Author Archives: Bob Aronson

We Are Too Fat and It’s Killing Us. Obesity — America’s Number One Health Threat.


evolution of obesityBy Bob Aronson

Obesity may well be the greatest threat to public health ever, at least that’s the conclusion of a good many national and international health agencies ranging from the American Centers For Disease Control and Prevention (CDC) to the World Health Organization (WHO).

Too many people see obesity as a cosmetic problem and dismiss it as such.  It isn’t.  bad haircutA bad haircut is a cosmetic problem but a bad haircut never killed anyone.  Obesity can and does with great regularity.  Obesity is not about how you look, it is about slow suicide.

Before we get into the details it is important to define obesity.  According to the medical profession men are obese if fat makes up more than 25% of their body weight. Women are obese at more than 30% body fat.  In order to measure the percentage of body fat health professionals use a formula called the Body Mass Index (BMI).  It is based on height and weight (there is some controversy about the accuracy of BMI in some professional circles but that determination is best made by experts in the field and not by this author.  This link will give you more information http://healthland.time.com/2013/08/26/why-bmi-isnt-the-best-measure-for-weight-or-health/

The obesity epidemic is a fact, though, and will continue to be a problem regardless of how the BMI debate is settled).

  • A BMI of 18.5 to 24.9 is normal weight.bmi index
  • 25,0 ti 29.9 is overweight
  • 30.0 to 39.9 is obese
  • 40.0 and above is extremely obese

You can determine your BMI in private just by clicking on either of the two links below.

  1. If you want a simple BMI calculator click here. http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
  2. If you want a BMI that measures more and is more accurate, click here. http://www.healthstatus.com/calculate/body-fat-percentage-calculator

Studies indicate that nearly one in five US deaths is associated with obesity, which is nearly three times higher than previous estimates.  It is now thought that 34% of American adults are obese. Another 34% are overweight.

The preceding information is disturbing enough but even more upsetting is that fact that 17 percent of American children are obese. Another 15% are overweight.  That means that a third of our children have weight problems and you can bet that they will carry those problems into adulthood.

So – why worry about all of this, why is it important?  It is important because obesity kills. It kills just as sure as a 45 caliber bullet can kill, only it usually takes longer and the death can be painful and far more costly.  Bullets are usually mercifully quick.  Death by obesity is slower, much slower.  It creeps up on you, destroys your organs, debilitates, disables, depresses and costs far more than you can afford and then kills you anyway.  It is a long, hard and painful existence, but it can be avoided.  It’s not easy, but it can be avoided.

I am writing about obesity because it is a clear and present danger to everyone.  According to the National Institutes of Health (NIH) we run the risk of contracting any or all of the following when we ignore warnings about overweight and obesity..

Health Risks of Overweight and Obesity?

http://www.nhlbi.nih.gov/health/health-topics/topics/obe/risks

Being overweight or obese isn’t a cosmetic problem. These conditions greatly raise your risk for other health problems (this list has been edited.  To read all of it in detail click on the link above).

Coronary Heart Disease

As your body mass index rises, so does your risk for coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque (plak) builds up inside the coronary arteries and reduces blood flow to the heart thereby causing a heart attack or heart failure.

High Blood Pressureblood pressure cuff

Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.  Your chances of having high blood pressure are greater if you’re overweight or obese.

Stroke

Earlier we talked about a buildup of plaque in your arteries. Well, it can rupture, causing a blood clot to form and if that clot is close to the brain it can cause a stroke. The risk of having a stroke rises as BMI increases.

Type 2 Diabetes

Diabetes is a disease in which the body’s blood sugar, level is too high. In type 2 diabetes, the body’s cells don’t use insulin properly. Diabetes is a leading cause of early death, CHD, stroke, kidney disease, and blindness. Most people who have type 2 diabetes are overweight.

Metabolic Syndrome

Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.

A diagnosis of metabolic syndrome is made if you have at least three of the following risk factors:

  • A large waistline. This is called “having an apple shape.” Having extra fat in the waist area is a greater risk factor for CHD than having extra fat in other parts of the body, such as on the hips.
  • A higher than normal triglyceride level (or you’re on medicine to treat high triglycerides).
  • A lower than normal HDL cholesterol level (or you’re on medicine to treat low HDL cholesterol).
  • Higher than normal blood pressure (or you’re on medicine to treat high blood pressure).
  • Higher than normal fasting blood sugar (or you’re on medicine to treat diabetes).Being overweight or obese raises your risk for colon, breast, endometrial, and gallbladder cancers.Osteoarthritis is a common joint problem of the knees, hips, and lower back. The condition occurs if the tissue that protects the joints wears away. Extra weight can put more pressure and wear on joints, causing pain or broken bones.Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.Reproductive Problems
  • A person who has sleep apnea may have more fat stored around the neck. This can narrow the airway, making it hard to breathe.
  • Sleep Apneasleep apnea
  • Osteoarthritis
  • Cancer
  • Obesity can cause menstrual issues and infertility in women.

Dementia

  • Recent studies show that obesity is linked with brain atrophy. This increases the risk of dementia as people get older.

I think we have pretty well established that obesity can cause irreparable physical harm, but it can cause mental and emotional problems that is just as painful.  For example:

  • Obesity makes life more difficult. It is harder to tie your shoes, fit in an airplane seat, or find a mate.
  • Obese people are stigmatized by society. Many normal weight people look down on obese people.
  • Employers discriminate against obese people in hiring, pay increases, and promotions.
  • Obesity is a cause of depression in women.
  • Obese children rate their quality of life as being even lower than do children who have cancer.

Space does not allow for us to delve farther into adolescent or child obesity but it is a significant problem and we will tackle it in another separate blog.

So now we know about obesity and its effects.  Now let’s look into how we get that way and what can be done about it.

The problem and the solution to it seem simple.  All you have to do to maintain a healthy weight is to burn up as many calories as you take in. That’s not easy because some people burn calories at a different rate than others. The problem is that few pay any attention to the number or nature of the calories they consume.  Furthermore, even fewer people pay any attention to the trade-off of burning them up.

The secret to maintaining a healthy BMI is to be calorie conscious.  You should know what you are consuming and how much exercise or activity it takes to burn it off.  For example, if you go to a professional football game and eat just one of their hotdogs you will consume about 250 calories.  In order to get rid of 250 calories you would need to walk for about an hour (see calorie/exercise ing caloriescalculator and other calculators here  https://www.fitwatch.com  If this particular link does not satisfy you just Google calorie calculators and you’ll find dozens of free apps for your phone, tablet, PC or Mac).

Obesity does not come on overnight.  No one goes to bed fit and in good shape and awakens as a morbidly obese person.  The process is gradual and can be stopped at any point along the way if you do two things; 1) Eat right and 2)exercise.  That’s all, eat right and exercise.

Most of us live very busy lives and feel as though we don’t have time to cook so “Fast food” becomes a way of life, but there are faster healthy foods that you can prepare for yourself that won’t add inches to your waistline.  Try some of these or google “Healthy nutritious and fast food recipes” and you are bound to find something that appeals to you.  This site, for example, is very helpful. http://www.eatingwell.com/recipes_menus/collections/quick_healthy_dinner_recipes

Nearly everyone I know has some kind of a sweet tooth. Some have it more than others but almost everyone likes a little “Sweet” now and then and a little might be fine but we just don’t seem to be able to handle just a little.  Well, you’d better learn how.sugar

In September 2013, a bombshell report from Credit Suisse’s Research Institute brought into sharp focus the staggering health consequences of sugar on the health of Americans. The group revealed that approximately “30%–40% of healthcare expenditures in the USA go to help address issues that are closely tied to the excess consumption of sugar.”  The figures suggest that our national addiction to sugar runs us an incredible $1 trillion in healthcare costs each year. The Credit Suisse report highlighted several health conditions including coronary heart diseases, type II diabetes and metabolic syndrome, which numerous studies have linked to excessive sugar intake.

According to Medicine Net http://www.medicinenet.com/script/main/art.asp?articlekey=56589         Each American consumes one hundred and fifty-six pounds of added sugar.  That’s 31 five pound bags of sugar according to the U.S. Department of Agriculture (USDA). Imagine it: 31 five-pound bags for each of us.

In the U.S. diet, the major source of “added sugar” — not including naturally occurring sugars, like the fructose in fruit — is soft drinks. They account for 33% of all added sugars consumed, says Kristine Clark, PhD, RD, a spokeswoman for the Sugar Association. Clark is also director of sports nutrition in the athletic department of Penn State University.

Anne Alexander, editorial director of Prevention and author of The Sugar Smart Diet provided this explanation of what sugars can do to your body.

 Glucose

  • It seeps through the walls of your small intestine, triggering your pancreas to secrete insulin, a hormone that grabs glucose from your blood and delivers it to your cells to be used as energy.
  • But many sweet treats are loaded with so much glucose that it floods your body, lending you a quick and dirty high. Your brain counters by shooting out serotonin, a sleep-regulating hormone. Cue: sugar crash.
  • Insulin also blocks production of leptin, the “hunger hormone” that tells your brain that you’re full. The higher your insulin levels, the hungrier you will feel (even if you’ve just eaten a lot). Now in a simulated starvation mode, your brain directs your body to start storing glucose as belly fat.
  • Busy-beaver insulin is also surging in your brain, a phenomenon that could eventually lead to Alzheimer’s disease. Out of whack, your brain produces less dopamine, opening the door for cravings and addiction-like neurochemistry.
  • Still munching? Your pancreas has pumped out so much insulin that your cells have become resistant to the stuff; all that glucose is left floating in your bloodstream, causing prediabetes or, eventually, full-force diabetes.

Fructose

  • It, too, seeps through your small intestine into the bloodstream, which delivers fructose straight to your liver.
  • Your liver works to metabolize fructosei.e., turn it into something your body can use. But the organ is easily overwhelmed, especially if you have a raging sweet tooth. Over time, excess fructose can prompt globules of fat to grow throughout the liver, a process called lipogenesis, the precursor to nonalcoholic fatty liver disease.
  • Too much fructose also lowers HDL, or good cholesterol, and spurs the production of triglycerides, a type of fat that can migrate from the liver to the arteries, raising your risk for heart attack or stroke.
  • Your liver sends an S.O.S. for extra insulin (yep, the multi-tasker also aids liver function). Overwhelmed, your pancreas is now in overdrive, which can result in total-body inflammation that, in turn, puts you at even higher risk for obesity and diabetes Robert Lustig, an endocrinologist from California gained national attention after a lecture he gave titled “Sugar: The Bitter Truth” went viral in 2009.  www.youtube.com/watch?v=dBnniua6-oM

Fruit and Sugar substitutes

There are two questions associated with sugar that must be addressed, one has to do with the safety of sugar substitutes and the 2nd with fruit.

Stay away from sugar but eat more fruit! Huh?  Fruit is loaded with sugar so how can it possible be good for you?  Here is the definitive answer. EAT FRUIT! And here’s why.  While fruit does contain sugar it is digested and burned farfiber filled fruit differently than is the sweetener used in soft drinks, donuts, candy bars and cakes.  I could provide you with thousands of words on why fruit is good for you but you don’t need that.  What you need to know is this: it is almost impossible to over eat fructose by eating fruit.  If you need more details and the research behind the facts click on this link http://well.blogs.nytimes.com/2013/07/31/making-the-case-for-eating-fruit/?_r=0 Fruit can also help keep us from overeating according to Dr. David Ludwig, the director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital.  He says, “Unlike processed foods, which are usually digested in the first few feet of our intestines, fiber-rich fruit breaks down more slowly so it travels far longer through the digestive tract, triggering the satiety hormones that tend to cluster further down the small intestines.”

That brings us to the issue of artificial sweeteners.  There’s still a lot we don’t know about them and research is still being done but the scientific community generally believes that they are not harmful.  TStevia and other sweetenershey urge caution, though, and say that if you must have something sweet, go with the artificial variety preferably Stevia.  But, the jury is still out and its best to avoid all sweeteners if possible.  You can find more details in the report from CNN’s Dr. Sanjay Gupta.  http://www.everydayhealth.com/sanjay-gupta/myths-and-facts-about-sugar-substitutes.aspx

While there’s no medical evidence these sugar substitutes are dangerous, a recent study suggests they don’t guarantee weight loss either. Researchers from the Yale University School of Medicine found that eating foods with artificial sweeteners when we’re hungry or tired increases the likelihood of choosing higher-calorie foods later on.

“We still don’t fully understand the long-term effects of artificial sweeteners,” says Alexandra Kaplan Corwin, a registered dietician in the division of pediatric endocrinology and diabetes at The Children’s Hospital at Montefiore Medical Center in New York City. “Though the [U.S. Food and Drug Administration] has said they’re safe and the National Cancer Institute says they don’t cause cancer, we still don’t really know if there are long-term health consequences.”

Conclusion

 We’ve discussed obesity, it’s causes, the dangers of sugar and the advantages of eating more fruit.  Now the ultimate question, if you are obese, how do you lose that excess weight? Most experts will tell you that almost any program will help you lose weight.  The real trick, though, is losing it and keeping it off. It would be quite easy to list a number of diets and let you choose, but that would not be helpful because everyone’s condition is different.  We suggest that your very first step is to talk to your primary care physicians about the options he or she believes best suit you. Your physician knows your medical history and is far better able to make wise recommendations that the writer of a blog.  What I can say without fear of contradiction is that before you take on any weight loss program you must first assess your total medical condition. If you do not you could be headed for trouble. Your doctor will either make diet recommendations or direct you to someone who can.

Chances are that if you read this blog you are have more than a passing acquaintance with the Internet and will continue to do some research on your own on how to get rid of those excess pounds.  Well, we anticipated that and found one link in particular that might offer significant help. http://www.cdc.gov/healthyweight/index.html  Clicking here will lead you to scores of sites that can help you achieve the weight loss goals you seek. 

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New heart, new life, new man

Feeling better than ever at age 76

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org.  And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.  You can register to be a donor at http://www.donatelife.net.  It only takes a few minutes.

Bob’s NewHeart — The Impossible Dream


Bob Aronson:

As the group I founded, Facebook’s Organ Transplant Initiative (OTI) grows so do the number of questions that we get. There are so many people who are deathly ill and waiting for organ transplants and they all have a multitude of questions. That waiting period can be frightening because because patients really are forced to face their mortality.

My heart transplant was almost 8 years ago so while not an expert I have some experience that might interest both pre and post transplant patients.

Those awaiting organs want to know about “The call” how long I was on the list and whether recovery from the surgery was difficult.

Those who are new recipients are always interested in what lies ahead. I’m hoping this blog answers some of those questions.

Every transplant patient is different, our bodies, minds and conditions are different. My story speaks to my situation. I hope it helps others have a better understanding of what it’s like to be told you are dying and how it feels to get the “Gift of life.”

I wrote the following blog about two years ago. It is my story. I’d like to hear yours and would also appreciate any comments you choose to make.

Originally posted on Bob's NewHeart:

heart transplant cartoon

“Some men see things as they are and say why.  

I dream things that never were and say, why not”

George Bernard Shaw

This is post number 200 in the Bob’s Newheart Series of blogs on organ donation/transplantation and related issues

On February 17, 2014 I will turn 75.  It is an incredible feat for someone who abused his body as badly as I did.  By my count I have been dead three times. Once from sudden cardiac arrest, once during surgery in a hospital and I suppose once when they took my heart out to give me a new one (maybe that one doesn’t count).  I have to believe that I am only alive today because I was given a mission to do everything in my power to help others who face critical and/or life threatening illnesses.  The social media offer me that opportunity and I have gladly…

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From Farm to Fork — How Safe Is Our Food?


Food safety cartoonThe very food that we need to help us grow and live, could also cause us to become ill and die.   Food — we cannot live without it, but it can pose great danger.   Let’s look at cold hard reality.  Our food supply, our food storage systems and our cooking and eating habits may be responsible for a great deal of misery.  The Centers for Disease Control (CDC) estimates that contaminated food sickens approximately 76 million Americans, leading to some 325,000 hospitalizations and 5,000 deaths in the U.S. each year.

Food safety is particularly important to anyone with a take proactive measurescompromised immune system because we just don’t have the ability to fight infections whether they are bacterial or viral.  Certainly people who have had organ transplants fall into that category.  Transplant recipients must be especially careful.

As I started to research this posting the first question that popped into my mind was, “Which foods are most likely to make me sick. I found this list of the top ten from the Center for Science in the Public Interest as reprinted in the Fiscal Times

1) Leafy Greensleafy greens

Lettuce and spinach may be on the top of most nutritionists’ lists, but they’re also among the foods most linked to outbreaks of illness. The contaminations often starts at the farm through contact with wild animals or manure.

*Source: The Center for Science in the Public Interest

– See more at: http://www.thefiscaltimes.com/Media/Slideshow/2013/12/02/10-Foods-Most-Likely-Make-You-Sick#sthash.CTYjKR8I.dpuf

2) Eggs

The risk for salmonella makes eggs the second-most popular source of food-based illnesses. Consumers can protect themselves by fully cooking all eggs and eating or storing eggs promptly after cooking.

3) Tuna

tunaIf not properly stored immediately after being caught, tuna begins to decay and can release scrombotoxin, which can cause food poisoning.

4) Oysters

Raw or undercooked oysters can breed vibrio bacteria, which can cause mild food poisoning in healthy individuals and life-threatening illness among those with a weakened immune system. Best practices in preparing oysters is to discard any open shells before cooking, and any shells that didn’t open while cooking.

5) Potatoes

Baked potatoes become breeding grounds for botulism when they’re wrapped in foil and left out to cool too long. Unwrap potatoes after baking them, and store them in a cool, dark place before cooking.

6) Cheesecheese

Sticking with pasteurized cheese greatly reduces the risk of bacteria, but some soft cheeses—even those made with pasteurized cheese—are vulnerable to contamination during the cheese-making process.

7) Ice Cream

Everyone may scream for this summer treat, but when it’s made with undercooked eggs the cold stuff can become dangerous. Even store-bought ice cream can breed bacteria when it’s put back in the freezer after unfreezing.

8) Tomatoes

Salmonella can contaminate tomatoes on the farm via the roots, flowers or cracks in the skin. If an infected tomato is eaten raw, it has a high risk of infecting the person who consumers it.

9) Sprouts

utsThe humid settings ideal for cultivating sprouts are also model conditions for salmonella, listeria and E. Coli. The U.S. Department of Health and Human Services recommends that children, the elderly, pregnant women, and those with a weakened immune systems should avoid eating sprouts all together.

10) Berries

Strawberries, blackberries, and blueberries have been linked to a number of food-borne illness outbreaks in recent year. Last summer, a hepatitis A outbreak the sickened 150 people was traced back to frozen organic berries.

The Importance of Temperature

thermometerInadequate food temperature control is the most common factor contributing to food borne illness. Disease causing bacteria grow particularly well in foods high in protein such as meats, poultry, seafood, eggs, dairy products, cooked vegetables such as beans, and cooked cereal grains such as rice. Because of the high potential for rapid bacterial growth in these foods they are known as “potentially hazardous foods.”

Temperature Danger Zone

The temperature range at which bacteria grow best in potentially hazardous foods is between 41F. and 140F. The goal of all temperature controls is to either keep foods entirely out of this “danger zone” or to pass foods through this “danger zone” as quickly as possible.

So now you know which foods may pose the greatest threat to your health, but there are other factors that should concern us as well.  For example:

America’s food safety system has not been fundamentally modernized in more than 100 years.

Twenty states and D.C. did not meet or exceed the national average rate for being able to identify the pathogens responsible for foodborne disease outbreaks in their states.

Ensuring the public can quickly and safely receive medications during a major health emergency is one of the most serious challenges facing public health officials.  Sixteen states have purchased less than half of their share of federally-subsidized antivirals to use during a pandemic flu outbreak.

The main culprits are familiar. They include:

  • lmonellaSalmonella, bacteria that cause over 1.5 million illnesses per year. These commonly reside in uncooked poultry and eggs. Recent outbreaks have been linked to peanut butter, alfalfa sprouts and tomatoes.
  • E. coli 0157:H7, a dangerous bacterial strain that can cause kidney failure, turns up disproportionately in ground beef. Lately it’s been linked to spinach and pre-made cookie dough. (For a complete list, see the full report, which details also the geographical distribution of food-borne illnesses in the U.S.) You can read and learn more here http://tinyurl.com/k64har2

There are three types of hazards in a food manufacturing process: physical, chemical and biological. Foreign objects are the most obvious evidence of a contaminated product and are therefore most likely to be reported by production or by consumer complaints. However, they are also less likely than chemical or biological contaminants to affect large numbers of people.

Attributing illness to foods is a challenge for several reasons.  There are thousands of different foods, and we eat many varieties prepared in different ways, even in a single meal.  For the vast majority of foodborne illnesses, we simply don’t know which food is responsible for an illness.

One way to develop a fairly accurate estimate is to use  data collected during investigations of a food illness outbreak.   These investigations provide direct links between foodborne illnesses and which foods are responsible for them.

According to the National Institute of Allergies and Infectious Diseases, there are more than 250 known foodborne diseases. They can be caused by bacteria, viruses, or parasites. Natural and manufactured chemicals in food products also can make people sick. Some diseases are caused by toxins or poisons from the disease-causing microbe or germ, others are caused by your body’s reaction to the germ.

foodborne diseaseTypes of Foodborne Diseases as supplied by the National Institutes of Health (click on each one for details including symptoms and treatment or click this link for the NIH website http://www.niaid.nih.gov/)

Botulism, Campylobacteriosis, E. coli, Hepatitis A, Norovirus Infection, Salmonellosis, Shigellosis, Prevention

So how do you avoid these unpronounceable diseases?  Besides the information provided on the links to each disease, you might also want to make note of the following helpful suggestions

No matter how busy you are, from top to bottom, a clean kitchen is a main line of defense for your family and the prevention of food poisoning.  You simply must eliminate the breeding grounds for dangerous bacteria.

  •  Wash your hands often – front and back, between fingers, under fingernails – in warm soapy water for at least 20 seconds (or two choruses of “Happy Birthday”) before and after every step in preparing or eating foods. That includes your kitchen helpers, such as children.
  • Clean all work surfaces often to remove food particles and spills. Use hot, soapy water. Keep nonfood items – mail, newspapers, purses – off counters and away from food and utensils. Wash the counter carefully before and after food preparation.
  • wash dishesWash dishes and cookware in the dishwasher or in hot, soapy water, and always rinse them well. Remember that chipped plates and china can collect bacteria.
  • Change towels and dishcloths often and wash them in the hot cycle of your washing machine. Allow them to dry out between each use. If they are damp, they’re the perfect breeding ground for bacteria.
  • Throw out dirty sponges or sterilize them by rinsing the sponge and microwaving it for about two minutes while still wet. Be careful, the sponge will be hot.

Pay close attention to the refrigerator and the freezer – shelves, sides and door – where foods are stored. Pack perishables in coolers while you clean or defrost your refrigerator or freezer.

Splatters inside your microwave can also collect bacteria, so keep it clean.

Physical Hazards

We’ve talked a lot about diseases and illnesses but our health is also subject to physical hazards.  You can view a University of Nebraska Slide show on the subject here: http://tinyurl.com/k6k4qow

What is a physical hazard?

We’ve all heard the stories about Rocks, insects and other things showing up in soda and beer cans.  While those instances are rare, they still happen.  Any extraneous object or foreign matter in food which may cause illness or injury to a person consuming the product is a physical hazard. These objects include bone or bone chips, metal flakes or fragments, injection needles, BB’s or shotgun pellets, pieces of product packaging, stones, glass or wood fragments, insects, personal items, or any other foreign matter not normally found in food.

The 8 most common food categories implicated in reported foreign object complaints are bakery products, soft drinks, vegetables, infant’s foods, fruits, cereals, fishery products and chocolate and cocoa products.  Below you will find a list of hazards, their effect and the treatment.  You can find more detailed information by clicking on this link http://tinyurl.com/mbktawq

These materials have been found in food and can cause severe trauma, bleeding, cuts and even death.  In many cases surgery is required to correct the damage caused by; Glass, wood, stones, bullets, BBs, needles, jewelry, metal, .Insects and other contaminated material, building materials, bone, plastic and personal effects

As with any topic it is sometimes difficult to separate fact from fiction.  There are so many rumors, old Wives tales and myths people often think they are doing the right thing when in fact they may be making matters worse.  We can’t dispel all the rumors, but we can address a few.

Food Safety Myths Exposed

http://www.foodsafety.gov/keep/basics/myths/

We all do our best to serve our families food that’s safe and healthy, but some common myths about food safety might surprise you.

MYTH: Food poisoning isn’t that big of a deal. I just have to tough it out for a day or two and then it’s over.

FACT: Many people don’t know it, but some foodborne illnesses can actually lead to long-term health conditions, and 5,000 insectAmericans a year die from foodborne illness. Get the FACTs on long-term effects of food poisoning.

MYTH: It’s OK to thaw meat on the counter. Since it starts out frozen, bacteria isn’t really a problem.

FACT: Actually, bacteria grow surprisingly rapidly at room temperatures, so the counter is never a place you should thaw foods. Instead, thaw foods the right way.

MYTH When cleaning my kitchen, the more bleach I use, the better. More bleach kills more bacteria, so it’s safer for my family.

FACT: There is actually no advantage to using more bleach than needed. To clean kitchen surfaces effectively, use just one teaspoon of liquid, unscented bleach to one quart of water.

MYTH I don’t need to wash fruits or vegetables if I’m going to peel them.

FACT: Because it’s easy to transfer bacteria from the peel or rind you’re cutting to the inside of your fruits and veggies, it’simportant to wash all produce, even if you plan to peel it.

poultryMYTH: To get rid of any bacteria on my meat, poultry, or seafood, I should rinse off the juices with water first.

FACT: Actually, rinsing meat, poultry, or seafood with water can increase your chance of food poisoning by splashing juices (and any bacteria they might contain) onto your sink and counters. The best way to cook meat, poultry, or seafood safely is tomake sure you cook it to the right temperature.

MYTH: The only reason to let food sit after it’s been microwaved is to make sure you don’t burn yourself on food that’s too hot.

FACT: In FACT, letting microwaved food sit for a few minutes (“standing time”) helps your food cook more completely by allowing colder areas of food time to absorb heat from hotter areas of food.

MYTH: Leftovers are safe to eat until they smell bad.

FACT: The kinds of bacteria that cause food poisoning do not affect the look, smell, or taste of food. To be safe, use our Safe Storage Times chart to make sure you know the right time to throw food out.

MYTH: Once food has been cooked, all the bacteria have been killed, so I don’t need to worry once it’s “done.”

FACT: Actually, the possibility of bacterial growth actually increases after cooking, because the drop in temperature allows bacteria to thrive. This is why keeping cooked food warmed to the right temperature is critical for food safety.

MYTH: Marinades are acidic, which kills bacteria—so it’s OK to marinate foods on the counter.

FACT: Even in the presence of acidic marinade, bacteria can grow very rapidly at room temperatures. To marinate foods safely, it’s important to marinate them in the refrigerator.

MYTH: If I really want my produce to be safe, I should wash fruits and veggies with soap or detergent before I use them.

FACT: In FACT, it’s best not to use soaps or detergents on produce, since these products can linger on foods and are not safe for consumption. Using clean running water is actually the

cookie doughMYTH: Only kids eat raw cookie dough and cake batter. If we just keep kids away from the raw products when adults are baking, there won’t be a problem!

FACT: Just a lick can make you sick!
No one of any age should eat raw cookie dough or cake batter because it could contain germs that cause illness. Whether it’s pre-packaged or homemade, the heat from baking is required to kill germs that might be in the raw ingredients. The finished, baked, product is far safer – and tastes even better! So don’t do it! And remember, kids who eat raw cookie dough and cake batter are at greater risk of getting food poisoning than most adults are.

MYTH: When kids cook it is usually “heat and eat” snacks and foods in the microwave. They don’t have to worry about food safety – the microwaves kill the germs!

FACT: Microwaves aren’t magic!
It’s the heat the microwaves generate that kills the germs! Food cooked in a microwave needs to be heated to a safe internal temperature. Microwaves often heat food unevenly, leaving cold spots in food where germs can survive. Kids can use microwaves properly by carefully following package instructions. Even simple “heat and eat” snacks come with instructions that need to be followed to ensure a safe product. Use a food thermometer if the instructions tell you to!

MYTH: When kids wash their hands, just putting their hands under running water is enough to get the germs off.

How to wash handsFACT: Rubbing hands with water and soap is the best way to go!
Water is just part of what you need for clean hands! Washing hands properly is a great way to reduce the risk of food poisoning. Here’s how: Wet your hands with clean, running water and apply soap. Rub them together to make a lather and scrub them well; be sure to scrub the backs of hands, between fingers, and under nails. Continue rubbing for at least 20 seconds. Sing the “Happy Birthday” song twice to time yourself! Rinse hands well under running water. Dry your hands using a clean towel, paper towel, or an air dryer.

MYTH: My kids only eat pre-packaged fruits and veggies for snacks because those snacks don’t need to be washed before they eat them.

FACT: Read your way to food safety!
Giving your kids healthy snacks is a big plus for them! But just because produce is wrapped, it doesn’t always mean it’s ready to eat as is. Read the label of your product to make sure it is says: “ready-to-eat,” “washed,” or “triple washed.” If it does, you’re good to go! If it doesn’t, wash your hands and then rinse the fruits or vegetables under running tap water. Scrub firm items, such as melons and cucumbers, with a clean produce brush. Dry with a clean cloth towel or paper towel to further reduce germs that may be present.

While federal, state and local agencies provide a valuable service with their contributions to our food safety, the primary responsibility is yours.  Too many of us become too careless with our food preparation and storage procedures and each of us needs to pay far more attention to the cleanliness of the areas in which we prepare food and to the cleanliness of the food itself.

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bob minus Jay full shotBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org.  And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.  You can register to be a donor at http://www.donatelife.net.  It only takes a few minutes.

OPOs — the Quiet Angels


faith quoteYou rarely ever hear about them, they don’t really seek publicity and when they do talk they always give the credit for their life saving activities to others.  The “They” of which I’m speaking are Organ Procurement Organizations (OPOs).  They are the “Middle man” so to speak, they are the ones who make all the arrangements to get transplantable organs to the people who need them.

When the National Organ Transplant Act was signed into law in 1984 it directed that organ allocation would be managed on a national basis through a public-private partnership.  The United Network for Organ Sharing (UNOS) is the private non-profit agency that works under contract with the U.S. Department of Health and Human services to coordinate their national list of people who need transplants with available organs.  UNOS has its headquarters in Richmond, Virginia.

OPOs were also mandated by the 1984 act and there are 58 of them working on the local and regional level.  They are charged with two tasks. 1) increasing the number of registered donors, and 2) coordinating the donation process when actual donors become available.  When they learn of the availability of an organ or organs, OPOs evaluate the potential donors, check the deceased’s state donor registry, discuss donation with family members, contact UNOS, run a match list, and arrange for the recovery and transport of donated organs. They also provide bereavement support for donor families and volunteer opportunities for interested individuals.

OPOs employ a variety of staff including procurement coordinatorsrequestors, specialists in public relations, communication, and health education, as well as administrative personnel.  All of these people are specially trained for their jobs.

LifeSource is the OPO that serves more than 6 million people in communities across Minnesota, North Dakota, South Dakota and portions of western Wisconsin and I know them well.  As a consultant I worked closely with them for many years.  I can personally vouch for their expertise, compassion and effectiveness because I’ve seen them in action.

 

To be employed at LifeSource is not like employment elsewhere.  The people there don’t go to work every day, they embark on a journey to save lives.  That’s the attitude that permeates the entire organization.  Everything they do, every job in the organization is focused on one thing, saving lives. All you have to do to know their culture is to look into the eyes of any one of their people when they are talking about what they do and you will feel the sincerity and sense of mission.

Nearly three years ago the New York Times did a story on LifeSource. It is a magnificent piece that clearly illustrates what an OPO does and how their work affects each and every one of us. Once you read it, you’ll have a new understanding and appreciation for what these marvelous people do.

Read “After Death, Helping to Prolong Life” by clicking on this link  2012 New York Times article

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.  You can register to be a donor a thttp://www.donatelife.net.  It only takes a few minutes.

Prayer — Does It Work to Help Cure Illness?



“There is a mighty lot of difference
between saying prayers and praying.”

John G. Lake

 

tweety cartoonLet me start by saying that this is a “Think” piece.  What you are about to read are the conclusions I drew from the research I had time to conduct.  Another writer given the same amount of time and resources might have a different view.

I am penning this post so that the prayerful, sometimes prayerful, the skeptics and the cynics have a better understanding of the subject and of each other.

It is important to point out from the very beginning that with rare exception most religious organizations recommendscience religion prayer as a supplement to medical care.  Some, though, go much further: According to Religious Tolerance dot org   (http://www.religioustolerance.org/medical2.htm) they either:

  • Teach that certain medical procedures are not allowed, or
  • Recommend that members generally reject medical attention in favor of prayer.

Two of these groups are Christian Science and the Jehovah’s Witnesses.

We at Bob’s Newheart prefer the mainstream approach that allows for and encourages getting medical help when it is needed.  There is more than an adequate amount of scientific evidence to support the claim that medical intervention is more beneficial than prayer alone.

According to the New York Times about 300 children have died in the United States in the last 25 years after medical care was withheld on religious grounds.  http://www.nytimes.com/2009/01/21/us/21faith.html?_r=0

The courts often hear cases of medical treatment for children being withheld due to religious objections.  In the vast majority of those cases they have ruled in favor of treatment and against prayer being used as the only remedy.   We will return to this topic later.

Does prayer work?  That depends on what you mean by “work.”  If you are asking about the curative power of prayer well, there is a mixed bag of evidence on that one,  I was told once that if you torture Google long enough you can get it to c confess to anything  I believe that.  You can probably find just as much proof that prayer works as you can that it doesn’t.  There is an area, though, where we do know that it does offer some benefits to those who are doing the praying.  Not long ago researchers from Baylor University found that people who pray to a loving and protective God are less likely to experience anxiety-related disorders — worry, fear, self-consciousness, social anxiety and obsessive compulsive behavior — compared to people who pray but don’t really expect to receive any comfort or protection from God.

baylor universityOn the other hand, the same Baylor University research found that people who have more insecure attachments to a supreme being react differently.  If they feel rejected or that their prayers have gone unanswered they can suffer severe symptoms of anxiety and/or depression.  So does prayer work?  Yes, but perhaps not in the manner you might suspect.  Prayer and/or meditation can have a profound effect on your state of mind.  You can read more about the psychological effects of prayer here at Spirituality and Health.  http://tinyurl.com/ngntzva.

The real question, though, or the one most people are asking is, “Will prayer cure disease, save dying people, or bring me whatever I’m asking for?  To be even more precise the question might finally be boiled down to, “Do prayers get answered.”

Science and religion are often at odds on a number of topics but perhaps that’s because neither is very tolerant of or patient with the other.  The fact of the matter is that when put to scientific scrutiny some studies have clearly indicated that prayer can be a medical tool.

Psychologists tell us that there are three kinds of prayer, 1) egocentric prayer is when we pray for ourselves, 2) ethnocentric prayer is when you pray for another person and 3) geocentric prayer is when you pray for everyone.

A study of about 150 cardiac patients at the Duke University Medical Center included a sub-group who received duke universityethnocentric prayer had the highest treatment success rate within the entire group. This was a legitimate study, too.  It was double blind which means that neither the researchers nor the patients benefiting from the prayers knew who was on the receiving end.  The results were similar in another legitimate scientific double-blind study that was done at San Francisco General Hospital’s Coronary Care Unit.  The “prayed for patients” showed a greatly diminished need for critical care, maintenance medications and heroic measures.  There were also fewer deaths.  All of that suggests somehow, something intervened.  Just exactly what that variable might be is unclear but there most definitely was a connection.

The great difficulty in researching the topic is that there are so many different points of view and they all claim to be the most accurate source.  I decided to use information from those who most clearly communicated their thoughts to me regardless of religious, philosophical or political designation. So, let me begin.

It seems to me there are five groups of people.

  1. Those who strongly believe in the power of prayer and are devout in their religious convictions. They are often unshakeable even when it appears to others that their prayers have been rejected.
  2. Those who pray only in emergencies or when they really want or need something.
  3. Those who pray, but only because they are afraid not to pray. They hope some good will come of their efforts. I’ve known many who pray because they were taught to do so and don’t know what else to do even though they are doubt the effectiveness of the practice.
  4. Those who are ambivalent or skeptical. They tolerate prayer but don’t engage in it themselves
  5. Those who are more cynical and for the most part reject prayer and religion as an exercise in futility and a waste of time.

man prayingWhy do people pray?  When you Google the question, “What is
faith?” you have a choice of 801,000,000 results.  Eight hundred million.  Obviously I did not read but a tiny fraction of them but I did look at a few. The definitions I selected had seemed to best characterize the people I know who appear to be of great faith.  There is a very fine line to walk between religion and faith but I’ll attempt the balancing act anyway. .

What is faith?

One site tells us, “…..faith is such a powerful gift from Godfaith that with just a tiny measure of it, the size of a mustard seed, you can move mountains.”

Still another definition is, “Faith is a sacred, deep, emotionally involved kind of trust that a power greater than you can change anything.  Faith requires a trust in your belief that consumes your whole being. “

And finally, “Some argue that faith is a decision. Others understand it to be a gift. Many have never known their life without it, while others can point to a particular moment when faith became a part of their experience.  No matter, faith is simply a strong belief that a greater power exists and is in charge of everything.” Somewhere in one of those three definitions you may find a kernel of the element of your faith or lack of it.

If you have “Faith” you probably pray and that’s a word that also needs defining.  What constitutes prayer?  One definition says, “Prayer includes respect, love, pleading and faith. Through a prayer a devotee expresses his helplessness and endows the task to God. Prayer, it seems, is a very personal way for an individual to communicate with his or her God. In most cases people who pray are asking for something either for themselves or for others.  Some believe they always get answers to their prayers and that they actually talk with God and hear his responses.  Others pray and hope they are heard.  People have different experiences with prayer some good and some bad.

Are Prayers Answered?

huffington post
The Huffington Post is certainly not highly regarded for their expertise in prayer but some of the writers have interesting thoughts.  For example, in story from May of 2012 with the headline,” Prayer: What Does The Science Say? The post notes that an overwhelming 83 percent of Americans say that God answers prayers, but their reaction is a gut feeling and there’s little or no scientific validation offered.  Two researchers with opposing positions on the issue have written interesting books to explain their views.  If you are interested in learning more on either or both let me refer you to  Tanya Marie Luhrmann, an anthropologist at Stanford and author of the book “When God Talks Back” and Michael Shermer, executive director of the Skeptics Society and author of “The Believing Brain.”

 

One thing is clear.  Religion and prayer appear to be inseparable. If you engage in prayer or some kind of communion with a higher power it likely was heavily influenced by your experience and/or exposure to religion, but the water gets a little murky there because according to the Pew Foundation more than one-quarter of American adults (28%) have left the faith in which they were raised in favor of another religion – or no religion at all. If change in affiliation from one type of Protestantism to another is included, 44% of adults have either switched religious affiliation, moved from being unaffiliated with any religion to being affiliated with a particular faith, or dropped any connection to a specific religious tradition altogether.

When it comes to the effectiveness of prayer, there are as many answers as there are people. Most of the answers, though, are based on anecdotal rather than scientifically based evidence.

There are those who believe deeply that prayer brings results and therefore comfort and there are others who have no faith in faith and care even less for religion whether organized or not.

One can probably assume that many if not a majority of prayers have to do with health and longevity and our health care system has deep faith based roots that are made obvioublood transfusions with every hospital admission. Patients are almost always asked for religious preference so if an emergency arises the institution can satisfy the patient’s needs in that area.

People of faith are willing to accept a negative prayer response more than those without faith by saying, “Well, that’s the will of God.”

at the same time, though, a cynic might ask, “If prayers work, why do so many prayerful, religious people die horrible deaths?  Prayer vigils are organized often for sick people and they die anyway,” say the disbelievers.

I guess the answer depends on who you ask. The atheist would say, “No. Prayer can’t work because there is no God.”  For them it is a cut and dried issue.

The answer from agnostics might be a little more complex.  That particular group is more likely to equivocate because they claim neither faith nor disbelief in God.

One could site any one of a number of biblical passages regarding prayer.  Here are just a few:

John 15:7 If you abide in me, and my words abide in you, askholy bible whatever you wish, and it will be done for you.

Philippians 4:6 Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.

Mark 11:24 Therefore I tell you, whatever you ask in prayer, believe that you have received it, and it will be yours.

Most of the major religions, as pointed out earlier, believe a combination of prayer and medical science is the answer to most health issues.  Some take a harder line than others.

Shortly after my heart transplant in 2007 I started this blog and a Facebook group, Organ Transplant Initiative (OTI), which now has nearly 4200 members.  Recently I asked members to give me examples of how prayers worked or didn’t work for them.

Jon Claflin (He requested that he be identified) sent these words to me.

confusedEver since I was a child, prayer has confused me. Raised a Christian, I was taught that God has a plan and that He knows all. These two concepts run counter to me interfering with this plan by praying and asking God to make an exception or allow for a different outcome. Of course this is impossible as God knows the outcome anyway.

As an adult, my views on the futility of prayer only increased. As a student of logic and skepticism, I realized that prayer is an unfalsifiable concept as no matter what transpires, the believer can claim that prayer worked. If the promotion at work didn’t come through or their aunt died, they can simply claim that this was God’s will. And if their aunt survived or the promotion came through, then (again) prayer did its job.

This is all the personal belief of the individual turning to prayer and I wouldn’t seek to change this, but when prayer is artificially elevated the level of a legitimate healthcare choice, I do take issue. Heart failure is a serious life or death situation and inserting superstition or talking to invisible deities into this predicament as an alternative to medicine is extremely dangerous, and choosing prayer over evidence-based medicine is deadly. Until prayer can stand up to the rigorous double-blinded testing that medical therapies do, I opt for medical intervention over prayer.”

Other members had a different perspective and this letter is pretty typical of the kind of responses I got. She believes her prayers were answered.  Who are we to say she is wrong?

God“Almost a year ago now my son had been on PD for 16 months and was feeling sicker by the day. Also, he had developed a hernia most likely FROM PD and we were told he’d have to go on hemodialysis until after he had hernia surgery & had completely healed. I was so heartbroken for him that I went to bed that night desperate – praying & crying till I fell asleep, begging God to just show me what more I could do to help him. I woke up the next morning with the idea to make a Facebook page to find a living kidney donor. I just KNOW that’s what God TOLD me to do. A young man who was a former co-worker of my OTHER son’s emailed me & said he’d be willing to test, and in May it will be the 1 year anniversary of my son’s transplant. His donor has become a member of the family!! He is truly my boy’s miracle!! I love to tell this story!”

That story was told with conviction and with love and while some readers may want to dismiss her contention that God told her what to do, why would they?  To what end?  Why bother?  If she is happy with the outcome it shouldn’t be anyone’s business what she believes.

Of all the responses I got to my Facebook query, no one suggested that prayer alone would solve medical problems.

From what I have been able to gather, a combination of prayer and medical science certainly can’t hurt and it just may be of some help.  A story in the Underground Health Reporter said: “Not only can effects of prayer be an important curative tool in times of crisis, but it can also promote a sustained state of well-being. A fascinating study conducted by researchers from the Virginia Commonwealth University in Richmond analyzed the lives of 1,902 sets of twins.

It turned out that twins committed to spiritual lives tended to have lower rates of:

  • Depression
    • Addiction
    • Divorce

The Richmond study indicated that active involvement in a spiritual community is strongly linked to overall stability and health.

This is Your Brain on God

Most extraordinary of all is the way prayer has been shown to produce physical changes in the brain. Barbara Bradley Hagerty put together a 5-part NPR series called, “Is This Your Brain on God?” In the series, Hagerty explores a possible reason that prayer has such restorative and preventative potential. That is, scientists can see noticeable differences between the brains of those who pray or meditate often and those who don’t.

One scientist in particular had published astonishing findings. His name is Andrew Newberg, and he’s a practicing neuroscientist at the University of Pennsylvania and author of How God Changes Your Brain. Newberg has been scanning the brains of people with religious convictions for more than 10 years. He says meditation in particular has a very visible effect on the brain’s frontal lobe. He believes that the neurological effects of prayer and meditation can be long-lasting. Read more: http://undergroundhealthreporter.com/effects-of-prayer-can-lead-to-healing/#ixzz3RGrtNsjB

So that’s my report on prayer.  I came away with this thought.  If I or someone I love has a very serious disease I will do two things.  I likely will say a prayer or two and then find the best medical team money can buy.  Maybe….just maybe the medical team is the answer to   a prayer.

 

All I know is that when I pray, coincidences happen; and when I don’t pray, they don’t happen.”

Dan Hayes

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All the views

Thank you donors and donor families

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.  You can register to be a donor a thttp://www.donatelife.net.  It only takes a few minutes.

Hepatitis C — There are Cures for the Disease, But Not the Stigma


By Bob Aronson

 hep C ribbon
What it feels like to have Hepatitis C

“I was always exhausted to the point that I could not walk a block without having to stop and sit down to rest. The fatigue I felt was so intense that completing just a simple once over lightly housecleaning took days because I had to stop and rest so often. Nausea was a constant companion and my appetite came and went.  Sometimes I would go all day without eating which seems to add to my fatigue.  And then there’s the pain. The pain in the area around my liver was almost unbearable. Then I started the Interferon treatment and it all got worse“ (The words of a Hepatitis C. Patient).

Hepatitis C – The Stigma

stop the judgment“The stigma that surrounds Hep C is reminiscent of the early 80’s when the AIDS epidemic came to the forefront. The idea that only IV drug users get HCV is incorrect, much like the idea that only gay men can get HIV is incorrect. Many of us got Hep C through transfusions, some who worked in hospitals got it from accidental needle sticks.  I am reluctant to disclose my disease because I’m tired of hearing, “So you were an IV drug user, huh” I wasn’t — yet people seem to want to blame us for the disease we have, some seem to think we deserve it.  I am sick, what difference does it make how I got the disease, not a single one of us asked for it, no one would want to live this way.  I wish people would be more understanding instead of so judgmental. (The words of another HCV patient)

 The quotes above are from hepatitis C Patients.  For privacy purposes I have withheld their names.  As you read on you will find other anonymous quotes.  I can vouch for their veracity,

There is a Cure for Hepatitis C , But the Epidemic is Growing

 Here’s What You Need To Know

hep c and liver The Hepatitis C Virus (HCV) is a blood disease.  You can only get it if the blood of an infected person somehow gets into your blood and attacks your liver.  It is not airborne — sneezes and coughs don’t spread it, only blood does.  Not only does Hepatitis C have the power to disable or kill its victims, the people who are stricken with it also carry its stigma and in a way are blamed for getting the illness that could take their lives.  We will address the stigma issue more later, along with the facts and myths surrounding the disease.

The hepatitis C virus was discovered in 1989. Prior to that, it was associated with blood transfusions, but was called non-A, non-B hepatitis because the virus could not be identified.  Up until now the most effective treatment for Cure cartoonHCV was based on the drug Interferon, which was effective in some patients but carried some heavy duty side effects with it.  While some internet medical sites say “Interferon has manageable side effects,” that’s not the story that patients tell.  There are thousands of reports of debilitating fatigue, weakness (asthenia) so great as to limit one’s ability to walk very far, drowsiness, lack of initiative, irritability and confusion.   Often, especially in patients with a history of depression, the condition worsens to include thoughts of suicide and in a few cases committing the act itself.  While some people tolerated Interferon better than others, few tolerated it well and almost all patients prayed for something, anything that didn’t make you feel worse than the disease itself.

Interferon in conjunction with the toxic chemotherapy drug Ribaviron has been the standard treatment for HCV until recently.  The interferon side effects are bad enough, say patients, but when combined with the drug Ribaviron the reaction can and often does get even worse. Some patients report the reaction to the combination of drugs was so negative it had become life threatening.

Finally by the end of 2014 some highly effective, interferon-free, Hepatitis C oral treatments or “cures” were approved.   Gilead Sciences had two,  Sovaldi and Harvoni and AbbVie’s introduced Veikira Pak. These effective meds come with a high price tag, however.  It is hoped that the competition from several newer and yet unapproved drugs will bring the price down

One drug in particular, Gilead Science’s Harvoni, seems to be getting favor from the medical community and it is indeed a cure.  In clinical trials, Harvoni Harvonicured hepatitis C after 3 months of treatment in about 94% of people who took it. Cure rates approached 100% after 6 months in patients whose hep C was harder to treat, because of cirrhosis (source: Gilead Sciences)

Harvoni most certainly is a cure for those who can afford it.  The drug while highly effective, comes with an equally high price tag. That 3 month treatment program mentioned earlier can cost $95,000 and as of this writing many insurance companies are not yet on board.  One source told us, “the protocol for my mom is 24 weeks this treatment cost $ 204,120.00”  There is financial assistance available and links are listed elsewhere in this blog.

Harvoni is well researched and while calling it a “Cure” is accurate it is only recommended for patients with genotype 1a and 1b. Other genotypes still have to use Sovaldi (also a Gilead product) in conjunction with Ribaviron and some genotypes still have to use both Ribaviron and Interferon.

Sovaldi was released in December of 2013 but still had to use Ribaviron for all G types. Harvoni is a combination of Sovaldi and Ledipisvir and eliminated the need for Ribaviron in 1a-1b’s and was released in Oct 2014.

Space doesn’t allow us to take  a detailed look at all the HCV treatments and we can’t do justice to Harvoni the Gilead Sciences cure either.  We applaud the companies that developed these drugs, but no matter how wonderful the cure is, the disease continues because we still don’t have a vaccine that prevents people from getting the disease in the first place.  The cure is only effective with people who have the disease and  by the time it is identified they usually have already suffered incredible damage.  We must keep pushing for a vaccine that will wipe out the disease before it can infect anyone.  Right now there is no vaccine for HCV.  They are working on it, but so far such preventive measures have proven to be illusive and the disease continues to pile up victims. It now kills more Americans than AIDS. If you want more information about the HCV and the various treatments these links will help.

Viekera pak https://www.viekira.com/

Harvoni  http://www.gilead.com/~/media/Files/pdfs/Policy-Perspectives/ExpandingAccesstoHCVTreatments10214.pdf

If you have Hepatitis C and your physician has recommended any of the treatments but you are unable to pay the price of the medicine you should know this.  Harvoni manufacturer, Gilead offers free meds to the underinsured or patients who have been denied coverage by their insurance provider, if they meet financial requirements. There has been a great deal of confusion and misinformation about the “Coupon” offered by Gilead, so here’s the straight story.  The copay coupon is available to anyone who is insured.  It is not based on income and will pay up to 25% of the copay amount. The only restriction on the copay assistance is if the patient is covered by Medicaid or another government program, then they are not eligible. There are no financial requirements connected to the coupon.

People on Medicare with part D ( which they pay for) are eligible for assistance from Gilead if they are denied by Medicare or underinsured.  They are not eligible for the coupon. They also have to sign a form saying they will not try to get reimbursed for any out of pocket expenses. The coupon is for those who have private insurance with a copay.

There are other resources as well and you can explore them by clicking on the links below.

 financial aid resources

http://hepc.liverfoundation.org/resources/what-if-i-need-financial-assistance-to-pay-for-treatment/

http://www.hepmag.com/articles/hepatitis_paps_copays_20506.shtml

http://tinyurl.com/orbec8m

http://tinyurl.com/njbl3jm

Health experts estimate that over 3.2 million Americans have Hepatitis C and that worldwide the number of infected people is close to a quarter of a billion.  Many, if not most, may be financially unable to get the cure.

 “What is Hepatitis C and how do you get it?”

 As noted earlier, Hepatitis C is a blood disease that attacks the liver.  Simply put, in order to contract it the blood of an infected person must find its way into your blood.  Here are the facts that dispel the myths. (http://www.hepmag.com/articles/2512_18750.shtml)   You can get HCV from:

  • blood transfusionInjecting drugs with needles that have been used by others.
  • Needle-stick injuries and exposure of open wounds or mucous membranes to infected blood.
  • Transfusions.  Blood or blood-product transfusion (especially before 1992).

Unlikely sources of infection.

  • Piercing and tattoos. It is unlikely you can get HCV from tattoos done in a licensed, commercial tattooing facility. However, transmission of Hepatitis C (and other infectious diseases) is possible when poor infection-control practices are used during tattooing or piercing such as that done in prisons and other unregulated settings. More research is needed to be sure.
  • Sexual activity. it is generally believed that HCV cannot be transmitted through semen or other genital fluids, unless blood is present. While the risk of becoming infected with HCV through unprotected sexual intercourse is very low, medical  experts urge everyone to use safe sex practices whether HCV is involved or not.
  • Giving Birth. Women who have HCV run less than a 10 percent chance of passing the virus to their babies during pregnancy or delivery,
  • Breast Feeding It is also considered unlikely that HCV can be transmitted through breast feeding or breast milk unless the woman’s nipples are bleeding.
  • Sharing a drug snorting straw.  Yes, there is a chance, albeit, a very low one of being infected with the hepatitis C virus through sharing drug-snorting paraphernalia.  Hepatitis C is a disease of the liver, but the virus lives in the bloodstream. Snorting drugs, such as cocaine, heroin or methamphetamine, can cause damage to the tiny blood vessels in the nose, potentially resulting in traces of blood being deposited on the tip of the straw or other device. Sharing snorting paraphernalia isn’t a common mode of HCV transmission, but the threat exists.

Hepatitis C is a terrible disease.  Its symptoms often don’t show up for years and when they do it is because significant damage has been done.  Here are a few abbreviated patient’s stories about their disease, how they got it and the cost of the cure.

Patient story @ 1. “Harvoni is extremely expensive. It is I believe $1152.00 per pill. The protocol varies by 8, 12 and 24 weeks, depending on the amount of liver damage and viral load. Do I believe the price is fair? That’s a very hard question to answer. I think that it is necessary to look at the bigger picture.

 I have had HepC since between 1979 and 1985. I was in an auto accident and received several liters of blood and had several surgeries.  I was not diagnosed until 2002 when I was so fatigued that I could barely functionI subsequently did a 48 week course of the horrific drugs, interferon and ribivarin which led to horrific side effects, three times weekly injections of Neupogen and two times weekly injections of Procrit. My white cell count dropped so low that I was hospitalized, transfused and taken off treatment at 40 weeks. It took me 2 1/2 yrs to recover. I progressed from there to cirrhosis, liver cancer, ESLD and two liver transplants in 09. So, in the bigger picture, when adding up the cost of liver disease from HepC and all it’s complications the price seems fair.

 Patient Story number 2I had previously treated with interferon/ribavirin for 48 weeks with weekly injections of procrit along with the occasional transfusion. This treatment almost killed me and I have many chronic health issues as a result.

 I think Harvoni is extremely expensive, for those that don’t qualify for the co-pay offered by the manufacturer. I was able to receive that co-pay which was a total of $15 for my 12 week treatment. My husband and I were willing to pay whatever necessary for me to be treated by Harvoni because I have been symptomatic from the Hep c for over 10 years after being infected during a blood transfusion while giving birth to my daughter in the 70’s.

 Patient Story number 3. The price is fair when you compare total cure to a transplant (lets say $96,000 vs $500,000 minimum for a transplant).

