it may be that she'd love a similar romantic gesture from you. For example, "Picnics are so romantic" might mean "I'd love to go on a picnic with you sometime, especially if you surprised me." Sometimes, when she goes the extra mile for you, it's because she fears losing you and she wants to please you. If she's nervously doing something nice for you, it might be worth asking her if she's worried about something, and reassuring her that you're not going anywhere.  Don't jump to conclusions, though: nice gestures don't always mean something is worrying her. They can also mean that she really likes you, or is in a very good mood, or thinks you make her happy and wants to make you happy too. It's okay to ask for clarification, whether you do it casually or flirtatiously.   "Are you flirting with me?" "Do I see you hinting for a kiss?" "So what's on your mind?" "You seem a little stressed. Is something wrong?"


Recognize the signs of labor contractions. Know the other signs that labor is occurring. Know when to prepare for the birth.

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In some cases, women have series of contractions before they go into labor. These are called "false contractions," or Braxton Hicks contractions. Knowing the difference between real labor contractions and false contractions can help you determine what steps to take next.  Labor contractions get closer together and shorter in duration as the hours pass, while false contractions don't follow a predictable pattern.  Labor contractions continue even if you switch positions or move around, while false contractions may go away after you move.  Labor contractions get stronger and more painful over time, while false contractions tend to be weak. Aside from having regular contractions, there are other physical signs that a woman is experiencing labor, rather than false labor. Look for the following changes:  Water breaking. The baby "lightening," or dropping lower toward the cervix. Passing of the mucus plug. Dilation of the cervix. It's time to go to the hospital or have the midwife get ready to deliver the baby when "actual labor" occurs. This happens when strong contractions with a duration of 45 to 60 seconds occur 3 to 4 minutes apart.


Recognize the signs that you're too tired to drive. Read medication labels carefully. Avoid driving between midnight and 6 AM. Do not drink alcohol before driving.

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If you're too tired to drive safely, stop driving for the night. Driving when tired is extremely dangerous and can lead to accidents. If you notice any of the following, you are too tired to drive:  Frequent blinking and heavy eyelids Difficulty keeping your head up Frequent daydreaming Missing traffic lines, drifting into other lanes, tailgating Difficulty remembering the last few miles you drove Some medication can cause drowsiness. If you're on any medication, read the label carefully. Make sure drowsiness is not a side effect. If a medication causes drowsiness, it may not be safe to use while driving. If you have a medication you need to take regularly that causes drowsiness, talk to your doctor about how to manage driving while taking the medication. These are the times where your circadian rhythm has a natural dip. It is dangerous to drive during these hours as there is an increased risk of falling asleep at the wheel. If at all possible, refrain from driving between midnight and six in the morning. Alcohol, even in small amounts, causes drowsiness. Do not have anything to drink before you need to get behind the wheel of a car.


Recognize the symptoms of Hallucinogen-Persistent Perception Disorder (HPPD). Learn how HPPD impacts your physical health. Be prepared to feel disconnected. Consider the severity of your symptoms.

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Flashbacks are the trademark symptom of HPPD. You may notice that you continue to have flashbacks beyond the few days after drug use. You may also experience persistent changes in your perception after taking hallucinogenic drugs. If you have perception changes, you may see:  Geometric shapes Objects in your peripheral vision (along the sides or edges of sight) Colored flashes Enhanced color intensity Trailing and strobe-like moving objects After images or impressions Halos Objects that appear small or large Changes in perception can be annoying or even frightening, but they aren't necessarily a sign of any serious physical damage that is life threatening. Any alterations in brain chemistry are related to how you see things, not how your body generally functions. These alterations are also distinctly different from hallucinations since they're clearly not associated with what's happening in the present moment. Changes in perception shouldn't be confused with reality. Any serious health consequences of HPPD aren't caused by brain damage from whatever drug was used. Instead, health problems typically come from sustained depression or anxiety associated with the persistent flashbacks. You may feel depersonalized, or drastically disconnected from your body. For example, you may feel as though you're watching yourself from an outside perspective or from outside your body. This feeling of disconnect can also be accompanied by a sense that you're in a dreamlike state or that the world isn't a real place. Like other HPPD symptoms, this can be frightening and last for an unknown period of time. But, it's not necessarily a sign of serious physical damage that needs immediate treatment. Sometimes people who use hallucinogenic drugs notice visual disturbances in the weeks after use, while sometimes they last for years. Since this varies by individual, there’s really no clear way of knowing how long your visual disturbances will last. You most likely won't need to treat HPPD as if it was a serious health condition. But,...


Recognize the symptoms of PID. Take a warm Epsom salt bath. Avoid natural antibiotics.

