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Use Prescription Marijuana? No Transplant! May 27, 2008

Posted by Bob Aronson in Politics of organ donation.
1 comment so far

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Did you hear the story about the Seattle, Washington man who died after being denied a liver transplant because he used physician prescribed marijuana?

 

This horror story is just another effect of the failure of our “altruistic” organ donation system.  It hasn’t worked for twenty-four years and will not work in the next twenty-four, or fifty-four or a hundred-four.  To prevent this kind of discrimination we simply must change our approach to organ donation. Until we do, hospitals will continue to discriminate based on who they believe is the best candidate to receive a donated organ.  The best candidate, though, is not always the sickest candidate.      

 

56-year-old Timothy Garon, a Seattle, Washington resident, died after doctors refused to list him for a liver transplant.  The rejection, according to the hospital, was partly due to his use of medical marijuana.  Under federal law, marijuana is an illegal drug with no medical benefits.  Several states including Washington, Nevada, Oregon and California allow its use for medical purposes. Marijuana is often prescribed to ease the symptoms of glaucoma, diabetes, high blood pressure and AIDS.  The drug has also been shown to aid the appetites of patients who are not eating.
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Because transplant hospitals see federal law as superseding state law they can view marijuana as an illegal addictive drug and therefore refuse organ transplants for patients who use the medically prescribed substance..  So even if you are in a state where prescription marijuana is legal, transplant hospitals can view you as a habitual illegal drug user and deny you an organ transplant.  What?  

 

Ironically, the continued use of other addictive medicines like Oxycodone, do not automatically disqualify patients from transplant lists, because they are legal.  Wow, what convoluted logic.

 

I don’t know what kind of evidence is necessary for us to change the system to presumed consent and financial incentives (see my blog of May 13, 2008), but what more do we need?  Over 150,000 people have died because the current system could not provide them with needed organs.  Isn’t twenty-four years of failure evidence enough? 

Please read and comment on my World Wide Issues  blogs on http://blogsbybob.wordpress.com.   Also…visit my Facebook site, Organ Transplant Patients, Friends and You at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php 

Pay Up or Die! No Money No Transplant May 21, 2008

Posted by Bob Aronson in Paying for transplants.
2 comments

I’m angry!!!.  Many of our citizens are sick and dying because they can’t afford healthcare and our government is throwing money down ratholes wherever you look.  In the last quarter of a century, thousands of people needing transplants have died because they could not pay for the procedure.  Many of these good people were organ donors but when the time came for them to become recipients, they could not even get on the waiting list.  Is that what America is about?  Do we really want to say, “Sorry but no money no organ, you’ll just have to go home and die.”   Actually, our nation says much the same thing to anyone who can’t afford health care.  That is inexcusable!  Did you know that the United States is the only industrialized nation that doesn’t guarantee healthcare as a citizen’s right?  Do I sound as though I am in favor of a one-payer system – well, I am.

When suggestions are made that would end this disgraceful situation the response usually is, “It’s a raw deal but we just can’t afford to pay for everyone’s health care.”  Really?  How is it that we can’t afford to pay for transplants and other health care but we can pay for stupid “pork barrel” projects like Boston’s Big Dig.?  According to Wikipedia http://en.wikipedia.org/wiki/Pork_barrel):

The Big Dig in Boston cost $14.6 billion (over $4 billion a mile) to place a freeway underground.”  The boondoggle project resulted in criminal arrests, escalating costs, death, leaks and charges of poor execution and use of substandard materials.  You can read the Wikipedia explanation to get the full story but the Big Dig is not an isolated instance.  Each year we spend billions on so-called “Earmark” projects.

If we can grease the pockets of construction companies we can certainly make sure that anyone who needs a new organ can get it.  Why can’t people afford transplants?  The estimated costs for a heart transplant during the first post-operative year are $478,900, according to the health-care consulting firm Milliman USA.  Additionally there is the enormous cost of immunosuppressant medications that organ recipients have to take for the rest of their lives.   (More on transplantation costs at http://www.smu.edu/newsinfo/excerpts/cardiac-donation-ethics.html Southern Methodist University news).  If you don’t have insurance or cash you will likely be sent home to die, and that’s not the hospital’s fault.  Most of them spend millions each year for indigent care but they can’t pay for everyone’s treatment.   This is not a hospital problem rather, it is a societal issue.

At the very least our nation should provide catastrophic insurance for its citizens so whether the catastrophe is cancer, a heart attack or an organ transplant the ability to pay would no longer be a requirement for treatment.

