Tag: sick

  • Sick at school? – North Carolina Health News

    Sick at school? – North Carolina Health News

    By Michelle Crouch

    Co-published with Charlotte Ledger

    One morning last month, Ben Jacobs, a senior at Myers Park High School, woke up feeling nauseated with a terrible headache. He ran to the bathroom and vomited. Then he pulled himself together and hustled to school before the end of first period.

    Jacobs, who had already missed some school because of a medical issue, said he didn’t want to risk another absence in light of Charlotte-Mecklenburg Schools’ attendance policy – one of the strictest in the state, according to an informal analysis by The Charlotte Ledger/ NC Health News.

    The CMS policy says a high school student who misses more than 10 days of any class – whether the absence is excused or unexcused – will fail the course. To avoid a failing grade, a student must get a special medical waiver or make up the time through a process called “attendance recovery.”

    Although the rule has been in place since 1970, CMS is aggressively enforcing it this year as it tries to get students back on track after the pandemic, when absences soared and school performance tanked.

    Research shows excess absences – missing 10 percent or more of school days – is strongly linked to lower academic achievement.

    The policy is sparking controversy among parents and students who say it encourages students to go to school sick at a time when respiratory illnesses are surging. In addition to the ongoing threat of COVID – which triggers a five-day quarantine under CMS rules – respiratory syncytial virus (RSV) and flu are also on the rise.

    “It’s ridiculous,” said Erin Garvey, whose daughter is a sophomore at Hough High. “Ten days is not a lot when we have all sorts of illnesses spreading like wildfire. I know absenteeism has gotten out of hand with some kids. But there’s a big difference between kids who are just skipping and a straight-A student whose family says, ‘My kid was sick.’”  

    The goal: keep kids in school

    Matthew Hayes, CMS deputy superintendent for academic services, said emphatically that CMS does not want sick kids to come to school. At the same time, the district wants to send the message that families need to make school a priority and try to schedule vacations and appointments outside of school time.

    Chronic absenteeism leads to lower grades and test scores, less engagement in school and higher dropout rates, research shows.

    “If students are not in the classroom, they are missing instruction,” Hayes said. “Even if it’s an excused absence, it still is going to create a gap in the continuation of a student’s learning.”

    The CMS policy allows students who are absent for an extended amount of time for medical reasons to apply for a medical waiver with documentation. In addition, missing class for a school-sponsored activity such as a field trip or an athletic competition doesn’t count toward a student’s total absences.

    Hayes noted that absences skyrocketed during the pandemic when CMS suspended its attendance rule. About 29 percent of CMS students were “chronically absent” in the 2021-2022 school year – that’s twice as many as before the pandemic. CMS considers students chronically absent if they miss at least 10  percent of days in a school year – or about 18 days.

    Since the board reinstated the policy this school year, absences have dropped. In a Nov. 11 Charlotte Observer article, outgoing interim superintendent Hugh Hattabaugh listed better student attendance as one of his accomplishments, noting that chronic absenteeism is down to about 15 percent today.

    Hayes said the attendance policy is not intended to penalize students: “It’s about making sure they have the resources and the knowledge they need in order to be successful, not just for the course they are currently in but also for future courses.”

    One CMS high school teacher said he’s glad the district is cracking down. “I had students last year with 30-plus absences. I cannot do my job like that,” he said.

    The teacher said he did not want to be named because he feared retribution from school administrators – or from angry parents. “I’ve already been asked by parents to ignore the policy, falsify the recovery of time or allow students to make up the remediation work on their own time,” he said.  

    “A really wrong-headed idea”

    Although CMS may want sick kids to stay home, students and families said that’s not always what happens.

    Jacobs said he recently sat next to a student in class who admitted to having a fever, but who said she was there because of the attendance policy. And Garvey said her daughter returned to school early when she had a cold earlier this year.

    “She felt like garbage but went back, and I know she was not the only one. She has several friends who have gone back prematurely because they felt the pressure,” Garvey said.

    Meanwhile, some psychologists have another concern: they say the policy is creating unnecessary anxiety among teens with mental health issues, and it’s making kids opt out of getting therapy they need, because they can’t get appointments outside of school hours.

