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Depression and Bipolar Support Alliance

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If you have severe symptoms of an illness like depression or bipolar disorder, a brief stay in the hospital can help you stabilize. This brochure is intended to help you through your hospitalization. Some ideas may be useful to you; some may not. Everyone’s experience in the hospital is different. Use only the suggestions that make sense to you and help you.

When do I need to go to the hospital?

You might need to go to the hospital if you:

How can hospitalization help?

What do I need to know about the hospital?

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Your time in the hospital

You might want to ask a loved one to help you go through hospital check-in procedures and fill out forms. Ask your loved one to help you communicate with hospital staff if needed.

You or a loved one may also want to call the hospital in advance to find out about check-in procedures and items you can bring. Ask if you can bring music, soap, lotion, pillows, stuffed animals, books or other things that comfort you. Find out about visiting hours and telephone access. Be sure your family and friends are aware of hospital procedures. Tell them what they can do to help you.

If you sign yourself into the hospital, you can also sign yourself out, unless the staff believes you are a danger to yourself or others. If you are not a danger, the hospital must release you within two to seven days, depending on your state’s laws. If you have problems getting the hospital to release you, contact your state’s Protection and Advocacy agency.

You have the right to have your treatment explained to you. You have the right to be informed of the benefits and risks of your treatment and to refuse treatment you feel is unsafe. You also have the right to be informed about any tests or exams you are given and to refuse any procedures you feel are unnecessary, such as a gynecological exam or other invasive procedures. In addition, you have the right to refuse to be part of experimental treatments or training sessions that involve students or observers. Make sure the people treating you know your needs and preferences.

It may take time to get used to the routine in the hospital. If your symptoms are severe, some things may not make sense to you. Try to get what you can out of the activities. Concentrate on your own mental health. Listen to what others have to say in groups. Keep a journal of your own thoughts and feelings.

You will meet other people who are working to overcome their own problems. Treat them with courtesy and respect, regardless of what they may say or do. If someone is making you feel uncomfortable or unsafe, tell a staff member. Make the most of your time with your doctor. Make a list of questions you have. Ask your family or other hospital staff to help you with the list. Let your doctor and staff know about any other illnesses you have or medications you take. Be sure you receive your medications for other illnesses along with the medications for your depression or bipolar disorder.

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Wellness after hospitalization

Before you leave the hospital, make sure you have a written list of what medications to take, what dosage, and when to take them. Find out if there are any foods, medications (prescription, over-the-counter, or herbal) or activities you need to avoid while taking your medication, and write these things down. Track your medications and moods.

Talk to your doctor about new treatments you might want to try. Find out what to expect from treatments and how you know if your treatment is working. If you think you could be doing better, ask another doctor for a second opinion.

You might not feel better immediately. Allow yourself to slowly, gradually get back to your routine. Give yourself credit for doing small things like getting out of bed, dressing or having a meal.

and concentrate on one thing at a time. Write things down or ask friends and family to help you to keep from becoming overwhelmed.

Take time to relax. If you feel stressed or exhausted, you can say no or cancel plans. Schedule time to care for yourself and relax, meditate, take a long bath, listen to music, or do something else that is just for you.

Know that you can get well. If you were manic, you may not feel as productive as you felt before. But you will have a more stable and safe mood, which will help you be more productive over the long term.

Go to your health care appointments, therapy and support groups. Be patient as you wait for medication to take effect. You may have some side effects at first. If they continue for more than two weeks, talk to your doctor about changing your medication, your dosage, or the time you take your medication. Never change or stop your medication without first talking with your doctor.

Feeling very discouraged, hopeless, or irritable can be symptoms of your illness. If you feel very angry, your mind starts to race, or you start to think about hurting yourself, stop, think, and call someone who can help. Keep a list of your triggers and warning signs, along with a list of people you can call for help.

Your family and friends may be unsure of how to act around you at first. There may also be hurt feelings or apologies that need to be made because of things you may have done while in mania or depression. Show that you want to get well by sticking with your treatment. Encourage your loved ones to get support from a DBSA support group if they need it.

Ask for what you need. Tell them specific things they can do to help you. If you need help such as housework, rides, or wake-up calls, ask.

Explain to your supervisor and co-workers that you have been ill and you need to take things slowly. You don’t have to talk about your depression or bipolar disorder. If someone asks questions, politely but firmly tell them you don’t want to talk about it. Do your best at work. Try not to take on too much. On breaks, call a friend or family member to check in.

from people who have had similar experiences and are feeling better. Connect with a hospital aftercare group or DBSA group.