Please read and comment on my World Wide Issues  blogs on http://blogsbybob.wordpress.com.   Also…visit my Facebook site, Organ Transplant Patients, Friends and You at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php

Cellular Memory — Organ Recipients With Characteristics of Donor May 19, 2008

Posted by Bob Aronson in Cellular Memory.
9 comments

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“A 47-year-old Caucasian male received a heart from a 17-year-old African-American male. The recipient was surprised by his new-found love of classical music. What he discovered later was that the donor, who loved classical music and played the violin, had died in a drive-by shooting, clutching his violin case to his chest.”

 

“An eight-year-old girl received the heart of a ten-year-old girl who had been murdered. After the transplant, the recipient had horrifying nightmares of a man murdering her donor. The dreams were so traumatic that psychiatric help was sought. The girl’s images were so specific that the psychiatrist and the mother notified the police. According to the psychiatrist, “. . .using the description from the little girl, they found the murderer. He was easily convicted with the evidence the patient provided”

 

Some people, including prominent scientists and researchers believe that each cell in your body contains a “memory” of your personality, likes and dislikes and even emotions.  So far, it appears as though this “memory” has found itself primarily in heart transplant patients but there are reports of cell memory in other transplant patients as well.  The evidence manifests itself in the transplant patient taking on some of the characteristics of the donor.

 

As you may know, I had a heart transplant eight months ago and while I do not dismiss the possibility of Cellular Memory I believe I am the same person I was prior to the surgery.  Additionally, of all the transplant patients I know, I have not heard any of them suggest that they have changed or had feelings that did not belong to them.

The examples quoted above come from a paper written by Leslie A. Takeuchi, BA, PTA, a physical therapist assistant and currently a graduate student in Holistic Health Education at John. F. Kennedy University in Orinda, California.  To read the full text go to: http://www.med.unc.edu/wellness/main/links/cellular%20memory.htm

According to Ms.Takeuchi’s paper, “Medical opinion is skeptical over whether organ recipients can gain more than just a lifeline from their transplants. But Gary Schwartz, a professor of medicine, neurology, psychiatry and surgery at the University of Arizona, says research by a team he leads has found definite links. He calls it ‘cellular memory’.

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He has documented 70 cases where he believes transplant recipients have inherited the traits of their donors.  Prof Schwartz said, “When the organ is placed in the recipient, the information and energy stored in the organ is passed on to the recipient. The theory applies to any organ that has cells that are interconnected. They could be kidneys, liver and even muscles.”

 

I like to think I am a practical person but I am also open minded and while the idea of Cellular Memory sounds a little “out there” to me I would like to know more.  What are your experiences readers?  If you have been an organ recipient do you feel as though you are different?  Have you heard any stories from other transplant patients who feel “different” as a result of the surgery.  All of us here would sure like to hear from you. 

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Please read and comment on my World Wide Issues  blogs on http://blogsbybob.wordpress.com.   Also…visit my Facebook site, Organ Transplant Patients, Friends and You at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php

 

 

 

 

 

Dead? Ambulance Crew Will Save Your Organs May 15, 2008

Posted by Bob Aronson in New Ideas.
2 comments

 

New York City may soon be using ambulance crews to increase the number of available organs for transplantation.  The nation’s largest city has a great idea.  I hope it spreads to other communities as well.  I know it is controversial but what new idea isn’t.  Vaccinations were controversial when first introduced, too.  I like this idea, and I hope you like it as well.

 

According to the plan, ambulance attendants would be trained to preserve the organs of people who die from cardiac arrest, but would do so only after all life saving efforts failed.  The controversial part of this idea is that the procedures used by the paramedics would be without permission from any family member.  One of the procedures, the insertion of an endotracheal tube in the patient’s trachea, is obviously invasive.  Following is what Bellvue Hospital, the New York City Fire Department and the New York Donor Network propose as proper procedures. (NYFD www.nyc.gov/html/fdny/html/home2.shtml

Bellevue Hospital www.nyc.gov/html/hhc/html/facilities/bellevue.shtml

NY Donor Network, www.nyodn.org)   

 

1.      Paramedics will start an IV and inject the blood thinner Heparin into the patient.. .

 

2.      Attendants will continue ventilating the patient through the endotracheal tube inserted into the patient’s trachea.  This is done to keep organs oxygenated.

 

3.      The ambulance crew will continue chest compressions, using an automated compression device to keep blood pumping through the potential donor and perfusing the organs.

 

4.      The ambulance will transport the body to the hospital, where further preservation measures can be taken and the family can be consulted about organ donation.    

