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Post Transplant Depression. You Don’t Have To Feel That Way!


depression cartoon

By Bob Aronson

The very first thing you should know is that depression is common after an organ transplant – very common and no one is immune.  You should also know that there is help available.  You don’t have to feel that way!   I know because I suffer from it.  As of this writing I am six years post transplant and my depression is under control because I found help but it still rears its ugly head from time to time.

For two years following my 2007 heart transplant I wallowed in emotional pain, I felt useless, worthless, without value, guilty and empty.  I looked at myself as one might look at a car you’ve owned for many years.  It was useful and desirable once but now it is old and things keep going wrong and need fixing.   To keep it running just costs too much and sad as it is we are probably better off without it.  It is costing more than it is worth.   That’s pretty much how I felt about myself.

Depression, I think, is compounded by the patient’s inner battle between the armies of logical thought and those of emotion.  Your logical mind asks, “How can you be depressed when you just got a new heart that saved your life?”   But, your emotions say, “I don’t know but I feel awful and sometimes I wish I was dead.”  That is a horrible battle to have to fight alone…but you don’t have to, there’s help and you can win.

For a quarter of a century 228642_8263187420_1503_nI had been a communications consultant with a stable of highly respected internationally known clients many of which were based in Minnesota where I lived.  I needed a heart transplant and discovered that I stood a better chance of getting one if I moved to Jacksonville, Florida.  I learned that the Mayo Clinic there had an excellent record of obtaining and transplanting organs and data indicated I stood a better chance of getting a heart there than in Minnesota.  Furthermore, Jacksonville was my wife Robin’s home town and her son, parents and extended family lived there.  It made sense to move…but it also meant giving up a lion’s share of my business.

To shorten a long story we moved to Jacksonville and I got my new heart after only a 13 day wait but recovery took longer than expected.  There were complications…many of them. I got pneumonia, suffered two torn rotator cuffs which resulted in an extended period of excruciating pain and I became very, very depressed.  I could hardly function day to day never mind think of working again.  But, because I could not work I felt guilty and my depression got worse.

I sat in a dark corner of our family room every day watching the TV’s flickering light change the shadows in the room.  The set was on but rarely was I involved in what was playing…my mind was somewhere else.  I felt totally and utterly useless and guilty that I had taken an organ but couldn’t do anything to show that I was worthy of it. I felt that way for two years.  Each day I went through the motions of living, trying to be useful, trying to help my wife with her fledgling business but feeling totally inadequate and unnecessary.

You’ve seen the Roadrunner TV cartoon I’m sure where the poor coyote just can’t win against his fleet footed foe.  wiley hanging from a limbOften the canine victim is seen hanging by one hand from a branch on the side of a mountain…then the branch gives way and he falls the 5,000 feet  to the ground below which flattens him.  I felt like Wylie, like I was hanging from that branch waiting to fall and sometimes I wished the branch would break.

Two things kept me from giving up,  Robin’s constant encouragement and this blog along with my Facebook Group Organ Transplant Initiative (OTI).  Both were started two months after my transplant at the urging of my friends at Mayo.  These social media activities weren’t meant to be anti depressants but they turned out to be just that.   Thank God for both of them.

Then, one day, it occurred to me that maybe, just maybe I could get help and for the first time I mentioned depression as a problem to my Mayo Clinic transplant coordinator.  With virtually no delay I was seen by a physician who determined that anti depressants might help.  There were several false starts before we found one that worked but we did

At about the same time Robin asked me if I could make some wood fixtures for her art show booth; shelving, pedestals and other display items.  I soon found I loved woodwork and a new hobby was born, one that ensured my not returning to that dark corner in which I used to reside.

As I did the research for this blog I found a good deal of information about depression,  most of it clinical in nature and not real helpful.  From personal experience I know that fighting depression isn’t easy.  I know that it can last a long time, it can take even more time to find the right solution and sometime the solutions have a short life and the depression returns which forces you to find another solution.   It is a never ending battle but oh so worth it.

In a document titled “Issues for Today’s transplant Patients….A guide” published by the National Kidney Foundation (NKF) http://www.kidney.org/transplantation/transAction/pdf/UnderstandingDepression.pdf   there is an excellent section on post transplant depression, “Understanding Depression” I won’t re-print all of it but here’s some of it.

NKF LOGL

Depression is extremely common in the United States, and it can have a unique impact on transplant recipients. Practically every transplant recipient has likely felt—or fought off—depression at some time or another.

 Living with a new organ has daily challenges. These include medical bills and getting used to a new body. Some transplant recipients may also feel they are burdening their loved ones with constant doctors’ visits and a general need for extra help. All of this comes on top of the trials and tribulations that arise for everyone, transplant recipient or not.

It’s normal to have a range of feelings after a transplant.  We at the NKF believe that depression is one of the biggest issues people face, and something a lot of health care workers ignore.  Research shows that, in any given year, almost 10 percent of theU.S. population is depressed. That’s 19 million adults, with and without transplants.  And in people with chronic illness, the incidence of depression is much higher . Some research suggests that up to 25 percent of people with illnesses become depressed at some point in their lives. So, if you are a transplant recipient and you feel depressed, you are definitely not alone. 

Depression is different. It’s not just a bad mood, which is something everybody feels. Being depressed means that people feel at least five symptoms of depression for two weeks or longer. A bad mood should only last a couple of days. Depression is also more intense than a bad mood, even how the body feels.

 Nine symptoms of depression:

  1. Feeling depressed for most of the day, almost every day
  2. Lack of enjoyment of activities you once enjoyed, such as going to work or visiting friends.
  3. Weight changes (gaining or losing).
  4. Sleep problems (too much or too little).
  5. Feeling restless.
  6. Lacking energy, feeling easily fatigued.
  7. Feeling worthless or guilty.
  8. Trouble concentrating.
  9. Frequent thoughts of suicide.

 Remember that people have to have at least five of these nine symptoms for at least two weeks before doctors will diagnose depression. This is to make sure that people who have bad days here and there are not misdiagnosed.

The stress of having a transplant can trigger depression.  Having a transplant is a life-altering experience. The range of emotions people feel as a result of the procedure can definitely trigger depression in those who are susceptible to it.   It can be incredibly difficult for people to accept that one of the organs they were born with no longer works. For many, organ failure can feel like a profound loss. Some really grieve over it, which is totally under-standable. Unfortunately, this grief can also lead to depression.

 Having a transplant can create another loss, by changing recipients’ lives in an irreversible way. They may grieve that they can no longer lead the same life as before, now having to rely on doctors and medications to stay well. That can be hard to accept.

 Some recipients may also find it hard to accept that they are more dependent on their families. They may feel like their illness disrupts their families’ lives, and they are dependent on them emotionally and sometimes financially.

For recipients who are used to being the sole providers for their families, that can be really tough.  Financially, many transplant recipients also worry about their futures and how to afford the medicines they’ll need for the rest of their lives.  People with kidney transplants often worry about their health insurance,   knowing that they lose Medicare after three years.   

 Ok, all of that explanation makes a lot of sense but if you are depressed what can you do about it?  There’s much that can be done and you can start by talking to your transplant coordinator.  You can be sure they’ll have some resources for you to investigate or they can arrange for you for appointments.

While treatments abound there are two that are most common.  They are talk therapy and medication.  The most common type of therapy cognitive behavior therapy,  or CBT.  A highly skilled therapist can help you correct the negative thought patterns behind your depression. For instance, if people are constantly feeling hopeless, or that there’s no point in living, There is also a behavioral aspect to cognitive behavior therapy.  It focuses on how helping you avoid behaviors that cause or invite depression…behaviors like staying in bed all day or avoiding activities that had been enjoyable.  This kind of therapy can be done in a one on one or group setting, whichever makes you more comfortable and is most effective.

Another form of therapy is medication.  Sometimes both therapies are applied simultaneously but experts in depression can advise you best on when that is appropriate.

In my case it was medication that worked.  But it took time, there were months of trial and error.  It usually takes four to six weeks for an anti depression medication to work.  Sometimes it did but only for a short while and on other occasions there was no effect at all and we’d have to start all over again.  Different people react differently to the same medication.  What may work for your neighbor may not work for you at all but withy patience and the aid of a professional it is likely you will find the right one.

A word of caution: AVOID ST. JOHN’S WORT

st. John's wort

A lot of people use herbal medicines to treat a variety of conditions. One very popular herbal medicine is St. John’s Wort which has achieved some popularity in treating depression.  Transplant patients should avoid using it because medical evidence clearly indicates that St. John’s Wort interferes with other drugs like Cyclosporin, which people take to prevent transplant rejection.  There is documented evidence that some transplant recipients have lost their organs after taking St. John’s Wort.

Still another way to address depression is activity, a hobby, a business, a project.  The combination of medication and activity is what got me out of depression and keeps me there.  I rarely sit still and when I do it’s because I’m exhausted from all the activity.   I will be writing more about activities but woodwork, music, art, nature studies or astronomy can be of immense help in chasing away your demons.  There’s one for you…you just have to find it.