The cost is always a factor. I was lucky and appealed to my insurance company after 2 denials. I had to supply some of the research to the reviewing doctors to educate them that even though it wasn’t FDA approved for transplant recipients, it was made specifically for my genotype and it was actually fewer drugs than sovaldi/olisio (they wanted me to take that and I held out for Harvoni)

 I think most of the people who have HepC got it years ago before they had identified non A/nonB as HepC. Mine was from a blood transfusion. I think today the blood supply is safe.

 My message to others is this, find a way to get on one of these cures. They aren’t nearly as bad as the old regimens that were brutal and that many of us have lasting effects from being on them. These are relatively side effect free and it is best to take care of this before your liver becomes ravaged by the disease putting you in line for a transplant. That is a long line and the chances of dying while waiting for a life saving liver are getting larger. So many people die everyday waiting. I’m finally on the road to health with a new liver and noting will stop me now.

The preceding testimony is real, the stories are true.  The names have been withheld to protect privacy, but we’ve only scratched the surface of the misery of Hepatitis C.  The disease is bad enough.  Patients don’t need the additional emotional pain caused by public misperception of the disease which is stigma postershrouded in myths that result in blaming the victim for getting the disease.  Even some medical professionals believe that if you have HCV you were probably a drug addict who was infected by using a “dirty needle.”  The truth is that fewer than half of those infected were drug users, but so what?  Do we blame the victim of a shooting who happened to stop at a store in a high crime area for being there?  Do we blame the carpenter who lost his fingers to a table saw for using it?  Do we blame the physician who treats Ebola patients for getting the disease herself?

Blaming the victim is mean spirited and unfair.  The supposition that all HCV patients were drug users is the product of rumor and not supported by facts.  But again, so what?  No one wants to have HCV.  No one purposely sets out to get it.  Just because you are in a position of risk, doesn’t mean you should be blamed for the resulting illness. It’s time we got the facts and showed some compassion and understanding.  Blaming people for their health problems helps no one, whether it’s Cancer, COPD, drug addiction, obesity or diabetes.  The fact is that most 21st century medical conditions are due to some combination of genetics, environment, and personal choice.  So unless you believe that each of us brings on our own misfortune, then it only makes sense to get the facts and set the record straight.

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New heart, new life, new man

Feeling better than ever at age 73

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me atbob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.  You can register to be a donor a thttp://www.donatelife.net.  It only takes a few minutes.

So You Need an Organ Transplant. Here’s What You Need To Know.


By Bob Aronson

(Founder of this blog site and 2007 heart transplant recipient)

This blog is longer than most because it offers one-stop access to information that should save you hours of Internet research.  We hope this single click will lead you to the answers you need and deserve. .  

When You First Learn That You Need an Organ Transplant

cartoonThere is no news that is much more disturbing than being told you are suffering irreversible organ failure and that the only solution is a transplant.  The news becomes even more difficult to bear when you learn that there is a critical shortage of transplantable organs.  Most of us meet that news with stunned silence at first.  The tsunami of thoughts related to organ failure renders our brains incapable of developing a rational response or even asking the right questions.  Usually it is only after leaving the Doctor’s office that the cobwebs begin to clear, and the fear of dying starts to generate questions.  They are a trickle at first and then become a torrent as broad as Niagara falls and as long as Angel Falls.

The questions start with the first news and seem to multiply as you learn about organ donation, about lifestyle while waiting for an organ, getting on the list, the surgery, paying for it, recovery and living with a transplant.  And – because everyone is different everyone has different questions.

As a heart recipient I’ve been through that gauntlet and struggled to find answers by spending endless hours on the internet, asking questions of physicians and others and reviewing my own experience.  Below you will find a few resources to get you started.  This is not a complete list, it doesn’t even come close but it does give you links to some resources that will at least head you in the right direction.

**This blog was developed for U.S. audiences. While there may be some applicability in other countries, each nation has different laws, requirements and approaches to donation/transplantation issues.   Make no decisions until you check with experts in your country. 

Transplantable Organs and Tissue

First it is important to understand which organs and tissues are transplantable.  Here’s the list.  Organs include the heart, kidneys, liver, lungs, pancreas, and small intestines.  Transplantable tissues include blood, blood vessels, bones, bone marrow, cartilage, connective tissues, eyes, heart valves, and skin.

Most organs are recovered from deceased donors, but in the case of kidneys and a part of the liver donation can be made by living donors to specific individuals.

The following resources should either provide you with the information you seek or at least lead you in the proper direction.

If you are a kidney, heart or liver transplant patient one of the very best Give thanks givee lifeinformation resources available is, “The Transplant Experience.”  It was developed by Astellas Pharma US, Inc.  which is a manufacturer of “Prograf,“ an anti-rejection drug.   You will find answers to most of your questions on this site, but there are other very useful links as well that we include in this posting.   http://tinyurl.com/q6heovg

Another excellent source is Web MD.  http://tinyurl.com/3vst3cf

And — still another from the Mayo Clinic this stirring “Nightline” video about the process.  http://tinyurl.com/nqzomf6

Organ Donation Key Myths and Facts

According to the American Transplant Association (ATA) (http://tinyurl.com/m42br82 )  There are over 123,000 people awaiting organ transplants in the United States, but only about 28,000 are performed each year.  That’s because the supply lags far behind the demand.  While over 90% of Americans believe in donating organs only about 40% ever get around to it.  The result is that about 7,000 men, women and children die each year waiting for an organ that never comes.

Why don’t people donate?  There are as many answers as there are people, but some believe that if you are in an accident and brought to an ER the medical people will let you die in order to get your organs.  That is simply not true.   ER teams are not even associated with transplant teams and most hospitals aren’t transplant centers anyway.  The ethics that bind medical professionals demand that they do everything possible to save your life and no thought, none, is given to taking your organs.  The ER people aren’t even the ones who make that decision.

The ATA says there are other myths as well.  For example:

Myth:

If you are rich or a celebrity, you can move up the waiting list more quickly.

Fact:

Severity of illness, time spent waiting, blood type and match potential are the factors that determine your place on the waiting list. A patient’s income, race or social status is never taken into account in the allocation process.

Myth:

After donating an organ or tissue, a closed casket funeral is the only option.

Fact:

Organ procurement organizations treat each donor with the utmost respect and dignity, allowing a donor’s body to be viewed in an open casket funeral.

Myth:

My religion doesn’t support organ and tissue donation.

Fact:

Most major religions support organ and tissue donation. Typically, religions view organ and tissue donation as acts of charity and goodwill. Donor Alliance urges you to discuss organ and tissue donation with your spiritual advisor if you have concerns on this issue.

 Myth:

My family will be charged for donating my organs.

Fact:

Costs associated with recovering and processing organs and tissues for transplant are never passed on to the donor family. The family may be expected to pay for medical expenses incurred before death is declared and for expenses involving funeral arrangements.

Organ Donation Facts

  •  On average, 21 people die every day from the lack of available organs for transplant.
  • Another name is added to the national transplant waiting list every 12 minutes.
  • organ donoars save livesSeven percent of people on the waiting list—more than 6,500 each year—die before they are able to receive a transplant.
  •  One deceased donor can save up to eight lives through organ donation and can save and enhance more than 100 lives through the lifesaving and healing gift of tissue donation.
  •  Organ recipients are selected based primarily on medical need, location and compatibility.
  •  Over 617,000 transplants have occurred in the U.S. since 1988.
  •  Organs that can be donated after death are the heart, liver, kidneys, lungs, pancreas and small intestines. Tissues include corneas, skin, veins, heart valves, tendons, ligaments and bones.
  •  The cornea is the most commonly transplanted tissue. More than 40,000 corneal transplants take place each year in the United States.
  •  A healthy person can become a ‘living donor’ by donating a kidney, or a part of the liver, lung, intestine, blood or bone marrow.
  •  More than 6,000 living donations occur each year. One in four donors is not biologically related to the recipient.
  •  The buying and selling of human organs is not allowed for transplants in America, but it is allowed for research purposes.
  •  In most countries, it is illegal to buy and sell human organs for transplants, but international black markets for organs are growing in response to the increased demand around the world. Learn more about Transplant Tourism.

Qualifying for a transplant

Transplant eligibility depends on the organ you need.  Individual transplant qualifyingcenters may have different criteria but the links provided here will give you some idea.

Heart Transplant Qualification

University of Maryland http://tinyurl.com/klcjbns

 Kidney Transplant Qualification

Washington University, St. Louis, Mo.  http://tinyurl.com/nefho9x

 Liver Transplant Qualification

American Liver Foundation. http://tinyurl.com/cfnh7ro

Lung Transplant Qualification

Mayo Clinic.  http://tinyurl.com/lkmbwsx

 Pancreas Transplant Qualification

Johns Hopkins.  http://tinyurl.com/qdn9sbo

 Small Intestine transplant qualification

Cleveland Clinic.  http://tinyurl.com/m5ugaul

 Getting on the U.S. National Organ Transplant List.

the waiting listUniversity of California Davis Health System. . All organ transplants in the U.S. are coordinated by the United Network for Organ Sharing(UNOS) in Richmond, Virginia. It is a blind list with no names attached to patient records to ensure the fairness of organ and tissue allocation. . http://tinyurl.com/lhwywwv

 Living with a transplant

Transplant living.  http://tinyurl.com/k2tcpc2

Paying for the Transplants and Aftercare (Financial Assistance)

(This is a lengthy section that provides a great deal of information. If you are concerned about how to pay for your transplant and follow up care read it very carefully)

Because there is a shortage of organs the odds of getting a transplant are not good, There are a lot of factors that influence whether any one person will get an available organ and one of them is the ability to pay.  Unfortunately our system is heavily weighted toward those who either have insurance or an independent ability to finance the surgery and the aftercare. A transplant and the aftercare and medication for the first year after the surgery can cost as much as a million dollars.  Sometimes even those with the ability to pay need some assistance.

Transplant Living is a project of the United Network for Organ Sharing (UNOS), a nonprofit organization that maintains the national Organ Procurement and Transplantation Network (OPTN) under contract with the Health Resources and Services Administration of the U.S. Department of Health and Human Services.

UNOS is the private government contractor that facilities all organ transplants in the United States.  The information in his blog is copied from their website which provides a wealth of information about the entire donation/transplantation process.  It is one of the most comprehensive resources available.  Bob’s Newheart thanks them for compiling this information and for its willingness to share it with you via our blog.

About Anti-rejection Drugs

Almost everyone who receives an organ transplant has to take immunosuppressant drugs. The body recognizes a transplanted organ as a foreign mass. This triggers a response by the body’s immune system to attack it.  These drugs diminish that attack and allow the organ to continue to function, but there are other effects as well.  This lHealthline ink will take you to a comprehensive review of these life-saving drugs..   http://www.healthline.com/health/immunosuppressant-drugs#Overview1

Funding Sources

financial aidMost transplant programs have social workers and financial coordinators who can help you with the financial details of your transplant. Depending on the structure at your center, one or both will help you develop a strategy.

Common funding sources to help with the costs of transplants include:

Note: This information is only a brief summary and is not intended to provide complete information. Ask your transplant financial team and your insurance provider or employee benefits officer for the latest information or help.

Private Health Insurance

You or your family may have health insurance coverage through an employer or a personal policy. Although many insurance companies offer optional coverage for transplant costs, the terms and benefits of insurance vary widely. Read your policy carefully and contact your insurance company if you have questions about how much of your costs they will pay, including your lab tests, medications and follow-up care after you leave the hospital.

Some insurance questions to consider:

  • Is my transplant center in-network with my insurance company?
  • If my transplant center is out-of network, do I have an out-of-network benefit for transplant?
  • What deductibles will apply?
  • What are my co-payments for doctor visits, hospitalizations and medications?
  • Does my plan require prior authorization?
  • Who needs to get prior authorization?

Regardless of how much your insurance covers, you are responsible for any costs not paid by your insurance, unless you have made other arrangements. If you are responsible for paying any or all of your insurance premiums, be sure to pay them on time so that you do not lose your coverage.

Transplant center social workers and financial coordinators can also help you with the information you need. They can contact your insurance company to check on your benefits and explain your coverage in more detail.

Experimental and Investigative Procedures

If your transplant center asks you to be involved in any experimental procedures or studies, be sure to ask your center or insurance company if your  policy will cover the payment. It is important to know that you do not have to agree to be involved in any experimental procedures or investigational studies. If you still have questions, contact your insurance company, your employer’s benefits office or your state insurance commissioner.

Tips

  • Keep copies of all medical bills, insurance forms and payments (or canceled checks).
  • Ask your insurance company about pre-certification or using a specific provider.
  • Follow the rules set forth by your insurance company so that your benefits will not be decreased.
  • Always keep a log (who you talked to, date and time and questions answered) of your conversations with anyone in the hospital’s billing office or your insurance company.
  • Make sure to keep your transplant center informed about your insurance, especially if you have more than one insurance company.
  • For more helpful tips, see the Financial Q&A.

COBRA Extended Employer Group Coverage

If you are insured by an employer group health plan and you must leave your job or reduce your work hours, you may qualify for extended coverage through COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985). This federal law requires certain group health plans to extend coverage for 18 to 36 months after benefits end. This requirement is limited to companies employing 20 or more people. You pay the full cost of the premiums for the group health plan. Learn more by contacting your employer’s benefits office or visit the federal Department of Labor Web site >

Health Insurance Marketplace

Also known as the health insurance “exchange,” the marketplace is a set of government-regulated and standardized health care plans in the United States. Learn more at www.healthcare.gov >

Medicare

MedicareMedicare is a federal health insurance program available to people who are 65 or older, disabled or have end stage renal disease (ESRD).

Medicare, like most private insurance plans, does not always pay 100% of your medical expenses. In most cases, it pays hospitals and health providers according to a fixed fee schedule, which may be less than the actual cost. You must pay deductibles and other expenses. Medicare currently offers coverage for transplant of:

  • kidneys
  • kidney-pancreas
  • pancreas, either after a kidney transplant or for certain indications

If you already have Medicare due to age or disability, Medicare also covers other transplants:

  • heart, in certain circumstances
  • lung
  • heart-lung
  • liver, including transplants necessitated by hepatocellular carcinoma (HCC)
  • intestines

To receive full Medicare benefits for a transplant, you must go to a Medicare-approved transplant program. These programs meet Medicare criteria for the number of transplants they perform and the quality of patient outcomes.

If you have questions about Medicare eligibility, benefits, or transplant programs, contact your local Social Security office, or Medicare at 800-633-4227 or www.medicare.gov.

Medicare Prescription Drug Plans

Medicare Part D covers costs for prescription drugs. To get this coverage you must choose and join a Medicare drug plan. For more information call (800) MEDICARE ([800] 633-4227)/ TTY: (877) 486-2048 or visit www.medicare.gov (click on Medicare Basics >Part D).

MediGap Plans

Many people on Medicare also choose to buy a private “MediGap” policy to pay for costs not covered by Medicare. Check with a local insurance agent or go to www.medicare.gov (click on Resource Locator>MediGap).

State Health Insurance Assistance Program

The State Health Insurance Assistance Program (SHIP) is a national program that offers one-on-one counseling and assistance to people with Medicare and their families. Your transplant social worker or financial coordinator can provide information on your states SHIP program, or learn more now >

Medicaid

MedicaidMedicaid is a federal and state government health insurance program for certain low-income individuals. Each state determines criteria for:

  • eligibility
  • benefits
  • reimbursement rates

Most Medicaid programs only cover transplants performed in their state, unless there are no centers that can transplant that organ. For more information, contact your local human services department or the financial coordinator at your transplant center.

Charitable Organizations

Charitable organizations offer a range of support, from providing information about diseases, organs and transplants, to encouraging research into these diseases and treatments.

Also, although it is very unlikely that one organization can cover all of the costs for an individual patient, some organizations provide limited financial assistance through grants and direct funding. For example, an organization may only be able to help with direct transplant costs, food and lodging or medication costs.

Advocacy Organizations

Advocacy organizations advise transplant patients on financial matters. If you agree to a financial arrangement with an advocacy organization, it is important to make sure that the funds are available in a manner that suits your needs. You may even want legal assistance in reviewing a written agreement before signing. Your bank can also help you review the arrangement.

Every advocacy organization should be able to provide supporting information and background documentation to prove they are legally recognized to help those in need. Brochures and other background information should never serve as substitutes for these documents. Ask advocacy organizations to provide you with copies of the following documents:

  • a current federal or state certification as a charitable, non-profit organization
  • a current by-laws, constitution and/or articles of incorporation
  • a financial statement for the preceding year, preferably one that
  • an audit report from an independent organization
  • references

Fundraising Campaigns

fundraiser

Even if you have coverage for transplant, fundraising is a good path to take to assist with costs not covered by insurance, such as prescriptions and temporary housing. It is also a great way for your family and friends to be involved with your care.

Asking for help is perfectly okay, and you may find that many of your loved ones will step forward to support your fundraising campaign. If you do decide to raise funds, it is best to do it before your transplant, as the money raised will help you budget for your medical expenses.

Before you begin seeking donations, it may be necessary to check with your city/county governments, legal advisor or transplant team about the many legal and financial laws and guidelines.

If you decide to use public fundraising as a way to cover your expenses, you may want to contact local newspapers, radio or television stations to help support your cause. In addition, try to enlist the support of local merchants and other sponsors to promote or contribute to your events. Your friends, neighbors, religious groups, local chapters of volunteer or service groups and other community groups may also be able to help.

It is also very important to understand that the funds you raise only be used for your transplant-related expenses and donated money sometimes has to be counted as taxable income. In cases in which money must be counted as income, you may lose your Medicaid eligibility.

These organizations can help you plan your fundraising campaign:

Children’s Organ Transplant Association (COTA)

Help HOPE Live  (Formerly the National Transplant Assistance Fund (NTAF)

National Foundation for Transplants

TRICARE (formerly Champus) and Veterans Administration

Government funding for families of active-duty, retired, or deceased military personnel may be available through TRICARE. TRICARE standard may share the cost of most organ transplants and combinations. TRICARE also covers living donor kidney, liver, and lung transplants. Patients must receive pre-authorization from the TRICARE medical director and meet TRICARE selection criteria. Pre-authorization is based on a narrative summary submitted by the attending transplant physician. For more information about TRICARE, contact the health benefits advisor at your nearest military health care facility, call the TRICARE Benefits Service Branch at (303) 676-3526 or learn more now >

 

The National Marrow Donor Program is also a resource for information on where to get financial assistance.  They offer this advice.

Transplant insurance coverage.  These items may not be covered by your insurance.  Check to be sure.

You or someone you know might need an organ/tissue transplant you must show an ability to pay before you will be accepted by most transplant centers.  Most people rely on insurance but insurance policies differ from one company to the next.  Be sure about what your policy covers, talk to your plans benefits manager or to the hospital social worker to get a clear idea of what is covered.

It is very likely that the following items are NOT COVERED by your health insurance company.  This information was generated by the National Marrow Donor Program.  http://tinyurl.com/b8pb4s4 

You may want to ask if the following items are covered by your specific health insurance plan:

  • Testing to find a matched unrelated or related donor
  • Donor costs
  • Transplants for a rare diagnosis
  • Travel and lodging expenses to and from the transplant center for patient and/or caregiver
  • Food costs while staying near transplant center
  • Parking costs
  • Prescriptions for post-transplant discharge or outpatient medications
  • Office visits coverage
  • Home health care
  • Psychiatric coverage
  • IV injections
  • Clinical trials
  • Sperm/egg storage
  • Insurance premiums when patient is not employed
  • Fees for post-transplant home preparation (carpet and drapery cleaning, replacing filters on heaters, air conditioning cleaning)
  • Change in cost of living after transplant (different food needs, for example)
  • Child-care costs

If your insurance does not cover all of your costs related to transplant, you may be eligible for Financial Assistance for Transplant Patients.

Financial assistance for transplant patients

Your transplant center social worker will help you find financial aid that is available through Be The Match® and other organizations.

Planning for transplant costs

Applying for financial aid programs may include many steps. Your transplant center social worker will help you find financial aid that is available through Be The Match® and other organizations, and help you complete the applications.

Be The Match financial aid programs

financial aidBe The Match financial assistance is available for patients who are searching for a donor on the Be The Match Registry®, or who have had a bone marrow or cord blood transplant with a donor from the registry.  Financial assistance from these programs can help you pay for the cost of a donor search and for some post-transplant expenses. Talk with your transplant center financial coordinator to see if you are eligible for these programs.

*Funds for financial aid programs are available through the generous contributions to Be The Match.

Transplant costs worksheet can help you calculate the transplant costs not covered by insurance.

Search Assistance Funds

Search Assistance Funds can help pay the costs not covered by insurance for searching Be The Match Registry of unrelated adult donors and cord blood units. If you are eligible, Be The Match will notify the transplant center. This allows your donor search process to begin as quickly as possible.

To be eligible:

  • You are searching for an unrelated donor or cord blood unit from the Be The Match Registry.
  • Your transplant center has determined you do not have enough insurance coverage to cover the donor search costs.
  • You must be a U.S. resident.

Transplant Support Assistance Funds

Transplant Support Assistance Funds help pay for some costs during the first 12 months after transplant that are not covered by your insurance. These funds can be helpful with costs related to:

  • Temporary housing, if you and your family or caregiver needs to relocate for the transplant.
  • Food for you and your family or caregiver.
  • Parking and gas for ground transportation.
  • Co-pays for prescriptions and clinic visits.

To be eligible:

  • You have had a transplant using an unrelated donor or cord blood unit from the Be The Match Registry.
  • You must be within the first 12 months of your transplant.
  • You meet financial eligibility criteria.
  • You must be a U.S. resident.

ExploreBMT is a resource to connect you and your family with financial support and information from organizations you can trust.

Other financial aid programs

There are several more financial aid programs available to help you with your transplant costs. Ask your transplant center social worker to help you identify and apply for programs that you may be eligible for, including Be The Match financial aid programs.

The importance of Caregivers in Transplantation

four kinds of peopleOne cannot overestimate the importance of having a compassionate, organized and committed caregiver following a transplant.  For a while at least, the patient may be able to do very little for him or herself and will need varying degrees of care.  At first it will be important to make sure the patient gets to Clinic appointments, takes the appropriate medications at the right times, attends rehab sessions and follows dietary recommendations.  Many transplant centers won’t consider the surgery unless such a person is in place and committed to the patient.  This link should help those who agree to perform this most important function  http://tinyurl.com/lnq4vk9

While this may be a lengthy piece it only scratches the surface of resources available to transplant patients and their families.  If you have suggestions for additions, deletions or edits please contact bob@baronson.org the founder of this blog site.

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All the views

Thank you donors and donor families

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.  You can register to be a donor at http://www.donatelife.net.  It only takes a few minutes.

The Language of Loss. What Do You Say to Someone Who Has Lost a loved One?


Introduction by

Bob Aronson

What I saidIt is an unfortunate fact of life that those of us in the transplant community have not only faced death but seen many of our friends pass on while waiting for organs.  Like you, we struggle with what to say.

This post, like many we publish has applications everywhere whether you are a transplant patient or not because we all find ourselves in situations where we are expected to offer words of comfort to grieving friends or family.  Most of us struggle with finding the right words.  Knowing “The right thing to say” doesn’t seem to come naturally.  Guest blogger Dr. Priscilla Diffie-Couch offers excellent advice in this riveting piece about how your words affect someone in grieving.

Priscilla and I are not only cousins by marriage but professional cousins as well.  Both of us had careers in communication.  I cannot speak for her, but in my 50 plus years in that business I learned more than I taught.  I won’t list all my many “Aha” moments because this post is not about me, I will only mention the two that are particularly germane to this topic.

The first is that most of us take communication for granted.  We expect that the audience whether one or many will clearly understand and accept our words.  What we fail to realize is that communication is more than words.  You begin to communicate the moment you walk into a room – before you utter a single word. The way you walk, your facial expression, body language, grooming and attire all contribute to your communication effort.  Communication has as many facets as a well cut precious gem stone.

The second important lesson I learned is that while what you say is very important and kisses and punchesyou should carefully choose your words, most people will not remember the exact language you used.  What they will remember is how you made them feel.

What Priscilla has written here is brilliant.  It is advice given by someone who is not only a communications expert but who has experienced tragic loss first hand.  She has been on the receiving end of the language of loss and has also offered it.  Please read and re-read what she has written and then share it with anyone you think might be helped by these incredible words of wisdom.

THE LANGUAGE OF LOSS

By Dr. Priscilla Diffie-Couch

(I wrote these words in 1980 but because they are based on timeless communication principles they still apply.  I would not change a word.)

“Your mother was killed in a car wreck.”  More than a year and a half has passed since this devastating tragedy and yet these words still seem intended for someone else, not me.  I cannot totally accept the finality of the pronouncement of these painful words.  Yet they introduced events that have completely reshaped my thinking.

Of the lessons of life and death I have learned in these last eighteen months,words the one I have yet to discuss in professional circles is the role our language plays in reinforcing, re-establishing and even reducing relationships in times of grief.

Though one of the two areas of focus in my doctoral training was interpersonal communication, I am now quite sure I have always fallen short in conveying appropriate messages to people who have lost loved ones.  Not too long ago a friend confided that he had not inquired about a neighbor’s critically ill mother.  He feared arousing emotional responses she would not be able to handle, he explained.  I suspect he might admit under further probing that a greater fear was that he might not be able to handle her responses.  Too often I recall my own feelings of inadequacy in similar circumstances.  What if she began to cry?  Became angry?  Smothered me with too many feelings?  Lapsed into silence?  Expected me to understand?  Denied that I could understand?

Such imagined responses are enough to prevent many of us from fully extending our condolences or sharing sincere words of sympathy.  But intense discussions and extended research since my mother’s death persuade me that doing so is always worth risk.

As in any difficult communication situation, guidelines can be helpful.  As you examine these guidelines, remember that they are based on sound general communication principles.  Some will seem self-evident at first glance.  But if you look more closely, you may discover something that will shake your confidence in having done and said “the right things” instinctively.
For example, there is a strong temptation when confronted with difficult don't fix itcommunication situations to resort to easy, familiar phrases.  How simple it is to say to someone who has suffered loss, “You’ll get over it in time.”  “Time heals all wounds.”  “Keep your chin up.”  “Life goes on.”  “You’ve got to face it.”  “Death is just a part of life.”  “Don’t cry.”  “She’s happy now.”

Even as I write them, these safe, comfortable phrases cause me to shudder—as they did during my own loss.  I wasn’t quite sure why at the time.  I have come to realize that such clichés can increase rather than assuage anxiety.  Many of them tend to reinforce the sense of loss.  Yet psychologists remind us that it is very natural for us to experience “denial.”  I did.  I was not ready to accept the void.  I filled it continuously with images of my mom—laughing, smiling, thinking, talking, walking, painting, etc., etc.  These clichés asked me to push my mom—my best friend, the central force, the nucleus, the heart of our family—into the recesses of the mind she had so deeply touched and so strongly influenced.

So I resentfully resisted such repeated phrases as “Time is all it will take.”  To do what, I wanted to scream.  To erase my beloved mom from my mind and memory?  To remove her completely from our lives?  To relegate her spirit to some misty distant role, to be called up only in moments of family reminiscing?

Such common clichés carry the unintended message that you have not
suffered any special loss—yours is not the only mother who ever died.  clichesSuch reminders can seem cold and cruel.  They no more relieve suffering than any other recitation would—highway death statistics, for example.  As I look back, I am very sure that these clichés failed foremost because they did not provide the personal acknowledgement that something specifically and incomparably tragic had happened in my life.  Clichés cannot capture the uniqueness of my special relationship with a rare person whose spirit I shared in a way peculiar to the two of us.  Clichés cannot capture the particular adjustments required continuously throughout the rest of my life without her.  Clichés ignore the reality that her particular love can never be replaced, that her influence has now been permanently diminished in my life.  Clichés lie.  Life does not go on.  Not as it was before.

I could not then and I cannot now reduce the enormity of this event in my life to the casual unconcern implicit in a cliché.  So consider carefully the implications of those easy, familiar phrases before you say, “You’ll get over it.”  Get over what?  If you mean, “You’re in deep pain now.  I hope it will become easier to bear,” then say that.  Treat the loss as unique in the language you choose, no matter how much effort that takes.

Possibly an even greater misconception guiding people in response to another’s loss is that the less mention made of the deceased the less suffering will be imposed.  The opposite is more likely to occur.  The unstated message in such silence is often interpreted as indifference toward or disregard for the deceased.  Did she really make so little impression on you in life that you haven’t a single kind word for her after her death?

Even if you didn’t know the deceased personally, if you visit, you must be there because you personally know the bereaved.  If so, you can easily sincerely observe, “It’s obvious how close you felt to her.  She must have been very special” or “From all you’ve said, I know she was truly a warm and loving coping with lossperson,” or “I can see so many of the influences you have mentioned in your own life.”  Such verbalized reassurances are desperately-needed reminders that her life was not a waste. They acknowledge not only her worth but also the depth and genuineness of the grief.

A few weeks after my mother’s death, as I was going through her memorabilia, I was surprised to find a lengthy letter I had written her some years before.  In it I had detailed all the truly remarkable qualities of her vibrant sister who’d died unexpectedly, much too young.  My mom was not a pack rat, yet she had kept this letter.  She placed special value on the words I had written because they applied uniquely to her sister.

How cherished are those easily-remembered personal comments about Mom the day of her funeral.  “She was always so happy.”  “She was quite a lady.” “There was no one like LaVerna.”  How touched we all were by a poem composed by a neighbor who lost her own mother not many years before.

The second guideline should now be clear:  don’t be deceived into believing that all-too-common cliché that “silence is golden.”  Don’t be deceived into thinking that the words you didn’t say will never come back to haunt you.  They can.  I am still dismayed by words that were never spoken, by friends who didn’t get in touch, by notes and flowers never sent.

Perhaps you’re thinking now—as I once did—that my clumsy words would just increase the pain already felt by those suffering.  None of us has that kind of power.  I know that now.  The event itself is paramount.  It is the cause of the pain.  Whatever you say—if it is a personalized expression of your caring—will be welcomed, even if it does not visibly alleviate the pain.

In fact, it is often the totally spontaneous reaction that carries the most powerful message.  The day after my mom’s death, my brother walked into the woods behind Mom and Dad’s recently-realized dream home with his close friend, a man near forty.  After a long moment of silence, through tears spilling down his face, this friend blurted out, “I don’t think I can stand this!”  The intensity of such a profoundly-felt disclosure cannot be measured, but it left a marked impression on our family.  It served—in a way that no cliché or continued silence could—as a permanent weld in an already warm relationship.  Certainly, personal comments can evoke a fresh flow of tears, but not because they cause additional pain.  Tears are evidence that the hurt exists and an acknowledgement of your willingness to share it.

Of course, there are risks.  Who among us is wise enough to predict the exact responses our words are likely to evoke?  Sensitive communicators calculate the risks, think before they speak, and stand ever ready to adapt with flexibility.  This all takes more effort than it does to remain silent.  And  rest assured that sincere, carefully-considered words of comfort will never be as negative as total, continued silence.

At this point I would be remiss to ignore the role of nonverbal communication in expressing the deepest of emotions. hugs A hug, a touch, a meeting of eyes can convey your strongest feelings with unmatched intensity.  But such
expressions—as deeply as they may temporarily touch someone—will not suffice in a sustained relationship any more than the wedding kiss will meet the needs of a lifetime.  In a continuing relationship the words must eventually come.

Even after that condemnation of continued silence, I’d be tempted to opt for it over communication built solely on unacknowledged assumptions.  Assumptions are dangerous in daily communication; they can be disastrous in times of crisis.

Consider some common assumptions expressed shortly after a death:  “I know how you feel.”  “I’m sure you’d rather be alone right now.”  “Come on.  It will do you good to be with the others.”  “Go ahead. Talk about it.  It’ll help.”  “Don’t talk about it right now.  It will only make you feel worse.”  “This is the worst part.  Tomorrow will be better.”  “You should view the body.  It’s the easiest way to accept it.”  “Im sorry I made you cry.  I know you’d rather not discuss it right now.”

I wonder how many of you have been hurt by the kind of communication that followed assumptions somebody drew and then acted upon as if they were fact.  There are still people who assume I would rather not talk about my mother.  That assumption has caused a rift in one relationship I thought was close and has yet to be repaired.  Such breaks in relationships are often caused by confusing assumption with fact.  What is true for you may not be true for others.  Your assumptions are likely to be inaccurate, inadequate, inappropriate or all of these.

While most of us can accept the warning against treating assumption as fact, some of us may feel a bit cocky about really knowing certain people in our lives.  Do we?  Who is it in your life that knows exactly what you are thinking or feeling at every moment?  Your spouse of twenty years?  How many arguments have started with that faulty assumption?

I have been told that this is a confusing concept.  I seem to be advising against ever engaging in assumptions.  That, of course, would be impossible.  We cannot think, reason, or draw conclusions without engaging in assumptions.  What I am cautioning about is acting on those assumptions as if they were fact and then communicating on this basis.  Telling someone how you coped when your mother died may consist largely of factual reporting.  Sharing means of coping can indeed by helpful. Telling someone she should cope in the same way, however, involves assumptions and can lead to complications and cause communication barriers to develop.

I remember sharing a letter with my dad from my cousin about her eventual acceptance of her mother’s death (my dad’s sister).  Nowhere in her letter was any evidence of an assumption that we could find the same kind of acceptance.  She reported what she had felt and experienced and offered it for our consideration.  In that light, it was deeply appreciated.

If you sincerely care about the person in grief, then don’t assume.  Simply ask, “Would you like to be alone right now?”  Though persons in pain do not always know what they want, remember that you are even less certain.  Your approach should be one of discovering or helping them to discover what their needs are and how you might fill them.  One dear friend, though she had lost neither parent at the time, had an uncanny knack for adapting to my needs as we talked of my mother’s death.  She could turn my tears into laughter and then join me when they started up again.

Such responsiveness demanded that my friend play many roles as a communicator, but she never attempted to be a mind-reader.  She never assumed that she knew exactly what I was thinking or how I was feeling.  She seemed to know that none of us—no matter how intuitive we are—can really step inside another’s mind or heart.

By now it should be obvious that artful listening is a must in communicating with someone submerged in sorrow.  Some of what I say here will seem like common sense.  Yet there are a surprising number of people who apparently need constant reminders of the traits of a good listener. listningNever will you be called upon to exhibit these traits more consistently and compassionately than when communicating with someone who has suffered a painful loss.

Listen with all the empathy you can command.  Listen to the need for reassurance.  Listen to the need to talk about the deceased, about the events that led to the death.  Listen to the need to explore the universe, to make sense of what seems to be senseless. Listen to the need for temporary silence.  Listen to the desire to have the tension broken through laughter, tears, change of subject.  Listen to the anguish behind the anger.  Listen to the need to retrace again and again the “why” that can never be explained.  Listen with your ears, your eyes, your mind, your heart, your soul.

There is no magic formula for executing such delicate communication skills as those involved in fine-tuned listening.  But I can recommend against behaviors that are likely to interfere with effective listening.

Avoid judgmental behaviors and unsolicited advice.  What I am suggesting here may put people with deep religious convictions in a double bind.  One the one hand, they feel compelled to clearly enunciate why true solace in the face of death is available only through one supreme source.  At the same time they are advised not to impose controversial views on those in mental torment if they are to practice effective sensitive listening.  Some common sense guidelines would seem to be:  will what I say produce the desired effect?  Will it produce unnecessary discomfort for those already suffering?

Couple these considerations with the following tested communication concept:  No amount of sincerity will assure acceptance of your beliefs.  Excessive enthusiasm for a cause is often counterproductive.  People who argue too loudly and too long for a position can actually drive opponents further away.  In daily social use the term “sermonizer” has taken on negative connotations.  It suggests a desire to impose standards and opinions on others plus a refusal to listen to alternatives.  A truly effective listener cannot hold unalterable opinions.  The highly sensitive listener projects an attitude of inquiry and genuine desire to learn from others.

It is well to remember that not everyone shares your particular views.  If the bereaved does not even accept the notion of a “God” or an afterlife, then this same person can hardly be expected to find comfort in the notion that God decided the deceased was no longer needed on earth or that it was her time to go or that she is now happy in “heaven.”  Certainly, a religious card a Biblical reference, even a personally-composed prayer can be offered and may provide comfort if it is not accompanied with a sermon.  However well-intentioned, it is not wise to risk adding to a grieving person’s distress.

Suppose you are a very concerned person but one who is a better talker than listener.  Shouldn’t you rely on your natural skills in dealing with someone in grief?  I offer this for consideration:  It takes seconds to see in others what it takes a lifetime to see in oneself.  People who value their ability to talk too often talk about themselves, their feelings, their needs, their interests, their job, their troubles.  There is no such thing as a skillful communicator who talks well but listens poorly.  If there is any chance this describes you, then the kindest thing you can do is send a sympathy card.

I still find it hard to understand why a well-meaning couple, long-time acquaintances of my mom, chose to impose an endless stream of inconsequential incidents from their lives on our family the day Mom died.  They were totally oblivious to our obvious signs of discomfort.  When they finally terminated an unnecessarily long visit, my dad was completely drained and visibly relieved as he closed the door behind them.

Even as I write this, I realize that those who need this message most are least likely to see that it applies to them.  It should be noted that the presence of such ineffective communicators deepens our appreciation of those who are.  What a special place I have in my heart for those who still ask, “How is your dad” and wait expectantly for my emotion laden reply.  How dear are those who are compassionate enough to openly confront the emptiness and void, knowing it does not magically disappear in a few days or months.  How warm I feel toward those rarely empathic listeners whose eyes still moisten in response to my occasional tears.

As you read through these suggestions, you may be thinking, “I’m really a deeply-caring person.  I’ve sincerely tried to say and do the right things, but I still wasn’t very successful.  Somehow, my relationship with that special person has changed.  We are not as close as we were before this death.”

Such bewilderment is not uncommon.  Despite the once open lines of communication, a crisis can cause a distance to develop.  When a soul is shattered—as mine was—by such a destructive blow as my mother’s death, all other relationships are subject to some sort of splintering and must eventually be repaired.

My husband could not have been a more supportive communicator or a more sensitive listener.  He cried with me and followed me with intense empathy through repeated prolonged discussions of Mom, our family, life, death, funerals, religion.  But there were times when I couldn’t sufficiently explain and he couldn’t completely understand, my need to turn to or be with my dad, my sister, my brother.  I couldn’t resist the force pulling me back into my original family-minus-one.  I knew that no one outside that circle could completely comprehend or fully share my loss.  I’m sure my loving husband was confused by my lapse into childhood language the night he called with that inconceivable, never-contemplated news.  “Where is my daddy?  I want my daddy!”  I wailed after my screams had subsided into moans of agony.  I had not called him “Daddy” since I was a child.  But through this means and others I shut my husband out of that fairy-tale family who has struggled out of poverty, built a house together, worked side by side on a dairy farm—a family who lived, laughed, loved together…truly together.

My survival in those early months of mourning was primarily dependent on long tear-filled talks with my sister, my dad, my brother.  We shared what communication experts call a “common frame of reference.”  You can save yourself some unnecessary distress if you examine your expectations during crisis events in the lives of those you love.  You may not be invited to share the same level of disclosure or feelings reserved for close family members.  It may have little to do with your communication behaviors.  You can avoid all the empty clichés; you can set aside all the faulty assumptions; you can show awareness that silence does not suffice; you can practice the most sensitive listening skills.  And you may still end up feeling “shut out.”  But if you deeply care, that is certain to be a temporary condition.  I am fortunate to have an incomparable husband and devoted friends who considered our relationship worth preserving and continued to practice adaptive and perceptive communication skills that brought us so close in the beginning.

Don’t misunderstand.  My family deeply appreciated all expressions of sympathy, however awkward or misguided.  People are universally kind during times of grief.  My focus here, however, has not been how to deal with or receive expressions of comfort.  These guidelines are pointedly directed at all who are ever called upon to offer condolences. 

My primary concern is to remind you—and myself—that this is no easy group hugtask.  And though it is a topic rarely addressed, it should never be taken lightly.  You will want to insure that others benefit by the best possible results that can come out of your good intentions.  Don’t stop trying.  Don’t stop caring.  It is not too late to pick up the phone or a pen or appear in person with some special thought you somehow didn’t or couldn’t convey.  No matter how many years have passed since the tragedy occurred, your words—like the miracle of memories—can warm the heart.

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Apriscilla picturen award winning high school speech and English teacher, Priscilla Diffie-Couch went on to get her ED.D. from Oklahoma State University, where she taught speech followed by two years with the faculty of communication at the University of Tulsa.  In her consulting business later in Dallas, she designed and conducted seminars in organizational and group communication.

An avid tennis player, she has spent the last twenty years researching and reporting on health for family and friends.  She has two children, four grandchildren and lives with her husband Mickey in The Woodlands, Texas.

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A message from Bob Aronson, Founder of Bob’s Newheart blogs.

All the views

Thank you donors and donor families

Bob’s Newheart was established to support and help everyone, but particularly those who need or have had organ transplants.   Most of our blogs specifically address donation/transplantation issues while others are more general, but they are all related.  Because anti-rejection drugs compromise immune systems, transplant recipients are more susceptible to a variety of diseases.  We provide general health and medical information to help them protect themselves while at the same time, helping others live healthier lives and avoid organ failure.

The Bob’s Newheart mission is three-fold; 1) to provide news and information that promotes healthier living so people won’t need transplants; 2) To help recipients protect their new organs and; 3) to do what we can to ensure that anyone who needs an organ can get one.   About 7,000 Americans die every year while waiting for a life-saving organ.  I am sure you will agree that should not happen.

In the U.S. the great majority of people support organ donation, but only about 40% of us officially become organ donors.  Many have good intentions but just don’t get around to it.

No one likes thinking about their ultimate demise, but we all know there’s no way of predicting how long we will live.  There are just too many intangibles. My transplanted heart came from a 30 year old man.  I’m sure he had no intention of being a donor at that age.  So why leave donation to chance?  If you are not yet a donor, please register at www.donatelife.net it only takes a few seconds. Then, tell your family about your decision so there is no confusion when the time comes to donate.

One organ donor can save or positively affect the lives of up to 60 people.  There is no nobler thing you can do than becoming an organ donor.

How To Live Healthy, Live Long and Stay off the Transplant List



B
y Bob Aronson

healthy lifestyle

As of today here is the latest data from the United Network For Organ Sharing (UNOS).  There  are 123,961 people on the U.S. transplant waiting list; from January through August of this year there have been 19,426 transplanted organs from 9,512 donors.  Do the math and you will find that most of those nearly 127,000 will NOT get organs anytime soon.  Many, nearly 7,000 will die waiting.  Why?  The answer is simple, only about 40% of Americans become donors even though almost everyone agrees that donation is a good idea.  The fact is, most of us just don’t get around to signing up.  We have been putting it off since the Transplant Act was passed in 1984.  Anyone who thinks donation alone will end the shortage is fooling themselves.  It won’t…EVER!  Sure we have to keep encouraging people to donate…we can’t let up but we have to consider alternatives.  We must!

The key to solving the shortage of transplantable organs is to significantly diminish the demand.

“We have met the enemy and he is us,” has become a trite expression bu1ht that doesn’t make it any less true.  We are our own worst enemies.   The numbers are staggering.  We are killing ourselves in four ways:

  1. We drink too much alcohol
  2. We smoke too much
  3. We eat too much of the wrong food
  4. We don’t get anywhere near enough exercise

Let’s look at he facts:

  1. alcohol complicationsAlcohol abuse. 5% of Americans abuse alcohol or are alcohol dependent, The estimated annual medical expenditures associated with alcohol abuse total $26.3 billion.  Organs most commonly affected are the lungs, kidneys, pancreas, heart and liver.
  1. 22.5%  of Americans are current smokers, resulting in significant health problems cigarette damageand associated costs.   Medical costs caused by cigarette smoking exceed $75 billion a year.  According to the Centers for Disease Control in Atlanta, Georgia, Smoking harms nearly every organ of the body and causes many diseases.  Cigarette smoking remains the single most-common preventable cause of death in the United States. The adverse health effects from cigarette smoking account for more than 440,000 deaths, or nearly one of every five deaths, each year in the United States.
  1. obesityAbout 40 plus % of adults in the United States are obese.  Often caused by eating too much of the wrong food, a good number of obese people experience some organ failure.  The direct medical costs for obesity have been approximated at $51.6 billion per year. The organs most often affected are the heart, kidneys and pacnreas.
  1. Lack of Exercise. A study released by the Centers For Disease Control (CDC) estimatesbenefits of exercisethat nearly 80 percent of adult Americans do not get the recommended amounts of exercise each week, potentially setting themselves up for years of health problems. Physical inactivity can lead to obesity and Type 2 diabetes, according to the CDC, while exercise can help control weight, and reduce the risk for developing heart disease and some cancers, while providing mental health benefits.

This blog is about meeting the organ shortage by preventing organ failure.  One way to do that is to lead healthier lifestyles.  Alcohol abuse and tobacco use are obvious culprits and we won’t go into detail here.  You should know to severely limit alcohol and quit using tobacco altogether and if not just Google the topics, there are thousands of resources.  So, let’s concentrate on food and exercise.  Let’s start with food.  There are two lists here, 1) the worst foods and 2) the best foods.

Top 30 Worst Foods in America (from Food Matters

Note from Bob’s Newheart.  While Food Matters lists 30 I am only listing ten.  You can click on their link for the rest of the story)

Today’s food marketers have loaded many of their offerings with so much fat, sugar, and sodium that eating any of the foods in this article on a daily basis could destroy all your hard work and best intentions of eating healthy. This list is brought to you by Eat This Not That and Men’s Health. http://foodmatters.tv/articles-1/the-30-worst-foods-in-america-beware

  1. Worst Meal in America

guacamole bacon burgerCarl’s Jr. Six Dollar Guacamole Bacon Burger with Medium Natural Cut Fries and 32-oz Coke 1,810 calories – 92 g fat (29.5 g saturated, 2 g trans) – 3,450 mg sodium

Of all the gut-growing, heart-threatening, life-shortening burgers in the drive-thru world, there is none whose damage to your general well-being is as potentially catastrophic as this. A bit of perspective is in order: This meal has the caloric equivalent of 9 Krispy Kreme Original Glazed doughnuts, the saturated fat equivalent of 30 strips of bacon, and the salt equivalent of 10 large orders of McDonald’s French fries!

  1. Worst Drink

Baskin-Robbins Large Chocolate Oreo Shake. 2,600 calories – 135 g fat (59 g saturated, 2.5 g trans) – 1,700 mg sodium – 263 g sugars.  We didn’t think anything could be worse than Baskin-Robbins’ 2008 bombshell, the Heath Bar Shake. After all, it had more sugar (266 grams) than 20 bowls of Froot Loops, more calories (2,310) than 11 actual Heath Bars, and more ingredients (73) than you’ll find in most chemistry sets. Yet the folks at Baskin-Robbins have shown that when it comes to making America fat, they’re always up to the challenge. The large Chocolate Oreo Shake is soiled with more than a day’s worth of calories and 3 days’ worth of saturated fat. Worst of all, it takes less than 10 minutes to sip through a straw.

  1. Worst Ribs

Outback Steakhouse Baby Back Ribs 2,580 calories. Let’s be honest: Ribs are rarely served alone on a plate. When you add a sweet potato and Outback’s Classic Wedge Salad, this meal is a 3,460-calorie blowout. (Consider that it takes only 3,500 calories to add a pound of fat to your body. Better plan for a very, very long “walkabout” when this meal is over!)

4.Worst Pizza

Uno Chicago Grill Classic Deep Dish Individual Pizza. 2,310 calories – 165 g fat (54 g saturated) – 4,920 mg sodium – 120 g carbs. uno classic pizzaThe problem with deep dish pizza (which Uno’s knows a thing or two about, since they invented it back in 1943) is not just the extra empty calories and carbs from the crust, it’s that the thick doughy base provides the structural integrity to house extra heaps of cheese, sauce, and greasy toppings. The result is an individual pizza with more calories than you should eat in a day and more sodium than you would find in 27 small bags of Lays Potato Chips. Oh, did we mention it has nearly 3 days’ worth of saturated fat, too? The key to success at Uno’s lies in their flatbread pizza.

  1. Worst Mexican Dish

Chili’s Fajita Quesadillas Beef with Rice and Beans, 4 Flour Tortillas, and Condiments.  2,240 calories – 92 g fat (43.5 g saturated) – 6,390 mg sodium – 253 g carbs.  Since when has it ever been a smart idea to combine 2 already calorie- and sodium-packed dishes into one monstrous meal? This confounding creation delivers nearly a dozen Krispy Kreme original glazed doughnuts worth of calories, the sodium equivalent of 194 saltine crackers, and the saturated fat equivalent of 44 strips of bacon. Check please.

  1. Worst Seafood Dish

Romano’s Macaroni Grill Parmesan Crusted Sole. 2,190 calories – 141 g fat (58 g saturated) – 2,980 mg sodium – 145 g carbs.  Fish is normally a safe bet, but this entrée proves that it’s all in the preparation. If you fry said fish in a shell of cheese, be prepared to pay the consequences. Here that means meeting your daily calorie, fat, saturated fat, and sodium intake in one sitting.

  1. Worst Chinese Dish

pf chang combo lo meinP.F. Chang’s Combo Lo Mein.  1,968 calories – 96 g fat (12 g saturated) – 5,860 mg sodium.  Lo mein is normally looked at as a side dish, a harmless pile of noodles to pad your plate of orange chicken or broccoli beef. This heaping portion (to be fair, Chang’s does suggest diners share an order) comes spiked with chicken, shrimp, beef, and pork, not to mention an Exxon Valdez-size slick of oil. The damage? A day’s worth of calories, 1 ½ days’ worth of fat, and 2 ½ days’ worth of sodium. No meat-based dish beats out the strip.

  1. Worst Appetizer

On the Border Firecracker Stuffed Jalapenos with Chili con Queso. 1,950 calories – 134 g fat (36 g saturated) – 6,540 mg sodium. Appetizers are the most problematic area of most chain-restaurant menus. That’s because they’re disproportionately reliant on the type of cheesy, greasy ingredients that catch hungry diners’ eyes when they’re most vulnerable—right when they sit down. Seek out lean protein options like grilled shrimp skewers or ahi tuna when available; if not, simple is best—like chips and salsa.

  1. Worst Burger

Chili’s Smokehouse Bacon Triple Cheese Big Mouth Burger with Jalapeno Ranch Dressing. 1,901 calories – 138 g fat (47 g saturated) – 4,201 mg sodium.  Any burger whose name is 21 syllables long is bound to spell trouble for your waistline. This burger packs almost an entire day’s worth of calories and 2 ½ days’ worth of fat. Chili’s burger menu rivals Ruby Tuesday’s for the worst in America, so you’re better off with one of their reasonable Fajita Pitas to silence your hunger.

10. Worst Sandwich

Quizno’s Large Tuna Melt 1,760 calories – 133 g fat (26 g saturated, 1.5 g trans) – 2,120 mg sodium. In almost all other forms, tuna is aquiznos large tuna melt nutritional superstar, so how did it end up as the headliner for America’s Worst Sandwich? Blame an absurdly heavy hand with the mayo the tuna is mixed with, along with Quiznos’ larger-than-life portion sizes. Even though they’ve managed to trim this melt down from the original 2,000-plus calorie mark when we first tested it, it still sits squarely at the bottom of the sandwich ladder.

Now you know what to avoid, and we urge you to click on the Food Matters link to read the whole list.  So, if you can’t eat any of the aforementioned items what do you eat?  There’s plenty to choose from.   Health Life lists 100 and you can read them all by clicking on their link. Here are their top ten.

http://www.dwlz.com/HealthyLife/healthy50.html

THE 100 HEALTHIEST FOODS
Fruit Fat/Calorie Breakdown Body Benefits
(healthy foods1) Apples 1 medium apple:
81 calories, 0 g fat
An apple’s 3 g of fiber help you meet your fiber goal of 20 g to 30 g daily.  High-fiber diets can lower heart disease risk.
(2) Apricots 3 apricots:
51 calories, 0 g fat
A good source of beta-carotene (which is converted to vitamin A by the body), providing the equivalent of 35% of the RDA for vitamin A
(3) Bananas 1 medium:
105 calories, 0 g fat
Bananas are a great source of potassium, which plays a key role in heart health and muscle function.  Plus each one has 2 g of fiber.
(4) Blackberries 1 cup:
74 calories, 0 g fat
This fruit boasts a whopping 10 g of fiber in a single cup.
(5) Blueberries 1 cup:
81 calories, 0 g fat
Blueberries help prevent and treat bladder infections by making it hard for bacteria to stick to urinary tract walls.
(6) Cantaloupe 1 cup, cubed:
84 calories, 1 g fat
An antioxidant double whammy, with 68 mg of vitamin C and enough beta-carotene to cover 65% of your daily vitamin A quota.
(7) Cherries 1 cup:
84 calories, 1 g fat
A good source of perillyl alcohol, which helps prevent cancer in animals.  Heart-protective anthocyanins give cherries their color.
(8) Cranberry
juice
1 cup:
144 calories, 0 g fat
Fights bladder infections the same way blueberries do.
(9) Grapefruits 1/2 fruit:
39 calories, 0 g fat
A good source of vitamin C and a compound called naringenin, which helps suppress tumors in animals.
(10) Purple grapes
and juice
1 cup seedless:
113 calories, 9 g fat
Offer three heart-guarding compounds:  flavonoids, anthocyanins and resveratrol.  (Green grapes are not rich in them)

If you insist on eating meat there are some good choices you can make…we’ll jump ahead on the list to give you a sneak preview.

    Beef 3 oz, cooked:
150 to 280 calories,
5 g to 20 g fat
Beef is a good source of both CLA and iron, but since it’s also high in saturated fat, have it no more than three times a week.
Chicken,
without skin
3 oz, cooked:
162 calories, 6 g fat
Remove the skin and you’ve got an excellent, low fat source of protein.  And 3 oz provides 38% of the RDA for the B vitamin niacin.
( Lamb 3 oz, cooked, trimmed
of fat:
175 calories, 8 g fat
Lamb, like beef, is also a good source of CLA.  Ditto beef’s saturated fat warning and weelambkly consumption recommendation.
Lean
pork
3 oz, cooked, trimmed
of fat:
140 calories, 4 g fat
Fat-trimmed pork tenderloin has one-third less fat than even lean beef.  And it boasts 71% of the RDA for thiamine.

If Healthy Life doesn’t offer you enough good food ideas, here are some other excellent resources for you to peruse.

http://tinyurl.com/lcmlalt

http://tinyurl.com/lqg7ce8

http://tinyurl.com/k2zzypk

http://tinyurl.com/m9ojjbx

Exercise

Ok, now lets talk exercise.  Why is it important and what should you be doing to stay fit and healthy.  For more on that subject we turn to the famed Mayo Clinic.  Here’s what they say:

one hour workoutHow much should the average adult exercise every day? http://www.mayoclinic.org/healthy-living/fitness/expert-answers/exercise/faq-20057916

  • Aerobic activity.Get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity. You also can do a combination of moderate and vigorous activity. The guidelines suggest that you spread out this exercise during the course of a week.
  • Strength training.Do strength training exercises at least twice a week. No specific amount of time for each strength training session is included in the guidelines.

Moderate aerobic exercise includes such activities as brisk walking, swimming and mowing the lawn. Vigorous aerobic exercise includes such activities as running and aerobic dancing. Strength training can include use of weight machines or activities such as rock climbing or heavy gardening.

As a general goal, aim for at least 30 minutes of physical activity every day. If you want to lose weight or meet specific fitness goals, you may need to exercise more. Want to aim even higher? You can achieve more health benefits, including increased weight loss, if you ramp up your exercise to 300 minutes a week.