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PID doesn't often produce any symptoms during the early stages — especially if the infection is caused by chlamydia; however, when symptoms are present they usually include: pelvic and lower abdominal pain, low back ache, heavy vaginal discharge that smells unpleasant, irregular menstrual bleeding, chronic fatigue, pain during sexual intercourse and urination, and mild fever.  In the United States, almost 1 million women develop PID each year, and one in eight sexually active girls will get PID before they turn 20 years old.  Risk factors for contracting PID include: being sexually active, multiple sexual partners, not practicing safe sex, a history of having STIs, use of intrauterine devices, young age (14 – 25 years), and frequent vaginal douching. If you have symptomatic PID with pelvic and/or lower abdominal pain, then soaking your lower body in a warm Epsom salt bath can significantly reduce spasm, pain and swelling. The high magnesium content of the Epsom salt acts to soothe and relax muscle tension and cramping related to PID. Pour warm water in a bathtub and add a few cups of Epsom salt. You should start to feel results within 15-20 minutes of soaking in the tub.  Don't make your bath water too hot or soak for longer than 30 minutes at a time, because the hot salty water can pull moisture from your skin and potentially dehydrate you. Alternatively, apply moist heat to your pelvic/abdominal muscle cramps — microwaved herbal bags work quite well, especially the ones infused with aromatherapy (such as lavender) which have muscle-relaxing effects. While some home remedies may seem easier and less expensive than going to the doctor, PID is a very serious disease and can cause irreparable damage to your reproductive organs. You should not try to treat it yourself — it is essential that you see a doctor immediately and receive treatment.   Relying on home treatments to treat PID will only prolong the infection — early treatment is important to minimize complications. You may want to discuss supplementing...


Recognize the symptoms of Wobbly Hedgehog Syndrome. Find a vet with experience treating exotic animals. Get a diagnosis. Discuss a care plan with your vet.

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Symptoms usually start when a hedgehog is between the ages of one year and 36 months old. If you notice any of the following symptoms, your hedgehog may have Wobbly Hedgehog Syndrome:  Swaying and instability while standing still Tremors Regularly falling to one side Seizures Weakening muscles Partial paralysis of some limbs Muscle atrophy Slow progressive weight loss If you don't already have a vet, you should find one as soon as you notice symptoms of Wobbly Hedgehog Syndrome. Hedgehogs are considered exotic pets, so you'll need to find a vet in your region that treats exotic animals. You can look for a vet online or search the local yellow pages. Pet stores that sell exotic pets or hedgehog breeders often offer vet recommendations. If you're still in contact with the store or breeder where you bought your hedgehog, reach out to them for recommendations. The symptoms of Wobbly Hedgehog Syndrome can be caused by other neurological problems. However, keep in mind that a definitive diagnosis can only be confirmed using a necropsy after death. Your vet will likely need to take x-rays and conduct blood work to rule out other issues and get a working diagnosis. It's never easy to hear your pet has a terminal condition. The more information you know about the progression of the disease, the better. Talk to your vet about your hedgehog's life expectancy and ask what you can do to slow the progression of symptoms. Your vet may have specific recommendations for your hedgehog's diet and habitat depending on the stage of its illness.


Recognize the symptoms of a fracture in your foot. Learn the "RICE" treatment plan. Take some acetaminophen. Go see your personal physician.

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Foot fracture symptoms often start out as a slight discomfort towards the front of the foot, where most of the force and pressure is exerted. Many times, this pain is very slight and the onset is only during long periods of exercise, running or working out; this is called a "stress fracture" and is actually a tiny crack in the bone.  As soon as you stop your activity, the pain often vanishes. This leads many people to disregard and not even consider a fracture.  Other symptoms include swelling, throbbing pain, and discoloration or bruising. This is universal for any kind of bone fracture or stress fracture, and is the best way to treat a fracture at home for the first 72 hours after your injury or until you can seek medical care.  Rest. Immediately stop what you are doing and refrain from any activities that cause pain to your foot. No more exercising, running, or whatever it was you were doing when you felt the pain; stop and get off your feet. Ice. As soon as possible, put ice on the injured area. If your foot is fractured, it will soon start to swell, if it hasn't already. Do not apply heat, which would encourage more blood to rush to the area and make the swelling worse. Ice it down. Using crushed ice in a damp tea towel, ice the area for 20 minutes every two hours.  Compression. Wrap the injured area in a bandage fairly snugly to help reduce swelling. Be careful that it's not so tight that it cuts off the circulation; you'll know it's too tight if you experience numbness, tingling, or discoloration. Leave the toes unbandaged if possible to easily check the circulation. Elevation. Sit down or lie down, but keep the injured foot elevated. The idea is to keep the injured foot above the level of your heart in order to decrease swelling. Your fracture is likely to cause some considerable pain, so treat the pain safely while promoting healing in your bones. Avoid naproxen sodium and ibuprofen, which some doctors believe have the potential to delay the healing process with bone injuries. As soon as the pain and...


Recognize the symptoms of an acute infection. Get tested if you have a heightened risk of a dangerous infection. Ask your doctor to explain the test results.

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80 to 90% of the people who get infected with toxoplasmosis don’t show any symptoms at all and are never aware of it. Some people get flu-like symptoms that may last for a few weeks. Because toxoplasmosis is dangerous for unborn babies, get checked by a doctor if you have these symptoms while you are pregnant:  Fever Muscle aches Fatigue Sore throat Swollen lymph glands Toxoplasmosis is a serious danger to people with weakened immune systems and babies. You can be tested with a blood test conducted at your doctor’s office. Ask your doctor to be tested if:  You are pregnant or planning to become pregnant. Toxoplasmosis can be passed to an unborn baby in utero and can cause severe disabilities. You have HIV/AIDS. HIV/AIDS weakens your immune system and makes you more vulnerable to complications resulting from toxoplasmosis. You are receiving chemotherapy treatments. Chemo weakens your immune system to the point where an infection that normally wouldn’t be a problem suddenly becomes a real threat. You are taking immunosuppressant drugs or steroids. These medications can make you more vulnerable to serious infections and complications from toxoplasmosis. The blood test will show if you have antibodies against toxoplasmosis. Antibodies are the proteins your body produces to fight the infection. This means that the test doesn’t test for the parasites themselves, making the interpretation difficult.  A negative result could mean either that you are not infected or that you have been infected so recently that your body has not yet made antibodies. The latter can be ruled out by retesting a few weeks later. A negative result also means that you do not have immunity against a future infection. A positive result could mean one of two things. It could mean you are currently infected or it could mean you were previously infected and the antibodies reflect your immunity. If you have a positive test, the Centers for Disease Control and Prevention suggest that the results be verified by a specialist laboratory which can...