One way of beating depression is…not to get it.  Not long ago CBS TV news did an interesting story on the subject called, “Depression: Ten Traps to Avoid”  You can watch it on this link…or read it below.

http://www.cbsnews.com/2300-204_162-10004447.html

Clinical depression is a devastating illness, and profound sadness is just the beginning. Depression can rob people of their energy, memory, concentration, sex drive, interest in usual activities – and in severe cases, even the will to live. Seventy million Americans will be afflicted at some point.

Dr. Stephen Ilardi, author of “The Depression Cure,” has identified several things that can make depression worse.

Depression is a serious medical condition and should be treated by a doctor or licensed therapist.

Trap 1: Being a Couch Potato

couch potato

When you’re feeling down, it’s tempting to hole up in your bed or on the couch. Yet exercise –

Even moderate activity 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”

junk 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

alone in the dark

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

vitamin D from the sun

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

bad sleep habit

Chronic 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

depressed person

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

mulling

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

bad person

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

sugar donuts

Researchers now know that a depressed brain is an inflamed brain. And what we eat largely determines our 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. fruit and veggie plateEating them can protect the body’s omega-3s, providing yet another nice antidepressant boost.

Trap 10: Failing to Get Help

hopelessness

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.

We hope this blog has helped.  If you feel depressed or even if you are not sure talk to your transplant coordinator or any mental health professional. There is help. You don’t have to feel the way you do.

                                                                    

Bob informal 3

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 3,000 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

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

Please view our music video “Dawn Anita The Gift of Life” on YouTube https://www.youtube.com/watch?v=eYFFJoHJwHs.  This video is free to anyone who wants to use it and no permission is needed.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. JAgain, write to me and ask for “Life Pass It On.”  I will email it to you immediately.  This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound.  If you decide to use the show I will  also send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and I will send the show and book ASAP.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative  (OTI).  The more members we get the greater our clout with decision makers.

En Espanol

Bob Aronson de Newheart de Bob es un centro receptor de trasplante 2007, el fundador de la Iniciativa de Facebook cerca de 3.000 miembros de trasplantes de órganos y el autor de la mayoría de estos blogs de donación / trasplante.

Usted puede dejar un comentario en el espacio proporcionado o por correo electrónico a sus pensamientos a mí en bob@baronson.org. Y – por favor difundir la palabra acerca de la necesidad inmediata de más donantes de órganos. No hay nada que puedas hacer lo que es de mayor importancia. Si se convence a una persona para ser un donante de órganos y tejidos puede salvar o positivamente afectará a más de 60 vidas. Algunas de esas vidas puede haber gente que conoces y amas.

Por favor, vea nuestro video musical “Dawn Anita The Gift of Life” en YouTube https://www.youtube.com/watch?v=eYFFJoHJwHs. Este video es libre para cualquier persona que quiera usarlo y no se necesita permiso.

Si quieres correr la voz personal sobre la donación de órganos, tenemos otra presentación de PowerPoint para su uso gratuito y sin permiso. JAgain, escribir a mí y pedir “Life Pass It On.” Voy a enviar por correo electrónico a usted inmediatamente Esto no es un espectáculo independiente,. Necesita un presentador, pero es producido profesionalmente y objetivamente sonido Si usted decide utilizar el archivo. demuestro que también le enviará una copia gratuita de mi libro electrónico, Cómo obtener un Standing” O “que le ayudará con habilidades de presentación. Sólo escribo bob@baronson.org y enviaré el programa y el libro lo antes posible.

Además … hay más información sobre este sitio de blogs de otros temas de donación / trasplante. Además, nos encantaría que te unas a nuestro grupo de Facebook, la Iniciativa de Trasplante de Órganos (OTI). Cuantos más miembros que tienen la mayor influencia en nuestra toma de decisiones.

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Between Your Heart and Mine


The song, “Between Your Heart and Mine” was written and produced by Gregory Todd a Nashville,Tennessee country musician.  He wrote the song as a tribute to a friend who had a transplant.  I wrote to Mr. Todd yesterday to let him know about this blog and when he responded he said, among other things, “Incidentally, my friend Alan, the inspiration behind the song, has been doing incredibly well after 20 months of carrying the heart of his donor. He has recently been cleared to take his first flight- and it’s to go see his 10 year old daughter perform in the Cheerleading Championships in Orlando. How great is that??”  The song shows up in many places on the internet and you can hear more of Mr. Todd’s work by going to his website http://www.gregorytodd.com/Home_Page_DVPA.php

“Between Your Heart and Mine” is a touching song and the story that many of us who have had transplants have already lived.  Please take the time to listen to it…close your eyes, listen, remember and give thanks.  This Christmas is special for those who have had transplants and who are getting them right now, but there are thousands of others still waiting.  Please say a little prayer for them while you enjoy Mr. Todd’s wonderful song. You can click on the link above to listen to the song.  The lyrics are below.

Merry Christmas and happy holidays to everyone.

Between Your Heart and Mine

As the doctors took their places
I could see my kids and wife
Blowing kisses for good luck, not goodbye

Seven months with just one question
Then you answered with your life
You had one foot crossing heaven
I was one small breath behind

But you saved me when you gave me
The miracle I needed to survive
Now we both can go on
Between your heart and mine

Between your heart and mine
I’ll live a life worth living
I’ll take what I’ve been given
And pass it down the line

I’ll cherish every moment
Then breathe it in and hold in for the rest of my life
Between your heart and mine

I heard what happened late that night
Drinker driving through the light
He drove your hopes and dreams right to the ground

Just seventeen, you went too soon
But on my life I swear to you
Each morning when I wake up, I’ll make sure you’re smiling down

Cause you saved me when you gave me
The miracle I needed now it’s beating deep inside
So we both can go on
Between your heart and mine

I’ve been praying for your family
Hoping one day comes around
When I can let them know their boy is safe and sound
Between your heart and mine

And that I’ll live a life worth living
I’ll take what I’ve been given and pass it down the line
I’ll cherish every moment
Then breathe it in and hold it for the rest of my life
I’ll keep this feeling for the rest of my life
Between your heart and mine

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

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

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

The Ultimate Hypocrisy — Government Profiting on Killer Tobacco


Bob’s Newheart and our Facebook group Organ Transplant Initiative (OTI) support and encourage organ donation and potential biological and mechanical alternatives we also believe that the best solution for the organ shortage is to reduce the demand.

Tobacco products along with alcohol are two of the greatest contributors to organ damage and the need for transplants.  If we could get people to stop using those substances the demand for transplants would diminish significantly and that could mean that the supply of organs just might catch up to the reduced demand.

The affect of tobacco products on human organs is devastating.  There is almost no part of our bodies that the thousands of chemicals in tobacco and cigarette smoke can’t invade and ultimately destroy.  If you smoke, it likely will kill you!  If you quit your body will begin to recover and the cancers and other diseases will have to find a different host.

Our governments (city, county, state and federal) all tax tobacco often with the intention of using the revenue to finance stop smoking campaigns and most often some of the money collected is used for that purpose but not always.  As is usually the case when there is a pot of money available, lots of good causes want some of it, sometimes not so good causes get it so less than 3% of tobacco tax dollars go into anti smoking or smoking cessation programs.  Furthermore, settlements in and out of court in the 1990s mean that the tobacco industry is paying states nearly $250 billion over 25 years. Under the agreement, those payments to states will continue flowing even beyond 25 years as long as the tobacco industry is healthy. But the payments would phase out as cigarette company profits decline and would ultimately disappear if people stop smoking.  So while government must try to get people to quit smoking, they really don’t want to try too hard.

So, having given you some critical information about smoking  I’m hoping you will do two things,  1) if you smoke…quit.  2) tell your elected officials to get really serious about helping people who use tobacco products to quit using them, I submit this post for your consideration and comment.

There’s an adage that goes, ”If you borrow a hundred dollars from the bank, you owe the bank.  If you borrow a million you own the bank.”  That simply means the bank can’t be too hard on you if they want to get their money back.  That’s the situation governments find themselves in with tobacco.  In a strange twist, tobacco companies own the government.  Let me explain.

Tobacco Kills.  Cigarettes alone kill nearly a half million Americans every year.  That’s just a cold hard fact.  You probably don’t need reminding but I will anyway via the enters for Disease Control in Atlanta, Georgia.  They list these facts: http://tinyurl.com/lblldw

  • The adverse health effects from cigarette smoking account for an estimated 443,000 deaths, or nearly one of every five deaths, each year in the United States.
  • More deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined.
  • Smoking causes an estimated 90% of all lung cancer deaths in men and 80% of all lung cancer deaths in women.
  • An estimated 90% of all deaths from chronic obstructive lung disease are caused by smoking.

Smoking and Increased Health Risks

Compared with nonsmokers, smoking is estimated to increase the risk of—

  • coronary heart disease by 2 to 4 times,
  • stroke by 2 to 4 times,
  • men developing lung cancer by 23 times,
  • women developing lung cancer by 13 times, and
  • dying from chronic obstructive lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times.

