(Family Features) When kidney cancer spreads or becomes advanced, it can be challenging to treat. Common signs and symptoms can include blood in urine, lower back pain on one side, a mass on the side or lower back, loss of appetite or unexplained weight loss.
While a diagnosis of advanced kidney cancer can be overwhelming, there are steps patients can take to feel more empowered as they face the disease, starting with learning about the treatments that may be available for them.
Exploring Your Options When facing advanced kidney cancer, it’s important for patients and caregivers to have open communication with their healthcare team to understand the diagnosis and establish a treatment plan.
Asking questions to understand where the cancer has spread, what the expected prognosis is and the potential benefits of treatment – including the possibility to live longer – can be critical to aligning on a path forward.
Fortunately, there are several types of medicines available for advanced kidney cancer today, depending on the specifics of each patient’s disease. Chemotherapy, targeted therapy or immunotherapy are a few types of treatment that may be considered, sometimes in combination. Immunotherapy works differently than chemotherapy or targeted therapy, as it helps a person’s own immune system to fight cancer and can enable the immune system to find and attack cancer cells. For some patients, dual immunotherapy – or a combination of two immunotherapy treatments – may be recommended.
For example, Opdivo (nivolumab) + Yervoy (ipilimumab) is approved by the U.S. Food and Drug Administration (FDA) as a combination of two immunotherapies for certain newly diagnosed adults whose kidney cancer (also referred to as renal cell carcinoma) has spread. It is not known if Opdivo is safe and effective in children younger than 18 years of age. Opdivo (10 mg/mL) and Yervoy (5 mg/mL) are injections for intravenous use.
This combination of two immunotherapies has the potential to work with the immune system in different but complementary ways to help fight cancer. While Yervoy may stimulate the kind of cells that help fight cancer, Opdivo may help these cells find and fight the cancer cells again.
While doing so, this immunotherapy combination can also affect healthy cells. These problems can sometimes become serious or life threatening and can lead to death. These problems may happen anytime during treatment or even after treatment has ended. You may have more than one of these problems at the same time. Some of these problems may happen more often when Opdivo is used in combination with Yervoy.
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Opdivo and Yervoy can cause problems that can sometimes become serious or life-threatening and can lead to death. Serious side effects may include lung problems; intestinal problems; liver problems; hormone gland problems; kidney problems; skin problems; eye problems; problems in other organs and tissues; severe infusion reactions; and complications of stem cell transplant, including graft-versus-host disease (GVHD), that uses donor stem cells (allogeneic). Call or see your healthcare provider right away for any new or worsening signs or symptoms. Please see additional Important Safety Information below.
Understanding Overall Survival One of the most important considerations for choosing a treatment is the potential for survival, or the chance to live longer. Overall survival is sometimes reported as a survival rate, which is the percentage of people in a clinical trial who are still alive for a certain time period after being diagnosed with or starting treatment for a disease, such as cancer.
“After my cancer diagnosis, my wife and I prayed about our future and pursuing every avenue with that goal in mind,” said Terry Broussard, who has been living with advanced kidney cancer. “I wanted a treatment that may give me a chance to live longer in order to see my youngest child graduate high school.”
Broussard’s doctor recommended treatment with Opdivo + Yervoy, which has overall survival data at five years. The FDA approval of this dual immunotherapy in advanced renal cell carcinoma (RCC) was based on results from the CheckMate -214 clinical trial, which included 847 previously untreated patients with kidney cancer that had spread and with one or more risk factors.
In the primary analysis at two years (25.2 months), the length of time patients lived without tumors worsening was 11.6 months for this immunotherapy combination and 8.4 months for sunitinib. There was no meaningful difference between the two treatments.
Researchers also assessed the overall response rate, which is a measure of the percentage of patients whose cancer shrunk (partial response) or disappeared completely (complete response) after treatment.
At the two-year time point, 41.6% of patients treated with Opdivo + Yervoy (95% CI:36.9-46.5) responded to treatment (n=177/425) versus 26.5% (n=112/422) of those treated with sunitinib (95% CI:22.4-31.0). Partial tumor shrinkage occurred in 32.2% of the patients treated with this immunotherapy combination compared to 25.4% of those treated with sunitinib. Tumors disappeared completely in 9.4% of patients treated with this immunotherapy combination versus in 1.2% of patients treated with sunitinib. The disappearance of any measurable tumors in response to treatment does not necessarily mean the cancer has been cured. Opdivo + Yervoy will not work for everyone. Individual results may vary.
