The Mystery of Chronic Diseases: Understanding and Managing Long Term Illnesses
Siri Munnuluri
Chronic disease, according to CDC, is a broad term that pertains to conditions that last at least one year or more and require continuous medical attention; these diseases tend to limit activities of daily living. Chronic diseasesare the leading cause of illness, disability, and death in America. Some examples include heart disease, cancer, and diabetes. These chronic illnesses are the leading drivers of the nation’s $4.5 trillion in healthcare costs.
Characteristics of common chronic disease:
Complex causes
Many risk factors
Long latency periods
A long illness
Functional impairment or disability
These key factors help us understand that these diseases do not fix themselves, leading to the root problem.
Risk Factors:
Chronic diseases are generally caused by a short list of risk factors: smoking, poor nutrition, physical inactivity, and intense alcohol use.
Tobacco Use: Cigarette smoking leads to over 480,000 deaths each year in the U.S. Over 16,000,000 people in America are currently living with a disease caused by smoking. Smoking causes several chronic illnesses: cancer, heart disease, stroke, lung disease, diabetes, and chronic obstructive pulmonary disease.
Poor nutrition and physical inactivity: These two factors are significant risk factors for obesity and other chronic diseases such as type 2 diabetes, heart disease, stroke, cancers, and even depression.
Alcohol Use: Over time, excessive alcohol use can lead to serious problems including alcohol use disorder along with problems with learning, memory, and mental health. Chronic health conditions linked to intense alcohol use include high blood pressure, stroke, liver disease, heart disease, and some kinds of cancer.
In these diseases, some groups are more affected than others because of factors that limit their ability to make healthy choices for their body.
Background Risk Factors: age, sex, level of education, genetic composition, living location, and work.
Age: Older adults are disproportionately affected by chronic conditions, such as diabetes, arthritis, and heart disease. Nearly 95% have at least one chronic condition, and 80% have two or more. The leading causes of death among older adults in the U.S. include heart disease, cancer, COVID-19, stroke, chronic lower respiratory diseases, Alzheimer’s disease, and diabetes.
Sex: Statistics show U.S. men are more likely than women to die from heart disease, cancer and respiratory diseases; more specifically, they are more likely to die from chronic disease than women.
Living Location: some communities lack safe spaces like parks for people to be active, or grocery stores that sell fresh fruits and vegetables. On top of this, in some rural areas, it’s hard to get medical care because of doctor shortages, hospital closures, or long distances to medical care. This makes it difficult for them to get preventative screenings or professional care.
Examples of Common Chronic Disease:
Heart disease:
a. Coronary heart disease, along with stroke and blood vessel disease, is a part of a group of conditions known as “cardiovascular disease.” Coronary heart disease can occur when the arteries (supply blood and oxygen to your heart muscle) become clogged with fatty material known as plaque. This process is known as atherosclerosis. It can begin when you are young and can be well advanced by the time you reach middle age. If your arteries become blocked or too narrow, blood and oxygen cannot reach your heart and it can lead to symptoms like chest pain (angina). If a blood clot forms in the narrowed artery and blood supply to the heart, it can lead to heart attack. If this happens to the arteries supplying blood to the brain, it can cause a stroke.
b. Risk factors: tobacco smoking, poor diet, physical inactivity, obesity, and alcohol intake
Stroke:
a. A stroke is what happens when blood can’t get to all parts of your brain. Blood carries oxygen and nutrients for your brain cells. If the blood can’t get through, your brain can be injured. Your arteries can get blocked, which is known as an ischemic stroke. Or your arteries can break, which is known as an haemorrhagic stroke. Signs of a stroke include (use the acronym F.A.S.T.):
Face: Check their face; has their mouth drooped?
Arms: Can they lift both arms?
Speech: Are they speaking normally or is their speech slurred?
Time is CRITICAL; if you notice any of these symptoms, you need to call 911 immediately.
b. Risk factors: High blood pressure, high cholesterol, atrial fibrillation, diabetes, not being physically active, unhealthy eating, being overweight, drinking alcohol, smoking.
Cancer:
Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. It can start in any part of the body. In normal human bodies, cells grow and multiply through a process known as cell division to form new cells as the body needs them. When cells grow old or become damaged, they die and new cells take their place. Sometimes, however, this orderly process breaks down and abnormal or damaged cells grow and multiply when they shouldn’t be. These cells can form tumors, which are dangerous lumps of tissue. Tumors can be either cancerous or not cancerous. Cancerous tumors can invade nearby tissues and can travel to places in the body to form new tumors. A lot of cancers form solid tumors, but cancers of the blood, such as leukemias, tend to not.
Risk factors: Cancer is a special case when it comes to risk factors because very few cancers have a single known cause. Most, if not all, cancers seem to be caused by a complex mix of many risk factors, but sometimes cancer can even develop in people that don’t have these risk factors. Some of these risk factors include: getting older, smoking, not protecting yourself from the sun, having certain genetic changes, being overweight or obese, not having a healthy diet, not getting enough physical activity, drinking alcohol, coming into contact with harmful chemicals at home or at work, having certain types of infections.
Depression:
a. Depression affects how people think, feel, and act. Depression makes it difficult for one to manage oneself from day to day; it interferes with someone’s study, work, and relationships. Generally, depression is not a result from a single event, but from a combination of biological, psychological, social, and lifestyle factors.
b. Feelings caused by depression:
- Sadness, Misery, Unhappiness, Irritation, Overwhelmed, Guilt, Lack of confidence, Frustration, Indecisiveness, Inability to concentrate, disappointment
c. Behavioral symptoms:
- Withdraw from close family/friends, Stop going out, Stop their usual activities that give them joy, Not getting things done for work/school, Rely on alcohol or drugs as a coping mechanism
d. Personal factors:
- Family History: depression can run in families so there is a genetic risk
- Personality: people that tend to worry a lot, have low self-esteem, are perfectionists, are sensitive to personal criticism, or are self-critical and negative.