If trends continue, one billion people will die from tobacco use and exposure during the 21st century – one person every six seconds. Globally, tobacco-related deaths have nearly tripled in the past decade, and tobacco is responsible for more than 15% of all male deaths and 7% of female deaths. Tobacco is also a risk factor for the four leading noncommunicable diseases (NCDs) – cancer, heart disease, diabetes and chronic respiratory diseases – which account for more than 63% of global deaths according to the World Health Organization.

Tobacco use is the number one killer in China, causing 1.2 million deaths annually; this is expected to rise to 3.5 million deaths annually by the year 2030. Tobacco is also responsible for the greatest proportion of male deaths in Turkey (38%) and Kazakhstan (35%), and the greatest proportion of female deaths in the Maldives (25%) and the United States (23%).

Uniquely among cancer-causing agents, however, tobacco is a man-made problem that is completely preventable through proven public policies. Effective measures include tobacco taxes, advertising bans, smoke-free public places, mass media campaigns and effective health warnings. These cost-effective policies are among those included in the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC), a global treaty endorsed by more than 174 countries, and recommended by the World Health Organization in its MPOWER policy package.  http://tinyurl.com/bor7897

Our government knows all of this.  All of our elected officials know this and they all publicly support anti-smoking efforts.  They go to great extremes to condemn the use of tobacco while explaining the public health consequences.   Almost no one is pro smoking and yet everyone is pro smoking because we have come to depend on the billions of tax dollars generated by the sale of tobacco products.  It should be pointed out that at least the U.S,. Government no longer subsidizes tobacco farmers.  That program ended several years ago.

As usual the poor are hit the hardest by the addictive nature of tobacco.  In a study conducted on behalf of the New York State Department of Health, it revealed that low-income smokers (those in households making under $30,000), spent an average of 23.6% of their annual household income on cigarettes, compared to 2.2% for smokers in households making over $60,000.

Taxes on tobacco products total billions of dollars a year.  An example — in New York state the federal tax on a package of 20 cigarettes is $1.01, the state tax is $4.35. New York City adds a local tax of $1.50 to the state levy. That brings the combined tax rate on a package of 20 cigarettes in New York City to $6.36.  Tobacco manufacturers add their profit on top of that so depending on where you buy your cigarettes in the city you could pay as much as $12 a pack…twelve dollars for a pack of cigarettes.  By comparison, when I started smoking in 1954 you could buy a pack of “Wings” cigarettes for Ten cents. Major brands like Lucky Strikes or Camels were a quarter (quit smoking in 1991).

Tobacco Industry Profits Greater Than Ever
According to The Tobacco Atlas, estimates of revenues from the global tobacco industry likely approach a half trillion U.S. dollars annually. In 2010, the combined profits of the six leading tobacco companies was U.S. $35.1 billion, equal to the combined profits of Coca-Cola, Microsoft, and McDonald’s in the same year. If Big Tobacco were a country, it would have a gross domestic product (GDP) of countries like Poland, Saudi Arabia, Sweden and Venezuela.

In the meantime, tobacco companies are fighting laws with every weapon in their arsenal because just as their product kills people, restrictive smoking laws can kill the industry, a killing some say, is necessary and justified homicide.

As countries around the world ramp up their campaigns against smoking with tough restrictions on tobacco advertising, the industry is fighting back by invoking international trade agreements to thwart the most stringent rules.

A key battlefront is Australia, which is trying to repel a legal assault on its groundbreaking law requiring cigarettes to be sold in plain packs without distinctive brand logos or colors. Contesting the law, which takes effect Dec. 1, are the top multinational cigarette makers and three countries — Ukraine, Honduras and Dominican Republic — whose legal fees are being paid by the industry.  http://tinyurl.com/chypao4

Tobacco use has diminished considerably in most of the developed countries but not all of them.  The leafy crop is gaining new popularity among U.S. farmers. Cheaper U.S. tobacco has become competitive as an export, and China, Russia and Mexico, where cigarette sales continue to grow, are eager to buy. Since 2005, U.S. tobacco acreage has risen 20 percent. Fields are now filled with it in places like southern Illinois, which hasn’t grown any substantial amounts since the end of World War I.  http://www.freerepublic.com/focus/f-news/1899911/posts

While the price of cigarettes has continuously increased since 1965, the percentage of that price going towards taxes is now half of what it was then. ]While tobacco companies complain about the $1.01 cigarette tax, Phillip Morris, Reynolds American, and Lorillard have all increased their prices by almost $1.00 per pack on their own. Phillip Morris currently lists all taxes, including federal, state, local, and sales taxes, as 56.6% of the total cost of a pack of cigarettes.

One of the reasons for the support of increased cigarette taxes among public health officials is that many studies show that this leads to a decrease in smoking rates. The relationship between smoking rates and cigarette taxes is in fact very elastic; the greater the amount of the tax increase, the greater the proportion of smokers who stop smoking. This is especially prevalent amongst teenagers. For every ten percent increase in the price of a pack of cigarettes, youth smoking rates overall drop about seven percent. This rate is also true amongst minorities and low income population smokers.  The rates of calls to quitting hot-lines are directly related to cigarette tax hikes. When Wisconsin raised its state cigarette tax to $1.00 per pack, the hot-line received a record of 20,000 calls in a two month time period versus its typical 9,000 calls annually.

According to the New York Times taxes are not the only government revenue from cigarettes. Settlements in the late 1990s to end state lawsuits against tobacco companies mean that the cigarette industry is paying states nearly $250 billion over 25 years. Under the agreement, those payments to states will continue flowing even beyond 25 years as long as the tobacco industry is healthy. But the payments would phase out as cigarette company profits decline and would ultimately disappear if people stop smoking.

So the government has become a financial stakeholder in smoking, some would argue, even as public health officials warn people about its deadly consequences. Smoking declines as cigarette taxes increase, but a core group of smokers hang on to the habit.  http://www.nytimes.com/2008/08/31/weekinreview/31saul.html

Will the government or governments ever really crack down on smoking?  Doubtful, there is too much money in it for them so the tobacco companies and the politicians who seek to eradicate them have come to be bedfellows.  What many politicians fail to see is the savings that could be had if people didn’t smoke.  According to the CDC again, “Smoking is also a major contributor to many chronic diseases that are driving up the nation’s health care costs. Each year, diseases caused by cigarette smoking result in $96 billion in health care costs, much of which is paid by taxpayers through publicly-funded health programs.” http://www.cdc.gov/features/TobaccoControlData/ but the savings go beyond that when you consider the costs to employers and employees in higher premiums and lost work time due to tobacco caused illnesses.

If we truly wanted to wipe out smoking, taxes could be raised even higher than they are and the dollars generated could go a long way toward helping to solve our budget problems.  Unfortunately if everyone quit smoking, the tax revenue would disappear, too and therein lies the dilemma, but it does prove that you can be both for and against something at the same time.

The Caregiver — Critical to Transplant Survival


A note from Bob Aronson, founder and publisher of Bob’s Newheart

This blog is a re-print of a piece published by Gift of Life Family House in Philadelphia, Pennsylvania.  Gift of Life Family House describes itself as a “home away from home” for transplant patients and their families by providing temporary, affordable lodging and supportive services to those who travel to Philadelphia for transplant-related care. Gift of Life Family House is a 501(c)(3) non-profit charitable organization.

There are many similar organizations at Medical Centers all over the country.  Here in Jacksonville, Florida, Gabriel House of Care on the famed Mayo Clinic campus functions much like Gift of Life, but no matter where they are they need outside support with dollars if you have some to spare — and if not, donate packaged goods like paper towels, dish soap and Kleenex that are always in short supply.

In the entire transplant process the daily caregiver is second only in importance to the donor.   How important is the caregiver?  How important is your life?  Most medical centers consider the caregiver of such great importance that if the potential transplant recipient doesn’t have a competent, dependable and compassionate person to fill that role, then he or she may not qualify for a new organ.  Have I got your attention?

This post is of equal importance to both the patient and the caregiver.   The patient has to be sure he/she not only selects the right person but must ensure that the caregiver has a complete understanding of what the role entails.  The caregiver, not only has to understand the role they have accepted but must also make sure the patient understands their capabilities  and limitations.  Saying, “Yes,” to being a caregiver is making a commitment that is more than taking care of someone for a few days.  It could stretch out for years.

Being a caregiver for a transplant patient or recipient is no easy task.  It can be emotionally and physically draining and it can also be one of pride and even exuberance but caregivers ought to know what they are agreeing to when asked to take on the job.  This advice and information from Gift of Life Family House is invaluable.  You can learn more about this organization at http://www.giftoflifefamilyhouse.org/

Transplant Stages for Caregivers

From Diagnosis Until the Rest of our Lives…Organ transplant is a life-long battle. The battle may be very difficult when first diagnosed with a medical issue that requires a transplant but many people feel it becomes easier and is well worth it; however transplant does not end after surgery for the patient or the caregiver. When diagnosed with an illness that will ultimately require an organ transplant some patients and caregivers think that after surgery the battle is over. Having a positive outlook is good but it is also helpful to be prepared for the tough times ahead that can come with a transplant. Caregiver Lifeline will chronicle the stages of transplant and some of the feelings and issues transplant caregivers experience when the patient is initially diagnosed and told they need a transplant; what it is like to wait for a transplant; the actual transplant surgery; what it is like post-surgery up until one year; and lastly, what it may be like post-transplant one year after and on. Some personal accounts of actual transplant caregivers who have been through the stages will also be described in this section.