“Advanced kidney cancer is a complex disease with many treatment options, which can feel overwhelming for people facing a devastating cancer diagnosis,” said Ulka Vaishampayan, M.D., professor, Internal Medicine, Division of Hematology/Oncology, University of Michigan. “The goal of treatment is to help patients live longer, and research like these five-year data gives us insight into what treatment with Opdivo + Yervoy may look like for patients from the trial over time.”
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The most common side effects of Opdivo, when used in combination with Yervoy, include: feeling tired; diarrhea; rash; itching; nausea; pain in muscles, bones, and joints; fever; cough; decreased appetite; vomiting; stomach-area (abdominal) pain; shortness of breath; upper respiratory tract infection; headache; low thyroid hormone levels (hypothyroidism); constipation; decreased weight; and dizziness.
Establishing and Leaning on a Support System From diagnosis to treatment and beyond, many patients find the support from family, friends and loved ones invaluable. Identifying a friend, spouse or caregiver who can join doctor appointments, ask questions and take notes can be a helpful way to track all the details that can often be overwhelming when facing cancer. “I’ve been incredibly lucky to have the support of my wife, children, nurses and doctors every step of the way,” said Broussard. “Even in the most challenging moments, knowing they were by my side gave me the hope and inspiration I needed to continue moving forward.”
Photo caption: Terry Broussard and his wife, Tracy. Broussard is an actual patient who has been compensated by Bristol Myers Squibb for his time.
INDICATION AND IMPORTANT SAFETY INFORMATION OPDIVO® (nivolumab) is a prescription medicine used in combination with YERVOY® (ipilimumab) to treat adults with kidney cancer in certain people when your cancer has spread (advanced renal cell carcinoma) and you have not already had treatment for your advanced RCC.
It is not known if OPDIVO is safe and effective in children younger than 18 years of age.
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Information provided in this article is not a substitute for talking with your healthcare professional. Your healthcare professional is the best source of information about your disease.
Important Safety Information for OPDIVO® (nivolumab) + YERVOY® (ipilimumab) What is the most important information I should know about OPDIVO + YERVOY? OPDIVO and YERVOY are medicines that may treat certain cancers by working with your immune system. OPDIVO and YERVOY can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. These problems may happen anytime during treatment or even after your treatment has ended. You may have more than one of these problems at the same time. Some of these problems may happen more often when OPDIVO is used in combination with another therapy.
What are the serious side effects of OPDIVO + YERVOY? Call or see your healthcare provider right away if you develop any new or worse signs or symptoms, including:
Lung problems: new or worsening cough; shortness of breath; chest pain
Intestinal problems: diarrhea (loose stools) or more frequent bowel movements than usual; stools that are black, tarry, sticky, or have blood or mucus; severe stomach-area (abdominal) pain or tenderness
Liver problems: yellowing of your skin or the whites of your eyes; severe nausea or vomiting; pain on the right side of your stomach area (abdomen); dark urine (tea colored); bleeding or bruising more easily than normal
Hormone gland problems: headaches that will not go away or unusual headaches; eye sensitivity to light; eye problems; rapid heart beat; increased sweating; extreme tiredness; weight gain or weight loss; feeling more hungry or thirsty than usual; urinating more often than usual; hair loss; feeling cold; constipation; your voice gets deeper; dizziness or fainting; changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness
Kidney problems: decrease in your amount of urine; blood in your urine; swelling in your ankles; loss of appetite
Skin problems: rash; itching; skin blistering or peeling; painful sores or ulcers in the mouth or nose, throat, or genital area
Eye problems: blurry vision, double vision, or other vision problems; eye pain or redness.
Problems can also happen in other organs and tissues. These are not all of the signs and symptoms of immune system problems that can happen with OPDIVO and YERVOY. Call or see your healthcare provider right away for any new or worsening signs or symptoms, which may include:
Chest pain; irregular heart beat; shortness of breath; swelling of ankles
Confusion; sleepiness; memory problems; changes in mood or behavior; stiff neck; balance problems; tingling or numbness of the arms or legs
Double vision; blurry vision; sensitivity to light; eye pain; changes in eye sight
Persistent or severe muscle pain or weakness; muscle cramps
Low red blood cells; bruising
Getting medical help right away may help keep these problems from becoming more serious. Your healthcare team will check you for these problems during treatment and may treat you with corticosteroid or hormone replacement medicines. Your healthcare team may also need to delay or completely stop your treatment if you have severe side effects.