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How can I find people who understand?

DBSA support groups are groups of people with mood disorders, their families and their friends who meet to share experience, discuss coping skills and offer hope to one another in a safe and confidential environment. People who go to DBSA groups say the groups:

People who had been attending DBSA groups for more than a year were less likely to have been hospitalized for their illness during that year, according to a DBSA survey.

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How can I be prepared for a crisis in the future?

Make a crisis planning list. Briefly describe the kind of help you would like to receive if you have severe symptoms again. Include:

How can an advance directive or a medical power of attorney help me?

An advance directive and a medical power of attorney are written documents in which you give another person authority to make treatment decisions for you if you are too ill to make your own. It is best to consult a qualified attorney to help you put together an advance directive or medical power of attorney. These documents work differently in different states.

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Resources

Bazelon Center for Mental Health Law (Provides information but does not give individual legal advice.) (202) 467-5730 http://www.bazelon.org/

National Association of Protection and Advocacy (202) 408-9514 http://www.napas.org/

Treatment Advocacy Center (Explains each state’s hospitalization laws) (703) 294-6001 http://www.treatmentadvocacycenter.org/

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Edwards A , Elwyn G, Hood K, . The development of COMRADE: a patient-based outcome measure to evaluate the effectiveness of risk communication and treatment decision making in consultations. 2002 (in press).
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James

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I had a booking made on 15th December for arrival 16th December and processed a R 4500 deposit which went through. During a call from the guest he instructed me to do the balance later on the same day.

The guest name was different to that of the International card holder so on the 11th January i received a charge back request as it was claimed that the R 4500 didnt have the cardholder authorisation. I couldnt get an imprint as the card wasnt present on site and despite submitting the Booking.com reservation form, a paraphased letter from booking.com to the bank as well as my room list as, the chargeback was processed. As it was a international cardholder, the banks would contact the disputer, i then asked Booking.com for a contact number for the booker to which i was told that they no longer have those details on their database ( 25 Days after the booking). According to the Bank, this is a common issue with booking.com means of obtaining payment details but their system lacks the secure payment verification as with on-line shopping.

I am R 4500 out of pocket and booking.com states that they are merely the conduit between Guest Hotel and washed their hands of the problem. Yet they still expect me to pay the full commission on a disputed transaction, no calls from the channel manager or anybody from Booking.com; just No reply emails

I am not paying a cent until i have had this matter resolved

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Carol

Hi James,

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When the kidneys are healthy, virtually no proteins pass out of the kidneys and into the urine. However, if a person’s kidneys become diseased or damaged, they are less able to leave the proteins behind. Urine protein test screens for the presence of these proteins.

A urine protein test is a screening test to look for the presence of proteins in the urine. One of these proteins is called albumin.

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Proteins are the "building blocks" of the body that also perform other vital functions such as nourishing tissues; transporting hormones, vitamins, and other essential nutrients; and keeping the proper amount of fluids circulating through the body. When the kidneys are healthy, virtually no proteins pass out of the kidneys and into the urine (only waste products circulating in the blood are removed). However, if a person's kidneys become diseased or damaged, they are less able to leave the proteins behind, and some proteins begin to filter through and appear in the urine.

Albumin is a type of protein found in large amounts in the blood. Because it is a small molecule in size, it is one of the first proteins able to pass through the kidneys into the urine when there are kidney problems. This presence of small amounts of albumin in the urine is the condition called microalbuminuria. As kidney damage progresses and the amount of albumin in the urine increases, the name of the condition changes from microalbuminuria to albuminuria or proteinuria.

In its early stages, there may be no noticeable signs or symptoms. As kidney function declines and large amounts of proteins are passing into the urine, swelling of the hands, feet, abdomen and face may occur. If albuminuria progresses, it may result in permanent kidney damage. In some patients, it might result in the need for dialysis or a kidney transplant. With or without symptoms, the only way to find out how much protein is passing into the urine is to test it.

Proteinuria is also associated with cardiovascular disease. Damaged blood vessels can lead to stroke and heart failure in addition to kidney disease.

People with certain chronic diseases -- including diabetes, hypertension, and other forms of kidney diseases -- are at risk for developing microalbuminuria/proteinuria. Other at-risk groups include African-Americans, American Indians, Hispanic-Americans, Pacific Islander Americans, older people, overweight people, and people with a family history of kidney disease.

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