    “Our kids are in crisis,” said Kristin Daley, a psychologist at Base Cognitive Behavioral Therapy in Charlotte. “With all of the isolation during the pandemic, referrals are through the roof. Ideally, of course, we would love for all of these kids to be seen outside of school hours, but it’s just not feasible.”

    Daley said the CMS attendance policy came up at a recent staff meeting in her office, and it has also been a frequent complaint on a Facebook page of Charlotte area counselors, therapists and psychologists. There was even discussion about publishing an open letter urging the district to reconsider the policy, Daley said.

    “It just feels like a really wrong-headed idea,” Daley said. “It’s causing families to prioritize compliance to school over their physical health and mental health. Increasing anxiety is not going to improve test scores.”

    Other districts more lenient

    The Ledger/NC Health News reviewed the attendance policies of other large N.C. school districts as well as the ones immediately surrounding Charlotte and found that the CMS policy is among the toughest.

    • In Wake County, for example, high school students are “referred to the school-based attendance team” if they exceed 20 excused or unexcused absences – double the number that CMS allows. The team will then consider “appropriate interventions to improve the student’s attendance,” according to the district’s policy manual.
    • Cabarrus County schools call for a review (not an automatic failing grade) if a student exceeds eight absences in a semester. The review should consider the circumstances of the absences, other measures of academic achievement and the extent to which the student completed missed work, according to the district’s policy.
    • In Asheville, the Buncombe County school board voted to loosen its policy earlier this year, allowing high school students to miss 14 days of a year-long class, rather than the 10-absence limit it imposed before, said spokeswoman Stacia Harris. “We know that we must give grace and work with families as much as possible,” Harris said in an email.

    5-day limit in handbook not being enforced

    The CMS 2022-2023 parent-student handbook actually differentiates between students in year-long and semester-long classes. The handbook says students in a semester-long class will receive a grade of “F” for the course once they exceed  five absences.

    Hayes told the Ledger that CMS is not enforcing that five-absence limit and is focusing instead on students who exceed 10 absences total.

    He also noted that CMS counselors and teachers reach out to families long before they hit the 11th day.

    “When we see students with consecutive days out, teachers are speaking to counselors, and counselors making phone calls home: Is this a transportation issue? Is there something else keeping a student from getting to school? We want to solve for that.”  

    No state guidelines mandating failure

    The state Department of Public Instruction offers no specific guidelines requiring districts to fail students who miss a lot of school, said Rob Taylor, deputy state superintendent for district and school support services. 

    Years ago, the state required a certain amount of seat time before a student could earn course credit. That policy was eventually eliminated in favor of a focus on content mastery, but it may be why some districts still tie excess absences to failure, Taylor said in an email. 

  • Should I skip Thanksgiving if I feel sick?

    Should I skip Thanksgiving if I feel sick?

    By Rose Hoban

    The number of travelers on the move for the Thanksgiving holiday is up with airports expected to screen as many as 2.5 million passengers nationwide today, and possibly surpass that number on Sunday, Nov. 27, according to the federal Transportation Security Administration.

    “We expect to be busier this year than last year at this time, and probably very close to pre-pandemic levels,” said TSA Administrator David Pekoske. “We are prepared to handle the projected increase in travel volumes.”

    People are eager to get back to their holiday rituals after years of pandemic restrictions, but what happens if just as the holiday approaches, you find yourself sneezing, sniffling, coughing and maybe even testing positive for a COVID-19 infection? 

    “The name of the game for the last couple of years has been COVID, COVID, COVID. And now there’s a lot less masking and a lot less distancing,” said Laura Murray, an intensive care medicine specialist from the Cone Health Medical Group in Greensboro. “People are, you know, rejoicing and being in public together, maybe not being as careful about covering coughs or masking.”

    At this point in the pandemic, the worry is likely not so much about COVID, but about the other respiratory viruses that have been circulating with a vengeance. For older friends and family, or people who are immunocompromised, flu and RSV (respiratory syncytial virus) are real dangers.

    If you’re sick this week, it’s likely that you’ll be sick on turkey day. So, the question becomes, should you stay at home? Or go? And if you go, how should you act?  

