Angela, My 82 year old father went to the hospital for stomach pain. He led a very active life, lived on his own and was very happy. He had COPD from working with asbestos and followed all his doctors instructions and was managing it well. While in the emergency room he was his normal self, talking and joking around with the doctors. They ran various test and determined his white cell was high and his lactic acid was elevated, as well as enlarged liver. They decided to admit him for further testing. Shortly after he was given IV fentanyl and Zofran, he then became confused and he broke out in a cold clammy sweat and was unable to respond. He remained this way for quite awhile, they then gave him another dose of fentanyl and Zofran then went into respiratory distress and was put on a breathing tube. He continued to receive IV fentanyl. He was also taking sertraline, which continued while hospitalized. His lactic acid and CO2 levels were off the charts and his protein levels increased everyday. His organs began to fail one by one and he became so septic that blisters formed on his skin. I did not know about serotonin syndrome until I looked into drug interactions, my father was taking sertraline on a regular basis, then given fentanyl and Zofran in the hospital, he went downhill in a matter of hours. The hospital came to me and asked if they could do a autopsy because they did not understand what happened to him. The results of the autopsy were high grade endocrine cancer of the liver, with bone marrow involvement. He was never diagnosed with cancer nor showed any symptoms. Liver cancer increases serotonin levels, then he was given fentanyl and Zofran while taking sertraline. If I know this, how come a team of doctors and nurses did not know what could happen when these drugs are given together. I believed his death was from serotonin syndrome.

There are many diseases that need extra attention and care. Some of them are also known as "silent killers" for the very reason that they can become severe at any given point of time, sometimes even leading to sudden death. That said, to help you stay vigilant and to be on guard, here are some health conditions that kill you silently. Also, read on to find out how you can prevent or manage it.


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Sleep apnea is a severe sleep disorder where people breathe loudly while sleeping. It can lead to loud snores, extreme tiredness during the day and more. Patients with severe sleep apnea are more prone and vulnerable to sudden deaths and stroke during sleep, which also makes it a silent killer. Obstructive sleep apnea is the most common type, where in your airways repeatedly become completely or partially blocked during sleep.

Other countries were quick to take note of the American success, and those that could afford it swiftly put DDT into action. In Europe, malaria was virtually eradicated by the mid-1950s. South African cases of malaria quickly dropped by 80 percent; Ceylon (now Sri Lanka) reduced its malaria incidence from 2.8 million in 1946 to 17 in 1963; and India cut its malaria death rate almost to zero. In 1955, with financial backing from the United States, the U.N. World Health Organization launched a global campaign to use DDT to eradicate malaria. Implemented successfully across large areas of the developing world, this effort soon cut malaria rates in numerous countries in Latin America and Asia by 99 percent or better. Even for Africa, hope that the age-old scourge would be brought to an end appeared to be in sight.[13]

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related death in patients with refractory epilepsy. Convergent lines of evidence suggest that SUDEP occurs due to seizure induced perturbation of respiratory, cardiac, and electrocerebral function as well as potential predisposing factors. It is consistently observed that SUDEP happens more during the night and the early hours of the morning. The aim of this review is to discuss evidence from patient cases, clinical studies, and animal research which is pertinent to the nocturnality of SUDEP. There are a number of factors which might contribute to the nighttime predilection of SUDEP. These factors fall into four categories: influences of (1) being unwitnessed, (2) lying prone in bed, (3) sleep-wake state, and (4) circadian rhythms. During the night, seizures are more likely to be unwitnessed; therefore, it is less likely that another person would be able to administer a lifesaving intervention. Patients are more likely to be prone on a bed following a nocturnal seizure. Being prone in the accouterments of a bed during the postictal period might impair breathing and increase SUDEP risk. Sleep typically happens at night and seizures which emerge from sleep might be more dangerous. Lastly, there are circadian changes to physiology during the night which might facilitate SUDEP. These possible explanations for the nocturnality of SUDEP are not mutually exclusive. The increased rate of SUDEP during the night is likely multifactorial involving both situational factors, such as being without a witness and prone, and physiological changes due to the influence of sleep and circadian rhythms. Understanding the causal elements in the nocturnality of SUDEP may be critical to the development of effective preventive countermeasures. 2351a5e196

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