Recognize the symptoms of and triggers for kidney failure. Watch for later symptoms of kidney failure. Identify the signs of end stage kidney failure. Ask your doctor about peritoneal dialysis. Discuss hemodialysis with your doctor.

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When kidneys start to fail, symptoms related to fluid balance, electrolyte balance, clearing waste products, and production of red blood cells. The early symptoms may also mimic other illnesses, which can be confusing. If you experience these symptoms and they don’t resolve within a few days or there does not seem to be another cause, see a doctor. Symptoms to watch for include:  Appetite loss General feelings of fatigue Headaches Itchy, dry skin Nausea Weight loss (when you are not trying to lose weight) Later symptoms occur when kidney function has gotten much worse and the kidneys can no longer filter waste products from the blood. Symptoms of later kidney failure include:  Skin color changes Drowsiness or problems with concentration and thinking Muscle twitching and cramps Bone pain Numbness or swelling of the hands and feet Blood in the stool Frequent hiccups Excessive thirst Amenorrhea (in women, menstrual periods stop) Sleep difficulties Shortness of breath Vomiting (more often in the mornings) End stage kidney failure is the result of damage done to the kidneys. The final stage is called End Stage Renal Disease or ESRD, in which the kidneys are no longer able to filter enough waste products from the blood. At this point your body will either need kidney dialysis or a kidney transplant to keep working. Two of the most common reasons that ESRD develops is diabetes and high blood pressure or hypertension. Other conditions that may increase the potential for ESRD are:  Birth defects of the kidneys, such as polycystic kidney disease Injury to the kidney Kidney stones and infections Problems with the arteries that supply oxygen and nutrients to the kidneys Certain medications used to treat cancer or pain can damage the kidneys and cause failure Some toxic chemicals Autoimmune diseases such as scleroderma or systemic lupus erythematosus Reflux, or when urine flows back from the bladder to the kidneys and damages the organ Other kidney diseases Peritoneal dialysis does not require large machines, so you can...


Recognize the symptoms of depression. Validate their pain, but don't stay there. Avoid taking their depression personally. Don't underestimate how serious depression can be. Offer to help with small things. Be a compassionate listener. Remember that you aren't their therapist. Encourage your friend to seek professional help. Know that depression can come and go. Set your own boundaries.

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Sometimes people aren't necessarily depressed, they're simply going through a difficult time of life. However, if a friend shows signs of depression, you may need to pay close attention to make sure that it doesn't get worse.  Do they exhibit persistent sad, anxious, or empty moods? Do they present feelings of hopelessness or pessimism (nothing will ever get better; life is terrible)? Do they have lots of feelings of guilt, worthlessness, or helplessness? Are they fatigued, have decreased energy? Do they have difficulty concentrating on things, remembering things, or making decisions? Have you noticed insomnia, or oversleeping? Have they lost or gained significant weight? Are they restless and irritable? Have they mentioned or talked about thinking about death or suicide? Have they made or talked about making a suicide attempt? This could show by them saying something about how the world world be a better place if they weren't in it. Remember that their pain and feelings of hopelessness and helplessness are real. Validate the fact that they feel these negative feelings and then do your best to turn their attention elsewhere.  Depressed people may respond to distractions. You don't have to make the distraction super obvious. If you're taking a walk, for example, pointing out the beauty of the light on the water, or the color of the sky can turn the conversation. Going over the same negative feelings again and again can actually make things worse, because it encourages a depressed person to remain in that negative place. When someone is depressed they often have difficulty connecting to anyone on an emotional level, because of what they are going through. Taking it personally will mean that they will have a more difficult time reaching out.  A depressed person might lash out by saying something hurtful or angry towards you. Remember that this is the depression not the friend who is saying those things. This doesn't mean that you need to take abuse from them. If your friend is becoming abusive, as well as...


Recognize the symptoms of head lice. Examine everyone in the household for head lice. Put clean clothing on. Wash household items used by the infested person. Treat everyone in the household at the same time.