    A surge in RSV, flu

    Pulmonologist Brad Drummond who works at the main UNC Hospital in Chapel Hill said there’s a steady trickle of coronavirus cases in the intensive care unit, but it’s only one or two beds out of 30. 

    “During the Delta wave, it was ‘you’re young and healthy and sick as stink,’” he told NC Health News last week. “The COVID that’s being admitted now is ‘you’re on chemo or have chronic immunocompromised condition.’”

    Instead, it’s Flu A that’s making people sick. To him, it felt like it was doubling every week. 

    He’s not far off. Positive flu tests went from being about two percent positive  reported to North Carolina’s hospital-based surveillance network in the beginning of October to being 27 percent positive in the week ending Nov. 12. 

    “Not all of them are hospitalized, but we’re seeing increased hospitalizations,” Drummond said. He noted this time of year is always busy because of the flu, but it’s been extra busy this year.

    “RSV really kicked in before Flu A,” he said. “It’s been up for several months, at a high steady rate, mostly in pediatrics cases and in some immunocompromised adults” 

    Pediatric RSV rates are so high that last week UNC Hospital opened up a pediatric surge ICU for the first time. UNC Health spokesman Alan Wolf said the system is experiencing “an overwhelming demand for more pediatric beds as UNC Children’s Hospital in Chapel Hill is currently at capacity due to high RSV and flu volumes.”

    At UNC Hospitals in Chapel Hill last week, Wolf said they confirmed about 430 flu cases as well as 185 RSV cases.

    RSV is the most common cause of pneumonia among infants and it’s the leading cause of pneumonia deaths for babies in the first six months of life. The disease makes a child very sick because their airways are small and easily compromised. 

    The respiratory virus can also make an adult pretty sick, especially older adults and people who are immunocompromised, and can lead to pneumonia, especially if the person has asthma or chronic respiratory or heart problems. 

    Unlike COVID-19, though, which often came with few or no symptoms, people who have flu or RSV feel and appear sick. So, that’s a signal to perhaps mask up, isolate and stay home from work and school. 

    Or a holiday meal.

    Cloud of protection’

    Murray said part of the answer to the question of what to do about the holidays depends on who is going to be sitting around the table. If there is an older relative in attendance who might be at risk, then it’s time to ask other guests about their health, like that relative with a new cough.

    “If he’s coughing, or he’s got some new respiratory infection, or symptoms, you could suggest that he not come or that we keep a distance if he comes,” she said. “You could, as a host, have a conversation with more or less success, but you could at least put it out there.” 

    Murray said that vulnerable family members also have to weigh the risks of attending  a Thanksgiving dinner against their desire to see people after a long two years.

    “There’s some give and take there about what the host’s role could be, what the vulnerable person’s role could be, and what the person who has potentially an infection’s role is,” Murray said.

    She and Drummond both noted that for many of the people who end up in an ICU with an RSV infection or flu, it’s the underlying diseases that are the primary causes of serious illness.

    When it comes to COVID infections, people who are immunocompromised have reason to remain concerned. Newer variants of the virus are less responsive to some of the monoclonal antibodies that have successfully been used to provide both preexposure prophylaxis (Evusheld) or post-exposure treatment. In many parts of the country, these treatments are becoming less and less effective.

    For Shmuel Shoham, a professor from the Johns Hopkins University School of Medicine, there’s still enough oomph in the monoclonals to merit getting them for people with suppressed immune systems. 

    “Something like 30 percent to 40 percent of the variants that are out there are still susceptible to Evusheld,” he said during a webinar last week. “In my mind, a low toxicity drug that’s effective at 30 percent is better … than 0 percent.” 

    What Shoham suggested is creating a “cloud of protection” around people who are vulnerable, especially older people whose immune systems weaken with age or people on chemotherapy. That can include a combination of isolating and testing before seeing someone vulnerable, masking and social distancing, all familiar routines by now.

    “If you’re gonna hang out with grandma, no matter what, you’ve got to be careful, even if you’re fully vaccinated,” said David Wohl, an infectious disease specialist from UNC Health. “We know that the vaccines are really good at preventing us from getting really sick. We know that vaccines are pretty okay at preventing us from even getting infected, but they’re not perfect.”

