Author Archives: Bob Aronson

Why Prescriptions Cost So Much and What You Can Do About It

A couple of weeks ago the news was filled with stories about Martin Shkreli the CEO of Turing Pharmaceuticals, a relatively small drug manufacturer. Some media branded him with this headline world's biggest a holebecause he raised the price for one pill of Daraprim, a 62 year old drug,
from $13.50 to $750. That’s about 5,000 percent. Now, he says he will lower the price, but there’s no indication of how much or, as of this writing, when (According to Web MD Daraprim is used with other medication (such as a sulfonamide) to treat a serious parasite infection (toxoplasmosis) of the body, brain, or eye or to prevent toxoplasmosis infection in people with HIV infection).

As it turns out, though, the “World’s Biggest A–Hole case is not in the least bit unusual, it happens with pharmaceutical companies with great regularity as a tactic to increase profits on older drugs, drugs that have long since paid for themselves.

The global market for pharmaceuticals topped $1 trillion in sales in 2014. The world’s 10 largest drug companies generated $429.4 billion of that revenue. Five of these companies are headquartered in the U.S. They are: Johnson & Johnson, Pfizer, Abbot Laboratories, Merck and Eli Lilly.

Johnson and Johnson, America’s biggest pharmaceutical manufacturer raised prices on over 130 brand name products this year alone. Merck & Co. raised the price of 38 drugs. The increases in the U.S. have added over a billion dollars of revenue in the last three years. So, while Mr. Shkreli may get the award for being the biggest you know what, he is in good company — only the others were smart enough not to brag about it.

Before I go on it is important to point out that my interest in the topic is both personal and professional. I am a senior citizen, who has had a heart transplant and who also has Chronic Obstructive Pulmonary Disease (COPD). I take a good number of prescription drugs and despite having Medicare Part D insurance I still pay thousands of dollars a year for my prescriptions. Most of the drugs I take have been around for quite a while, but not long enough to allow the sale of generics and because there are few if any pricing restrictions, most of my meds are outrageously high priced.

One of the drugs I take is called Foradil. It was approved by the FDA in February 2001 for the maintenance treatment of asthma and the prevention of bronchospasm in reversible obstructive airways disease. Despite being on the market that long, it still retails for about $250.00 for a 30 day supply. Spiriva is another COPD drug and is often taken with Foradil. It retails for about $350.00. I take about a dozen drugs and these two alone total over $600.00 a month. Insurance cuts that cost in half, but they are still expensive. Because of these prices I know of many seniors and others who have to choose between eating and paying for their prescription meds.

In Europe, Asia, Australia and anywhere else with some form of socialized medicine strict government regulation helps prevent those kinds of actions and subsequently keeps prices down. Things are a whole lot looser in the U.S.

In 2013 each of us spent over $1,000 on prescription drugs. That works out to $429 billion. In case that figure boggles your mind, let me boggle it more by showing you what it looks like in black and white — $429,000,000,000. By anyone’s measure that’s a lot of money. To put it all in perspective Prescription medications make up close to 10 percent of the $2.9 trillion annual total spent on healthcare in the U.S.

Americans spend more on drugs than any other country in the world and – we also pay more for them than any other country.

big pharmaBefore we go into detail on why prescription drugs cost more here than anywhere else, let’s look at the biggest drug and biotech companies in the world. They account for more than a third of the industry’s total market share according to the World Health Organization. We won’t go into detail but here’s the top ten and their 2014 revenue.

  • Gilead Sciences $24.474 billion.
  • Bayer $25.47 billion.
  • AstraZeneca $26.095 billion.
  • GlaxoSmithKline $37.96 billion.
  • Merck’$42.237 billion.
  • Sanofi $43.07 billion.
  • Pfizer 49.605 billion.
  • Roche $49.86 billion.
  • Johnson & Johnson $74.331 billion.

If you were to ask any of those companies why prescription drugs cost so much they would likely tell you that the price reflects the immense costs of research and development. They would explain that it costs millions andcosts millions of dollars to develop a new drug and then millions more to get through animal and human studies and FDA approval, and that’s partially true. Partially. Those costs are very high, but what big pharma won’t tell you is that you are also paying for the costs of marketing the drug to physicians and patients and those costs dwarf the research and development expense.

The world’s largest pharma company, Johnson & Johnson, spent $17.5 billion on sales and marketing in 2013, compared with $8.2 billion for R&D. Most of that marketing effort is aimed directly at physicians, the people who write the prescriptions, rather than customers like you and me. It should be noted that the U.S. and New Zealand are the only two countries that allow any form of advertising for prescription drugs.

No sane person can object to a company making a profit, it’s part of the American way, but the drug industry’s profits are excessive. At the risk of being accused of repetitiveness I must say again. We pay significantly more than any other country for the exact same drugs. United States spends more than $1,000 per person per year on pharmaceuticals. Per capita drug spending in the U.S. is about 40 percent higher than Canada, 75 percent greater than in Japan and nearly triple the amount spent in Denmark. So why is that?

Well, first the U.S. is a very rich and therefore lucrative market because we use more medicine than any other developed country. We account for 35 percent of the world market for pharmaceuticals. Americans have become quite accustomed to leaving their doctor’s office with a handful of prescriptions.

Due to our ill health and our wealth, companies often choose the U.S. in which to launch new products. And, because the US market is so big and profitable, investments in research and development have long been steered towards meeting clinical needs.

But if we Americans take more prescription drugs, we also pay an arm and a leg more for them. Why? Because other countries have tough regulations about pharmaceutical prices and they set reimbursement limits. MedicareAnother smart thing they do is to agree to pay for a drug only if the price is justified by the medical benefits. In the U.S., Medicare which is the world’s largest buyer of prescription drugs is prohibited from negotiating prices with drug companies. If the company says that a pill is $100, Medicare has no choice, but to pay it if the patient needs it. They have no wiggle room and that costs taxpayers billions of dollars a year in a direct giveaway to the pharmaceutical behemoths and speaks to the power of their lobbyists.

Speaking of lobbyists, here’s the real rub. The pharmacy industry views congress as a place to invest against future price controls and this is what really adds to the price of your prescriptions.

Big Pharma Spends More on Lobbying Than Anyone
lobbyistsSince 1998, the industry spent more than $5 billion on lobbying in Washington, according to the Center for Responsive Politics. To put that in context, that’s more than the $1.53 billion spent by the defense industry and more than the $1.3 billion forked out by Big Oil.

From 1998 to 2013, Big Pharma spent nearly $2.7 billion on lobbying expenses — more than any other industry and 42 percent more than the second highest paying industry: insurance. And since 1990, individuals, lobbyists and political action committees affiliated with the industry have doled out $150 million in campaign contributions.

Now here’s how it works for you and me. In the U.S. insurers only accept the price set by the drug makers. If the drug is exclusive, meaning there is no competing medication from other companies. Insurers then cover the total cost by forcing a higher co-pay on patients. Unlike Medicare, insurers have bargaining power when there are competing drugs and therefore can reduce the co-pays.

generic drugs1Then, there is the Generic drug market, those are drugs in which the patent has run out and other manufacturers are allowed to produce the product. As an example the antidepressant Remeron is also known by its generic name Mirtazapine. Remeron is the brand name given it by the original manufacturer, but Mirtazapine can be made and distributed by any pharma company and sold for a much lower price.

Competition in that area is fierce and generic drug prices are usually low. Today generics account for about 85 percent of drugs dispensed in the U.S.

Despite generics and their low prices, there are still many Americans who daily make the choice between food or drugs, between paying the rent and drugs or giving up some other type of health care in order to afford the drugs that keep them going. Many Americans don’t take their recommended prescriptions because they can’t afford them. One recent survey showed that about one in five U.S. adults did not fill their prescription or skipped doses due to cost as opposed to Australia and some other countries where the ratio is one in ten.

Some people have turned to foreign sources for their prescriptions and advairthere are many with some of the more popular ones thriving in Canada. Here’s an example of the savings that can be had. If you want a three month supply of the popular asthma inhaler Advair it will likely cost you somewhere in the neighborhood of $600 to purchase it from one of your local pharmacies. If you select one of the Canadian pharmacies you can import the same three month supply of the same medication, Advair, for about $150, with shipping included. That amount may not mean much to the Donald Trump tax bracket, but to average Americans it’s a whole lot of money. Advair is just the tip of the iceberg. ABC news reports the following price comparisons:

  • Mirapex, for Parkinson’s disease: $157 in Canada vs. $263 in the United States.
  • Celexa, for depression: $149 in Canada vs. $253 in the United States.
  • Diovan, for high blood pressure: $149 in Canada vs. $253 in the United States.
  • Oxazepam, for insomnia: $13 in Canada vs. $70 in the United States.
  • Seroquel, for insomnia: $33 in Canada vs. $124 in the United States.

Tufts University in Boston released a study in the year 2000 that placed the cost of approval for a single drug at $802 million, and that was fifteen years ago. To be fair it must be revealed that the dollar amount adds in each successful drug’s prorated share of failures (only one out of fifty drugs eventually reaches the market), but that still does not explain why the retail price is higher here than anywhere else.

The only logical explanation I can come up after some a fair amount of research is that pharmaceutical companies can get away with much higher prices in the U.S. and they can’t elsewhere. Period!

So what are your options, what can average patients who have difficulty Optionaffording some drugs do to stay healthy and be able to eat and pay their rent and other bills at the same time?

Well, there are several steps you can take. Among them are:

  • Contact state and federal legislators and ask them to allow Medicare to negotiate the price of prescription drugs
  • Also ask them to allow importing of essential drugs from foreign companies through approved pharmacies.
  • Ask big pharma companies to see if you qualify for their reduced prices for people who have trouble affording them.
  • Read the Consumers Report story on the issue. It will give you the information you need to identify trustworthy pharmacies.

But, if you are like me you want even more detail. Ok. Here’s the best I can do.

You can shop for the best price and because of the internet that’s become a whole lot easier. You can look up a specific drug and find the best price at a pharmacy near you. Here are two resources. I’m sure you can find a lot more  or All you have to do is type in the drug you need and your zip code and it will find the price of that drug in pharmacies near you.

Transplant recipients might be interested in the cost of anti-rejection drugs. The price is hard to stomach but easy to find. In my zip code 32244 100 Mg Cyclosporine capsules range in price from $526.00 at Wall Mart to $584 at Target. If you are a heart patient and take Carvedilol in my neighborhood it ranges from $4.00 at Wal Mart to $9.54 at Kmart. Lisinopril also has a wide range. At the Publix Supermarket pharmacy near me it is FREE…that’s right FREE.  But at CVS it is $12.00.  Those price variations might make it worth a little longer drive to get a better bargain.