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Many things can cause an itchy scalp, and it’s easy to mistake conditions such as dandruff for head lice. It’s important to know what to look for so that you can treat head lice effectively:  Use a fine-toothed comb to examine the hair and scalp for lice and nits. Live head lice are about the size of a sesame seed (between 2-3mm long). Nits, or lice eggs, are usually yellowish white and stick onto hairs near the scalp. They are slightly smaller than adult lice.  Look for nits that are stuck to the hair shaft. Nits stuck to the hair shaft within ¼ inch of the scalp are the most likely to be viable (i.e., will hatch into lice). This is because head lice feed on tiny amounts of blood they draw from the human scalp. They also thrive on the warmth provided by your head. Nits that are further down the hair shaft are usually dead or already hatched.  Use a magnifying glass to examine the hair and scalp. Dirt particles and dandruff can often be mistaken for lice, so use a magnifying glass to determine whether there are live lice in addition to nits. If you don’t see live lice and the only nits are further down the hair shaft from the scalp, the infestation is probably already over.  Look behind the ears and at the hairline. Lice and nits are often easier to see in areas where the hair is thinner. Although they cannot fly or jump, head lice are extremely contagious and can easily infest everyone in a household. If one person in your household has head lice, check everyone’s hair and scalp for signs of infestation. Head lice are most easily spread by sharing hair brushes, hats, or beds with an infested person. If you have children who sleep in the same bed or room, or who share clothing regularly, make sure you examine everyone for head lice. If someone in your household has head lice, have them remove their clothing and put on fresh clothes. There may be some nits on their clothes, especially shirts, scarves, or hats. Head lice are not caused by poor hygiene. However, they can cling to fabric and household items and...


Recognize the symptoms of heart failure. Link heart failure to other heart problems. Talk to your doctor if you are at risk of heart failure.

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Heart failure does not actually mean your heart is failing or about to stop working. It means your heart muscle has weakened over time and cannot receive or pump blood as well as it used to. This can lead to congestion or a backup of blood in the heart. As a result, not enough oxygen-rich blood will be pumped to your body’s other organs. Heart failure can be acute, occurring suddenly, or it can be chronic and ongoing. The symptoms of heart failure can include:  Shortness of breath when you do physical activity (dyspnea) or when you lie down (orthopnea) Fatigue and weakness. A rapid or irregular heartbeat. Swelling (edema) in your legs, ankles, and feet. Your abdominal area may also swell due to fluid build-up (ascites).  Reduced ability or inability to exercise. Persistent coughing or wheezing with white or pink blood-tinged phlegm. Increased need to urinate at night. Sudden weight gain due to fluid retention. Lack of appetite and nausea. Difficulty concentrating and decreased alertness. Chest pain. Heart failure is often the result of other heart problems or issues that become worse or that weaken your heart. You can experience heart failure on the left side or ventricle, on the right side or right ventricle, or both sides of your heart at once. In general, heart failure starts on the left side of your heart, which is your heart’s main pumping chamber. Heart conditions that can lead to heart failure include:  Coronary artery disease: This is the most common form of heart disease and the most common cause of heart failure. If you have this disease, your arteries begin to narrow due to a buildup of fatty deposits, causing a reduction of blood flow to your heart. This disease can lead to a heart attack, as the buildup of fatty deposits can cause a blood clot to form and block blood flow to your heart. High blood pressure or hypertension: Blood pressure is amount of force of blood that is pumped to your heart by your arteries. If you have high blood pressure, this means your heart has to work harder than normal...


Recognize the symptoms of regular sore breasts caused by puberty and your menstrual cycle. Perform regular breast self-examinations. Get checked out by a doctor if you notice a lump in your breast. Talk to your doctor if you notice any blood or pus. Monitor other signs of infection. Take antibiotics if your breasts are sore because of an infection. Talk to a doctor or parent if you may be pregnant.

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If you are a teenager who has sore breasts, you are more than likely going through puberty. This means that your breasts are growing and your menstrual cycle is getting under way. It is normal to experience sore breasts at this time. Common symptoms include:  Tenderness in your breast, especially in the nipple area. This can be caused by hormonal changes and by wearing a bra that is too tight, or sleeping with a bra on. Feeling like you have heavy breasts. As fat and duct cells increase in your breasts, their tissue content also increases. Experiencing a warm feeling in your breasts. This occurs because multiple reactions are occurring at the cellular level, when hormones act on the glands and cells. See your doctor if the pain is very sharp or constant, is getting worse, or interferes with your daily activities. Doctors do not normally require full breast examinations until after the teenage years. However, it is a good idea to get in the habit of performing self-examinations of your breasts, especially if you experience soreness in the area. An exam will help you discover the issue in the rare event that you have a major problem. Sometimes you might feel a lot of lumps in your breast; this is caused by estrogen during your period. During puberty, you may also notice harmless lumps (such as breast buds) that are a normal part of your breast development. If you find a hard, unmoving lump, however, or if you are concerned, see your doctor for an examination. If you notice any pus or blood coming from your nipple while you are also experiencing sore breasts, you should go to a doctor. Pus or blood suggests an underlying infection, usually treatable with antibiotics. If there is localized (meaning in just one spot) tenderness and warmth in any part of your breast, it could mean you have an infection. This localized tenderness does not necessarily need to be accompanied by pus or blood. Instead, you may notice a part of your breast that is red, painful, or swollen. Antibiotics are prescribed to combat infections,...


Recognize the symptoms of the flu. Distinguish between the flu and a cold. Distinguish between the flu and a stomach bug. Know when to seek emergency medical treatment.