Diagnosis

Diagnosis of a medical issue that requires a life-saving transplant can produce many different emotions in caregivers and family members. Those emotions can vary from one person to the next and are many times natural feelings that occur when dealing with a difficult medical diagnosis. Regardless of the organ, age or relationship you have with the patient, knowing that your loved one could die without a transplant can be very overwhelming, scary, upsetting and even angering.

At the moment of diagnosis some transplant caregivers and family members have admitted that they were very scared, but quite often due to lack of information and education about what their loved one was going through and what to expect in the future. Once they received that information their feelings of being scared or upset decreased because they knew what to expect. One brother of a kidney recipient admitted feeling very scared when he and his family initially found out about his brother’s kidney disease. He then described feeling more confident once he learned more about his brother’s condition and even better when he found out he could donate his own kidney to his brother, which he eventually did. The education this family received helped them prepare for the future and cope better with their situation. Not all individuals and families are alike. Other families and patients have admitted that too much information is a bad thing for them and they become more anxious or scared when they are given too much information all at once. It is helpful to know what type of person you are: do you like all of the information “no holds barred” or a little information at a time so you have time to process it at your own pace? Letting the transplant team know how you and your family would like to be treated can be very helpful so they can try to treat you and the patient accordingly.

When the diagnosis of an illness that requires a transplant happens suddenly, families and caregivers can be overwhelmed and may not retain information given or may forget to ask important questions about the transplant process. Some questions that may be helpful to ask the medical team are:

  1. Why does the patient need a transplant?
  2. Who will the patient receive a transplant from?
  3. How long will the patient need to wait for a transplant?
  4. What other treatments options are available?
  5. What treatment will the patient need to receive while they wait for their transplant? And how will that treatment affect their life (will they need to stop working, or will they need to be hospitalized?)
  6. Will the transplant prolong their life?
  7. What will be required after they receive a transplant? More hospitalization? Medication?
  8. How much will everything cost? And what will happen if we can’t afford the cost?

It is helpful to keep these questions and answers written in a journal to have available to look on when needed.

One mother describes finding out during her pregnancy that her son had significant kidney issues while in her uterus and he may not survive. She described being very shocked after already having given birth almost two years previous to a healthy son. She also described feeling like she was in a “nightmare waiting to wake up.” She states she never woke up and had to come to the realization that their family was in for a tough ride, if her son survived at all. Fortunately her son did survive and he was eventually able to receive a kidney transplant.

Many people who require a transplant have some knowledge beforehand that a transplant may be necessary. For instance, one transplant caregiver of her son (who required a heart transplant) was somewhat prepared for the day they were told he would need a new heart. Her son had medical issues for many years and a transplant was always a distinct possibility. During the time previous to needing a transplant this mother had a chance to educate herself on the process so the initial diagnosis was not a huge shock or completely overwhelming. This mother was still scared due to the risk of surgery and the risk the new heart would not work, but she also had a chance to become prepared and ask for support from her family and friends.

It may be difficult to prepare for a diagnosis that you had no previous knowledge of or any reason to prepare for, which is why it is ok to call your transplant team at any time if you have a concern or question. You could also make an appointment after you compile all your questions together. It seems scary to go home from the hospital or the doctors not having all the information you would like, so you can always perform the research yourself through reputable internet sites like www.Donors1.org or www.UNOS.org. The next step in the transplant process may also allow for some extra time to prepare for the future.

The “Wait”

Between the time when a patient, caregiver and family receive the news of needing a transplant and when they officially have surgery and receive their new organ, there is a waiting process. The wait while the patient is actually on the UNOS wait list can be short or very long, though there may be many emotional and physical issues experienced by the patient and family regardless of the duration of their wait. Quite a few things can determine how quickly a person receives a transplant and those standards differ from one organ to the next. For instance, a kidney transplant could happen rather quickly if a patient has a family or friend who is willing to be their living donor. A willing person (not bribed or forced) must be tested to see if they are a match for the patient. If they are a match, surgery can be scheduled and the transfer of kidney from the living donor to the patient can happen. If a person has no willing, matching, living person to donate to them, then they are placed on a waiting list through UNOS and must wait for a kidney from a deceased donor.

Some hospitals also do living donor liver transplants, where a willing person can donate part of their liver. The living donor must also match the recipient, though the guidelines are different than are for a living kidney donor transplant. Heart, lung and pancreas are organs that must be taken from a deceased donor, which unfortunately may make the wait longer. For more information on the specifics of different organs and wait times please visit the UNOS Website.

Because the wait time is so unknown, many caregivers and patients feel out of control and powerless. One mother described how helpless she felt and that there was nothing she could do to help her son while he was waiting for a transplant, which caused her much stress. Many caregivers and patients experience emotional “ups and downs” while waiting for a transplant because the future is unknown. It is not uncommon to feel like you are living one day to the next hoping for the call from the transplant center about a possible organ for your loved one. A transplant social worker suggested that one way to feel more in control during the wait time is to stay in contact with the transplant team, call when you have questions, keep appointments as scheduled and help the patient take responsibility for their health care. By staying in contact with the transplant team, you and the patient can feel more connected to the transplant process which may alleviate some of the uncertainties of the wait process.

During the wait process caregivers experience many different emotions. One of the most common emotions described by caregivers is fear that their family or friend will not live long enough to get their organ. Others experience emotions such as anger at the patient, medical team, or even themselves. Some caregivers may feel anxiety regarding their own life regarding their financial situation and how they will afford to care for their family member or friend and whether they will have to stop working or stop doing things they enjoy. Another emotion may be denial. Caregivers may think the issue is not as serious as it truly may be. Most emotions felt by caregivers are natural and quite universal. Support groups can be very helpful because it allows transplant caregivers to hear some of the universal concerns and issues of other transplant patients and caregivers. It is also common for a caregiver to feel as though they are the only person on earth going through the issues related to being a transplant caregiver, which is another reason a support group can be helpful. It can be beneficial to be able to talk to others who have dealt with or are dealing with the same issues.

Another emotion that many patients and families feel is grief; some even call it “survivor’s guilt.” One mother described feeling quite a bit of grief that she was waiting for someone else to die in order for her son to receive a kidney to live. She states, “That was the hardest part for me, knowing that our overwhelming joy would be another family’s overwhelming grief.” A different mother to a 14 year-old heart recipient was so excited when her son received his heart and had a second chance at life, but her family struggled for some time as well realizing that another person passed away in order for her son to receive a heart. She stated, “We are so joyful that our son will have a second chance but it is tempered because there is a huge loss associated with it for someone else.” This type of feeling is extremely natural for many transplant caregivers and organ recipients. In the exception of a living kidney or liver donor, in order for one person to receive an organ transplant, another person will pass away and their family has the option to donate their organs. However it is a wonderful gift for a person to donate their organs after they pass away, because it is giving another person a second chance at life. To understand the donation process better, visit www.Unos.org or www.Donors1.org.

The wait for an organ can vary so it may be helpful to address your feelings as they occur and get help if you are in need. Finding out that others have gone through similar issues can be helpful through support groups. Talking to the transplant social worker can also be beneficial because they can connect you to other options such as counseling or other supportive services. Support groups and counseling can be helpful to the patient as well as the caregiver because the wait process can be difficult for both parties. Don’t forget to include other siblings or family of the patient because many times they may also have similar feelings requiring additional support.

During the waiting period, caregivers and family may have time to prepare for the future. Finances usually play a large role in any medical issue that requires a lot of medication or frequent appointments or hospitalization. Because transplants are not over after surgery, planning and preparing for the financial cost is important. There are many resources to assist with transplant costs if a person has limited means. For instance, most prescription companies provide assistance for drug costs. Many large hospitals also may have financial assistance programs for patients. If there is ever a financial concern, talk to the transplant social worker immediately and let them help through the process. Many times the caregiver is left to deal with those issues, especially if they become the financial provider because the patient cannot work. As the caregiver your employment may become affected, which could also affect your health insurance. It may be helpful to prepare your employer if there is going to be any changes with your ability to work and how that could affect your health insurance.

Also see Financial Burden on Caregivers for more information.

In addition to planning financially or preparing for your own work issues, it may be helpful to begin to talk with the patient about their future. The patient’s future can include many different things, so it is important to identify what is important to them. For instance, has the patient thought about their job or hobbies and how that will affect their financial state or health insurance? It may be scary to think about, but what if the patient becomes too sick and no longer can make decisions? Who will be the medical power of attorney or a financial power of attorney? Does the patient have an advance directive, and if not, do you know their wishes? Your relationship with the patient may determine your involvement in their care if they cannot make their own decisions, however it is still important to encourage the patient to think about their own future.