Possible side effects of OPDIVO + YERVOY OPDIVO and OPDIVO + YERVOY can cause serious side effects, including:
See “What is the most important information I should know about OPDIVO + YERVOY?”
Severe infusion reactions. Tell your healthcare team right away if you get these symptoms during an infusion of OPDIVO or YERVOY: chills or shaking; itching or rash; flushing; shortness of breath or wheezing; dizziness; feel like passing out; fever; back or neck pain
Complications, including graft-versus-host disease (GVHD), of bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). These complications can be severe and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with OPDIVO or YERVOY. Your healthcare provider will monitor you for these complications.
The most common side effects of OPDIVO, when used in combination with YERVOY, include: feeling tired; diarrhea; rash; itching; nausea; pain in muscles, bones, and joints; fever; cough; decreased appetite; vomiting; stomach-area (abdominal) pain; shortness of breath; upper respiratory tract infection; headache; low thyroid hormone levels (hypothyroidism); constipation; decreased weight; and dizziness.
These are not all the possible side effects. For more information, ask your healthcare provider or pharmacist. You are encouraged to report side effects of prescription drugs to the FDA. Call 1-800-FDA- 1088.
Before receiving OPDIVO or YERVOY, tell your healthcare provider about all of your medical conditions, including if you:
have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus
have received an organ transplant
have received or plan to receive a stem cell transplant that uses donor stem cells (allogeneic)
have received radiation treatment to your chest area in the past and have received other medicines that are like OPDIVO
have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome
are pregnant or plan to become pregnant. OPDIVO and YERVOY can harm your unborn baby
are breastfeeding or plan to breastfeed. It is not known if OPDIVO or YERVOY passes into your breast milk. Do not breastfeed during treatment with OPDIVO or YERVOY and for 5 months after the last dose of OPDIVO or YERVOY.
Females who are able to become pregnant: Your healthcare provider should do a pregnancy test before you start receiving OPDIVO or YERVOY.
You should use an effective method of birth control during your treatment and for at least 5 months after the last dose of OPDIVO or YERVOY. Talk to your healthcare provider about birth control methods that you can use during this time.
Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with OPDIVO or YERVOY. You or your healthcare provider should contact Bristol-Myers Squibb at 1-844-593-7869 as soon as you become aware of a pregnancy.
Tell your healthcare provider about all the medicines you take, including prescription and over-the- counter medicines, vitamins, and herbal supplements.
Please see U.S. Full Prescribing Information and Medication Guide for OPDIVO and YERVOY.
Josh is a native Phoenician, lives in the west Valley with his wife, daughter and two sons. He has a BA in Management and 24 years of experience in Information Technology. Joshua also has multiple publications for IT education, which are used in universities around the world.
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Josh is a native Phoenician, lives in the west Valley with his wife, daughter and two sons. He has a BA in Management and 24 years of experience in Information Technology. Joshua also has multiple publications for IT education, which are used in universities around the world.
There is currently no bird flu vaccine for people.
Digicomphoto/ Science Photo Library via Getty ImagesHanna D. Paton, University of Iowa
The flu sickens millions of people in the U.S. every year, and the past year has been particularly tough. Although infections are trending downward, the Centers for Disease Control and Prevention has called the winter of 2024-2025 a “high severity” season with the highest hospitalization rate in 15 years.
Since early 2024, a different kind of flu called bird flu, formally known as avian influenza, has been spreading in birds as well as in cattle. The current bird flu outbreak has infected 70 Americans and caused two deaths as of April 8, 2025. Public health and infectious disease experts say the risk to people is currently low, but they have expressed concern that this strain of the bird flu virus may mutate to spread between people.
As a doctoral candidate in immunology, I study how pathogens that make us sick interact with our immune system. The viruses that cause seasonal flu and bird flu are distinct but still closely related. Understanding their similarities and differences can help people protect themselves and their loved ones.
What is influenza?
The flu has long been a threat to public health. The first recorded influenza pandemic occurred in 1518, but references to illnesses possibly caused by influenza stretch back as as early as 412 B.C., to a treatise called Of the Epidemics by the Greek physician Hippocrates.