Short on long chunks of time? Even brief bouts of activity offer benefits. For instance, if you can’t fit in one 30-minute walk, Exercise seniortry three 10-minute walks instead. What’s most important is making regular physical activity part of your lifestyle.

Other exercise links:

http://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx

http://www.nytimes.com/health/guides/specialtopic/physical-activity/recommended-exercise-methods.html

https://www.google.com/url?

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A message from Bob Aronson, Founder of Bob’s Newheart blogs.

bob cropped smallerBob’s Newheart was established to support and help everyone, but particularly those who need or have had organ transplants.   Most of our blogs specifically address donation/transplantation issues while others are more general, but they are all related.  Because anti-rejection drugs compromise immune systems, transplant recipients are more susceptible to a variety of diseases.  We provide general health and medical information to help them protect themselves while at the same time, helping others live healthier lives and avoid organ failure.

The Bob’s Newheart mission is three-fold; 1) to provide news and information that promotes healthier living so people won’t need transplants; 2) To help recipients protect their new organs and; 3) to do what we can to ensure that anyone who needs an organ can get one.   About 7,000 Americans die every year while waiting for a life-saving organ.  I am sure you will agree that should not happen.

In the U.S. the great majority of people support organ donation, but only about 40% of us officially become organ donors.  Many have good intentions but just don’t get around to it.

No one likes thinking about their ultimate demise, but we all know there’s no way of predicting how long we will live.  There are just too many intangibles. My transplanted heart came from a 30 year old man.  I’m sure he had no intention of being a donor at that age.  So why leave donation to chance?  If you are not yet a donor, please register at www.donatelife.net it only takes a few seconds. Then, tell your family about your decision so there is no confusion when the time comes to donate.

One organ donor can save or positively affect the lives of up to 60 people.  There is no nobler thing you can do than becoming an organ donor.

A Better Way to Combat Obesity


By Dr. Priscilla Diffie-Couch

Introduction by Bob Aronson

Obesity is an equal opportunity disease.  It is no respecter of age, gender, race or religion.  It is deadly and growing so that it now affects more than a third of U.S. adults (nearly 80 million people).  According to the Obesity Society, 69 percent of American adults are either affected by obesity or having excess weight.  http://www.obesity.org/resources-for/what-is-obesity.htm

The National Institutes of Health (NIH) says the combination of poor diet and physical inactivity cause about 300.000 deaths a year, the second leading cause of preventable death in the U.S.

Obesity puts individuals at risk for more than 30 chronic health conditions including:  type 2 diabetes, high cholesterol, hypertension, gallstones, heart failure, fatty liver disease, sleep apnea, GERD, stress incontinence, heart failure, degenerative joint disease, birth defects, miscarriages, asthma, and numerous cancers.

Priscilla Diffie-Couch E.E.D. has been researching and writing about health issues for over two decades.  Her reporting is factual, objective, helpful and frank. She is a frequent contributor to Bob’s Newheart.

A Better Way to Combat Obesity

By Priscilla Diffie-Couch E.E.D

dead 24 hrs

Obesity is more than an abundance of food and a shortage of exercise.  It is more than the substitution of sugar for fat or the easy access to cheap fast foods.  Few would question the ever-increasing obsession with food or need to get to the root of that problem.  But too few treat obesity as a genuine threat.  Yet what good does it do to make the world safe from terrorism while we watch millions of people being held hostage by food until they eat themselves to death?

obese person on airplaneWhat caused Americans to get so fat?  Research is replete with the absolute proof that eating fat does not cause us to get fat   ( www.wnyc.org/story/eating-fat-doesnt-make-us-fat).    In fact, we have learned that the introduction of low-fat food into our diet was one of the greatest health mistakes ever made.  We have only learned lately that, with the exception of transfat, fat is not a culprit in causing disease.  On the contrary, when we remove fat from our diet, we deprive ourselves of vital nutrients that prevent disease, in particular, vitamin D ( medicinenet.com/ vitamin_d_deficiency/related…/index.htm ).

A shocking number of diseases are associated with low levels of vitamin D:  Alzheimer’s, dementia, diabetes, fatty liver, high blood pressure, Chron’s disease, allergy, MS, depression, osteopenia, cancer, rickets, cystic fibrosis, celiac disease and obesity itself.  Reliable recent evidence shows that many Americans are short of vitamin D (health.usnews.com/…/many-americans-fall-short-on-their-vitamin-d).

Making matters worse, obese people do not make as much vitamin D3 in their guts as normal weight people do.  That exacerbates the shortage of vitamin D.  In one study obese subjects had significantly lower basal 25-hydroxyvitamin D concentrations and higher parathyroid hormone concentrations than did age-matched control subjects.  Evaluation of blood vitamin D3 concentrations 24 hours after whole-body irradiation showed that the incremental increase in vitamin D3 was 57% lower in obese than in non-obese subjects (ajcn.nutrition.org/content/72/3/690.abstract).

Besides the fact that low levels of vitamin D contribute to obesity and obesity further reduces levels of vitamin D, we are caught in another vicious cycle.  Omitting fat deprives us of the unequalled satiating power of full-fat foods.  That circles us right back into further weight gain.

Another result compounds the problem.  Food without fat loses much of its flavor.  So food manufacturers fill that void with added sugar and

sugarsalt.  But neither the presence of sugar or salt is independently responsible for the fattening of America.  Our bodies have always been able to tolerate salt and sugar in controlled amounts.  It is the unregulated unparalleled quantities of sugar in our foods–not ingested fat–that turns to fat in the human body.

Upon closer observation, it is not just the quantity of sugar that causes our bodies to lose essential metabolic control.  It turns out that simple carbohydrates in any food form are treated the same as sugar when we ingest them.  Table sugar and white bread work equally efficiently to impair our body’s ability to use insulin.  And that causes constant hunger and disease and bulging bodies.  Bulging bodies crave food.

So someone came up with the brilliant idea of replacing sugar in food and drink.  Along came the introduction of sugar substitutes, possibly the second biggest health mistake ever made.  Recent research strongly suggests that sweeteners cause blood sugar spikes.  (See the study published in Nature, September 17, 2014 “Artificial Sweeteners Induce Glucose Intolerance by Altering Gut Bacteria.”)  The negative consequences are the same–possibly worse.  Drinks sweetened with sugar substitutes have zero calories.  So we happily consume greater quantities of sugar-free food and drink with abandon, never realizing how much this contributes to our weight problem.

That still does not fully explain why we are getting more and more obese as a nation.  Obviously, easy access to abundant food and drink of any whole heaalth sourcekind makes it harder to control our weight.  The super-sizing of everything we eat is now so common that we feel cheated if we are offered what once was a normal sized hamburger or portion of fries.  The original six ounce soda now seems like a drink intended for a small child.  Just as we have readjusted our view of what is overweight because there are so many more overweight people than ever before, we have readjusted our view of portion size.  That results in eating far more calories than ever before.Is quantity then the real culprit in packing on the pounds?  Without a doubt, it is a major contributor to obesity.  A summary reported in April of this year by Whole Health Source charts the rise in calorie intake and its impact on obesity.  “Calorie Intake and the U.S. Obesity Epidemic” points out that Americans increased their total calorie intake by 363 calories a day between 1960 and 2009.  Surprisingly, during this time obesity has trebled yet we have cut our intake of fat from 45% of total calorie to less than 33%.  What is not so surprising is that we now consume mostly simple carbohydrates.  (www.hsph.harvard.educ/nutritionsource/fats-full-story/).

Substituting simple for complex carbohydrates changes the food equation.  What is almosthigh fiber super stars always missing when we eat the wrong foods in any quantity is fiber.  Fiber is a magic agent that prevents sweetened food and drink from causing a sharp insulin spike (www.sharecare.com/health/type-2…/food-and-blood-sugar-levels).  Fiber is the friendly element in food that causes us to detect texture and tricks our stomachs into feeling fuller on less quantity.  We need from 25 to 35 grams of fiber daily.  Yet it impossible to find a single meal when we eat out that offers more than two or three grams of fiber, if that.  Even when we eat at home, we fill our plates with everything but fiber.

Eating to stay slim requires daily monitoring of what we put in our bodies.  It is not easy.  Yet, Americans have continued to search for some simple formula for fighting the fat that creeps on to our bodies more readily with each passing year.  Diet pills don’t work.  Diet plans are a dismal failure.

It goes without saying that Americans are less active now than ever before in history.  The sad fact is that, the obesity on wheelsfatter people are, the harder it is to be active.  Slim people tell fat people to walk.  They can’t.  Many rely on riding on special carts to even be able to navigate through the grocery store.  The amount of effort required to lose only a few pounds causes too many of the overweight and obese simply to give up.

So what is the solution to obesity?  No one seems to know.  Individually, however, I feel certain that we could make a discernible dent in the problem by doing something very simple.  Retrain ourselves and our children to abide by the nutrition rules that worked so well back when obesity was a rare burden.  Every meal should consist of single portions on a 10-inch dinner plate (except for salad) consisting of 30% full fat, 30% protein, and 60%  complex carbohydrates, which contain multiple grams of fiber.  Substantial gains in loss of fatness could be achieved if we asked ourselves before every meal or snack, “Where is the fiber?”

Allowing ourselves and our children dessert only if we followed the rules for healthy eating spelled out above would provide a bonus for maintaining a healthy weight.

But most of us know what we should do individually to avoid getting fat. Having that knowledge has yet to solve the obesity problem.  We have been left alone too long.  Sporadic solutions are not the answer.  Companies that have independently created incentive programs that reward people who lose weight find themselves subject to discrimination lawsuits.

I cringe as I write these words but I have come to believe that we have no choice but to get the government of every nation with an obesity problem directly involved.  Independent drug researchers are never going to discover the magic fat-dissolving pill.  National research agencies must be fully funded to seek causes and solutions for the world-wide obesity malady.  New standards for defining obesity must be based on actual medical outcomes.  Validity of using Body Mass Index or waist circumference for predicting negative health effects must be re-examined and adjusted for age.  Meanwhile, steps need to be taken to implement workable plans to gain a foothold in arresting obesity.  I have never been an advocate of total government intervention.  But, when every possible private option has been exhausted, imposing universal programs may be the only answer.

The government must step up to reduce the burden of being fat.  There are at least 300,000 reasons why.  That is the number of deaths per year in the US estimated to be associated with obesity.  More than 78 million Americans can now be classified as obese.  That is more than the combined populations of California, Texas and New York.  If the current trend continues, by 2030 that number will increase to a shocking 45 to 51% of the population.

Obesity is now the second leading preventable cause of death in our country.  It is linked to sixtydeaths from obesity chronic conditions like diabetes, high blood pressure, stroke, heart disease, osteoporosis, breast cancer and others.  It is now safer to smoke, drink to excess, or be impoverished than it is to be obese.

The fatter we get, the less active we are.  The less active we are, the sicker we get.  The sicker we get, the greater the demand for costly drugs and hospital care and doctor visits. The more we spend on medical care, the more stress we feel.  The more stress we feel, the more we turn to food.  Clearly, the problem of obesity has ballooned into a never-ending cycle.

This cycle is not easily broken.  Sadly, in a routine trip to the grocery store, we can see a disturbing number of people so obese that they could have been found only in “freak” shows fifty years ago.  We are no longer surprised to see a rack of size 5X clothing on display at Wal-Mart.  Ironically, the fatter we get, the fewer of us see ourselves as fat.  By current definition, an ordinary person six foot tall who weighs 221 pounds is classified as obese.  But because one in three Americans is now overweight, our perception of “fatness” has changed.  Fat people look at fatter people with disgust.  Other people are fat.  We just need to lose a few pounds. 

Losing pounds is not easy.  Studies show that most of us underestimate our calorie intake and overestimate our level of activity. Fat people sit on the sidelines while others ride bikes, hit obese chldrentennis balls and swim.  Fat kids watch TV and sit in front of computers while their slimmer counterparts run and play.  The multi-billion dollar diet industry has failed.  The misguided low-fat diet craze has failed.  The only success story we can point to is the supersizing of America.

What will it take to break this supersizing cycle?  Thirteen years later, we are still aware of the changes in our lives prompted by the attack on 9-11-2001.  If terrorists had killed 300,000 Americans that day—as obesity does each year–it is hard to imagine the extent of government intervention in our lives aimed at protecting our safety and well-being.

What will it take to wake us up?  Obesity now claims more lives than illicit drug use, car and plane wrecks combined.  In 2009 alone, obesity cost our nation $152 billion.  These enormous costs are borne by us all. They show no signs of abating.  Individual efforts to curb obesity have failed.  That leaves little choice but to turn to the government for solutions.

The specific role of government should take the form of incentives, not mandates like those used in national security.  Medical research needs to be funded to provide clear guidance for designing programs that can break the cycle of disease and disorders resulting from being fat.  Government must first focus on finding out why we are fat and then on prevention.  Providing specific incentives associated with being fit not fat must be incorporated into the infrastructure of our lives.  A massive campaign must be mounted to make the public aware of these new programs.

Such government programs should begin early in our public schools.  Required physical education classes should be reinstated from primary through the twelfth grade.  Physical fitness should be given prestigious treatment among honors awarded to students of all ages.  Teachers in every field of study should be rewarded for creating curricula that require students to get up move around the classroom.  School systems should receive monetary incentives for the number of students they graduate that are not fat.  Government recognition of healthy fit kids should once again become a central concern of Health, Education, and Welfare.

Nutrition courses should be required at all grade levels.  Schools should be rewarded for increasing the number of students who stay on campus and eat nutritious meals.  Healthy snack breaks should be a part of daily school ritual at every level so that teachers can verbally reward students who actually eat their fruit.  Tax payer money should not be spent on school lunch programs that compete with fast-food fare.  Advertisements of non-nutritious foods—as has been done with alcoholic beverages and cigarettes–must be banned from television and certainly in the schools.  Deals between schools and the soft drink industry must be ended.

Programs for adults must also be designed to provide incentives for not being fat.  Providing discounts for drugs required because of conditions caused by obesity is counterproductive.  Doing so not only fails to discourage weight gain, but it also ignores what studies show to be the number one medicine to prevent and treat common diseases.  It does not come in a bottle.  It is called exercise.  Exercise, we now know, is superior tTop 20 exercise benefitso Prozac for treating mild to moderate depression.  Exercise can reverse certain kinds of heart disease and do away with the need for medicine to control blood sugar.  Abundant research shows that even light weight-lifting can enable elderly people to get up out of their wheel chairs and walk after only few weeks.   A proper diet and exercise can free many people with high blood pressure from medication.  Something as simple as daily brisk walks can produce far more dramatic results than drugs in how fat and fit we are.

Ways for identifying people eligible for health discounts can be established.  People who get a driver’s license must pass written and driving tests.  Safe drivers and home owners get discounts on insurance.  Similar systems can be set up to reward fit people when they apply for health insurance.  A certificate from a doctor can show the results of blood tests, blood pressure readings and other health measures that indicate fitness.  Scales can easily give readings on site.  Just as cars are given a sticker showing they have passed inspection, centers of fitness and nutrition can be certified to provide evidence of completion of nutrition tests and other requirements that must be met for various levels of discount entitlement.  Discounts for proven health supplements, as opposed to drugs to treat the maladies associated with obesity, can be awarded as part of the fitness incentive program. Obviously, such programs would demand universal fitness standards based on valid current research and updated upon discoveries in medical science.   For example, safe limits for cholesterol need to be reviewed just as blood pressure limits have recently been changed for older folks.

Goals and measurements must be stated in language that confronts the negative consequences of our present behavior.  As a communication specialist, I know that words influence behavior.  We have to stop beating around the verbal bush.  “Fat” and “obese” must be clearly defined and used openly to denote where we are and what we need to change.  We must stop fooling ourselves and our children.  Fat is not fun or funny or beautiful.  Fat is costly and risky.  And too often deadly.

The failure rate in managing our fatness and fitness has remained too high for too long.  We don’t need to spend more tax dollars on helping people buy more drugs or use more health care.  We should not be handing out tickets to help people end up in an early grave.  Exercise is free and eating right can be done without extra cost.  Doing both will save us all billions of health care dollars each year.

Federal intervention sounds like a nasty solution to some.  To the contrary, it can be accomplished by built-in rewards for those of us who successfully assume greater personal responsibility for our health, nutrition, and fitness.  And those of us who are already fit and healthy reap our rewards by not being forced to subsidize those who are not.

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An award winning high school speech and English teacher, Priscilla Diffie-Couch went on to get her ED.D. from Oklahoma State University, priscilla picturewhere she taught speech followed by two years with the faculty of communication at the University of Tulsa.  In her consulting business later in Dallas, she designed and conducted seminars in organizational and group communication.

An avid tennis player, she has spent the last twenty years researching and reporting on health for family and friends.  She has two children, four grandchildren and lives with her husband Mickey in The Woodlands, Texas.

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A message from Bob Aronson.bob half of bob and jay photoBob’s Newheart was established to support and help everyone, but particularly those who need or have had organ transplants.  Some of our blogs are specifically related to donation/transplantation issues while others are more general, but they are all related.  Because anti-rejection drugs compromise immune systems, transplant recipients are more susceptible to a variety of diseases.  We provide general health and medical information to help them protect themselves while at the same time, helping others live healthier lives and avoid organ failure.

Bob’s Newheart mission is three-fold; 1) to provide news and information that promotes healthier living so people won’t need transplants; 2) To help recipients protect their new organs and; 3) to do what we can to ensure that anyone who needs an organ can get one.   About 7,000 Americans die every year while waiting for a life-saving organ.  I am sure you will agree that should not happen.

In the U.S. the great majority of people support organ donation, but only about 40% of us officially become organ donors.  Many have good intentions but just don’t get around to it.  It is hard to accept, but no one knows how long they will live.  My transplanted heart came from a 30 year old man.  I’m sure he had no intention of being a donor at that age.  If you are not yet a donor, please register at www.donatelife.net it only takes a few seconds. Then, tell your family so there is no confusion when the time comes to donate.  One organ donor can save or positively affect the lives of up to 60 people.  There is no nobler thing you can do than becoming an organ donor.

Bob Aronson Founder of Bob’s Newheart Established November 3, 2007

The Greatest Public Health Threat is Here Now — Antibiotic Resistant Diseases


By Bob Aronson

partners in antibiotic resistance

Antibiotics and drugs called antimicrobial agents have been used for the last 70 years to treat patients with infectious diseases who might genotherwise have died.  Unfortunately these “Miracle” drugs were used for such a long time and so indiscriminately that the organisms they were designed to kill have mutated and become more resistant to them. In some cases the drugs don’t work at all anymore.

Each year in the United States, at least 2 million people become infected with antibiotic resistant bacteria and at least 23,000 of them die as a result. While 23,000 is a significant number it does not even come close to being in the catastrophic category so there’s not much media attention given to the problem  – until now and this headline.

Is Antibiotic resistance: the greatest public health threat of our time?

Tsuperbugshis is not the stuff of science fiction.  It is real and it is supported by both the World Health Organization (WHO) and by the U.S. Centers For Disease Control in Atlanta, Georgia (CDC)

The WHO says we are in a “post-antibiotic era”, in which even the most minor bacterial infections could mean death, a statement made true because of antibiotic misuse, overprescribing and poor diagnoses.

A world without antimicrobials would be a world without modern medicine, so why is there not more urgency in addressing the global rise of drug resistance? The New Statesman brought leading health experts together to discuss the problem. http://www.newstatesman.com/sci-tech/2014/07/antibiotic-resistance-greatest-public-health-threat-our-time

Antibiotic-resistant infections can happen anywhere. The CDC says that most of them happen in the general community; however, most deaths related to antibiotic resistance happen in healthcare settings such as hospitals and nursing homes.  http://www.cdc.gov/drugresistance/threat-report-2013/index.html

 The Threat to You

Diseases that either are or are becoming antibiotic resistant http://www.cdc.gov/drugresistance/DiseasesConnectedAR.html

A growing number of disease-causing organisms or pathogens, are resistant to one or more antimicrobial drugs—including the bacteria that cause tuberculosis, the viruses that cause influenza, the parasites that cause malaria, and the fungi that cause yeast infections.  All are becoming resistant to the antimicrobial agents used for treatment.  Curious about other diseases that may not respond to your antibiotics?   Here’s a partial list from the CDC.  The full list can be seen by clicking on the above link.

Acinetobacter acinetobacteris a type of gram-negative bacteria that is a cause of pneumonia or bloodstream infections among critically ill patients. Many of these bacteria have become very resistant to antibiotics.

Anthrax

Anthrax is a serious disease caused by Bacillus anthracis, a bacterium that forms spores. Anthrax most commonly occurs in wild and domestic mammalian species, but it can also occur in humans when they are exposed to infected animals or to tissue from infected animals or when anthrax spores are used as a bioterrorist weapon. Some strains of B. anthracis may be naturally resistant to certain antibiotics and not others. In addition, there may be biologically mutant strains that are engineered to be resistant to various antibiotics.

EnterobacteriaceaeCarbapenem resistant Enterobacteriaceae

Untreatable and hard-to-treat infections from carbapenem-resistant Enterobacteriaceae (CRE) bacteria are on the rise among patients in medical facilities. CRE have become resistant to all or nearly all the antibiotics we have today. Almost half of hospital patients who get bloodstream infections from CRE bacteria die from the infection.

Gonorrhea

Neisseria gonorrhoeae causes gonorrhea, a sexually transmitted disease that can result in group b strepdischarge and inflammation at the urethra, cervix, pharynx, or rectum.

Group B streptococcus

Group B Streptococcus (GBS) is a type of bacteria that can cause severe illnesses in people of all ages, ranging from bloodstream infections (sepsis) and pneumonia to meningitis and skin infections.

Methicillin-resistant Staphylococcus aureus (MRSA)

Methicillin-resistant Staphylococcus aureus (MRSA) causes a range of illnesses, from skin and wound infections to pneumonia and bloodstream infections that can cause sepsis and death. Staph bacteria, including MRSA, are one of the most common causes of healthcare-associated infections.

Salmonella, non-typhoidal serotypes

Non-typhoidal Salmonella (serotypes other than Typhi, Paratyphi A, Paratyphi B, and Paratyphi C) usually causes diarrhea (sometimes bloody), fever, and abdominal cramps. Some infections spread to the blood and can have life-threatening complications.

Shigella

hand washingShigella usually causes diarrhea (sometimes bloody), fever, and abdominal pain. Sometimes it causes serious complications such as reactive arthritis. High-risk groups include young children, people with inadequate hand washing and hygiene habits, and men who have sex with men.

Streptococcus pneumoniae

Streptococcus pneumoniae (S. pneumoniae, or pneumococcus) is the leading cause of bacterial pneumonia and meningitis in the United States. It also is a major cause of bloodstream infections and ear and sinus infections.

Tuberculosis

Tuberculosis (TB) is among the most common infectious diseases and a frequent cause of death TBworldwide. TB is caused by the bacteriaMycobacterium tuberculosis (M. tuberculosis) and is spread most commonly through the air. M. tuberculosis can affect any part of the body, but disease is found most often in the lungs. In most cases, TB is treatable and curable with the available first-line TB drugs; however, in some cases, M. tuberculosis can be resistant to one or more of the drugs used to treat it. Drug-resistant TB is more challenging to treat — it can be complex and requires more time and more expensive drugs that often have more side effects. Extensively Drug-Resistant TB (XDR TB) is resistant to most TB drugs; therefore, patients are left with treatment options that are much less effective. The major factors driving TB drug resistance are incomplete or wrong treatment, short drug supply, and lack of new drugs. In the United States most drug-resistant TB is found among persons born outside of the country.

Typhoid Fever

Salmonella serotype Typhi causes typhoid fever, a potentially life-threatening disease. People with typhoid fever usually have a high fever, abdominal pain, and headache. Typhoid fever can lead to bowel perforation, shock, and death.

Vancomycin-Intermediate/Resistant Staphylococcus aureus(VISA/VRSA)

Staphylococcus aureus is a common type of bacteria that is found on the skin. During medical procedures when patients require catheters or ventilators or undergo surgical procedures, Staphylococcus aureus can enter the body and cause infections. When Staphylococcus aureus becomes resistant to vancomycin, there are few treatment options available because vancomycin-resistant S. aureus bacteria identified to date were also resistant to methicillin and other classes of antibiotics.

Malaria

malariaMalaria is a mosquito-borne disease caused by a parasite. People with malaria often experience fever, chills, and flu-like symptoms. The development of resistance to drugs poses one of the greatest threats to malaria control and has been linked to recent increases in malaria morbidity and mortality. Antimicrobial resistance has been confirmed in only two of the four human malaria parasite species, Plasmodium falciparum and P. vivax.

 WHO: Antibiotic Resistance Now a ‘Major Threat to Public Health’

Antibiotics are powerful tools for fighting illness and disease, but their overuse has helped create bacteria that are outliving the drugs used to treat them.

Antibiotic resistance is a quickly growing, extremely dangerous problem. World health leaders have described antibiotic-resistant bacteria as “nightmare bacteria” that “pose a catastrophic threat” to people in every country in the world. Many more people die from other conditions that were complicated by an antibiotic-resistant infection.

In addition, almost 250,000 people who are hospitalized or require hospitalization get Clostridium difficile each year, an infection usually related to antibiotic use. C. difficile causes deadly diarrhea and kills at least 14,000 people each year. Many C. difficile infections and drug-resistant infections can be prevented.

How Bacteria Become Resistant

When bacteria are exposed to antibiotics, they start learning how to outsmart the drugs. This process occurs in bacteria found in humans, animals, and the environment. Resistant bacteria can multiply and spread easily and quickly, causing severe infections. They can also share genetic information with other bacteria, making the other bacteria resistant as well. Each time bacteria learn to outsmart an antibiotic, treatment options are more limited, and these infections pose a greater risk to human health.

Infections Can Happen to Anyone, Anywhere

Anyone can become infected with antibiotic-resistant bacteria anywhere and anytime. Most infections occur in the community, like skin infections with MRSA and sexually transmitted diseases. However, most deaths related to antibiotic resistance occur from drug-resistant infections picked up in healthcare settings, such as hospitals and nursing homes.

 What you can do to protect yourself against drug-resistant infections

 Bob’s Newheart is providing two answers to this question.  The first from the CDC and the second from a panel of physician experts who were interviewed for the PBS TV show, Frontline.

 CDC Advice

 There are many ways you can help prevent the creation and spread of resistance. First, when you are sick, do not demand antibiotics from your doctor or take antibiotics that were not prescribed to you directly for your specific illness. When taking antibiotics, do not skip doses, and make sure to follow the directions about dose and duration from your doctor.

Second, like all diseases, common safety and hygiene methods can prevent disease and spread. Make sure to:

  • Get updated and regular vaccinations against drug-resistant bacteria
  • Wash your hands before eating and after using the restroom to avoid putting drug-resistant bacteria into your body
  • Wash your hands after handling uncooked food to prevent ingesting drug-resistant bacteria that can live on food
  • Cook meat and poultry thoroughly to kill bacteria, including potential drug-resistant bacteria

What healthcare providers can do to protect patients from drug-resistant infections (CDC)

patientsThere are many ways to help provide the best care to your patients while protecting them against antibiotic-resistant infections.

  • Follow all necessary infection control recommendations, including hand hygiene, standard precautions, and contact precautions.
  • Diagnose and treat resistant infections quickly and efficiently. Treatment options change often because resistance is complex. Make sure to follow the latest recommendations to ensure you are prescribing appropriately.
  • Only prescribe antibiotics when likely to benefit the patient, and be sure to prescribe the right dose and duration.
  • Be sure to clearly label dose, duration, and indication for treatment, and include appropriate laboratory diagnostic tests when placing antibiotic orders. This will help other clinicians caring for the patient to change or stop therapy when appropriate.
  • Take an antibiotic time out, reassessing therapy after 48-72 hours. Once additional information is available, including microbiology, radiographic, and clinical information, a decision can be made on whether to continue the same therapy.
  • When transferring patients, ensure the other facilities are notified of any infection or known colonization.
  • Keep tabs on resistance patterns in your facility and in the area around your facility.
  • Finally, encourage prevention methods with your patients. Make sure they understand how to protect themselves with vaccines, treatment, and infection control practices such as hand washing and safe food handling.

From PBS “Frontline”

 Eight Ways to Protect Yourself from Superbugs

http://www.pbs.org/wgbh/pages/frontline/health-science-technology/hunting-the-nightmare-bacteria/eight-ways-to-protect-yourself-from-superbugs/

protet yourself from superbugsOctober 22, 2013, 9:32 pm ET by Sarah Childress

Everyone is at risk of becoming infected by drug-resistant bacteria, especially as some have begun to appear outside of hospitals in the general community. So how worried should you be?

The PBS investigative show, “FRONTLINE” asked three infectious disease doctors these questions: what the risks are, how to protect yourself, and what questions to ask when a loved one is in the hospital.

Dr. Sean Elliott is the medical director of infection prevention at the University of Arizona Health Network Dr. Brad Spellberg is an infectious diseases specialist at Harbor-UCLA Medical Center Dr. Wendy Stead is an infectious diseases specialist at Beth Israel Deaconess Medical Center in Boston

Frontline condensed their advice into eight handy tips to help keep bugs at bay.

Of course, none of this substitutes for actual medical advice. For serious concerns, always consult your doctor.

 1. Don’t Panic

Everyone may be at risk, but the chances of catching a drug-resistant bug outside of the hospital are small for most. “For the average healthy person walking down the street?  Those organisms are not much of a threat,” Stead says.

“The first principle is to try to live a healthy lifestyle to reduce the need to be in the hospital” where you are more likely to encounter these bugs, Spellberg says. Keep your home and work space clean. Be aware of the food you eat: Wash fruits and vegetables carefully and cook other food properly to reduce your chance of coming into contact with harmful bacteria.

2. Know What to Look For

How do you know if you have a superbug?

“You don’t.  And your doctor won’t either, at least at first,” Spellberg said. “The infections caused by antibiotic-resistant bacteria do not cause different symptoms than infections caused by antibiotic-susceptible infections.”

While it’s impossible to give broad advice about so many different kinds of bacteria — and if you’re concerned, you should call your doctor first — there are some signs that an illness might be more serious. “In general, fevers, if they’re accompanied by shaking chills, if they’re getting worse instead of better, that would suggest there’s a bacterial process,” Elliott said.

With community-acquired MRSA, many people first notice a skin infection or boil that becomes larger and more painful, Stead says.

But if you do suspect such an infection, don’t rush to the emergency room, where you might be exposed to other bugs or infect others. Call your primary-care doctor first for advice.

3. Wash Your Hands with Soap and Water. Really wash them. Doctors say they cannot recommend this enough.

 “Wash your hands regularly and religiously in the normal times that you would think you should wash them,” Stead says. “Give it a good amount of time” — about 15 seconds — “scrubbing hands thoroughly, not just in and out of the water.”

Turn off the faucet using a paper towel.

Alcohol-based hand-sanitizers are handy too, but remember that one bug, C.Diff, is resistant to that as well. But it does respond to soap and water. So Wash. Your. Hands.

4. Be Careful with the Antibacterial Soap

 antibacterial soapThe FDA hasn’t determined whether these soaps are more effective than regular soap, and some doctors don’t recommend using them. “You do not need to take ‘antibacterial’ soaps for routine use,” Spellberg says. “There may be specific medical circumstances that warrant special antibacterial cleansers, but these should be prescribed by your physician.”

“A lot of the antibacterial soaps are more drying to the skin than would be a simple soap,” Elliott says. “So the more that we break down our skin barriers the higher the risk of getting superimposed bacterial. The real key is the soap and water and the physical action  — and keeping hands moisturized. “

5. Ask Your Doctors to Wash Their Hands

“It is every patient’s right to have every health-care provider entering the room to have clean hands,” Elliott says. “We’re supposed to do it, we mandate 100 percent hand- hygiene wash your handscompliance, but the reality is that doesn’t happen,” he says.

Some hospitals even make health-care providers wear buttons encouraging patients to ask them if they’ve washed their hands. Even if they’re buttonless, you should feel free to ask your providers about it.

“Really — we are not offended by that,” Stead says.

6. Get A Flu Shot

“When people get influenza, they actually become at higher risk as they recover for complicating bacterial infections,” Stead says, because people with weakened immune systems are more vulnerable to other bugs.

“Community-acquired MRSA is a big risk in patients who have recently had influenza,” she notes. “They get influenza and they start to get better, and then the staph comes in. … That’s life threatening.  They wouldn’t have been at risk for that if they hadn’t had influenza in the first place.”

7. Ask Whether You Need that Antibiotic

 Doctors sometimes feel pressured by patients or their families to prescribe an antibiotic, even if it’s not necessary. Don’t assume you need one — antibiotics don’t work on viral infections like colds or the flu. If your doctor does recommend one, ask whether you really need it.

“Using antibiotics does kill off non-resistant bacteria in your body and makes you likely to acquire antibiotic-resistant bacteria in their place,” Spellberg says. “If your doctor says that they think your infection is probably caused by bacteria and that you do need an antibiotic, ask, ‘Do I need a broadly active antibiotic, or can I take a narrower antibiotic?’ The broader the antibiotic, the more damage to your normal bacteria can be caused. We want physicians to try to prescribe antibiotics that are as narrow as possible for a given infection.”

8. Advocate for Loved Ones in the Hospital

 patient advocateOne of the ways drug-resistant bacteria spreads in hospital is through tubes inserted in the body, such as catheters. If someone you care about is on such a device, don’t be afraid to ask doctors whether they still need it, and when the tubes can come out.

“Hospitals are much more aggressive about removing things if they’re not needed anymore,” Stead says. “But having patients be aware and try to get things out too is good.”

“Every day that decision needs to be made: Do these things need to stay in or do they need to come out?” Elliott says. The key, he says, is “empowering patients or their advocates to stand up for their health-care needs.”

Conclusion

While physicians and health care workers have a responsibility to provide the best health care, patients also have some responsibility for their own well-being and it boils down to being informed and not being afraid to ask tough questions.

Most of us don’t like challenging physicians, we just assume that will all those many years of education and the raft of framed diplomas on the wall that they must know what they are doing, but the practice of medicine is as much art as it is science.  That means even highly educated medical experts can come to the wrong conclusions, so it is extremely important for patients to expand their knowledge of the conditions to which they are exposed or have contracted, ask tough, knowledgeable questions and then, demand clear unequivocal answers. Doing so could mean the difference between life and death.

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bob minus Jay full shot Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org.

Bob’s Newheart was established to support and help everyone, but particularly those who need or have had organ transplants.  Some of our blogs are specifically related to donation/transplantation issues while others are more general, but they are all related.  Because anti-rejection drugs compromise immune systems, transplant recipients are more susceptible to a variety of diseases.  We provide general health and medical information to help them protect themselves while at the same time, helping others live healthier lives and avoid organ failure.

Bob’s Newheart mission is three-fold; 1) to provide news and information that promotes healthier living so people won’t need transplants; 2) To help recipients protect their new organs and; 3) to do what we can to ensure that anyone who needs an organ can get one.   About 7,000 Americans die every year while waiting for a life-saving organ.  I am sure you will agree that should not happen.

In the U.S. the great majority of people support organ donation, but only about 40% of us officially become organ donors.  Many have good intentions but just don’t get around to it.  It is hard to accept, but no one knows how long they will live.  My transplanted heart came from a 30 year old man.  I’m sure he had no intention of being a donor at that age.  If you are not yet a donor, please register at www.donatelife.net it only takes a few seconds. Then, tell your family so there is no confusion when the time comes to donate.  One organ donor can save or positively affect the lives of up to 60 people.  There is no nobler thing you can do than becoming an organ donor.

Bob Aronson

Founder of Bob’s Newheart

Established November 3, 2007

Is Your Doctor Ordering Unnecessary Tests? 7 To Watch For


 Introduction by Bob Aronson

arrow through the head

Dr. Priscilla Diffie-Couch, regularly sends out health, fitness and medical tips and ideas to family members and some friends.  She is highly regarded as a resource, and an amazing researcher with a knack for cutting through the medical terminology and making it understandable.  In our family it is not uncommon to hear, “Priscilla says…..”  and that makes it gospel.

Today I received this email from her:

“INAPPROPRIATE TEST ORDERS INUNDATE HEALTH SYSTEM”

From Priscilla Diffie-Couch

 That was the headline in one of my health sources today.  They cited three health tests that are misused frequently:

  • Test for healthy vitamin D levels.  The correct test is called 25-dehydroxyvitamin D test.  The incorrect test ordered more often than not is called 1,25-hidroxyvitamin D test.  Note the 1 and the comma in front of the wrong test (designed to detect renal failure) plus the “I” instead of an “E” in the word dehydroxyvitamin.  Of course, you who read my health notes have known the correct test to request for several years now.
  • Test for anemia by determining levels of B12.  The older you are, the more questions you need to ask about the lab standards that apply to your B12 test results.
  • Ionized calcium tests are overused and do not tell you if you have a shortage of calcium.

Upon reading Priscilla’s email I wondered what other tests might be unnecessary so I did some quick internet research and found plenty.  Here’s my quick intro followed by a report from AARP.

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Physicians are among the most trusted people on earth.  When a Doctor orders a CT scan or an X Ray or even a blood test few of us think to question her.  We know she has completed several years of medical school and for many of us it is unthinkable to question that kind of expertise.

But – question we must because physicians regularly order unnecessary tests and those tests can negatively affect the patient in two ways; 1) it could well be money out of your pocket either in higher medical bills (An MRI, or magnetic resonance imaging scan, can cost $1,000 or more), increased co-pays or more costly insurance and; 2) the tests could be dangerous. Ordinary X-rays are rarely a concern, but super-sharp X-rays called CT scans involve relatively large radiation doses and can raise the risk of cancer.  And So, you might ask, “Why would they order tests they know are unnecessary?  Is it because they are afraid of lawsuits?”  Good question, and lawsuits are part of the answer.  Professional pride is another.  Like us, doctors don’t like being wrong either.

As suggested, the most commonly cited reason is “defensive medicine”: the fear of being sued by lawsuitpatients for not ordering a test. An American Academy of Orthopedic Surgeons study that involved 72 orthopedic surgeons who saw over 2,000 patients reported ordering 20% of their expensive imaging tests “for defensive reasons.”  Included was 57% of bone scans, 53% for ultrasounds, 38% for MRIs, 33% for CT scans and 11% for x-rays.

Those unnecessary and overused tests account cost the American patient upwards of $60 billion a year. That’s a whole lot of hard earned money, but fear of lawsuits alone is not the prime motivator.  The leader is something most people have never heard of. It’s called the M & M conference (Morbidity and Mortality).  That’s where you stand up in front of your peers and “fess up” to your mistakes.  Needless to say, that can be quite embarrassing.  The M & M conference, though, is a double edged sword because while it is unlikely the physician will ever make that mistake again, it is very likely they will order more unnecessary tests because they are good insurance against another M & M visit.Medical tests 2

With that background here is a summary of 7 tests that may be unnecessary.  Tests you should ask about when you are scheduled for any of them.  AARP did a fine job of assembling this information along with the dangers the tests present and the exceptions that can be made for having them.

 

7 Medical Tests and Treatments You May Not Really Need

Think twice before getting these procedures 

by: Elizabeth Agnvall, AARP

The American Board of Internal Medicine Foundation (ABIM) asked nine medical societies —American board of internal medicine from family doctors to allergists and cardiologists — to each identify five commonly used medical tests and treatments that are often unnecessary. A list of 45 overused procedures was presented Wednesday, April 4, 2012, at a news conference at the National Press Club in Washington, D.C.

“We’re changing the culture in medicine,” says Christine K. Cassel, M.D., president of the ABIM, about this new Choosing Wisely campaign, which represents some 375,000 doctors. Consumer Reports also has joined the doctors’ campaign.

Related

“Too much testing is being done that isn’t needed, that doesn’t work,” says John Santa, M.D., who directs health ratings for Consumer Reports.

Here are seven of the most popular, most overused tests and treatments for people over age 50 that the AARP Bulletin has selected from the Choosing Wisely campaign. For the complete list go to www.choosingwisely.org.

  1. ekgEKG and other heart screening tests for low-risk people without symptoms.

American Academy of Family Physicians

These can be lifesaving for those experiencing chest pain or other symptoms of heart disease. But a 2010 Consumer Reports survey found that 44 percent of people with no signs or symptoms of heart diseasehad an EKG, an exercise stress test or an ultrasound. For several years, cardiology guidelines have discouraged heart screening tests for people who have no symptoms and are not at high risk, and yet their use “is more common than it needs to be,” says James Fasules, M.D., an official with the American College of Cardiology. For those at low risk for heart disease, an EKG or cardiac stress test is far more likely to show a false positive result than find a real problem.

DangersFalse positive tests often lead to more tests and even invasive heart procedures.

Exceptions: If you have diabetes or other conditions that raise your risk, talk to your doctor. Use this calculator to find out your 10-year risk of having a heart attack.

2. Bone scans for osteoporosis for women under 65 and men under 70 with nobone scan 2 risk factors.

American Academy of Family Physicians

Bone density decreases and the risk of fractures increases with age, but medical experts say that most women don’t need a bone density test until age 65. Still, many doctors recommend the scan starting at age 50.

Dangers: Bone density (DXA) scans can lead to unneeded medications that can have serious side effects.

Exceptions: Talk to your doctor about a scan before age 65 (70 if you’re a man) if you were or are a smoker; you’ve used steroid medications regularly; have low body weight; or have already had a fracture. ThisFRAX tool can help you calculate your risk.

antibiotics3. Antibiotics for mild-to-moderate sinus infections.

American Academy of Family Physicians, American Academy of Allergy, Asthma & Immunology

Despite physician awareness campaigns about the overuse of antibiotics for sinus infections, the drugs are prescribed in more than 80 percent of cases, according to the American Academy of Family Physicians. More than 90 percent of sinus infections are caused by viruses — and the drugs only work against bacterial infections. 

Dangers: The widespread overuse of antibiotics is behind the spread of increasingly virulent strains of drug-resistant bacteria.

Exceptions: If symptoms last more than seven days or worsen after initially improving. Some people develop a secondary bacterial infection and then antibiotics may be needed.

4. NSAID painkillers for people with high blood pressure, heart failure and anynsaids chronic kidney disease.

American Society of Nephrology

Many people use Advil, Motrin (ibuprofen) or prescriptions such as Celebrex and Voltaren for everything from arthritis to headaches. But these common painkillers can be dangerous, especially for people with high blood pressure or kidney disease. (These medications can raise blood pressure, cause fluid retention and interfere with kidney function.) Tylenol (acetaminophen), tramadol, or short-term use of narcotic painkillers may be safer than NSAIDs, according to the nephrologists.

Dangers: These drugs are linked to stomach bleeding and increased risk of heart and kidney problems.

X ray5.  X-ray, CT scan or MRI for low back pain.

American College of Physicians, American Academy of Family Physicians

About 80 percent of Americans will suffer from back pain. Low back pain is the fifth most common cause for all doctor’s visits. “The vast majority of people with nonspecific low back pain simply get better … within four to six weeks, with or without a physician’s intervention,” says Patrick Alguire, M.D., an official with the American College of Physicians. If older people get an image, experts say the results will almost always show an innocent abnormality that has nothing to do with the back pain.

Dangers: Some tests expose people to unnecessary radiation and can lead to expensive back surgery.

Exceptions: When the doctor suspects serious underlying conditions or if the pain isn’t better in six weeks.

6. Diagnostic tests for suspected allergies.allergy tests

American Academy of Allergy, Asthma & Immunology

Some 35 million Americans suffer from seasonal allergies. And millions of Americans increasingly blame a food allergy or sensitivity — fromgluten to milk — for their health woes. Some doctors or health providers now perform a blood test, called an immunoglobulin (IgG), for food allergies. But Linda Cox, M.D., president elect of the allergy group, says the test simply doesn’t work. For seasonal allergies, many doctors run abattery of blood and skin tests dubbed IgE, when just a few specific tests would do. By asking patients when and where they have symptoms, doctors can pinpoint what tests they should run.

7. CT scans and other imaging procedures for uncomplicated headaches.ct scan

American College of Radiology

Severe headaches can be excruciating and frightening, but unless they are accompanied by other key symptoms it rarely makes sense to get a CT scan or MRI of the brain. Yet “it happens all the time,” says David Seidenwurm, M.D., a neuroradiologist in Sacramento, Calif. Patients get frightened, doctors worry about lawsuits and people “want all the information right away,” he says. “It’s easier to do the scan than to have the conversation.”

Dangers: Radiation exposure raises cancer risks in the population and false-positives lead to more testing and patient anxiety.

Exceptions: Worrisome symptoms — trouble speaking, blurred vision, weakness on one side — or other signs that the headache is caused from something more dangerous, such as a brain tumor.

Remember readers, despite all the diplomas on the wall, the high tech office and the “Dr.” title, the physician works for you, just like your plumber, electrician or carpenter.  If you don’t understand, if you are confused or if you disagree, speak up. It is your health we are dealing with here so be polite and courteous but be firm.  Physicians have been known to make mistakes.  Make sure they don’t happen to you.  Probe a little more and demand understandable answers .  By being a little more assertive you just might get better care.

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 bob magic kingdomBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Do You Believe In Miracles — Medical Miracles?


 Introduction by Bob Aronson

blackboard cartoon

Since Bob’s Newheart began publishing on WordPress over seven years ago, we have tried to offer encouragement, sound medical information, choices for healthy living,  news of what’s to come and  as much inspiration as possible for those who suffer from debilitating diseases.   As a heart transplant recipient I know what its like to feel desperate and without hope.  I also know there is always hope,  always.

Dr. Priscilla Diffie-Couch and her sister Dawn Anita Plumlee have been contributors to our inspiration series in the past.  Today Dr. Diffie-Couch returns with the amazing story of how she suvived what could have been — what should have been–
a deadly cancer. 

MY PERSONAL MEDICAL MIRACLE

Priscilla Diffie-Couch ED.D.

Friday morning I awake relieved.  My doctor has pronounced my ulcer completely healed.  I return from my errands humming happily and stop to check my message machine.  Why has my doctor’s office tried three times to reach me?  I already know the good news.  Now I have my doctor on the phone and listen to his strange tight voice. phone answering machine

“We need to repeat your biopsy.  I’m afraid it looks suspicious.”

“Suspicious?”  Characters in murder mysteries look suspicious.  People lurking in dark alleys look suspicious.  My biopsy looks suspicious?

“How suspicious?” I ask cautiously.

“Highly suspicious?”

“You mean, as in malignant?”

“Well…yes.”

“So are we talking cancer in my stomach?”

“Yes.  I’m afraid so.”

“The prognosis if that’s true?”

“Not very good, I’m afraid.”

He’s afraid?  I’m trembling with fear.  We settle the details for another more extensive biopsy.  I call my husband Mickey.  Probably a mix-up, we agree–someone else’s tissue.  My friend Donna, who happens to be a pathologist calls.  Her voice too is strained.  Having reviewed my biopsy, she and her pathologist husband Dee appear after work with two bottles of their best wine.  We toast to a “mistake in the lab.”  And feel for the real owner of the suspicious biopsy tissue because the samples they both examined were literally cluttered with countless cancer cells.

stomach cancer factsSaturday begins with a long close silent hug.  If the biopsy tissue truly is mine and I have cancer, we need to be informed.  We head for the medical books in the huge used book store.  We go from there to the library.  We read in silence–page after page of gloom and doom. It is a deadly disease.  Statistics point to a 10% survival rate for victims of stomach cancer. Pictures of my grieving family flash through my mind as the tears well up in my eyes.

Another sustained quiet hug when we get home.  I break away suddenly and declare that the statistics are on our side. If ten percent of the people beat this cancer, that will include me, so my chances then become one hundred percent.  That is how we will present the news to family.  That is optimistic but believable, given my general good health and fighting spirit.

Sunday Mickey calls family members.  My son Jeff and his wife Diana arrive shortly to share our outlook of a hundred percent chance of survival.  My sister tells me to get a copy of Bernie Siegel’s Love, Medicine and Miracles, which I vow to do immediately.  Later that evening Mickey and easily win our mixed doubles tennis match.  I begin reading the book my sister suggested.  The seeds for positive thinking are being planted as I do.

On Monday I undergo what is called a D & C for a feminine bleeding problem also related to cancer and set a tentative schedule for full removal of my stomach on Thursday, should these suspicious cancer cells truly be mine.  They are.  Donna and Dee deliver that dreaded news.  They know the grim outlook for stomach cancer.  Shattering silence.  I say something funny.  I must have.  We all burst out laughing.  I can feel a change in the climate.  I can see they are now on board as believers in my chances of survival.

On Tuesday I spell out my situation to my friend Sharon, who recently sold her share in Sound Warehouse for $46 million dollars.  Upon arrival at my doorstep, she declares with authority that she is “here to insure that I have the best medical care that money can buy.”  The doorbell rings again.  Cissy. Nancy.  Charlene.  Margie.  All bearing gifts–elegant gowns.  I may end up without a stomach but I will be the most beautifully dressed patient in the cancer ward.  We laugh at my concern about bleeding all over the operating table since the D & C didn’t arrest my flow.  We women are commonly such vain creatures.  But good friends like these are rare indeed.

The healing process begins the moment the diagnosis is confirmed with a third biopsy.  As I look at Mickey, his shoulders shaking with stifled sobs—a weak moment of looking ahead at life without me—he apologies.  Suddenly my role in this ordeal becomes clear.

When faced with your own mortality, your primary concern becomes protecting those who love you from all possible pain.  It is not a matter of bravery.  It is just a matter of loving that deeply.  Mickey and I share an uncommon love.  We have overcome enormous obstacles and built a history oIllness and the mind 1f disproving fatalistic predictions.  I have developed an extraordinary closeness with his family.  My own family fills my life with indescribably intense feelings.  They have known the never-ending anguish of losing Mom to a drunk driver.  They don’t deserve to deal with another untimely death.  I cannot let any of them suffer.  So the smile on my face is not an act.  It is an act of love prompted by a genuinely selfish need to be there with them to share whatever memorable moments await us all.

Donna and Dee have already made certain that I will have the best cancer surgeon in the area.  The chairman of Fina Oil, where Mickey works as a VP, vows to see that I receive VIP treat at the best cancer treatment center available.  I have too many people determined that I will be among the survivors.  I cannot let them down.

I arrange for pictures of all my family to surround me when I come out of surgery.  Sitting up on my knees on the gurney, wondering why I can’t trot down the hall to the OR, I smile at my family’s faces and remind them not to have too much fun for the next five hours.  The last thing I remember is Mickey’s hand holding mine as I am wheeled away.  I am still smiling.

Sometime during those next five hours, I lose my sense of humor.  I am groggy but aware and can hear my plaintive plea:  “Pain.  Pain.  Pain.”  I can faintly make out the images above me—my ICUhusband, son, daughter-in-law.  They watch as I am transported to ICU.  The next morning I am sure my scream shatters the glass window when two huge orderlies toss me onto the waiting gurney.  “Don’t—you—touch—me—again—without—a—member—of—my–family—present.”  They step back and are surprised when I pull myself from the gurney to the bed in my room.  My daughter, worlds away from me in lifestyle and philosophy—will stay with me the next ten days.  I watch with wonder as she handpicks the most attentive and caring staff of nurses anyone could hope for and begins to line out the plan for my care.

My gastroenterologist drops by and asks if I mind being a “teaching subject” since mine is such an unusual case.  I eagerly agree, glad to be a part of advancing medical science.  He is joined by my pathologist friend Donna, who announces that my stomach was totally clear of cancer save a tiny millimeter located at the top.  Leaving even a small part of my stomach will be too risky I am told.  “Yours must be the earliest case of stomach cancer ever diagnosed,” she declares.  How could my stomach, so full of cancer five days ago, be almost totally free of it now?  No one tries to explain that but I would later discover other equally rare and miraculous instances of spontaneous remission.SPONTANEOUS REMISSION  My body was eradicating the cancer by itself.

My cancer surgeon tells me he will construct a pouch from a piece of my large intestine that will serve as my stomach.  (I am eating a small portion of sugar-free Jello as he describes this phenomenal feat.  I smile as I recall a passage from humorist Dave Berry’s delightful book Stay Fit and Healthy Until You Are Dead in which he claims that our skin is the most important of our vital organs, because without it, all the disgusting hideous inner parts of us would fall out onto the sidewalk for all manner of people to trip over.

“Ok, Mother,” my daughter beams brightly at 7:00am (she who has never knowingly arisen before noon any day in her life since she ran away from home).  “Up we go now.  We have our goals for the day.”  First, soap bubbles so thick I have little peep holes for eyes, the triple scrub, a quick shave under the arms, a little talcum powder here and there, and lots of lotion everywhere.  Maneuvering seamlessly around all the wires and tubes, she is making sure every inch of me will be supremely soft and supple.

In and out of my morphine mind, I make a list of questions for her to ask my cancer surgeon, should I be asleep when he drops in.  I can hear him now whistling cheerfully down the hallway.  I emulate his demeanor as I am trying for the perfect-patient-of-the-ward award.  That shouldn’t be difficult since I am surrounded by the most efficient medical staff in America.

I feel for those people who hear the word cancer and drop into a deep and unalterable depression.  With the constant arrival of guests, flowers, gifts and cards, I am not likely to let my spirits sag. I am already writing thank you notes in my mind.  And they seem so inadequate when I think of the how everyone continues to buoy my spirits in so many countless ways.

Flitting around my hospital room, I accidentally pull out the feeding tube that was implanted in my side to insure my nourishment should my new “stomach” fail in some way.  I will be fine, I tell myself.  (I later learn that this little set-back will have a serious impact on my recovery.)

Following the highly regimented eating plan the first few weeks at home is not working.  Revulsion and nausea are my constant companions.  One day, as I step out of the bath tub, I glance up at the bank of mirrors I have so carefully avoided.  I gasp.  Looking back at me is the image of a captive in a concentration camp.  My skin clings to my bones.  My eyes are buried deep in their sockets.  I have gone too long without sufficient nourishment.

I call a friend who listens to my plight and reports that she knows someone who stopped his weight loss with Ensure, a repulsive high-calorie sickeningly sweet shake.  I have no choice.  Slowly, I begin to restore my lost pounds.ENSURE

This morning I am awakened by my loving husband who has been sleeping elsewhere, partly because of his cold and partly because I have to sleep upright to keep bile from coming into my throat.  “It’s time to get out and see what’s happening in the rest of the world.  We are going to Jeff’s  weightlifting meet.”  I smile.  Life is full.  Life is good.  I’m still in it.

A quarter of a century later, I am still in it.  I beat the odds and way beyond.  In 2005 two doctors from Australia were awarded the Nobel Prize in medicine for their discovery that the bacteria H-Pylori causes almost 90% of gastric ulcers and these can lead to stomach cancer.  The actual date of their discovery was three years before my ulcer appeared in 1988.  But one study shows that it can take as many as seventeen years before American doctors adapt new medical discoveries into their practice.  That means that we must all do diligent research on the nature of and treatment for our own medical conditions.  As late as 1999, still at risk for a new cancer in my intestine, I could not find a gastroenterologist who would test me for H-Pylori.  It was my family doctor, an osteopath, who did so and prescribed the two-week treatment of triple antibiotics that could have saved my stomach in 1989.