You can also get help with coupons which are an obvious choice to savecouponmoney when grocery or clothes shopping, but they’re often overlooked as a way to cut costs of over-the-counter and prescription drugs. Manufactures frequently offer one time and repeat coupons that can save consumers hundreds of dollars on their medicines. “For our family it has been incredibly effective [in saving money] for a number of regular prescriptions,” says Stephanie Nelson, founder of the coupon website

The costs of prescription drugs and over-the-counter medications have been steadily rising and patients facing tight budgets are often forced to make hard decisions when it comes to what they can afford.

The savings vary by manufacturer, but many companies offer discounts at each prescription refill while others offer discount cards that take $20 off co-pays. Others offer one-time coupons to cover the first use of a drug.

  • Consumer Reports Magazine says that there are other ways to save money, too. Whichever drugstore or pharmacy you use, choosing generics over brand-name drugs will save you money. Talk to your doctor, who may be able to prescribe lower-cost alternatives in the same class of drug. In addition, follow these CR tips.
  • Request the lowest price. Our analysis showed that shoppers didn’t always receive the lowest
    available price when they called the pharmacy. Sometimes they were given a discounted price, and other times they were quoted the list price. Be sure to explain—whether you have insurance or not—that you want the lowest possible price. Our shoppers found that student and senior discounts may also apply, but again, you have to ask.
  • Leave the city. Grocery-store pharmacies and independent drugstores sometimes charge higher prices in urban areas than in rural areas. For example, our shoppers found that for a 30-day supply of generic Actos, an independent pharmacy in the city of Raleigh, N.C., charged $203. A store in a rural area of the state sold it for $37.
  • Get a refill for 90 days, not 30 days. Most pharmacies offer discounts on a three-month supply.
  • Consider paying retail. At Costco, the drugstore websites, and a few independents, the retail prices were lower for certain drugs than many insurance copays.
  • Look for additional discounts. All chain and big-box drugstores offer discount generic-drug programs, with some selling hundreds of generic drugs for $4 a month or $10 for a three-month supply. Other programs require you to join to get the discount. (Restrictions apply and certain programs charge annual fees.)
  • Experts say that although the low costs could entice you to get your prescriptions filled at multiple pharmacies, research indicates that it’s best to use a single pharmacy. That keeps all of the drugs you take in one system, which can help you avoid dangerous drug interactions.”

Finally, what do you do if you’ve done the shopping, used coupons, followed all of the Consumer Report Tips and are still unable to pay for your prescriptions? Well, there is some limited assistance. Here are some resources.


bob half of bob and jay photoBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,200 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 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  It only takes a few minutes. Then, when registered, tell your family about your decision so there is no confusion when the time comes.


Our Hospitals are Killing us, But Where’s the Outrage?

By Bob Aronson

This blog is dedicated to friends Kerry and Marsh Wick. Marsh, who underwent surgery in a local hospital, contracted an infection while there and died a few weeks ago. His wife Kerry, who was constantly at his side hopes that a more informed public will lead to fewer such cases.

'The patient in the next bed is highly infectious. Thank God for these curtains.'

Most of us still believe that hospitals are places that help the sick and dying get well. But are they? If you look at the most recent patient safety data one can’t help but arrive at the conclusion that there are safer places to be than hospitals. Here are some sobering facts.

Preventable medical errors are the No. 3 killer in the U.S. – following only heart disease and cancer – and claiming 400,000 lives a year.


400,000 people die each year in American hospitals due to preventable errors. Preventable errors — but there is no public outrage, it doesn’t lead the news each night and no politician is using that issue to get elected.

Ok, If that number doesn’t shock you, let’s put it in terms that will. The Airbus A380 is a double-deck, wide-body, four-engine jet airliner and is the world’s airplane crashlargest providing seating for 525 people in a typical three-class configuration. In order to kill 400,000 passengers a year, 761 of these monstrous jets would have to crash every year…761, that’s over two a day. There aren’t that many A380s in the world. Probably never will be.

So if planes were falling out of the sky at that rate, would there be congressional investigations, demonstrations in the streets, charges of criminal misconduct and airlines going out of business faster than you can say your own name. Pilots, co-pilots, airline executives, airline mechanics, air traffic controllers and even airport managers would be going to jail, but because that same number of people die due to errors in hospitals there is virtually no public outrage. Maybe old Uncle Joe Stalin who killed millions of his own people had it right when he said, “One death is a tragedy; a million is a statistic.”

If this was happening to airplanes it would be a lead story on every newscast and in every newspaper every day. So don’t you think just a little outrage is in order? 1,000 of our friends and neighbors die every day from preventable yes, preventable causes. But, if the cost of human life doesn’t get your attention, how about this. Preventable medical errors cost you and me over one trillion dollars a year. Yes, that’s trillion with a T, a thousand billion.

Killing patients at the rate of 400,000 a year has caused preventable medical errors to become the third leading cause of death in the United States, right behind heart disease and cancer.

So you likely are asking yourself, “Just exactly what is a medical error?” Well, there are thousands of them. I’ll give you just a few and you’ll soon realize that if you can imagine it, it likely has happened.

  • Treating the Wrong Patient. If your identity gets mixed up with someone else’s, you can get the wrong medications or even the wrong surgery.
  • Surgical Souvenirs. Surgical tools or other objects are left inside people after surgery far more often than you’d like to think.
  • Air Bubbles in Blood. If the hole in your chest isn’t sealed correctly (airtight) after a chest tube is removed, air bubbles can enter the wound and cut off blood supply to your lungs, heart, kidneys and brain — a life-threatening event.
  • Operating on the Wrong Body Part. It can happen if a surgeon misreads your chart, or if the chart is incorrect.
  • Infection Infestation. Hospital-acquired infections (HAIs) are alarmingly common. Many people are admitted infection free, but partially because of antibiotic resistant bugs and partly because of sheer carelessness many of them acquire several infections and far too many die as a result.

Ok…you got the idea. Pretty gruesome, huh?   So let’s talk about infections, the point of this blog.

I am the founder of the Facebook support group, Organ Transplant Initiative. We have over 4,000 members. Recently during a discussion of HAIs, one of our members posted this horror story, unlike so many others he lived to tell it.

“Back at the time of my rapidly progressing illness and eventual transplants I went into the hospital with ONE infection acquired from contaminated soil it’s believed. After being in a local hospital for over a month I had no less than 15 other bacterial and fungal infections. Some acquired while beingcanada-hospital-deaths operated on. That particular hospital was cited for their infection issues too. One of the things uncovered was they were using mesh for hernia type repairs and then autoclaving the unused portion and repackaging it. That is absolutely forbidden.”


The September 2015 edition of Consumers Rconsumer reportseports Magazine includes a major report on HAIs. This is a story everyone ought to read and soon. I will report some of my personal research findings later but CR did such a good job of framing the issue, I’ve included the first couple of paragraphs here.

The Rise of Superbugs

“In the ongoing war of humans vs. disease-causing bacteria, the bugs are gaining the upper hand. Deadly and unrelenting, they’re becoming more and superbugsmore difficult to kill. You might think of hospitals as sterile safety zones in that battle. But in truth, they are ground zero for the invasion.

Though infections are just one measure of a hospital’s safety record, they’re an important one. Every year about 700,000 people in the U.S. develop infections during a hospital stay, and about 75,000 die with them, according to the Centers for Disease Control and Prevention (CDC). That’s more than twice the number of people who die each year in car crashes. And many of those illnesses and deaths can be traced back to the use of antibiotics, the very drugs that are supposed to fight the infections.”

What’s shocking is that the harm caused by these infections is mostly preventable. The CDC (Centers for Disease Control and Prevention) in Atlanta, Georgia says healthcare facility surveys indicate a grave situation that is getting worse (HAI)prevalence survey). patient deaths Based on a large sample of U.S. acute care hospitals, the survey found that on any given day, about 1 in 25 hospital patients has at least one healthcare-associated infection. There were an estimated 722,000 HAIs in U.S acute care hospitals in 2011. About 75,000 hospital patients with HAIs died during their hospitalizations. More than half of all HAIs occurred outside of the intensive care unit.

This is the official U.S. Government estimate of infections occurring in Acute Care Hospitals in the United States.

Pneumonia 157,500
Gastrointestinal Illness 123,100
Urinary Tract Infections 93,300
Primary Bloodstream Infections 71,900
Surgical site infections from any inpatient surgery157,500
Other types of infections 118,500
Estimated total number of infections in hospitals 721,800
To read the full report, please visit: CDC HAI Prevalence Survey
Magill SS, Edwards JR, Bamberg W, et al. Multistate Point-Prevalence Survey of Health Care–Associated Infections.  N Engl J Med 2014;370:1198-208.

  • And here is some other startling information. Did you know you are at risk even while in the shower? Studies indicate that moisture-loving bacteria living in showerheads include huge populations of potential pathogens and, they can be quite different from their relatives who live on shower curtains just a few feet away.
  • A common misconception is that germs have very short life spans, but that’s simply not true. Drug-resistant staph germs can live for up to a week on some common furniture fabrics. Strep germs can survive for months on a dry surface. You simply cannot overdo cleaning or washing your hands. Who knows whose life you might save by doing so…it could be yours or someone very dear to you.

Raw numbers are cold and impersonal, the human side of the equation is anything but. Here are but a few real experiences that were posted on Facebook’s Organ Transplant Initiative support group

  • On my Father’s death certificate, it actually says “Health Care Aquired pneumonia”.I asked my doc what that’s all about (Dad died from complications from cancer) He said that more and more these days, they are putting that on death certificathospital acquired infectionses because they are required to by law.

I got C-DIFF (Clostridium difficile colitis is an infection of the colon) and I’m in good health, one year ago this month I was in hospital for 10 days- in the ICU for 3. They couldn’t figure it out- infectious disease came in every day- it’s scary out there!!!

***Editor’s note. The law requires healthcare facilities to report hospital or healthcare acquired infections (HAI) and to include them on the death certificate if, in fact, they caused the death. The doctor’s explanation that they are required to do that is fudging the facts. They are only required to do that if an HAI actually was the cause of death. No healthcare facility likes talking about a problem that may be one of their own making, so downplaying it as a government requirement removes them of complicity.

  • My husband was so deconditioned by the time he was able to be released post-transplant, that he had to go to an LTAC (Long Term Acute Care Hospital…aka as “hell”) At one point I told the person who called herself a nurse that he had managed to live, contrary to everyone’s expectations, and survive a liver transplant, and now “they” were going to kill him through neglect). Sadly, this is one of the circumstances that very ill transplant patients face. My only advice is be very vigilant. Take notes. Take pictures. Ask questions. Keep a journal. But for the attention of the ONE full-time physician and the contracted therapy staff, I’m really not sure he would have survived there.

Here are some examples of preventable contagion.