Today, the World Health Organization estimates that the flu infects 1 billion people every year. Of these, 3 million to 5 million infections cause severe illness, and hundreds of thousands are fatal.
Influenza is part of a large family of viruses called orthomyxoviruses. This family contains several subtypes of influenza, referred to as A, B, C and D, which differ in their genetic makeup and in the types of infections they cause. Influenza A and B pose the largest threat to humans and can cause severe disease. Influenza C causes mild disease, and influenza D is not known to infect people. Since the turn of the 20th century, influenza A has caused four pandemics. Influenza B has never caused a pandemic.
A notice from Oct. 18, 1918, during the Spanish flu pandemic, about protecting yourself from infection.Illustrated Current News/National Library of Medicine, CC BY
An influenza A strain called H1N1 caused the famous 1918 Spanish flu pandemic, which killed about 50 million people worldwide. A related H1N1 virus was responsible for the most recent influenza A pandemic in 2009, commonly referred to as the swine flu pandemic. In that case, scientists believe multiple different types of influenza A virus mixed their genetic information to produce a new and especially virulent strain of the virus that infected more than 60 million people in the U.S. from April 12, 2009, to April 10, 2010, and caused huge losses to the agriculture and travel industries.
Both swine and avian influenza are strains of influenza A. Just as swine flu strains tend to infect pigs, avian flu strains tend to infect birds. But the potential for influenza A viruses that typically infect animals to cause pandemics in humans like the swine flu pandemic is why experts are concerned about the current avian influenza outbreak.
Seasonal flu versus bird flu
Different strains of influenza A and influenza B emerge each year from about October to May as seasonal flu. The CDC collects and analyzes data from public health and clinical labs to determine which strains are circulating through the population and in what proportions. For example, recent data shows that H1N1 and H3N2, both influenza A viruses, were responsible for the vast majority of cases this season. Standard tests for influenza generally determine whether illness is caused by an A or B strain, but not which strain specifically.
Officials at the Food and Drug Administration use this information to make strain recommendations for the following season’s influenza vaccine. Although the meeting at which FDA advisers were to decide the makeup of the 2026 flu vaccine was unexpectedly canceled in late February, the FDA still released its strain recommendations to manufacturers.
The recommendations do not include H5N1, the influenza A strain that causes avian flu. The number of strains that can be added into seasonal influenza vaccines is limited. Because cases of people infected with H5N1 are minimal, population-level vaccination is not currently necessary. As such, seasonal flu vaccines are not designed to protect against avian influenza. No commercially available human vaccines currently exist for avian influenza viruses.
How do people get bird flu?
Although H5N1 mainly infects birds, it occasionally infects people, too. Human cases, first reported in 1997 in Hong Kong, have primarily occurred in poultry farm workers or others who have interacted closely with infected birds.
Initially identified in China in 1996, the first major outbreak of H5 family avian flu occurred in North America in 2014-2015. This 2014 outbreak was caused by the H5N8 strain, a close relative of H5N1. The first H5N1 outbreak in North America began in 2021 when infected birds carried the virus across the ocean. It then ripped through poultry farms across the continent.
The H5N1 strain of influenza A generally infects birds but has infected people, too.NIAID and CDC/flickr, CC BY
In March 2024, epidemiologists identified H5N1 infections in cows on dairy farms. This is the first time that bird flu was reported to infect cows. Then, on April 1, 2024, health officials in Texas reported the first case of a person catching bird flu from infected cattle. This was the first time transmission of bird flu between mammals was documented.
As of March 21, 2025, there have been 988 human cases of H5N1 worldwide since 1997, about half of which resulted in death. The current outbreak in the U.S. accounts for 70 of those infections and one death. Importantly, there have been no reports of H5N1 spreading directly from one person to another.
Since avian flu is an influenza A strain, it would show up as positive on a standard rapid flu test. However, there is no evidence so far that avian flu is significantly contributing to current influenza cases. Specific testing is required to confirm that a person has avian flu. This testing is not done unless there is reason to believe the person was exposed to sick birds or other sources of infection.
How might avian flu become more dangerous?
As viruses replicate within the cells of their host, their genetic information can get copied incorrectly. Some of these genetic mutations cause no immediate differences, while others alter some key viral characteristics.