I still face challenges associated with having no stomach.  Battling the bile that comes up from my liver makes getting good sleep an elusive dream.  Ballooning up when my colon locks up brings on birthing-like pain.  Staying hydrated to avoid arrhythmia remains a struggle.  But trips to the ER are increasingly rare and sublingual B-12 has replaced those dreaded self-administered shots. I can, I can I can now say with conviction that I am an active healthy survivor who has much to be thankful for.  I credit my friends for their devotion and for referring me to the gastroenterologist who was thorough enough to biopsy my healed ulcer.  I credit him and the talented surgeon who constructed a replacement “stomach” that has worked so flawlessly all these years.  When diagnosed with stomach cancer, most people are dead within five years.  So, many call my case a medical miracle.

I remain dubious about a beneficent god who would opt to save me while letting more deserving people die.  I am more open to the possibility that having a positive spirit causes the body to pump out protective agents yet to be identified.  I don’t pretend to be able to explain medical miracles but I am deeply thankful–for the sake of those who care–that one happened to me.

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priscilla pictureAn award winning high school speech and English teacher, Priscilla Diffie-Couch went on to get her ED.D. from Oklahoma State University, where she taught speech followed by two years with the faculty of communication at the University of Tulsa.  In her consulting business later in Dallas, she designed and conducted seminars in organizational and group communication.

An avid tennis player, she has spent the last twenty years researching and reporting on health for family and friends.  She has two children, four grandchildren and lives with her husband Mickey in The Woodlands, Texas.

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 Bob Aronson  has worked as a broadcast journalist, Minnesota Governor’s Communications Director and for 25 years led his own company as an international communication consultant GIF shot bob by TVspecializing in health care.

In  2007 he had a heart transplant at the Mayo Clinic in Jacksonville, Florida.  He is the Bob of Bob’s Newheart and the author of most of the nearly 250 posts on this site.  He is also the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) support group.

You may comment in the space provided or email your thoughts to him at bob@baronson.org.  And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

EBOLA — WHAT YOU NEED TO KNOW


By Bob Aronson

statue of libertyOver the years this blog has offered a lot of information on how to take care of your organs.  We believe strongly that the way to solve the shortage of transplantable organs is to 1) encourage donation and 2) do everything possible to reduce the demand.  That means we must continually be on guard  to prevent threats to our health and we depend on public health officials and the news media to provide us with that information.  Ebola is the latest threat and it’s a dandy. It can destroy all of your organs — all of them.

After watching the Ebola story develop in the past few weeks I came to the conclusion that we are getting mixed messages from a number of sources and the mass media doesn’t do a very good job of filtering them, they just hop,  skip and jump from one new development to another with little effort given to finding and tying loose ends.

To date most of the regular TV news stories on the Dallas, Texas Ebola incident lack detail and as a result serve no purpose but to inflame, confuse and cause panic.  Print stories have been better but it has been hard to find many really comprehensive reports.   That’s probably because Ebola is a moving target.  Just as I was about to publish this blog, there were two new developments.

The first new development is that one of the health care workers at the Dallas hospital where the first Ebola patient died, has tested positive for the Ebola Virus.  This is a breaking news story so it won’t be covered in detail here.  The second development today is from President Obama’s National Security advisor Susan Rice who is expressing some dismay at the sorry state of the world response to the Ebola Threat. She is not so subtly sounding the alarm and calling for “All hands on Deck.”

With the exception of some investigative or in-depth network reports, TV news channels have been saying pretty much the same thing.  As the story goes, a man who had recently traveled from Liberia in West Africa to Dallas, Texas checked into an emergency room at Presbyterian hospital there with a temperature of 103 degrees.  He was treated for a stomach virus and sent home.  That’s pretty much what most people know about the Dallas situation and the Ebola virus.  The story, though, is grossly incomplete.  That is not to say the hospital in question should be exonerated of any responsibility, they should not, but nothing is ever as simple as it sounds.

It is important first, to understand what we are dealing with.  Ebola hemorrhagic fever (EHF), caused by the Ebola virus, is a severe viral hemorrhagic disease characterized by initial fever and malaise followed by gastrointestinal symptoms, bleeding, shock, and multi-organ system failure. Over 25 different viruses cause viral hemorrhagic fever. Ebola virus is a member of the virus family Filoviridae, along with Marburg virus.

EHF is difficult to distinguish from a host of other febrile illnesses, at least early in the course of disease. Other viral hemorrhagic fevers need to be excluded, especially Marburg hemorrhagic fever, as well as malaria and typhoid fever.

Patients should be isolated and viral hemorrhagic fever precautions (face shields, surgical masks, double gloves, surgical gowns, and aprons) should be used to prevent transmission. As there is presently no antiviral drug available for EHF, treatment is supportive, following the guidelines for treatment of severe septicemia. Persons who had unprotected contact with someone with EHF should be monitored.  Case fatality rates vary consistently with the specific infecting virus, ranging from zero to over 80%.

I spent 25 years of my life as a communication consultant and specialized in working with health care organizations like infection controlclinics, hospitals, research centers, pharmaceutical companies, research labs and more.  I know how important infection/contagion control is in these facilities and how much time, effort and money is spent on programs to ensure patient safety.  That’s why what happened in Dallas with the Ebola patient stands out.  Numerous studies make it very clear that in the great majority of cases in which patient safety is at risk communication is the culprit.

While Ebola may sometimes be difficult to diagnose, every hospital and clinic in this country has check lists on contagious diseases and infections.  They do regular drills, have training sessions and should be well prepared for any eventuality.  What happened in Dallas shouldn’t have happened, but it did.  Now what?

Dr. Anthony FauciDr. Anthony Fauci from the National Institutes of Health (NIH) an acknowledged expert on infectious diseases says that while he understands our fears we also need to understand that what is happening in West Africa is because of the weaknesses in their health system.  “West Africa,” he says, “Is not the United States, we won’t have an outbreak. Scientists know how to stop the virus from spreading.”

While I hope he is right, I wish Dr. Fauci had not said that.  Knowing how to do something and actually accomplishing it may be worlds apart.  This isn’t just about the medical profession knowing what to do, it is about all of us knowing what to do and when — and then communicating properly and following the plan.  Nothing, Dr. Fauci, is as easy as it seems. and your overly simplistic assurances could be harmful, lulling us into a false sense of security. I’ll explain more shortly.

An ABC News report tells a story that differs from Dr. Fauci’s view.   The Network account quoted Dr. Ryan Stanton, an emergency room physician in Lexington, Kentucky, and spokesman for the American College of Emergency Physicians as saying, “We’re all a little bit on edge because we’ve never seen it before.  Stuff we’ve seen before, like heart attack and stroke, we recognize as soon as we walk in the door. For Ebola, it’s not going to come as naturally.  It’s not even a needle in a haystack,” he went on. “It’s a needle in a hayfield we’re trying to find.”  That statement kind of casts some doubt on Dr. Fauci’s position.  Add the Susan Rice comments to the mix and Dr. Fauci is sounding far too positive.  If after reading this far you think, “There’s more to the Ebola outbreak than meets the eye,” you’d be right.  There is.

The question on everyone’s mind is, “How could the ER people in Dallas have missed this case?  Well, they did not miss it, it kind of missed them.  Dallas presbyterian We have it on good authority that the Dallas ER nurse properly accounted for the feverish patient’s recent travel in Africa, but that information did not get communicated to the rest of the team. Instead, the patient was treated with antibiotics for a presumed run-of-the-mill stomach virus. So it appears that while the checklist was completed poor team communication prevented its proper execution.

It is entirely possible that the Nurse’ proper reaction was ignored for any number of reasons. 1) It came from a nurse, not a doctor (yes, there is institutional, professional arrogance) 2. The team was busy, tired and careless and chose to ignore the Nurse’ efforts and 3) the Nurse did not communicate with the right people and the communication was unclear, unreadable or could not be heard. I suspect that there might be a dozen more reasons or excuses as well.

I am not qualified to argue medical facts with Dr. Fauci — I don’t even want to and the reason is simple, he is right.  What he said is absolutely correct.  The medical profession does know how to stop Ebola.  What they don’t do very well,  is communicate what they know to those of us who don’t.

After 25  years of working as a communications coach and consultant to the medical profession I can tell you that communication is not one of their strong suits.  I have great respect for physicians and loved working with them but their ability to speak in understandable and memorable terms is not a well developed skill.  Think about your interactions with your doctors and how many times you leave his or her office saying, “I don’t think my questions got answered,” or, “What did he mean when he said,….”

But, let’s go back to the Dallas case.  I do not doubt that the Dallas medical team knew how to deal with Ebola.  The question that is at the core of the issue, though is, “How effective was the communication they used to put the systems in place to accomplish that end?  It is not their medical expertise I doubt, it is their ability to communicate what they know and suspect in an effective and understandable manner.   And — if the patient safety record in American health care institutions is any indication of that prowess then we are in a heap of trouble. This is where the Fauci assurances fall flat.  A 2013 story in Forbes Magazine said: http://www.forbes.com/sites/leahbinder/2013/09/23/stunning-news-on-preventable-deaths-in-hospitals/

Forbes logo“In 1999, Americans learned that 98,000 people were dying every year from preventable errors in hospitals. That came from a widely touted analysis by the Institute of Medicine (IOM) called To Err Is Human. This was the “Silent Spring” of the health care world, grabbing headlines for revealing a serious and deadly problem that required policy and action.

As it turns out, those were the good old days.

According to a new study just out from the prestigious Journal of Patient Safety, four times as many people die from preventable medical errors than we thought.  That could be as many as 440,000 deaths a year.

With these latest revelations, medical errors now claim the spot as the third leading cause of death in the United States, dwarfing auto accidents, diabetes and everything else besides Cancer and heart disease.

These people are not dying from the illnesses that caused them to seek hospital care in the first place. They are dying from mishaps that hospitals could have prevented. What do these errors look like? The sponge left inside the surgical patient, prompting weeks of mysterious, agonizing abdominal pain before the infection overcomes bodily functions. The medication injected into a baby’s IV at a dose calculated for a 200 pound man. The excruciating infection from contaminated equipment used at the bedside. Sadly, over a thousand people a day are dying from these kinds of mistakes.

If you aren’t alarmed enough that our country is burying a population the size of Oakland every year, try this: you are paying for it. Hospitals shift the extra cost of errors onto the patient, the taxpayer and/or the business that buys health benefits for the infected patient. My nonprofit, which provides a calculator of the hidden surcharge Americans pay for hospital errors, finds most companies are paying millions or even billions of extra dollars for the cost of harming their employees.

No Cure,  No Vaccine Because There’s No Money In It

A recurring question in the case of Ebola or diseases like it is, “Why don’t we have a vaccine or a cure?”  Part of the answer to that orphan diseasesquestion is that diseases like Ebola and Marburg fall into the “Orphan disease” category. These are very rare diseases.  The rarity of the diseases provides little incentive for private industry to invest in research and development because the cost per prescription or treatment per patient would be so high few could afford them.  There is some government assistance for research but nowhere near enough.

The Orphan Drug Act of 1983 http://tinyurl.com/3vkffup provides incentives for drug companies to develop treatments for rare diseases. Since the Act was signed into federal law, the U.S. Food and Drug Administration (FDA) has approved more than 200 treatments for rare diseases.

While that number sounds good it is small when put in perspective because there are about 7,000 orphan diseases and some are quite familiar like:

  • Cystic fibrosis, which affects the respiratory and digestive systems.
  • Huntington disease which affects the brain and nervous system.
  • Single genes are also responsible for some rare, inherited types of Examples of these are the BRCA1 and BRCA2 genes, in which certain mutations increase the risk for hereditary breast and ovarian cancers, and the FAP gene, in which mutations increase the risk for hereditary colon cancer.

You can find more information here http://rarediseases.info.nih.gov/about-ordr/pages/31/frequently-asked-questions

As noted the Orphan Drug Act is why there is any activity around Orphan diseases, but it is nowhere near enough because there are so many of them.

Thanks to marketing campaigns aimed at people exposed to asbestos we are all likely familiar with the disease called mesothelioma — perhaps the best-known orphan disease in the nation.

About 3,000 patients are diagnosed with mesothelioma each year, placing it well within the U.S. definition of a rare or orphan disease as one that affects no more than 200,000 patients at a given time.  To further complicate matters there are several different forms of the disease so what might work to control one, likely wouldn’t for another. Patients with mesothelioma live for 1 to 2 years past their diagnosis.
mesothelioma“One of the difficult aspects of mesothelioma is that it often not diagnosed until it is in the later stages, and it is a very aggressive cancer,” says Joe Belluck, a New York mesothelioma lawyer.

The disease is difficult to detect since symptoms come after asbestos fibers have invaded organ linings and often mimic that of a bad cold or virus. It also surfaces decades after exposure to asbestos, so it has historically affected an older population with age-related health

It is a very deadly form of cancer and one that falls into the “Orphan” category. Mesothelioma is listed as an orphan disease on registries like rarediseases.org maintained by the National Organization for Rare Diseases (NORD).

Because it affects fewer than 200,000 people at a given time (due to its high mortality rate), treatments specifically for mesothelioma are eligible for orphan drug funding from the Food and Drug Administration (FDA). Under the Orphan Drug Act, companies involved in developing and testing drugs, biologics, and other treatments specifically to treat rare diseases can get tax credits and other incentives to continue development them including:

  • 7 years of exclusive marketing for the drug
  • Tax credits to cover half the cost of clinical investigations
  • Waiving user fees

As you can see, there is far more to the Ebola story than meets the eye.  It is a complex issue because Ebola is an Orphan disease that attacks in a multitude of ways and is not always easy to identify.  So what can you do?  Be informed. Don’t wait for information, seek it out, you might save your life and the lives of people you love.  Below are some essential facts, but click on the links, too.

Here are some fast facts on Ebola from CNN:  http://tinyurl.com/npqfzt2

CNN Eb0la Fact Sheet

Ebola hemorrhagic fever is a disease caused by one of five different Ebola viruses. Four of the strains can cause severe illness inCNN humans and animals. The fifth, Reston virus, has caused illness in some animals, but not in humans.

The first human outbreaks occurred in 1976, one in northern Zaire (now Democratic Republic of the Congo) in Central Africa: and the other, in southern Sudan (now South Sudan). The virus is named after the Ebola River, where the virus was first recognized in 1976,according to the Centers for Disease Control and Prevention.

Ebola is extremely infectious but not extremely contagious. It is infectious, because an infinitesimally small amount can cause illness. Laboratory experiments on nonhuman primates suggest that even a single virus may be enough to trigger a fatal infection.

Instead, Ebola could be considered moderately contagious, because the virus is not transmitted through the air, well at least not much.  A sneeze could spread it if the droplets  from an infected person come in contact with someone who is not, but that’s a very short distance.  In the most contagious diseases, such as measles or influenza, virus particles are airborne for longer distances and much more time.

Humans can be infected by other humans if they come in contact with body fluids from an infected person or contaminated objects from infected persons. Humans can also be exposed to the virus, for example, by butchering infected animals.

While the exact reservoir of Ebola viruses is still unknown, researchers believe the most likely natural hosts are fruit bats.

Symptoms of Ebola typically include: weakness, fever, aches, diarrhea, vomiting and stomach pain. Additional experiences include rash, red eyes, chest pain, throat soreness, difficulty breathing or swallowing and bleeding (including internal).

Typically, symptoms appear 8-10 days after exposure to the virus, but the incubation period can span two to 21 days.

Unprotected health care workers are susceptible to infection because of their close contact with patients during treatment.

Ebola is not transmissible if someone is asymptomatic or once someone has recovered from it. However, the virus has been found in semen for up to three months.

Deadly human Ebola outbreaks have been confirmed in the following countries: Democratic Republic of the Congo (DRC), Gabon, South Sudan, Ivory Coast, Uganda, Republic of the Congo (ROC), Guinea and Liberia.

According to the World Health Organization, “there is no specific treatment or vaccine,” and the fatality rate can be up to 90%. Patients are given supportive care, which includes providing fluids and electrolytes and food.

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I  hope this report helped to clarify the Ebola issue. If you have comments make them in the space provided or contact me directly at bob@baronson.org.bob cropped smaller

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

One More Last Chance


optimism cartoonIntroduction by Bob Aronson

Post  by Dawn Anita Plumlee

This post is one of several in the “Inspirational” category.  It is about hope, it is also a love story  and it’s about the pot of gold at the end of a rainbow.  Best of all, it is true, every word of it.  I can vouch for its veracity because I know the author very well.

Bob’s Newheart blogs was launched over seven years ago to help support and motivate critically ill people, their families, caregivers and friends. Many if not most of our posts speak directly to medical and health issues. A good many focus on organ donation/transplantation issues because my 2007 heart transplant is what motivated me to start writing this blog. Today’s entry, while not about medical issues or transplants in particular is true to our original intent because it deals with motivation and inspiration. 

Dawn Anita (Diffie) Plumlee is my wife Robin’s (Diffie) cousin. She is a remarkable woman with a “Can do,” upbeat attitude. Dawn Anita and her husband Jerry are special people. They have overcome incredible odds to get where they are today. Many who might experience setbacks or reversals in life are bitter and resentful. Not so with these two. I know them well and we talk often. They endured incredible life hardships but viewed them as learning experiences and never looked back other than to use their knowledge to help others.

Bob’s Newheart gets a lot of requests for “inspirational posts,” for blogs that give hope to those who feel they have none. I often get notes from people who feel hope is lost, that they cannot recover from whatever hardships have befallen them. I know  about Dawn Anita’s journey, having heard some of it from her and the rest from reading her Amazon book, “One More Last Chance,” and cannot think of a story more likely to inspire and to give hope.  It is in that spirit that we present it today.  

I should point out that she did not write this posting to sell books. That’s not Dawn Anita. Rather, she wrote it because I asked her to submit part of her story so I could include it in the “Inspirational” category of my blogs. While Dawn Anita would not use this forum to promote her book, I can. It’s a darn good read. If you like what you read here you can get more under the same title at Amazon.com.

One more note. Dawn Anita’s sister is Priscilla Diffie-Couch, another of our guest bloggers here on Bob’s Newheart.

By: Dawn Anita Plumlee

If we live long enough, all of us will face hardship in our lives, i.e. finances, death of a loved one, illness. It is up to us to decide how we handle life’s challenges. As I see it, there are two choices. Give up or have the grit and determination it takes to tackle life’s dilemmas. There is always a way if you choose to seek one more last chance. I came to this realization while writing my memoirs which bear the same title. Reaching back into my past was definitely a challenge and not one I was sure I could achieve. Recalling events in my life led me to a better understanding of myself and the way I handled adversity and the many second chances I had.

Dawn Anita and Jerry, the beginning.

Dawn Anita and Jerry, the beginning.

I was a naïve 16-year old country girl from Oklahoma when I decided to run away to marry my sweetheart Jerry Plumlee.

I met my first challenge on the 5-day bus trip from Oklahoma to Seattle when I divulged my story about running away to a young military man who punches masher b and wboarded the bus late one night. He saw what he thought was an opportunity to take advantage of a young, innocent country girl, only to be met with a right hook to the jaw which landed him in the aisle of the bus.

That incident, along with the very charming man with a smooth easy way of talking who convinced me that he had my best interests at heart when he asked me to come to his apartment in LA during an eight-hour layover, didn’t deter my faith in people. I could have chosen to give up and terminate my journey, but I still held on to the hope that life would be rosy once I reached my destination.

scorpionLearning to survive in a mouse infested, run-down shack with stinging scorpions so thick that several were trapped in our bathtub and in the glasses and bowls each morning with wasps swarming the house all day and copper heads under the front porch was indeed a challenge. We survived on 50 cent watermelons for several days because the $80.00 my husband earned didn’t stretch to the end of the month. The real revelation is that when I remember this time in our lives, I remember it as a great experience, and I realize that these events helped us become better equipped to face other dilemmas in life. The ironic thing is, you can survive one dilemma only to find yourself entrapped in another one just as bad or worse.

Traveling from Oklahoma to Idaho in an old pickup that rocked and rolled down the road pulling pickup and horse traileran enclosed U-haul  trailer with 3 horses inside and trying to calm a two-week old baby was definitely an adventure I will never forget. Having to overcome the fear of an empty gas tank in the middle of nowhere in Wyoming, knowing you have no milk for your baby was indeed a challenge, unaware at the time that this was merely one mishap in a long line of difficulties on the same trip. A flat tire with no spare, having to unload a horse to take the tire to be repaired, not knowing how far it may be and later to have the u-joint on the pickup break in the middle of a treacherous road on a dark and dreary night definitely can test ones character

Relieved that our resourceful brother-in-law came to our rescue and repaired the u-joint, we could not know that just a short time later, we would literally “run into” another dilemma; our brother-in-law hit a cow and smashed in the radiator on the truck. Still, we were not defeated. Our brother-in-law pulled our pickup, horse trailer, horses and all with his car over 100 miles to our destination. This was an unbelievable feat in itself. Arriving at our destination In Idaho, we did not find the paradise we were hoping for. Turmoil filled the household with too many families living under one roof.

parkMoving out in the middle of the night, we found ourselves stranded in a park in Coeur d-Alene with no money, food or shelter. Leaving me alone in the park with our baby, Jerry assured me that he could enroll in college, get a student loan and find a place for us to live. As I watched Jerry leave, an empty feeling washed over me. My baby is hungry; I have no milk for him and no money to buy any. Then suddenly a thought struck me; Ipop bottles can trade the empty pop bottles lying around in the park for some milk for my baby. I walked into a little store nearby with my baby and the empty bottles in hand, and with a touching display of generosity, the clerk gave me some milk for the bottles.

Thankful but still distraught, it seemed an eternity before Jerry returned and he had indeed accomplished his mission. He enrolled in college, obtained a $200.00 loan and found a place to live where we could keep our horses. Once again, perseverance and determination paid off. Life was good in Idaho with a few bumps along the way. I had a beautiful baby girl, Jerry was in college and I went to work for a flower shop, but Oklahoma was calling us.

It was a struggle when we moved back to Oklahoma, but we eventually found our way. Jerry went to work on the ranch where my dad was the foreman. I went to work for an attorney, and although I dawn anita, the early daysloved my job, I had an ever-burning desire to become a country singer. I joined a local band and sang almost every weekend. Many opportunities presented themselves in the music business. I let several chances slip away which would have no doubt led to fame, the most significant of which was a contract with RCA Records. I wanted it so badly, but I couldn’t bear to leave my children and go on tour. I felt sure I could achieve my goal in music when the kids graduated. Little did I know that when we finally took the leap of faith and moved to Nashville, that Music City welcomes a 40-year-old female with a closed mind and a cold heart. I did have several regional hits, won several awards for my singing and songwriting, including “Female Vocalist of the Year” and “Entertainer of the Year” at the Oklahoma Opry, but it seemed that my vision of becoming a country music star would be an elusive dream.

The years passed quickly; our lives were full with our jobs, family and music. Little did we know that life as we knew it was about to come to an end. The company who owned the ranch where Jerry had worked for ten years and Dad had worked for over twenty changed management and fired Dad and Jerry. We had to move out in thirty days. Shattered, we didn’t know how we would survive; where would we live, where would Jerry work. It was so sudden. This upset in our lives was devastating, but it could not begin to compare with the tragedy that would soon tear our lives apart. My mother was killed in a car wreck. Such a waste, a horrible, tragic loss. Mom was only 55. She was our strength; how could we go on without her? We were not prepared to handle a trauma of this magnitude.

Mom and Dad had a rare and beautiful relationship like no other.

Dawn Anita's Mom and Dad

Dawn Anita’s Mom and Dad

He needed comfort, someone to lean on, and I was that person. Somehow I pulled myself together because I knew Dad needed me now more than ever. It was difficult for him to cope, and the everyday struggles of life without Mom were insurmountable. At times his actions were not those of the dad I had always known. A neighbor called one morning to report that Dad had spent the night in the pasture in a cow trough. I completely understood when he told me that sometimes he just couldn’t face that empty house. Dad eventually learned how to cope and make the pieces in life fit once again. Evidence that with just a little help and a strong will, you can recover and overcome the toughest of times.

oil gusherOur life definitely took a sudden turn when Jerry went into the oil business and we decided to move to Dallas. Our world quickly crumbled around us when the oil business went south. We were sitting in a house that didn’t belong to us, obligated for furniture we didn’t need with a responsibility to pay a year’s lease on an office and office furniture. The most devastating part was not our loss, but Dad’s. He had invested a sizeable sum of money in the business and we had no way to recover his money.

We returned to our little ranch house in Oklahoma with sad hearts and empty pocketbooks only to discover that all of our worldly possessions had been stolen. Times like these can definitely test ones spirit. Desperate times call for desperate measures, so we decided Dawn Anita and Jerryto saddle our horses and embark on a journey from Oklahoma to Nashville with only a few dollars, a lot of guts, my old guitar and some cassette tapes with my music. Our goal was to make it to Nashville in time for me to sing at FanFair. We were definitely a sight to behold with all of the gear loaded onto our horses… saddles, saddle-bags, bed rolls, nose bags, horse feed, camping supplies, canteens and slickers. We could not begin to fathom what an adventure we were about to undertake. Our journey took 24 days and it rained 22 days. We had many close calls…a lightning storm, Jerry’s horse jumping out in traffic, close calls on slick bridges, but the memories of the wonderful friends we made along the way helped us forget the saddle sores, the danger and the aching bones.

Total strangers opened their hearts, their homes and their pocketbooks to help us on our journey. The healing rain during that long ride from the state we have always known as home to the city of country music had washed our spirits clean. I knew that there might never be one more last chance for fame and fortune in the tenuous trouble-strewn world of music, but I was certain there would be one more last chance for us to feel whole again.

It has now been 56 years since I first boarded that bus in Tulsa, Oklahoma, as a naïve 16-year old country girl and 22 years since our horseback ride from Oklahoma to Nashville. It seems so long ago, and yet time has passed so quickly. There have been many twists and turns in the road on our journey up the hill, but we have persevered. We have 2 gorgeous children, 7 grandchildren and 4 great-grandchildren. Life is beautiful, but the road hasn’t always been smooth. I lost my dad and many other close friends and relatives.

We’ve had to overcome sickness and have had many personal struggles, but through it all, we have Dawn anita singingbelieved and held onto the hope that all will turn out well. As we stroll hand in hand down the other side of the hill, we feel confident that whatever happens, we will remain strong and resilient to the end.”

Another note from Bob Aronson

Dawn Anita’ s story is inspirational because of her spirit.  She just refuses to lose faith and to give in to adversity.  While she may  not have become a huge country music star that’s Nashville’s loss.  Go to her website http://www.freecountryrecords.com/ watch and listen to her perform and you’ll agree.  She is the consummate performer, when she takes the stage and begins to sing, audiences are captivated.  I am proud to call her “Cousin” and friend.  Thank you Dawn Anita and Jerry, you are wonderful examples of the American Spirit.

bob minus Jay full shotBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Follow-up To; How do You Apologize and Why Should You?


By Dr. Priscilla Diffie-Couch

A while back, family member Priscilla Diffie-Couch who holds a doctorate in communication, penned a blog for Bob’s Newheart titled, “How do You Apologize and Why Should You?”  (https://bobsnewheart.wordpress.com/2014/08/18/how-do-you-apologize-and-why-should-you/) It became very popular but in its popularity generated a multitude of questions.  Dr. Diffie-Couch, who is never comfortable with loose ends provided some very thoughtful and effective answers.  Please feel free to share them and the original blog with anyone you choose.

In forwarding her response draft she said, “I am pleased that so many of you read my blog on effective apologies.  Several of your comments and questions have prompted some points of clarity.”

QUESTION

I have repeated my apology so many different times that my friends now treat it as though it is not sincere.sincerity

If you find yourself repeating the same apology for the same offense to the same people, you must question whether you have ever included all of the five dimensions of an effective apology:

 

  1. RECOGNITION
  2. RESPONSIBILITY
  3. REMORSE
  4. RESTITUTION
  5. REPETITION

At the very minimum, you are evidently repeating the offensive behavior that caused the original distress.  People grow tired of hearing repeated promises when a change in your behavior is what they really expect from you.

QUESTION

I try to explain my offensive behavior very carefully before I actually say the words “I’m sorry” when I apologize.  Is that the best approach?sorry puppy

 

No.  You run two risks with this approach.  (1) You will add to the anger and hurt of those you have offended, the longer you put off saying the two words they want to hear:  “I’m sorry.”  (2) You will waste your lengthy explanation because the listener or reader will be so focused on hearing or seeing those two magic words that they will miss much of the rest of your message.

QUESTION

What is the best way to end an apology so that it doesn’t drag on endlessly?Get two the point

Start by saying you are sorry.  Determine what the hurt party expects.  Make sure you come to a mutual understanding of the exact nature of the offense.  Work to include the five dimensions.  Is it something you said or didn’t say?  Did or didn’t do?  Then end by saying exactly what you intend to do to avoid repeating the offense.

QUESTION

How soon do I have to apologize?     timimg            

Apologize without delay.  Undue delay adds to the offended person’s distress and allows for compounding the problem and even encourages imagined transgressions that never occurred.  Allow yourself enough time to pull your thoughts together and assess the nature of your offensive words or behavior.  It never hurts to take great pains in how you plan to phrase an apology.

 QUESTION

Is it better to apologize in person or in writing?  Can I do so on the phone?

Faceo to faceYou would think apologies should be done in person.  But that is not always the best or most practical approach.
You can express a simple “I’m sorry” immediately through any medium.  But you need to let the party know you plan to follow up with specifics.  Even when it is practical to apologize in person, a carefully-thought-out written apology can smooth the way for a more comfortable and satisfying personal interaction.  Put yourself in the reader’s place.  Reread your apology many times with a careful eye as to the “tone” of the words you have chosen.

As a person who wears top-of-the-line hearing aids, I can tell you that apologizing on the phone is fraught with potential perils.

QUESTION

Isn’t it better to keep my apology very general so that I can avoid getting into the same issues that caused the hurt feelings?say what you mean

Absolutely not.  In fact, the offended party will be looking for a direct reference to the exact hurtful deed or word and will wonder if you really understand why you are giving an apology if you fail to recognize the specific nature of your offense.  It is pointless to promise to make obscure and general behavior changes when it is a particular offense that caused the hurt.  Until you address the matters of contention fully, the offended person is unlikely to view your apology as satisfying or sincere.

QUESTION

Regardless of how explicitly I apologize for my offense, the wounded party keeps bringing up some other offense I’ve committed in the same altercation?  Isn’t enough enough?gunny sack

Unfortunately, it is all too common for people to “gunny sack” a lot of old grievances and then to dump them all at once in a given confrontation.  Ask yourself if you recognize your guilt in each separate issue the offended party raises.  If you do, you are obligated to make amends for each issue as a separate matter.  In healthy relationships, people avoid “gunny sacking.”  Every disagreement should be dealt with independently without delay.

QUESTION

Shouldn’t I just keep my apology very simple if that is my style?

That depends on your goal.  If you seek only satisfy your own personal standards with your apology, mistakesyou can choose what to include and hope for the best.  However, if your goal is to repair and restore a damaged relationship, then you should heed the approach that works most successfully in a larger world.

QUESTION

Wouldn’t it be better in some cases just to skip the apology, let things go, and growthmove on with your life?
That is what many people do who are left wondering why they have so much trouble maintaining close, trusting relationships.  Those same people excuse offending behavior by saying, “That’s just the way I am.”  If you are one, ask yourself, “When did the death of my growth occur”?  At age three?  Thirty-three?  Sixty-three?

CONCLUSION

Unresolved issues left to smolder can burst into flames in sudden and devastating ways. firey image

Valued relationships must be nurtured.  That demands taking responsibility for any role you may play in eroding a relationship.  responsibilityAs human beings, we will find ourselves guilty more than once of causing temporary distress in other people’s lives.  Learning how to repair the damage that distress can cause necessarily involves utilizing effective apologies.  That is a part of actively becoming a better person.  That kind of growth is possible and desirable as long as we live.

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Apriscilla picturen award winning high school speech and English teacher, Priscilla Diffie-Couch went on to get her ED.D. from Oklahoma State University, where she taught speech followed by two years with the faculty of communication at the University of Tulsa.  In her consulting business later in Dallas, she designed and conducted seminars in organizational and group communication.

An avid tennis player, she has spent the last twenty years researching and reporting on health for family and friends.  She has two children, four grandchildren and lives with her husband Mickey in The Woodlands, Texas.

Bob informal 3Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

 

Got “Low T?” Buyer Beware — the Therapy May Not Be Safe!


By Bob Aronson

Almost everyone is familiar with the commercials and ads that offer relief for men suffering from “Low T.”   Most interpret that to mean “diminished sex drive” and there is no end to the number of claims of treatments and/or cures.  Bottom line?  They are selling sex.  The manufacturers   of “Low T” products, physicians, clinics and therapists are pandering to the male fear of erectile dysfunction and there’s absolutely no guarantee that any of the products will work.  Worse yet, they could kill you.

The ads produced by those who are promoting Testosterone therapy amount to fear mongering at itskeep it up ad...
worst.  Nothing will destroy a man’s ego faster than an inability to perform in bed and many will go to any extreme to make sure that doesn’t happen.  If you could drill deeply into the male ego you likely would find that the ability to get and hold an erection is extremely important and when that ability is lost even once, many men will feel as though they have lost their manhood and that their life is over. The ads posted here are real.

low T sexual image ad

 

low t ad

 

 

The “Low T” condition should not be taken lightly, if in fact that is an accurate diagnosis.  Unfortunately the number of physicians and others who offer that diagnosis is far greater than the number who are qualified to do so or who even perform a thorough examination

In 2013, 2.3 million men received a prescription for testosterone, up from 1.3 million in 2010, according to the U.S. Food and Drug Administration (FDA).  About 70 percent of men prescribed testosterone drugs were between the ages of 40 and 64.

According to an FDA analysis, 21 percent of patients prescribed testosterone drugs did not appear to have had their testosterone concentrations tested before or during treatment, something the agency described as “concerning.”

Ofda logo 2n Tuesday, September 17, 2014 an FDA advisory panel said that Testosterone replacement therapies should be “Reserved for men with specific medical conditions that impair function of the testicles.”  While the FDA is not obligated to follow advisory panel advice, it typically does.  The panel also recommended that companies be required to conduct additional studies to assess the cardiovascular risk of their products for patients with age-related low testosterone.

Symptoms of low testosterone include loss of libido, decreased muscle mass, fatigue and depression.

The panel voted 20-1 in favor of restricting the drugs’ authorization to people with medically related low testosterone, such as a tumor or genetic disorder.

If the FDA acts on the recommendation companies could not market or promote their products for age-related low testosterone, but physicians would still have the right to prescribe products “off label” in any way they choose.  An important lesson for consumers is that just because a physician prescribes it, doesn’t mean it’s right for you.

What is Testosterone?

The Mayo Clinic says this: Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintain men’s:

  • Bone density
  • Fat distribution
  • Muscle strength and mass
  • Red blood cell production
  • Sex drive
  • Sperm production

Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.

What are the Risks of Testosterone Therapy?

Also according to the Mayo Clinic http://www.mayoclinic.org/healthy-living/sexual-health/in-depth/testosterone-therapy/art-20045728?pg=2

Testosterone therapy has various risks. For example, testosterone therapy may:

  • Contribute to sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts
  • Increase your risk of a heart attack
  • Cause acne or other skin reactions
  • Stimulate noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer
  • Enlarge breasts
  • Limit sperm production or cause testicle shrinkage
  • Increase the risk of a blood clot forming in a deep vein (deep vein thrombosis), which could break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism)

The American Recall Center  http://www.recallcenter.com is a consumer oriented groupAmerican recall center logo with the following vision.  “At the American Recall Center, we aim to give pertinent information on FDA warnings for prescription drugs and medical devices. Through our extensive library of recalls and medical information, and our experienced editorial team, it is our mission to empower those who have been adversely affected.”  In other words, they monitor the health care environment and provide accurate and timely information about drugs, procedures, devices and practices that affect individual Americans.

Recently I was contacted by The American Recall Center http://www.recallcenter.com and alerted to their concerns about Testosterone Therapy and the various actions being taken with regard to the practice.  I looked carefully at what they had to say and also conducted my own brief investigation that resulted in verification of their claims.  What follows is a direct copy from their website.  It is alarming and should be taken very seriously by anyone either undergoing such therapy or considering it.

lawsuit imageTESTOSTERONE LAWSUIT

http://www.recallcenter.com/featured-topics/testosterone-replacement-therapy/testosterone-recall/

The treatment of low testosterone (also known as hypogonadism or Low-T) in men has increased significantly since the year 2000. However, with the growth of such testosterone replacement therapy, there has also been an increase in the number of studies that have shown a link to various medical problems, such as the increased risk of heart attacks, strokes and other potentially deadly outcomes. As a result, the FDA has issued several statements on the use of testosterone therapy, and a number of lawsuits have been filed claiming that treatments to combat low testosterone have resulted in harm to the patient or even fatalities.

FDA Investigation and Testosterone Replacement Therapy

Although the FDA has not issued any recalls of testosterone due to the possibly dangerous nature of various treatments, early in 2014 the agency published an alert stating that it was going to begin investigating the potentially adverse outcomes of testosterone supplements. Specifically, the FDA denied any conclusions related to increased probability of heart attacks, strokes or death in men undergoing testosterone replacement therapy. However, the agency said that would analyze data from multiple studies and monitor side effects of testosterone treatments as reported through its MedWatch program. The FDA also advised patients and physicians to understand both the risks and the benefits of drugs and supplements before beginning any treatment.1

In June 2014, the FDA announced that it manufacturers of testosterone would be required to add a warning label to their products indicating the possible formation of blood clots in patients’ veins. The agency stressed that this requirement was unrelated to the separate investigation into the other health problems that may be associated with testosterone use.2

Testosterone Lawsuits and Multidistrict Litigation

As a result of the potentially dangerous consequences of taking various low-testosterone treatments — which are available as topical gels, transdermal patches, buccal systems, subcutaneous pellets and injections — a significant number of lawsuits have been filed against manufacturers of testosterone products.

Because of the large number of cases related to testosterone products, and the even larger number of potential future case that could expand into the thousands, the United States Judicial Panel on Multidistrict Litigation has created MDL No. 2545 to handle actions related to testosterone products. In the original order, the panel noted its hesitancy to encompass an entire industry with a broad range of products under a single MDL. However, the panel members acknowledged that even among different products and across competing companies, many of the claims associated with the testosterone cases have common discovery, and thus are suitable for MDL status.

At the time of the original order on June 6, 2014, forty-five cases across four districts were pending. Since then, additional cases have been added.4

Testosterone Manufacturers Facing Lawsuits

The following table lists companies that have faced lawsuits related to their testosterone treatments, along with the names of some commonly known testosterone products they have developed. Other companies also may have faced litigation for their testosterone products.

COMPANY TESTOSTERONE PRODUCT(S)
AbbVie Inc./Abbott Laboratories Inc. AndroGel
Eli Lilly and Co./Lilly USA LLC Axiron
Endo Pharmaceuticals Aveed, Delatestryl, Fortesta
Actavis, Inc. ANDA, LibiGel, Testosterone Enanthate Injection USP, Testosterone Cypionate Injection USP, AndroDerm
Auxilium Pharmaceuticals, Inc. Testim, Testosterone Gel CIII, Testopel, Striant
Pfizer, Inc./Pharmacia & Upjohn Co. Depo-Testosteroneh, Depo-Testadiol

Alternatives?

According to Healthline (http://www.healthline.com/health/low-testosterone/natural-boosters#1),  there are some alternatives to Testosterone Therapy and while there’s no guarantee they will work, there is no guarantee the therapy will work either and these alternatives, unlike the therapy, won’t hurt you.

Additionally, following these suggestions can help your general health as well as low testosterone production.  Try them, you have nothing to lose and a better life to gain.

  1. Get a Good Night’s Sleep

It doesn’t get more natural than a good night’s sleep. A University of Chicago study showed that lack of sleep can greatly reduce a healthy young man’s testosterone levels. That effect is clear after only one week of shortened sleep. Testosterone levels were particularly low between 2:00 and 10:00 p.m. on sleep-restricted days. Study participants also reported a decreased sense of well-being as their blood testosterone levels dropped.

How much sleep your body needs depends on many factors, but theNational Sleep Foundation suggests that adult males generally need between seven and nine hours per night.

  1. Lose That Excess Weight

It is not uncommon for overweight, middle-aged men with prediabetes to also have low testosterone levels. A 2012 study revealed that weight loss among men with prediabetes improved their testosterone levels by almost 50 percent.

These findings don’t mean you have to go on a crash diet. The healthiest way to achieve and maintain a healthy weight is through a sensible diet and regular exercise.

  1. Get Enough Zinc

Men with hypogonadism generally have zinc deficiencies. Studiessuggest that zinc plays an important part in regulating serum testosterone levels in healthy men.

According to the Office of Dietary Supplements, adult males should get 11 mg of zinc and females should get 8 mg of zinc each day. Oysters have a lot of zinc. It is also found in red meat and poultry. Other food sources include beans, nuts, crab, lobster, whole grains, and many fortified foods.

  1. Go Easy on the Sugar

Zinc isn’t enough to ensure you’re getting the all the nutrition you need. The human body is a complex system that requires a wide variety of vitamins and minerals for smooth operation.

Research published by The Endocrine Society shows that glucose (sugar) decreases testosterone levels in the blood by as much as 25 percent. This was true of study participants whether they had prediabetes, diabetes, or a normal tolerance for glucose.

  1. Get Some Good Old-Fashioned Exercise

Studies show an increase in total testosterone levels after exercising, especially after resistance training. Low testosterone levels can affect your sex drive and your mood, but the good news is that exercise improves mood and stimulates brain chemicals that help you feel happier and more confident. Exercise also boosts energy and endurance and helps you sleep better. All that can help with your sex drive and sexual performance, too. Fitness experts recommend 30 minutes of exercise every day.

Avoid Alcohol.  And…a final tip and this one is mine.  If you are concerned about your ability to perform sexually you should know that consuming alcohol will not help.  Alcohol often will present two contradictory effects.  The first effect is that it will diminish your inhibitions and therefore boost your desire for sex.  Unfortunately, the increased desire is usually met with a decreased ability to get an erection.  You get all dressed up with nowhere to go.

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bob minus Jay full shotBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Answers to the Most Common Health Questions


                Author unknown but provided to us by Priscilla Diffie-Couch, E.d. D

priscilla pictureDr. Priscilla Diffie-Couch is my wife’s cousin and the health advisor to the entire Diffie family.  Priscilla stays on top of the latest research and provides all of us with updates on a regular basis.  Recently she sent the information you are about to read.  She knows  not where it originated but vouches for it’s accuracy.  I think you will find  these commonly asked questions and the answers most helpful.  

Does olive oil prevent heart disease? 

olive oil

Short answer: Yes
The health benefits of olive oil come from the presence of polyphenols, antioxidants

That reduce the risk of heart diseases and cancers.
But to get these healthy compounds, consumers should buy good-quality, fresh “extra-virgin” olive oil, which has the highest polyphenol content. Most commercially available olive oils have low levels of polyphenols associated with poor harvesting methods, improper storage, and heavy processing.

cough syrup

Do cough syrups work?
Short answer: No
In 2006, the nation’s chest physicians agreed that the majority of over-the-counter cough medicines don’t actually work.

These colorful syrups typically contain doses of codeine and dextromethorphan that are too small to be effective.
Only cough suppressants that contain older antihistamines seem to relieve coughs.

That includes brompheniramine, an active ingredient in Dimetapp.

sugary drinks

Do sugary soft drinks lead to diabetes? 
Short answer: Yes
The majority of health research is stacked against sugar-sweetened soda. A large 2004 study in the Journal of the American Medical Association found that women who drank one or more sugary drinks per day increased their risk of developing type 2 diabetes by 83% compared to those who consumed less than one of these beverages per month.

sunscreen

Do I need sunscreen with more than 30 SPF?
Short answer: No
Sunscreens with an SPF (sun protection factor) of 30 block about 97% of ultraviolet rays,

While sunscreens with an SPF of higher than 30 block 97%-98%.
It’s more important that you choose “broad-spectrum” sunscreen, meaning it protects against both UVB and UVA rays.

Sunbathers also need to apply a generous amount of sunscreen in order to get the full benefit of the SPF.

chinese food

Is the MSG in Chinese likely to give you a headache?
Short answer: No
A review of 40 years of clinical trials, published in the journal of the American Academy of Nurse Practitioners in 2006,

Found that all previous research “failed to identify a consistent relationship between the consumption of MSG

And the constellation of symptoms that comprise the syndrome,” including headaches and asthma attacks.
The misconception spawned from several poorly-done small studies in the 1960s that seemed to connect MSG with a variety of maladies that people experienced after eating at Chinese restaurants.

Learn more about the MSG myth here »

nuts make you fat

Do nuts make you fat?
Short answer: No
As much as 75% of a nut is fat. But eating fat doesn’t necessarily make you fat.

The bigger factor leading to weight gain is portion-size.

Luckily, nuts are loaded with healthy fats that keep you full. They’re also a good source of protein and fiber.
One study even found that whole almonds have 20% less calories than previously thought because

A lot of the fat is excreted from the body.

running v  walking

Is walking as effective as running? 
Short answer: Yes
Studies have shown that how long you exercise — and thus how many calories you burn — is more important

Than how hard you exercise. Running is a more efficient form of exercise, but not necessarily better for you.
A six-year study published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology in April found that walking at a moderate pace and running produced similar health benefits, so long as the same amount of energy was expended.

fruit juice and fruit

Is drinking fruit juice as good for you as eating fruit?
Short answer: No
Calorie for calorie, whole fruit provides more nutritional benefits than drinking the pure juice of that fruit.

That’s because when you liquefy fruit, stripping away the peel and dumping the pulp, many ingredients like

Fiber, calcium, vitamin C, and other antioxidants are lost.
For comparison, a five-ounce glass of orange juice that contains 69 calories has .3 grams of dietary fiber and 16 milligrams of calcium, whereas an orange with the same number of calories packs 3.1 grams of fiber and 60 milligrams of calcium.

breads

Are all wheat breads better for you than white bread? 
Short answer: No
Not all wheat breads are created equal. Wheat breads that contain all parts of the grain kernel,

Including the nutrient-rich germ and fiber-dense bran, must be labeled “whole grain” or “whole wheat.”
Some wheat breads are just white bread with a little bit of caramel coloring to make the bread appear healthier,

According to Reader’s Digest.

hot tubs

Can a hot tub make me sick?
Short answer: Yes
Hot tubs — especially ones in spas, hotels, and gyms — are perfect breeding grounds for germs.
The water is not hot enough to kill bacteria, but is just the right temperature to make microbes grow even faster.

Even though hot tubs are treated with chlorine, the heat causes the disinfectant to break down faster

than it would in regular pools.
The most common hot tub infection is pseudomonas folliculitis, which causes red, itchy bumps.

A more dangerous side-effect of soaking in a dirty Jacuzzi is a form of pneumonia known as Legionnaire’s disease.

This is what reportedly sickened more than 100 people at the Playboy Mansion back in 2011.

coffee

Does coffee cause cancer? 
Short answer: No
Coffee got a bad rap in the 1980s when a study linked drinking coffee to pancreatic cancer.

The preliminary report was later debunked.
More recently, health studies have swung in favor of the caffeinated beverage.

Coffee has been linked to a lower risk of type 2 diabetesParkinson’s disease, liver cancer, and even suicide.

Eggs and cholesterol

Do eggs raise cholesterol levels? 
Short answer: No
Although egg yolks are a major source of cholesterol — a waxy substance that resembles fat — researchers have learned that saturated fat has more of an impact on cholesterol in your blood than eating foods that contain     cholesterol.
“Healthy individuals with normal blood cholesterol levels should now feel free to enjoy foods like eggs in their diet every day,” the lead researcher from a 25-year University of Arizona study on cholesterol concluded.

bottled water

Can you drink too much water?
Short answer: Yes
It is very rare for someone to die from drinking too much water, but it can happen.
Overhydrating is most common among elite athletes. Drinking an excess of water, called water intoxication, dilutes the concentration of sodium in the blood leading to a condition known as hyponatremia.

The symptoms of hyponatremia can range from nausea and confusion to seizures and even death in severe cases.
To avoid this, drink fluids with electrolytes during extreme exercise events.

yogurt

Can yogurt ease digestive problems?
Short answer: Yes
Our digestive tract is filled with microorganisms — some good and some bad. Yogurt contains beneficial bacteria, generically called probiotics, that helps maintain a healthy balance.

Probiotics can relieve several gastrointestinal problems, including constipation and diarrhea.
Certain brands of yogurts, like Activa by Dannon, are marketed exclusively to treat tummy issues.

whitening toothpaste

 

Do whitening toothpastes whiten teeth more than regular toothpastes?
Short answer: No
Whitening toothpastes usually contain peroxides and other strong abrasives that might make

your teeth appear whiter by removing stains. Unlike at-home whitening strips and gels that contain bleach,

these toothpastes do not actually change the color of your teeth.

Microwave

Is it safe to microwave food in plastic containers?
Short answer: Yes
But the plastic container should display the words “microwave safe.” This means that the Food and Drug Administration has tested the container to make sure no chemicals used to make the plastic leech into foods during microwaving.

If chemicals do seep out into food, the amounts are tiny and not dangerous to our health.
As a general guideline, plastic grocery bags as well as most plastic tubs that hold margarine, yogurt, cream cheese,

and condiments are not microwave safe.

TV

Can watching TV ruin your eyesight?
Short answer: No
Watching TV will not destroy your rods and cones as the outdated myth suggests. Before the 1950s,

TVs emitted radiation that could increase an individual’s risk of eye problems after excessive TV viewing.

Modern TVs have special shielding that blocks these harmful emissions.

wine

 

Is red wine better for you than white wine?
Short answer: Yes
Red wine contains much more resveratrol than white wine, an antioxidant found in the skin of grapes

that has been shown to fight off diseases associated with aging.

bottle v tap water Is bottled water better for you than tap water? 
Short answer: No
Bottled water is no safer or purer than tap water, although it is substantially more expensive.
A recent study by Glasgow University in the U.K. found that bottled water is actually

more likely to be contaminated than water from your faucet because it is less well-regulated.
Bottled water and tap water typically come from the same sources — natural springs, lakes, and aquifers.

While public water supplies are tested for contaminants every day, makers of bottled water are only required

to test for specific contaminants every week, month, or year.

Dr. Priscilla Diffie-Couch will be a featured guest blogger from time to time on Bob’s Newheart. Watch for her posts and know that if Priscilla says it, you can depend on its accuracy.

 bob cropped smallerBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

How do You Apologize and Why Should You?


Introduction by Bob Aronson

I'm sorry cartoonThis blog has addressed many issues over the years, but we’ve never approached the issue of how our behavior when ill sometimes results in hurt feelings, the loss of friends and even the dissolution of marriages because so few of us know how to say, “I’m sorry,” in an effective and meaningful manner.

Anyone who has suffered a serious, life-threatening illness has at one time or another lost their temper, or become overly emotional and said and did things that are out of character.  Unfortunately we rarely know just how deeply our words and actions can hurt others and worse yet, when and if we apologize we do so ineffectively.  “I’m sorry,” are two words that are extremely difficult for most people to say and when we do use them it is often too late and without sincerity.

I’m a member of Alcoholics Anonymous.  It is a twelve step program and two of the steps are devoted to apologizing.  In AA it’s called  “Making Amends” or apologizing to those you have hurt or harmed in some manner.  Specifically step eight admonishes members to “make a list of all persons we had harmed, and became willing to make amends to them all.”  And –Step Nine says, “Make direct amends to such people wherever possible, except when to do so would injure them or others.”

Having been part of that program for 33 years I should have more than a passing acquaintance with apologizing, but I don’t. I’m not very good at it and I don’t like doing it because like most people I don’t like having to admit that I’ve made mistakes….who does?

The bottom line is that making amends or apologizing is good for one’s mental health and I was made aware of that recently by Dr. Priscilla Diffie-Couch a family member with a Doctorate in Communication.  A brilliant woman, Priscilla has for years served as a healthy living advisor to the Diffie family and her advice is always spot on.  Recently I asked her to pen a guest blog for Bob’s Newheart and she responded with this essay on apologizing.  It’s a subject to which I’ve given almost no thought and am grateful that she brought it to our attention.

I’m hoping we can talk Dr. Diffie-Couch into being a more regular contributor to our efforts.   Thanks Priscilla.

 How do You Apologize and Why Should You?

By Dr. Priscilla Diffie-Couch ED.D.

One of the most fundamental communication skills needed to maintain trusting and close relationships is found in the art of apologizing.  The most common mistake we make is to respond to someone who expresses hurt feelings by saying, “Oh, you misunderstood.  I didn’t mean to hurt you.”  That only serves to insult that person’s intelligence. Few people would say, “I meant to hurt your feelings or offend you.”

Effective Apology—Mending Fences by John Kador is an excellent resource for understanding the skills involved in apologies that actually repair hurt feelings.  His five “R’s” explain why an effective apology is far more than simply sincere and why extracted apologies leave us feelingFranklin quote so unsatisfied:

  1. RECOGNITION
  2. RESPONSIBILITY
  3. REMORSE
  4. RESTITUTION
  5. REPETITION

By RECOGNITION, he means acknowledging that feelings are not debatable or deniable.  You must treat that person’s declaration of being hurt as valid and true.  Denying the truth of your offense will do nothing toward healing.  Of course, confining your attacks to the issues–not the persons who raised them–will greatly reduce your need to make apologies.

By RESPONSIBILITY, he means acknowledging your real role in this hurt.  You must own the words that you said and accept that they caused hurt.  Responsibility means saying, “I’m sorry.  I see how that was offensive to you.”   You must acknowledge your guilt and convey a willingness to do something about it.  Saying “You misunderstood” not only adds insult to injury, it suggests you think the responsibility for fixing the hurt belongs with the person who is offended.

By REMORSE, he means verbally admitting that you made a mistake in the way you conveyed a message and you feel bad about causing the hurt.  Arguing with someone who has expressed that your words were hurtful exposes that you do not feel contrite; your real goal is to prove you were right.  Excuses are equally offensive.  They only widen the wounds.

By RESTITUTION, he means the willingness to invest whatever time is required to ensure that the hurt party sees that you are sincere, feels better and knows that you care.  Saying “That’s just the way I am” is tantamount to saying, “You are the problem, not me.  You are too sensitive when I express my strong opinions.  You are the one who should change, not me.”  You are not alone in having strong opinions.  It’s how and when you choose to express them that most affects your relationship with others.

When deeds and words collide, words seldom win.  Saying, “I love you” is meaningless unless you are willing to take specific actions that truly reflect that love.  Words have the power to inflict wounds that only deeds can heal.  When you hurt others, the act of making a full apology is the deed required. It is critical in repairing a relationship damaged by hurt.  Expressions of love are poor imposters of apologies.

By REPETITION, he means promising to avoid repeating the offense.  Apologies that fall short are seldom seen as “wholehearted.”  Vows to change help insure acceptance of your apology and increase the hurt party’s desire to take on responsibilities and benefits that come with forgiveness.  But that is another story.

Effective apologies restore and improve relationships and pave the pathway to personal growth.  People who have good relationships live longer and healthier lives.

This summary focuses on only part of what Kador deals with regarding effective apologies.  Maybe you have questions.  I did.

QUESTION:  Do all my apologies have to include all five dimensions?  The short answer is no.  Passing events in our lives like bumping into someone or creating a disturbing noise call for little more than “I’m sorry.”  The focus in this book, however, is repairing and improving relationships.  Achieving that goal demands consideration of each dimension in framing your apology.