 

You can expect an outpouring of criticism on this innovative idea.  USA TODAY (http://www.usatoday.com/news/health/2008-05-07-organ-donor-consent_N.htm) already received dozens of letters, both critical and supportive.  Many of the critical letters were based on inadequate information and unsupported claims.  I expect that will continue as more people learn of the New York City experiment.  Hats off to you Big Apple! 

Please read and comment on my World Wide Issues  blogs on http://blogsbybob.wordpress.com.   Also…visit my Facebook site, Organ Transplant Patients, Friends and You at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php

 

A Two-Tier Approach to Increase Organ Donation May 13, 2008

Posted by Bob Aronson in Presumed Consent.
6 comments

 

When a human organ is recovered and transplanted everyone involved gets paid, the physicians, the hospital and the OPO, and they deserve it.  The donor or donor’s family, however, gets nothing but a thank you. I have long  believed that the answer to the organ shortage is a combination of presumed consent and some sort of financial aid for living donors and for deceased donor’s families.

 

I will address both issues but first, presumed consent.  I fully endorse the policy proposed by David W. Courtney, an eminently qualified expert on the subject.  His full article and bio can be read at     http://www.trioweb.org/resources/YourChoiceFirstCourtney070107.pdf.  Presumed Consent is already in place in Austria, Belgium, Bulgaria, Czech Republic, Denmark, Finland, France, Greece, Hungary, Italy, Latvia, Luxembourg, Norway, Poland, Portugal, Singapore, Slovak Republic, Slovenia, Spain, Sweden, and Switzerland

 

Here is my edited version of Courtney’s proposal.  Again, I urge you to read the entire document.  According to Courtney, “Presumed Consent Policy in the US should be implemented with these four areas of integral capabilities:”

 

1) Notification, Education, and Awareness- Every adult will need to be formally notified of the law and given an opportunity to state their choice.

 

2) A Central Registry- The most reasonable is a national “opt-out” registry. In Europe only 2% opt out of the program, so it would be easier and less expensive to track those that opt-out than those that opt-in.

 

3) Program management- As an extension of the OPO’s, we need a Dr. or at least a nurse in every hospital with over 150 beds to coordinate and manage the program.

 

4) Oversight- We would have to guard against abuses. We don’t want a system that promotes “death mongers” and we don’t want a system that allows any one person or part to be ignored or fail.

 

Courtney goes on to say, “Our current system with the United Network for Organ Sharing (UNOS), our regionally located OPO’s, and the existing transplant centers can be utilized continuing their current roles. We would still need the OPO’s to provide procurement coordination and donor family services and UNOS could be utilized to maintain a confidential “opt out” registry to verify a potential donor’s wishes while continuing their current mission. Making a choice remains the most important part of this policy as no one should be ridiculed for their choice and every one is entitled to have their choice honored.”

 

Scott Carney, an investigative journalist based in Chennai, India, quotes Eric Johnson, professor of business at Columbia University and a proponent of presumed-consent policy, as saying,  “Research shows that there would be an increase of between 16 percent to 50 percent in the availability of organs, and others have speculated that this would eliminate the shortage of organs in some categories,”

http://www.wired.com/medtech/health/news/2007/05/india_transplants_donorpolicy

 

My support for the Courtney plan is strong, but I do not think his plan alone will accomplish the goal.  In order for us to greatly diminish or even eliminate the organ and tissue shortage, we need to implement a financial incentive program.  This, too, could be managed by UNOS.   

 

1.    Living donors should be provided adequate lifetime healthcare insurance.  While the donor’s surgery and care is currently financed by the recipients insurance, the donor is responsible for any complications that may appear later.  They shouldn’t have to bear that expense. 

 

2.    Families of deceased donors should receive an amount not to exceed $10,000 to be used only for funeral and related expenses.

 

These payments could be financed a number of ways.  One might be a small surcharge (50 cents) for all drivers’ licenses in the fifty states or we could also involve the private sector and/or utilize other fund raising efforts to help raise the money.        

 

I know full well that this two-tier approach will be difficult to accomplish and may take awhile.  But at least it offers a solution to an ever broadening problem.  Since 1984 the effort to obtain more transplantable organs and tissue has depended entirely on altruism, on people who will do the, “Right thing.”  We have been very patient as a nation but it is now twenty four years after the first donor registered and more people are dying on the waiting list than ever before, fewer than two out of 10 U.S. families donate the organs of relatives after death.

 

It is time that politicians, regulators, opinion leaders and ethicists opened their eyes to what’s happening.   As long as we cannot decide what to do, we will have decided to do nothing, and good people will continue to die. 