Influenza viruses mutate in a special way called reassortment, which occurs when multiple strains infect the same cell and trade pieces of their genome with one another, potentially creating new, unique strains. This process prolongs the time the virus can inhabit a host before an infection is cleared. Even a slight change in a strain of influenza can result in the immune system’s inability to recognize the virus. As a result, this process forces our immune systems to build new defenses instead of using immunity from previous infections.
Reassortment can also change how harmful strains are to their host and can even enable a strain to infect a different species of host. For example, strains that typically infect pigs or birds may acquire the ability to infect people. Influenza A can infect many different types of animals, including cattle, birds, pigs and horses. This means there are many strains that can intermingle to create novel strains that people’s immune systems have not encountered before – and are therefore not primed to fight.
It is possible for this type of transformation to also occur in H5N1. The CDC monitors which strains of flu are circulating in order prepare for that possibility. Additionally, the U.S. Department of Agriculture has a surveillance system for monitoring potential threats for spillover from birds and other animals, although this capacity may be at risk due to staff cuts in the department.
These systems are critical to ensure that public health officials have the most up-to-date information on the threat that H5N1 poses to public health and can take action as early as possible when a threat is evident.Hanna D. Paton, PhD Candidate in Immunology, University of Iowa
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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(Family Features) Throughout history, humans’ ability to rely on one another has been crucial to survival. Despite modern developments that help individuals live with minimal human engagement, the human need to connect remains.
However, in many parts of America, a trend toward isolation is emerging. Over the past two decades, people are spending more time alone and less time engaging with others in person, according to data from the Office of the U.S. Surgeon General. One segment of Americans at particular risk of social isolation, loneliness and their negative impacts are select populations who live in rural areas.
“There is an urgent need to take action and improve mental health in rural America,” said Jeff Winton, dairy farmer and founder and chairman of Rural Minds, a nonprofit mental health advocacy organization that partnered with Pfizer to raise awareness about the physical and mental risks of social isolation. “Challenges to mental health can be inherent in a rural lifestyle, including a belief in self-reliance as a virtue, fear of judgment and difficulty getting an appointment with a limited number of mental health professionals, among others.”
Many Americans are increasingly spending more time alone according to the American Time Use Survey. They are increasingly more likely to take meetings, shop, eat and enjoy entertainment at home, making it easier for them to stay within their own four walls and avoid social interactions.
Authentic human connection is a basic but often unacknowledged necessity for health, “as essential to survival as food, water and shelter,” according to the U.S. Surgeon General’s Advisory on the Health Effects of Social Connection and Community.
Understanding Social Isolation
According to the Centers for Disease Control and Prevention (CDC), about one-third of U.S. adults reported feeling lonely and about one-fourth said they don’t have social and emotional support (the basis of social isolation).
The concepts of social isolation and loneliness can go hand-in-hand, but the two are actually quite different.
Social isolation is defined by an absence of relationships or contact with others. Someone experiencing loneliness may or may not have social connections, but lacks feelings of closeness, support or belonging. Despite the distinction, both can have a negative impact on a person’s mental and even physical health.
Several factors can influence a person’s risk for social isolation and loneliness.
“Social connection is a dynamic that changes over time,” said Nikki Shaffer, senior director, occupational health and wellness, Pfizer. “Transient feelings of loneliness or solitude may be beneficial because they can serve as motivation to reconnect. However, chronic loneliness (even if someone is not isolated) and isolation (even if someone is not lonely) can represent significant health concerns.”
Isolation in Rural America
Compared to people who live in urban areas, many rural Americans experience higher rates of depression and suicide but are less likely to access mental health care services, according to the “Health Disparities in Rural America: Current Challenges and Future Solutions” study published in “Clinical Advisor.” What’s more, CDC data shows suicide rates among people living in rural areas can be 64-68% higher than those in large urban areas.
Rural areas have 20% fewer primary care providers compared to urban areas, according to a report in JAMA, and the Health Resources and Services Administration reports more than 25 million rural Americans, more than half of rural residents, live in mental health professional shortage areas.
Among rural counties, 65% lack a psychiatrist. Nearly 30% of rural Americans don’t have internet access in their homes, which complicates the option for telehealth. These figures from Rural Minds exemplify the challenges facing rural America.