  • A cleaning person enters your hospital room, puts on gloves and empties the trash. The trash could include old dressings contaminated with various bodily fluids and other infectious material. Then without glovedchanging gloves starts a new box of facial tissue and opens rolls of toilet paper and paper towels. That worker has just used the same gloves on everything he/she touched  — and those items will then be used on your face and other sensitive areas.
  • Also, consider this. How many times have you seen a urinal sitting on the bedside table that swings over the bed? That table is where they place your food.
  • As these infections become more common it is incumbent on all of us to be more aggressive in demanding better infection control procedures. When you see an infraction, report it to the offending person’s supervisor. Hospital workers must follow strict hand washing procedures, change gloves often, clean flat surfaces more than once a day and NEVER allow urinals to come in contact with any other human especially those who are untrained and unprotected. As for patients, we had better use every precaution we can and the best of all of them is frequent hand washing.

Hospital Acquired Infections are a very real and constant threat, but prevention efforts appear to be paying off. The numbers aren’t big yet, but it should come as a relief to many that they are headed downward. By clicking on the following link you can get a detailed summary of the progress being made in the fight against HAIs.

HAI Progress Report

The CDC National and State Healthcare-Associated Infections Progress Report is a report that gives a closer look at the healthcare-associated infections (HAIs) most commonly reported to CDC using the National Healthcare Safety Network (NHSN). This is an annual report that describes national and state infection prevention progress.

The current report is based on 2013 data. On the national level, the report includes these highlights.

  • progress reportA 46 percent decrease in CLABS (Central Line Associated Bloodstream Infections)between 2008 and 2013

A 19 percent decrease in SSIs related to the 10 select procedures tracked in the report between 2008 and 2013 (An SSI is an infection that happens after surgery affecting the part of the body where the surgery was performed. Some SSIs are superficial skin infections, while others are more serious and involve tissue under the skin or organs)

  • A 6 percent increase in CAUTI between 2009 and 2013; although initial data from 2014 seem to indicate that these infections have started to decrease (CAUTI = Cather Associated Urinary Tract Infections).
  • An 8 percent decrease in hospital-onset MRSA bacteremia between 2011 and 2013 (Methicillin-Resistant Staphylococcus Aurens)
  • A 10 percent decrease in hospital-onset C. Diff infections between 2011 and 2013

While blogs like this can shine a spotlight on certain problems, we cannot even begin to give you all the information you need so you can decide which hospital is best for you. All we can do is offer you information that will lead you to the information you seek.

There are several organizations that gather information on Patient Safety for nearly every hospital in America. Some, like Consumer Reports require you to subscribe before giving you access. Others offer you access to a point and then place conditions on further cooperation on their part. If you Google “Compare hgoogleospital patient safety records” you’ll get plenty of hits to explore. A warning; The process can be time consuming, confusing, frustrating and may even result in inaccurate information.  You may even have to do some studying in order to understand the information you find.

I did much of what I suggested to you. It took many hours and I cannot guarantee accuracy. I tried hard to achieve that goal but when there are as many disparate sources of information as there are on this particular topic it all boils down to an educated crap shoot.

One of the best resources I found for comparing hospital patient safety records is this one. but if you find it inadequate and not meeting your needs, then look around, there are plenty of other resources.


bob aronsonBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,200 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  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  It only takes a few minutes. Then, when registered, tell your family about your decision so there is no confusion when the time comes.


Post Transplant Depression, It’s Common and There’s Help!

By Bob Aronson

gloomy gusHaving suffered from post transplant depression myself, I know of what I speak.  It hits you like a sledge hammer and keeps pounding away.  The pain isn’t physical, it’s emotional and it can be intense.  You can feel useless, unnecessary, irrelevant and totally without purpose.  Some patients even feel suicidal, but it doesn’t have to be that way.  There is help.

If there’s one  message you should take away from this blog, it is this.  Depression is not your fault, you did not cause it and therefore you alone can not fix it. “Cheer up, look at the bright side,” may sound like good advice but it isn’t because it assumes you decided to feel lousy.  Who on earth would choose to be depressed?  It is sad, but true that sometimes even the people closest to you don’t understand.  They continue to hold on to the belief that you can snap out of it if you really want to.  The reality of depression just isn’t that simple.  Frankly, it is very, very complex and takes highly skilled and trained professionals to help you find your way back to the sunny side of the street.

Unfortunately if you have had or if you are going to have an organ transplant, chances are good that you might fall victim to post transplant depression. Estimates of how many patients become depressed following an organ transplant range from 10 percent all the way up to 50%, but no matter what the percentage the fact is that some people will have serious emotional struggles following their transplant.

One can easily ask, “Depression? Why on earth would anyone be depressed after their life has been saved by the donor/transplantation process?”  Well, there are a number of reasons, chief among them is the haunting feeling that someone had to die in order for you to live.  The fact is, the person who died, would have died anyway whether they were an organ donor or not and if they were, someone might gain new life as a result, but that’s logic and logic alone cannot solve the problem and help the patient. Besides, there are other issues that contribute to depression like:

  • Living with the psychological highs and lows that are sometimes not okcaused by immunosuppressives such as corticosteroids
  • The steroids you take can have the effect of a mood amplifier. In the first few weeks, especially, when the doses are highest, the medicine will wind you up and make it hard to sleep. The sudden changes in the family — and in your behavior — can be extreme.
  • Managing a complex post-transplant regimen that encompasses: (1) multiple meds and schedules, (2) monitoring vital signs, (3) exercise and dietary requirements, (4) regular medical evaluations and lab tests, and (5) lifestyle restrictions on smoking, alcohol, and other potentially harmful substances
  • Major life alterations such as transitioning from being critically ill or dying patients and family caregivers to roles that are more wellness-focused)
  • Coping with new and taxing financial and economic issues like the cost of transplant surgery, hospital stays, follow-up care, cost of drugs and health insurance.

To some that list of changes is so overwhelming as to be nearly impossible to manage.  Some have been seriously ill for such a very long time and so focused on dying that they cannot adjust to an attitude that centers on life and living.   What is even worse is that unless the patient is getting professional psychiatric help he or she may not be able to identify a single stressor that brought on their depressed state.

What is Depression?depression

Simply put, depression is a mood disorder that causes a persistent feeling of sadness and loss of interest in those things that had been of great importance.  It affects how you feel, think and behave and can lead to a variety of problems. Day to day activities become ponderous and boring and patients sometimes feel their lives are not worth living.

Depression isn’t just feeling “down” and you can’t just “snap out of it.” It can require long-term treatment with either medication, psychological counseling or a combination of the two. Above all you must know that suffering from depression is not a personal weakness.  You didn’t bring it on and will power alone cannot defeat it.

Depression can occur once or several times in a lifetime and according to the Mayo Clinic ( the symptoms can appear all day, every day and may include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Other people may feel generally miserable or unhappy without really knowing why.

Health Concerns

(Material gathered here comes from several sources primary among them is UNOS (the United Network for Organ Sharing).

What happens after transplantation depends on the organ transplanted and the recipient’s specific medical situation. Most patients recover fully, return to work and resume a normal, active life after receiving a new organ. However, there is a possibility of developing unrelated health problems after transplantation. That’s why it is important to work closely with your doctor concerning your overall wellness, as well as regarding the following health concerns:

Anxiety and Depression

anxiety symptomsPatients and their families face a new lifestyle after transplantation that may cause them to feel nervous, stressed or depressed. Because emotional and psychological support is a continuing process, ask your social worker about counseling services that can help you and your family deal with these changes. Professionals can help you work through concerns about your self-image; mood swings; job planning; rehabilitation; family stresses, such as parent-child conflicts, marital conflict or changes in sexual functioning; and financial concerns, such as questions about Medicare, disability or insurance.  Any and all of the following can contribute to your depression and/or anxiety.


Some anti-rejection medicines are known to cause high blood sugar. Although it is typically a temporary condition after transplantation, it is more common in patients who have a family history of diabetes and patients who are overweight. It can be controlled by reducing the dose of a patient’s anti-rejection medicines or changing medications all together.

GI Upset

GI (gastrointestinal) or stomach upset is also a common complaint after a transplant. Patients on steroid therapy may be at an increased risk of developing ulcers due to increased hydrochloric acid from the stress of the procedure. Treatment of GI upset may include one or a combination of drugs that reduce acid production. In addition, people with GI upset should take several steps to reduce symptoms, including:

  • Reducing the intake of caffeine, alcohol and over-the-counter medications that cause GI upset.
  • Eliminating carbonated drinks can help
  • And it sometimes helps to take your meds with food to decrease irritation.


Gout is a painful and potentially disabling form of arthritis. Diagnosing gout can be difficult and treatment plans vary based on a patient’s existing medical problems and medications.  Often Gout will show up in the big toe and it is very painful.  Sometimes even a bedsheet touching the Gout area will result in extreme pain.

High Cholesterol

Many immunosuppressant drugs can contribute to high cholesterol. This condition therefore affects many transplant recipients. When a patient develops high cholesterol, blood vessels, including the ones attached to the transplanted organ, become clogged, which affects the flow of blood. This slowing of blood flow can affect the success of your transplant and may even lead to heart disease. It is important to talk to your doctor about how to reduce the risk factors of heart disease, including controlling your cholesterol.


Hypertension, or high blood pressure, is common immediately after
transplant. Certain anti-rejection medications, as well as the original disease, all can contribute to hypertension. Treatment of hypertension may include one or a combination of drugs, and often, as anti-rejection medicines are tapered to a maintenance dose, hypertension may decrease. Talk to your doctor about what’s right for you and how to avoid high blood pressure.

Sexual Relations

Sexual concerns after transplantation are commonly experienced, yet seldom discussed or addressed during evaluation. It is therefore very important to talk with your doctor about your sexual history and concerns.

However, sexual function and interest can be related to how well your body has accepted your new organ and how realistic your expectations were for life after your transplant. A counselor can also help a couple understand the difference between pre- and post-transplant problems. Often, support groups can be very helpful in this regard.

Additionally, in sexual relations, as in all issues, recipients must remember that they are immune suppressed and subject to many kinds of infections. In fact, some infections in recently transplanted patients can be potentially life threatening. Consequently, it is important to consider the following points:

  • The sharing of saliva during kissing can expose both partners to active diseases, such as colds or other viruses.
  • Condoms don’t prevent diseases that are spread by contact between the area surrounding the penis and external genitals.
  • The risk of contracting infectious diseases though oral sex is possible, especially if ejaculation occurs or if there are any sores or wounds on either partner.


People with weakened immune systems, such as transplant recipients treated with immunosuppressive drugs, risk developing shingles. Shingles is a painful infection of the central nervous system caused by the Varicella virus that causes a blistering rash and severe burning pain, tingling or extreme sensitivity to the skin and is usually limited to one side of the body. The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with antiviral drugs.  You should also ask your doctor about getting the Shingles vaccine.