 

 

Please read and comment on my World Wide Issues  blogs on http://blogsbybob.wordpress.com.   Also…visit my Facebook site, Organ Transplant Patients, Friends and You at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php

 

I Said “NO” to Organ Donation — Don’t do the Same May 11, 2008

Posted by Bob Aronson in Organ Donation.
2 comments

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On Christmas of 1990 and New Years of 1991, my 77-year-old father, Art Aronson, was in intensive care at the University of Minnesota Hospital.  He had been rushed 200 miles in a snowstorm to Minneapolis after suffering a heart attack.  He also had severe emphysema.  He was immediately taken to surgery for a quadruple bypass, he remained unconscious for days when finally a physician called me aside and said that dad was brain dead. 

 

At that time, I knew nothing of organ donation.  I only knew my dad was gone.  Someone from the hospital asked if I would like to donate his organs and in my grief I said, “NO!”  No one from an OPO (Organ Procurement Organization) was there to explain as they do now, and the question was asked almost as though it was an afterthought.  I wrongly believed that “donation” meant his organs would go to a medical school to be studied by students. It seemed to me that there were plenty of dead people so they sure didn’t need dad’s organs. Isn’t it ironic that 16 years later I needed and got a heart transplant from a total stranger?

 

In 1991 as now, there was an organ shortage, not as severe, but a shortage just the same – people were dying because of it.  After my dad’s death, I forgot about the issue until I was hired a couple of years later as a communications consultant for UNOS (the United Network for Organ Sharing) the national organization that coordinates available organs with people who need them.  Slowly, I began to realize I had not only made a bad decision but that others may have been affected as a result. You see, you can be an organ donor at any age.  Even though my dad was 77, there might have been something, whether tissue or organs, he could have donated.

 

So when I hear people criticize others for not being organ donors I get incensed.  We should not be criticizing people who are not organ donors; we should be educating them and their families.  Let’s face it, when you are young and healthy, donating your organs after death is not only an unpleasant thought, it is considered to be so far in the future you can do it later.  Well, there is no “later” for people on the transplant list and when you are dead you don’t need your organs. 

 

I think I am an excellent example of an intelligent, concerned and informed human being but I still said “NO!”  I said it because I was not at all informed about organ donation and never thought it would affect me anyway.  Millions of people are in the same position and that’s why I get incensed when I hear phrases like, “Donors should get organs first.”  That attitude is wrong, cruel and inhumane.  I am an example of someone who said “NO” and then received a new heart.  What if your loved one was dying but neither she nor the family knew anything about donation and transplants.  Should she be denied an organ because she wasn’t a donor?  I think not. 

 

I know that OPOs do a great job of working with families at the time of brain death.  But when you are grieving, you are not always rational.  If everyone would register as an organ donor and tell their families their wishes, a lot of problems would be solved, and we would have many more organs and transplants.  Register today by visiting Donate Life America at http://donatelife.net/  UNOS at http://www.unos.org/ or your regional OPO.  And – when you get your drivers license renewed be sure you check the “donor” box.

 

Please don’t make the same mistake I did.  You will regret it forever.

 

Please read and comment on my World Wide Issues  blogs on http://blogsbybob.wordpress.com

 

Also…visit my Facebook site, Organ Transplant Patients, Friends and You at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php

Would You Give Up a Kidney for $47,000 U.S.? May 6, 2008

Posted by Bob Aronson in Donor Compensation.
1 comment so far

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THIS IS NOT AN OFFER TO BUY ORGANS – EFFORTS TO SELL ORGANS HERE WILL NOT BE PUBLISHED. 

 

While the organ shortage is bad here in the U.S. it is much worse in Australia where only 10 percent of its citizens become organ donors as compared to the U.S. where it is 27 percent.  In both cases, though, the gap between those who need organs and available organs grows wider each year causing the needless deaths of thousands of people worldwide, 7,000 in the U.S. alone.

 

Australian kidney specialist Gavin Carney proposes paying kidiney donors $47,000 U.S. for one of their two kidneys.  You can read the full Associated Press story at the following URL   

http://www.wtop.com/?nid=106&sid=1398289

He says, ”Allowing the sale of organs would save thousands of lives and billions of dollars in care for patients on transplant waiting lists. He also said it would stop people from buying organs on the black market in developing countries, where they pursue risky, unregulated surgeries.”   
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“I don’t support (illegal trade),” Carney said. “But I also do not agree with the fact that we should let people just rot on dialysis until they have been on dialysis so long they are untransplantable.”