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Before you can effectively treat this viral infection, make sure that's what you actually have. Flu symptoms are similar to everyday cold symptoms, but they are more severe and occur more rapidly. They may last two to three weeks. The following are common symptoms of the flu:  Cough, often severe. Sore throat, and a lot of wheezing. Fever above 100°F (38°C). Headaches and/or body aches. Runny or stuffy nose. Chills and sweats. Fatigue or weakness. Shortness of breath. Loss of appetite. Nausea, vomiting, and/or diarrhea (more common in young children). While the flu shows some similar symptoms to the common cold, cold symptoms develop more slowly and follow a predictable pattern of escalation and retreat. Symptoms of the common cold usually last less than a week or two and include:  Mild cough. Low-grade or no fever. Slight aches or a headache. Congestion. Runny or stuffy nose. Itchy or sore throat. Sneezing. Watery eyes. Mild or no fatigue. What’s commonly called “stomach flu” or a “stomach bug” is actually not influenza at all, but a type of viral gastroenteritis. The flu affects your respiratory system, while “stomach flu” affects your intestines and is usually a less serious illness. Common symptoms of viral gastroenteritis include:  Watery diarrhea. Abdominal cramping and pain. Bloating. Nausea and/or vomiting. Mild or occasional headaches and/or body aches. Low-grade fever. Symptoms of viral gastroenteritis usually only last a day or two but can last as long as 10 days. In extreme cases, the flu can cause severe dehydration or symptoms severe enough to require hospitalization. Seek immediate medical treatment if you or your child is experiencing the following symptoms:  Shortness of breath or difficulty breathing. Chest pain or pressure. Severe, persistent vomiting. Dizziness or confusion. Bluish skin tone or purplish lips. Seizures. Signs of dehydration (e.g., dry mucous membranes, lethargy, sunken eyes, decreased urination or very dark urine). Severe headache or neck pain or stiffness. Flu-like...


Recognize the symptoms of the manic phase of bipolar disorder. Note the symptoms of the depressive phase of bipolar disorder. Acknowledge that you need help. Contact a mental health professional.

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To seek help for bipolar disorder, you first need to recognize and accept that you have this condition. Start by recognizing the symptoms you may be experiencing due to the disorder on a daily basis. During the manic phase, you may have symptoms like a high level of energy and activity, an irritable mood, rapid thoughts, a tendency to get distracted, and increased recklessness. You may also experience delusions or hallucinations as well as paranoid or suspicious thoughts.  Write down your symptoms and pay close attention to how your moods swing back and forth throughout the day or week. You can then use these notes when you meet with a mental health professional to discuss your treatment options. Be aware that bipolar disorder may be misdiagnosed because there is another type of bipolar that includes a hypomanic state. This form is more subtle and often hard to pick up. Hypomanic symptoms include spending an excessive amount of money, impulsive shopping, binge eating, and difficulty sleeping. During the depressive phase, you may have symptoms like a lack of appetite, a lack of sleep or too much sleep, fatigue and low energy, and poor concentration. You may also feel worthless or guilty and have thoughts of death or suicide. Having bipolar disorder means you will swing from the manic phase to the depressive phase. You may have periods where you feel more manic and periods where you feel more depressed. However, keep in mind that there will also be many times when you feel normal, especially if you are being treated for your bipolar disorder. Rapid cycling between these two phases is rare. However, if you feel that your mood easily fluctuates day to day or week to week, speak to your doctor about whether or not you have bipolar disorder and learn what your treatment options are. Once you recognize that you have the symptoms of bipolar disorder, take steps to acknowledge that you need help and treatment for this condition. Be honest with yourself and those around you. Admit that you have the disorder and accept...


Recognize the symptoms.  Breathe deeply Try to find a quiet place. Reorient yourself to the environment. Fend off anxiety with water. Talk to a friend or someone you trust.

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There are several symptoms of an anxiety attack, and each person has a unique feeling when an attack happens. In the middle of a panic attack, your body enters “fight or flight” mode. Since this response can't be sustained long-term, an attack generally fades after a few minutes. Nonetheless, some people experience repeated attacks that span hours. The most common symptoms of an attack are:  Racing heart Feeling flushed or hot Debilitating terror Experiencing chest pains Having trouble breathing Experiencing “pins and needles” in the fingers or toes Thinking that you will die Feeling claustrophobic . One of the common side effects of an attack is not being able to catch your breath. Therefore, mastering deep breathing can be one of your strongest weapons during an attack. Try to control your breathing by placing one hand on your belly and the other on your chest. Exhale sharply and let your upper body fall into a relaxed state. Now, breathe in slowly through your nose for 4 counts. You should feel the hand on your belly moving outwards. Pause and hold the breath for 1 or 2 counts. Now, gradually release the air out through your mouth for 4 counts. Repeat the process for several minutes as the natural relaxation response comes into effect. Frequently, panic attacks are set off by feeling overwhelmed in a large group of people. Go to a quiet room or corner where you can feel your back against a wall, grounding you. Sit down if you can, and drink some water. While getting away from your environment may help, you want to try your best to resume your usual activities as soon as possible. You can  stop panic attacks that occur during any activity by learning relaxation and grounding techniques. Derealization and/or depersonalization involve feeling as though you are disconnected from the surrounding environment or from your body respectively. Some people experience these sensations during anxiety attacks.  Grounding techniques are an effective remedy for derealization and depersonalization. Connect with your...


Recognize the symptoms. Call 911 or your local emergency services number. Check for breathing and circulation. Check blood pressure if possible. Start CPR if necessary. Place the person in the shock position. Do not move the person. Provide basic first aid to visible injuries. Keep the person warm. Make the person as comfortable as possible.