Sometimes our own irresponsible behavior is responsible for feelings of depression or inadequacy.  It has been established that noncompliance appears to be relatively common during the first several years after transplantation. That means some patients just don’t take the right amount of medication at the right time, if they take it at all. Furthermore, compliance in most areas of the medical regimen worsens over the first year after the transplant just as it does for most patients who begin new medical therapies.  For example:

  • Up to 20% of heart transplant recipients and 50% of kidney transplant recipients have been found to be noncompliant with prescribed immunosuppressant medications during a given 12-month period in the early post-transplant years
  • 5% to 26% of heart transplant recipients smoke at least once after being transplanted; no study has determined what proportion of these patients become regular smokers.
  • 11% to 48% of liver transplant recipients return to some level of alcohol consumption during the first year post-transplantation.
As a result of noncompliance patients are likely to experience rejection symptoms or actual rejection and, of course when this happens patients experience anxiety and/or depression.

Treatment options

time to healResearchers at Henry Ford Hospital have found that emotional closeness between transplant patients and their caregivers helps reduce depression and anxiety after surgery.  While this study was about liver transplant patients, it is likely that the conclusions probably have universal application.

“People with close networks and good support recover faster after liver transplant and have less depression and anxiety at six months after transplant,” says Anne Eshelman, Ph.D., Henry Ford Health System Behavioral Health Services, lead author of the study.

“These findings suggest caregiving relationships as a target for psycho-therapeutic intervention among patients with end-stage liver disease.”

Study results were presented at the International Congress of Behavioral Medicine in Washington D.C., held by the International Society of Behavioral Medicine and the Society of Behavioral Medicine.

The study looked at 74 liver transplant surgery candidates and their primary caregivers. Transplant patients were surveyed before surgery and at a six-month follow-up. Caregivers rated the degree of closeness they felt in their relationship to the patient.

The sample was divided into groups with caregivers reporting maximum closeness or less closeness.

For patients with end-stage liver disease, depression and anxiety improve after liver transplant, but the study found that these changes are not as great for individuals with emotionally distant caregiving relationships.

“If you live with someone who loves you, the quality of care they provide may be much better, they may be more encouraging, you may want to please them and recuperate faster so you can spend quality time with them,” says Dr. Eshelman.  “Caregivers who are not close, may provide the basic requirements, but don’t help give someone a reason to live and look to the future.”

The study results also suggested that emotional closeness was critical for affective improvement in men, but less so for women, though interpretation is limited by a small sample size, explained Dr. Eshelman.

“Men who had adequate number of support people, but did not have close support, were still depressed and anxious at follow up, compared to those who had closer support,” says Dr. Eshelman. “Other literature shows that women have wider support, more friends and family they are connected to than men, and if the primary support person is not that close, they probably rely on the other people such as girlfriends.”
The study was funded by Henry Ford Transplant Institute.

Treatments for Depression

From Web MD

If you are diagnosed with depression, here’s some good news: Excellent treatment options are available to you.

Many people use a combination of treatments, such as medication and psychotherapy. For depression that doesn’t respond to standard treatment, non-drug approaches can be effective, either alone or used with other treatments.

Learn more here about the most common approaches to treating depression.

Talk Therapy for Depression

Talking with a trained therapist is one of the best treatments. Some people choose to be in therapy for several months to work on a few key issues. Other people find it helpful to continue in therapy for years, gradually working through larger problems. The choice is up to you and your therapist. Here are some common types of therapy:

  • Cognitive behavioral therapyhelps you see how behaviors and the way you think about things plays a role in your depression. Your therapist will help you change some of these unhealthy patterns.
  • Interpersonal therapyfocuses on your relationships with other people and how they affect you. Your therapist will also help you pinpoint and change unhealthy habits.
  • Problem-solving therapyfocuses on the specific problems you face and helps you find solutions.

Medicines for Depression

Medicines are the other key treatment for depression. If one antidepressantdepression meds doesn’t work well, you might try a similar one or a different kind. Your doctor might also try changing the dose. In some cases, he or she might recommend taking more than one medication for your depression. There are now many different antidepressants that your doctor can choose from. The entire listing can be seen here:

Just keep in mind that recovery is a process that may need constant adjustment and takes time.


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 4,200 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  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  It only takes a few minutes. Then, when registered, tell your family about your decision so there is no confusion when the time comes.

What You Need To Know About Your Liver and The Transplant Process

By Bob Aronson

cartoonThe liver is an incredibly important organ and the only one in the human body that can regenerate itself.  It is second only in size to the skin (yes the skin is an organ) and has been described as boomerang shaped.  Virtually every nutrient we consume passes through the liver so it can be processed and turned into a different biochemical form for use by other organs.

Located just below the rib cage in the upper right side of your abdomen the liver has three main functions.  It helps in digestion makes proteins and helps eliminate toxic substances.the liver

The liver is the only organ in the body that can easily replace damaged cells, but if enough cells are lost, the liver may not be able to meet the needs of the body.

The liver is like a very complex factory.  Included in its many functions are:

  • Production of bile that is required in the digestion of food, in particular fats;
  • Storing of the extra glucose or sugar as glycogen, and then converting it back into glucose when the body needs it for energy;
  • Production of blood clotting factors;
  • Production of amino acids (the building blocks for making proteins), including those used to help fight infection;
  • The processing and storage of iron necessary for red blood cell production;
  • Manufacture of cholesterol and other chemicals required for fat transport;
  • Conversion of waste products of body metabolism into urea that is excreted in the urine; and
  • Metabolizing medications into their active ingredient in the body.
  • Cirrhosis is a term that describes permanent scarring of the liver. In cirrhosis, the normal liver cells are replaced by scar tissue that cannot perform any liver function.
  • Acute liver failure may or may not be reversible, meaning that on occasion, there is a treatable cause and the liver may be able to recover and resume its normal functions.

The Liver can be affected by any one of a number of diseases.  Click on the item of interest in the list below for a complete explanation.

The Liver Disease Information Center provides information on a variety of topics related to liver health and liver diseases

liver disease.

How does alcohol affect the liver? (From the American Liver Foundation)

Alcohol can damage or destroy liver cells.

liver disease stagesThe liver breaks down alcohol so it can be removed from your body. Your liver can become injured or seriously damaged if you drink more alcohol than it can process.

What are the different types of alcohol-related liver disease?

There are three main types of alcohol-related liver disease: alcoholic fatty liver disease, alcoholic hepatitis, and alcoholic cirrhosis.

Alcoholic fatty liver disease
Alcoholic fatty liver disease results from the deposition of fat in liver cells. It is the earliest stage of alcohol-related liver disease. There are usually no symptoms. If symptoms do occur, they may include fatigue, weakness, and discomfort localized to the right upper abdomen. Liver enzymes may be elevated, however tests of liver function are often normal. Many heavy drinkers have fatty liver disease. Alcoholic fatty liver disease may be reversible with abstinence of alcohol.

Alcoholic hepatitis
Alcoholic hepatitis is characterized by fat deposition in liver cells, inflammation and mild scarring of the liver. Symptoms may include loss of appetite, nausea, vomiting, abdominal pain, fever and jaundice. Liver enzymes are elevated and tests of liver function may be abnormal. Up to 35 percent of heavy drinkers develop alcoholic hepatitis and of these 55% already have cirrhosis.

Alcoholic hepatitis can be mild or severe. Mild alcoholic hepatitis may be reversed with abstinence. Severe alcoholic hepatitis may occur suddenly and lead to serious complications including liver failure and death.

Alcoholic cirrhosis
Alcoholic cirrhosis, the most advanced type of alcohol induced liver injury is characterized by severe scarring and disruption of the normal structure of the liver — hard scar tissue replaces soft healthy tissue. Between 10 and 20 percent of heavy drinkers develop cirrhosis. Symptoms of cirrhosis may be similar to those of severe alcoholic hepatitis. Cirrhosis is the most advanced type of alcohol-related liver disease and is not reversed with abstinence. However, abstinence may improve the symptoms and signs of liver disease and prevent further damage

The Liver Transplant

Liver transplants are performed only for patients with end-stage liver disease for whom standard medical and surgical therapies have failed. Conditions that can lead to liver transplantation include: transplant(

Liver transplants are the second most common transplants after kidneys.  They require that the blood type and body size of the donor match the person receiving the new organ. There are more  6,000 liver transplants are performed each year in the United States. The surgery usually takes between four and twelve hours and most patients can expect a hospital stay of up to three weeks following surgery. . .

Essential Information For The Transplant Patient

Most transplant centers function in pretty much the same manner, but Johns Hopkins Medical Center in Baltimore, Maryland offers one of the best summaries of what the transplant patient can expect.,P07698/

Risks of the procedure

As with any surgery, complications can occur. Some complications from liver transplantation may include, but are not limited to, the following:

  • Bleeding
  • Infection
  • Blockage of the blood vessels to the new liver
  • Leakage of bile or blockage of bile ducts
  • Initial lack of function of new liver

The new liver may not function for a brief time after the transplant. The new liver may also be rejected. Rejection is a normal reaction of the body to a foreign object or tissue. When a new liver is transplanted into a recipient’s body, the immune system reacts to what it perceives as a threat and attacks the new organ, not realizing that the transplanted liver is beneficial. To allow the organ to survive in a new body, medications must be taken to trick the immune system into accepting the transplant and not attacking it as a foreign object.

Contraindications for liver transplantation include, but are not limited to, the following:

  • Current or recurring infection that cannot be treated effectively
  • Metastatic cancer. This is cancer that has spread from its primary location to one or more additional locations in the body.
  • Severe cardiac or other medical problems preventing the ability to tolerate the surgical procedure
  • Serious conditions other than liver disease that would not improve after transplantation
  • Noncompliance with treatment regimen
  • Alcohol consumption

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Before the procedure

In order to receive a liver from an organ donor who has died (cadaver), a recipient must be placed on a waiting list of the United Network for Organ Sharing (UNOS). Extensive testing must be done before an individual can be placed on the transplant list.

Because of the wide range of information necessary to determine eligibility for transplant, the evaluation process is carried out by a transplant team. The team includes a transplant surgeon, a transplant hepatologist (doctor specializing in the treatment of the liver), one or more transplant nurses, a social worker, and a psychiatrist or psychologist. Additional team members may include a dietitian, a chaplain, and/or an anesthesiologist.

Components of the transplant evaluation process include, but are not limited to, the following:

  • Psychological and social evaluation. Psychological and social issues involved in organ transplantation, such as stress, financial issues, and support by family and/or significant others are assessed. These issues can significantly impact the outcome of a transplant.
  • Blood tests. Blood tests are performed to help determine a good donor match, to assess your priority on the donor list, and to help improve the chances that the donor organ will not be rejected.
  • Diagnostic tests. Diagnostic tests may be performed to assess your liver as well as your overall health status. These tests may include X-rays, ultrasound procedures, liver biopsy, and dental examinations. Women may receive a Pap test, gynecology evaluation, and a mammogram.

The transplant team will consider all information from interviews, your medical history, physical examination, and diagnostic tests in determining your eligibility for liver transplantation.