Transplant Surgery

Finally, your family member is getting their organ and a second chance at life! Transplant surgery can be very exciting because the wait is over and life can restart. You may be able to go back to work or begin doing what you used to enjoy; the patient can be normal again, and live a long, happy, healthy life. All of this can be true but the surgery and recovery are very important and sometimes the most difficult part of the transplant process.

During the transplant surgery stage the patient can be hospitalized for anywhere between 5 days and 14 days, without complications. If there is a complication during surgery the patient may then be required to stay in the hospital for longer than expected. At this time you may physically not want to leave the patient’s side but you may also have to take care of the rest of your family or continue to work. It can be very stressful for a caregiver to balance their life with that of the patient’s transplant recovery. It is important for a caregiver to remember that taking personal time is essential, even during this time, because chronic stress can build up and potentially cause medical and emotional issues which could limit the caregiver’s ability to be a good caregiver. Leaving the hospital for an hour a day, or taking an hour a day to do something enjoyable could make a positive difference while dealing with the stress involved with the hospitalization. Don’t forget there are many transplant team members available if you have any concerns.

Post Surgery – 1 year

Many transplant social workers have said that the first year after a transplant can be very difficult for patients and families. Transplant does not end after surgery, and many times people feel that after surgery and a short recovery everything will be fine and life will resume with little obstacles. Sometimes it is not always possible to jump back into your previous routine and lifestyle so quickly. For some people, one year after transplant can be the most difficult. Trying to get your life back while the patient is continually being monitored by doctors for rejection and getting used to a new life with a new organ can be tough. Each organ is different and recovery times and needs are different for each patient, so it is important to always talk to the transplant team about concerns or questions and to better understand what it could be like for the patient.

One family stated they were in and out of the hospital more in the one year post-transplant than any other time because of so many rejection episodes. Every patient and transplant is different; some patients experience many rejection episodes and need to go back and forth to the hospital, which is not uncommon, while other patients may never experience a rejection episode. If the patient feels they are having symptoms of rejection, it is important to follow the discharge directions from the transplant team and contact them as soon as possible.

Because recovery times can differ from one transplant to the next it is not easy to identify a set recovery time. For lung transplants, a patient may be required to attend up to three appointments per week post-transplant for up to three months, whereas for a kidney transplant only two appointments for 6 weeks may be required. If a person does not reside in the transplant hospital area it can make life even more difficult post-transplant. Similarly, if the caregiver needs to return to their life or work they also may have a tough time arranging the patient’s transportation to and from the hospital for their appointments. It may seem stressful for a transplant caregiver one year post-transplant because there may be alot of pressure to keep the patient healthy with their new organ. Some things that are important to consider after transplant is monitoring for rejection, getting used to taking new medications, nutrition, getting back to doing things you and the patient love and keeping a positive outlook. Talk to your transplant team to find out the best way to monitor the patient post-transplant, as every patient is different.

Depression and other mental health disorders have been known to be prevalent up to one year post transplant, and emotional health could affect compliance which can in turn affect the survival of the transplant. Caregivers may also experience symptoms of depression due to lifestyle changes and stress that transplant can cause. Caregiver and family support has been found to be very effective in assisting with emotional and mental issues post-transplant so the caregiver should always plan for continued contact with the medical team as needed.

As a caregiver it can be an emotional rollercoaster trying to monitor the patient’s health after a transplant while living your own life and caring for other family members or working. The section about compliance may provide some assistance when it comes to getting the patient to care for their organ and prevent rejection with good compliance. The transplant team is there to help with concerns and issues as well. Please see Emotional Health for Transplant Caregivers for more information.

Post Transplant – Until the Rest of our Lives

The patient will always have their transplant doctors and team to contact with questions or concerns at any point down the line. Transplant is life-long and although stable patients’ and families’ contact with the transplant team may lessen, the transplant team should always be there for the patient and family as long as needed.

At this point in the transplant the patient may be stable enough to have very little contact with the transplant team; therefore it’s time to get back to life if you and the patient have not done so already. It is recommended to go back to enjoying things you and your loved ones once enjoyed. One important reason a person would want to receive a transplant would be to extend their life so they can continue to live their life by doing what they love.

Many caregivers have a difficult time letting their caregiver role go because it has been an identity for quite some time. If there is no need for you to be a caregiver any longer then it is important to move on to your next role and place the caregiver role on the back burner. If you enjoyed being a mom, a worker or soccer coach for example, then take on those roles again and make them an important priority. The same can be said for the patient who may no longer be the patient, and also must place that role to the side. This stage can be difficult for both parties because many people have trouble returning to work, or spending time with friends without having a constant worry of the transplant patient.

How can a caregiver stop being a caregiver? It may be helpful to first identify what you enjoy in life. Do you love being a mother? Did/do you love your job? Did you previously spend every Thursday with your friends playing golf or going to the movies? Then try to do those enjoyable things as often as possible without thinking about transplant. Encourage the patient to do this as well.

Though you are being encouraged to let the caregiver role go, it does not mean you and the patient no longer have transplant responsibilities. Transplant is a lifelong process so you and the patient may need to take on the patient/caregiver role again at some point down the line. Additionally, there are some transplant pieces the patient cannot put on the back burner, such as good nutrition, exercise and medication compliance.

Another piece of life post-transplant is you and the patient continuing to live a healthy lifestyle. The patient will need to keep their new organ healthy, and as a caregiver you may play a large role in encouraging them. Without good health the organ could reject, placing the patient back where they were previously: needing a transplant. The patient’s transplant team, including their dietician, will be able to give good advice on good nutrition and exercise for the patient. Similarly, it is important for you to have good nutrition and exercise practices to keep yourself healthy as well. Good nutrition and exercise habits have even been shown to decrease depression. Please see the Physical Health for Transplant Caregivers and Emotional Health for Transplant Caregivers sections for more information and education for the caregiver.

Don’t forget to live your life to the fullest now that you and the patient have a second chance at life. The transplant is giving you and your family the opportunity to appreciate life and everything it has to offer.

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Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

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

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

76 Inspirational Quotes to Help Make Your Day Better*


Being a pre or post transplant patient a donor or donor family or a caregiver can be very difficult.  Sometimes just a good word or two can make the difference between a good and a bad day.  With that in mind I thought that perhaps somewhere in this list of 76 quotes, there is a thought that will help make your day be a better one.

1. Life isn’t about finding yourself. Life is about creating yourself – George Bernard Shaw.

2. Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did do. So throw off the bowlines.  Catch the trade winds in your sails.  Explore,  dream, discover….Mark Twain.

 3. Don’t judge each day by the harvest you reap but by the seeds you plant – Robert Louis Stevenson.

4. We don’t see things the way they are. We see them the way WE are – Talmud.

5. I have found that if you love life, life will love you back – Arthur Rubinstein.

6. The reason people find it so hard to be happy is that they always see the past better than it was, the present worse than it is, and the future less resolved than it will be – Marcel Pagnol.

7. A journey of a thousand miles begins with a single step – Lao Tzu.

8. Don’t ask what the world needs. Ask what makes you come alive and go do it. Because what the world needs is more people who have come alive – Howard Thurman.

9. All life is an experiment. The more experiments you make, the better – Ralph Waldo Emerson.

10. Too many people spend money they haven’t earned, to buy things they don’t want, to impress people they don’t like – Will Rogers.

11. I skate to where the puck is going to be, not where it has been – Wayne Gretzky.

12. Pain is inevitable. Suffering is optional – Anony-mouse.

13. Every man dies. Not every man really lives – William Ross Wallace.

14. Life isn’t a journey to the grave with the intention of arriving safely in a well preserved body, but rather to skid in sideways, chocolate in one hand, latte in the other, body thoroughly used up, totally worn out and screaming ‘Woohoo WHAT A RIDE’!

15. There are two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle – Albert Einstein.

16. Uncertainty is the only certainty there is, and knowing how to live with insecurity is the only security – John Allen Paulos.

17. You are not in this world to live up to other people’s expectations, nor should you feel the world must live up to yours – F Perl.

18. How you do one thing, is how you do everything. Be aware.

19. Life is either a daring adventure or nothing – Helen Keller.

20. Life is not about kissing a**, it’s about kicking a**!

21. The price of anything is the amount of life you exchange for it – Henry David Thoreau.

22.  Never be bullied into silence. Never allow yourself to be made a victim. Accept no one’s definition of your life; define yourself – Harvey Fierstein.

23. Be more concerned with your character than your reputation, because your character is what you really are, while your reputation is merely what others think you are – John Wooden.

24. In the end, it’s not going to matter howmany breathsyou took, but how many moments took your breath away – Shing Xiong.

25. Dance like the photo’s not being tagged. Love like you’ve never been unfriended. Sing like nobody’s following. Share like you care. And do it all like it won’t end up on youtube!