QUESTION:  Isn’t it true that some people are overly sensitive and require an unusual number of apologies?  True, but you have little to gain by excusing yourself from giving an apology based on what you see as the recipient’s personality shortcomings.  Life demands dealing with all kinds of personalities.  You cannot change others.  You can control only your own behaviors.  People with the greatest number of satisfying relationships are those who recognize the value of understanding and adaptation.

QUESTION:  I am not a great communicator.  Can’t I just send the injured person flowers or some kind of gift?  No gift can convey the five dimensions that characterize a wholehearted apology.  Gifts can easily be seen as taking the easy way out of situations that are full of needs and complexities.

QUESTION:  But isn’t it possible that whatever I did or whatever I said does not warrant an apology?  That is possible. Your first objective with someone who claims to be offended is to be sure that you have a full understanding of the basis for that claim.  Use the words “Help me understand exactly what I said or did….”  When no specific examples or explanations can be provided, then an extracted apology will do nothing to promote trust.  Instead, say something like this: “I value our relationship, but giving you an empty insincere apology for something so vague will not bring us closer.”

QUESTION:  Are there specifics about what I should or should not include in my apology?  Begin with “I.”  Use active voice.  Example:  “I’m sorry I hurt you,” not “I’m sorry you were hurt.”  Do not include “if’s” or “buts.”  Don’t joke.  Don’t assume.  Ask how someone feels.  Use the person’s name.  Don’t ramble.  Don’t argue.  Listen.  Really listen.  Then apologize.

Learn to apologize effectively.  It’ll do your heart good.

 -0-

priscilla pictureAn award winning high school speech and English teacher, Priscilla Diffie-Couch went on to get her ED.D. from Oklahoma State University, where she taught speech followed by two years with the faculty of communication at the University of Tulsa.  In her consulting business later in Dallas, she designed and conducted seminars in organizational and group communication.

An avid tennis player, she has spent the last twenty years researching and reporting on health for family and friends.  She has two children, four grandchildren and lives with her husband Mickey in The Woodlands, Texas.

 Bob Aronson  has worked as a broadcast journalist, Minnesota Governor’s Communications Director and for 25 years led his own company as an international communication consultant specializing in health care.

In  2007 he had a heart transplant at the Mayo Clinic in Jacksonville, Florida.  He is the Bob of Bob’s Newheart and the author of most of the nearly 250 posts on this site.  He is also the founder of Facebook’s nearly 4,000 member Organ TransplantMy new hat April 10 2014 Initiative (OTI) support group.

You may comment in the space provided or email your thoughts to him at bob@baronson.org.  And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Managing Your Health After an Organ Transplant


A note from Bob Aronson

FacebookWhen you become an organ transplant recipient your life changes.  Not only does the quality of life improve but you have a new awareness of the importance of healthy living.  Transplantable organs are in short supply and those of us who are fortunate enough to get one have a special obligation to take care of it.  It is a gift of life that many never receive and your transplant center will make every effort to help you take care of yourself and your new organ.  Follow their advice, eat healthy, live healthy and by all means, exercise as much as possible.

I have researched and written the great majority of blogs that are published on Bob’s Newheart but not this one.  It was researched and published by the American Society of Transplantation (AST).  I only made some minor editing and formatting changes (the complete post can be found here– http://tinyurl.com/pcteky5).   

This entry is longer than most because it offers critical information that you will need.  It is not only comprehensive in scope,  it is easy to understand and the principles are immediately and easily applicable.  Please take the time to read and thoroughly consider every point.  The information contained here can ensure not only a longer life but one of enhanced quality as well.  And…while this post is meant for transplant recipients, the advice contained here will keep you healthy even if you haven’t had and don’t need an organ transplant.

KEEPING A HEALTHY OUTLOOK ON LIFE

After an organ transplant, there is hope for the future. However, there are a number of health concerns that you will face. For example, there is the chance that your new organ will not always function as well as it should. Transplant recipients also have a higher risk of developing certain conditions such as high blood pressure, high blood lipid levels, diabetes, kidney problems, liver problems, and bone disease. Infection and cancer are also conditions you need to keep in mind. Some conditions can affect any transplant recipient and some conditions are specific to the type of organ transplanted.

CARING FOR YOUR NEW ORGAN

Lab Tests for Measuring Organ Function

It is important to keep all of your scheduled checkups and lab appointments for monitoring organ function. Testing allows your transplantheart of love team to monitor the status of your transplant, detect rejection early, and start effective therapy right away.Common tests for checking organ function are listed below:

Liver function tests — Blood tests are used to monitor liver function (e.g. albumin); damage to liver cells (e.g., alanine transaminase [ALT], Aspartate transaminase [AST]) and some with conditions linked to the path by which bile is produced by the liver (e.g., gamma-glutamyl transferase and alkaline phosphatase)

·    Pulmonary function tests — Tests like spirometry show how well you lungs are working

·    Bronchoscopy — A test that uses an instrument (bronchoscope) to view the airways and diagnose lung disease

·    Chest x-ray

·    Upper and lower gastrointestinal (GI) endoscopies — These evaluations can detect abnormalities of your esophagus, stomach, and intestine
·    Hemodynamic monitoring — Sonar-type echos may be used to detect high blood pressure in your heart and lungs or a catheter may be placed           in the heart for periods of six to 12 hours

·    Echocardiogram — Sonar-type echos can show abnormalities in the heart and lungs

·    Electrocardiogram (EKG or ECG) — Asseses the electrical activity within your heart

·    Renal function studies — Your doctor may ask you to collect your urine (usually for 24 hours) to evaluate if your kidneys are working                         properly. Blood tests such as serum creatinine are performed to measure kidney function

·    Biopsy — A biopsy may also be taken to determine if a rejection episode has occurred. This is done by collecting a small piece of tissue from the       organ and examining it under a microscope

OTHER HEALTH ISSUES

Anti-rejection medications increase your risk of developing certain conditions such as infection and cancer. Other side effects of some anti-rejection medications include high blood pressure, diabetes, high blood lipids, kidney disease, heart attack, stroke, and bone disease. Knowing the risks and taking steps now to prevent them is a good way to keep you and your new organ healthy.

HIGH BLOOD PRESSURE

High blood pressure (hypertension) is a common complication in patients who receive a transplant. High blood pressure can damage the arteries and the heart, increasing the risk of a stroke, a heart attack, kidney problems, or heart failure.For many patients, the cause of hypertension is not known. However, people with kidney disease, diabetes, or high blood pressure before the transplant are at higher risk of high blood pressure after the transplant. Other factors that contribute to high blood pressure after a transplant include a diet high in salt, clogged arteries, high blood lipid levels, smoking, obesity, and some anti-rejection medications such as cyclosporine, tacrolimus, and steroids (prednisone).

Recommended Blood Pressure Levels

People with a blood pressure of 140/90 mm Hg or higher are considered hypertensive. While most transplant recipients should have a blood pressure of 130/80 mm Hg, the ideal blood pressure can vary from person to person. The American Heart Association (AHA) guidelines for the target blood pressure in the general population can also be used as guidelines for organ transplant recipients. Normal blood pressure values for children are based on age, sex and height and in general are much lower than in adults.

  • Normal Systolic (top) 120 Diastolic (bottom) 80
  • Prehypertension Systolic 120-139, Diastolic 80-89
  • Stage 1 hypertension Systolic 140-159, Diastolic 90-99
  • Stage 2 hypertension Systolic 160 or higher, Diastolic 100 or higher

High blood pressure usually does not cause any symptoms so it is important to have your blood pressure checked by your transplant team at regular follow-up exams. Your transplant team may also want you to monitor your blood pressure closely while at home.

Reducing High Blood Pressure

  • Making some lifestyle changes can lower your blood pressure and prevent hypertension
  • Sometimes hypertension can be controlled with lifestyle changes such as diet and exercise, but most patients also require medication.
  • There are a variety of medications for treating and controlling high blood pressure
  • The most commonly prescribed medications include ACE inhibitors, ARBs, calcium channel blockers, beta-blockers, and diuretics. Some of these medications may have interactions with certain anti-rejection medications.

HIGH BLOOD LIPIDS

While lipids (cholesterol and related compounds) in your blood are necessary for good health, too high levels of some lipids can increase your risk of cardiovascular disease, a leading cause of death among transplant recipients. Most transplant recipients develop high blood lipids. Kidney, heart, and liver transplant patients usually display similar elevations in total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol (“bad cholesterol”).Eating the wrong foods, lack of exercise, and being overweight can increase your risk of developing high levels of LDL cholesterol (“bad cholesterol”), high levels of triglycerides, and low levels of HDL cholesterol (“good cholesterol”). Transplant recipients who are obese, smoke cigarettes, or have high blood pressure are more likely to have high cholesterol. Steroids and some of the other anti-rejection medications, such as cyclosporine, sirolimus, and tacrolimus, can also cause high blood lipid levels.

Recommended Blood Lipid Levels

Be sure to ask your doctor what your cholesterol levels should be. In some instances, transplant recipients can follow target levels of blood lipids recommended in the National Cholesterol Education Program (NCEP) guidelines.

Lipid
Low
Optimal
High
LDL Cholesterol

100 mg/dL
160-189 mg/dL
HDL Cholesterol
40 mg/dL

60 mg/dL
Total Cholesterol

240 mg/dL
Reducing High Blood Lipid Levels

not easy but worth itMaking healthy lifestyle changes can lower your chances of developing heart disease. You can help lower your blood lipid levels with a proper diet and regular exercise. A diet low in cholesterol and saturated fats may also help reduce your risk of coronary artery disease. In addition to making healthy changes to your diet, exercising for a minimum of 20 to 30 minutes 3 to 4 times a week can also reduce your lipid levels and lower your risk of heart attack or stroke. If you smoke, it is important that you STOP! If adjustment of your anti-rejection drugs, diet, and exercise are not successful in reducing lipid levels, your doctor may want you to take cholesterol-lowering medications. T

Here are several medications that work to lower blood lipids. The most commonly prescribed medications are called statins, which include atorvastatin (Lipitor®), simvastatin (Zocor®), pravastatin (Pravachol®), fluvastatin (Lescol®), rosuvastatin (Crestor®), and lovastatin (Mevacor®). If your doctor prescribes a statin, you will need to be monitored for side effects because the risk of side effects is greater when taken with anti-rejection medications. You will also need blood tests to monitor liver and muscle function. Other types of medication that your transplant team might prescribe to treat high blood lipids include bile acid sequestrants, nicotinic acid, fibric acids, and cholesterol absorption inhibitors.

DIABETES

High blood glucose can cause many health problems, including diabetes, heart disease, kidney injury, nerve damage, and eye problems.Post-transplant diabetes (PTDM) is more common in transplant recipients who have a family history of diabetes as well as those who are overweight, are taking steroids, or have hepatitis C. Diabetes after a transplant is also more common among African Americans and some other ethnic groups such as Native Americans. Other risk factors for PTDM include older age of the recipient.

Controlling Blood Sugar Levels

Most transplant recipients with diabetes can follow the American Diabetes Association (ADA) guidelines. Patients with PTDM should establish a healthy (weight-reducing, if necessary) diet with a structured exercise program. A healthy diet is needed to prevent diabetes or to help control your glucose if diabetes does occur. For all transplant recipients, it is best to eat a healthy diet and exercise regularly to avoid weight gain and reduce the risk of developing high blood glucose or diabetes. Your transplant coordinator or dietician can help determine your recommended daily calorie intake. Limiting the amount of fats and sugar in your diet can also help to maintain a healthy level of blood glucose.

Treatment Options for Controlling Diabetes

There are several types of medications available for patients with diabetes. Depending on the level of glucose in your blood, treatment with oral hypoglycemic drugs and/or insulin may be indicated. For many transplant recipients, insulin injections or an insulin pump is an option for controlling blood sugar. Or, you may be given an oral medication to control blood glucose levels. Your transplant team will determine which medication is right for you.

KIDNEY DISEASE

Kidney function is often decreased in transplant recipients. This may be caused by a pre-existing condition such as diabetes, high blood pressure, or injury to the kidney before a transplant. Or it may be caused by medications used to prevent rejection after a transplant.The best way to help prevent kidney disease is to keep your blood pressure and blood glucose under control and to maintain a healthy weight. In addition, regular checkups with blood and urine tests will give your doctor important information for detecting early changes in kidney function and allowing appropriate steps to be taken.

BLOOD VESSELS DISEASE

Transplant recipients have a higher risk of developing blood vessel disease. Some anti-rejection medications increase the risk of high lipid levels, which can clog arteries and restrict the flow of blood to the heart and brain. Deposits — called atherosclerotic plaque — can completely or partially block blood vessels resulting in a myocardial infarction (heart attack) or acute coronary syndromes.Likewise, a stroke can occur if an artery that supplies blood to the brain becomes blocked. Partial blockage may temporarily reduce the blood supply to the brain. A complete loss of blood supply to the brain results in a stroke.

BONE DISEASE

Bone disease is a problem for many organ transplant recipients. Organ failure before your transplant may cause bones to become thin and brittle (osteoporosis). Other causes of osteoporosis include use of some anti-rejection drugs (corticosteroids), overactive parathyroid gland, cigarette smoking, and not enough calcium in your diet.

Preventing Bone Disease

There are some basic things you can do to help prevent or treat bone disease.

Exercise regularly, including weight lifting or strength training — be sure to discuss weight limits with your transplant team beforebones beginning an exercise program
Eat foods that are high in calcium, including low-fat yogurt, cheese, and milk
Choose foods and juices with calcium added
Get plenty of dietary protein (unless restricted by your doctor)
Take calcium supplements if directed by your doctor
Take vitamin D only as directed by your doctor
Stop smoking
Your doctor or transplant dietician will tell you if you need to take calcium or vitamin D supplements. Your doctor may also want you to take medications that prevent bone thinning, including bisphosphonates such as alendronate (Fosamax®), etidronate (Didrocal®), and risedronate (Actonel®) or calcitonin.

STAYING FIT

Diet – Things are shaping up

The recommended diet for transplant patients consists of 30% fats, 50% carbohydrates and 20% protein.

Your transplant dietician will give you specific instructions about your recommended daily allowance of specific nutrients. Some tips for following a healthy diet include:

Eat high-fiber foods such as raw fruits and vegetables
Increase your calcium intake by eating low-fat dairy products and green leafy vegetables or by taking calcium supplements (if directed by your doctor)
Eat less salt, processed foods, and snacks
Use herbs and spices to add flavor instead of salt
Drink plenty of water (unless you are told to limit fluids)
Eat as little fat and oil as possible
Eat high-protein foods such as lean meat, chicken (without the skin), fish, eggs, nuts (unsalted), and beans
Select healthier condiments such as mustard, low-fat mayonnaise, and low-fat salad dressing
Instead of frying, try baking, broiling, grilling, boiling, or steaming foods
Instead of using oil to cook, use nonstick, fat-free spray
Exercise

Exercise is a great way to help increase your energy and strength after a transplant. A regular exercise routine will also help you maintain your ideal weight, prevent high blood pressure and high lipid levels, and keep your bones strong. It also helps relieve stress and overcome feelings of depression.Soon after your transplant, you’ll want to start slow with a low-impact activity such as walking. With time, you can increase your workout with more demanding activities such as bicycling, jogging, swimming, or whatever exercise you enjoy. Training with dumbbells, cuff weights, or weights will increase strength and help prevent bone loss, but check with your transplant team first to determine how much weight is safe for you to lift. Stretching exercises are also important for muscle tone and flexibility. Be sure to check with your doctor before beginning or changing your exercise routine.

STOP Smoking

smokingSmoking also contributes to already high risk of cardiovascular, particularly in patients with diabetes and may be detrimental to kidney function. Transplant recipients who smoke should to STOP smoking as soon as possible.

Dental Care

Routine dental care is important both before and following transplantation as oral infections can cause significant medical problems and even death. According to the American Heart Association (AHA), pre-treatment with antibiotics is not needed for routine dental care unless the patient has an underlying heart condition that increases the risk of developing a heart infection. These include patients with heart transplants with graft valvulopathy (or a previous history of endocarditis, prosthetic valves, and certain forms of congenital heart diseases.)Gingival overgrowth (hypertrophy) is a dental issue that can arise in transplant patients especially those using cyclosporine. This occurrence of gingival overgrowth can be reduced by practicing good oral hygiene.

ROUTINE FOLLOW-UP EXAMS

All people should have regular exams to help prevent illness.

As we get older, there are some specific tests that should be done on a regular basis

Self-Monitoring

In addition to the tests that your transplant team will perform at regular follow-up visits, you will need to do some self-testing at home. Here are some things you will need to monitor:

Weight – Weigh yourself at the same time each day, preferably in the morning. If you gain 2 pounds in a day or more than 5 pounds total, call your transplant team.
Temperature – You should take your temperature daily, especially when you feel like you have a fever. Call your transplant team if your temperature is too high.
Blood pressure – Check your blood pressure as often as your transplant team recommends.
Pulse – You should check your pulse daily. A normal heart rate when not exercising should be 60 to 100 beats per minute. (If you have had a heart transplant, your resting heart rate may be as high as 110 to 120 beats per minute.)
Blood sugar – If you have high blood sugar or diabetes, you will need to monitor your blood sugar using a glucometer.
Do not take any pain medication (for example, Tylenol®, Motrin®, or Advil®), cold remedy, antacid, herbal medication, or any over-the-counter medication unless your transplant team tells you to.

PREGNANCY: BENEFITS AND RISKS

For female transplant recipients of child-bearing age, fertility is usually restored immediately after a transplant.

There have been thousands of births among women with transplanted organs.

Although pregnancy is now an expected part of the benefits afforded to women by organ transplantation, there are also a number of considerations. Getting pregnant is generally not recommended within the first year after a transplant because the doses of anti-rejection medications are highest; there is a greater risk of rejection; and many other medications are prescribed that are toxic to the developing fetus. Female transplant recipients of child-bearing age should continue using birth control until the doctor says that it is okay to get pregnant. Male transplant recipients may also be concerned about their ability to have children. Men may have fertility problems related to some transplant medications, but many men have been able to father healthy children after a transplant. If you are interested in, or thinking about, becoming pregnant you must talk to your transplant team first. Pregnancy should be planned when organ function and anti-rejection therapy are stable and there are no signs of rejection, high blood pressure, or infection.

High Risk Pregnancy

According to National Transplantation Pregnancy Registry (NTPR) over 70% of births to female transplant recipients are live births and most have favorable outcomes for child and mother. Although this success is encouraging, these pregnancies are still considered high risk. There are risks of complications during pregnancy for the transplant recipient as well as risk of infection and exposure to anti-rejection drugs for the fetus.For example, there is a greater risk of high blood pressure during pregnancy in the woman who has received a transplant. The risk of infection is higher for all transplant recipients, and urinary tract infections are the most common infections during pregnancy.

Other infections that may cause concern during pregnancy include herpes, hepatitis, toxoplasmosis, and cytomegalovirus. Other risks include preeclampsia and preterm delivery. The fetus is also at risk for infections such as cytomegalovirus and herpes simplex virus related to the suppression of the mother’s immune system by anti-rejection drugs. A common question is whether the baby born to a woman with a transplanted organ will be normal. We know that some babies are born premature to mothers with transplants and that they have low birth weights. It is not known whether there are long-term effects on the baby’s development. You should inform your baby’s pediatrician that your baby was exposed to anti-rejection drugs in the womb.

pregnancyThere is a higher risk of birth defects with some anti-rejection drugs especially mycophenolate mofetil and azathioprine. The levels of anti-rejection drugs in the mother’s blood must be monitored closely. Monitoring of blood levels is particularly important in the third trimester, when fetal metabolism may increase the clearance of anti-rejection drugs from the blood. Ask your transplant team whether or not you should breast-feed. It is not known whether breast-feeding while on certain anti-rejection medications can harm the baby.

A major concern for transplant recipients is whether pregnancy will lead to organ rejection or decreased function of the transplanted organ. In general, pregnancy does not affect organ function or patient survival as long your organ is working very well. But, it is very important to discuss with your transplant team whether or not a pregnancy will be too risky. Because pregnancy is considered high risk for transplant recipients, your transplant team may recommend and work with an obstetrician who specializes in high-risk pregnancies.

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ TransplantBob informal 3 Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org.  And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one persBon to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Sugar Could Be Killing us Physically and Financially


 By Bob Aronson

 sugar cartoonIn September 2013, a bombshell report from Credit Suisse’s Research Institute brought into sharp focus the staggering health consequences of sugar on the health of Americans. The group revealed that approximately “30%–40% of healthcare expenditures in the USA go to help address issues that are closely tied to the excess consumption of sugar.”  The figures suggest that our national addiction to sugar runs us an incredible $1 trillion in healthcare costs each year. The Credit Suisse report highlighted several health conditions including coronary heart diseases, type II diabetes and metabolic syndrome, which numerous studies have linked to excessive sugar intake.

This blog is not meant to be a condemnation of sugar.  It is a condemnation of our addiction to it.  We all love a sweet taste and frankly, we deserve it from time to time.  Often,there is no better reward, but we have to learn to limit our intake.  Like so many things in life it is the abuse of any substance that can cause us to suffer.  Sugar is particularly tough because it is unavoidable.  It is in almost everything and often is a naturally occurring substance.  We would all be a lot healthier if we would just read food labels and limit our excesses.  Having established this little disclaimer, we can now discuss sugar and its potential and real dangers.

 Women’s Health Magazine says that the typical American now swallows the equivalent of 22 sugar cubes every 24 hours. That means the average woman eats 70 pounds—nearly half her weight—of straight sugar every year. Women’s Health Magazine. http://www.womenshealthmag.com/health/dangers-of-sugar

In a major story on sugar Women’s Health goes on to say: When eaten in such vast quantities, sugar can wreak havoc on the body. Over time, that havoc can lead to diabetes and obesity, and also Alzheimer’s disease and breast, endometrial, and colon cancers. One new study found that normal-weight people who loaded up on sugar doubled their risk of dying from heart disease. Other research pinpoints excess sugar as a major cause of nonalcoholic fatty liver disease, which can lead to liver failure.

The magazine characterized the use of sugar this way, “The instant something sweet touches your tongue, your taste buds direct-message your obesity graphicbrain: deee-lish. Your noggin’s reward system ignites, unleashing dopamine. Meanwhile, the sugar you swallowed lands in your stomach, where it’s diluted by digestive juices and shuttled into your small intestine. Enzymes begin breaking down every bit of it into two types of molecules: glucose and fructose. Most added sugar comes from sugar cane or sugar beets and is equal parts glucose and fructose; lab-concocted high-fructose corn syrup, however, often has more processed fructose than glucose. Eaten repeatedly, these molecules can hit your body…hard.

Anne Alexander, editorial director of Prevention and author of The Sugar Smart Diet provided this explanation of what sugars can do to your body.

 GlucoseGlucose graphic

  • It seeps through the walls of your small intestine, triggering your pancreas to secrete insulin, a hormone that grabs glucose from your blood and delivers it to your cells to be used as energy.
  • But many sweet treats are loaded with so much glucose that it floods your body, lending you a quick and dirty high. Your brain counters by shooting out serotonin, a sleep-regulating hormone. Cue: sugar crash.
  • Insulin also blocks production of leptin, the “hunger hormone” that tells your brain that you’re full. The higher your insulin levels, the hungrier you will feel (even if you’ve just eaten a lot). Now in a simulated starvation mode, your brain directs your body to start storing glucose as belly fat.
  • Busy-beaver insulin is also surging in your brain, a phenomenon that could eventually lead to Alzheimer’s disease. Out of whack, your brain produces less dopamine, opening the door for cravings and addiction-like neurochemistry.
  • Still munching? Your pancreas has pumped out so much insulin that your cells have become resistant to the stuff; all that glucose is left floating in your bloodstream, causing prediabetes or, eventually, full-force diabetes.

FructoseFructose graphic

  • It, too, seeps through your small intestine into the bloodstream, which delivers fructose straight to your liver.
  • ​Your liver works to metabolize fructosei.e., turn it into something your body can use. But the organ is easily overwhelmed, especially if you have a raging sweet tooth. Over time, excess fructose can prompt globules of fat to grow throughout the liver, a process called lipogenesis, the precursor to nonalcoholic fatty liver disease.
  • ​Too much fructose also lowers HDL, or “good” cholesterol, and spurs the production of triglycerides, a type of fat that can migrate from the liver to the arteries, raising your risk for heart attack or stroke.
  • ​Your liver sends an S.O.S. for extra insulin (yep, the multi-tasker also aids liver function). Overwhelmed, your pancreas is now in overdrive, which can result in total-body inflammation that, in turn, puts you at even higher risk for obesity and diabetes

Robert Lustig, an endocrinologist from California gained national attention after a lecture he gave titled “Sugar: The Bitter Truth” went viral in 2009.  www.youtube.com/watch?v=dBnniua6-oM

Lustig’s research looked at the connection between sugar consumption and the poor health of Americans came to a conclusion that startled many.  The Doctor has published twelve articles in peer-reviewed journals identifying sugar as a major factor in the epidemic of degenerative disease that now afflicts our country.  Lustig’s data clearly show that excessive sugar consumption is a key player in the development of some cancers along with obesity, type II diabetes, hypertension, and heart disease. As a result he has concluded that 75% of all diseases in America are brought on by our lifestyle and are entirely preventable.

While most in the medical profession seem to accept Lustig’s assessment of sugar at least one MD David Katz the director of the Yale Prevention Center, disagrees.  http://www.huffingtonpost.com/david-katz-md/sugar-health-evil-toxic_b_850032.html  Katz says, among other things, “So those most motivated to get the sugar they need wind up getting the most sugar. They, in turn, benefit from this by having more of the needed food energy — and thus are more likely to survive. In particular, they are more likely to survive into adulthood, and to procreate. And thus they become our ancestors, who pass traits along to us.”

Lest you think I am making a mountain of a molehill allow some of the body of evidence that sugar can cause health problems.   The claims about the ill health effects of sugar are not just those leveled by Dr. Lustig, they are backed by a solid body of research.  Here are just a few of the research headlines.

  • Consumption of Sugar-Sweetened Drinks Linked to Heart Disease
  • How Fructose Causes Obesity and Diabetes
  • Fructose intake connected with an increased risk of cardiovascular illness and diabetes in teenagers
  • Fructose consumption increases the risk of heart disease.
  • The Negative Impact of Sugary Drinks on Children.
  • Sugar and High Blood Pressure
  • Sugar Consumption Associated with Fatty Liver Disease and Diabetes
  • The Adverse Impact of Dietary Sugars on Cardiovascular Health
  • Rats Fed High Fructose Corn Syrup Exhibit Impaired Brain Function
  • High Fructose Corn Syrup Intake Linked with Mineral Imbalance and Osteoporosis.
  • Diet of Sugar and Fructose Impairs Brain Function

 To be healthy and avoid sugar or at least limit your intake you simply must read labels.  Unfortunately those who seek to force sugar into our systems have found many ways of complying with the law and telling us there’s sugar in their food but they do it in a manner that sounds less menacing.  

SWEET SYNONYMS
Watch for these sneaky ingredients when reading food labels. Some sound scientific, some almost healthy—but in the end, they all mean “sugar.”

Agave Nectar
Barbados Sugar
Barley Malt Syrup
Beet Sugar
Blackstrap Molasses
Cane Crystals
Cane Juice Crystals
Castor Sugar
Corn Sweetener
Corn Syrup
Corn Syrup Solids
Crystalline Fructose
Date Sugar
Demerara Sugar
Dextrose
Evaporated Cane Juice
Florida Crystals
Fructose
Fruit Juice
Fruit Juice Concentrate
Galactose
Glucose
Glucose Solids
Golden Sugar
Golden Syrup
Granulated Sugar
Grape Juice Concentrate
Grape Sugar
High-Fructose Corn Syrup
Honey
Icing Sugar
Invert Sugar
Lactose
Malt Syrup
Maltodextrin
Maltose
Mannitol
Maple Syrup
Molasses
Muscovado Syrup
Organic Raw Sugar
Powdered Sugar
Raw Sugar
Refiners’ Syrup
Rice Syrup
Sorbitol
Sorghum Syrup
Sucrose
Table Sugar
Treacle
Turbinado Sugar
Yellow Sugar

PICK YOUR POISON
Ultimately, added sugar is added sugar—it all affects you roughly the same way, regardless of where it comes from. Below you will find a short list of the most active and dangerous evil doers. .

High-Fructose Corn Syrup (HFCS)

High fructose corn syrup

Derived from corn starch, syrupy HFCS might be the scariest sweet. Much of it contains mercury, a by-product of chemical processing. But another danger is its high artificial fructose content, not to mention that it can be 75 times sweeter than white sugar. (Listen up, agave eaters: The processed nectar can be up to 85 percent fructose and possibly more damaging to your liver than HFCS!)

Honey (http://tinyurl.com/ogge3r6

Honey sugar comparison

Often touted as far healthier than refined sugar, these do contain fewer chemicals and a better glucose-fructose balance (plus a few helpful antioxidants). However, says Anne Alexander, author of The Sugar Smartdiet even if the unique flavors of maple syrup and raw honey may lead people to use less, these sweeteners can still spike the body.

Natural Sugar

sugar

Sweet news! Unless it’s all you eat, it’s hard to go overboard on truly natural sugars that come directly from fruits and some veggies. Here’s the trick: You have to actually eat the produce. Fruit juices, even those without added sweeteners, will still sugar-bomb your bloodstream. The key is in the fiber, which slows sugar’s absorption in your body, preventing an insulin spike. Any fruit is fair game. “Ones with the most natural sugar have the most fiber,” says Robert Lustig, M.D.

So what’s the bottom line?  Should we avoid sugar completely?  Is that even possible?  Are sugar substitutes a healthy alternative?

First, you probably cannot avoid sugar completely and still eat because it appears naturally in so much of our daily diet.  Additionally, sugar is added to almost every product on the supermarket shelves so the best you can do is severely limit the amount you consume.  Here’s what the Mayo Clinic says. http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/added-sugar/art-20045328

How to reduce added sugar in your diet

To reduce the added sugar in your diet, try these tips:

  • Drink water or other calorie-free drinks instead of sugary, nondiet sodas or sports drinks. That goes for blended coffee drinks, too.
  • When you drink fruit juice, make sure it’s 100 percent fruit juice — not juice drinks that have added sugar. Better yet, eat the fruit rather than juice.
  • Choose breakfast cereals carefully. Although healthy breakfast cereals can contain added sugar to make them more appealing to children, plan to skip the non-nutritious, sugary and frosted cereals.
  • Opt for reduced-sugar varieties of syrups, jams, jellies and preserves. Use other condiments sparingly. Salad dressings and ketchup have added sugar.
  • Choose fresh fruit for dessert instead of cakes, cookies, pies, ice cream and other sweets.
  • Buy canned fruit packed in water or juice, not syrup.
  • Snack on vegetables, fruits, low-fat cheese, whole-grain crackers and low-fat, low-calorie yogurt instead of candy, pastries and cookies.

The final analysis

By limiting the amount of added sugar in your diet, you can cut calories without compromising on nutrition. In fact, cutting back on foods with added sugar and solid fats may make it easier to get the nutrients you need without exceeding your calorie goal.

Mayo concludes it’s summary on sugary by saying, “Take this easy first step: Next time you’re tempted to reach for a soda or other sugary drink, grab a glass of ice-cold water instead.”

Artificial sweeteners

artificial sweeteners

“So if I am supposed to avoid sugar, but I like sweets what are my alternatives?”  Well, there’s a lot of controversy surrounding this topic so we’ll turn to Web MD for an answer. http://www.webmd.com/food-recipes/features/best-sugar-substitutes

Thanks to the newest sugar substitutes, it’s becoming easier (and healthier) to bake your cake and eat it too!

There are so many alternative sweeteners available now that they seem to be elbowing sugar right off the supermarket shelf. But what’s so wrong with sugar? At just 15 calories per teaspoon, “nothing–in moderation,” says Lona Sandon, R.D., an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas. “The naturally occurring sugar in an apple is fine, but if we can reduce some of the added sugar in our diet, we can remove some of the empty calories.” Less than 25 percent of your daily calories should come from the added sugar in foods like cookies, cereal, and ketchup, she says. To satisfy your sweet tooth–especially if you’re counting calories, limiting carbs, or dealing with diabetes–try these options:

SWEETLEAF AND TRUVIA

What they are: These sugar alternatives are the latest made from stevia, an herb found in Central and South America that is up to 40 times sweeter than sugar but has zero calories and won’t cause a jump in your blood sugar. Stevia was slow to catch on because of its bitter, licorice-like aftertaste, but makers of Truvia and SweetLeaf have solved this problem by using the sweetest parts of the plant in their products.

Where to find them: In grocery stores and natural-food stores throughout the country and online at sweetleaf.com and truvia.com.

 How to use them: Both work well in coffee and tea or sprinkled over fruit, cereal, or yogurt. You can’t substitute stevia-based products for sugar in baked goods, though, because these products are sweeter than sugar and don’t offer the same color and texture. Makers of SweetLeaf promise to come out with a baking formulation soon.

Health Rx: “Truvia’s one of the most promising alternatives out there,” says nutritionist Jonny Bowden, Ph.D., author of The Healthiest Meals on Earth . “Right now, it looks safe. It tastes just like sugar and has almost no glycemic index, which means it won’t spike your blood sugar.”

WHEY LOW

What it is: Three naturally occurring sugars–fructose, the sugar in fruit; sucrose, or table sugar; and lactose, the sugar in milk–are blended to create this sweetener. While individually the sugars are fully caloric, when blended in Whey Low they interact in such a way that they aren’t completely absorbed into the body. As a result, at four calories per teaspoon, Whey Low has one quarter of the calories and less than one third of the glycemic index of sugar, so you’re less likely to crash after consuming it. It’s available in varieties similar to granular sugar, brown sugar, maple sugar, and confectioners’ sugar.

 

bobBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

 

Vitamin Supplements — May Not Be Necessary and They Could Harm You


By Bob Aronson

vitamin b from bagelsThe National Institutes of Health (NIH) says Americans have been taking multivitamin/mineral (MVM) supplements since the early 1940s, when the first such products became available. MVMs are still popular dietary supplements and, according to estimates, more than one-third of all Americans take them. MVMs account for almost one-fifth of all purchases of dietary supplements.

“You have to get your vitamins.”  I’ve heard that phrase since I was a child, but why?  What are Vitamins and are vitamin pills or supplements the same as the vitamins found naturally in what we eat and in sunshine?  Vitamins are not all the same.  There can be a huge difference between those that are naturally contained in our food and the sometimes “smelly” things that come in a bottle from your Pharmacy.

Over the past several years there have been a number of news reports about vitamins. Some experts support their use, some say the supplements are worthless and others say they can actually cause harm.  What’s true?  All of the above!  We’ll try to shed some light on the subject so let’s start with their importance to our health.

Vitamin deficiencies lead to a wide range of problems spanning from anorexia to obesity, organ malfunction, confusion, depression and fatigue.  We need vitamins.  The question that must be answered is; how do you know which ones?  We’ll provide an answer.

Tough question when you consider the fact that the NIH says, “No standard or regulatory definition is available for an MVM supplement—NIH LOGOsuch as what nutrients it must contain and at what levels. Therefore, the term can refer to products of widely varied compositions and characteristics. These products go by various names, including multis, multiples, and MVMs. Manufacturers determine the types and levels of vitamins, minerals, and other ingredients in their MVMs. As a result, many types of MVMs are available in the marketplace.”

It is entirely possible that there are no standards because the vitamin industry is huge and can afford heavy lobbying to ensure that they remain free of government regulation.  The NIH says that sales of all dietary supplements in the United States totaled an estimated $30.0 billion in 2011. This amount included $12.4 billion for all vitamin- and mineral-containing supplements, of which $5.2 billion was for MVMs.  If the government set standards, every single manufacturer would have to reformulate their products to meet them.  Doing so would be costly so there is no wonder that the industry would rather not rock their very profitable boat.

vitaminsWhether your vitamins are hurting you is another story. What people are not aware of is that all vitamins are not created equal, and most are actually synthetic and the synthetic vitamins are rarely like the real thing.

The type of vitamins that benefit us most is murky but there are some.  However, a healthy diet should provide most of the nutrients our bodies need.  Sometimes, though, supplements can help. The problem is, which ones?  How do you know what to buy?

For the most part, medical science has made it clear that most vitamin supplements are either useless or cause harm and we’ll elaborate on those claims shortly.  First, though, you ought to know what’s good for you and what seems to work for some conditions.

This article in Smithsonian.com lists five supplements that can be helpful. http://www.smithsonianmag.com/science-nature/five-vitamins-and-smithsonian.com2supplements-are-actually-worth-taking-180949735/#VsZOfYrBAkvtVYvY.99

Of all the “classic” vitamins—the vital organic compounds discovered between 1913 and 1941 and termed vitamin A, B, C, etc.—vitamin D is by far the most beneficial to take in supplement form. Researchers found that adults who took vitamin D supplements daily lived longer than those who didn’t.

Other research has found that in kids, taking vitamin D supplements can reduce the chance of catching the flu, and that in older adults, it can improve bone health and reduce the incidence of fractures.

Probiotics

A mounting pile of research is showing how crucial the trillions of bacterial cells that live inside us are in regulating our health, and how harmful it can be to suddenly wipe them out with an antibiotic. Thus, it shouldn’t come as a huge surprise that if you do go through a course of antibiotics, taking a probiotic (either a supplement or a food naturally rich in bacteria, such as yogurt) to replace the bacteria colonies in your gut is a good idea.

In 2012, a meta-analysis of 82 randomized controlled trials found that use of probiotics significantly reduced the incidence of diarrhea after a course of antibiotics.

All the same, probiotics aren’t a digestive cure-all: they haven’t been found to be effective in treating irritable bowel syndrome, among other chronic ailments. Like most other supplements that are actually effective, they’re useful in very specific circumstances, but it’s not necessary to continually take them on a daily basis.

Zinc

Vitamin C might not do anything to prevent or treat the common cold, but the other widely-used cold supplement, zinc, is actually worth taking. A mineral that’s involved in many different aspects of your cellular metabolism, zinc appears to interfere with the replication of rhinoviruses, the microbes that cause the common cold.

This has been borne out in a number of studies

Niacin

Also known as vitamin B3, niacin is talked up as a cure for all sorts of conditions (including high cholesterol, Alzheimer’s, diabetes and headaches) but in most of these cases, a prescription-strength dose of niacin has been needed to show a clear result.

At over-the-counter strength, niacin supplements have only been proven to be effective in helping one group of people: those who have heart disease. A 2010 review found that taking the supplement daily reduced the chance of a stroke or heart attack in people with heart disease, thereby reducing their overall risk of death due to a cardiac

​Garlic

Garlic, of course, is a pungent herb. It also turns out to be an effective treatment for high blood pressure when taken as a concentrated supplement.

A 2008 meta-analysis of 11 randomized controlled trials (in which similar groups of participants were given either a garlic supplement or placebo, and the results were compared) found that, on the whole, taking garlic daily reduced blood pressure, with the most significant results coming in adults who had high blood pressure at the start of the trials.

On the other hand, there have also been claims that garlic supplements can prevent cancer, but the evidence is mixed.

Vitamin Supplements are unnecessary and may cause harm.

In December of last year, the Annals of Internal Medicine reported that, “Not only are the pills mostly unnecessary, but they could actually doAnnals of internal medicine logo harm those taking them. We believe that the case is closed—supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful.  These vitamins should not be used for chronic disease prevention. Enough is enough.”  http://www.cbsnews.com/news/multivitamin-researchers-say-case-is-closed-supplements-dont-boost-health/

Based on three studies examining multivitamins’ links to cancer prevention, heart health, and cognitive function, the research is a blow to the multi-billion dollar industry that produces them and to the millions of Americans who religiously shell out their dollars for false hope.

The doubts about vitamin supplements are not new.  In his 2013 book Do You Believe in Magic, Dr. Paul Offit pointed to a handful of major studies over the past five years that showed vitamins have made people less healthy. “In 2008, a review of all existing studies involving more than 230,000 people who did or did not receive supplemental antioxidants found that vitamins increased the risk of cancer and heart disease.”

Last year, researchers published new findings from the Women’s Health Initiative, a long-term study of more than 160,000 midlife women. The data showed that multivitamin-takers are no healthier than those who don’t pop the pills, at least when it comes to the big diseases—cancer, heart disease, stroke. “Even women with poor diets weren’t helped by taking a multivitamin,” says study author Marian Neuhouser, PhD, in the cancer prevention program at the Fred Hutchinson Cancer Research Center, in Seattle.

That said, there is one group that probably ought to keep taking a multi-vitamin: women of reproductive age. The supplement is insurance in case of pregnancy. A woman who gets adequate amounts of the B vitamin folate is much less likely to have a baby with a birth defect affecting the spinal cord.

The problem is that many vitamin and mineral supplements are manufactured synthetically. Some estimates place the amount at 90 percent and higher and while they are made to mimic natural vitamins they are not the same. Natural vitamins come directly from plants and animals, they are not produced in a lab and — most synthetic vitamins lack co-factors associated with naturally-occurring vitamins because they have been “isolated.”

Isolated vitamins can’t always be used by the body, and are either stored or excreted. Most synthetic vitamins don’t have the necessary trace minerals either and must use the body’s own mineral reserves which can then cause mineral deficiencies.

Most synthetic supplements contain chemicals that do not occur in nature. The history of the human race is such that our bodies have grown accustomed to consuming the food we grow and gather naturally, from the earth, not food that is synthesized in a lab.

web md logoWeb MD offers this assessment.

What Vitamin and Mineral Supplements Can and Can’t Do

http://www.webmd.com/vitamins-and-supplements/nutrition-vitamins-11/help-vitamin-supplement 

 By Kathleen M. Zelman, MPH, RD, LD

Reviewed By Elizabeth Ward, MS, RD

Experts say there is definitely a place for vitamin or mineral supplements in our diets, but their primary function is to fill in small nutrient gaps.  They are “supplements” intended to add to your diet, not take the place of real food or a healthy meal plan.

 WebMD takes a closer look at what vitamin and mineral supplements can and cannot do for your health.

Food First, Then Supplements

Vitamins and other dietary supplements are not intended to be a food substitute. They cannot replace all of the nutrients and fruits and veggiesbenefits of whole foods. 

 “They can plug nutrition gaps in your diet, but it is short-sighted to think your vitamin or mineral is the ticket to good health — the big power is on the plate, not in a pill,” explains Roberta Anding, MS, RD, a spokesperson for the American Dietetic Association and director of sports nutrition at Texas Children’s Hospital in Houston. 

 It is always better to get your nutrients from food, agrees registered dietitian Karen Ansel.  “Food contains thousands of phytochemicals, fiber, and more that work together to promote good health that cannot be duplicated with a pill or a cocktail of supplements.”

 What Can Vitamin and Mineral Supplements Do for Your Health?

 When the food on the plate falls short and doesn’t include essential nutrients like calcium, potassium, vitamin D, and vitamin B12, some of the nutrients many Americans don’t get enough of, a supplement can help take up the nutritional slack. Vitamin and mineral supplements can help prevent deficiencies that can contribute to chronic conditions.

 Numerous studies have shown the health benefits and effectiveness of supplementing missing nutrients in the diet.  A National Institutes of Health (NIH) study found increased bone density and reduced fractures in postmenopausal women who took calcium and vitamin D.

  Beyond filling in gaps, other studies have demonstrated that supplemental vitamins and minerals can be advantageous. However, the exact benefits are still unclear as researchers continue to unravel the potential health benefits of vitamins and supplements. 

 Web MD offers these tips to guide your vitamin and mineral selection:

  • Think nutritious food first, and then supplement the gaps.  Start by filling your grocery cart with a variety of nourishing, nutrient-rich foods.  Use the federal government’s My Plate nutrition guide to help make sure your meals and snacks include all the parts of a healthy meal.
  •  Take stock of your diet habits. Evaluate what is missing in your diet. Are there entire food groups you avoid? Is iceberg lettuce the only vegetable you eat? If so, learn about the key nutrients in the missing food groups, and choose a supplement to help meet those needs. As an example, it makes sense for anyone who does not or is not able to get the recommended three servings of dairy every day to take a calcium and vitamin D supplement for these shortfall nutrients.
  • When in doubt, a daily multivitamin is a safer bet than a cocktail of individual supplements that can exceed the safe upper limits of the recommended intake for any nutrient.  Choose a multivitamin that provides 100% or less of the Daily Value (DV) as a backup to plug the small nutrient holes in your diet.
  •  Are you a fast food junkie?  If your diet pretty much consists of sweetened and other low-nutrient drinks, fries, and burgers, then supplements are not the answer.  A healthy diet makeover is in order. Consult a registered dietitian.
  •  Respect the limits. Supplements can fill in where your diet leaves off, but they can also build up and potentially cause toxicities if you take more than 100% of the DV.
  •  Most adults and children don’t get enough calcium, vitamin D, or potassium according to the 2010 Dietary Guidelines.  Potassium-rich foods, including fruits, vegetables, dairy, and meat are the best ways to fill in potassium gaps. Choose an individual or a multivitamin supplement that contains these calcium and vitamin D as a safeguard.
  •  The best way to judge any supplement or medication is by reviewing clinical trials. There aren’t a lot of them done on vitamins, vitamin clinical trialbut those that have been conducted are quite revealing.  The NIH concluded that most supplements not only don’t work as intended, they actually make things worse. They examined the efficacy of 13 vitamins and 15 essential minerals as reported in long-term, randomized clinical trials and there were some positive results like:
  • A combination of calcium and vitamin D was shown to increase bone mineral density and reduce fracture risk in postmenopausal women.
  • There was some evidence that selenium reduces risk of certain cancers.
  • Vitamin E maydecrease cardiovascular deaths in women and prostate cancer deaths in male smokers.
  • Vitamin D showed some cardiovascular benefit.

Those few positives are overwhelmed by the negative findings.

  • Trials of niacin (B3), folate, riboflavin (B2), and vitamins B6 and B12 showed no positive effect on chronic disease occurrence in the general population
  • There was no evidence to recommend beta-carotene and some evidence that it may cause harm in smokers.
  • High-dose vitamin E supplementation increased the risk of death from all causes.

So what’s the bottom line?  Our research indicates that most medical authorities pretty much dismiss the usefulness of most vitamin supplements. Most revealing, though, and also dangerous is the fact that there are no standards for vitamin supplements.  The companies that make them can each have their own formulations and there is no approval process so the consumer may be at great risk.  Buyer beware.  Don’t believe the advertising.  If you are determined to take these supplements, though, google them and look for clinical trials.  If there are none, don’t buy.  If there are, read them carefully.  For the most part the best advice is, save your money because most of us don’t have a clue as to what we are buying.

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant
My new hat April 10 2014Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Chiropractic Manipulation — What is it and Does It Work?


By Bob Aronson

aching back cartoon

When I was growing up in Chisholm, Minnesota my dad swore that a chiropractor did more for his aching back than anyone else.  Dad was a meat cutter (he despised the term “Butcher” because he butchered nothing) and carried quarters of beef from the truck into his supermarket meat cooler.  Those things are heavy, bulky and very hard to handle and as a result he suffered back problems all his life.  Sometimes he could barely get out of bed he hurt so badly.  When that happened he would call Dr. Cole who, like all doctors then, made house calls.

My mom had an old fashioned, very heavy, super sturdy all wood ironing board set up in the living room and that’s whaironing boardt Doc Cole would use as a treatment bed.  Dad would lie face down on that old ironing board and Doc Cole would begin doing whatever manipulation Chiropractors do.  I don’t remember a time when it didn’t work.  Dad always felt better and was back at work the next day, but the pain always returned.  That’s the sum total of my experience with Chiropractors.  I have never been to see one or been in the care of a Chiropractor nor do I know anyone who has.

Here is the definition of the treatment as provided by the American Chiropractic Association (ACA).   Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health.  Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.

logoDoctors of Chiropractic – often referred to as chiropractors or chiropractic physicians – practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling (there is much more to the definition. You can read it here http://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=61

There is no shortage of definitions of the practice so “Cherry Picking” a few can be misleading but from what I can find, traditional medical science is becoming more accepting of the practice in recent years, but still seems to stop short of an endorsement.  Here is the definition of Chiropractic according to Medicine Net dot com. http://www.medterms.com/script/main/art.asp?articlekey=2706

Chiropractic: A system of diagnosis and treatment based on the concept that the nervous system coordinates all of the body’s functions, and that disease results from a lack of normal nerve function. Chiropractic employs manipulation and adjustment of body structures, such as the spinal column, so that pressure on nerves coming from the spinal cord due to displacement (subluxation) of a vertebral body may be relieved. Practitioners believe that misalignment and nerve pressure can cause problems not only in the local area, but also at some distance from it. Chiropractic treatment appears to be effective for muscle spasms of the back and neck, tension headaches, and some sorts of leg pain. It may or may not be useful for other ailments.

Not all chiropractors are alike in their practice. The International Chiropractors Association believes that patients should be treated by spinal manipulation alone while the American Chiropractors Association advocate a multidisciplinary approach that combines spinal adjustment with other modalities such as physical therapy, psychological counseling, and dietary measures. For some years the American Medical Association (AMA) opposed chiropractic because of what it termed a “rigid adherence to an irrational, unscientific approach to disease.” However, Congress amended the Medicare Act in 1972 to include benefits for chiropractic services and in 1978 the AMA modified its position on chiropractic.

So, now that we have defined terms the question is, “When should I choose a chiropractor to treat a condition, and which conditions can they successfully treat?”  The answer to that question depends entirely on who you talk to.  Even Chiropractors differ with one another on exactly what conditions they can and can’t treat.

Preston H. Long is a licensed Arizona Chiropractor who practiced for almost 30 years.  Be warned, his assessment of the Preston long book coverChiropractic profession is quite negative.

Long has testified at about 200 trials, performed more than 10,000 chiropractic case evaluations, and served as a consultant to several law enforcement agencies. He is also an associate professor at Bryan University, where he teaches in the master’s program in applied health informatics.  What follows is just a half dozen bullet points from a blog he wrote titled, “20 Things Most Chiropractors Won’t Tell You.”(I Bob Aronson selected only the first six points and edited them for brevity) you can read the entire unedited version here http://edzardernst.com/2013/10/twenty-things-most-chiropractors-wont-tell-you/

Have you ever consulted a chiropractor? Are you thinking about seeing one? Do you care whether your tax and health-care dollars are spent on worthless treatment? If your answer to any of these questions is yes, there are certain things you should know.

 1. Chiropractic theory and practice are not based on the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community.

Most chiropractors believe that spinal problems, which they call “subluxations,” cause ill health and that fixing them by “adjusting” the spine will promote and restore health. The extent of this belief varies from chiropractor to chiropractor. Some believe that subluxations are the primary cause of ill health; others consider them an underlying cause. Only a small percentage (including me) reject these notions and align their beliefs and practices with those of the science-based medical community. The ramifications and consequences of subluxation theory will be discussed in detail throughout this book.

 2. Many chiropractors promise too much.

The most common forms of treatment administered by chiropractors are spinal manipulation and passive physiotherapy measures such as heat, ultrasound, massage, and electrical muscle stimulation. These modalities can be useful in managing certain problems of muscles and bones, but they have little, if any, use against the vast majority of diseases. But chiropractors who believe that “subluxations” cause ill health claim that spinal adjustments promote general health and enable patients to recover from a wide range of diseases. Some have a hand out that improperly relates “subluxations” to a wide range of ailments that spinal adjustments supposedly can help. Some charts of this type have listed more than 100 diseases and conditions, including allergies, appendicitis, anemia, crossed eyes, deafness, gallbladder problems, hernias, and pneumonia.

3. Our education is vastly inferior to that of medical doctors.

I rarely encountered sick patients in my school clinic. Most of my “patients” were friends, students, and an occasional person who presented to the student clinic for inexpensive chiropractic care. Most had nothing really wrong with them. In order to graduate, chiropractic college students are required to treat a minimum number of people. To reach their number, some resort to paying people (including prostitutes) to visit them at the college’s clinic.

4. Our legitimate scope is actually very narrow.

Appropriate chiropractic treatment is relevant only to a narrow range of ailments, nearly all related to musculoskeletal problems. But some chiropractors assert that they can influence the course of nearly everything. Some even offer adjustments to farm animals and family pets.

 5. Very little of what chiropractors do has been studied.

Although chiropractic has been around since 1895,  little of what we do meets the scientific standard through solid research. Chiropractic apologists try to sound scientific to counter their detractors, but very little research actually supports what chiropractors do.

6. Unless your diagnosis is obvious, it’s best to get diagnosed elsewhere.

During my work as an independent examiner, I have encountered many patients whose chiropractor missed readily apparent diagnoses and rendered inappropriate treatment for long periods of time. Chiropractors lack the depth of training available to medical doctors. For that reason, except for minor injuries, it is usually better to seek medical diagnosis first.

Obviously the previous report is pretty damning but the author’s views are not universally shared.  The problem with finding positive reports about the Chiropractic profession is that there are very few traditional double blind placebo studies.  Double blind studies are the “Gold Standard” in medicine.  Most of the supporting evidence for Chiropractic medicine is of the testimonial variety otherwise known as “Anecdotal” evidence. Often you will see ads that suggest 9 out of 10 who tried something got relief and while that sounds good, it is anecdotal, not double blind and that’s why Chiropractors are suspect in the eyes of the medical profession, even though Medical Doctors will on occasion for specific ailments send their patients to Chiropractors.

Here’s an evaluation of the top ten Chiropractic studies of 2013…it is not positive because, the author says, the studies were not really studies. http://www.sciencebasedmedicine.org/top-10-chiropractic-studies-of-2013/

web md logoThe Medical Profession Does Recognize that Chiropractic Manipulation Can Help.

So, what about the good side of the profession? Where’s the evidence that Chiropractic manipulation of the spine actually has lasting benefits?

I searched for a long time and the best non anecdotal defense I could find for the Chiropractic profession was in Web MD. You can read all of it here, but note that the endorsement is strictly for back pain. http://www.webmd.com/pain-management/guide/chiropractic-pain-relief

Among people seeking back pain relief alternatives, most choose chiropractic treatment. About 22 million Americans visit chiropractors annually. Of these, 7.7 million, or 35%, are seeking relief from back pain from various causes, including accidents, sports injuries, and muscle strains. Other complaints include pain in the neck, arms, and legs, and headaches.

Learn The Truth About Back Pain Causes and Treatments

What Is Chiropractic?                                       ,

Chiropractors use hands-on spinal manipulation and other alternative treatments, the theory being that proper alignment of the body’s musculoskeletal structure, particularly the spine, will enable the body to heal itself without surgery or medication. Manipulation is used to restore mobility to joints restricted by tissue injury caused by a traumatic event, such as falling, or repetitive stress, such as sitting without proper back support.

Chiropractic is primarily used as a pain relief alternative for muscles, joints, bones, and connective tissue, such as cartilage, ligaments, and tendons. It is sometimes used in conjunction with conventional medical treatment.

The initials “DC” identify a chiropractor, whose education typically includes an undergraduate degree plus four years of chiropractic college.

What Does Chiropractic for Back Pain Involve?

A chiropractor first takes a medical history, performs a physical examination, and may use lab tests or diagnostic imaging to determine if treatment is appropriate for your back pain.

The treatment plan may involve one or more manual adjustments in which the doctor manipulates the joints, using a controlled, sudden force to improve range and quality of motion. Many chiropractors also incorporate nutritional counseling and exercise/rehabilitation into the treatment plan. The goals of chiropractic care include the restoration of function and prevention of injury in addition to back pain relief.