Once you have been accepted as a transplant candidate, you will be placed on the UNOS list. Candidates in most urgent need of a transplant are given highest priority when a donor liver becomes available based on UNOS guidelines. When a donor organ becomes available, you will be notified and told to come to the hospital immediately.

If you are to receive a section of liver from a living family member (living-related transplant), the transplant may be performed at a planned time. The potential donor must have a compatible blood type and be in good health. A psychological test will be conducted to ensure the donor is comfortable with the decision.

The following steps will precede the transplant:

  • Your doctor will explain the procedure to you and offer you the opportunity to ask any questions about the procedure.
  • You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully and ask questions if something is not clear.
  • For a planned living transplant, you should fast for eight hours before the operation, generally after midnight. In the case of a cadaver organ transplant, you should begin to fast once you are notified that a liver has become available.
  • You may receive a sedative prior to the procedure to help you relax.
  • Based on your medical condition, your doctor may request other specific preparation.

During the procedure

Liver transplantation requires a stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.

Generally, a liver transplant follows this process:

  • You will be asked to remove your clothing and given a gown to wear.
  • An intravenous (IV) line will be started in your arm or hand. Additional catheters will be inserted in your neck and wrist to monitor the status of your heart and blood pressure, as well as for obtaining blood samples. Alternate sites for the additional catheters include the subclavian (under the collarbone) area and the groin.
  • You will be positioned on the operating table, lying on your back.
  • If there is excessive hair at the surgical site, it may be clipped off.
  • A catheter will be inserted into your bladder to drain urine.
  • After you are sedated, the anesthesiologist will insert a tube into your lungs so that your breathing can be controlled with a ventilator. The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
  • The skin over the surgical site will be cleansed with an antiseptic solution.
  • The doctor will make a slanting incision just under the ribs on both sides of the abdomen. The incision will extend straight up for a short distance over the breast bone.
  • The doctor will carefully separate the diseased liver from the surrounding organs and structures.
  • The attached arteries and veins will be clamped to stop blood flow into the diseased liver.
  • Depending on several factors, including the type of transplant being performed (whole liver versus a portion of liver), different surgical techniques may be used to remove the diseased liver and implant the donor liver or portion of the liver.
  • The diseased liver will be removed after it has been cut off from the blood vessels.
  • The doctor will visually inspect the donor liver or portion of liver prior to implanting it.
  • The donor liver will be attached to the blood vessels. Blood flow to the new liver will be established and then checked for bleeding at the suture lines.
  • The new liver will be connected to the bile ducts.
  • The incision will be closed with stitches or surgical staples.
  • A drain may be placed in the incision site to reduce swelling.
  • A sterile bandage or dressing will be applied.

After the procedure In the hospital

After the surgery you may be taken to the recovery room before being taken to the intensive care unit (ICU) to be closely monitored for several days. Alternately, you may be taken directly to the ICU from the operating room. You will be connected to monitors that will constantly display your EKG tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level. Liver transplant surgery requires an in-hospital stay of seven to 14 days, or longer.recovery

You will most likely have a tube in your throat so that your breathing can be assisted with a ventilator until you are stable enough to breathe on your own. The breathing tube may remain in place for a few hours up to several days, depending on your situation.

You may have a thin plastic tube inserted through your nose into your stomach to remove air that you swallow. The tube will be removed when your bowels resume normal function. You will not be able to eat or drink until the tube is removed.

Blood samples will be taken frequently to monitor the status of the new liver, as well as other body functions, such as the kidneys, lungs, and blood system.

You may be on special IV drips to help your blood pressure and your heart and to control any problems with bleeding. As your condition stabilizes, these drips will be gradually weaned down and turned off as tolerated.

Once the breathing and stomach tubes have been removed and your condition has stabilized, you may start liquids to drink. Your diet may be gradually advanced to more solid foods as tolerated.

Your immunosuppression (antirejection) medications will be closely monitored to make sure you are receiving the optimum dose and the best combination of medications.

When your doctor feels you are ready, you will be moved from the ICU to a room on a regular nursing unit or transplant unit. Your recovery will continue to progress here. Your activity will be gradually increased as you get out of bed and walk around for longer periods of time. Your diet will be advanced to solid foods as tolerated.

Nurses, pharmacists, dietitians, physical therapists, and other members of the transplant team will teach you how to take care of yourself once you are discharged from the hospital.

At home

Once you are home, it will be important to keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit, if they were not removed before leaving the hospital.

You should not drive until your doctor tells you to. Other activity restrictions may apply.

Notify your doctor to report any of the following:

  • This may be a sign of rejection or infection.
  • Redness, swelling, or bleeding or other drainage from the incision site
  • Increase in pain around the incision site. This may be a sign of infection or rejection.
  • Vomiting and/or diarrhea

Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.

What is done to prevent rejection?

To allow the transplanted liver to survive in a new body, you will be given medications for the rest of your rejectionlife to fight rejection. Each person may react differently to medications, and each transplant team has preferences for different medications.

New antirejection medications are continually being developed and approved. Doctors tailor medication regimes to meet the needs of each individual patient.

Usually several antirejection medications are given initially. The doses of these medications may change frequently, depending on your response. Because antirejection medications affect the immune system, people who receive a transplant will be at higher risk for infections. A balance must be maintained between preventing rejection and making you very susceptible to infection.

Some of the infections you will be especially susceptible to include oral yeast infection (thrush), herpes, and respiratory viruses. You should avoid contact with crowds and anyone who has an infection for the first few months after your surgery.

The following are the most common symptoms of rejection. However, each individual may experience symptoms differently. Symptoms may include, but are not limited to, the following:

  • Fever
  • A yellowing of the skin and eyes due to bile pigments in the blood.
  • Dark urine
  • Itching
  • Abdominal swelling or tenderness
  • Fatigue or irritability
  • Headache
  • Nausea

The symptoms of rejection may resemble other medical conditions or problems. Consult your transplant teaoncerns you have. Frequent visits to and contact with the transplant team are essential.

Organ transplants are expensive and the cost goes well beyond the surgery itself.  If you are told you need a transplant and are sent to a transplant center for evaluation you can bet one of the first questions you will be asked is, “Do you have the financial resources to pay for your transplant?”

According to the National Foundation for Transplants the average cost of a liver transplant and first year expenses in the United States is $575,000.

The Mayo Clinic developed this helpful list of questions that will help you develop the answer to that question.

Insurance information

Before your transplant, it’s important that you work closely with your insurance company to understand your benefit plan. You’ll be responsible for any of your transplant and medical care costs not covered by your insurance company.costs

You may want to ask your insurance company several questions regarding your transplant expenses, including:

  • What is the specific coverage of my plan? What are my deductibles, coinsurance, copayments, lifetime maximum amount and annual maximum amounts for both medical care and transplant services?
  • Does my plan have a pre-existing or waiting period clause? If so, what is the time frame? Can this be waived?
  • Does my plan include pharmacy coverage? If so, will my plan cover my current medications and immunosuppressant medications?
  • Does my plan require any special approvals for evaluation or transplant? How long does the approval process take once submitted to insurance?
  • Does my plan cover my transportation and lodging expenses during my transplant care?
  • Does my current insurance require enrollment in Medicare when eligible?
  • Does my insurance follow Medicare Coordination of Benefits guidelines?
  • How will my current coverage change after enrolling in Medicare? Will my plan become a supplemental or secondary plan?

If your plan is a Medicare supplement, ask questions including:

  • Does my plan follow Medicare guidelines?
  • Does my plan cover Medicare Part A and B deductible and coinsurance?
  • Does my plan have a pre-existing or waiting period? If so, what is the time frame?
  • Does my plan offer an option for Medicare Part D coverage?

Other expenses

Please plan for other expenses that may occur related to your transplant, which may include follow-up medical appointments, long-term medications, caregiver expenses, travel, parking, lodging and other expenses.

Financial Aid

If you need an organ transplant, but don’t have the financial resources to pay for it you should first work with the transplant center social worker to see what is available. There are a number of resources for which you may qualify.  Just click on this link for the complete list and explanation of services.

bob 2Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,200 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  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  It only takes a few minutes.

How to Get the Most Bang for Your Prescription Medicine Buck

By Bob Aronson

cartoonI am a senior citizen, who has had a heart transplant and who also has Chronic Obstructive Pulmonary Disease (COPD).  I take a good number of prescription drugs and despite having Medicare Part D insurance I still pay thousands of dollars a year for my prescriptions.  Most of the drugs I take have been around for quite a while, but not long enough to allow the sale of generics and because there are few if any pricing restrictions, most of my meds are outrageously high priced.

One of the drugs I take is called Foradil.  It was approved by the FDA in February 2001 for the maintenance treatment of asthma and the prevention of bronchospasm in reversible obstructive airways disease..  Despite being on the market that long, it still retails for about $250.00 for a 30 day supply.  Spiriva is another COPD drug and is often taken with Foradil.  It retails for about $350.00.  I take about a dozen drugs and these two alone total over $600.00 a month. Insurance cuts that cost in half, but they are still expensive.  Because of these prices I know of many seniors and others who have to choose between eating and paying for their prescription meds.

It is an unfortunate fact of life that prescription drugs are more expensive in America than any other place in the world and as a result if you contract a serious illness like cancer you may not be able to afford the treatment that can save your life, even if you are insured.

It costs a whole lot of money to be sick in this country and a whole lot of people die — not because there iscartoon two no medicine or treatment but because they can’t afford to get well.  That strikes me as being just plain wrong.

Healthcare costs are skyrocketing, but prescription drugs lead the parade. Americans now spend a staggering $200 billion a year on them and the end is nowhere in sight.  The cost of staying alive is growing at the rate of about 12 percent a year.  It appears as though people are taking a lot more drugs than they used to and they are taking the really expensive new ones instead of older, cheaper drugs.  The reason?   Either physicians are pushing new medications too hard or, more likely, people are seeing the ads for new drugs in the media and are demanding them.  Strangely, unlike most other businesses where prices come down with time, that’s not true with drugs.  Price increases are commonplace even with the older ones and the increases aren’t one time adjustments. Often the price tag increases several times a year.

Earlier I pointed out that Americans pay more for their drugs than any other country in the world — but it isn’t just a little more…it’s a whole lot.  On average, the cost of prescription drugs in the U.S. is at least double what people in other countries pay for the same exact prescription and it some cases it is 10 times more.

A 2013 report from the International Federation of Health Plans, says Nexium, the pill commonly prescribed for acid reflux, costs U.S. patients more than $200, while Swiss citizens only pay $60 and people who live in the Netherlands pay $23. But Nexium is a drop in the bucket compared to cancer drugs.