Predictable, of course, was an outpouring of objections from the medical community and the ubiquitous ethicists.  None of them offered anything but criticism.  God forbid they should offer a solution; these people exist to object not to solve problems.

Fortunately, Thomas Mone who is certainly qualified to comment could at least see some merit to the idea.  (Mone is chief executive of OneLegacy, a non-profit organ procurement organization serving L.A. and six neighboring counties. He is also president of the Association of Organ Procurement Organizations, and is a director of the United Network for Organ Sharing.  He had many comments that you can read for yourself in his March 31, 2008 commentary in the Los Angeles Business Journal.  (http://www.entrepreneur.com/tradejournals/article/178189602.html)

Among other things he says, “It isn’t difficult to identify a stronger incentive. If potential donors were offered cold, hard cash and made aware that they can lead a normal life with a single kidney, there’s little doubt that the donation rate would be much higher.”

But to do so in this country would raise a number of concerns.

How much should be paid for a kidney -and who should pay it? The recipient, or the government, via Medicare? A payment of $5,000 would probably be sufficient to attract more than enough donors to erase the current shortage of 45,000 kidneys a year.

“Or,” he notes, “Instead of a fixed amount for the kidney itself, should the payment also cover expenses for hospitalization and recovery? And what about wages lost by the donor during the donation and recovery period? Should donors get guaranteed insurance coverage rather than cash?”

Mr. Mone points out the downside, too,  “…. there is little doubt that if payment for donation were permitted in this country, a huge percentage of the donors would be poor people. And if the recipients of kidneys, and not the government, were paying for them, the practice would be viewed by many Americans as allowing the rich to take advantage of the poor.”.  To avoid the risk of readers saying I took Mr. Mone out of context, I urge you to read the full commentary by clicking the URL link above.

He sums up his article by saying, “I believe the best way to proceed would be with small-scale pilot programs that offer donors lifetime insurance coverage and see what the effect would be.

If such programs do not indicate that there would be any negative effect on the national organ donation process, then the practice of paying for kidneys through insurance coverage and similar non-cash incentives should be allowed”.

Here is what I believe.  I think we have to change the current system to one of presumed consent tied to some form of compensation.  I like the idea of providing donors with free lifetime healthcare.  But even that may not be enough.

Thank you Mr. Mone.  Finally, a voice of reason from those in the health care industry

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BOBSERVATIONS — WHAT I LIKE AND WHAT MAKES ME TIRED May 1, 2008

Posted by Bob Aronson in Bobservations.
4 comments

I’m tired of people who say, “It can’t be done, it won’t work,” when it comes to presumed consent and/or an organ compensation program.  Why don’t you offer solutions instead of more problems?  If you can’t offer a solution, be quiet! 

 

I like OPOs (organ procurement organizations).  They do a wonderful job of trying to solve the organ shortage.  They are almost unknown and invisible.  They are some of the kindest most caring people I have ever met.  Thanks OPOs.

 

I’m tired of seeing LifeSharers go unchallenged.  The fact is LifeSharers has not saved a single member’s life.  In order to be effective LifeSharers would have to enroll about 85 percent of the 300 million Americans.  Currently they have 11,000 members.  If they quadrupled their current growth rate, it would still take 125 years for them to reach a million.  LifeSharers is a cruel fantasy.

 

I like blogging about organ donation.  I’ve learned a great deal and hope that in some small way someone has been helped.

 

I’m tired of politicians who are afraid to rock the boat.  If they had any guts and if they really cared about saving lives they would work to change the present organ donation system. Each year more people die and they make no attempt to change the system.  This one makes me tired and angry!

 

I like organ donors, donor families and organ transplant patients.  They are good and kind people.  I am moved every time I hear their stories and am so very grateful to my donor family.

 

I’m tired of the news media and their emphasis on Britney Spears, Paula Abdul and bloody crashes.  Why can’t they do more on organ donation, the problems of people without health care insurance and seniors who have to choose between taking medication and eating.  I don’t care about Britney!

 

I like MSNBC’s Morning Joe (www.morningjoe.com).  We’ll see if I still like Joe and Mika after the election when they’ll have to discuss other issues.  Maybe organ donation will be one of them. 

 

I’m tired of apathy.  If you are not an organ donor why not?  Give me one legitimate reason for not registering, just one reason.  

 

I’m tired of ethicists.  It seems all they ever do is to find more reasons we can’t change the organ donation system.

 

I like the Mayo Clinic.  They saved my life and treat me with respect.

 

 

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