26. The most important thing in life is to learn how to give out love, and let it come in – Morrie Schwartz.

27. You cannot be lonely if you like the person you’re alone with – Dr. Wayne Dyer.

28. Happiness is like a butterfly.
The more you chase it, the more it eludes you.
But if you turn your attention to other things,
It comes and sits softly on your shoulder.
 – Henry David Thoreau

29. I think everyone should be told they’re beautiful until they believe it – Unknown

30. People were created to be loved. Things were created to be used. The reason the world is in chaos, is because things are being loved, and people are being used.

31. Dear Heart, fall in love only when you’re ready, not when you’re lonely – Anony-mouse.
32. ”It’s impossible” said pride. “It’s risky” said experience. “It’s pointless” said reason. “Give it a try” whispered the heart – Anonymous

33. To love oneself is the beginning of a lifelong romance – Oscar Wilde.

34. Being deeply loved by someone gives you strength, while loving someone deeply gives you courage – Lao Tzu.

35. When in doubt, choose Love.

36. Your task is not to seek love, but to seek and find all the barriers within yourself that you have built against it – Rumi.

37. Happiness always sneaks in a door you did not think was open – Anony-mouse.

38. Bitterness is like cancer. It eats upon the host. But anger is like fire. It burns it all clean – Maya Angelou.

39. Be happy while you’re living, for you’re a long time dead – Scottish Proverb.

40. The minute I heard my first love story, I started looking for you, not knowing how blind that was. Lovers don’t finally meet somewhere. They’re in each other all along – Rumi.

41. Being happy doesn’t mean that everything is perfect. It means that you’ve decided to look beyond the imperfections.

42. Whoever said money can’t buy happiness didn’t know where to shop – Gertrude Stein.

43. The appearance of things change according to the emotions and thus we see magic and beauty in them, while the magic and beauty really are in ourselves – Kahlil Gibran.

44. You’re at the zoo, you have a popsicle, how can you be unhappy? – Dewey, Malcolm in the Middle.

45.  Find the guy who calls you beautiful instead of hot, who calls you back when you hang up on him, who will lie under the stars and listen to your heartbeat, or stay awake just to watch you sleep. The one who turns to his friends and says, “thats her” – Anony-mouse.

46. Don’t worry. Be happy.

47. Self-worth comes from one thing – thinking that you are worthy.

48. Be helpful. When you see a person without a smile, give them yours – Zig Ziglar.

49. My life has  no purpos, no direction, no aim, no meaning, and yet I’m happy. I can’t figure it out. What am I doing right? – Charles Schultz (probably # 50!).

50. Happiness is a choice. Choose happy.

 51. If you’re going through hell, keep going – Winston Churchill.

52. Feelings come and feelings go. There is no need to fear them and no need to crave them. Let them come, and then let them go. No feeling is your permanent reality, no matter how intense it is.

53. No matter what, no matter how, where or who – you can almost always turn around and get a second chance – Anony-mouse.

54. When one door closes, another opens; but we often look so long and so regretfully upon the closed door that we do not see the one which has opened for us – Alexander Graham Bell.

http://www.andrewmitchellphotography.tumblr.com

55. The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man – George B Shaw.

56. You cannot solve a problem with the same mind that created it – Albert Einstein.

57. Do or Do Not. There is no Try – Yoda.

58. We must let go of the life we had planned so as to have the life that is waiting for us – Joseph Campbell.

59. You gain strength, courage and confidence by every experience in which you really stop to look fear in the face – Eleanor Roosevelt.

60. When we are no longer able to change a situation, we are challenged to change ourselves – Viktor Frankl.

61. Change is inevitable. Progress is optional – Tony Robbins.

62. Be smart enough to hold on, be brave enough to let go. Sometimes, we need to hold onto faith while letting go of the outcome. Open your hand and hold your dreams gently, don’t try to grab them.

63. If you are irritated by every rub, how will you be polished? – Rumi

64. If there is anything that we wish to change in the child, we should first examine it and see whether it is not something that could better be changed in ourselves – Carl Jung.

65. I’ve developed a new philosophy. I only dread one day at a time – Charlie Brown

66. Even if you’re on the right track, you’ll get run over if you just sit there – Will Rogers.

http://www.cpthatsme.com

67. The great thing in the world is not so much where we stand, as in what direction we are moving – Oliver W Holmes.

68. The harder you fall, the higher you bounce – Unknown.

69. I may not have gone where I intended to go, but I think I’ve ended up where I needed to be  – Douglas Adams.

70. The best way to predict the future is to create it.

71. People will hate you, rate you, shake you, and break you. But how strong you stand is what makes you – Unknown.

72. We cannot change the cards we are dealt, just how we play the hand – Randy Pausch.

73. You’ve got to do your own growing, no matter how tall your grandfather was – Irish proverb.

74. You are who you are and what you are because of what has gone into your mind. You can change who you are and what you are by changing what goes into your mind – Zig Ziglar

75. Whether you believe you can do a thing or not, you are right – Henry Ford.

76.  God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference – Reinhold Niebuhr. (The Serenity Prayer rocks!)

WANT MORE? GO TO https://bobsnewheart.wordpress.com/2013/08/01/half-a-hundred-quotes-on-hope-inspiration-love-and-living/

The entire list with great poster-like illustrations can be found at http://www.yourlifeyourway.net/2011/09/06/75-best-kickass-inspirational-quotes-on-life-love-happiness-change-growth/  

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

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

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

“The Letter” How to Write to Your Donor Family


Writing a personal letter of gratitude for an organ donation is the ultimate humbling experience. How do you begin to thank  someone for saving your life? Words don’t seem adequate when you would like to hug someone and hold their hand while you say think you.   It would seem almost impossible to express the gratitude you and your family feel.

Because of circumstances, though, words are your only choice therefore they should be carefully considered and come from your heart.  Your letter should show an appropriate amount of thoughtfulness and sincerity, it should not gush or be overly emotional. Balance is the key.

A handwritten letter is always best but, if your handwriting is like mine, a typed letter will be much easier for the recipient to read.

When you write, and I say when because “if” is usually not even a consideration , you should not only write and edit it yourself but also have someone you trust look it over.  Then read it out loud to the person to determine how he or she feels upon hearing the words.  This letter can be like no other you have ever written, because you will be talking to a total stranger; a family who lost a loved one and whose organ or tissue is now helping to keep you alive. Remember no matter when you write that the family may still be grieving.

Your letter cannot be sent directly from you to your donor family.  It must go through your transplant center.  Talk to  your coordinator or social worker about where to send you letter so it can be forwarded to your donor family.

Why A Thank You Letter is Important

Saying thank you is as much about the writer as it is about the reader. It is a social grace that benefits both parties equally.  Organ donation is a powerful reminder of just how wonderful gift giving can be…especially when the gift is one of life.

The death of a family member is a horrible experience, regardless of the nature or time of death.  When organ donation is a consideration the experience can become even more traumatic because while in the depths of pain and grief families must also make the decision to help others who are critically ill by donating their loved ones organs and/or tissues.   Knowing first-hand how the recipient’s life has changed and what they have been able to do since their transplant can help give meaning to the senselessness surrounding their loss. Sharing such the emotions of a life saving experience can the organ recipients recovery as well as helping the donor family through their grieving process.

Key Components of a “Thank you donor family” Letter

  1. Write your thank you letter by hand if possible because it indicates thoughtfulness and caring, and gives it the attention it deserves.  If you type the letter explain why you are doing so.
  2. Always keep in mind who your audience is.  It is the donor family, not yourself.  Don’t lose sight of that simple fact.
  3. Take the time to think and draft your letter before you write: It should be error free and look professional so the reader knows you gave it considerable time and consideration.
  4. Do not use canned and expected language.  Avoid clichés and “Sympathy Card” pseudo poetry but you can include a brief   quote from a famous person.
  5. Sincerity is key: avoid exaggerations and focus on highlighting a few specifics about the gift so as to remain credible with your message
  6. Compose a well thought out closure: think about a special close that truly encapsulates the spirit of your letter

What to say and what not to say

In this first letter it is important that all parties remain anonymous.  You should not include any information that might lead to your identity.   That means you should not include last names, streets or numbers, email addresses names of hospitals and names of physicians and staff.  If there is further correspondence or contact and both parties agree to exchanging identities then and only then is it appropriate to do so.

The safest assumption you can make is that the donor family is still grieving, regardless how much time has passed. Communicating with sensitivity is of utmost importance.

Here are some suggestions of what to include in your letter but remember, it must come from the heart and the words must be yours:

  1. Open your letter with “Dear Donor Family”
  2. Thank the donor family for their gift
  3. Speak about your transplant experience – consider including details surrounding your wait, the surgery and recovery
  4. Elaborate how the transplant has changed your life
  5. Use first names only and talk about yourself and your family
  6. Mention your occupation and any activities which you once again can enjoy
  7. Include photos (void of identifying information)

Sample Organ Donation Thank You Letter

Date

Dear Donor Family:

On August 21, 2007 I received a heart from your loved one. You, he and it saved my life. I promise I will take care of this gift far better than I took care of my own natural organ. Each day before I get up I take a moment to feel this marvelous gift steadily thumping in my chest. It is alive and healthy and has created in me a new appreciation for life.