Not long ago CBS’ 60 Minutes devoted a segment to the absurdly high cost of cancer drugs. Correspondent Lesley Stahl reported that many cancer drugs cost well over $100,000 for a year’s worth of medicine. She said that in the fight against cancer, most people can expect to be on more than one drug. The bill for medications can escalate to nearly $300,000, a price tag that doesn’t include fees charged by a doctor or a   hospital. Health insurance companies – including government polices like Medicare – don’t cover the full cost of these drugs. Some policies don’t cover some of these drugs at all. cancerrBut cancer is not alone in the extreme price arena. Drugs for chronic diseases like multiple sclerosis also carry inflated prices. Prescriptions of Copaxone and Gilenya cost about $4,000 and $5,500, respectively and that amount is almost three times more than the most-expensive price in other countries.

In the case of almost every other product sold on the free market, the older a product gets the less it costs. In the case of cancer drugs in America, the inverse is actually true. Novartis developed Gleevec, one of the most popular cancer drugs, in 2001 and sold it for $28,000 a year. By 2012, its cost rose to $92,000. Despite not being a novel treatment, Novartis is allowed to hike up the price every year in the United States.

So If you are a reasonably intelligent person you will ask three questions.  1) Why do these drugs cost so much? 2) What is being done to bring the prices down? And 3) Is there help available to people who can’t afford the drugs that can keep them alive.

Let’s answer the questions one at a time.  First.  Why are drugs so expensive?  Well, if you listen to the bigbig pharma pharma companies they will tell you that the cost reflects their investment in research and development of the drugs.  They will tell you they spend millions on drugs that don’t pan out and that expense is passed on to the patient.  But are they telling the truth?  No they aren’t! Pharmaceutical companies are fond of saying Americans take the lion’s share of the R&D costs for the rest of the world – calling other countries “foreign free riders.” So, drug companies are forced to charge Americans more to recover what they don’t get from other countries.

In fact, the more disturbing truth is that companies charge what they want in the U.S., and it’s a profiteering paradise for them.  U.S. law protects these companies from free-market competition.  For example, Medicare is not allowed to negotiate prices. By law, it has to pay exactly what the drug companies charge for any drug.  In effect our lawmakers told the pharmaceutical companies that they can charge whatever they want and we (the taxpayers) will pay it. Even may insurance companies don’t negotiate or do it half-heartedly.  Companies make billions on most of these drugs, and they receive massive tax breaks for R&D, leading to inflated figures. Another huge portion of the costs are subsidized by taxpayers.

Here’s the sad part of all this R and D and the introduction of new drugs.  Only 1 in 10 of them actually provides substantial benefit over old drugs.  To add insult to injury the side effects of the new entries create the need for more drugs. And — some of these drugs have horrible complications that result in lawsuits to recover damages.

University of Medicine and Dentistry of New Jersey Health professor and policy expert Donald W. Light says, “We can find no evidence to support the widely believed claims from industry that lower prices in other industrialized countries do not allow companies to recover their R&D costs so they have to charge Americans more to make up the difference and pay for these ‘foreign free riders,’”

In contrast, governments in other countries put caps on the price of drugs and negotiate prices based on what the actual therapeutic benefit is. And Big Pharma still turns a healthy profit in other countries, despite costs being 40 percent lower than they are in the United States.

Big Pharma would have many Americans believe that it is disadvantaged by the costs of developing a new drug. The truth is, drug companies are far from impoverished. EvaluatePharma’s most recent report shows that 2013 was the biggest year since 2009 for drug approvals. These new drugs will add nearly $25 billion to Big Pharma’s coffers by 2018, and prescription drug sales will exceed one trillion dollars by 2020.

The health care industry as a whole has more than enough money, with billions left to continue pursuing its interests in Washington.

Big Pharma Spends More on Lobbying Than Anyone

campaign contributionsSince 1998, the industry spent more than $5 billion on lobbying in Washington, according to the Center for Responsive Politics. To put that in context, that’s more than the $1.53 billion spent by the defense industry and more than the $1.3 billion forked out by Big Oil.

From 1998 to 2013, Big Pharma spent nearly $2.7 billion on lobbying expenses — more than any other industry and 42 percent more than the second highest paying industry: insurance. And since 1990, individuals, lobbyists and political action committees affiliated with the industry have doled out $150 million in campaign contributions.

The world’s 11 largest drug companies made a net profit of $711.4 billion from 2003 to 2012. Six of these companies are headquartered in the United Sates: Johnson & Johnson, Pfizer, Abbot Laboratories, Merck, Bristol-Myers Squibb and Eli Lilly. In 2012 alone, the top 11 companies earned nearly $85 billion in net profits. According to IMS Health, a worldwide leader in health care research, the global market for pharmaceuticals is expected to top $1 trillion in sales by 2014.

But the large amount of cash Big Pharma bestows on government representatives and regulatory bodies is small when compared with the billions it spends each year on direct-to-consumer advertising. In 2012, theadvertising industry invested nearly $3.5 billion into marketing drugs on the Internet, TV, radio and other outlets. The United States is one of only two countries in the world whose governments allow prescription drugs to be advertised on TV (the other is New Zealand).

A single manufacturer, Boehringer Ingelheim, spent $464 million advertising its blood thinner Pradaxa in 2011. The following year, the drug passed the $1 billion sales mark. The money in this business appears to be well-spent.

No sane person can object to a company making a profit, it’s part of the American way, but the drug industry’s profits are excessive.  We paysignificantly more than any other country for the exact same drugs. Per capita drug spending in the U.S. is about 40 percent higher than Canada, 75 percent greater than in Japan and nearly triple the amount spent in Denmark.

So you might ask, “What can I do to get the lowest possible price for my  prescriptions?”  Well, there are a few things.  You can shop for the best price and because of the internet that’s become a whole lot easier.  You can look up a specific drug and find the best price at a pharmacy near you.  Here are two resources, I’m sure you can find a lot more  or All; you pharmacieshave to do is type in the drug you need and your zip code and it will find the price of that drug in pharmacies near you.

Transplant recipients might be interested in the cost of anti-rejection drugs.  The price is hard to stomach but easy to find.  In my zip code 32244 100 Mg Cyclosporine capsules range jn price from $526.00 at Wal Mart to $584 at Target.  If you are a heart pateint and take Carvedilol in my neighborhood it ranges from $4.00 at WalMart to $9.54 at Kmart . Lisinopril also has a wide range.  At the Publix Supermarket pharmacy near me it is FREE…that’s right FREE.  But at CVS it is $12.00.  Those price variations might make it worth a little longer drive to get a better bargain.

You can also get help with coupons which are an obvious choice to save money when grocery or clothes shopping, but they’re often overlooked as a way to cut costs of over-the-counter and prescription drugs.  Manufactures frequently offer one time and repeat coupons that can save consumers hundreds of dollars on their medicines.  “For our family it has been incredibly effective [in saving money] for a number of regular prescriptions,” says Stephanie Nelson, founder of the coupon website

The costs of prescription drugs and over-the-counter medications have been steadily rising and patients facing tight budgets are often forced to make hard decisions when it comes to what they can afford.

The savings vary by manufacturer, but according to Nelson, many companies offer discounts at each prescription refill while others offer discount cards that take $20 off co-pays. Others offer one-time coupons to cover the first use of a drug.

Consumer Reports Magazine says that there are other ways to save money, too.  Whichever drugstore or pharmacy you use, choosing generics over brand-name drugs will save you money. Talk to your doctor, who may be able to prescribe lower-cost alternatives in the same class of drug. In addition, follow these tips.

  1. Request the lowest price.Our analysis showed that shoppers didn’t always receive the lowest couponavailable price when they called the pharmacy. Sometimes they were given a discounted price, and other times they were quoted the list price. Be sure to explain—whether you have insurance or not—that you want the lowest possible price. Our shoppers found that student and senior discounts may also apply, but again, you have to ask.
  2. Leave the city.Grocery-store pharmacies and independent drugstores sometimes charge higher prices in urban areas than in rural areas. For example, our shoppers found that for a 30-day supply of generic Actos, an independent pharmacy in the city of Raleigh, N.C., charged $203. A store in a rural area of the state sold it for $37.
  3. Get a refill for 90 days, not 30 days.Most pharmacies offer discounts on a three-month supply.
  4. Consider paying retail.At Costco, the drugstore websites, and a few independents, the retail prices were lower for certain drugs than many insurance copays.
  5. Look for additional discounts.All chain and big-box drugstores offer discount generic-drug programs, with some selling hundreds of generic drugs for $4 a month or $10 for a three-month supply. Other programs require you to join to get the discount. (Restrictions apply and certain programs charge annual fees.)
  6. Consumer Reports goes on to say that “although the low costs we found at a few stores could entice you to get your prescriptions filled at multiple pharmacies based only on price, our medical consultants say it’s best to use a single pharmacy. That keeps all of the drugs you take in one system, which can help you avoid dangerous drug interactions.”

Finally, what do you do if you’ve done the shopping, used coupons, followed all of the Consumer Report Tips and are still unable to pay for your prescriptions.  Well, there is some limited assistance. Here are some resources.





bob 2Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,200 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  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  It only takes a few minutes.

Disabled and Nearly Invisible

Bob Bob Aronson

(Yes, we cover disabled permits, disabled parking and disability shopping carts)

Tdisabled cartoonhis is a blog about what it means to be disabled, who can claim that designation and what the rest of us can do to make life easier for those who fall into that category.

As an old journalist I am a pretty good observer.  I often see things that others do not see because my former profession taught me to look for things that are out of place or just don’t make sense.  Here’s one of them.  There are millions of disabled people in the world, maybe  close ot a billion  — yet they are often not seen or, to be honest, they are ignored.  “Why,” you ask?  Well,  year after year, survey after survey reveals that the average, healthy person is uncomfortable around disabled people. They are afraid of saying or doing the “wrong” thing so instead they do nothing.

Sometimes it is difficult to know who is and who isn’t disabled. Almost without fail the word disabled brings to mind the image of a person in a wheelchair.  Even the blue disabled permits you see hanging from rearview mirrors or embossed on parking signs are based on the wheelchair image and that, of course, reinforces the stereotype.

permit tag We have come to expect that if you have a disabled permit you are very likely in a wheelchair and if you are in a wheelchair it is quite likely you are unable to walk. At least that’s the logic that’s applied.  The result is that disabled people who can walk get a lot of “dirty looks.”  You have all seen it happen and probably reacted negatively to the sight of a man or woman who parks her car in a disabled spot, hangs the placard from the mirror and walks into the store without so much as a limp. It is common for people to jump to the conclusion that this person is cheating on the permit hanging from the mirror.   Some are even verbally assaulted for using a disabled parking spot when they don’t need one. about 15 years ago a poll revealed that there were 26 million Americans considered to have a severe disability and only 7 million of them use  wheelchairs, canes, crutches or walkers (U.S. Department of Commerce).  I am one of those healthy looking disabled persons.
At 6’4” and 200 pounds I look fit enough, despite my gray beard, to walk a long way.  Well, I am not in the least bit fit and cannot walk very far because I have Chronic Obstructive Pulmonary Disease (COPD) which means I get out of breath with even minimal exertion.  Sometimes walking from the disabled parking space to the door of the store (a hundred feet or so) will cause me to stop to rest, but there are other disabilities, too. Some require wheelchairs, some don’t.