“Some people in rural communities still don’t understand or accept that mental illness is a disease,” said Winton, who grew up on a rural farm. “Rather, a mental illness can often be viewed as a personal weakness or character flaw. A lot of the stigma around mental illness results in unwarranted shame, which adds to the burden for someone already suffering from mental illness.”
Health Impacts of Social Isolation
Loneliness is far more than just a bad feeling; it harms both individual and societal health. In fact, loneliness and social isolation can increase the risk for premature death by 26% and 29%, respectively.
Lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day or drinking six alcoholic drinks daily.
In addition, poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke.
Social isolation is also associated with increased risk for anxiety, depression and dementia. Additionally, a lack of social connection may increase susceptibility to viruses and respiratory illness.
Learn more about the impact of social isolation, especially on residents of rural areas, and the steps you can take to reduce isolation and loneliness by visiting ruralminds.org.
Boost Your Social Connections
Take a proactive approach to combatting social isolation and loneliness with these everyday actions that can promote stronger social ties.
Invest time in nurturing your relationships through consistent, frequent and high-quality engagement with others. Take time each day to reach out to a friend or family member.
Minimize distractions during conversation to increase the quality of the time you spend with others. For instance, don’t check your phone during meals with friends, important conversations and family time.
Seek out opportunities to serve and support others, either by helping your family, co-workers, friends or people in your community or by participating in community service.
Be responsive, supportive and practice gratitude. As you practice these behaviors, others are more likely to reciprocate, strengthening social bonds, improving relationship satisfaction and building social capital.
Participate in social and community groups such as religious, hobby, fitness, professional and community service organizations to help foster a sense of belonging, meaning and purpose.
Seek help during times of struggle with loneliness or isolation by reaching out to a family member, friend, counselor, health care provider or the 988 crisis line.
(Family Features) Many people don’t think much about whether their blood is clotting properly. However, when you have a bleeding disorder, a condition that affects the way your body controls clots, it’s no small matter.
According to the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, abnormal clotting can lead to a host of problems, including excessive bleeding after an injury or during surgery.
About 3 million people in the U.S. have bleeding disorders. Some types, such as hemophilia, are inherited, meaning a person who has it is born with it. Inherited bleeding disorders are caused by certain genes passed down from parents to children. These genes contain instructions for how to make proteins in the blood called clotting factors, which help blood clot. If there is a problem with one of these genes, such as a mutation – a change in the gene’s instructions – the body may make a clotting factor incorrectly or not make it at all.
You can also have what’s called an acquired bleeding disorder, meaning you develop it during your lifetime. Acquired bleeding disorders can be caused by medical conditions, medicines or something unknown. Your risk of developing a bleeding disorder depends on your age, family history, genes, sex, or other medical conditions. If bleeding disorders run in your family, you may have a higher risk of developing or inheriting one.
Symptoms of a bleeding disorder may appear soon after birth or develop later in life and can include:
Excessive bleeding or bruising, such as frequent or long nose bleeds (longer than 15 minutes) or frequent or long menstrual periods
Petechiae, which are tiny purple, red, or brown spots caused by bleeding under the skin
Redness, swelling, stiffness, or pain from bleeding into muscles or joints
Blood in urine or stool
Excessive umbilical stump bleeding
Excessive bleeding during surgery or after trauma
If you believe you, or someone you care for, may have a bleeding disorder, talk to a health care provider. Your provider may make a diagnosis based on symptoms, risk factors, family history, a physical exam, and diagnostic tests. Health care providers typically screen for bleeding disorders only if you have known risk factors or before certain surgeries.
How your bleeding disorder is treated depends on its type. If your disorder causes few or no symptoms, you may not need treatment. If you have symptoms, you may need daily treatment to prevent bleeding episodes, or you may need it only on certain occasions, such as when you have an accident or before a planned surgery.
If you have been diagnosed with a bleeding disorder, it’s important to be proactive about your health and follow your treatment plan. To lower your risk of complications:
A Story of Bravery, Balance, and a Bleeding Disorder
There are lots of things that make Mikey White Jr. special. He’s a dedicated athlete. He’s determined, disciplined, and optimistic. He’s also living with hemophilia, a type of bleeding disorder.
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White was diagnosed with hemophilia at age 3 after experiencing several severe bleeding episodes. He had to give up baseball and basketball, his passions, because of the high risk of injuries, but he found competitive swimming – and he’s been breaking records ever since.