More than that, though, I am always aware that this heart is not mine. It belongs to the kind of person all of us should aspire to be. Moreover, he came from the kind of people all of us should aspire to be. Maybe it is my imagination but since receiving my new heart, I feel a serenity I have never before felt. I feel a concern for others far greater than I thought possible. I feel a responsibility to all organ donors and their families to do what I can to honor their loved ones by committing the rest of my life to promoting organ donation.

I was very sick prior to my transplant. I could no longer get around very well because my heart just could not pump efficiently enough. I knew I was dying and as a 68 year-old man with COPD and B positive blood, I did not think a transplant was in the cards. But it was. As a result, I believe that God saved me for a reason and that reason was to promote organ donation to honor you and your loved one.

I appreciate the simple things now, much more than before. I look forward every morning to seeing my loving wife and caregiver, Robin. Staying in contact with family and friends has become more important than ever before. I enjoy sitting in our sunroom watching the sunrise and sunset. Each day gives me a new thrill because each day is a gift from you and from God.

I don’t know if we will ever meet and although I am likely to be at a loss for words, I would like to thank you personally. You gave me life, you gave me peace and you gave me a profound sense of gratitude and understanding. I am a new person and I hope that in your grief it helps to know that a part of your loved one is alive and that with his help I am trying to live my life in a way that would make you proud.

God bless

Bob, Robin and family

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

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

Obamacare — Your Questions Answered


Whether your agree with it or not, the Affordable Care Act, also known as “Obamacare” is one of the most significant pieces of legislation ever to pass the U.S. Congress. Some of it is already in effect but it will continue to unfold in years to come.

Politics aside, there are thousands of questions about this sweeping reform of American healthcare and this post only answers a few, but they are important questions.  Others will emerge as the act unfolds and people have real, day to day experience with it.

What you are about to read was developed by the Henry J. Kaiser Foundation, a non-profit, non-partisan research organization.  This is what their website says about them:

The Henry J. Kaiser Foundation http://www.kff.org/

Who We are

A leader in health policy analysis, health journalism and communication, the Kaiser Family Foundation is dedicated to filling the need for trusted, independent information on the major health issues facing our nation and its people.  Kaiser is a non-profit, private operating foundation focusing on the major health care issues facing the U.S., as well as the U.S. role in global health policy.  Unlike grant-making foundations, Kaiser develops and runs its own research and communications programs, sometimes in partnership with other non-profit research organizations or major media companies.

We serve as a non-partisan source of facts, information, and analysis for policymakers, the media, the health care community, and the public. Our product is information, always provided free of charge — from the most sophisticated policy research, to basic facts and numbers, to information young people can use to improve their health or elderly people can use to understand their Medicare benefits.

The Kaiser Family Foundation is not associated with Kaiser Permanente or Kaiser Industries.

A Post-election Consumer’s Guide to Health Reform

By Mary Agnes Carey and Jenny Gold, Kaiser Health News

Now that President Barack Obama has won a second term, the Affordable Care Act is back on a fast track.

Some analysts argue that there could be modifications to reduce federal spending as part of a broader deficit deal; for now, this is just speculation. What is clear is that the law will have sweeping ramifications for consumers, state officials, employers and healthcare providers, including hospitals and doctors.

While some of the key features don’t kick in until 2014, the law has already altered the health care industry and established a number of consumer benefits.

Here’s a primer on parts of the law already up and running, what’s to come and ways that provisions could still be altered.

I don’t have health insurance. Under the law, will I have to buy it and what happens if I don’t?

Today, you are not required to have health insurance . But beginning in 2014, most people will have to have it or pay a fine. For individuals, the penalty would start at $95 a year, or up to 1 percent of income, whichever is greater, and rise to $695, or 2.5 percent of income, by 2016.

For families the penalty would be $2,085 or 2.5 percent of household income, whichever is greater. The requirement to have coverage can be waived for several reasons, including financial hardship or religious beliefs.

Millions of additional people will qualify for Medicaid or federal subsidies to buy insurance under the law.

While some states, including most recently Alabama, Wyoming and Montana, have passed laws to block the requirement to carry health insurance, those provisions do not override federal law.

I get my health coverage at work and want to keep my current plan. Will I be able to do that? How will my plan be affected by the health law?

If you get insurance through your job, it is likely to stay that way. But, just as before the law was passed, your employer is not obligated to keep the current plan and may change premiums, deductibles, co-pays and network coverage.

You may have seen some law-related changes already. For example, most plans now ban lifetime coverage limits and include a guarantee that an adult child up to age 26 who can’t get health insurance at a job can stay on her parents’ health plan.

What other parts of the law are now in place?

You are likely to be eligible for preventive services with no out-of-pocket costs, such as breast cancer screenings and cholesterol tests.

Health plans can’t cancel your coverage once you get sick – a practice known as “rescission” – unless you committed fraud when you applied for coverage.

Children with pre-existing conditions cannot be denied coverage. This will apply to adults in 2014.

Insurers will have to provide rebates to consumers if they spend less than 80 to 85 percent of premium dollars on medical care.

Some existing plans, if they haven’t changed significantly since passage of the law, do not have to abide by certain parts of the law. For example, these “grandfathered” plans can still charge beneficiaries part of the cost of preventive services.

If you’re currently in one of these plans, and your employer makes significant changes, such as raising your out-of-pocket costs, the plan would then have to abide by all aspects of the health law.

I want health insurance but I can’t afford it. What will I do?

Depending on your income, you might be eligible for Medicaid. Currently, in most states nonelderly adults without minor children don’t qualify for Medicaid. But beginning in 2014, the federal government is offering to pay the cost of an expansion in the programs so that anyone with an income at or lower than 133 percent of the federal poverty level, (which based on current guidelines would be $14,856 for an individual or $30,656 for a family of four) will be eligible for Medicaid.

The Supreme Court, however, ruled in June that states cannot be forced to make that change. Republican governors in several states have said that they will refuse the expansion, though that may change now that Obama has been re-elected.

What if I make too much money for Medicaid but still can’t afford to buy insurance?

You might be eligible for government subsidies to help you pay for private insurance sold in the state-based insurance marketplaces, called exchanges, slated to begin operation in 2014. Exchanges will sell insurance plans to individuals and small businesses.

These premium subsidies will be available for individuals and families with incomes between 133 percent and 400 percent of the poverty level, or $14,856 to $44,680 for individuals and $30,656 to $92,200 for a family of four (based on current guidelines).

Will it be easier for me to get coverage even if I have health problems?

Insurers will be barred from rejecting applicants based on health status once the exchanges are operating in 2014.

I own a small business. Will I have to buy health insurance for my workers?

No employer is required to provide insurance. But starting in 2014, businesses with 50 or more employees that don’t provide health care coverage and have at least one full-time worker who receives subsidized coverage in the health insurance exchange will have to pay a fee of $2,000 per full-time employee. The firm’s first 30 workers would be excluded from the fee.

However, firms with 50 or fewer people won’t face any penalties.

In addition, if you own a small business, the health law offers a tax credit to help cover the cost. Employers with 25 or fewer full-time workers who earn an average yearly salary of $50,000 or less today can get tax credits of up 35 percent of the cost of premiums. The credit increases to 50 percent in 2014.

I’m over 65. How does the legislation affect seniors?

The law is narrowing a gap in the Medicare Part D prescription drug plan known as the “doughnut hole.” That’s when seniors who have paid a certain initial amount in prescription costs have to pay for all of their drug costs until they spend a total of $4,700 for the year. Then the plan coverage begins again.

That coverage gap will be closed entirely by 2020. Seniors will still be responsible for 25 percent of their prescription drug costs. So far, 5.6 million seniors have saved $4.8 billion on prescription drugs, according to the Department of Health and Human Services.

The law also expanded Medicare’s coverage of preventive services, such as screenings for colon, prostate and breast cancer, which are now free to beneficiaries. Medicare will also pay for an annual wellness visit to the doctor. HHS reports that during the first nine months of 2012, more than 20.7 million Medicare beneficiaries have received preventive services at no cost.

The health law reduced the federal government’s payments to Medicare Advantage plans, run by private insurers as an alternative to the traditional Medicare. Medicare Advantage costs more per beneficiary than traditional Medicare. Critics of those payment cuts say that could mean the private plans may not offer many extra benefits, such as free eyeglasses, hearing aids and gym memberships, that they now provide.

Will I have to pay more for my health care because of the law?

No one knows for sure. Even supporters of the law acknowledge its steps to control health costs, such as incentives to coordinate care better, may take a while to show significant savings. Opponents say the law’s additional coverage requirements will make health insurance more expensive for individuals and for the government.

That said, there are some new taxes and fees. For example, starting in 2013, individuals with earnings above $200,000 and married couples making more than $250,000 will pay a Medicare payroll tax of 2.35 percent, up from the current 1.45 percent, on income over those thresholds. In addition, higher-income people will be taxed 3.8 percent on unearned income, such as dividends and interest.

Starting in 2018, the law also will impose a 40 percent excise tax on the portion of most employer-sponsored health coverage (excluding dental and vision) that exceeds $10,200 a year and $27,500 for families. The tax has been dubbed a “Cadillac” tax because it hits the most generous plans.