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Before you administer any kind of treatment it's important to know what you're dealing with. Signs and symptoms of shock include the following:  Cool, clammy skin that may appear pale or grayish Profuse sweating or moist skin Bluish lips and fingernails Rapid and weak pulse Rapid and shallow breathing Enlarged or contracted pupils (pupils can enlarge in septic shock, but can constrict in traumatic shock) Low blood pressure Low or no urine output If the person is conscious, he or she will display an altered mental status such as being disoriented, confused, anxious, agitated, dizzy, lightheaded, or feel faint, weak, or fatigued The person may complain of chest pain, nausea, and experience vomiting Losing consciousness follows Shock is a medical emergency, will require expert medical attention, and hospitalization.  You may save the person’s life by ensuring that paramedics are on the way while you initiate treatment. If possible, stay on the line with the emergency services dispatcher to continually provide updates about the person’s condition. Follow the instructions provided by the dispatcher until emergency medical help arrives. Make sure the airway is clear, be sure the person is breathing, and check for a pulse.  Observe the person's chest to see if it rises and falls, and place your cheek next to the person’s mouth to check for breath. Continue to monitor the person’s respiration rate at least every 5 minutes, even if they are breathing on their own. If blood pressure equipment should be available and can be used without causing further injury, monitor the person’s blood pressure and report it to the dispatcher. Only administer  CPR if you are trained to do so. An untrained person may do serious harm to someone by attempting CPR.  Only trained people should administer CPR to adults,  children, and  infants, due to the risk of serious and life-threatening injury. The American Red Cross has recently implemented new protocols for administering CPR. It is important that only people trained in the new...


Recognize the symptoms. Diagnose and treat gonorrhea. Learn the risks of not getting treatment. Be aware of how you can’t contract gonorrhea.

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Gonorrhea presents itself with different symptoms and can occur on different parts of your body. Learning the symptoms of gonorrhea can help you identify them and get treatment for the disease.  You can get gonorrhea infections in your genitalia, rectum, eyes, throat, and possibly even in your joints. Most women have no or mild symptoms of gonorrhea, and they may seem like a bladder or vaginal infection.  The most common symptoms of gonorrhea include: a burning sensation when urinating, discharge from the penis or increased vaginal discharge, vaginal bleeding between periods.  Infections in the rectum may cause no symptoms in both men and women, but you may experience discharge, anal itching, soreness, bleeding, or painful bowel movements.  Gonorrhea of the eyes may cause sensitivity to light and you may notice a pus-like discharge from one or both eyes. Gonorrhea of the throat may be accompanied by a sore throat and swollen lymph nodes in the neck. If you have any symptoms of gonorrhea or suspect exposure, consult your doctor as soon as possible. She can confirm the disease and prescribe a course of treatment.  Your doctor will likely examine your genitals for symptoms and signs of gonorrhea. She may also perform lab or urine tests to confirm this diagnosis.  The most common medications used to treat gonorrhea are an injection of ceftriaxone given in conjunction with an oral antibiotic such as azithromycin or doxycycline.  Your partner should also get tested for gonorrhea. The treatment is the same for both partners if a diagnosis is concerned. If you don’t see a doctor and get treatment for gonorrhea, you increase your risk for serious health conditions. Knowing the risks of not getting treatment may influence your decision to see your doctor and get treatment.  Untreated gonorrhea can cause infertility in both men and women. Gonorrhea can increase your risk of contracting sexually transmitted diseases, especially HIV/ AIDS. Untreated gonorrhea can cause an infection that spreads to the rest of your body,...


Recognize the symptoms. Treat jock itch with an over-the-counter antifungal  medication. Go to a doctor if self-care doesn’t work.

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It is a red rash that covers the inside of your upper thigh, skin on your genitals, and may go as far back between your buttocks as your anus.  The rash will likely itch and burn. If it spreads to your anus, you may also have anal itching. It may look flaky with a raised, swollen appearance. Blisters, bleeding, and pus-filled sores are common. The edges of the patches are often very red or silvery, while the skin in the center may not be discolored. This may give it the classic “ringworm” appearance. However, it is not a worm. The rings get larger as the fungus spreads. The scrotum or penis may remain fungus-free. Apply the medication as indicated on the manufacturer’s instructions.  Over-the-counter options include ointments, lotions, creams, powders, or sprays. Effective medications may contain miconazole, clotrimazole, terbinafine, or tolnaftate. If may take several weeks before it is fully cleared up. If the infection lasts longer than two weeks, is very bad, or keeps coming back, you may need something stronger.  Your doctor can give you prescription strength antifungal medications. These may be either topical or oral. If you have a bacterial infection from scratching, your doctor will also give you an antibiotic.


Recognize the symptoms. Understand the causes. Ensure that you do not have Candida Yeast Overgrowth by testing your saliva.

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While some people experiencing extremely dry and chapped lips may assume they have this disease, exfoliative cheilitis is actually an extremely rare condition that few people actually suffer from. It is characterized by the following symptoms:  Cracking, flaking, itching, and/or burning of the lips. Discoloration, especially around the vermillion border of the lips (in other words, the outside edge of your lips).  Repeated peeling of a layer of excessive keratin that forms on the surface of the lips.  Swelling of the lips. The exact cause of the condition is unknown, but researchers have suggested that a variety of factors could cause it, including reaction to dental implants, hormone imbalances, diet imbalance, or liver malfunction, internal or external toxins, fungal or bacterial infections, improper diet, and poor mouth hygiene.  It has been suggested that this form of cheilitis may develop from other, less severe, forms. Exfoliative cheilitis may also be caused by a fungal mouth infection called “Candida Yeast Overgrowth”, or Thrush. You can buy a pH tape testing kit or you can check for signs. The best time to do this test is first thing in the morning, before brushing your teeth or drinking anything.  Start by collecting a mouthful of saliva and spit it into a clear glass filled with bottled or distilled water.  After 15 minutes check back - normal saliva should just float on top. Any of the following are positive signs that you have Candida Yeast Overgrowth and you should contact your doctor for treatment:  The saliva has formed strings that hang down into the water. There are cloudy globs that slowly sink or suspend below the surface.