“Competitive swimming is a noncontact sport, so it complements my hemophilia while still being an intense and rigorous sport,” White said.
Being an athlete with hemophilia requires support, White admits. He works with his healthcare team and coaching staff to make sure he safely manages his condition and balances it with his training. He hopes his story encourages others living with bleeding disorders to accept and appreciate their bodies the way they are.
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Hanna D. Paton, PhD Candidate in Immunology, University of Iowa
This article is republished from The Conversation under a Creative Commons license. Read the original article.
(Family Features) Throughout history, humans’ ability to rely on one another has been crucial to survival. Despite modern developments that help individuals live with minimal human engagement, the human need to connect remains.
However, in many parts of America, a trend toward isolation is emerging. Over the past two decades, people are spending more time alone and less time engaging with others in person, according to data from the Office of the U.S. Surgeon General. One segment of Americans at particular risk of social isolation, loneliness and their negative impacts are select populations who live in rural areas.
“There is an urgent need to take action and improve mental health in rural America,” said Jeff Winton, dairy farmer and founder and chairman of Rural Minds, a nonprofit mental health advocacy organization that partnered with Pfizer to raise awareness about the physical and mental risks of social isolation. “Challenges to mental health can be inherent in a rural lifestyle, including a belief in self-reliance as a virtue, fear of judgment and difficulty getting an appointment with a limited number of mental health professionals, among others.”
Many Americans are increasingly spending more time alone according to the American Time Use Survey. They are increasingly more likely to take meetings, shop, eat and enjoy entertainment at home, making it easier for them to stay within their own four walls and avoid social interactions.
Authentic human connection is a basic but often unacknowledged necessity for health, “as essential to survival as food, water and shelter,” according to the U.S. Surgeon General’s Advisory on the Health Effects of Social Connection and Community.
Understanding Social Isolation
According to the Centers for Disease Control and Prevention (CDC), about one-third of U.S. adults reported feeling lonely and about one-fourth said they don’t have social and emotional support (the basis of social isolation).
The concepts of social isolation and loneliness can go hand-in-hand, but the two are actually quite different.
Social isolation is defined by an absence of relationships or contact with others. Someone experiencing loneliness may or may not have social connections, but lacks feelings of closeness, support or belonging. Despite the distinction, both can have a negative impact on a person’s mental and even physical health.
Several factors can influence a person’s risk for social isolation and loneliness.
“Social connection is a dynamic that changes over time,” said Nikki Shaffer, senior director, occupational health and wellness, Pfizer. “Transient feelings of loneliness or solitude may be beneficial because they can serve as motivation to reconnect. However, chronic loneliness (even if someone is not isolated) and isolation (even if someone is not lonely) can represent significant health concerns.”
Isolation in Rural America
Compared to people who live in urban areas, many rural Americans experience higher rates of depression and suicide but are less likely to access mental health care services, according to the “Health Disparities in Rural America: Current Challenges and Future Solutions” study published in “Clinical Advisor.” What’s more, CDC data shows suicide rates among people living in rural areas can be 64-68% higher than those in large urban areas.
Rural areas have 20% fewer primary care providers compared to urban areas, according to a report in JAMA, and the Health Resources and Services Administration reports more than 25 million rural Americans, more than half of rural residents, live in mental health professional shortage areas.
Among rural counties, 65% lack a psychiatrist. Nearly 30% of rural Americans don’t have internet access in their homes, which complicates the option for telehealth. These figures from Rural Minds exemplify the challenges facing rural America.
“Some people in rural communities still don’t understand or accept that mental illness is a disease,” said Winton, who grew up on a rural farm. “Rather, a mental illness can often be viewed as a personal weakness or character flaw. A lot of the stigma around mental illness results in unwarranted shame, which adds to the burden for someone already suffering from mental illness.”
Health Impacts of Social Isolation
Loneliness is far more than just a bad feeling; it harms both individual and societal health. In fact, loneliness and social isolation can increase the risk for premature death by 26% and 29%, respectively.
Lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day or drinking six alcoholic drinks daily.
In addition, poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke.
Social isolation is also associated with increased risk for anxiety, depression and dementia. Additionally, a lack of social connection may increase susceptibility to viruses and respiratory illness.
Learn more about the impact of social isolation, especially on residents of rural areas, and the steps you can take to reduce isolation and loneliness by visiting 