What Are the Benefits and Risks of Chiropractic Care?

Spinal manipulation and chiropractic care is generally considered a safe, effective treatment for acute low back pain, the type of sudden injury that results from moving furniture or getting tackled. Acute back pain, which is more common than chronic pain, lasts no more than six weeks and typically gets better on its own.

Research has also shown chiropractic to be helpful in treating neck pain and headaches. In addition, osteoarthritis and fibromyalgia may respond to the moderate pressure used both by chiropractors and practitioners of deep tissue massage.

Studies have not confirmed the effectiveness of prolotherapy or sclerotherapy for pain relief, used by some chiropractors, osteopaths, and medical doctors, to treat chronic back pain, the type of pain that may come on suddenly or gradually and lasts more than three months. The therapy involves injections such as sugar water or anesthetic in hopes of strengthening the ligaments in the back.

People who have osteoporosis, spinal cord compression, or inflammatory arthritis, or who take blood-thinning medications should not undergo spinal manipulation. In addition, patients with a history of cancer should first obtain clearance from their medical doctor before undergoing spinal manipulation.

All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history, including ongoing medical conditions, current medications, traumatic/surgical history, and lifestyle factors. Although rare, there have been cases in which treatment worsened a herniated or slipped disc, or neck manipulation resulted in stroke or spinal cord injury. To be safe, always inform your primary health care provider whenever you use chiropractic or other pain relief alternatives.

On my OTI Facebook group I asked for individual experiences with chiropractors and got very few, most were positive but general in nature offering few details.

Other Non-Traditional Remedies

There are other non-traditional remedies for back pain that we have not mentioned here.  Below you will find several that were listed in “About dot com. “ For the full list of 15 options click on this link. http://altmedicine.about.com/od/chronicpain/a/back_pain.htm

 Acupuncture

A 2008 study published in Spine found “strong evidence that acupuncture can be a useful supplement to other forms of accupunctureconventional therapy” for low back pain. After analyzing 23 clinical trials with a total of 6,359 patients, the study authors also found “moderate evidence that acupuncture is more effective than no treatment” in relief of back pain. The authors note that more research is needed before acupuncture can be recommended over conventional therapies for back pain.

 

Just how does acupuncture work? According totraditional Chinese medicine, pain results from blocked energy along energy pathways of the body, which are unblocked when acupuncture needles are inserted along these invisible pathways. Acupuncture may release natural pain-relieving opioids, send signals to the sympathetic nervous system, and release neurochemicals and hormones.

 See Also: Using Acupuncture to Help Relieve Chronic Pain | Sciatica – Causes, Symptoms, and Natural Treatments | What is Trigger Point Therapy?

Massage Therapy

massage therapyIn a 2009 research review published in Spine, researchers reviewed 13 clinical trials on the use of massage in treatment of back pain. The study authors concluded that massage “might be beneficial for patients with subacute and chronic nonspecific low back pain, especially when combined with exercises and education.” Noting that more research is needed to confirm this conclusion, the authors call for further studies that might help determine whether massage is a cost-effective treatment for low back pain.

Massage therapy may also alleviate anxiety and depression associated with chronic pain. It is the most popular natural therapy for low back pain during pregnancy.

The Alexander Technique

Alexander Technique is a type of therapy that teaches people to improve their posture and eliminate bad habits such as slouching, which can lead to pain, muscle tension, and decreased mobility.

 There is strong scientific support for the effectiveness of Alexander Technique lessons in treatment of chronic back pain, according to a research review published in the International Journal of Clinical Practice in 2012. The review included one well-designed, well-conducted clinical trial demonstrating that Alexander Technique lessons led to significant long-term reductions in back pain and incapacity caused by chronic back pain. These results were broadly supported by a smaller, earlier clinical trial testing the use of Alexander Technique lessons in treatment of chronic back pain.

You can learn Alexander technique in private sessions or group classes. A typical session lasts about 45 minutes. During that time, the instructor notes the way you carry yourself and coaches you with verbal instruction and gentle touch.

Hypnotherapy

Also referred to as “hypnosis,” hypnotherapy is a mind-body technique that involves entering a trance-like state of deep relaxation and concentration. When undergoing hypnotherapy, patients are thought to be more open to suggestion. As such, hypnotherapy is often used to effect change in behaviors thought to contribute to health problems (including chronic pain).

Preliminary research suggests that hypnotherapy may be of some use in treatment of low back pain. For instance, a pilot study published in the International Journal of Clinical and Experimental Hypnosis found that a four-session hypnosis program (combined with a psychological education program) significantly reduced pain intensity and led to improvements in mood among patients with chronic low back pain.

 Balneotherapy

One of the oldest therapies for pain relief, balneotherapy is a form of hydrotherapy that involves bathing in mineral water or warm water.

For a 2006 report published in Rheumatology, investigators analyzed the available research on the use of balneotherapy in treatment of low back pain. Looking at five clinical trial, the report’s authors found “encouraging evidence” suggesting that balneotherapy may be effective for treating patients with low back pain. Noting that supporting data are scarce, the authors call for larger-scale trials on balneotherapy and low back pain.

Dead Sea salts and other sulfur-containing bath salts can be found in spas, health food stores, and online. However, people with heart conditions should not use balneotherapy unless under the supervision of their primary care provider.

Meditation

An ancient mind-body practice, meditation has been found to increase pain tolerance and promote management of chronic pain in a number of small studies. In addition, a number of preliminary studies have focused specifically on the use of meditation in management of low back pain. A 2008 study published in Pain, for example, found that an eight-week meditation program led to an improvement of pain acceptance and physical function in patients with chronic low back pain. The study included 37 older adults, with members meditating an average of 4.3 days a week for an average of 31.6 minutes a day.

 Although it’s not known how meditation might help relieve pain, it’s thought that the practice’s ability to induce physical and mental relaxation may help keep chronic stress from aggravating chronic pain conditions.

One of the most commonly practiced and well-studied forms of meditation is mindfulness meditation.

Tai Chi

Tai chi is an ancient martial art that involves slow, graceful movements and incorporates meditation and deep breathingTai chi. Thought to reduce stress, tai chi has been found to benefit people with chronic pain in a number of small studies.

 Although research on the use of tai chi in treatment of back pain is somewhat limited, there’s some evidence that practicing tai chi may help alleviate back pain to some degree. The available science includes a 2011 study published in Arthritis Care & Research, which found that a 10-week tai chi program reduced pain and improved functioning in people with long-term low back pain symptoms. The study involved 160 adults with chronic low back pain, half of whom participated in 40-minute-long tai chi sessions 18 times over the 10-week period.

 Music Therapy

Music therapy is a low-cost natural therapy that may reduce some of the stress of chronic pain in conjunction with other treatment. Studies find that it may reduce the disability, anxiety, and depression associated with chronic pain.

 A 2005 study published in Annals of Physical and Rehabilitation Medicine evaluated the influence of music therapy in hospitalized patients with chronic back pain. Researchers randomized 65 patients to receive, on alternate months, physical therapy plus four music therapy sessions or physical therapy alone and found that music significantly reduced disability, anxiety, and depression

 Conclusion

It is difficult at best to arrive at a conclusion about the effectiveness of Chiropractic manipulation for two reasons. 1) there are very few real scientific studies and 2) The members of the profession don’t even seem to agree on just when and on which conditions Chiropractors can offer lasting relief.  I can only conclude with this thought.  At one time Chiropractors were ridiculed by the medical profession and not covered by health insurance.  Now, that has changed and the profession seems to be enjoying a degree of legitimacy It has never before had.

If you will take anecdotal evidence as scientific proof then Chiropractors are very effective.  If you prefer to make a decision based on scientific studies…well, the jury may still be out.

The bottom line is quite simple.  If you have been to a Chiropractor and the visit or visits have resulted in relief from what ails you, then keep going.  You are the best judge of what’s right for you.

 

Bob AronsonBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Clinical Depression. You Can Defeat Your Demons!


By Bob Aronson

loneliness cartoonDepression, what is it? Why can’t you just snap out of it? Many people including family and friends who have not experienced depression have great difficulty understanding it much like people who are not addicts can’t understand addiction. In both cases we often hear advice like, “Snap out of it, you’ve got things pretty good. There’s no reason to be depressed.” Or, “You made the choice to start drinking or using drugs so choose to stop.” Oh, if it were that simple.

Here’s a cold slap in the face to bring us into reality. Depression is a mental illness, like the common cold is a physical illness. There has long been a stigma associated with mental illness held over from the days of Insane Asylums and “Crazy” people. That stigma is rapidly disappearing because so many people suffer from depression which is often a chemical imbalance that is quite treatable. Your mental health is every bit as important as your physical health and one can affect the other.

Here are some shocking statistics from the National Institutes of Mental Health (NIMH).

Major Depressive Disorder

  • Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.3
  • Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.1, 2
  • While major depressive disorder can develop at any age, the median age at onset is 32.5
  • Major depressive disorder is more prevalent in women than in men

Major or clinical depression is an awful feeling. It is a gnawing at the pit of your stomach, in your gut that makes you feel hopeless, helpless and alone. It is as though someone locked up your ability to reason, your sense of humor and your will to live in a windowless, dark, solitary confinement jail cell from which there is no escape. It is a constant feeling of impending doom combined with a profound sadness and even fear. It can steal your energy, memory, concentration, sex drive, interest in activities you used to love and…it can even destroy your will to live. Depression may not be as common as the common cold but it is much more common than ever before. Nearly 20 percent of Americans suffer from it at one time or another.

Logic says that you should be able to “Will” yourself out of this mood, but will power alone cannot give you tStop being sadhe boost you need to get your life’s engine started again. Mental illness is not unlike physical illness. You cannot use will power to eliminate depression any more than you could use it to stop cancer. No one wants to be depressed, no one,. Think about it. If will power would work as an anti-depressant there would be no depression because again, no one wants to feel like what I described.

Let’s get to the medical description and symptoms as offered by the Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/clinical-depression/faq-20057770

“To be diagnosed with clinical depression, you must have five or more of the following symptoms over a two-week period, most of the day, nearly every day. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Signs and symptoms may include:
• Depressed mood, such as feeling sad, empty or tearful (in children and teens, depressed mood can appear as constant irritability)
• Significantly reduced interest or feeling no pleasure in all or most activities
• Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected)
• Insomnia or increased desire to sleep
• Either restlessness or slowed behavior that can be observed by others
• Fatigue or loss of energy
• Feelings of worthlessness, or excessive or inappropriate guilt
• Trouble making decisions, or trouble thinking or concentrating
• Recurrent thoughts of death or suicide, or a suicide attempt
Your symptoms must be severe enough to cause noticeable problems in relationships with others or in day-to-day activities, such as work, school or social activities. Symptoms may be based on your own feelings or on the observations of someone else.
Clinical depression can affect people of any age, including children. However, clinical depression symptoms, even if severe, usually improve with psychological counseling, antidepressant medications or a combination of the two.”

The National Institutes of Health (NIH) has this to say about depression.

What causes depression?

Several factors, or a combination of factors, may contribute to depression.
• Genes—people with a family history of depression may be more likely to develop it than those whose families do not have the illness.
• Brain chemistry—people with depression have different brain chemistry than those without the illness.
• Stress—loss of a loved one, a difficult relationship, or any stressful situation may trigger depression.
Depression affects different people in different ways.
• Women experience depression more often than men. Biological, life cycle, and hormonal factors that are unique to women may be linked to women’s higher depression rate. Women with depression typically have symptoms of sadness, worthlessness, and guilt.
• Men with depression are more likely to be very tired, irritable, and sometimes even angry. They may lose interest in work or activities they once enjoyed, and have sleep problems.
• Older adults with depression may have less obvious symptoms, or they may be less likely to admit to feelings of sadness or grief. They also are more likely to have medical conditions like heart disease or stroke, which may cause or contribute to depression. Certain medications also can have side effects that contribute to depression.
• Children with depression may pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. Older children or teens may get into trouble at school and be irritable. Because these signs can also be part of normal mood swings associated with certain childhood stages, it may be difficult to accurately diagnose a young person with depression.

get out of bedOk we’ve defined the malady and we know how clinicians determine if patients have it so the next logical question is, “What can you do about it.” Well, the answer is simple, but it will take a major commitment on your part to make the answer work for you, we can start by identifying some hazards, potholes on the road to good mental health.

Depression: Ten Traps to Avoid

Dr. Stephen Ilardi, author of “The Depression Cure,” has identified several things that can make depression worse. First, know this. Depression is a serious medical condition and should be treated by a doctor or licensed therapist. Having said that, here”s what Dr. Ilardi suggests.

Trap 1: Being a Couch Potato

When you’re feeling down, it’s tempting to hole up in your bed or on the couch. Yet exercise – Even moderate activityclinical depression image like brisk walking – has been shown to be at least as effective against depression as antidepressant medication. It works by boosting the activity of the “feel-good” neurochemicals dopamine and serotonin.
For an “antidepressant dose” of exercise, try at least 40 minutes of brisk walking or other aerobic activity three times a week.

Trap 2: Not Eating “Brain Food”

Omega-3 fats are key building blocks of brain tissue. But the body can’t make omega-3s; they have to come from our diets. Unfortunately, most Americans don’t consume nearly enough Omega-3s, and a deficiency leaves the brain vulnerable to depression. Omega-3s are found in wild game, cold-water fish and other seafood, but the most convenient source is a fish oil supplement. Ask your doctor about taking a daily dose of 1,000 mg of EPA, the most anti-inflammatory form of omega-3.

Trap 3: Avoiding Sunlight

Sunlight exposure is a natural mood booster. It triggers the brain’s production of serotonin, decreasing anxiety and giving a sense of well-being. Sunlight also helps reset the body clock each day, keeping sleep and other biological rhythms in sync.

During the short, cold, cloudy days of winter, an artificial light box can substitute effectively for missing sunlight. In fact, 30 minutes in front of a bright light box each day can help drive away the winter blues.

Trap 4: Not Getting Enough Vitamin D

Most people know vitamin D is needed to build strong bones. But it’s also essential for brain health. Unfortunately, more than 80 percent of Americans are vitamin D deficient. From March through October, midday sunlight exposure stimulates vitamin D production in the skin – experts advise five to 15 minutes of daily exposure (without sunscreen). For the rest of the year, ask your doctor about taking a vitamin D supplement.

Trap 5: Having Poor Sleep Habits

sleepChronic sleep deprivation is a major trigger of clinical depression, and many Americans fail to get the recommended seven to eight hours a night. How can you get better sleep?

Use the bed only for sleep and sex – not for watching TV, reading, or using a laptop. Turn in for bed and get up at the same time each day. Avoid caffeine and other stimulants after midday. Finally, turn off all overhead lights

Trap 6: Avoiding Friends and Family

When life becomes stressful, people often cut themselves off from others. That’s exactly the wrong thing to do, as research has shown that contact with supportive friends and family members can dramatically cut the risk of depression. Proximity to those who care about us actually changes our brain chemistry, slamming the brakes on the brain’s runaway stress circuits.

Trap 7: Mulling Things Over

When we’re depressed or anxious, we’re prone to dwelling at length on negative thoughts – rehashing themes of rejection, loss, failure, and threat, often for hours on end. Such rumination on negative thoughts is a major trigger for depression – and taking steps to avoid rumination has proven to be highly effective against depression.

How can you avoid rumination? Redirect attention away from your thoughts and toward interaction with others, or shift your focus to an absorbing activity. Alternatively, spend 10 minutes writing down the troubling thoughts, as a prelude to walking away from them.

Trap 8: Running with the Wrong Crowd

Scientists have discovered that moods are highly contagious: we “catch” them from the people around us, the result of specialized mirror neurons in the brain. If you’re feeling blue, spending time with upbeat, optimistic people might help you “light up” your brain’s positive emotion circuits.

Trap 9: Eating Sugar and Simple Carbs

Researchers now know that a depressed brain is an inflamed brain. And what we eat largely determines simple carbsour level of inflammation. Sugar and simple carbs are highly inflammatory: they’re best consumed sparingly, if at all.

In contrast, colorful fruits and veggies are chockablock with natural antioxidants. Eating them can protect the body’s omega-3s, providing yet another nice antidepressant boost.

Trap 10: Failing to Get Help

Depression can be a life-threatening illness, and it’s not one you should try to “tough out” or battle on your own. People experiencing depression can benefit from the guidance of a trained behavior therapist to help them put into action depression-fighting strategies like exercise, sunlight exposure, omega-3 supplementation, anti-ruminative activity, enhanced social connection, and healthy sleep habits.

So you think you’ve avoided all the traps, but you are still depressed, now what? According to the National Alliance on Mental Illness (NAMI) here are the options. (http://www.nami.org/Content/NavigationMenu/Mental_Illnesses/Depression/Depression_Treatment,_Services_and_Supports.htm)

Treating Major Depression

pillsAlthough depression can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and a treatment plan. Today, there are a variety of treatment options available for depression. There are three well-established types of treatment: medications, psychotherapy and electroconvulsive therapy (ECT). A new treatment called transcranial magnetic stimulation (rTMS), has recently been cleared by the FDA for individuals who have not done well on one trial of an antidepressant. For some people who have a seasonal component to their depression, light therapy may be useful. In addition, many people like to manage their illness through alternative therapies or holistic approaches, such as acupuncture, meditation, and nutrition. These treatments may be used alone or in combination. However, depression does not always respond to medication. Treatment resistant depression (TRD) may require a more extensive treatment regimen involving a combination of therapies.

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Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 mmagic kindom in backgroundember Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

That Bad Headache Could be Sight Stealing Glaucoma


By Bob Aronson

If you have cataracts, even the beginnings of cataracts, you could experience the same sudden and painful glaucoma attack I did.  Recently on my Facebook group, Organ Transplant Initiative (OTI) I wrote about my experience with Acute Closed Angle Glaucoma.  It started headache imagewith a little headache and by the time I got to the ER had foolishly endured 16 hours of searing hot, constant, ever increasing pain.  I knew I had early stage cataracts but never associated that condition with the pain I was experiencing.

Since that episode I have learned that transplant recipients or anyone taking corticosteroids (Cortisone, Hydrocortisone and Prednisone) may have a greater risk of contracting Glaucoma, more on that in coming paragraphs.

We rarely hear about Glaucoma  and when we do we get the impression that it develops slowly and only affects old people.  I have spent a good share of my lifetime working with the medical profession and have had the beginnings of cataracts for a while and still did not know that Glaucoma could attack suddenly, with intense pain and be caused by a cataract.

Before I go into any detail about what you can do should the same thing happen to you, let me first explain the two eye afflictions.  They are very different diseases and both can lead to blindness if not treated.  Here’s the simple answer.  A cataract is an opaque (you can’t see through) area on the lens. It’s kind of like one of those windows that lets light in but you can’t see through it.  Research indicates that about 90% of people have some cataract activity by age 65, but many get it earlier.  Regular eye exams will reveal it, even if it is just getting started.  The surgery for cataracts is pretty simple and very effective because the medical team will replace the lens.  There is a marked and significant improvement  in vision.

Glaucoma is totally different.  It is a complicated group of eye diseases which affect the optic nerve and can lead to progressive, irreversible vision loss.  It is the second leading cause of blindness caused by fluid accumulation that increases pressure inside the eyeball.

There are two main types of glaucoma, 1) open angle and 2) closed angle glaucoma. I won’t go into the medical details here., just some quick definitions.  If you would like more information just Google Glaucoma.

1) Closed Angle Glaucoma (acute angle-closure glaucoma). This is the condition that affected me.  It can come on suddenly closed angle glaucoma(and it did) and the patient commonly experiences pain and rapid vision loss. Fortunately, the symptoms of pain and discomfort make the sufferer seek medical help, resulting in prompt treatment which usually prevents any permanent damage from occurring.  In my case I waited too long and was lucky they were able to save my left eye.

 

 

2) open angle glaucomaPrimary Open Angle Glaucoma (chronic glaucoma) – progresses very slowly. The patient may not feel any symptoms; even slight loss of vision may go unnoticed. In this type of glaucoma, many people don’t get medical help until some permanent damage has already occurred.

 

 

Here are some of the signs and symptoms of closed angle glaucoma

  • Eye pain, usually severe (It came on suddenly and kept getting worse.  Like a red hot poker in the eye.  It finally becomes unbearable pain).
  •  Blurred vision(in started out blurred and by the time I got to the ER I had no vision in the eye)
  • Eye pain is often accompanied by nausea, and sometimes vomiting (the symptoms were not unlike the worst hangover you’ve ever had.  Or…if you don’t drink, like the worst case of stomach flu you’ve ever had).
  • Lights appear to have extra halo-like glows around them
  • Red eyes
  • Sudden, unexpected vision problems, especially when lighting is poor

Signs and symptoms of primary open-angle glaucoma

Peripheral vision is gradually lost. This nearly always affects both eyes.

  • In advanced stages, the patient has tunnel vision

Rrisk factors are linked to glaucoma?

  • Advanced age – people over 60 years have a higher risk of developing glaucoma. For African-Americans, the risk rises at a much younger age.
  • Ethnic background is a risk factor as well.  For example,  East Asians, because of their shallower anterior chamber depth, have a higher risk of developing glaucoma compared to Caucasians. The risk for those of Inuit origin is considerably greater still. Studies show that African-Americans are three to four times more likely to develop glaucoma than whites.  Also…it appears as though Glaucoma favors women over men.  Studies indicate that women are three times as likely to develop glaucoma as men.  There are other risk factors as well and included among them is the use of corticosteroids.
  • Patients who take Corticosteroids like cortisone, hydrocortisone and prednisone for long periods of time have a raised risk of developing several different conditions, including glaucoma. The risk is even greater with eyedrops containing corticosteroids.

Now that you have some background lets talk about the disease.  I get frequent headaches, I always have and aspirin has always worked for me.  When this attack hit me, I took some aspirin, it did nothing.  Then I remembered telling a physician about my headaches and he suggested that maybe they were mini-migraines but we did not pursue the topic even though his suggestion stuck with me.

As the headache worsened I thought about the mini migraines and my wife Robin went to the pharmacy to get some over the counter migraine medicine.  It had no effect and the headache kept getting worse.  Then we called my primary care doc, told him I was having a migraine and he called in a prescription.  I was to take it every four hours, which I did but the headache got worse.  Several times during this ordeal Robin asked me if I wanted to go to the ER to which I responded negatively.  Finally after 16 hours of worsening pain, loss of vision and vomiting I gave in.  It was 4 AM when I awakened Robin to tell her I could no longer tolerate the pain so she drove me to the Mayo Clinic Emergency Department in Jacksonville.

Upon entering the ER I was asked to describe my symptoms which I did but also said I was experiencing a migraine headache.  The Doctor listened but immediately looked at my eyes and expressed some doubt about my self-diagnosis.  She ordered morphine for pain a CT scan of my head and called for an ophthalmologist, who arrived within minutes and conducted a more thorough exam of my eyes which included testing for pressure on the eyeball.  He quickly arrived at the conclusions that I was suffering from  acute closed angle glaucoma.  Subsequent research tells me that medical people are concerned about eye pressures that are over 23-25.  Mine was 60.  I had waited far too long to come to the ER.  The eye specialist continually put drops in the eye until the pressure was down to a safer level at which time I was hurried into a laser surgery room where they zapped the eye to create a tiny hole that would release more pressure.  It took only a few minutes.  The headache was gone, my stomach was back to normal and I was high on morphine for two days.

I’m writing this so that others don’t make the same mistake. Headaches can be serious, and when you combine a bad headache with vision loss and vomiting the Emergency Room is where you should be headed.  I got lucky….my vision was not lost.  A few days after this incident I went back to Mayo and they did the laser surgery on the other eye.

In about six weeks I will return to the clinic and have the cataracts repaired and that, I hope, will be the end of this vision episode.

There are some steps you can take to prevent this condition.  Here’s what the Mayo Clinic Says.  http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/definition/con-20024042

  • iglaucoma preventionGet regular eye care. Regular comprehensive eye exams can help detect glaucoma in its early stages before irreversible damage occurs. As a general rule, have comprehensive eye exams every three to five years after age 40 and every year after age 60. You may need more frequent screening if you have glaucoma risk factors. Ask your doctor to recommend the right screening schedule for you.
  • Treat elevated eye pressure. Glaucoma eyedrops can significantly reduce the risk that elevated eye pressure will progress to glaucoma. To be effective, these drops must be taken regularly even if you have no symptoms.
  • Eat a healthy diet. While eating a healthy diet won’t prevent glaucoma, it can improve your physical and mental health. It can also help you maintain a healthy weight and control your blood pressure.
  • Wear eye protection. Serious eye injuries can lead to glaucoma. Wear eye protection when you use power tools or play high-speed racket sports on enclosed courts. Also wear hats and sunglasses if you spend time outside.

Don’t make the same mistake I did.  Don’t  self-diagnose, don’t delay.  When a condition has the potential to destroy your vision you must get immediate medical attention.


Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member OrganMy new hat April 10 2014Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Kidney Disease — A Quiet, Sneaky Epidemic. Are You At Risk?


By Bob Aronson

You are what you eatAs I did the research for this blog, I “Cherry Picked” information from a great many sources.  I am not a medical professional, but made every effort to ensure that the information I used came from experts.  I have identified sources where possible. 

This is a blog, it is made up of a good many opinions.  You should not make decisions about your health based on this or any other posting or even your own research. Only a highly skilled, educated and experienced physician can do that.  Blogs like this can only offer you general information.  As you read this remember that no two people are exactly alike.  What works for one person may cause serious damage to another even though they share similar characteristics.  Your health is too important to be left to chance.  It should be managed by a qualified physician who can focus on your specific condition, examine you, call for appropriate tests, diagnose and then develop a treatment program to meet your unique needs.

Kidney disease is disabling and killing us and no one seems to be paying attention.   To get yours I am going to start this post with some startling, even shocking facts.

  • Chronic kidney disease can lead to kidney failure, heart attack, stroke and death. In factkidney graphic, kidney disease is the nation’s ninth leading cause of death
  • 26 million Americans have kidney disease (many of whom don’t yet know it) and an additional 76 million are at high risk of developing it.
  • Of the 122,000 people on the national organ transplant waiting list about 100,000 are waiting for kidneys and there are not enough to go around.
  • Nearly a half million Americans are getting dialysis and the number is growing rapidly.
  • Diabetics are in the greatest danger of developing kidney disease and The American Diabetes Association says 25.8 million of us have it, that’s 8.3 percent of the U.S. population. Of these, 7 million do not know they are diabetic.
  • And – a final startling fact.  Kidney disease kills 100 thousand Americans a year, that’s more than prostate and breast cancer combined, but kidney disease gets nowhere near the publicity or concern of those two malignancies.

 

Got your attention?  Ok…there’s a lot more to come but first let’s define the topic. – just exactly what do kidneys do and what is kidney disease?  Here’s what the National Kidney Foundation says:

The kidneys are bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. The kidneys are sophisticated reprocessing machines. Every day, a person’s kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of waste products and extra fluid. The wastes and extra fluid become urine, which flows to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination.”

 So what is kidney disease?  The Mayo Clinic offers this explanation:

Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.”

Causes of Kidney Disease

What causes Kidney disease?  First let’s define terms.  There’s ESRD (End Stage Renal Disease or Kidney failure), where the organs just quit working and there is CKD (Chronic Kidney Disease) which can lead to kidney failure.  The causes could be many but the most common are diabetesDiabetes and High blood pressure.  There are concerns, too, that some environmental factors may also contribute to both CKD and ESRD.  Sri Lanka, for example, has banned Monsanto Corporation’s “Roundup” herbicide on the grounds that it causes both kidney maladies.  Monsanto says its studies offer convincing evidence that the charges are not true.

What to do about it

Much is known about who faces the greatest risks of developing chronic kidney disease and how it can be prevented, detected in its early stages, and treated to slow or halt its progression. But unless people at risk are tested, they are unlikely to know they have kidney disease; it produces no symptoms until it is quite advanced.

Even when it is not fatal, the cost of treating end-stage kidney disease through dialysis or a kidney transplant is astronomical, more than fivefold what Medicare pays annually for the average patient over age 65. The charges do not include the inestimable costs to quality of life among patients with advanced kidney disease.

Much is known about who faces the greatest risks of developing chronic kidney disease and how it can be prevented, detected in its early stages, and treated to slow or halt its progression. But unless people at risk are tested, they are unlikely to know they have kidney disease; it produces no symptoms until it is quite advanced.  And…it appears as though it is quite common that many physicians overlook simple tests that could save lives.  For example, high blood pressure, is a leading cause of kidney failure yet many physicians don’t check to see how well vital organs are functioning.  Patients, then, have to be their own advocates and insist on tests to see what effect diabetes and/or high blood pressure are affecting their organs. For some reason kidney disease often is not on the medical radar, and in as many as three-fourths of patients with risk factors for poor kidney function, physicians fail to use a simple, inexpensive test to check for urinary protein.  So, our message to you is simple…make sure your doctor checks the amount of protein in your urine at least once a year.

A study published in April online in The American Journal of Kidney Disease demonstrated how common lifestyle factors can harm the kidneys. Researchers led by Dr. Alex Chang of Johns Hopkins University followed more than 2,300 young adults for 15 years. ParticipantJohns Hopkinss were more likely to develop kidney disease if they smoked, were obese or had diets high in red and processed meats, sugar-sweetened drinks and sodium, but low in fruit, legumes, nuts, whole grains and low-fat dairy.

Only 1 percent of participants with no lifestyle-related risk factors developed protein in their urine, an early indicator of kidney damage, while 13 percent of those with three unhealthy factors developed the condition, known medically as proteinuria. Obesity alone doubled a person’s risk of developing kidney disease; an unhealthy diet raised the risk even when weight and other lifestyle factors were taken into account.

Overall, the risk was highest among African-Americans; those with diabetes, high blood pressure or a family history of kidney disease; and those who consumed more soft drinks, red meat and fast food.

Dr. Beth Piraino, president of the National Kidney Foundation, said, “We need to shift the focus from managing chronic kidney disease to preventing it in the first place.”  And one of the ways to prevent kidney disease is to live healthier.  I know, no one wants to hear those words, “Live Healthier.”  Ok, I won’t use them again, but if you eat right and get the right kind and amount of exercise you can avoid kidney problems.  Want some good recipes and ideas for weight control?  Try this link  http://www.kidney.org/patients/kidneykitchen/FriendlyCooking.cfm

You are at greater risk of having kidney disease if others in your family have it or had it, genetic factors are important, but in addition you should know that African-Americans, Hispanic Americans, Asian-Americans and American Indians are more likely than white Americans to develop kidney disease.  I have been unable to find out why.  One Doctor said that prevention is the key and that it is not very complicated.  “I wouldn’t have to work so hard if they didn’t smoke, reduced their salt intake, ate more fresh fruits and vegetables, and increased their physical activity. These are things people can do for themselves. They involve no medication.”

Physicians also urge patients with any risk factor for kidney disease to be screened annually with inexpensive urine and blood tests. That includes seniors 65 and above, for whom the cost is covered by Medicare. Free testing is also provided by the National Kidney Foundation for people with diabetes.

The urine test can pick up abnormal levels of protein, which is supposed to stay in the body, compared with the amount of creatinine, a waste product that should be excreted. The blood tUrine testest, called an eGFR (for estimated glomerular filtration rate), measures how much blood the kidneys filter each minute, indicating how effectively they are functioning.

If it is determined that you have kidney disease you should be referred to a nephrologist.  If you are not referred, ask for a referral.  The Nephrologist will work closely with your family physician to help control the disease.

There are two medications commonly used to treat high blood pressure that often halt or delay the progression of kidney disease in people with diabetes: ACE inhibitors and ARB’s (angiotensin receptor blockers). Careful control of blood sugar levels also protects the kidneys from further damage.

As I conducted the research for this blog I found that one of the most comprehensive websites for factual, understandable information about Kidney Disease is India’s “The Health Site.” It also contains a good deal of advertising and other questionable material, but its information on the kidneys and kidney disease is backed up by solid research.  What follows is some of it.  http://www.thehealthsite.com/

12 Possible Kidney Disease Symptoms

Even an unhealthy lifestyle with a high calorie diet, certain medicines. lots of soft drinks and sugar consumption can also cause kidney damage. Here is a list of twelve symptoms which could indicate something is wrong with your kidney:

  1. Changes in your urinary function: The first symptom of kidney disease is changes in the amount and frequency of your urination. There may be an increase or decrease in amount and/or its frequency, especially at night. It may also look more dark coloured. You may feel the urge to urinate but are unable to do so when you get to the restroom.
  2. Difficulty or pain during voiding: Sometimes you have difficulty or feel pressure or pain while voiding. Urinary tract infections may cause symptoms such as pain or burning during urination. When these infections spread to the kidneys they may cause fever and pain in your back.
  3. Blood in the urine: This is a symptom of kidney disease which is a definite cause for concern. There may be other reasons, but it is advisable to visit your doctor in case you notice it.
  4. Swelling: Kidneys remove wastes and extra fluid from the body. When they are unable to do so, this extra fluid will build up causing swelling in your hands, feet, ankles and/or your face. Read more about swelling in the feet.
  5. Extreme fatigue and generalised weakness: Your kidneys produce a hormone called erythropoietin which helps make red blood cells that carry oxygen. In kidney disease lower levels of erythropoietin causes decreased red blood cells in your body resulting in anaemia.  There is decreased oxygen delivery to cells causing generalised weakness and extreme fatigue. Read more about the reasons for fatigue.
  6. Dizziness & Inability to concentrate: Anaemia associated with kidney disease also depletes your brain of oxygen which may cause dizziness, trouble with concentration, etc.
  7. Feeling cold all the time: If you have kidney disease you may feel cold even when in a warm surrounding due to anaemia. Pyelonephritis (kidney infection) may cause fever with chills.
  8. Skin rashes and itching: Kidney failure causes waste build-up in your blood. This can causes severe itching and skin rashes.
  9. Ammonia breath and metallic taste: Kidney failure increases level of urea in the blood (uraemia). This urea is broken down to ammonia in the saliva causing urine-like bad breath called ammonia breath. It is also usually associated with an unpleasant metallic taste (dysgeusia) in the mouth.

10. Nausea and vomiting: The build-up of waste products in your blood in kidney disease can also cause nausea and vomiting. Read 13 causes for nausea.

11. Shortness of breath: Kidney disease causes fluid to build up in the lungs. And also, anaemia, a common side-effect of kidney disease, starves your body of oxygen. You may have trouble catching your breath due to these factors.

12. Pain in the back or sides: Some cases of kidney disease may cause pain. You may feel a severe cramping pain that spreads from the lower back into the groin if there is a kidney stone in the ureter. Pain may also be related to polycystic kidney disease, an inherited kidney disorder, which causes many fluid-filled cysts in the kidneys. Interstitial cystitis, a chronic inflammation of the bladder wall, causes chronic pain and discomfort.

It is important to identify kidney disease early because in most cases the damage in the kidneys can’t be undone. To reduce your chances of getting severe kidney problems, see your doctor when you observe one or more of the above symptoms. If caught early, kidney disease can be treated very effectively.

http://www.thehealthsite.com/diseases-conditions/12-symptoms-of-kidney-disease-you-shoulnt-ignore-world-kidney-day-special/

Kidney Disease Prevention

Ten Steps you can take

 Our kidneys are designed such that their filtration capacity naturally declines after the age of 30-40 years. With every decade after your 30s, your kidney function is going to reduce by 10%. But, if you’re going to increase the load on your kidneys right from the beginning, your risk of developing kidney disease later in life will definitely be higher. To be on the safe side, follow these few tips and take good care of your kidneys to prevent the risk of developing kidney problems.

1. Manage diabetes, high blood pressure and heart disease: In most of the cases, kidney disease is a secondary illness that results from a primary disease or condition such as diabetes, heart diseases or high blood pressure. Therefore, controlling sugar levels, cholesterol and blood pressure by following a healthy diet, exercise regimen and medication guidelines is essential to keep kidney disease at bay.

2. Reduce the intake of salt: Salt increases the amount of sodium in diet. It not only increases blood pressure but also triggers the formation of kidney stones. Here are a few tips to actually cut down your salt intake.

3. Drink lots of water every day:  Water keeps you hydrated and helps the kidneys to remove all the toxins from your body. It helps the body to maintain blood volume and concentration. It also helps in digestion and controls the body temperature. At least 8-10 glasses of water a day is a must.

4. Don’t resist the urge to urinate: Filtration of blood is a key function that your kidneys perform. When the process of filtration is done, extra amount of wastes and water is stored in the urinary bladder that needs to be excreted. Although your bladder can only hold a lot of urine, the urge to urinate is felt when the bladder is filled with 120-150 ml of urine.

So, if start ignoring the urge to go to the restroom, the urinary bladder stretches more than its capacity. This affects the filtration process of the kidney.

5. Eat right:  Nearly all processes taking place inside your body are affected by what you choose to eat and how you eat. If you eat more unhealthy, junk and fast food, then your organs have to face the consequences, including the kidneys. Here’s more information on the relation between unhealthy diet and kidney damage.

You should include right foods in your diet. Especially foods that can strengthen your kidneys like fish, asparagus, cereals, garlic and parsley. Fruits like watermelon, oranges and lemons are also good for kidney health. 

6. Drink healthy beverages: Including fresh juices is another way of drinking more fluids and keeping your kidneys healthy. Juices help the digestive system to extract more water and flush out wastes from the body. Avoid drinking coffee and tea. They contain caffeine which reduces the amount of fluids in the body. So, the kidneys have to work harder to get rid of them.

If you’re already suffering from kidney problems, you should avoid juices made from vegetables such as spinach and beets. These foods are rich in oxalic acid and they help in the formation of kidney stones. But you can definitely have coconut water.

7. Avoid alcohol and smoking: Excess intake of alcohol can disturb the electrolyte balance of the body and hormonal control that influences the kidney function. Smoking is not directly related to kidney problems but it reduces kidney function significantly. It also has an adverse effect on heart health which can further worsen kidney problems.

8. Exercise daily: Researchers believe that obesity is closely linked to kidney related problems. Being overweight doubles the chances of developing kidney problems. Exercising, eating healthy and controlling portion size can surely help you to lose extra weight and enhance kidney health. Besides, you will always feel fresh and active. Here’s more about how obesity and kidney disease are linked.

9. Avoid self-medication: All the medicines you take have to pass through the kidney for filtration. Increased dosage or taking medicines that you are not aware of can increase the toxin load on your kidneys. That’s why you should always follow dosage recommendations and avoid self-medication. Read more about how drugs affect the kidneys. 

10. Think before you take supplements and herbal medicine: If you’re on vitamin supplements or if you’re taking some herbal supplements, you should reconsider your dosage requirement. Excessive amount of vitamins and certain plant extracts are linked to kidney damage. You should talk to your doctor about the risk of kidney disease before taking them.

Dialysis and Transplantation

By Ed Bryant

(I could find no additional information about Mr. Bryant other than the following website.  His information, though, is sound).

https://nfb.org/images/nfb/publications/vod/vow0006.htm

Dialysis

Dialysis is not an “artificial kidney.” A person undergoing hemodialysis must be hooked up to a machine three times a week, three to four hours per session. A normal vein cannot tolerate the 16–gauge needles that must be inserted into the arm during hemodialysis, so the doctor must surgically connect a vein in the wrist with an artery, forming a bulging fistula that will better accommodate the large needles needed for treatment.dialysis

Like the kidney, a hemodialysis machine is a filter. Where it uses tubes and chemicals, the kidney uses millions of microscopic blood vessels, fine enough to pass urine while retaining suspended proteins. Long–term high blood glucose can significantly damage the kidney’s filters, leading to scarring, blockage, and diminished renal function. Diabetes is the leading cause of kidney disease. Long–term diabetics often have cardiovascular and blood pressure problems, and the added strain of hemodialysis, with its rise in blood pressure straining eyes and heart function, can be too much for some. The diabetic dialysis patient spends, on the average, 33% more time in the hospital than does the non–diabetic dialysis patient, according to 1999 USRDS figures.

Some patients choose CAPD (continuous ambulatory peritoneal dialysis) or its variant, CCPD (continuous cycling peritoneal dialysis), both of which can be carried out at home, without an assistant. Unlike hemodialysis, which uses a big machine to remove toxic impurities from the blood, peritoneal dialysis works inside the body, making use of the peritoneal membrane to retain a reservoir of dialysis solution, which is exchanged for fresh solution, via catheter, every four to eight hours. CAPD is carried out by the patient, who simply exchanges spent for fresh solution, every four to eight hours, at home, at work, or while travelling. CCPD, its variant, makes use of an automated cycler, which performs the exchanges while the patient is asleep. Although more complicated and machine–dependent, it does allow daytime freedom from exchanges, and may be the appropriate choice for some. Though the risk of infections is heightened (as it is with any permanent catheterization), these two processes have advantages, one being that insulin can be added to the dialysis solution, freeing the patient from the need to inject, and giving good blood sugar control.

Transplantation

Kidney transplantation is a logical alternative for many. It substantially improves a patient’s kidney transplantquality of life. Although the transplant recipient must be on anti–rejection/ immunosuppressive therapy for life, with the inherent risk from otherwise nuisance infections, a transplant frees the patient from the many hours spent on hemodialysis procedures each week, or from the periodic “exchanges” and open catheter of CAPD, allowing a nearly normal lifestyle. For those ESRD patients who can handle the stresses of transplant surgery, the resulting gains in physical well–being add up to real improvement in quality of life and overall longevity.

“Fifty percent of all kidney transplantations taking place today are into diabetics,” states Giacomo Basadonna, MD, PhD, a transplant surgeon at Yale University School of Medicine, in New Haven, Connecticut. He reports that success rates are identical with kidney transplants performed on non–diabetic ESRD patients. “Today,” he advises, “average kidney survival, from a living donor, is greater than 15 years.”

One of the areas where we are seeing rapid improvement is immunosuppressive medication. The traditional mix of immunosuppressants: cyclosporine, prednisone, imuran, is giving way to more targeted medications that may have fewer side effects. Cellcept, by Roche/Syntex, and Rapamycin (Rapamune), by Wyeth/Ayerst, have been approved by the FDA, and others are being tested. The risk of organ rejection is always present, but each new development increases the chances of success.

I and others knowledgeable in kidney transplantation advise you to pick the best transplant center possible. Once you have read their statistics, ask your prospective center the following questions. If they don’t answer to your satisfaction, you should consider going to another center.

1. Do you have an information packet for prospective donors and recipients?

2. Can you put me in touch with someone who has had a transplant at your center?

3. What is your “graft survival” (success) rate?

4. Who will my transplant surgeon be? If a fellow or resident, will he/she be supervised by a practicing transplant surgeon?

5. How long have your current surgeons been doing kidney transplants? How many have they done? That your center has 35 years experience with kidney transplants is of little consequence if my surgeon has only done ten in his or her career.

6. What is the average post–operative stay in your hospital?

7. When I come for my transplant, or come back for follow–ups, will there be any affordable housing for me and/or my family? (Ronald McDonald House, or other lodging with discount rates…) or will I get stuck in a luxury hotel for $125 a night?

8. How often will I need to come back to the center for follow–ups? Can my nephrologist do the blood tests and send you the results?

9. Can you recommend a nephrologist in my area?

10. Do you have a toll–free number to call for after–transplant information?

11. What is your policy on people with insufficient health insurance? Will you work with an uninsured patient? What will it cost?

12. Are you prepared to satisfy my doubts? Will you show me the documents that answer my questions? Will you guarantee the price quoted?

Conclusion

Kidney disease can be manageable if caught early and treated appropriately.  The information contained in this blog should allow you to make good decisions that can provide you with the quality of life you seek and deserve.  For more information about kidney disease and treatment here are some additional sources.

  • The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

http://tinyurl.com/qfna7f2

 

 

 

 


My new hat April 10 2014Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient,
 the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Sleepless in Seattle, Duluth, Toronto and Rome — Insomnia, and What You Can Do About It


 By Bob Aronson

insomnia imageNormally I hope my blogs are interesting enough to keep people engaged and awake while reading them.  In this case if you get sleepy, go with it because chances are that if you are reading this you are an insomniac.

I can fall asleep at the drop of a hat.  I wake up shortly after it has fallen.  Insomnia or the inability to sleep normally is a terrible malady and one which affects millions of people, especially transplant patients both pre and post surgery.  Often insomnia is the result of the drugs we take – but not always.

It’s always good to start with a definition of terms.  Exactly what is insomnia?  Well, I’m going to offer a couple of sources.  First the National Sleep foundation says there are at least five ways to describe insomnia: http://tinyurl.com/n8mjwsu

  1. Acute insomnia is a brief episode of difficulty sleeping usually caused by a life event, such as a stressful change in a person’s job, insomnia math cartoonreceiving bad news, or travel. Often acute insomnia resolves without any treatment.
  2. Chronic insomnia is a long-term pattern of difficulty sleeping. It is usually considered chronic if a person has trouble falling asleep or staying asleep at least three nights per week for three months or longer. Some people with chronic insomnia have a long-standing history of difficulty sleeping. Chronic insomnia has many causes.
  3. Comorbid insomnia is insomnia that occurs with another condition. Psychiatric symptoms — such as anxiety and depression — are known to be associated with changes in sleep. Certain medical conditions can either cause insomnia or make a person uncomfortable at night (as in the case of arthritis or back pain, which may make it hard to sleep.
  4. Onset insomnia is difficulty falling asleep at the beginning of the night.
  5. Maintenance insomnia is the inability to stay asleep. People with maintenance insomnia wake up during the night and have difficulty returning to sleep.

The American Academy of Sleep Medicine elaborates even more.  They say there are the following kinds of insomnia. http://tinyurl.com/lus3682

  1. General insomnia

A classification of sleep disorders in which a person has trouble falling asleep, staying asleep, or waking up too early. These disorders may also be defined by an overall poor quality of sleep.

  1. Adjustment insomnia

internet cartoonThis disorder, also called acute insomnia or short-term insomnia, disturbs your sleep and usually stems from stress. The sleep problem ends when the source of stress is gone or when you adapt to the stress. The stress does not always come from a negative experience. Something positive can make you too excited to sleep well.

  1. Behavioral insomnia of childhood

This condition occurs when children don’t go to bed on time unless a parent or guardian enforces a bedtime. If the children are made to go to bed at a specified time, then they tend to fall asleep at a normal hour. If they are not given strict bedtimes, then they may linger awake for hours at night.

  1. Idiopathic insomnia

Idiopathic insomnia is a lifelong sleep disorder that starts during infancy or childhood and continues into adulthood. This insomnia cannot be explained by other causes. It is not a result of any of the following other sleep disorders.

  • Medical problems
  • Psychiatric disorders
  • Stressful events
  • Medication use
  • Other behaviors

It may result from an imbalance in your body, such as an overactive awakening system       and/or an underactive sleep system, but the true cause of this disorder is still unclear.

  1. Insomnia due to a drug or substance

This type of insomnia is directly related to the use of any of the following substances:

  • Medication
  • Caffeine
  • Alcohol
  • A food item

Your sleep is disrupted by your use of the substance. This type of sleep problem may also   occur when you stop using a substance

  1. Insomnia due to a medical condition. 

This insomnia is caused by a mental health disorder. The insomnia is a symptom of the   disorder. The course and severity of insomnia are directly linked to that of the mental health disorder, but the insomnia is a separate focus of treatment. This insomnia is a disorder only if it is severe enough to require separate treatment.

  1. Insomnia nonorganic, unspecified. 

This type of insomnia suggests that known substances and other physical causes of  the insomnia have been ruled out. This means that the cause of insomnia is most likely due to an underlying mental health disorder, psychological factor, or sleep disruptive behaviors.

The name may also be used on a temporary basis while further evaluation and testing are completed. It is the name used when a person with insomnia does not meet the criteria for another type of insomnia.

  1. Insomnia organic, unspecified. 

This type of insomnia is caused by a medical disorder, physical condition, or substance exposure. But the specific cause remains unclear. Further testing is required to discover the exact cause. The name may be used on a temporary basis while further evaluation and testing are completed.

  1.  Paradoxical insomnia is a complaint of severe insomnia. It occurs without objective evidence of any sleep disturbance. Daytime effects vary in severity, but they tend to be far less severe than one would expect given the expressed sleep complaints.People with this disorder often report little or no sleep for one or more nights. They also describe having an intense awareness of the external environment or internal processes consistent with being awake. This awareness suggests a state of hyperarousal. A key feature is an overestimation of the time it takes them to fall asleep. They also underestimate their total sleep time.10.
  2. Psychophysiological insomnia.

This insomnia is associated with excessive worrying, specifically focused on not being able to sleep. The insomnia may begin suddenly following an event or develop slowly over many years.

People with this sleep disorder worry too much about their insomnia and about being tired the next day. As a result, they learn to become tense and anxious as bedtime approaches. They may have racing thoughts that all relate to insomnia and trying to fall asleep. As they worry about falling asleep, they become more and more tense, which makes it less likely that they will be able to fall asleep.

While all transplant patients may suffer from some form of insomnia,
Kidney transplant patientresearch clearly indicates that those who have kidney transplants are much more likely to have sleep problems.  This eye opening  article will give you some insight and solutions as well. “The Kidney Transplant Side Effect That No One Tells Chronic Kidney Disease Patients About

December 07, 2013 Kidney Buzz http://tinyurl.com/m5bmhky

 And, there’s a lot more about kidney disease and sleep which can cause major health complications and even increase the risk of death.

Recommended Reading: Sleep Disorders are common in Individuals with Kidney Disease on Dialysis

A study published in Biomedcentral Nephrology Journal found that the most frequent sleep problem among people with a Kidney Transplant was difficulty staying asleep (49.4%), followed by problems falling asleep (32.1%). 62.9% of transplant patients had to wake up to urinate which was the most common sleep disturbance, and caused 27% of transplant recipients to have reduced daytime functionality.

Recommended Reading: Chronic Kidney Disease Patients Do Not Have To Suffer Sleep Loss

Another study first reported by Science Nordic and later published in the Journal of Sleep Research, further confirms that insomnia is linked with a wide range of health problems including higher risk for anxiety, depression, fibromyalgia (chronic widespread pain), whiplash, rheumatoid arthritis, arthrosis

(an age-related cartilage degeneration condition), severe headache, asthma, heart attack and osteoporosis. Researchers also found a less strong association between insomnia and obesity, hypertension and stroke.

Recommended Reading: The Natural Way For Chronic Kidney Disease Patients To Get A Good Night’s Sleep

 

Solutions….How to Get Some Sleep

“Ok,” you say, “That’s good, now what do I do about it?  How can I get a good  night’s sleep?”  And…that’s the $64 or $64,000 or $64,000,000 question depending on the era in which you grew up.  There are a lot of answers to that question and none of them work for everyone.   So let’s start with some advice from the National Institutes for Health NIH) http://tinyurl.com/mo6v483

How Is Insomnia Treated?

http://tinyurl.com/lyvl5or

Lifestyle changes often can help relieve acute (short-term) insomnia. These changes might make it easier to fall asleep and stay asleep.

Several medicines also can help relieve insomnia and re-establish a regular sleep schedule. However, if your insomnia is the symptom or side effect of another problem, it’s important to treat the underlying cause (if possible).

Lifestyle Changes

If you have insomnia, avoid substances that make it worse, such as:

  • booze and smokesCaffeine, tobacco, and other stimulants. The effects of these substances can last as long as 8 hours.
  • Certain over-the-counter and prescription medicines that can disrupt sleep (for example, some cold and allergy medicines). Talk with your doctor about which medicines won’t disrupt your sleep.
  • Alcohol. An alcoholic drink before bedtime might make it easier for you to fall asleep. However, alcohol triggers sleep that tends to be lighter than normal. This makes it more likely that you will wake up during the night.

Try to adopt bedtime habits that make it easier to fall asleep and stay asleep. Follow a routine that helps you wind down and relax before bed. For example, read a book, listen to soothing music, or take a hot bath.

Try to schedule your daily exercise at least 5 to 6 hours before going to bed. Don’t eat heavy meals or drink a lot before bedtime.

Make your bedroom sleep-friendly. Avoid bright lighting while winding down. Try to limit possible distractions, such as a TV, computer, or pet. Make sure the temperature of your bedroom is cool and comfortable. Your bedroom also should be dark and quiet.

Go to sleep around the same time each night and wake up around the same time each morning, even on weekends. If you can, avoid night shifts, alternating schedules, or other things that may disrupt your sleep schedule.

Cognitive-Behavioral Therapy

CBT for insomnia targets the thoughts and actions that can disrupt sleep. This therapy encourages good sleep habits and uses several methods to relieve sleep anxiety.

For example, relaxation techniques and biofeedback are used to reduce anxiety. These strategies help you better control your breathing, heart rate, muscles, and mood.

CBT also aims to replace sleep anxiety with more positive thinking that links being in bed with being asleep. This method also teaches you what to do if you’re unable to fall asleep within a reasonable time.

biofeedbackCBT also may involve talking with a therapist one-on-one or in group sessions to help you consider your thoughts and feelings about sleep. This method may encourage you to describe thoughts racing through your mind in terms of how they look, feel, and sound. The goal is for your mind to settle down and stop racing.

CBT also focuses on limiting the time you spend in bed while awake. This method involves setting a sleep schedule. At first, you will limit your total time in bed to the typical short length of time you’re usually asleep.

This schedule might make you even more tired because some of the allotted time in bed will be taken up by problems falling asleep. However, the resulting tiredness is intended to help you get to sleep more quickly. Over time, the length of time spent in bed is increased until you get a full night of sleep.

For success with CBT, you may need to see a therapist who is skilled in this approach weekly over 2 to 3 months. CBT works as well as prescription medicine for many people who have chronic insomnia. It also may provide better long-term relief than medicine alone.

For people who have insomnia and major depressive disorder, CBT combined with antidepression medicines has shown promise in relieving both conditions.

Prescription Medicines

Many prescription medicines are used to treat insomnia. Some are meant for short-term use, while others are meant for longer use.  There are so many drugs that can be prescribed we are not even going to attempt to list them.  Just know that your primary care physician or, better yet, your sleep specialist has a huge armory of drugs from which to draw, but they’ll want a “history” from you before they even begin to suggest remedies..  And…remember, those remedies may not be medicinal.

medsTalk to your doctor about the benefits and side effects of insomnia medicines. For example, insomnia medicines can help you fall asleep, but you may feel groggy in the morning after taking them.

Rare side effects of these medicines include sleep eating, sleep walking, or driving while asleep. If you have side effects from an insomnia medicine, or if it doesn’t work well, tell your doctor. He or she might prescribe a different medicine.  Also, if you are either pre or post transplant, tell the physician who’s treating you for sleep.  Some medications may not mix well with those you are taking for your condition.   And…as a precaution, never take any medication before you personally check with your transplant team.

Some insomnia medicines can be habit forming. Ask your doctor about the benefits and risks of insomnia medicines.

Over-the-Counter Products

Some over-the-counter (OTC) products claim to treat insomnia. These products include melatonin, L-tryptophan supplements, and valerian teas or extracts.

The Food and Drug Administration doesn’t regulate “natural” otc drugsproducts and some food supplements. Thus, the dose and purity of these substances can vary. How well these products work and how safe they are isn’t well understood.

Some OTC products that contain antihistamines are sold as sleep aids. Although these products might make you sleepy, talk to your doctor before taking them.

Antihistamines pose risks for some people. Also, these products may not offer the best treatment for your insomnia. Your doctor can advise you whether these products will benefit you.

At the risk of sounding overly cautious you should take the same precautions with Over the Counter Drugs as you would with prescriptions.  Talk to your transplant team before you take anything.