Recognize the threat of recreational water illnesses (RWIs). Watch for symptoms of RWIs. Be cautious of different water areas.

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Despite being hygienic, you or your family may still develop a recreational water illness (RWI). These conditions develop when you are exposed to fungi, viruses, bacteria, or additional microbes in the water. The most common of these are E. coli, norovirus, and cryptosporidium.  The RWIs can also be caused by pool chemicals.  You are unlikely to get head lice, MRSA, and pinworms by swimming in a public pool. There are many different types of RWIs that you can catch from public swimming pools. These may affect your skin, ears, eyes, respiratory system, or gastrointestinal tract. Look for the common symptoms of the RWI illnesses, which are:  Diarrhea, which develops most often Ear infections Skin rashes Eye and lung irritation Upper respiratory infections Public pools are not the only area where you can contract RWIs. Despite the chemicals used in pools, the germs are still prevalent. This is true of any communal water source, so you need to be cautious of any public recreational area. In addition to the pools, other areas to be careful are:  Splash pads Water parks Hot tubs Spray parks  Rivers Lakes Water fountains Oceans


Recognize the truth of the relationship. Acknowledge your thoughts are not facts. Challenge irrational thinking. Try to forgive. Avoid feelings of blame.

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It can be hard to stop thinking about someone when you're romanticizing what you had. If you're missing someone, you may ignore painful memories and only focus on the good times or the good qualities about the person.  The relationship probably ended for a reason. Did you two fight a lot? Were you simply not right for each other? What happened that caused things to sour? Remind yourself the relationship was imperfect. Remembering the imperfections can actually help you think about him less in the long run. It will lessen your longing for him. When you're reeling from something, you're more prone to irrationality. You may experience thoughts that you see as facts. However, feelings are subjective. When you have negative or irrational thoughts about yourself or the situation, remind yourself of this.  Your feelings are real, but that does not mean they are true. Just as you don't believe everything you hear, don't believe everything you think. For example, you find yourself thinking something like, "I will never find anyone like him." Say something to yourself like, "I'm feeling that way right now, and that's okay, but it's probably not true." You may experience a lot of irrational thoughts when trying to forget someone. When you experience a very negative thought about yourself, pause and challenge it. Think to yourself, "Is this really reality?"  Try to examine the evidence when you have a negative thought. For example, you think, "No one else will want me." Is this really true? Aren't you basing a big generalization on one experience? You've been with other people who have valued you. Look for perspective. Think about the last time your heart was broken. You probably experienced similar negative thoughts, but they were not necessarily true. You did love again and find someone else. Ask yourself questions like, "If someone else were saying these things, how would I react?" and "How would I look at this situation if I was being positive?" It can be hard to forgive someone who hurt you. However, if you forgive...


Recognize the wishes of the family. Consider the faith of the deceased. Consider your relation to the deceased. Make a tribute to the personality of the deceased. Choose your flowers carefully. Consider color meanings.

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Some funeral announcements will say “In lieu of flowers…” and ask for a donation to be made to a favorite charity or a personal cause. Some people choose to send flowers in addition to making a donation. This decision is up to you, but when in doubt, respecting the wishes of the family is always appreciated. The most appropriate flower arrangements can vary depending on the faith, cultural beliefs, or religious traditions of the deceased and the bereaved. What is appropriate in one culture may not be so in another, so it is important to consider this before purchasing flowers for a funeral. Here are some suggestions for more common religious affiliations:  Catholic and Protestant Christian: there are no specific recommendations or styles to avoid; nearly all colors and types flowers and floral arrangements are acceptable. Mormon: while most flowers are acceptable, avoid arrangements with crucifixes or crosses. Greek Orthodox: while most flowers are accepted, white flowers are often chosen as a preferred option. Jewish: flowers are not typically displayed at a funeral home where the service for the deceased is held; instead, it is more common to send flowers to the family members’ homes. However, you should not take flowers to a Jewish home sitting Shiva.  Baha’i: most types of flower arrangements are acceptable; there are no specific recommendations or styles to avoid. Buddhist: most types of flower arrangements are acceptable; there are no specific recommendations or styles to avoid. Hindu: instead of floral arrangements, garlands are more commonly seen at Hindu funerals. Ask the funeral home about the possibility of sending a garland instead. Muslim: the acceptability of flowers at an Islamic funeral varies across the faith, and therefore it is important to ask about the desires of the bereaved before sending them. Different types of floral arrangements are sent by individuals with different familial proximity to the deceased. Consider this when choosing an arrangement of flowers to send.  Choose a casket...


Recognize tooth disease. Feed your rabbit soft food. Take your rabbit to a veterinarian.