    What about me? 

    For people who are vaccinated and worried, the risks from a COVID infection are diminishing. 

    But a lot still depends on overall health status. 

    “Part of the problem with advising folks is that everyone is a little bit different, and some people are a lot different,” Wohl said. “If you’re somebody who is unvaccinated, or hasn’t seen the pointy end of a vaccine in over a year, you might be more vulnerable to severe COVID 19 than people who are more recently vaccinated or more recently infected.” 

  • Can depression make you sick?

    Can depression make you sick?

    Despair is a widespread psychological health and fitness dysfunction that affects persons of all ages and backgrounds. It is also identified as significant depressive dysfunction, and it can lead to physical indications, which includes sickness.

    Even though the most frequent signs of depression are psychological, this sort of as sensation hopeless and unhappy, some individuals also working experience physical indications, this sort of as feeling unwell. These actual physical problems can be just as debilitating as temper-associated indicators and lead to every day troubles for quite a few persons.

    This write-up solutions the concern, “Can depression make you unwell?” and seems to be at other actual physical indicators of melancholy, as nicely as their cure and some purely natural treatments that could support.

    Melancholy can certainly bring about illness and influence an individual’s digestive health. Ordinarily, signs or symptoms of despair contain psychological concerns, but some people today can encounter cramps and digestive difficulties that do not have a clear induce.

    Gastrointestinal symptoms might arise due to the fact of the physical and chemical connection amongst the mind and the digestive program. Physicians may well contact this the intestine-brain axis. It is a bidirectional pathway, which means the intestines talk any problems to the mind, and the mind also communicates difficulties to the intestines.

    Experts have linked melancholy to a variety of digestive issues. For case in point, a substantial 2018 review involving more than 19,000 participants discovered that individuals with gastroesophageal reflux disorder (GERD) experienced elevated prices of anxiety and despair.

    GERD will cause the stomach contents to flow back again into the esophagus, primary to heartburn and soreness.

    Researchers also uncovered a link concerning irritable bowel syndrome (IBS) and depression. The soreness of IBS can also be very stress filled, and investigate suggests that 50–90{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of men and women searching for treatment method for IBS also have a psychiatric disorder these kinds of as stress and anxiety or melancholy.

    Besides gastrointestinal concerns, depression may well bring about other actual physical signs, these as:

    Ache

    People with melancholy may well expertise generalized pain that affects the joints, bones, or back again. However, researchers even now do not thoroughly understand the marriage involving soreness and depression, as men and women living with continual soreness may well come to be depressed, and men and women with despair might develop long-term pain.

    1 idea is that people dwelling with despair method suffering differently. A compact 2015 examine looked at this chance and observed that folks with key despair experienced decrease discomfort tolerances and thresholds.

    Interestingly, a 2017 study located that reduce back ache was immediately joined to melancholy. Exploration suggests that persons living with despair are 60{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} far more most likely to create back pain than individuals who are not depressed.

    Fat improvements

    Individuals with depression may possibly have problems retaining a average excess weight. Weight problems also looks to be typical among men and women with melancholy. In accordance to more mature information from the Centers for Disorder Management and Prevention (CDC), about 43{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of grownups with melancholy also experience weight problems.

    Professionals stay unsure of the precise marriage in between despair and bodyweight changes, given that depression is a danger component for being overweight and vice versa. Health professionals also feel that taking antidepressant treatment can lead to fat obtain.

    Conversely, other people today with depression may perhaps expertise a reduction in urge for food and subsequent pounds reduction.

    Immune method purpose problems

    Melancholy, anxiousness, and other psychiatric problems can raise the danger of issues with an individual’s immune process. Proof suggests that worry and depression impair the immune technique and deliver small-quality, long-term swelling that can increase an individual’s danger of infections, metabolic disorders, and most cancers.

    On top of that, folks with autoimmune issues these as rheumatoid arthritis, inflammatory bowel disease, and bronchial asthma have an elevated risk of melancholy.