Other quick tips

At night.

  • Use the bed and bedroom for sleep and sex only
  • Establish a regular bedtime routine and a regular sleep-wake schedule
  • Do not eat or drink too much close to bedtime
  • Create a sleep-promoting environment that is dark, cool and comfortable
  • Avoid disturbing noises – consider a bedside fan or white-noise machine to block out disturbing sounds

During the day:

  • Consume less or no caffeine, particularly late in the day
  • Avoid alcohol and nicotine, especially close to bedtime
  • Exercise, but not within three hours before bedtime
  • Avoid naps, particularly in the late afternoon or evening
  • Keep a sleep diary to identify your sleep habits and patterns that you can share with your doctor
  • The prevalence of insomnia is higher among older people and women. Women suffer loss of sleep in connection with menstruation, pregnancy, and menopause. Rates of insomnia increase as a function of age but most often the sleep disturbance is attributable to some other medical condition.
  • Some medications can lead to insomnia, including those taken for:

o   colds and allergies

o   high blood pressure

o   heart disease

o   thyroid disease

o   birth control

o   asthma

o   pain medications

o   depression (especially SSRI antidepressants)

  • Some common sleep disorders such as restless legs syndrome and sleep apnea can also lead to insomnia.
  • Sleep is as essential as diet and exercise. Inadequate sleep can result in fatigue, depression, concentration problems, illness and injury.

nih logoNational Institutes of Health- (NIH) supported research is shedding light on how sleep and lack of sleep affect the human body. The NIH and its partners will continue to work together to advance sleep research. Read the full fact sheet…

Insomnia Clinical Trials  Clinical trials are research studies that explore whether a medical strategy, treatment, or device is safe and effective for humans. To find clinical trials that are currently underway for Insomnia, visitwww.clinicaltrials.gov.

PLEASE SHARE THIS BLOG ANYWHERE YOU THINK IT WILL HELP SOMEONE.  ATTRIBUTION APPRECIATED  –PERMISSION NOT REQUIRED. 

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Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, GIF shot bob by TVthe founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Retirement Means You Quit Working — Not Living.


By Bob Aronson

“Working people have a lot of bad habits, but the worst of these is work.” 

Clarence Darrow

Preparation for old age should begin not later than one’s teens.  A life which is empty of purpose until 65 will not suddenly become filled on retirement.

Dwight L. Moody

Retirement: It’s nice to get out of the rat race, but you have to learn to get along with less cheese.

Gene Perret

 pot gardenHow many times have you heard about “Uncle Joe” who retired from his 50 year long career to a recliner chair and died an unhappy man?   That story is all too common and totally unnecessary.  Take  it from this 75 year old retired guy who is busier and happier than at any other time of my life.

At some point all of us retire from our chosen profession or trade and you should know early on that retirement from a job does not mean retirement from life.  Frankly, retirement should mean new opportunities and exciting new experiences that serve to restore your old enthusiasm for life.  Retirement is not a sentence it is a destination and you can write your own ticket.

Often retirement is not by choice but by necessity.  In my case the need for a heart transplant made it a necessity, but so what?  While everyone knows they will retire few are ready for it.  Retirement is a drastic change in lifestyle, one in which you have to change some major habits and behaviors and learn new ones.

Prior to retirement I was a communications consultant who traveled a great deal. I absolutely loved mrunning through airportsy work.  I trained and coached executives, was a frequent keynote speaker at conventions and wrote extensively about communication.  My days started at 5 AM and often didn’t end until midnight.  I had a closet full of suits, ties and freshly pressed shirts and rarely wore anything else, there wasn’t time.

When I retired all of that came to a sudden and screeching halt and the shock was as intense as if I had been shot head first from a cannon into a brick wall target.  I was used to getting up and meeting with the captains of industry, but now in retirement I got up to Captain Crunch and an empty day.  I knew for a very long time, 12 years to be exact, that this day would come.  I had been told I would need a heart transplant and would get weaker and weaker until I got one.  The prediction came true in 2006.  Reluctantly I retired and late that year we moved from Eagan, Minnesota (a twin cities suburb) to Jacksonville, Florida because the Mayo clinic there had a great record of obtaining transplantable organs.

My first rescue from boredom came two months after I got a new heart from the very people who had saved my life, the Mayo Clinic.  One of my Mayo friends called to ask if I would like to write a blog (this one, Bob’s Newheart) and start a Facebook group with a focus on organ donation and transplantation (Organ Transplant Initiative).  This required some learning because I knew nothing about social media or blogging.  Both were in their infancy.  I dove headfirst into cyberspace and found it fascinating and fun because it called upon many of my old skills.

Manother booth shoty second rescuer was my wife Robin.  She ran two businesses out of our home one of them was
designing and making anodized aluminum jewelry.  She sold her colorful creations at art shows all over the south, and southeastern U.S.  In order to do that she not only needed a tent but the furnishings, too.  Items like display cases, necks for necklaces, pedestals, pictures and frames, and other items used to display her work are necessities and can be expensive.  She knew I had an interest in woodwork so she asked if I’d like to build some of those things.

“Oh fun,” was my first thought, but I had few tools.  Slowly and with great deliberation I built a woodworking shop and began to build what she needed to furnish her booth.  It became a never ending job because as styles and tastes changed so did the need for new and different furnishings.

That takes me to today.  This blog, Bob’s Newheart, is my 222nd since November 3, 2007 and the Facebook group, Organ Transplant Initiative (OTI) now has nearly 4,000 members.  I have branched out in the woodworking department as well and have built a number of items for gifts for friends and family.  When I am not at my keyboard I am In my shop and have found that I am at least as busy now as I was when working and even happier.

So I got lucky, I stumbled into avocations that interested me and kept me busy to the point where I don’t miss the job from which I retired at all.  Now…what should you do?  How do you keep your mind and body active and engaged and avoid all the fears every spouse or partner has about retirement?  How do you avoid becoming a couch potato,couch potato 2 the stereotypical old person who sits in front of the TV all day eating unhealthy food and feeling sorry for him (her) self?  It’s really pretty easy and I can sum it up in one word –planning, but you have to do it now!  Check out this link. “http://health.howstuffworks.com/wellness/aging/retirement/10-tips-for-adjusting-to-retirement.htm

Whether you retire through necessity or choice you will retire and, as I said earlier, it can be a major shock to the system. Going from working a full-time job to having nowhere specific that you “have” to be each day may sound wonderful but it doesn’t always work out that way.  Some retired people feel bored and unproductive and when that happens, the days can seem endlessly long and empty. It doesn’t have to be that way.

Options for Action

Teaching

senior citizen teacherHave you considered teaching?  Even if that wasn’t your profession, it’s still something that you can do when you retire.  Teaching others what you’ve learned in the years spent in your chosen trade or profession can be very rewarding and some colleges and technical schools like to employ people with real-world experience.  You will also find that some companies employ speakers to share their knowledge and often those engagements result in contracts for more speeches or even training sessions.

 Speaking and/or Training

Speaking and training could be a paying gig, or you could do it simply for the joy of helping others.  One organization that might be of help is SCORE, the Service Corps of Retired Executives. SCORE bills itself as “counselors to America’s small business.”   Volunteers with the organization mentor small business owners, provide counseling, create and lead workshops, and write articles.

Move to an exotic location

I have a friend and former boss, Rick Lewis, who retired big time.  He moved to Cotacachi, Ecuador.
He sold almost all his earthly possessions and took with him only what he could carry, which wasn’t muc13654641373_736dfa7d31_nh.  He lives in the shadow of some beautiful mountains.  He walks everywhere, has lost a some extra pounds, buys food at open air markets at wonderfully low prices, has a much healthier diet, writes blogs about his experience and started a company that will help South American women be more independent.  He travels extensively and is enjoying life to the fullest and  while he has access to all the modern conveniences he uses few other than his computer and cell phone.

Go Back to School

I am convinced that to really enjoy your retirement years you must keep your brain actively engaged and what better for that than the learning environment.  Taking classes ins something that interests you can keep your mind razor sharp but even more importantly it could give you the opportunity to learn more about a lifelong passion, or the start of aSenior studentnother career.  Maybe you wanted to play a musical instrument or learn woodwork or how to write a book…the possibilities are endless.

Best of all…you can go to school again at little or no cost.  There are grants and scholarships available y for senior citizens to attend college but often you don’t even need them.  Some colleges, universities and trade schools provide tuition waivers or discounts for seniors.

And…you can always audit a class, if you have no interest in getting a degree.   Auditing simply means that you attend and participate in the classes, but don’t take exams or receive a grade or credit for taking the class.  Check with the college or university of your choice.  You likely will find several Audit opportunities.

Hobbies

ow about a hobby? Yeah, I know everyone who counsels retirees says the same thing, “Get a hobby,” but it is good advice.  When I was a kid I used to play the harmonica.  At age 70 I took it up again.  Robin is already an accomplished musician and we often practice together.  Better yet, we are now involved in a once a week local jam session and my hobby has morphed into ownership of 15 harmonicas.

If you are at a loss as to what kind of hobby suits you, don’t give up. Keep looking.  Hobby and craft stores conduct free or inexpensive classes in knitting, scrapbooking, leatherwork, jewelry making and more.  You’ll also fin
harmonica collectiond that places like Home Depot and Lowes have classes in carpentry and other woodwork skills along with instruction on gardening.  Stores that sell kitchenware often have cooking classes.  There’s no end to what you can learn, but you have to look.  . Maybe you don’t want to learn how to do anything, but you’re interested in starting a collection. Whether you want to collect autographs or antique dolls, there are plenty of online groups and forums dedicated to your new hobby. Some of them meet in person or even hold conventions. No matter what your interest, you can find others out there with whom to discuss it.

Ok..you don’t want to take classes, free or not,  you just want a hobby that’s fun.  How about starting a collection?  As a youngster I always carried a pocket knife, they can come in very handy for a whole lot of reasons.  I remember, too, seeing a movie starring Allan Ladd called, “The Iron Mistress.”  It was about Jim Bowie of frontier and Alamo fame and how he developed the Bowie Knife.  Ever since then I wanted one of them.  At age 72 I started a knife collection (you can get some very nice knives at a very low cost through Amazon and other internet sites).  Today I have seven fixed blade knives (variations on the Bowie theme) and ten folding pocket knives.

Volunteer

aliensThen there is Volunteering.    God knows we need volunteers in almost any pursuit.  The University of Michigan conducted a study of retirees who were active volunteers and found that 40 percent were more likely to be alive at the end of the study than people who did not volunteer. [Wheeler]. If that isnt’ reason to consider volunteering for something I don’t know what is and — it keeps you moving and engaged.

Other volunteer opportunities include, helping out at local schools, animal shelters, museums and churches.  And…the area in which you can likely land a volunteer job right way…HealthCare.  Hospitals and nursing homes always need volunteers and you could be in on the ground floor of making a significant contribution  in those two areas alone.

I know, too, that there are organizations that specifically recruit senior citizens, such as Senior Corps where the Foster Grandparents program matches exceptional children with adults ages 60 and older who mentor them and help them with reading and schoolwork.  Talk about a rewarding experience…that one alone could give your ego a much needed boost.

Travel

If you like to travel and see the country consider an RV, the come in a wide variety of shapes and sizes from trailers to bus2012 traceres and in every price range.  We own a 30 foot travel trailer so when we go to art shows (we do about 20 a year) we bring our home and our dogs with us.  Of course that means you have to do some serious research into how you want to use your RV.  This can be a major purchase and it pays to take your time and thoroughly investigate every angle.  We love our RV and are old hands at it now and can highly recommend it if you like to travel, meet new people and live, “on the road.”

Become an employee again

Yep…that’s another term for work.  Maybe you need it so keep the door open to returning to the world of the retired but employed ranks.  It doesn’t have to be a full time job and it doesn’t have to be as a Wal Mart Greeter, although there is nothing wrong with that.  I have a 75 year old friend who works part time at a Menards store.  Menards is a Home Depot type story in the Midwest and they employ a good many senior citizens as do many companies. Here are some ideas on what you could do:

  • Hire out as a consultant on based on the expertise you gained while employed
  • Do research in your field for colleges and universities
  • Check city, county, state and federal government listings for openings that might appeal to you
  • Maybe you only want money for special occasions if so try seasonal work.  Companies are always seeking help during holiday seasons.
  • Entertainment venues like ball parks and theaters may need ushers to lead patrons to their seats
  • Customer service reps.  You could get a job answering the phone, working in sales or returns or even store security.
  • If you are handy with tools and can fix things around your home perhaps you can hire out as a handyman or woman on specific projects.
  • Tutor a student.  The money may not be great but there is some to be made tutoring both college and high school students.
  • Make things at home and sell them on line through Craigs list or by opening your own website.
  • Home care.  If you have some medical or therapy credentials you might quality to help care for either an adult or a child in their home
  • If you have bookkeeping or accounting skills many a small business could use you and chances are you could work from home.
  • Clerical work. If you can type and if you are computer literate you might get a part or full time job doing just that.

Essential skills.  

computerIt’s the 21st century and almost any job you take on is going to require computer literacy.  If you don’t know how to type it would be to your advantage to take a typing class and to learn basic word processing and even PowerPoint.

There is virtually no job anywhere today that is not going to require some computer skills so if volunteering or becoming employed again is an option you want to consider then by all means brush up on your computer and typing skills.

Mental and Physical Health

So far we’ve talked about what you can do to keep from being bored and to feel as though you have some value.  What’s missing from this blog, though, is how you take care of your health.  That issue beings with a word few like — Exercise.

No matter what the state of your health you must find ways to be active and to exercise.  Health expenses can be not only a huge financial burden, they can destroy your quality of life.  There are two kinds of exercise I recommend. One is mental and the other is physical.   You should read, research and write as often as possible and social media offers incredible opportunity to do all of that. Even games of solitaire or crossword puzzles can keep you mentally engaged and fit.

When it comes to physical exercise it is important to do what you can when you can.  A brisk walk every
day can do wonders for you and if that sounds boring, try Mall walking where at least you will see other people and iPeople walkingnteresting displays in stores and in the hallways.  If you play golf or tennis all the better, but any kind of activity that will exercise your muscles and elevate your heartbeat and respiration is good for you.

Remember above all else that you have great value.  Your years of service have given you invaluable experience from which others can learn.  Studies indicate that the years beyond midlife are one of life’s most creative, innovative and entrepreneurial periods for many and that us older people can be incredibly creative when given the opportunity. Check out this link for more information.

http://www.usatoday.com/story/money/personalfinance/2013/10/22/preparing-mentally-retirement/2885187/

When I was working I believed I had a mission and a purpose for being and that feeling was reinforced daily by clients who continued to hire me for my advice.  My fear was that upon retirement I would no longer have a purpose and that I would become irrelevant.  Well, that’s possible if you only think of yourself in terms of what you used to do, but what if you change the paradigm?  For example, I am no longer a communication consultant. I am an advocate for organ donation and transplantation and that has become my new relevancy, my new purpose and my new identity.  More and more there are people who know me for my new purpose and know nothing about what I used to be and do.  That’s an old life and frankly, I don’t miss it at all.

Relationships
Finally, the most important consideration of all, your relationship with your spouse or significant other.  Many of us who have worked outside the home for an entire lifetime are a pain in the butt when we are home all the time.  Our life partners aren’t used to it either and both have to make a concerted effort to work on strengthening this new retured couplerelationship.  In my case Robin has her business and I do what I can to help her, but otherwise am pretty much involved in my own activities.  We enjoy each other a great deal and often plan outings or dates when we can spend time together talking about and doing things unrelated to business or hobbies.

Retirement can be very rewarding, if you plan for it, but if you view retirement as the end of life you will be in for a miserable time because it can be the beginning and it should be.  It’s all in your attitude.  You can choose to quit or you can choose to explore new frontiers.  I am not a quitter and I’ll be most of you aren’t either and if that’s the case…get out and find those new frontiers.

Last Resorts

And….if all else fails try some of these:

  • Make a bucket list and start doing all the things on it
  • Make bird houses
  • Become a master gardener
  • Become an expert Starcraft player
  • Sail, backpack, walk[1] or cycle around the world[2]
  • Enter ham radio competitions (contact every state, etc.)
  • Read trashy novels
  • Have a lot of sex while your body is still in full working order
  • Fix up cars or motorcycles
  • Build a boat
  • Build a log cabin
  • Research your family tree
  • Watch birds
  • Amateur astronomy
  • Finally get adequate sleep
  • Become as healthy as possible
  • Save the world
  • Rebuild civilization from scratch
  • Live very well without money for a year
  • Go to the top of a high building and throw away $100.000
  • Burn $100.000 on a public place
  • Spend the last day in the job speaking all the truth to clients

You can find more here http://earlyretirementextreme.com/wiki/index.php?title=Long_list_of_things_to_do_when_you_retire

I always try to practice what I preach so let me recap where I am today at age 75 after a career that I absolutely loved.  My life has changed completely and I love every minute of it.  I am not only not bored, I don’t have time to be bored.  I am having too much fun doing the following:

  1. I took up the harmonica after a 60 year hiatus from it.  Now I own 15 of them and once a week my the Fig Newtonswife and I play in an old time music jam session.  Robin plays several instruments and often we spend an evening playing together.
  2. Woodwork. I’ve always loved working with wood but never had time.  Now I make fixtures and furnishings for Robin’s Art show booth.  I make jewelry boxes for friends and family, front with keyboard and buttonsand recently completed making a CD storage unit that looks like an accordion.
  3. Social media.  As you know I started and run Facebook’s nearly 4,000 member Organ Transplant Initiative group (OTI) and recently wrote my 223rd blog on Bob’s Newheart for WordPress.
  4. I am in the process of writing two books.  One is just a look at life from my earliest memories until now .  So far I have written about 145 pages, and that only got me to when I was 23 years old.  There’s a lot more to write.  The other book is fiction, it is about the first Hispanic President of the United States and the challenges he faces.  It’s part SCI FI, part  James Bond type action and heavy on political intrigue.
  5. I do the grocery shopping, some cooking a little housework and very little sitting.
  6. We travel the country going to art shows in which Robin sells he Jewelry creations.

I think you can tell, by that list that at age 75 I am a very busy guy.  Rarely do I sit still for long.  I absolutely refuse to be bored.  I think I lead a rather exciting life and I’m enjoying every moment of it.  You can do the same.  Retirement can be like being born again because it is what you make it.

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My new hat April 10 2014Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

 

From a Medical Nightmare to a New Life –The Curt Green Story


curt greenIntroduction by Bob Aronson

Story by Curt Green

 inspirational quoteIntroduction

This is the first in a series of blogs about people with the Helen Keller, Jesse Owens spirit.  Let me explain.  Some people inspire us to soar to great heights because they did.  Some people see adversity as a speed bump and confidently roll over it.  Some people are “unsinkable” and bounce back no matter what.  This is the first in a series of blogs about ordinary people who do just that.

I was inspired to write these blogs by two of my personal heroes, Helen Keller and Jesse Owens.  If you are not familiar with these names here are some very brief bios.

Helen Keller

helen kellerHelen would not be bound by conditions. She became deaf and blind before she turned two as the result of scarlet fever.  She learned to read (in several languages) and even speak, eventually graduating with honors from Radcliffe College in 1904. It is remarkable that she accomplished any of this in an age when few women attended college and the disabled were often hidden and spoken of only in hushed tones.

 Keller’s many other achievements are impressive by any standard:

hellen Keller with President Eisenhower she authored 13 books, wrote countless articles, and devoted her life to social reform. She lectured on behalf of disabled people everywhere. She also helped start several foundations that continue to improve the lives of the deaf and blind around the world.  She is remembered for a great many pieces of wisdom but this is my personal favorite:

“Although the world is full of suffering, it is full also of the overcoming of it. My optimism, then, does not rest on the absence of evil, but on a glad belief in the preponderance of good and a willing effort always to cooperate with the good, that it may prevail.” – Helen Keller

Jesse Owens

Jesse owens runningJesse was an athlete, a black athlete and a very special one. His performance on a spring afternoon in 1936 was beyond unbelievable.  In 45 minutes, he established three world records and tied another, but what made the accomplishment special, extra special is that he did it in Nazi Germany before a regime of white supremacists.    

Jesse Owen’s story transcended athletics. Berlin, on the verge of World War II, was Jesse Owensbristling with Nazism, red-and-black swastikas were flying everywhere while Adolf Hitler was busy haranguing about the “unbeatable master race” of blond, blue eyed Aryans. 

When Owens finished competing, the African-American son of a sharecropper and the grandson of slaves had single-handedly crushed Hitler’s myth of Aryan supremacy.  On the sacred soil of the Nazi Fatherland he humiliated the so-called master race by winning four, count ‘em, four gold medals.  Hitler, left the stadium. 

I never met Helen Keller but I had the distinct pleasure and honor of meeting and interviewing Jesse Owens when I was a young radio announcer in 1961.  I got his autograph for my brother who treasures it to this day.  Owens lived by a very simple motto, “One chance is all you need!”

Our Keller/Owens courage series will focus on people, just ordinary people who have managed to survive and win under amazingly adverse circumstances

Curt Green.

Ocurt greenur first story is about Curt Green.  I met Curt as the result of a long and thoughtful comment he made about one of my Bob’s Newheart blogs.  His words  were insightful, compelling and inspirational.  Those same terms describe his story, one that truly is in the Keller/Owens spirit .

  

Whenever I find myself overwhelmed, depressed or in need of a motivational kick in the pants, I think about Curt’s incredible journey, his undying faith and his commitment to “Paying it forward.”

 Curt Green is a very special man and I am honored to call him a friend.  Thank you Curt for  taking the time to write your story.  It will serve to inspire others for a very long time.   

The Sandwich

In September of 2005 at age 44 I was working for Schwans as a route manager (The Schwan Food Company is a multi-billion dollar privately owned company with 15,000 employees.  They sell frozen foods from home delivery trucks, in grocery store freezers, by mail, and to the food service industry). My work days where long and it was usually after 11 P.M. when I got home feeling both tired and hungry.   On this particular evening I didn’t feel like cooking so before I went to bed I p b and j sandwichhad a plain old peanut butter and jelly sandwich.  While that may sound pretty bland and harmless it turned out to be anything, but. To say it didn’t’ sit well would be putting it mildly.  It wasn’t long after I ate it that something in that sandwich triggered a gall bladder attack.  Despite experiencing significant discomfort I managed to find my way to the Emergency Room in a Fairmont, Minnesota hospital.

On arrival they took X-rays and decided I needed care they could not provide so they wheeled me into an ambulance and sent me to the famed Mayo Clinic in Rochester, Minnesota.  The highway the ambulance used to get me to Rochester was not in good Mayo clinic Rochester, Minnesota gonda bldngcondition so the 120 mile ride which took about two hours was rough and uncomfortable. Finally, though, at 5 AM the next morning I was admitted to Mayo’s St. Mary’s hospital.

The Problem

The Mayo doctors wasted no time and after some tests to determine the severity of my condition and to locate the gall stones, they did an ERCP (Endoscopic retrograde cholangiopancreatography). ERCP is an x-ray exam of the bile ducts that is aided by a video endoscope which allows the physician to view the inside of the stomach and duodenum, and inject dyes that can be seen on x-rays.   The lighted probe that goes down your throat has a tiny claw at the end that allows them to open the passageway and let any gall stones pass.

Complications

It all seemed to go well but there was a complication.  The surgeons didn’t know until later that my intestine was punctured during the procedure and that’s where my long journey began — instead of a normal recovery from a routine surgery my condition worsened.  I spiked a fever and kept getting sicker, so sick that my kidneys shut down.  That’s when they had to take drastic measures to save my life.  What started as a simple gall stone attack had now turned into a life threatening situation.  I can only thank God I was at Mayo where they are well equipped to handle such an emergency.  It was going to be 207 days before I was released from the hospital.  That simple peanut butter and jelly sandwich changed my life and almost ended it.

In order to keep me comfortable yet treat me effectively and remove the infection physicians put me in a drug induced Patient in ICucoma which lasted 21 days into October.  While comatose they opened my abdominal cavity and washed out handfuls of dead, blackened fat. This procedure helps to ensure the removal of the infections, something they had to do seven times over the course of the month.  Naturally I remember none of it.  As part of my recovery the Mayo Doctors then placed me in a special bed that would rock me gently back and forth so that no fluids would settle in my body, but even with that extraordinary step my hands and head swelled to almost twice their normal size.

When I finally awakened I had over 12 tubes coming out of my stomach which were not only for drainage but also for feeding and other healing purposes.  In the middle of my stomach there was a very large 9 inch diameter hernia.  For three months I was unable to drink anything and could not eat for six months.

Studies indicate that being immobilized for long periods has a very negative effect.  It is estimated that we can lose 10 to 20 percent of our muscle strength per week in bed so upon awakening from the coma I found that the combination of immobilization and the surgery left me so weak walking was almost impossible. Because of all the drainage and feeding tubes, I was forced to lie on my back for the first 2 months. Three times a week, they would wheel me down to the dialysis unit to undergo the cleansing process.  It was their hope that my kidneys would be able to bounce back from the trauma, but as time went on and despite the best efforts of the Mayo team, the possibility of this happening decreased. We still had a long, long way to go before I would walk out of the hospital and return to anything that even remotely resembled a normal life.

Probably the scariest time for me was in early March of 06, I had a blood clot pass through my lungs and I could not catch my breath. Not being able to breathe is very frightening, I was gasping for air while the medical team worked feverishly to get it under control.  It took a couple of hours, but finally they were able to transfer me to an Intensive Care Unit (ICU).  At the same time I had a skin graft done for my hernia that developed during the two weeks following the initial surgery.

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Yale, South Dakota jpegI was in the hospital for 207 days or 7 months when I was finally discharged on April 23, 2006. Weak, and unable to care for myself I went to Yale, South Dakota to live with my parents and try to recover. They estimate that for every day you are in the hospital, it takes 3 days to recover.

.I had a long road ahead, my kidneys were still not functioning properly and never would. I started dialysis in Huron, S.D and made 3 trips a week to the dialysis unit there on Tuesday, Thursday, and Saturday.

Dialysis

Dialysis is a procedure of cleaning the blood and taking out excess fluids since the kidney cannot produce urine. dialysisOnce connected to the machine it takes about four and a half hours for the cleansing process to be completed.  The procedure leaves you drained of energy so for all practical purposes it results in a lost day.

If you are on dialysis your liquid intake is very limited and almost impossible to follow. It is recommended that you consume less than 50 ounces between treatments. I had great difficulty with that limitation so they would have to remove 10 to 12 pounds of fluid with each treatment and that’s a problem because too much liquid represents a danger to the heart.

I was also limited in what I could eat since the kidney works at balancing potassium and phosphorous in the body. Too much potassium could cause a heart attack, therefore, it was recommended that I not eat potatoes, tomato products, or any dairy products.

From May of 2006 to October of 2007, I went to Avera McKennan hospital in Sioux Falls, South Dakota ten times because the vein in my arm kept narrowing and the blood could not return to it causing extreme swelling.  With the exception of being admitted to the hospital just once all of the trips involved outpatient surgery to correct the swelling.  Finally they put in a stent which solved the problem.

In March of 2007 I saw Dr. Fred Harris in Sioux Falls who did a masterful job of fixing the hernia in my stomach. Although the surgery was a success, infection kept me in the hospital for two weeks. I also had a new dialysis catheter put in, a fistula (the Medline Encyclopedia defines fistula as an abnormal connection between an organ, vessel, or intestine and another structure). In my case the fistula was combining a vein and an artery in my arm to allow the dialysis needle to enter and function properly.  Without the fistula the vein would collapse.

Kidney Transplant

During this time it was a matter of recovery and being evaluated for a kidney transplant so I could be placed on the national transplant list. I had decided to have the transplant done in Sioux Falls where I lived only because it was close.  While I was excited about getting on the list I was not optimistic about getting an organ.  The fact is, I really had little hope of getting a kidney because my blood type, which is O, is quite common and that means kidneys of that type are in greatest demand. The doctors told me that it would be at least a 5 year wait.  When I asked what the average life span of someone on dialysis, they said 5 years. So, I just resigned myself to thinking that dialysis would be a part of my life until I die.

Kidney transplantThen in 2008 a miracle happened.  A friend of the family came forward in January and offered to donate a kidney. This is so much better than a kidney from a deceased patient because they last much longer.

My donor Joey Bich (pronounced Bish) wanted to have it done at Mayo In Rochester so that’s where I went for my evaluation in June.  Finally I knew beyond a doubt that the transplant would be a reality, it was really going to happen.  Dialysis was going to end and I had a shot at a normal life again.  And…I was very happy with the decision to go to Mayo because of their experience.  They average a transplant every day.   Joey and I were approved and the transplant date of July 25, 2008 was set.

Remnants of that black cloud that followed me around for moths after the PB and J sandwich still appeared, though.  It seems as though when it comes to things medical issues, complications are a fact of life for me.  While the transplant was successful, it was not without a hitch.  What is normally a two-hour surgical procedure that some surgeons are now calling “Routine surgery” was for me an 11 hour ordeal because there was so much scar tissue on the right side of my abdomen.  As a result they had to put the kidney on the left side. My doctor told me in confidence later that he was about ready to give up, obviously he didn’t, but it still wasn’t’ over.  A day later they had to open me up again because there was a leak in one of my bowels. They fixed it but my recovery was delayed by about a month. I left the hospital on August 11 and had to stay in a motel till September 10 for checkups. Then I was free to go home.

Good news…It looks like the bad news stopped.  Since being discharged for the final time my future has been wide open and bright.  Now I can drink as much as I want and eat what I like without fear or worry. I can travel for longer than a day and am free now to live like a normal human again, just as I did before that fateful PB and J sandwich.  I have a life again and all because someone was brave, kind and generous enough to give up one of his kidneys.  Thank you Joey…thank you.

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Curt was featured in a news report that you can watch on YouTube.  It is called “Three year detour” and there is the link. http://www.youtube.com/watch?v=ZAVFh2vcG2Y

If you would like Curt to speak to your group, you can contact him here. curtgreenspeaks@yahoo.com

About Curt Green. 

He describes his life this way:

“Right now, I live in Sioux City, Iowa and work a couple of part-time jobs. My hobby is being a baseball fan but my main focus is doing anything I can to promote organ donation. I speak at high schools maybe 5 to 10 times a year, visit my local dialysis unit to bring hope to those still hooked to a machine, and am involved with a new non-profit group called Doug’s Donors who mission is to assist those on dialysis in getting on a transplant list.

I have 3 daughters and 2 sons with a daughter in North Carolina, my oldest son in Minnesota, my next son and youngest daughter in Sioux City with me and my other daughter studying to be a Vet Tech in Rochester, MN

Curt Green is a very honest and straightforward man.  When I asked him about his faith and how prayer helped him in his recovery he said, “One thing I learned is that when I was sick and hurting, I could not focus enough to pray. That is when I learned the importance of people praying for me.  I really so believe this is the cause of my recovery. Now when in church, I take it very seriously when prayers for others are requested.”

My faith plays a big part in my life as it guides and directs me on how I live. Not perfectly but progressively. There is a verse in the Bible that I feel describes my life today. It is Joel 2:25. “I will repay you for the years the locusts have eaten…” These were God’s words to the Jews through the prophet Joel. God had punished them for their disobedience and yet, in the midst of it, he offers his grace. God has been showing me his grace all along but now I can see it. He has restored unto me the years the locusts have eaten and continues to do so.

One verse that I have on my white board is Romans 12:12 “ Be joyful in hope, patient in affliction, faithful in prayer.”  Also, my sister put this saying on the board, “Everything will be alright in the end, and if it is not alright, it’s not the end.”  That really spoke to me and I still tear up when I read it.”

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My new hat April 10 2014Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

50 Inspirational Quotes About Kindness, Courage and Compassion


Introduction by Bob Aronson

(Attribution is given with each quote)

Scartoonometimes the saying the right thing in the right tone at the right time can have a powerful impact, but often search as we may, we cannot find the right words within us.  That is when the search area must be expanded to those who may have had similar experiences, but also the time to weigh and articulate their thoughts — thoughts that clearly express your feelings.  While ironic, it is also a fact of life that often those most quoted are those who quote most often.  

There is no harm done in quoting others to help you make your point,.  There is only good to be found when the well considered words of another help you to find peace and give comfort.  It is in that spirit that we offer this collection of inspirational quotes about Kindness, Courage and Compassion.  They are among my favorites.  I hope you like them, too.

 

Be kind, for everyone you meet is fighting a harder battle.”
― Plato

 

“Dare to Be

When a new day begins, dare to smile gratefully.

When there is darkness, dare to be the first to shine a light.

When there is injustice, dare to be the first to condemn it.

When something seems difficult, dare to do it anyway.

When life seems to beat you down, dare to fight back.

When there seems to be no hope, dare to find some.

When you’re feeling tired, dare to keep going.

When times are tough, dare to be tougher.Dare to be different

When love hurts you, dare to love again.

When someone is hurting, dare to help them heal.

When another is lost, dare to help them find the way.

When a friend falls, dare to be the first to extend a hand.

When you cross paths with another, dare to make them smile.

When you feel great, dare to help someone else feel great too.

When the day has ended, dare to feel as you’ve done your best.

Dare to be the best you can –At all times, Dare to be!”

― Steve MaraboliLife, the Truth, and Being Free

 

 “If we have no peace, it is because we have forgotten that we belong to each other.” ― Mother Teresa

 

giving“No one has ever become poor by giving.” ― Anne Frankdiary of Anne Frank

 

 Love and compassion are necessities, not luxuries. Without them, humanity cannot survive.” ― Dalai Lama XIVThe Art of Happiness

 

“for there is nothing heavier than compassion. Not even one’s own pain weighs so heavy as the pain one feels with someone, for someone, a pain intensified by the imagination and prolonged by a hundred echoes.” ― Milan KunderaThe Unbearable Lightness of Being

 

“In the end, though, maybe we must all give up trying to pay back the people in this world who sustain our lives. In the end, maybe it’s wiser to surrender before the miraculous scope of human generosity and to just keep saying thank you, forever and sincerely, for as long as we have voices.”  ― Elizabeth GilbertEat, Pray, Love: One Woman’s Search for Everything Across Italy, India and Indonesia

 

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.” ― Leo Buscaglia

 

“Remember, if you ever need a helping hand, it’s at the end of your arm, as you get older, remember you have another hand: The first is to help yourself, the second is to help others.” ― Sam Levenson

 

 

Courage is not the absence of fear, but rather the judgement that
something else is more important than fear.”   Ambrose Redmoon

 

“A ship is safe in harbor, but that’s not what ships are for.”  William G.T. Shedd

 

“Life shrinks or expands in proportion to one’s courage.”   Anaïs Nin

 

“Courage is resistance to fear, mastery of fear – not absence of fear.”   Mark Twain

 

“Freedom lies in being bold.”   Robert Frost

 

“For me, I am driven by two main philosophies: know more today about the world than I knew yesterday and lessen the suffering of others. You’d be surprised how far that gets you.”  ― Neil deGrasse Tyson

 

“We must learn to regard people less in the light of what they do or omit to do, and more in the light of what they suffer.” ― Dietrich BonhoefferLetters and Papers from Prison

 

 “The lotus is the most beautiful flower, whose petals open one by one. But it will only grow in the mud. In order to grow and gain wisdom, first you must have the mud — the obstacles of life and its suffering. … The mud speaks of the common ground that humans share, no matterlotus what our stations in life. … Whether we have it all or we have nothing, we are all faced with the same obstacles: sadness, loss, illness, dying and death. If we are to strive as human beings to gain more wisdom, more kindness and more compassion, we must have the intention to grow as a lotus and open each petal one by one. ”  ― Goldie Hawn

 

“How much can we ever know about the love and pain in another heart? How much can we hope to understand those who have suffered deeper anguish, greater deprivation, and more crushing disappointments than we ourselves have known?” ― Orhan PamukSnow

 

“When I give food to the poor, they call me a saint. When I ask why the poor have no food, they call me a communist.” ― Hélder CâmaraDom Helder Camara: Essential Writings

 

 “Some people think only intellect counts: knowing how to solve problems, knowing how to get by, knowing how to identify an advantage and seize it. But the functions of intellect are insufficient without courage, love, friendship, compassion, and empathy.” ― Dean Koontz

 

“True compassion is more than flinging a coin to a beggar; it comes to see that an edifice which produces beggars needs restructuring. ” ― Martin Luther King Jr.

 

“Love is not patronizing and charity isn’t about pity, it is about love. Charity and love are the same — with charity you give love, so don’t just give money but reach out your hand instead.”  ― Mother Teresa

 

“You have not lived today until you have done something for someone who can never repay you.”  ― John Bunyan

 

Let us not underestimate how hard it is to be compassionate. Compassion is hard because it requires the inner disposition to go with others to place where they are weak, vulnerable, lonely, and broken. But this is not our spontaneous response to suffering. What we desire most is to do away with suffering by fleeing from it or finding a quick cure for it.” ― Henri J.M. Nouwen

 

“The thought manifests the word

The word manifests the deed;

The deed develops into habit;
And habit hardens into character;
So watch the thought and its ways with care,
And let them spring forth from love
Born out of compassion for all beings.
As the shadow follows the body, as we think, so we become.”
― Juan Mascaró

 

  Do not oppress the widow, the fatherless, the sojourner,  or the poor, and  let none of you devise evil against another in your heart.  echariah 7:10

 

“The only time you look in your neighbor’s bowl is to make sure that they have enough. You don’t look in your neighbor’s bowl to see if you have as much as them.”  ― Louis C.K.

 

“Protect your enthusiasm from the negativity and fear of others. Never decide to do nothing just because you can only do little. Do what you can. You would be surprised at what “little” acts have done for our world.”  ― Steve Maraboli

 

When asked what was the greatest commandment, Jesus responded that it is to love God with all our heart, mind and strength. But He added that the second commandment “is like it: ‘Love your neighbor as yourself’” (Matthew 22:34-40). The Pharisee had asked Him which single command of God is the greatest, but Jesus provided two, stating not only what we are to do, but also how to do it. To love our neighbor as ourselves is the natural result of our loving devotion toward God.

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“The nature of compassion isn’t coming to terms with your own suffering and applying it to others: It’s knowing that other folks around you suffer and, no matter what happens to you, no matter how lucky or unlucky you are, they keep suffering. And if you can do something about that, then you do it, and you do it without whining or waving your own fuckin’ cross for the world to see. You do it because it’s the right thing to do.”  ― John ConnollyDark Hollow

 

“Be kind to people whether they deserve your kindness or not. If your kindness reaches the deserving good for you if your kindness reaches the undeserving take joy in your compassion.”
― James FadimanEssential Sufism

 

“[The] insistence on the absolutely indiscriminate nature of compassion within the Kingdom is the dominant perspective of almost all of Jesus’ teaching.
What is indiscriminate compassion? ‘Take a look at a rose. Is is possible for the rose to say, “I’ll compassionoffer my fragrance to good people and withhold it from bad people”? Or can you imagine a lamp that withholds its rays from a wicked person who seeks to walk in its light? It could do that only be ceasing to be a lamp. And observe how helplessly and indiscriminately a tree gives its shade to everyone, good and bad, young and old, high and low; to animals and humans and every living creature — even to the one who seeks to cut it down. This is the first quality of compassion — its indiscriminate character.’ (Anthony DeMello, The Way to Love)…

 

 

What makes the Kingdom come is heartfelt compassion: a way of tenderness that knows no frontiers, no labels, no compartmentalizing, and no sectarian divisions.” ― Brennan ManningAbba’s Child: The Cry of the Heart for Intimate Belonging

 

“These things will destroy the human race: politics without principle, progress without compassion, wealth without work, learning without silence, religion without fearlessness, and worship without awareness.”  ― Anthony de Mello

 

“When morality comes up against profit, it is seldom that profit loses.” ― Shirley Chisholm

 

Enlightened leadership is spiritual if we understand spirituality not as some kind of religiou
Leaderships dogma or ideology but as the domain of awareness where we experience values like truth, goodness, beauty, love and compassion, and also intuition, creativity, insight and focused attention. Deepak Chopra

 

Never apologize for showing feeling, my friend. Remember that when you do so, you apologize for truth.   Benjamin Disraeli, in Contarini Fleming :

 

A good character is the best tombstone. Those who loved you and were helped by you will remember you when forget-me-nots have withered. Carve your name on hearts, not on marble. ~Charles H. Spurgeon

 

Never miss an opportunity to make others happy, even if you have to leave them alone in order to do it. ~Author Unknown

 

Don’t wait for people to be friendly, show them how. ~Author Unknown

 

You cannot do a kindness too soon, for you never know how soon it will be too late. ~Ralph Waldo Emerson

 

There’s a lot of not caring that goes under the name of minding your own business. ~Robert Brault, rbrault.blogspot.com

 

The only people with whom you should try to get even are those who have helped you. ~John E. Southard


bob magic kingdom
Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

THE PRICE WE PAY FOR THE HIGH COST OF ANTI-REJECTION DRUGS


dialysis scam cartoonIntroduction by Bob Aronson

Blog by James Myers

 James Myers lives in Indiana and is a member of Facebook’s Organ Transplant Initiative (OTI).  He suffers from End Stage Renal Disease (ESRD) or Kidney failure.  Jim is on dialysis and has been active locally and nationally in the effort to end the 36 month limit on Medicare coverage of anti-rejection drugs.  He is one of the 100,000 kidney patients on the national transplant wjames myersaiting list. Jim is a frequent thoughtful and valuable contributor to the discussions on OTI and we thank him profusely for writing the following blog. 

 

 

ARE DIALYSIS PATIENTS NOT SEEKING KIDNEY TRANSPLANTS BECAUSE ANTI-REJECTION DRUGS COST TOO MUCH?

 By James Myers

I guess the best place to start a blog about kidney disease is to explain what the kidneys do.  This graphic pretty much explains it.What do kidney's do graphic

Everyone is born with two kidneys, but we can survive with one if necessary.  Sometimes called “The Silent Epidemic” Kidney disease affects millions and threatens even more.   600,000 American citizens suffer from ESRD (End Stage Renal Disease) and kidney failure which leaves you with 3 choices: (1) dialysis; (2) a kidney transplant or (3) death. Kidney transplant recipients must take immunosuppressive drugs for the life of their transplant, or they risk losing their new organ. Medicare pays for the transplant and immunosuppressive drugs for 36

medicare logo 2months post-transplant unless beneficiary is Medicare-aged (65) or Medicare-disabled.   The Medicare (ESRD) program pays for dialysis or transplantation for over 600,000 kidney disease patients every year, regardless of age, and has saved millions of lives in the four decades since its enactment. After a transplant, recipients must take immunosuppressive drugs every day for the  rest of his or her life.   Failure to do so significantly increases the risk of organ rejection and therefore, death.   If you are covered by Medicare due to either age or disability and have a transplant your anti-rejection drugs are covered for life.kidney transplant  If you are not covered due to age or disability Medicare will still pay for your kidney transplant, but will only cover anti-rejection drugs for 36 months, then you are on your own.  this policy makes absolutely no sense because, ironically, Medicare will pay for a lifetime of dialysis which costs more and even more ironically, if you go into rejection because you can’t afford to buy the drugs that prevent it, Medicare will pay for another transplant and/or dialysis at costs that are many times that of the annual expense of immunosuppressant drugs.  This political slight of hand act not only wastes U.S. taxpayer dollars, it can actually cause death.

Here are some startling facts that make you wonder woman wired for carewhy congress refuses to make a common sense change.   When Medicare coverage ends after 36 months many transplant recipients have difficulty finding other coverage for their immunosuppressive drugs. Medicare spends around $90.000 per year for an individual who is on dialysis and $125,000 during the first year of a kidney transplant. However, after that first year the transplant patient’s drug costs plummet to $25,000 or a little over $2,000 a month.  Not many people have an easy time paying that bill but for the federal government it would be a cost saving measure to cover the drugs rather than pay for a new transplant or more dialysis.  Furthermore, extending mmunosuppressive  coverage beyond the 36-month post-transplant limit would improve outcomes and enable more kidney patients who lack adequate insurance to consider transplantation. Most transplant recipients also have a higher quality of life, and are more likely to return to work than dialysis patients, and if they return to work they again become taxpayers.

Currently, there is a bill pending in the U.S. senate (S. 323), “The Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act,” would extend Medicare Part B coverage for kidney transplant recipients for the purpose of immunosuppressive drugs only. All other Medicare coverage would end 3U.s. senate6 months after the transplant. Beneficiaries would be responsible for the appropriate portion of the Part B premium, as well as applicable deductible and coinsurance requirements. For patients who have another form of health insurance, Medicare would be the secondary payer. The bill also requires that group health plans currently providing coverage of immunosuppressive drugs for kidney transplant recipients maintain this coverage.

There is a corresponding bill in the U.S. House of Representatives (H.R. 1428): Comprehensive Immunosuppressive Drug Coverage for Kidney pay for the good news cartoonTransplant Patients Act.   The Senate version of the bill has been passed out of committee.

Last week, I read a blog I found to be disturbing. Coupled with that, I received a note from one of my friends. The note and the blog indicated that people who were unable to age/disability qualify for Medicare were refusing transplants due to the high costs of the anti-rejection medications. According to Cameron Field and Kidney Buzz, of the 275,000 people who are on dialysis in the United States, only 93,000 chose to be listed on the US Kidney Transplant Waiting List. Two thirds of dialysis patients are not listed, while only one third had chosen to list.

Does the prospect of Medicare coverage for only 36 months and then the average monthly cost of approximately $2100/ month cause people to decline the transplant option? Of course, there may be others reasons to decline; it requires a surgery, the risk of infection, the risk of rejection even if you take the meds, the necessary follow up, and pain, but sources are now saying that it may be possible that up to 34% of dialysis patients are declining transplants due to the cost of anti-rejection meds.  They know they will die without the transplant but they have no choice.

The Dialysis Patient Citizens conducted a survey last year on this issue. 29% said they had other medical conditions. 26% said they were too old. 7% said they were overweight. 6% said their doctors didn’t recommend it. 5% said they were satisfied with dialysis. However, 6% cited financial reasons generally, 4% said they couldn’t afford the surgery, and 2.5% said they couldn’t afford the medications. 17% cited personal reasons. Who knows how many in that 17% didn’t want to disclose financial hardship. So according to the DPC’s data, between 13% and 30% aren’t on the list due to financial reasons.   Of the 13,000 transplants performed last year, 6,000 were from living donors, but there are some barriers to living donation that must be overcome, as well.

Nearly everyone knows that while we are born with two kidney’s we can live with just one, so many people choose to donate the second kidney tliving organ donorso a dying patient,.  While the recipients insurance pays the medical costs the donor is often left footing the bill for lost wages while hospitalized and travel to and from the transplant center.   Some states,but not all will provide reimbursement in the form of tax deductions, but nice as they are, they don’t put cash in the pocket of the donor.  The feds have a few grants available but they are grossly underfunded and so many have to foot the bill themselves.  That knowledge may prevent many from offering to be donors. The DPC estimates that cost to reimburse lost wages is about $6,000 for one surgery. When you look at in in terms of Medicare paying for the transplant surgery ($100,000) and for the cost of anti-rejection drugs ($24,000 a year), travel and lost wages for the donor would be a minimal expense and if available would likely increase the number of living donors.

So where do we stand?  If 30% of the people taking dialysis refuse to be listed due to the costs of transplant autoimmune medications, then we are talking about approximately 100,000 people who cannot afford a life-saving transplant.

Everyone on dialysis knows that life expectancy while on that machine is, on average, from 3-5 years. Life expectancy for a transplant, from a living donor is on average, 12 to 20 years, while a deceased donor kidney is somewhat less, 8 to 12 years. If you receive a kidney transplant before you are required to begin dialysis then you will live 10 to 15 years longer than if you stayed on dialysis.  So, even though a kidney transplant involves major surgery and requires some risk, in comparison it offers you a longer life.   Most patients who have been on dialysis before their transplant see an amazing difference in their quality of life.

There are two closely related issues here that can be resolved.by one simple action.  The Congress must pass and the President must sign the bill that would provide lifetime coverage of anti-rejection drugs.  It is the only logical, financially responsible and humane solution to a problem that has already caused untold misery and death.

If you find the current law absurd and a waste of money and want to see it changed to save lives and taxpayer dollars then you can help by writing to your congressional representative or U.S. Senator ttake actionoday.  The sample letter below can be used as a guide, but we encourage you to use your own words.

Sample language

Dear ­­­­­____; I am contacting you to request that you cosponsor important legislation for chronic kidney disease patients (for the house, refer to file H.R. 1428.  For the senate refer to file S 323), the “Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act to help kidney transplant recipients obtain the life-saving immunosuppressive medications that are necessary to maintain the viability of their new kidney.

Individuals with chronic kidney failure require kidney dialysis or a transplant to survive, and are eligible for Medicare regardless of age or other disability. There is no time limit on Medicare coverage for dialysis patients. However, transplant recipients who are not aged or disabled retain Medicare eligibility only for 36 months following their transplant. After their Medicare ends, they often face the challenge of obtaining group health insurance or other coverage, greatly increasing the risk of organ rejection if they cannot afford their required medications. If the transplanted kidney fails, they return to dialysis or receive another transplant, both of which are more costly (Medicare spends about $90,000 annually on a dialysis patient and about $25,000 per year for a kidney transplant recipient, after the year of the transplant).

The current bill would extend Medicare Part B eligibility, and only for immunosuppressive medications. Coverage for any other health needs would end 36 months after the transplant, as under current law. The legislation also requires group health plans to maintain coverage of immunosuppressive drugs if they presently include such a benefit in their coverage. Lifetime immunosuppressive coverage will improve long term transplant outcomes, enable more kidney patients who lack adequate insurance to consider transplantation, and reduce the number of kidney patients who require another transplant. Nobody should lose a transplant because they are not able to pay for the drugs to maintain it.

On behalf of thousands of transplant patients, I respectfully request your support of this legislation. Sincerely,

Your name

 

In order to help you write to your representative in congress Bob’s Newheart has provided the following resource.  You can find your elected representatives and others here http://www.usa.gov/Contact/Elected.shtml or you can use the following links as well

To find your U.S. Senator’s address click on this link http://www.senate.gov/general/contact_information/senators_cfm.cfm

To find your congressional representative click on this link. http://www.house.gov/representatives/find/

 

bob minus Jay full shotBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

The Incredible Healing Power of Pets


By Bob Aronson

Cat cartoon

There’s something about petting a dog or having a cat nestle in your lap that brings one a certain serenity or at least a warm feeling. It’s been shown medically that the company of a pet can bring blood pressure down, lessen depression, calm frayed nerves and even help to settle an upset stomach.

Is there anything cuter than a puppy or kitten? Even at their destructive worst they are cute. When we got Reilly, our Soft Coated Wheaten Terrier as a puppy she loved to shred paper and those razor sharp puppy teeth can do that in a split second.

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Reilly and the toilet paperLook at this mess. She had gotten a hold of some toilet paper and made a mess of our living room, there were shreds of paper everywhere. And…when we found her amidst that pile of blowing and drifting tissue, she looked up and wagged her tail, proud of her accomplishment and willing to destroy even more if it would please us. Look at this picture, how could you possibly do anything but laugh upon seeing this mess.

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Besides the laughs, the warm fuzzy feelings and the love what can pets do for you?  According to the Centers for Disease Control and Prevention, the company of a pet can help people who are living with depression. Why is that? I think it’s because they ask for very little and Reilly and Ziggy sleeping in basket togethergive unlimited affection and companionship. Maybe it’s because cats, dogs and other companion creatures offer unlimited affection and nonjudgmental companionship. They lift our spirits and lower our stress. They counteract symptoms such as isolation, rumination and lethargy.  Even just looking at our two dogs Reilly and Ziggy (mini schnauzer)  and how much they like each other gives one a warm all over feeling.

 

People who study human behavior tell us that caring for animals is an ego boost, a shot in the self-esteem department that gives people a sense of purpose, of being needed and necessary. Knowing that another living being depends on us for sustenance and protection gives our self-worth a good shot in the arm.

 

According to a 2009 study published in the American Journal of Orthopsychiatry.Jennifer P. Wisdom, PhD, an associate professor of clinical psychology at Columbia University Medical Center and several of her colleagues surveyed 177 nearly 200 patients with varying degrees of mental illness to determine how the recovery process works. The study concluded that besides offering the boost in self-worth, Pets can serve as either substitute or additional family members. Yes, family. If you’ve ever had a pet you know that you consider them family— because they are.

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For some people the only love in their lives is the love shared between them and cat cuddlingtheir companion animals. Now, I don’t know who invented the term companion animal but it is perfect because they are more than possessions, they are friends, companions, confidants and you could even say, therapists. If you can find a single human being who is a better listener that your dog or cat or bird or whatever I’ll buy you lunch. They never object, they don’t interrupt they just listen very carefully and wag their tails or curl up close to you. Their affection washes over you like a hot shower after a long run and all the troubles of the day run into the drain.

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Our dogs are happy to see us at least a dozen times a day. If I leave to go the store, I get a reception when I come home that is as though I had been gone for a year. I get the same reception if I go to the mail box and come back in a minute later. Open the door and Ziggy is running in circles with joy and Reilly is licking my hand. They are always glad to see me and you know there is nothing phony about it…they really are glad to see you every time they see you.

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Here’s a classic video…it’s a must see and it’s short.  A soldier returns from a tour of duty in Afghanistan and the first one to greet him is his dog.  This will bring tears to your eyes.  https://www.youtube.com/watch?v=ysKAVyXi0J4

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Not only are pets good for your mental health, they can be of immeasurable assistance in maintaining your physical health as well.  Dogs need to be walked and that means you need to walk with them. You may not think of it this way but your dog is helping you It's time for your walkget exercise you might not get otherwise. Every medical study done on the value of exercise says the same thing, even a casual walk is good for you. You don’t have to sprint or run or jog, just walk with Fido and you are getting a health benefit. I haven’t seen any studies on the matter but I’ll bet that dog owners walk more than people who don’t have them. And…I’ve read that people who have pets, or companion animals also have lower blood pressure and decreased cortisol…that’s the stuff that causes stress.

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Most nursing homes or extended care facilities allow visits from animals. When my mom was in a nursing home we used to bring our terrier/Chihuahua mixed dog Lady with us. Mom loved seeing her and lady, who could be a cranky little dog, loved seeing mom. I think they both loved all the attention they got. Other nursing home residents always stopped and wanted to pet Lady. One little 12 pound dog could make a whole nursing home happy at least for a few minutes.

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“Okay,” you say, “I’ll buy all the benefits of having a pet but I can’t. I’m not home much, I travel a lot, I just can’t care for one.” Well, you can benefit from animals anyway. Alan Beck who is the Director of the Center for Human-Animal Bonding at Purdue University suggests the following:

Visit a zoo. Farms that open their barns to visitors and even petting zoos can also be an entrée into the animal world.

  • Put up a birdfeeder in your backyard or outside your apartment window. You could also get out to a park to enjoy birds, chipmunks and other critters in their natural setting.
  • Set up a home aquarium. It may take a little work to get the pH levels balanced, but an established fish tank is fairly easy to maintain.
  • Walk a friend’s dog. You could also offer to pet-sit for dogs, cats, fish and so forth when friends and family members go on vacation, but be sure you’re ready to take on the responsibility.
  • Volunteer at an animal shelter. This is a win-win-win. The shelter gets extra hands to groom, play with or clean up after their charges; you get the feel-good effects of being around animals, and the abandoned pets benefit from your attention.