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Dental disease can be caused by a misalignment of the teeth or the wearing down of a tooth. This can be a dangerous situation. It can cause your bunny to stop eating, endangering its health.  Signs of tooth disease include loss of appetite, hair loss on chin and neck, slobbering, and drooling. Your rabbit might still show signs that it has an appetite, but is unable to eat. Perhaps it will approach food, even pick it up, before backing off and dropping it. If you believe that your rabbit might have tooth disease rub its cheeks. Any evidence of discomfort would suggest that it has a dental problem. Until you can reach a veterinarian, try to force-feed your rabbit canned pumpkin, baby-food, or veggies. You can purchase a feeding syringe from a pet store. These can be used to insert fluid directly into the rabbit’s mouth.  To prepare for syringe feeding, wrap your rabbit in a towel and secure its head with an index finger under the head, and the thumb on the opposite end of the head, under the base of the skull.  Insert the syringe into the gap between the incisors and cheek teeth. Begin by inserting no more than .2 to .5 ml of food and never feed more than 1 ml. Too much food at one time creates the risk that the rabbit will choke. Go slowly. Then repeat with 5 to 10 ml of water. Ultimately your rabbit will need professional assistance. Because of the variety of possible dental issues, treatment varies. If you do not do so already, you should begin yearly dental examinations to ensure that there are no future complications.


Recognize toxic friendships. Talk to an egomaniac friend calmly about how you feel. Cut ties with your self-centered friend if (s)he dismisses your concerns or is a negative presence in your life. Flip the script and focus on yourself when you find yourself married to an egomaniac. Get help if you find yourself in a controlling, manipulative, or physically abusive relationship. Create a healthy sense of self within a narcissistic family.

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If you’ve been friends for a long time, it might be hard to see that the egomaniac isn’t really an exciting, larger than life personality. (S)he is just obsessed with themself. Egomaniacs can often be the life of the party, so many people are, at least initially, drawn to them. If your friend isn’t interested in you, or never gives you a chance to talk, it might be time for a change. Let the know that their behavior is hurting you and that you’d like to make some space in the relationship for your needs and feelings. You might say, “I care about you and our friendship, but I feel like we spend a lot of time talking about your feelings. I would like to share some of my experiences with you, but I’ll need you to listen.” There is a range of egotistical personalities, some more fixable than others, so pointing out a friend’s bad behavior might fix the problem. You are not required to maintain friendships that are detrimental to your happiness and well being. If the relationship seems truly toxic, cut ties and try not to feel guilty. Narcissism in intimate relationships can be especially difficult. Egomaniacs lack empathy, so a romantic partner can feel unloved and lonely.  Think about what needs you are fulfilling by partnering with an egoist. Often, it is a lack of self-worth or co-dependency.  Review your own childhood. A narcissistic parent might have trained you to deny your own needs in favor of someone else. Take control of the situation by respecting yourself and working on your own sense of self-esteem.  Do some activities that you are interested in, whether it's reading, gardening, or watching your favorite movie. Remember that you matter, too. When your partner begins another self-centered outburst, calmly say something like, "I understand that that you are really excited about your idea, but I've been listening to you talk for a while. I'd like you listen to some things that I have to share." Or, "It makes me feel like you don't care about me when you talk over me and ignore the things that I say. I...


Recognize unreachable standards. Forgive yourself.

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Like Picasso's paintings, perfection changes in the eye of the beholder. Perfection is a state that is subjective and often self-imposed. It's okay to hold yourself to higher standards, but often, those standards are idealistic because life doesn't always go as planned. It is easy to get frustrated when you cannot match our ideal image of yourself. This isn't necessarily a bad thing, because this is what motivates people to improve, find better and more efficient ways of doing things, and be the most excellent they can be. You can learn to prevent this very human tendency from becoming unproductive by becoming more forgiving of yourself when things don't go the way you'd like, and more supportive of ourselves by feeling good in our accomplishments and strengths so we can truly enjoy being who we are right now at this very moment.


Recognize unusual startle reflex, anxiety, and low mood as signs of PTSD. Choose an experienced  therapist. Challenge negative or faulty thinking in therapy. Try gradual exposure. Consider taking medications.

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Many people experience trauma and recover on their own. Others may develop a serious condition known as post-traumatic stress disorder. Look for signs of PTSD and get professional help if needed. PTSD involves experiencing recurring stress responses that are similar to what you experienced during the actual event long after that event has passed. This might include overwhelming fear or helplessness, sadness, trouble sleeping, and/or a pounding heartbeat. One effective way of coping with trauma is by talking to a therapist, so ask your primary care physician for a referral. Look for a therapist who has experience working with trauma survivors. Your therapist should have treated others with anxiety or PTSD. It may also help to find a professional who conducts cognitive behavioral therapy or dialectical behavior therapy, two proven treatments that benefit trauma survivors. Professional treatment of traumatic stress typically involves cognitive restructuring exercises that help you identify and change negative thought patterns. For instance, you might think “I am weak.” Your therapist will work with you to reframe that thought into something like, “It's normal to feel paralyzed when you face danger. I did the best I could.” Another method for dealing with traumatic stress is by slowly allowing yourself to re-experience the trauma. With the guidance of your therapist, return to the scene of the event and recreate the sensations you felt when it happened.  Don't consider doing this on your own without guidance and support. You might do this over and over again until the memory of the event evokes less of an emotional or physical reaction. PTSD is an anxiety disorder, so you might feel overly alert and even experience panic attacks. Medications may help relieve symptoms of anxiety so that you can function more fully in your day-to-day life. Talk to your doctor to see if they are a good choice for you. Both antidepressants and anti-anxiety medication have proven helpful in reducing the symptoms of PTSD.