- Serious medical conditions: they can bring out depression directly or they can contribute to depression through the associated worry and distress.
- Drug and alcohol abuse.
- Life events: long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness or prolonged exposure to stress at work can lead to depression.
Type 2 diabetes:
Diabetes is a condition where there is too much glucose in the blood; this is a major problem. The body uses glucose as its main source of energy. Glucose can come from carbohydrates. Once the food is digested, the glucose is released and absorbed into the bloodstream. We always need to have a certain level of glucose in our body. Insulin is a hormone made by the pancreas; it lowers blood glucose levels by moving glucose from the blood into the muscle cells by opening the glucose channels. Type 2 diabetes happens when the cells do not respond to insulin properly and the pancreas doesn't produce enough insulin for the body’s increased needs. If the insulin does not work properly, the glucose builds up in the blood rather than getting to the cells for energy.
Symptoms:
Extreme thirst
Excessive urination
Lethargy
Slow-healing wounds
Recurring infection
Blurred vision
c. Risk factors:
Pre-diabetes
Aboriginal and torres strait islander people
People of high risk ethnicities
People aged 40 and older
High blood pressure
People with a first degree relative with type 2 diabetes
People with cardiovascular disease
Women with polycystic ovary syndrome
Women who have had gestational diabetes
People aged 55 or over
People taking certain antipsychotic medication or corticosteroid medication
Overweight individuals
Low levels of physical activity
Unhealthy eating habits
Cigarette smoking
High cholesterol levels
Arthritis:
Arthritis is a general term for over 150 different conditions. The term for this group is “musculoskeletal conditions.” These conditions affect the muscles, bones, and joints. Some common conditions that fall under this category include osteoarthritic, back pain, rheumatoid arthritis, fibromyalgia, osteoporosis, gout, polymyalgia, rheumatica, lupus and ankylosing spondylitis.
Symptoms:
Pain
Swelling, redness, and warmth in a joint
Muscular aches and pain
Stiffness or reduced movement of a joint
General symptoms such as fatigue and feeling unwell
Risk factors: It is important to note that anyone can get arthritis.
Women are more likely to develop osteoarthritis, rheumatoid arthritis, and fibromyalgia than men.
Men are more likely to develop gout than women.
Older adults
People with a family history of arthritis
People with obesity
Smoking
Infections
Joint injury
Osteoporosis:
It is a condition in which your bones have holes in them; the bones lose minerals such as calcium more quickly than the body can replace them. They become less dense, lose strength, and are a lot more prone to breaking.
Risk factors: inadequate amounts of calcium intake, low vitamin D levels, cigarette smoking, alcohol, lack of physical activity, early menopause.
Asthma:
Asthma is what happens when the muscles in the airways tighten and the airway becomes inflamed and swollen, creating a sticky mucus. These changes lead the airways to becoming narrow, leading to difficulty breathing. It can be triggered by several factors such as pollen, house dust mites, cigarette smoke, exercise, or even a common cold. The symptoms worsen at night, in the early morning, or during exercise. Symptoms include:
Wheezing
Shortness of breath
A tight feeling in the chest
Coughing
Risk factors: family history, allergies, viral respiratory infections, occupational exposures, smoking, air pollution, obesity
Chronic obstructive pulmonary disease (COPD):
COPD is a collective term for a number of lung diseases that prevent proper breathing/ventilation. Three of the most common COPD conditions are emphysema, chronic bronchitis and chronic asthma. Symptoms include:
Breathlessness after exertion
Wheezing
Coughing
Coughing up sputum
Fatigue
cyanosis
Increased susceptibility to chest infections
Risk factors: cigarette smokers and ex-smokers are most at risk of COPD, longtime exposure to lung irritants, genes.
Chronic kidney disease:
Kidneys work as your body’s waste filtration system. Kidney disease is also known as a “silent disease” since there are often few or no symptoms. Some signs and symptoms include:
A change in the frequency/quantity of urine
Blood in your urine
Changes in the appearance of your urine
Puffiness around legs and ankles
Pain or burning when urine is passed
Pain in your back
High blood pressure
Tiredness
Generally feeling unwell
Loss of appetite
Nausea and vomiting
Shortness of breath
Itching
Bad breath and a metallic taste in the mouth
Risk factors: high blood pressure, diabetes, established heart problems, obesity, 60+ years of age, family history, smoking, aboriginal or Torres Strait Islander origin.
Treatment and Management:
Take your medicines as prescribed: taking the right dosage at the right time is crucial for bettering one’s health with a chronic disease.
Monitor your health at home: it is very important to consistently check your vitals.
Schedule regular checkups with your doctor.
Learn more about your condition and how to manage it: Self-management education programs. can help you learn skills to manage symptoms of your condition.
Get regular physical activity and eat well: help control your weight, decrease pain and improve function, improve your mental health, etc.
Prevention and Health Care Initiatives:
Talking to your GP (doctor) can prove to be beneficial, especially in the early stages of the illness. Immediately beginning preventative measures can help do wonders.
If it is your child that has the chronic illness, talking to your child’s school can be beneficial as well.
Support groups can help you feel safe; for example, the CCI (Center for Chronic Illness) promotes well-being and decreases isolation for those impacted by chronic illness through support and education.
Mental Health Foundation and the National Mental Health Helpline can certainly be valuable in terms of mental chronic illness.
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