Upon researching this topic I was surprised to learn from the U.S. Census Bureau that about 56.7 million people — 19 percent of the population had disabilities in 2010.  We will break that down into specific categories later.

I always like to start my blogs with a definition of terms but the term ”Disabled” is very broad which makes it difficult to define. Finally, though, I selected three definitions because they seem to cover every angle of the subject.

The  Americans with Disabilities Act (ADA) defines an individual with a disability as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.

statute imageThe Social Security Administration says that to be considered disabled, individuals must have an impairment, either medical, psychological, or psychiatric that keeps them from being able to do substantial gainful activity (SGA). The impairment must have prevented SGA for at least 12 months, or be expected to prevent the individual from doing SGA for at least 12 months.

And, finally — Federal and state statute — the law books.  Federal laws define a person with a disability as “Any person who has a physical or mental impairment that substantially limits one or more major life activities; has a record of such impairment; or is regarded as having such an impairment.”  These impairments include walking, talking, hearing, seeing, breathing, learning, performing manual tasks, and caring for oneself.

Who Is Disabled?

For obvious reasons older Americans are most likely to be disabled.  If you are 80 or over you are eight times more likely to be disabled. If you are from 15 to 24 years old the chance of having a severe disability is one in 20.

What are the most common disabilities?

  • About 8.1 million people had difficulty seeing, including 2.0 million who were blind or unable to see.
  • About 7.6 million people experienced difficulty hearing, including 1.1 million whose difficulty was severe. About 5.6 million used a hearing aid.
  • Roughly 30.6 million had difficulty walking or climbing stairs, or used a wheelchair, cane, crutches or walker.
  • About 19.9 million people had difficulty lifting and grasping. This includes, for instance, trouble lifting an object like a bag of groceries, or grasping a glass or a pencil.
  • Difficulty with at least one activity of daily living was cited by 9.4 million noninstitutionalized adults. These activities included getting around inside the home, bathing, dressing and eating. Of these people, 5 million needed the assistance of others to perform such an activity.
  • The final inconvenience suffered by the disabled is that they are also monetarily handicapped. Adults age 21 to 64 with disabilities had median monthly earnings of $1,961 compared with $2,724 for those with no disability.  Those figures are from 2010, the last U.S. Census.

So, why do you need to know all of this?  Because I believe disabled people are almost invisible.  We don’t make much of a fuss about much of anything.  We don’t have huge conventions or demonstrations and we don’t demand very much from anyone.  For the most part we just want to be treated fairly, equally and with respect.

My experience as a disabled person mirrors that of others with the same diagnosis.  Most people just ignore us and they do so because they don’t know what to do.  In the supermarket the other day I was on my mobility scooter slowly going up the aisle to the jams and jellies.  Directly in front of me and stopped on the other side of the aisle was a woman with a regular shopping cart.  She looked up saw me and said, “Oh my God, I’m sorry,” turned her cart around and went the other way.  I have no idea why she did that or what she was sorry about.

Some people are uncomfortable talking with people with disabilities for fear of saying or doing the wrong thing and some people feel sorry for people with disabilities, and assume that they are bitter about their condition.  The fact is that people with disabilities are just like anyone else.  They learn to cope and lead their lives in as productive a manner as possible.

A recent public opinion survey in Great Britain revealed that Two-thirds – 67 per cent – of those surveyed said that they would worry about speaking about disability in front of a disabled person, with many worrying they would say something inappropriate or use an offensive term by mistake —  so what do they do?  They totally avoid contact with disabled persons.
Obviously ignoring people is of no help to them so what do you do?  This list from the Diversity shop struck me as quite helpful.

  1. Speak directly rather than through a companion or sign language interpreter who may be present.
  2. Offer to shake hands when introduced. People with limited hand use or an artificial limb can usually shake hands and offering the left hand is an acceptable greeting.
  3. Always identify yourself and others who may be with you when meeting someone with a visual disability. When conversing in a group, remember to identify the person to whom you are speaking. When dining with a friend who has a visual disability, ask if you can describe what is on his or her plate.
  4. If you offer assistance, wait until the offer is accepted. Then listen or ask for instructions.
  5. Treat adults as adults. Address people with disabilities by their first names only when extending that same familiarity to all others. Never patronize people in wheelchairs by patting them on the head or shoulder.
  6. Do not lean against or hang on someone’s wheelchair. Bear in mind that people with disabilities treat their chairs as extensions of their bodies. And so do people with guide dogs and help dogs. Never distract a work animal from their job without the owner’s permission.
  7. Listen attentively when talking with people who have difficulty speaking and wait for them to finish. If necessary, ask short questions that require short answers, or a nod of the head. Never pretend to understand; instead repeat what you have understood and allow the person to respond.
  8. Place yourself at eye level when speaking with someone in a wheelchair or on crutches.
  9. Tap a person who has a hearing disability on the shoulder or wave your hand to get his or her attention. Look directly at the person and speak clearly, slowly, and expressively to establish if the person can read your lips. If so, try to face the light source and keep hands, cigarettes and food away from your mouth when speaking. If a person is wearing a hearing aid, don’t assume that they have the ability to discriminate your speaking voice. Never shout to a person. Just speak in a normal tone of voice.
  10. Don’t be embarrassed if you happen to use common expressions such as “See you later” or “Did you hear about this?” that seems to relate to a person’s disability.

Effective communication can mean the difference between the success and failure of any given project, job or effort.  It is always important to give some extra thought to what you want to communicate and that is particularly true when working with groups of disabled persons.

The State of Illinois Department Of Human Services developed this list of tips on how to best communicate with those who have disabilities.

  1. The most important thing to remember when you interact with people with disabilities is that they are people.
  2. Their disability is just one of the many characteristics they have. People with disabilities have the same needs we all do: first and foremost among them is to be treated with dignity and respect.
  3. When you interact with people with disabilities, focus on their abilities, not their disabilities. People with disabilities are unique individuals who have a wealth of knowledge, skills, talents, interests, and experiences that add tremendous diversity, resourcefulness, and creative energy to our society.
  4. Remember, people with disabilities may do things in different ways than people without them however, they can achieve the same outcomes.

General Etiquette Tips

  1. Practice the Golden Rule. Treat everyone as you would like to be treated. Think of the person first, not their disability. Don’t shy away from people with disabilities – relax and be yourself
  2. Always Ask Before Giving Assistance. Just because a person has a disability, they don’t necessarily need or want your assistance. Never help someone without first asking them.
  3. One woman recalls: “When I walked on crutches, I was once knocked down by two little old ladies who were going to ‘help’ me walk on an icy sidewalk. Without asking, they came up, grabbed me, threw me off balance, and down I went!”
  1. Think Before You Speak. Avoid using labels when you speak – they are offensive to everyone, including people with disabilities.
  2. Avoid Showing Pity or Being Patronizing. People with disabilities aren’t victims. As a person in a wheelchair said, “I am not a wheelchair victim. Wheelchair victims are the people I run into with my footrest at the supermarket.”
  3. When you talk to a person with a disability, don’t use pet names, such as “honey”. It is also very disrespectful to pat people with disabilities on the head or talk down to them as though they were children.

Interacting with People with Disabilities

  1. When you interact with people with disabilities, talk directly to them, not to their companions, aides, or interpreters. I am always amazed when Robin and I are on an outing and stop at a restaurant where I have to leave my scooter to walk in. Often the Maitre D’ will ask Robin, “Can he walk, in.”  What am I, a potato?  Here are some other ways to interact with people with specific types of disabilities:
  2. communicatingWhen you interact with someone who is Deaf or Hard of Hearing, remember that some individuals may be able to hear, some may be able to lip read, while others prefer to use sign language or assistive technology. Ask them how they prefer to communicate.
  3. When you interact with someone who is blind or visually impaired, always introduce yourself and let them know when you are leaving. You may offer your arm or elbow as a guide if they request assistance but never push, pull or grab the individual. Don’t pet or distract a guide dog. The dog is responsible for its owner’s safety and is always working – it.
  4. When you interact with someone who uses a wheelchair, do not push, lean on, or hold the person’s wheelchair. Try to put yourself at eye level when talking with someone in a wheelchair.
  5. When you interact with someone with a cognitive disability, speak to the person in clear, simple sentences. Be patient with them and give them time to communicate with you.
  6. When you interact with someone with a speech impairment, allow them as much time as they need to communicate. Be respectful and avoid trying to finish their sentences.

People First language

Always use positive, people first language that empowers rather than marginalizes people with disabilities.

Here are some examples of offensive language and language that should be used:


This next section is a cut and paste from a website.  The format simply won’t adjust to WordPress so I apologize for the poor placement, but I’m sure you will figure it out and get the meaning.  Thank you.

Offensive                                                                                Preferred

Birth defect                                        Person who is disabled since birth, congenital disability

Cerebral palsied                                 Person who has cerebral palsy

Cripple                                                            Person who needs mobility assistance

Deaf and Dumb, Deaf Mute              Person who is deaf and does not speak

Deformed                                           Person who has a physical disability

Emotionally disturbed                                   Person with an emotional disability

Handicapped                                      Disabled person

Hunchbacked                                     Person with a spinal curvature

Insane, deranged, deviant                 Person with a mental illness

Midget, Dwarf                                     Person who is small in stature

Mongoloid                                          Person who has Down Syndrome

Normal                                                Non-disabled, able-bodied

Retarded                                             Person with a cognitive disability

And, finally.  Disabled permits, disabled parking and mobility shopping carts.permits and licenses

First the permits.  Disabled parking permits are reserved for those who have been certified as such by a qualified physician.  Almost all states have the same criteria for issuing these permits and they include:

  1. The applicant named is legally blind or is a disabled person with a permanent disability that limits or impairs his/her ability to walk 200 feet without stopping to rest.
  2. Inability to walk without the use of or assistance from a brace, cane, crutch, prosthetic device, or other assistive device, or without assistance of another person. If the assistive device significantly restores the person’s ability to walk to the extent that the person can walk without severe limitation, the person is not eligible for the exemption parking permit.
  3. The need to permanently use a wheelchair.
  4. Restriction by lung disease to the extent that the person’s forced (respiratory) expiratory volume for 1 second, when measured by spirometry, is less than one liter or the person’s arterial oxygen is less than 60 mm/hg on room air at rest.
  5. Use of portable oxygen.
  6. Restriction by cardiac condition to the extent that the person’s functional limitations are classified in severity as Class III or Class IV according to standards set by the American Heart Association.
  7. Severe limitation in a person’s ability to walk due to an arthritic, neurological, or orthopedic condition.
  8. Legally Blind (This is the only disability an Optometrist can certify.)