    Medical doctors can typically deal with even serious circumstances of melancholy employing a combination of medicines and psychotherapy. On the other hand, if an individual’s signs do not make improvements to with this strategy, physicians could contemplate electroconvulsive treatment (ECT) and other brain stimulation selections.

    Drugs

    Health professionals prescribe antidepressants to improve an individual’s mood. A particular person may have to have to try out various antidepressants right before locating a single that performs and has the mildest facet results.

    These remedies normally consider up to a month to perform, and an unique could observe that their snooze, appetite, and focus difficulties make improvements to in advance of their temper. Hence, it is crucial to allow for antidepressants ample time to have a positive influence.

    Prevalent antidepressants involve:

    Psychotherapies

    Cognitive behavioral therapy (CBT) may perhaps support persons with depression by shifting how they consider and behave so they can greater handle their indicators. It aids men and women reprogram unfavorable imagined cycles and may support them control their thoughts.

    Find out extra about varieties of therapy here.

    Brain stimulation therapies

    If other strategies are unsuccessful in cutting down depressive indicators, medical professionals may look at electroconvulsive therapy (ECT). This form of remedy may perhaps deliver relief for persons with extreme melancholy.

    ECT is usually an outpatient technique requiring a brief interval of general anesthesia and muscle mass relaxant. It ordinarily consists of various classes, frequently three occasions weekly for up to four months. It is not a unpleasant course of action, and the personal are not able to experience the electrical pulses.

    Nevertheless, ECT may well trigger limited-expression aspect consequences, these as confusion and memory reduction. Even though, from time to time, these challenges continue on for an extended time.

    Persons may obtain that creating life-style modifications increases their depression. Attainable modifications contain:

    • rising bodily action degrees
    • working with mindfulness techniques these types of as yoga and meditation
    • lessening intake of liquor and caffeine
    • using tobacco less cigarettes or quitting entirely
    • enhancing slumber program
    • developing constructive, supportive associations
    • expending time in character

    The subsequent solutions may possibly also demonstrate beneficial to some persons residing with melancholy.

    Omega-3 polyunsaturated fatty acids

    Omega-3 vital fatty acids might simplicity mental overall health signs or symptoms, like despair. However, evidence supporting this dietary dietary supplement is slender. Though some investigate has observed promising evidence for omega-3 fatty acids in managing depression, some others identified no sizeable worth.

    That explained, the chance of utilizing these supplements is very low, so individuals could look at attempting them along with other melancholy therapies.

    Kava kava

    Kava kava is a plant-dependent classic medicine. It has attained popularity in the United States, with about 1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of grown ups employing it for despair, tension, anxiety, and irritation.

    If people today are using monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate), they should really not use kava as it may well boost the consequences. Whilst the interactions with other antidepressant medications are not known, persons really should normally check with their doctor’s assistance ahead of using kava kava.

    Animal treatment

    Analysis signifies that animal therapy can assist with signs and symptoms of panic and despair. Illustrations consist of equine-assisted psychotherapy (EAP), which helps boost people’s moods and modify detrimental behaviors by caring for and riding horses.

    Despite the fact that good scientific evidence is scarce, some reports display that this horse-centered therapy may well ease the signs or symptoms of despair and other psychiatric difficulties.

    If an specific experiences indicators of despair for two months or much more, they need to look for their doctor’s assistance. The physician may recommend drugs to boost their temper, and the earlier they get started remedy, the a lot more helpful it is.

    In addition, a health practitioner can accomplish actual physical examinations and checks to rule out other possible results in.

    Master a lot more about support teams for melancholy right here.

    While many people today take into consideration despair a psychological well being disease, it can result in physical symptoms, like sickness. Gurus have located backlinks among melancholy and a number of gastrointestinal disorders, this kind of as irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD).

    Medical practitioners take care of melancholy with a mix of remedies, this kind of as antidepressants, and therapies, these kinds of as cognitive behavioral treatment (CBT).

    Folks really should find their doctor’s assistance if they working experience symptoms of depression for more than two weeks. Their health practitioner can rule out any physical leads to and can endorse medication. Beginning treatment as before long as probable allows raise the probabilities of achievements.