If none of that appeals to you how about a good movie. One that tugs at your heart strings and makes you feel good. Try any one of these.
1. Beethoven

beethoven

 

 

 

 

 

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This giant but adorable St. Bernard’s real name was Chris.
2. Buddy

buddy

 

 

 

 

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Buddy — from the “Air Bud” movies — was his real name, and he also played Comet in Full House!
3. Marley

Marley and Me

 

 

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Marley, of “Marley and Me” was played by 18 different dogs. All really freaking cute.

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You can find more great “Feel good” dog movies at http://www.buzzfeed.com/lyapalater/30-of-the-greatest-movie-dogs

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Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – spread the word about the immediate need for more organ donors.  On-line registration can be done at www.donatelife.net  Whenever you can, help people formally register.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.  

You are also invited to join Facebook’s Organ Transplantation Initiative (OTI) a 3,500 member  group dedicated to providing help and information to donors, donor families, transplant patients and families, caregivers and all other interested parties.  Your participation is important if we are to influence decision makers to support efforts to increase organ donation and support organ regeneration, replacement and research efforts. 

 bob half of bob and jay photoBob Aronson is a 2007 heart transplant recipient, the founder and primary author of the blogs on this site and the founder of Facebook’s Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

Are You an Alcoholic? Here’s the Test


Bob Aronson:

If you find that alcohol may be a problem in your life and your drinking habits are causing problems with and for other people you may have an alcohol problem. If you have ever wondered if you were an alcoholic you can get a very private answer here. We don’t track who takes the test so take it in the privacy of your home and if the results are negative, do something about it. You have control if you are willing to take it.
This blog was first published several years ago. I have updated it and published it again because of the demand for answers to the question, “Am I an alcoholic and how do I find out?”

Originally posted on Bob's NewHeart:

By Bob Aronson

devil cartoonAlcohol, Drugs and Tobacco can have deadly effects on your organs and constitute one of the leading contributors to the need for organ transplantation.  I have long contended that while organ donation is important we just aren’t making enough headway under the current system.  Too many people are dying because of the organ shortage.  One way of reducing the organ shortage is to diminish the demand.   Healthier living could help achieve that goal. Look at this listing of the short and long term effects of alcohol.

Depending on how much is taken and the physical condition of the individual, alcohol can cause:

  • Slurred speech
  • Drowsiness
  • Vomiting
  • Diarrhea
  • Upset stomach
  • Headaches
  • Breathing difficulties
  • Distorted vision and hearing
  • Impaired judgment
  • Decreased perception and coordination
  • Unconsciousness
  • Anemia (loss of red blood cells)
  • Coma
  • Blackouts (memory lapses, where the drinker cannot remember events that occurred while under the influence)

Long-term…

View original 1,086 more words

DEA Bullying Denies Relief to Those With Chronic Pain


By Bob Aronson

morphine is the best medicine 

I suffer from Chronic Pain and do millions of others and it’s getting more and more difficult to get any relief from it because two federal agencies are bullying physicians.

My neck and shoulder pain started after my heart transplant and some of it was directly related to the position of my arms while I was in surgery.  Many transplant recipients suffer the same fate, but transplant or not if a person is in pain relief should be no farther away than your doctor’s office.  It’s not!

I have received dozens of messages from pain sufferers since I published the previous two posts on the subject of chronic pain and physicians who simply will not prescribe narcotics (1. Why You Can’t Get Pain Meds http://tinyurl.com/knltszh   and (2. Suffering from Chronic Pain? Here’s what you need to know http://tinyurl.com/lzy8o22 and that’s what prompted me to write this third blog on the subject. I’m angry, frustrated and helpless.

The U.S. Drug Enforcement Administration (DEA) mission (more on that later)dea badge is essentially to stop the production and sale of illegal drugs in America. Their “War on Drugs” is well known and it has recently expanded from the poppy fields to the practice of medicine and to pharmacies. 

A few years ago Florida was the state of the “Pill Mills,” places where almost anyone could get powerful prescription pain killers just by showing up at the Doctor’s office. So flagrant were the violations that the DEA had a pill mill 2heyday of arrests and convictions but like many federal agencies they didn’t know when to stop.  Not satisfied with putting the “Pill Mill” docs out of business, they turned to the regular physicians and warned them of investigations and loss of license if they were found to be prescribing narcotic pain meds to people who weren’t in pain.

Many physicians who saw the DEA overreaction to the “Pill Mills” overreacted themselves and decided not to prescribe opioids (narcotics or controlled substances) to anyone.  The result is that many who suffer from chronic pain that cannot be relieved by anything other than narcotics can’t get them and are suffering needlessly.

How chilling is the DEA’s action.  Try this on for size.  44% of American doctors confess that a fear of a police or DEA investigation into their practice influenced the way that they prescribed medications to chronic pain patients. This according to a poll of doctors for the Center for Addiction and Substance Abuse.

The DEA’s actions are harming patients and maybe it is because their mission is the most convoluted, overly broad, confusing detailed mess you’ll ever see. 

Here are three of examples of Mission Statement excellence

  • TED: Spreading Ideas. (2 words)
  • Smithsonian: The increase and diffusion of knowledge. (6 words)
  • USO lifts the spirits of America’s troops and their families. (9 words)
  • DEA (347 words)

(This is only part of it you can see the rest at http://www.justice.gov/dea/about/mission.shtml)

The mission of the Drug Enforcement Administration (DEA) is to enforce the controlled substances laws and regulations of the United States and bring to the criminal and civil justice system of the United States, or any other competent jurisdiction, those organizations and principal members of organizations, involved in the gDEA arrestrowing, manufacture, or distribution of controlled substances appearing in or destined for illicit traffic in the United States; and to recommend and support non-enforcement programs aimed at reducing the availability of illicit controlled substances on the domestic and international markets.

They wrote a mission statement that sets them up to invade anyone at any time for any reason.  If they were legitimately concerned with stopping the flow of illegal drugs their mission statement probably could have said. “The Mission of the DEA is to stop the production and sale of illegal drugs in the United States” (19 words).  Instead, they chose to write a book that gives them the authority to assume more authority.

Essentially what the DEA is talking about is Opioids so let’s start with a definition. opioids What is an Opioid?  According to the National Institute on Drug Abuse opioids are medications that relieve pain. They reduce the intensity of pain signals reaching the brain and affect those brain areas controlling emotion, which diminishes the effects of a painful stimulus.

Medications that fall within this class include hydrocodone (e.g., Vicodin), oxycodone (e.g., Oxycontin, Percocet), morphine (e.g., Kadian, Avinza), codeine, and related drugs. Hydrocodone products are the most commonly prescribed for a variety of painful conditions, including dental and injury-related pain. Morphine is often used before and after surgical procedures to alleviate severe pain. Codeine, on the other hand, is often prescribed for mild pain. In addition to their pain relieving properties, some of these drugs—codeine and diphenoxylate (Lomotil) for example—can be used to relieve coughs and severe diarrhea.

pain cartoonIn their zeal to accomplish the impossible mission the DEA has now ventured into the practice of medicine a discipline for which they are not qualified nor are they welcome.  As a result, thousands upon thousands of Americans are suffering incredible pain.  They can’t get relief because their physicians have been intimidated by the DEA and to a lesser degree the Food and Drug Administration (FDA).  We have here a sort of medical paradox, the feds want to practice medicine and the medical doctors are afraid to. 

This report from the Reuters news agency pretty much sums up the way many physicians are reacting to DEA’s bullying: “Many physicians have increased patient monitoring, which means more urine tests, more documentation, and more frequent “pill count” checks, where patients must go to the prescriber’s office with their pill bottles to prove they have not sold or misused their medication.

“Every hour of the day I have concerns I’ll be audited, that my ability to take care of my patients and my family can be taken away, and I’m as legitimate as you can get,” said one frazzled physicianprescriber who has a private orthopedic practice in Florida. “You’re constantly watching over your shoulder and it takes a toll,” he told Reuters news.

Safety and security are one thing but when a law enforcement agency decides to run rampant over a legitimate segment of the private sector, someone, somewhere ought to stand up and take notice.

In their long but terribly unsuccessful effort to control illegal drugs the DEA has now focused their attention on prescription drugs and in particular those few physicians (most of them were in Florida) who wrote narcotics prescriptions for nearly anyone who wanted them.  And…they’ve been successful. Most of the pill mills are gone, babrams tankut the DEA is like a runaway Abrams tank and is now rumbling over the medical profession.

In typical federal overreaction to the “Pill Mill” crisis, the DEA decided to crack down on all physicians by letting them know that they were being watched and that they had better be damned sure they were prescribing narcotics for real pain and not to junkies.

The overreaction by the Feds was met by an equal overreaction by many physicians.  They just quit prescribing opioid (narcotic) pain meds because they don’t want the hassle. Both the feds and the docs seem to have forgotten us patients.  We are the ones who get the short, sharp, infected end of the stick.

Not satisfied with their efforts, but impressed with their nearly effortless intimidation of the medical profession the DEA then decided that while they concentrated on powerful narcotics like oxycontin and oxycodone the effort should not stop there.  They also bullying imagewanted restrictions on a lower level of painkillers as well so they crossed the street and bullied the FDA into telling docs they had better be careful when they prescribe Vicodin and Lortabs.  Both contain hydrocodone and are usually combined with over the counter analgesics like aspirin or Tylenol.

The result?  If you suffer from chronic pain you are going to have a very difficult time getting any drug containing a narcotic or other controlled substance.  The medical profession has been scared to cause many docs to refuse to prescribe narcotics or any other controlled substance including drugs like Valium which is non-narcotic but still a controlled substance.

Many so-called “Pain Clinics” will not prescribe narcotics at all for any reason. Instead they will look for “root causes” and try a raft of anti-inflammatory and other treatments.  And, to be fair, in some cases those “other treatments” work, but while the pain experts are searching for non-opioid solutions, the patient suffers. I know I’m one of them.  When I asked one pain clinic doc for narcotics after repeated failed attempts to control my pain he said,”I can’t do that, see your primary.”  The “can’t” part of the answer is pure BS.  Won’t is the correct word to use — won’t because he has been intimidated by the feds.  I endured weeks of agonizing, debilitating pain because they refused to prescribe narcotics even though nothing else was working.

There are some docs who have the courage to practice medicine despite thewe are watching you fact that two powerful federal agencies are threatening them with a minimum of being investigated and a maximum of license revocation.  Physicians feel as though they are constantly being watched.

My primary care doc understands that I really do suffer from chronic pain and that I have tried other approaches that have failed.  Despite that, to protect his license he monitors my use of the Oxycodone he prescribes very carefully.  He requires that once a month, when it is time for a prescription refill he sees me in his office where he reviews my case, questions me about my pain level and then reminds me of the dangers of opioids even though I have never sought an increase in dosage and am not an addict.. 

I still believe that while the DEA and the FDA are being heavy handed, physicians who are licensed to practice medicine and fail to prescribe drugs that have been proven to be effective must bear some of the responsibility for the suffering many chronic pain patients are experiencing.  

eyes in the darkReminiscent of so many tyrannical regimes the DEA absolves itself of any responsibility for the suffering they have caused among patients with chronic pain.  Here’s what they told The National Pain Report.  

“The agency is not trying to limit access to opioid painkillers. And if legitimate pain medication prescriptions are not being written or filled, it’s the fault of doctors and pharmacists, not the government,” said DEA spokesman Rusty Payne. 

“We’re not doctors. We’re regulators and enforcers of the law. If something is prescribed for a legitimate medical purpose, we’re certainly not going to get in the way.  If a pharmacy chooses not to fill a prescription for someone, that’s their decision. It’s not the DEA’s decision,” he said.

To me that’s a whole lot like a cop stopping you for no good reason, warning you about speeding and then telling you that he and other cops are watching you very carefully to be sure you abide by all the rules.  Then, if due to fear you just quit driving they say, “That was his choice, we didn’t tell him to stop driving.”

So our bottom line is this. If you have chronic pain and all the non-narcotic remedies don’t work you are going to have to grin and bear it for a while.  No physician in this environment is going to write opioid prescription for someone who walks in from the street complaining of pain.  You are going to have to prove it.  Your chances of getting relief maybe better from your primary care physician but bring evidence of your pain

  • X-rays, MRIs, CT scans
  •  Written diagnosis, prognosis, treatment and instructions from other physicians or emergency departments
  •  Prescription records
  •  Police or other reports if you’ve had an injury
  • Reports from physical therapists or Chiropractors
  • Anything else that will help prove your claim that you have chronic pain and that opioids may be your only relief.

If you want a primary care physician to help you, it is going to take a little time to build a relationship and he or she may even want you to repeat some tests you have already undergone.  Be prepared to hurt for a while because it is unlikely that any physician you have not seen before will prescribe a narcotic pain killer after only one or two appointments.  That’s what our friends at DEA have done for us.

If all of this really gets under your skin, call, write, email, text, holler at or visit your Congressional Representative, Your Senator and/or The President of the United States.

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bob minus Jay full shotBob Aronson is a 2007 heart transplant recipient, the founder and primary author of the blogs on this site and the founder of Facebook’s over 3,000 member Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

 

 

Proposed Medicare Rule Would End Support of Anti-Rejection Drugs While We Pay More For Boondoggles


By Bob Aronson

UPDATE MARCH 10, 2014

Attention readers — Your outrage worked. Congratulations!!!!

The Obama administration said Monday that it would scrap much of a proposed plan to limit the types of antidepressants and other drugs that seniors can get through Medicare after a backlash from lawmakers and the health industry.

Original blog published February 28, 2014

This is one of the most important blogs I have published.  It is a direct appeal to you to take action.  You will find the steps you need to take at the end of this post.

here to help cartoonA government bureaucracy is seeking to change the rules that allow organ transplant recipients a broad choice of anti-rejection drugs.  If adopted it is the opinion of many medical experts that without the flexibility to select optional drugs many transplant recipients could die. 

Ask yourself, “How does it make sense to pay the cost of a transplant and then refuse to pay for the drugs that make it work? Would we train thousands of men and women to be soldiers and then send them into battle without weapons?”  It is quite likely that your answer would be, “Of course not! That would be insane.”

Unfortunately some bureaucrats are incapable of making decisions based on logic.  They waste billions of dollars and in the process hope we are fooled into thinking that wasted money represents good “investments.”  When these good “investments” go bad they don’t stop pouring money into them they cut expenditures elsewhere — and those cuts cause great harm to the citizens whose tax dollars pay their salaries.

This report is factual and intentionally biased. It is biased because I am a 75 year old heart transplant recipient who counts on Medicare to provide me with my anti-rejection drugs — drugs the government would like to take away so they can fund boondoggles.

Here is some perspective.  When you get a transplant, you must take anti-rejection or immunosuppressant drugs for the rest of your life.  Often, though, it is medically necessary to change to something different and more effective.  If the option for a life-saving change is taken away, many of us will die. 

How the rule makers can ignore that simple, medical fact is beyond me, but they also ignore reality when they say making these cuts will save $1.9 billion over several years.  Here’s reality.  If the changes are adopted they will not only endanger lives, they will in the end, result in taxpayers paying more, not less as the rule’s advocates suggest.   

Here’s how it works in real life.  If organ transplant patients don’t take their immunosuppressant drugs they will go into rejection and will be hospitalized at Medicare’s expense.

Physicians who are sworn to save lives will make every effort to do just that regardless of cost.  In the case of Kidney failure, rejection dialysiscould mean years of dialysis, a treatment that costs about $50,000 per patient per year (there are currently about 400,000 Americans on dialysis). In all cases it is entirely possible that patients who are rejecting their organs could be re-listed for second transplants. Depending on the organ, a transplant can cost in excess of $1 Million for the surgery and the first year of care.

It seems that the cost cutters think that by limiting options there is an almost immediate savings.  There isn’t.  There is, instead, an almost immediate rise in cost.  They seem to use the same twisted logic when trying to save money that they use when spending it.  You can read the detailed proposal here http://www.gpo.gov/fdsys/pkg/FR-2014-01-10/pdf/2013-31497.pdf

Some lawmakers insist that budget cuts be made and they are right, we spend too much as a nation but does it make sense to cut spending that will kill people?

There are two current military projects that are a very big part of the motivation behind the budget cuts.  They are the Gerald R. Ford aircraft carrier and the F-35 Joint Strike Fighter.  Together they have created cost overruns of nearly $200 Billion.  That’s right $200 Billion and the defense department wants more money even though the two projects are plagued with problems. 

These ghouls would actually take medicine from people who will die without it rather than cut dollars from bloated out-of-control projects that were never necessary anyway.

In 2005 the cost of the Gerald R. Ford was estimated to be about $8 billion, excluding the $4.7 billion spent on research Gerald r ford 3and development. Each year the estimate has gone up.  In 2013 a Government Accounting Office (GAO) report said that construction costs are now estimated at $12.8 billion.  That’s 22% over the 2008 budget, plus $4.7 billion in research and development costs.  Not only have the costs continued to rise above the original estimates the Navy is now asking for another $500 million and the aircraft carrier is nowhere near being ready for sea and is plagued with problems. If you would like to know more about the Ford and its problems this link will get you started.  http://www.freerepublic.com/focus/f-news/3110602/posts

F-35 3Then there is the F-35 Joint Strike Fighter.  According to Senator John McCain it is the most expensive weapons system in history and there’s no assurance it will ever do what it was designed to do.  Despite repeated disappointments and failures, we keep throwing good money after bad at it and now that project is $163 billion over budget, seven years behind schedule, and will cost taxpayers about twice as much as sending a man to the moon.  The cost of manufacturing the jets has increased a whopping 75 percent from its original estimate, and is now closing in on $400 billion. Over its lifetime, the F-35 program is expected to cost U.S. Taxpayers $1.5 trillion, between construction and maintenance of the jets.  http://www.pogo.org/blog/2013/03/20130306-air-forces-f-35a-not-ready-for-combat.html

If you would like more details on the F-35 this report provides them along with other links.
http://swampland.time.com/2013/12/18/how-not-to-buy-the-most-costly-weapon-system-in-the-history-of-the-world/

Instead of cutting out the fat in the national budget, though, the bureaucrats have decided to cut spending that very likely will result in death.  They would limit coverage of anti-rejection medicine that keeps organ transplant recipients alive.  Here’s a simple declarative sentence, “When you take away medicine that keeps people alive, they will die.” What part of that sentence don’t they understand? 

The American Kidney Fund is one ofakf logo two many organizations that takes exception to the proposed new rule.  Recently they sent out this letter to their members and other interested parties.

akf logo two

Dear____,

I’m writing to request your help with an issue that is of great importance to our nation’s transplant recipients.

Individuals who are fortunate enough to receive a kidney transplant—or a transplant of any other organ—must take immunosuppressive medications for the life of the transplanted organ to reduce the risk of losing the organ. Some patients rely on Medicare Part D to cover the cost of these medications.

Immunosuppressive drugs are one of six “protected classes” of drugs under Medicare Part D. This means that Medicare Part D must cover all approved immunosuppressive drugs, giving transplant recipients access to the full range of available medications.

On January 10, 2014, the Centers for Medicare & Medicaid Services (CMS) proposed a change to Medicare Part D that would revise the criteria for these protected classes of drugs. Part D plans would no longer be required to cover all approved immunosuppressive medications—instead, Part D plans would only be required to cover each subclass of immunosuppressive medications.

The American Kidney Fund believes that by not covering all of the specific drugs within each subclass, this rule would put patients’ health at risk. Transplant recipients often need adjustments to their immunosuppressive drug regimen. They require access to the full range of approved medications.

We are working hard to ensure that policymakers hear from the kidney community on this issue. You may click here to send a personalized letter to your Congressional representatives urging CMS to reverse this proposal. https://secure2.convio.net/akf/site/Advocacy?cmd=display&page=UserAction&id=119

Thank you for your participation in the American Kidney Fund’s Advocacy Network. Your voice makes a difference!

Sincerely,

Nikia Okoye

CMS (Centers for Medicare and Medicaid Services) will take public comment through March 7th. Please urge them to reject the draft rule change.  You can contact CMS with your comments in this manner. 

If you would like to comment directly to CMS you must do so before 5 PM on March 7, 2014.  Here’s how.

ADDRESSES

In commenting, please refer to file code CMS–4159–P. Because of  staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission.  You may submit comments in one of

four ways (please choose only one of the ways listed):

1. Electronically.  You may submit electronic comments on this regulation to http://www.regulations.gov  or go directly to http://www.regulations.gov/#!documentDetail;D=CMS-2014-0007-0002 . Follow the ‘‘Submit a comment’’ instructions.

2. By regular mail.  You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–4159–P, P.O. Box 8013, Baltimore, MD 21244–8013. Please allow sufficient time for mailed comments to be received before the close of the comment period.

3. By express or overnight mail.  You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–4159–P, Mail Stop C4–26–05, 7500 Security Boulevard, Baltimore, MD 21244–1850.

4. By hand or courier. Alternatively, you may deliver (by hand or courier) your written comments NLY to the following addresses prior to the close of the comment period: a. For delivery in Washington, DC—Centers for Medicare & Medicaid Services, Department of  Health and Human Services, Room 445– G, Hubert H. Humphrey Building, 200 Independence Avenue SW., Washington, DC 20201.

(Because access to the interior of the Hubert H. Humphrey Building is not readily available to persons without federal government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an

extra copy of the comments being filed.) b. For delivery in Baltimore, MD— Centers for Medicare & Medicaid Services, Department of Health and Human Services, 7500 Security Boulevard, Baltimore, MD 21244–1850.If you intend to deliver your comments to the Baltimore address, call telephone number (410) 786–9994 in advance to schedule your arrival with one of our staff members.

Comments erroneously mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period.

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magic kindom in backgroundBob Aronson is a 2007 heart transplant recipient, the founder and primary author of the blogs on this site and the founder of Facebook’s over 3,000 member Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

How to Avoid Scams, Frauds, Quacks and Crooks


cartoon By Bob Aronson

When you have a serious illness you want relief and most often it does not come quickly or simply. The proper practice of medicine is measured, deliberate and often slow.  Medical experts depend on established scientific protocols to determine the effectiveness of treatments.  Because the mass media offer the same advertising and promotional opportunities to everyone it is often difficult to determine which ads are legitimate and which are not.  This blog aims to help you decide.

While there is no shortage of local, state and federal agencies who seek to protect consumers from scams, fraud and quackery there is no way that every offer made in the media, on the phone and through the internet can be monitored.  Your protection depends for the most part of your being alert to scams and can recognize offers that are without merit.  There is no shortage of frauds and crooks who scheme daily to find new ways to get you to part with your money. That means you must do everything possible to protect yourself.

The U.S. Food and Drug Administration (FDA) has broad responsibilities in its role as a consumer protection agency.  Here is just a part of what FDA is mandated to do:

“FDA is responsible for protecting the public health by assuring the safety, efficacy and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, and products that emit radiation.

FDA is also responsible for advancing the public health by helping to speed innovations that make medicines more effective, safer, and more affordable and by helping the public get the accurate, science-based information they need to use medicines and foods to maintain and improve their health.”

You can read more of the FDA’s mission here http://www.fda.gov/aboutfda/whatwedo/

Exposing fraud is but one aspect of the FDA’s role and there is no shortage of fraudulent claims being made.  You can find more by clicking on this link.: http://www.fda.gov/forconsumers/protectyourself/healthfraud/default.htm   Often companies make health claims about their products that not only are not true but can cause great harm, even death.  Here’s just one example of a medical claim deemed dangerous enough by the FDA to issue a public warning (I have edited the warning. For the official language go to http://tinyurl.com/m2u8s7b)

Public Notification: Pro ArthMax Contains Several Hidden Drug Ingredients

[1-15-2014] The Food and Drug Administration (FDA) is advising consumers not to purchase or use Pro ArthMax, a product promoted and sold as a dietary supplement for joint, muscle and arthritic pain.

FDA laboratory analysis confirmed that Pro ArthMax contains the active ingredients diclofenac, ibuprofen, naproxen, indomethacin, nefopam, and chlorzoxazone.

  • Diclofenac, ibuprofen, naproxen, and indomethacin are NSAIDs which may cause increased risk of heart attack and stroke, as well as serious gastrointestinal damage including bleeding, ulceration, and fatal perforation of the stomach and intestines.
  • Chlorzoxazone is a muscle relaxant that is only available by prescription. Chlorzoxazone may cause drowsiness, dizziness, and lightheadedness, which may impair the ability to perform certain tasks, such as driving a motor vehicle or operating machinery.
  • Nefopam is a non-narcotic pain relieving drug that is not approved for marketing in the U.S. is not FDA-approved and its safety or efficacy has not been established.

arthritis drugConsumers should stop using this product immediately and throw it away. Consumers should consult a health care professional as soon as possible if they have experienced any negative side effects, such as unusually dark stools or urine, stomach pain, increased bruising, other signs of bleeding, confusion, sedation, hallucinations, and seizures.

Health care professionals and patients are encouraged to report adverse events or side effects related to the use of this product to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

Contact FDA Toll Free (855) 543-3784, or (301) 796-3400 druginfo@fda.hhs.gov

How to Recognize a Scam

There are thousands perhaps millions of scams that find their way into our lives every dayscam alert.  Some of them sound and look so legitimate we don’t recognize them until it is too late.

QuackWatch is a website run by a couple of physicians who keep an eye out for phony medical claims.  One such claim is that we all suffer from some sort of vitamin deficiency.  Stephen Barrett, M.D. and Victor Herbert, M.D., J.D. are pretty astute and have developed a list of 26 Ways to Spot Quacks and Vitamin Pushers.  I will list only a few here.  You can find the rest on their website. http://www.quackwatch.com/

They Claim That Most Americans Are Poorly Nourished

This is an appeal to fear that is not only untrue, but ignores the fact that the main forms of bad nourishment in the United States are obesity in the population at large (particularly the poor) and undernourishment among the poverty-stricken. Poor people can ill afford to waste money on unnecessary vitamin pills. Their food money should be spent on nourishing food.

It is falsely alleged that Americans are so addicted to “junk” foods that an adequate diet is exceptional rather than usual. While it is true that some snack foods are mainly “naked calories” (sugars and/or fats without other nutrients), it is not necessary for every morsel of food we eat to be loaded with nutrients. In fact, no normal person following the Dietary Guidelines for Americans is in any danger of vitamin deficiency.

They Say That Most Diseases Are Due to Faulty Diet
and Can Be Treated with “Nutritional” Methods.

This simply isn’t so. Consult your doctor or any recognized textbook of medicine. They will tell you that although diet is a factor in some diseases (most notably coronary heart disease), most diseases have little or nothing to do with diet. Common symptoms like malaise (feeling poorly), fatigue, lack of pep, aches (including headaches) or pains, insomnia, and similar complaints are usually the body’s reaction to emotional stress. The persistence of such symptoms is a signal to see a doctor to be evaluated for possible physical illness. It is not a reason to take vitamin pills

They Suggest That a Questionnaire Can Be Used
to Indicate Whether You Need Dietary Supplements.

questionaireNo questionnaire can do this. A few entrepreneurs have devised lengthy computer-scored questionnaires with questions about symptoms that could be present if a vitamin deficiency exists. But such symptoms occur much more frequently in conditions unrelated to nutrition. Even when a deficiency actually exists, the tests don’t provide enough information to discover the cause so that suitable treatment can be recommended. That requires a physical examination and appropriate laboratory tests. Many responsible nutritionists use a computer to help evaluate their clients’ diet. But this is done to make dietary recommendations, such as reducing fat content or increasing fiber content. Supplements are seldom necessary unless the person is unable (or unwilling) to consume an adequate diet.

They Use Anecdotes and Testimonials to Support Their Claims.

Establishing medical truths requires careful and repeated investigation—with well-designed individual endorsementexperiments, not reports of coincidences misperceived as cause-and-effect. That’s why testimonial evidence is forbidden in scientific articles, is usually inadmissible in court, and is not used to evaluate whether or not drugs should be legally marketable. (Imagine what would happen if the FDA decided that clinical trials were too expensive and therefore drug approval would be based on testimonial letters or interviews with a few patients.)

They Claim They Are Being Persecuted by Orthodox Medicine
and That Their Work Is Being Suppressed Because It’s Controversial.

conspirancyThe “conspiracy charge” is an attempt to gain sympathy by portraying the quack as an “underdog.” Quacks typically claim that the American Medical Association is against them because their cures would cut into the incomes that doctors make by keeping people sick. Don’t fall for such nonsense! Reputable physicians are plenty busy. Moreover, many doctors engaged in prepaid health plans, group practice, full-time teaching, and government service receive the same salary whether or not their patients are sick—so keeping their patients healthy reduces their workload, not their income.

Phony Pharmacies

phony pharmacyThere is not a single area of healthcare that has not been scammed by crooks.  Consumers must continually keep their guard up. Because prescription drugs can be costly many people turn to on-line pharmacies who offer huge discounts for what they say is the same medicine but sometimes under a different name.   Again…buyer beware.

ScamWatch is an Australian organization that provides excellent advice.  They offer these tips to avoid wasting your money on offers that are, “Too good to be true.” I have edited their material.  For more and complete information go to http://www.scamwatch.gov.au/content/index.phtml/tag/Scamwatch/

Miracle cure scams?

Miracle cure scams cover a whole range of products and services which can appear to be legitimate snake oil cures allalternative medicine. They cover health treatments for all kinds of medical conditions from cancer and AIDS to arthritis and colds. Miracle cure scams usually promise quick and easy remedies for serious medical conditions.

Miracle cure scams are particularly nasty because they usually increase health and emotional stress, they are costly, and they can be dangerous if they prevent you from seeking expert medical advice. They exploit people’s hopes for improved health and end up causing more problems for people who already have enough to deal with.

Warning signs

  • The treatment claims to be effective against a very wide range of ailments.
  • The miracle cure is suggested after a condition is diagnosed using a questionnaire (often on the internet).
  • The product is sold through unconventional means. For example, it might be sold over the internet, by unqualified individuals, through mail order ads, or on television infomercials.
  • The product relies on some guru figure, or a certain ingredient that is claimed to have mystical properties.
  • There is no scientific evidence to back up the claim that the miracle cure actually works.
  • Miracle cures usually include anonymous testimonials, for example ‘Luke, from

Do your homework

You should seek independent medical advice from your doctor or other qualified health care professional about the miracle cure to see if it is safe and suitable for you. Remember that a legitimate diagnosis cannot be made by someone who is not qualified or has not seen you. Do not rely solely on information you find on the internet.

If you are interested in the product, find out if there are any published medical or research papers to back up the claims. Make sure you know the full cost of the product or service, and if there is a genuine money back guarantee.

Senior Citizens are Targets of Scammers and Quacks

senior scamsAs a senior citizen myself I see the scams and phony offers on a daily basis.  They come by email, snailmail, telephone and internet “News” flashes.  The best advice we can give is this.  If you don’t know the people who are making a claim, dismiss them and seek advice from someone you trust.

Here are some of the top scams that target senior citizens

http://www.ncoa.org/enhance-economic-security/economic-security-Initiative/savvy-saving-seniors/top-10-scams-targeting.html  (again, I have edited the material for the complete report click on the above link)

Financial scams targeting seniors have become so prevalent that they’re now considered “the crime of the 21st century.”  Over 90% of all reported elder abuse is committed by an older person’s own family members, most often their adult children, followed by grandchildren, nieces and nephews, and others.

Financial scams also often go unreported or can be difficult to prosecute, so they’re considered a “low-risk” crime. However, they’re devastating to many older adults and can leave them in a very vulnerable position with little time to recoup their losses.

Some ways to identify scams

Health Care/Medicare/Health Insurance Fraudsenior on phone

Every U.S. citizen or permanent resident over age 65 qualifies for Medicare, so there is rarely any need for a scam artist to research what private health insurance company older people have in order to scam them out of some money.

In these types of scams, perpetrators may pose as a Medicare representative to get older people to give them their personal information, or they will provide bogus services for elderly people at makeshift mobile clinics, then use the personal information they provide to bill Medicare and pocket the money.

Counterfeit Prescription Drugs

Most commonly, counterfeit drug scams operate on the Internet, where seniors increasingly go to find better prices on specialized medications.

The danger is that besides paying money for something that will not help a person’s medical condition, victims may purchase unsafe substances that can inflict even more harm. This scam can be as hard on the body as it is on the wallet.

Funeral & Cemetery Scams

funeral scammerThe FBI warns about two types of funeral and cemetery fraud perpetrated on seniors.

In one approach, scammers read obituaries and call or attend the funeral service of a complete stranger to take advantage of the grieving widow or widower. Claiming the deceased had an outstanding debt with them, scammers will try to extort money from relatives to settle the fake debts.

Another tactic of disreputable funeral homes is to capitalize on family members’ unfamiliarity with the considerable cost of funeral services to add unnecessary charges to the bill.

In one common scam of this type, funeral directors will insist that a casket, usually one of the most expensive parts of funeral services, is necessary even when performing a direct cremation, which can be accomplished with a cardboard casket rather than an expensive display or burial casket.

Fraudulent Anti-Aging Products

In a society bombarded with images of the young and beautiful, it’s not surprising that some older people feel the need to conceal their age in order to participate more fully in social circles and the workplace.

Whether it’s fake Botox like the one in Arizona that netted its distributors (who were convicted and jailed in 2006) $1.5 million in barely a year, or completely bogus homeopathic remedies that do absolutely nothing, there is money in the anti-aging business.

Botox scams are particularly unsettling, as renegade labs creating versions of the real thing may still be working with the root ingredient, botulism neurotoxin, which is one of the most toxic substances known to science. A bad batch can have health consequences far beyond wrinkles or drooping neck muscles.

Telemarketing

Perhaps the most common scheme is when scammers use fake telemarketing calls to prey on older peopsenior scams on phonele, who as a group make twice as many purchases over the phone than the national average.

Examples of telemarketing fraud include:

“The Pigeon Drop”

The con artist tells the individual that he/she has found a large sum of money and is willing to split it if the person will make a “good faith” payment by withdrawing funds from his/her bank account. Often, a second con artist is involved, posing as a lawyer, banker, or some other trustworthy stranger.

“The Fake Accident Ploy”

The con artist gets the victim to wire or send money on the pretext that the person’s child or another relative is in the hospital and needs the money.

“Charity Scams”

Money is solicited for fake charities. This often occurs after natural disasters.

Investment Schemes

investment scammersBecause many seniors find themselves planning for retirement and managing their savings once they finish working, a number of investment schemes have been targeted at seniors looking to safeguard their cash for their later years.

From pyramid schemes like Bernie Madoff’s (which counted a number of senior citizens among its victims) to fables of a Nigerian prince looking for a partner to claim inheritance money to complex financial products that many economists don’t even understand, investment schemes have long been a successful way to take advantage of older people.

Homeowner/Reverse Mortgage Scams

The reverse mortgage scam has mushroomed in recent years. With legitimate reverse mortgages increasing in frequency more than 1,300% between 1999 and 2008, scammers are taking advantage of this new popularity.

As opposed to official refinancing schemes, however, unsecured reverse mortgages can lead property owners to lose their homes when the perpetrators offer money or a free house somewhere else in exchange for the title to the property.

Sweepstakes & Lottery Scams

This simple scam is one that many are familiar with, and it capitalizes on the notion that “there’s no such thing as a free lunch.”

Here, scammers inform their mark that they have won a lottery or sweepstakes of some kind and need to make some sort of payment to unlock the supposed prize. Often, seniors will be sent a check that they can deposit in their bank account, knowing that while it shows up in their account immediately, it will take a few days before the (fake) check is rejected.

During that time, the criminals will quickly collect money for supposed fees or taxes on the prize, which they pocket while the victim has the “prize money” removed from his or her account as soon as the check bounces.

The Grandparent Scam

The Grandparent Scam is so simple and so devious because it uses one of older adults’ most reliablegrandparent scam assets, their hearts.

Scammers will place a call to an older person and when the mark picks up, they will say something along the lines of: “Hi Grandma, do you know who this is?” When the unsuspecting grandparent guesses the name of the grandchild the scammer most sounds like, the scammer has established a fake identity without having done a lick of background research.

Once “in,” the fake grandchild will usually ask for money to solve some unexpected financial problem (overdue rent, payment for car repairs, etc.), to be paid via Western Union or MoneyGram, which don’t always require identification to collect.

At the same time, the scam artist will beg the grandparent “please don’t tell my parents, they would kill me.”

While the sums from such a scam are likely to be in the hundreds, the very fact that no research is needed makes this a scam that can be perpetrated over and over at very little cost to the scammer.

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smaller stillBob Aronson is a 2007 heart transplant recipient, the founder and primary author of the blogs on this site and the founder of Facebook’s over 3,000 member Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

Hate to Wait? Learn While You Burn. Amazing Facts Help Pass the Time


By Bob Aronson

wasted timeOne of the biggest lies we tell ourselves is, “I don’t have time for….”  You can complete the sentence.  The fact is you only think you don’t have enough time, you have plenty it’s just that it comes in fits and starts – little pieces of time that we don’t acknowledge as “useful.”

This blog is about organ donation/transplantation and related subjects and there are a lot of related subjects.  Today’s post is about time, time chalked up as wasted, the time you spend waiting.

Yesterday as I sat waiting in my Doctor’s office it occurred to me that I spend a lot of time waiting, not just as a heart transplant recipient but everywhere I go I wait. people waiting I wait at the bank, the pharmacy, getting the car serviced and standing in line at check-out counters in stores.  I wait for the pasta water to boil, the alarm to go off, for traffic lights to change and in line to use a public restroom.  I wait a lot and so do you and for the most part that time is totally unproductive and non-edifying.

While sitting in the “Waiting room” at the clinic I did what a lot of people do, I took out my cell phone (it does everything but make coffee, I can even use it as the remote control for the TV) and began to surf the net (don’t you love that tech talk) looking for something, anything interesting. people on cells I looked around the room and almost everyone sitting there either had a laptop, a phone or a tablet and I wondered if they were surfing, too, or if they had something specific they were studying.  Being the curious type I couldn’t wait to get home to my laptop.

Here’s what I found; the Timex company (you know the ones who said, “Takes a licking and keeps on ticking”) did a study a while back on just how much time we spend waiting and the results were very interesting.

Timex made it quite clear that we all know we waste time, we just hwasting time bent clockaven’t made the effort to determine how much.  The Timex survey revealed that on average each day, people wait seven minutes for a cup of coffee, 20 minutes in traffic, 20 minutes for the bus or train and 32 minutes each time they go to the doctor…that’s for each appointment.  If you have three or four physician’s appointments in a day you could waste up to two hours waiting.

Having established that we have a lot of free (wasted) time I can get to the point of this blog.  Do you use that time wisely?  As long as you have to wait doesn’t it make sense to use the time to be entertained, to learn or even to meditate?  The problem is that most of us aren’t prepared to use the time wisely, we spend it surfing.  So I thought, “I’ll give my readers something interesting and entertaining so that “Waiting” time is not “Wasted” time.

I love science and technology stuff, you know interesting pieces of information about science and space and space travel and the building blocks of life and all that.  Actually I love to read something and say, “Wow, I didn’t know that.”  When that happens I tuck that information away for use as a conversation starter or enhancer when needed.  Anyway, I did some research for you so the next time you are waiting somewhere you can say, “I’ll click on some of that stuff from Bob’s Newheart.”hubble-universe

Let us start with some absolutely mind boggling information.

  • According to NASA the biggest thing in the universe is a recently discovered Galaxy. From “Tip to tip” the NGC 6872 spans 522,000 light years, five times the length of our own Milky Way…which is pretty darned big.  522,000 light years and a single light year is almost 6 Trillion miles (5,878,499,810,000 miles).  And…remember that is just one galaxy.  So, your next question then is, “How many galaxies are there?”  Good question but tough to find an exact answer because no one really knows but, the most current estimates guess that there are 100 to 200 billion galaxies in the Universe, each of which has hundreds of billions of stars. A recent German supercomputer simulation put that number even higher: 500 billion. In other words, there could be a galaxy out there for every star in the Milky Way.

What do you think is the biggest living organism on the planet?  I’ll bet you said a Blue Whale or some other sea creature.  Wrong!   Nope…not a Redwood tree either.  The biggest living organism on earth is a honey mushroom that grows underground in Oregon. It covers 2,385 acres—a single organism, with identical DNA all the way through. That’s the biggest living thing on earth.

More mind bogglers

  • When you look at the stars you are looking into the past.  The starlight we see looking through telescopein the night sky has taken a long time to travel across space to reach our eyes. This means whenever we star gaze we are looking at how they looked a long time ago. For example, the bright star Vega is pretty close to us at only twenty five light-years away. That means that what you are seeing took place twenty five years ago. As you view stars even farther away your look into history becomes ever deeper until your peek into the past allows you to witness the Big Bang itself.
  • Sagittarius B is a vast molecular cloud of gas and dust floating near the center of the Milky Way, 26,000 light-years from Earth, 463,000,000,000 kilometers in diameter and, amazingly, it contains 10-billion-billion-billion liters of alcohol. That’s a lot of beer or vodka…wow!   The vinyl alcohol in the cloud is an important organic molecule which offers some clues how the first building blocks of life-forming substances are produced.
  • venusVenus is the slowest rotating planet in our Solar System, so slow it takes longer to fully rotate than it does to complete its orbit. This means Venus has days that last longer than its years. It’s also home to one of the most inhospitable environments imaginable, with constant electronic storms, high CO2 readings, and it’s shrouded by clouds of sulfuric acid.
  • You may not remember the Voyager Program which launched two spacecraft, Voyager 1 and Voyager 2, in 1977. The probes explored the planets and moons of the outer Solar System over several decades and are now continuing their mission to travel through the edge of our Solar System and into interstellar space.

On March 20 2013, Voyager 1 became the first human-made object to leave our Solar Sytem and is now the furthest human-made object from Earth, it’s around 1.15581251×1010 miles away. Putting it mildly this is a long way from home.

  • dark-energy-abell-cluster-100819-02Did you know that there could be 500 million planets capable of supporting life in our galaxy?  Scientists searching for extraterrestrial life focus on “Goldilocks Planets“; whose which fall into a star’s habitable zone. Planet Earth seems to have exactly the right conditions for life to exist – its distance from the Sun means the temperature is right, water can exist as a liquid solid and a gas, and there are the right combination of chemical compounds available to build complex life forms. Other planets thought to have similar features are known as Goldilocks planets.
  • In the Milky Way alone there are estimated to be 500 million potential Goldilocks planets, so if life can exist in places other than Earth there is a huge number of potential planets on which it might thrive. If these numbers are applied to all the galaxies in the universe there could be a staggering variety of planets capable of supporting life. Of course, we have no evidence life exists elsewhere, but if it does there are plenty of places for it to set up home.
  • There May Be More Universes.  Credit: Stephen Feeney/UCLThe idea that we live in a multiverse, in which our universe is one of many, comes from a theory called eternal inflation, which suggests that shortly after the Big Bang, space-time expanded at different rates in different places. According to the theory, this gave rise to bubble universes that could function with their own separate laws of physics.

The concept is controversial and had been purely hypothetical until recent studies searched for physical markers of the multiverse theory in the cosmic microwave background, which is a relic of the Big Bang that pervades our universe. [Full Story]

Are you finding these items interesting?  Well, there’s more.  Here are 25 amazing space facts. http://www.amazingspacefacts.50webs.com/

1. Saturn’s moon Titan has plenty of evidence of organic (life) chemicals in its atmosphere.

2. Life is known to exist only on Earth, but in 1986 NASA found what they thought might be fossils of microscopic living things in a rock from Mars.

3. Most scientists say life’s basic chemicals formed on the Earth. The astronomer Fred Hoyle said they came from space.

4. Oxygen is circulated around the helmet in space suits in order to prevent the visor from misting.

5. The middle layers of space suits are blown up like a balloon to press against the astronaut’s body. Without this pressure, the astronaut’s body would boil!

6. The gloves included in the space suit have silicon rubber fingertips which allow the astronaut some sense of touch.

7. The full cost of a spacesuit is about $11 million although 70% of this is for the backpack and the control module.

8. Ever wondered how the pull of gravity is calculated between heavenly bodies? It’s simple. Just multiply their masses together, and then divide the total by the square of the distance between them.

9. Glowing nebulae are named so because they give off a dim, red light, as the hydrogen gas in them is heated by radiation from the nearby stars.

10. The Drake Equation was proposed by astronomer Frank Drake to work out how many civilizations there could be in our galaxy – and the figure is in millions.

11. SETI is the Search for Extra Terrestrial Intelligence – the program that analyzes radio signals from space for signs of intelligent life.

12. The Milky Way galaxy we live in: is one among the BILLIONS in space.

13. The Milky Way galaxy is whirling rapidly, spinning our sun and all its other stars at around 100 million km per hour.

14. The Sun travels around the galaxy once every 200 million years – a journey of 100,000 light years.

15. There may be a huge black hole in the very middle of the most of the galaxies.

16. The Universe is probably about 15 billion years old, but the estimations vary.

17. One problem with working out the age of the Universe is that there are stars in our galaxy which are thought to be 14 to 18 billion years old – older than the estimated age of the Universe. So, either the stars must be younger, or the Universe older.

18. The very furthest galaxies are spreading away from us at more than 90% of the speed of light.

19. The Universe was once thought to be everything that could ever exist, but recent theories about inflation (e.g. Big Bang) suggest our universe may be just one of countless bubbles of space time.

20. The Universe may have neither a center nor an edge, because according to Einstein’s theory of relativity, gravity bends all of space time around into an endless curve.

21. If you fell into a black hole, you would stretch like spaghetti.

22. Matter spiraling into a black hole is torn apart and glows so brightly that it creates the brightest objects in the Universe – quasars.

23. The swirling gases around a black hole turn it into an electrical generator, making it spout jets of electricity billions of kilometers out into space.

24. The opposite of black holes are estimated to be white holes which spray out matter and light like fountains.

25. A day in Mercury lasts approximately as long as 59 days on earth.

And, in case you want still more:

  • Did you know that the Blue whale’s heart is the size of a VW Beetle and that you could swim through some of its arteries?

Via whalefacts.org

  • Were you aware that hydrogen is a light, odorless gas, which, given enough time, turns into people.

Via smithsonianmag.com

  • And did you know that all of the gold mined in the history of the world would more or less fit into a 20 x 20 x 20 meter cube.

Via omgfans.wordpress.com

From Wikipedia: A total of 165,000 tons of gold have been mined in human history, as of 2009.1 This is roughly equivalent to 5.3 billion troy ounces or, in terms of volume, about 8,500 cubic meters, or a 20.4m cube.

  • Finally, consider this.  There are more atoms in a single glass of water, than glasses of water in all the oceans of the Earth.

.-0-

Bob Aronson is a 2007 heart transplant recipient, the founder and primary Bob_Aronson at Mayo Jax tight shot 2008-01-30DJH--02author of the blogs on this site and the founder of Facebook’s over 3,000 member Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

Reflections — What I learned in My First 75 years


By Bob Aronson

cartoonIntroduction

I turn 75 on the 17th of February 2014.  That birthday brings with it mixed emotions and a flood of memories.  Most people I know have one or two birthdays in their lifetime that stand out and have a more lasting effect.  I’ve had three; when I turned 21 for obvious reasons; when I turned 50 and now this one, 25 years later.

Age 50 made me feel as though I had climbed the mountain and on the way had accomplished all that I had set out to do in life.  I stood at the summit and saw no new challenges or goals only a life of sameness and boredom.  I had no idea what was ahead but I somehow felt the excitement of life was over and that I was like a rudderless ship in storm tossed waters.  For the first time in my life I was without goals and therefore without ambition.  It was a horrifyingly depressing feeling. Recovery came only after I awakened one morning scolded myself, adjusted my attitude and set new goals.  That is when I realized 50 was just a number — not a sentence or a punishment.

25 years later I look back and realize that when I turned 50 in1989 there was a whole new life ahead of me. It was to be mixed with success, tragedy, love and a new lease on life, but in 1989 50 was only a number. Birthdays are really quite meaningless because their real significance can only be known when viewed from the future.

That means that age 75 has no meaning yet either.  It, too, is just a number.  As I approach it I feel more emotionally and intellectually alive than ever. Physically I am limited by some of the issues that affect a man of my years but for the most part I am able to do what my lifestyle demands.  If there is a change from 25 years ago it is that I reflect more on the past.  When younger I lived life and never looked back. Now I thoughtfully examine my history seeking to find reasons for my choices and what I learned as a result.  I wish I had done that earlier because having an awareness of what you’ve learned can eliminate the repetition of life’s errors.

Most notable about every birthday in the last six years is the fact that I can celebrate it only because a stranger somewhere in South Carolina decided to be an organ donor. I got his heart in 2007 without which I would have expired years ago.

The heart saved my body but my wife Robin saved my life and my sanity.  robinShe took care of me both pre and post-transplant in times where I was near death’s door, depressed and despondent.  My extended illness could not have been easy for her but despite having to move to a new city, run two businesses and take care of me her disposition never changed and her concern for my well-being never flagged.

Robin made life worth living and because of her care and love, attention and encouragement I was restored and alive again.  Her compassion, concern, optimism and good humor are contagious and I know that with her by my side nothing is impossible.  She captured my old heart and also its replacement.  I am the recipient of blessings that far exceed what I deserved.  Her influence gave me the courage and the will to heal and to develop new interests and skills and today I am a newer and I hope better person than I was.

Turning 75 is a watershed moment, a turning point of sorts when one must admit despite powerful internal forces of denial that “elderly” is a more than apt description.  I am older than the “old men” of my youth but younger than many of my friends.  I feel good, I don’t feel old nor do I think that I think old — but my body sends different signals than does my mind resulting in confusing messages being received by the control centers of my brain. “Get up and run” results in “rise slowly and shuffle.”

Early one morning, as the coffee maker gurgled and steamed and some new aches and pains emerged in new places, I put my arthritic fingers on the keyboard and the following is what magically appeared on the screen. I don’t pretend that what I wrote is particularly profound or even new but, it is what I was thinking at 4 AM on one particular day.

When you are young you should enjoy, appreciate and savor every delicious drop of life.  It is so incredibly short.  There should be no room for pessimism only joy, adventure. success and the pleasure derived from helping others.

When You Are Young, When You Are Old

bu Bob Aronson

cocoonWhen you are young your dreams have eons of time to develop and emerge from the warm confines of their incubator cocoons.  And – the dreams never die, they gently morph into something better and more spectacular.

 ·    

     When you are young you are limited only by the infinity of your imagination.  Nothing is impossible, unhealthy or fatal.  When you are young you are immortal, impervious to harm.

      When you are young “time” is but an insignificant word with no power to limit your possibilities.stopped clock

 ·  The tick and tock of life’s relentless clock is muted while the hands lie almost paralyzed and motionless pointing not to hours or minutes or seconds but rather to eternity. When you are young.

 ·    In the early spring of life you own the world with no thought given to losing those you love because time is not a factor and death is not yet part of living.

 ·    When you are young the effects of time are not visited upon our minds or bodies. As with a good wine or cheese,  aging for the young is gentle and enhances the flavor of life.

·       And when you are young you know you will see the future but it is many calendars away and you have confidence that everything will be better. 

·       When you are young the future is distant and is yours and it abounds with opportunity but…

 ·     When you are old it is seconds away – each experience is a future lived while awaiting the next.

flowersWhen you are old the future is now.  Each new day is a realization of yesterday’s future and the measurement of the quality of life is based on being remembered by those you hold dear.

·       When you are old each new day is a victory, each step a record, each breath a miracle, and each new pain is but a pinch to remind you that life still exists within these bones.

        When you are old you wonder if your life had meaning, If you helped not hindered, if you made a positive mark somewhere on someone – if the people who count still care.

·      When you are old you think about old more often than the young think about youth because senior bodies send some not so simple reminders like pain and…

·       Unlike the young who dream of blissful futures and of unbelievable opportunity the elderly think mostly about what has been, who they were and if they made a difference.

·      When you are young you meet challenges with a determination to overcome them, “your way.”  I might have been far more successful had I taken advantage of the knowledge of those who preceded me who had already invented that wheel.

 ·     When you are old you are free from the stress of wondering what will you be question marksand where you will go. You already know.

 ·     When you are old you are filled with gratitude for your many blessings and a joy for life’s victories already accomplished and you can celebrate again and again.

 ·     When you are old you are eager to share knowledge gleaned from profound life experiences but age and lack of title denies us access to settings where our thoughts can be heard and recognition is often given posthumously — I would rather hear it. 

 ·    When you are old your chest swells with pride when you think of your children and grands and great grands and you hope that someday, when they reflect that you are to them what they are to you. 

      When you are old you desperately miss those you love who live in distant places and you try to assuage the pain with memories and images and anticipation of the next contact.  Nothing is more important than family and close friends….nothing.

 ·      When you are old you achieve a wisdom gained from facing and defeating adversity and of creating and tasting success but all too often the wisdom is left unshared because no one sought to hear it.

·       One_hand animated clock fast  When you are old, you think about time and those paralyzed hands that have been miraculously cured and now speed past the numbers in a frantic race toward —-what?  When you are old.

    And — finally, when you are gone they will speak with great emotion and affection about your fine qualities and contributions.  Words of high praise will be offered by those who mourn your loss.  Words never spoken aloud in the presence of the dearly departed.   Why?

 -0-

Bob Aronson is a 2007 heart transplant recipient, the founder and primary Bob_Aronson at Mayo Jax tight shot 2008-01-30DJH--02author of the blogs on this site and the founder of Facebook’s over 3,000 member Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

“Some Assembly Required”– The Most Terrifying Words Ever Written


Introduction by Bob Aronson

Story by Bob Huck

This is a humor column.   While normally we delve into those topics that are of great interest to the donation/transplantation community once in a while we take a break to have some fun.  This story is one with which we can all relate because there’s not a one of us that hasn’t been in a similar situation.  Perhaps not quite as dramatic but similar nonetheless.

Bob Huck and I were adversaries before we became friends.  Total opposites, we began our relationship on Facebook arguing political philosophy.  Two men could not be more different in their politics.  One day, though, we found common ground.  I won’t go into detail but from that discovery came others until it was obvious there was much to discuss and much upon which we agreed.  We set our differences aside and concentrated on developing a friendship and it worked.

Bob Huck is a fascinating man with a background rich in human experience.  His narrative here is dedicated to those who have had to assemble something for their kids and I guess that’s most of us.  “So easy a child can put it together” is a commonly used phrase.  Commonly used but inaccurate. 

When you read the words, “Some assembly required” It usually means you must reinvent the wheel and you can be guaranteed that the directions were translated from a foreign language by someone who does not speak yours. “Insert part B as seen on Illustration C and also on B14 in book 2″ are common instructions that boggle the mind.  I’ll go no farther.  Here’s Bob Huck to tell you his story about assembling a simple kit for his kids.  One more note.  Bob is now fully recovered from the experience.

THE FLAT BOX  A Narrative Case History From The ICU

intensive careThe following tragic case history was dictated from the patient’s bed in an anonymous hospital intensive care unit. It has been recorded as a patient interview and except for the more profound interruptions, outlined in the parenthetical notes herein; most of the routine interruptions have been excluded as the patient’s voice was faltering and weak at best. He alternated frequently between extreme agitation and short bouts of catatonia throughout the interview process. Also, the patient would occasionally issue sounds rather than words. In such instances the sounds have been added as accurately as possible to the text in an effort to reflect the level of stress the patient was suffering at the time.

The following is the chronology of events as dictated by the patient. The interview was conducted over a period of several weeks as serious relapses followed by extended recovery periods were common.

Day One, The Morning

sunshiny morning“It was a bright Saturday morning. It started in a routine way. A quiet breakfast on the deck after sleeping in, a