Physicians are put on notice in most states that their responsibility is a great one.  Most applications warn applicants and physicians that the permits are only for those people who are severely mobility impaired. Any physician who signs an application for someone who is not eligible can be fined $1,000 or one year in jail or both. All applications are tracked by computer and the number signed by specific physicians can be reviewed. Any person who applies and is not eligible can be fined the same as a physician.go to jail

Anyone who obtains or uses a permit that does not belong to them can be charged with a second degree misdemeanor – $1000 fine or up to 6 months in jail. Improper use of the permit is now twice the fee of a disabled parking violation. This should deter people from loaning their permits to family members.  It does not matter if you are running an errand for the person with a disability. If the person with a disability is not present — the fine is $1000.

Disabled parking is designated in that manner because some people need to get as close to the facility as possible.  There is usually a hefty fine for parking in a disabled spot if you do not have a permit hanging from your rear view mirror.  There is also a hefty fine for using a permit that was not issued to you.

WARNING  (this is the Florida law, but most states say the same thing. “Any person who knowingly makes a false or misleading statement in an application or certification commits a misdemeanor of the first degree, punishable as provided in section 775.082 or 775.083, F.S.  The penalty is up to one year in jail or a fine of $1,000 or both.”

Now that you know about the disabled Parking permits you should also know:

  • It is not OK to park in a disabled spot just to use the ATM real quickly.
  • It is not ok to park in a disabled spot and leave the disabled person in the car while you run into the store.
  • It is not ok to use someone else’ permit
  • The laws offer no exceptions for parking in a disabled parking spot so it is not ok to park, run in to drop off your Wife’s lunch and leave again.

And finally, mobility shopping carts.mobility shopping carts

As far as we can determine there is no law requiring only disabled people ride the shopping carts provided by some stores, it is generally a common courtesy to leave the carts charged so a disabled person can use one when he/she needs it.  It is unlikely that store officials will ask people who ride their carts if they are in fact disabled.  Unfortunately there are many who do ride them for any one of a number of reasons, the least of which is having a disability.  I wish people who weren’t disabled would leave the carts for those of us who are and really can’t get around without one.  Children should be told in no uncertain terms that the carts are for people who have great difficulty walking, they are not to be ridden for the pleasure of the child.

Anyone who rides a supermarket or shopping center cart should return it to its original spot and plug it in so it is ready for the net disabled person who needs to use it.

bobaronsonBob 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  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  It only takes a few minutes.

People Who Say they Can’t Quit Smoking Are Gutless Liars!

By Bob Aronson…former smoker

smoking cartoon

if that headline doesn’t get your attention I don’t know what will.

“I can’t quit smoking,” is BS.  You can quit, but you are a pansy, no guts.  You can spread that “Can’t quit” manure elsewhere.  It doesn’t work here because it’s a big lie.

Do I have your attention?

This post is aimed at smokers, whether you are just starting the habit or have smoked for a while and are thinking about quitting.  I am writing this to alert you to smoking related issues not to draw attention to myself or my condition.  I seek no sympathy nor attention.

Yes, this is a posting that encourages you to ignore the temptation to start smoking and/or to quit smoking if you already have the habit. In the interest of full disclosure let me tell you why you should read this. You should do so because I offer hope and straight talk.  No one could possibly have had a greater addiction to cigarettes than I did.  And…I know about addiction, too.  Not only did I quit smoking (1991) I also quit drinking (1982) after years as a practicing alcoholic.   I have not had a drink since.

Let me get right to the point.  Even though I quit smoking almost 25 years ago it is killing me.  When I die I would imagine that my addiction to cigarettes will be the chief cause of my demise because I have emphysema and asthma, Chronic Obstructive Lung Disease (COPD).  Had I not quit smoking when I did I would have been dead long ago.  Recently my pulmonologist told me that If I had continued to smoke,  I would have needed a lung transplant long ago.  For those of you who don’t know me I had a heart transplant in 2007 and smoking may have been a contributor to the heart failure that caused me to need that life-saving surgery.

I know how hard it is to quit smoking and I refuse to accept, “I’ve tried many times and cannot quit.”  That, my friend, is pure unadulterated BS.  You are only fooling yourself with that nonsense.  The fact of the matter is you don’t have the guts to quit.  You can’t handle a little discomfort so you light up another smoke and say, “I can’t quit.”  And again I say, “BS.”  Tough talk?  Damned right it is.  If you think the discomfort of quitting smoking is hard to handle try the discomfort a of lung cancer as an option, or maybe emphysema.

I smoked up to 4 packs a day for 37 years and I quit.  Was it easy?  Of course not!  It hurt, it was painful, I was an SOB to live with, but damnit I quit.  I used every gimmick out there to help me break the habit and finally was rescued by nicotine gum.  I probably quit smoking 3 or 4 dozen times maybe more.  You see, you don’t quit once, fail and say, “I tried, I can’t quit,” because you haven’t tried.  The way to quit smoking is to keep quitting until you quit. You never give up, you quit every day, several times a day until finally you have quit for good.

I always kept my smokes and a lighter in my shirt pocket.  Almost every day when I left home for work I would automatically reach for a cigarette and the lighter so I could get my hit of nicotine.  Finally, I got to the point where every time I reached into that pocket for the cigarettes and lighter I would pull both out and throw them out the window of the car.  I did that every day for weeks.  Later in the day I’d find myself buying another pack and a lighter and the next day I would toss them out the window. “The hell with littering,” I would say, “My life’s at stake here.”

After about a year of all this nonsense I finally had my last cigarette in January of 1991.  You see, I had just watched my father die of emphysema.  At least something good came of his death.  I was able to quit.  I was addicted to nicotine gum for two years after that and lemon drops for another year but I quit, by God, I quit.

You know why it’s so hard?  It is because you are an addict, just like any drunk or junkie.  When you hear someone say, “A cigarette tastes so good after a meal,” that’s just more BS.  The reason it feels good is because it’s been a while since your last cigarette and you are going into withdrawal.  As soon as you light up you stop the withdrawal and feel better.  It is no different than getting a hit of heroin or a good slug of booze.

From the time I was 15 years old in 1954 until 1991 (37 years) when I was 52 years old I was a smoker, a heavy smoker.  Some days when I went to work I would throw 4 packs of cigarettes in my briefcase and finish them before I retired for the night..  That’s 80 cigarettes.

There are approximately 600 ingredients in cigarettes. When burned, they create more than 7,000 chemicals. At least 69 of these chemicals are known to cause cancer, and many are poisonous as well.  Here are just a few of the chemicals in tobacco smoke, and other places they are found:

  • Acetone –nail polish remover
  • Acetic Acid –  ingredient in hair dye
  • Ammonia –household cleaner
  • Arsenic – rat poison
  • Butane – lighter fluid
  • Cadmium –battery acid
  • Carbon Monoxide car exhaust fumes
  • Formaldehyde – embalming fluid

A final note on this subject.  In 1998 I lost my wife of 35 years to lung cancer. She, too was a smoker and she died a horrible death, no one should have to suffer the way she did and the way thousands of others do every day.  Smoking is a terrible, disgusting and deadly habit.  I don’t care who you are, you have a responsibility to yourself and to those who love you to quit smoking.  You must.  After a while the urges disappear and you can live a normal life again.  You might even find that you’ll take great pride in being able to say, “I used to smoke, but I don’t anymore.”


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 at  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  It only takes a few minutes.

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

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.
  2. If you want a BMI that measures more and is more accurate, click here.

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?

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.


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.


  • 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  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.

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         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.


  • 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.


  • 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.

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 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.

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.”


 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.  Clicking here will lead you to scores of sites that can help you achieve the weight loss goals you seek. 


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  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  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…

View original 8,480 more words

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:

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

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

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:

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

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

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.


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  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  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 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 t  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   ( 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.

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.

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, “… 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:

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


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 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 t  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


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

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. (   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.


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 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 t  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.

Another excellent source is Web MD.

And — still another from the Mayo Clinic this stirring “Nightline” video about the process.

Organ Donation Key Myths and Facts

According to the American Transplant Association (ATA) ( )  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:


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


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.


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


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.


My religion doesn’t support organ and tissue donation.


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.


My family will be charged for donating my organs.


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

 Kidney Transplant Qualification

Washington University, St. Louis, Mo.

 Liver Transplant Qualification

American Liver Foundation.

Lung Transplant Qualification

Mayo Clinic.

 Pancreas Transplant Qualification

Johns Hopkins.

 Small Intestine transplant qualification

Cleveland Clinic.

 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. .

 Living with a transplant

Transplant living.

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..

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.


  • 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 >


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

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 (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 (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 >


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


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. 

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

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 the founder of this blog site.


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 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  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.


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.


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.


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 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

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.

  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.

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
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.
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.
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.


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?

  • 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:


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 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.

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   (    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 ( 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 (…/many-americans-fall-short-on-their-vitamind).

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 (

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 (…/food-and-blood-sugarlevels).  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.


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.


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 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.

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.

 The Threat to You

Diseases that either are or are becoming antibiotic resistant

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 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.


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.


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 (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.


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

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.”


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.


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’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 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:


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.


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.


“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

  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.


 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 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. 


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?”


“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.


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 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  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.


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:

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 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

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 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:

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.


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 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 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

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 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 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?”  ( 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.”


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:



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.


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.


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.


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.


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.


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.


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.


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.


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?


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.


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 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

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 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 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.


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.

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


According to Healthline (,  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.


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 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.


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.


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.


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.


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.


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.


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.



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 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:


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.


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  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–   

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.


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.


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


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 (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.


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.

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.


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 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.


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 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.


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 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.


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


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.


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  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.

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.

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.  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.  

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
Evaporated Cane Juice
Florida Crystals
Fruit Juice
Fruit Juice Concentrate
Glucose Solids
Golden Sugar
Golden Syrup
Granulated Sugar
Grape Juice Concentrate
Grape Sugar
High-Fructose Corn Syrup
Icing Sugar
Invert Sugar
Malt Syrup
Maple Syrup
Muscovado Syrup
Organic Raw Sugar
Powdered Sugar
Raw Sugar
Refiners’ Syrup
Rice Syrup
Sorghum Syrup
Table Sugar
Turbinado Sugar
Yellow Sugar

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 (

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


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.

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.

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:


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 and

 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.”


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 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 lists five supplements that can be helpful.

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.


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.


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


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, 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.”

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 

 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 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

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.

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

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.

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.

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.


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.


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.


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.


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


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 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.

“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. (,_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.


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 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.

  • 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 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

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.

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.

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).


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.


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?


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)





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 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:

  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.

  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

 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)

How Is Insomnia Treated?

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,



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 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. “

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


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.


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. 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.


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.


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.

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.

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

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.


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 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.


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.

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 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.


Curt was featured in a news report that you can watch on YouTube.  It is called “Three year detour” and there is the link.

If you would like Curt to speak to your group, you can contact him here.

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.”


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 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.


“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,


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 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.


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. 




 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 m