In addition, the law also imposes taxes and fees on several major health industries. Beginning in 2013, medical device manufacturers and importers must pay a 2.3 percent tax on the sale of any taxable medical device to raise $29 billion over 10 years. An annual fee for health insurers is expected to raise more than $100 billion over 10 years, while a fee for brand name drugs will bring in another $34 billion.

Those fees will likely be passed onto consumers in the form of higher premiums.

Hasn’t the law hit some bumps in the road?

Yes. For example, the law created high-risk insurance pools to help people buy health insurance. But enrollment in the pools has been less than expected. As of Aug. 31, 86,072 people had signed up for the high-risk pools, but the program, which began in June 2010, was initially expected to enroll between 200,000 and  400,000 people. The cost and the requirements have been difficult for some to meet.

Applicants must be uninsured for six months because of a pre-existing medical condition before they can join a pool. And because participants are sicker than the general population, the premiums are higher.

Enrollment has increased since the summer, after the premiums were lowered in some states by as much as 40 percent and some states stepped up advertising.

A long-term care provision of the law is dead for now. The Community Living Assistance Services and Supports program (CLASS Act) was designed for people to buy federally guaranteed insurance that would have helped consumers eventually cover some long-term-care costs. But last fall, federal officials effectively suspended the program even before it was to begin, saying they could not find a way to make it work financially.

Are there more changes ahead for the law?

Some observers think there could be pressure in Congress to make some changes to the law as a larger package to reduce the deficit. Among those options is scaling back the subsidies that help low-income Americans buy health insurance coverage. The amount of the subsidies, and possibly the Medicaid expansion as well, could be reduced.

It’s also possible that some of the taxes on the health care industry, which help pay for the new benefits in the health law, could be rolled back. For example, legislation to repeal the tax on medical device manufacturers passed the House with support from 37 Democrats (it is not expected to receive Senate consideration this year). Nine House Democrats are co-sponsoring legislation to repeal the law’s annual fee on health insurers.

Meanwhile, the Independent Payment Advisory Board (IPAB), one of the most contentious provisions of the health law, is also under continued attack by lawmakers. IPAB is a 15-member panel charged with making recommendations to reduce Medicare spending if the amount the government spends grows beyond a target rate. If Congress chooses not to accept the recommendations, lawmakers must pass alternative cuts of the same size.

Some Republicans argue that the board amounts to health care rationing and some Democrats have said that they think the panel would transfer power that belongs on Capitol Hill to the executive branch. In March, the House voted to repeal IPAB but that bill did not get past the Senate.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

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

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

Addiction — A Journey Into Hell


If you are suffering from organ failure and you are an addict you can be eligible for an organ transplant but you have to be clean and sober first and  most transplant centers require at least six months of sobriety before they will consider you.

Yesterday I posted a blog “My Last Drunk..” about the time 30 years ago I checked myself into treatment for alcoholism.  It was not a particularly outrageous story but it was significant  to me because it was my very last drunk.

I write a lot about addiction because it is one of the primary killers of human organs and because this group is dedicated to ending the organ shortage I’m hoping that stories about addiction and recovery will  help those suffering from the disease find their way into a recovery program.  If we can do that the demand for organs will decrease and those who remain on the list will have a better chance of getting a transplant.

I realize that there are many who refuse to believe that addiction is a disease and many who think addicts even if they are in recovery should not be eligible for transplants because of what they did to themselves.  And I will be the first to admit that addicts do the damage to themselves but it’s not on purpose, it is not because they choose to destroy their organs, their families and their careers.  Who would be crazy enough to do that?  The life of an addict is pure hell and readers will just have to believe me when I say, “No one would choose to live like that, no one!”

When you are an addict you are totally out of control and you don’t set out to harm anyone including yourself but the power of the disease is so great it is irresistible.  When the demand for your drug of choice invades your body you must respond to it no matter who gets hurt along the way. You will lie, cheat, steal and in some cases even physically harm anyone who gets between you and, in my case, my bottle.

Being an addict also means you spend inordinate amounts of time trying to figure out how to feed your habit.  With alcohol money is not as much a problem as with illegal or prescription drugs.  Alcohol is easy to get and relatively cheap but you still must plan.  In most places you can’t buy a bottle of booze on a Sunday so you have to make sure that you have enough booze on Saturday to take you through Monday.  Then in many cases, especially if you have a family you don’t want to know about your addiction, you have to have a place to hide your drug of choice.  I had a secret panel in the wall of our finished basement, a cubby hole In the garage, a special place in a sand pit near my home where I could hide and then dig up my bottle, inside an old tire in the garage and the bottom of the waste basket under used paper towels in the men’s room at my place of employment.

If illegal drugs are your problem then money becomes a huge issue and you will either steal it or con your best friends or family out of it by manipulating them in any one of a number of ways.  No lie is too outrageous for the addict and in many cases no action is too outrageous.  That’s how powerful the addiction is.  You will literally sell your soul to get what you need and the worst part of it is that you can’t even really get high anymore, you use to try to feel normal but all you really get is sicker and sicker both mentally and physically until either you are hospitalized, treated or die.

Addiction will overwhelm your sense of ethics, pride, morals, self-worth and will to live.  I remember having a conversation with myself once in which I said, “Bob you have to stop drinking, you are killing yourself!”  My response without thinking and without pause was, “I don’t care.”  That’s the power of the drug.

When I drank I sometimes consumed up to two quarts of vodka a day.  I was a big man 6’4” and 250 lbs.  I could hold a lot and miraculously I functioned.  I got up every day, put on a suit threw a quart of vodka in my oversized briefcase and went to work.  I drank my way through four years as a Governor’s press secretary and appeared to many if not most to be sober, I almost never was.

In the four years I anchored Morning Edition on the Minnesota Public Radio Network I rarely drew a sober breath yet I interviewed people, had impeccable timing, read news and performed all the other duties an on-air person can do. Sometimes I struggled mightily to keep from slurring words and to walk straight but I was able to fool most  of the people, most of the time.

But it all catches  up with you and at some point you find yourself in places and with people you would not normally associate with.  It is as though the rest of the world can’t see you.  All the while you know it is wrong but you just keep sinking deeper and deeper into the bottomless pit of despair and the more you realize how you have degenerated the more you use your drug of choice to help you forget what you have become.

Addiction is a horrible disease and as I mentioned in yesterday’s blog it cannot be overcome with will power it takes help, a lot of help from a lot of people and then it takes superhuman effort and the help of those same people and even more to stay sober.

One of the toughest parts of recovery is following the Alcoholics Anonymous step that dictates that you make amends to those you have harmed.  It means you must apologize and it also means your apology may not be accepted and you have to learn to live with that.  It’s part of the soul and conscience cleansing process and it is difficult but necessary.

Recovery from addiction is on-going.  You are never recovered because one drink, just one, will send you right back into that deadly spiral into the depths of living hell.  As the expression goes, “One drink is too many and a thousand is not enough.”

I’ll close with this. If you are an addict, there is hope and there is help. It isn’t easy and it isn’t quick but it can work and you can live a normal life again but you cannot do it alone.  You need help.  You can start by calling your local chapter of Alcoholics Anonymous or Narcotics Anonymous or any accredited treatment center. In most cases insurance will cover treatment.  If you are uninsured there is still help available through AA and NA.  It is only a phone call away. You just have to take it one day at a time, sometimes, it is one moment at a time but it is always moving forward, sober!

f you are an addict, think you might be or know someone who needs help here are some resources. 

http://nationalsubstanceabuseindex.org/

http://www.addictionresourceguide.com/resources.html

http://www.drugabuse.gov/publications/principles-drug-addiction-treatment/resources

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

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

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show, it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

Using the DMV to Inrease Organ Donation


By PAULINE W. CHEN, M.D.

Reprinted from The New York Times

| May 17, 2012, 12:35 pm

Last summer I went to my local Department of Motor Vehicles to renew my driver’s license. When it was my turn after a half-hour wait, a woman behind the counter summoned me, muttered a greeting and began shuffling through my papers.

After a few minutes she broke the silence and asked, “Do you want to be an organ donor?”

As a surgeon specializing in liver transplants, I’ve spent more time than most people thinking about that question. But on that particular afternoon, after a long wait on hard benches in a spartan room with a dozen others gazing glassy-eyed into space, a question about death and the dispersal of body parts felt as if it had come from out of the blue. Or from the script of a bad existential play.

It took me a minute to collect my thoughts and agree, but the experience reminded me why there are not enough organs available for transplant in the United States and why only half of all Americans consent on their driver’s licenses to organ donation. It’s hard to think about dying anywhere. It’s particularly difficult in the middle of the D.M.V.

Unfortunately, there are significant repercussions to those decisions. More than 100,000 patients are currently on the transplant waiting list, and about 7,000 of them die each year because of the organ shortage. Even more dire is the situation of African-American patients, who have a higher incidence of diseases that can result in kidney failure. These patients make up almost a third of the waiting list but account for only about 15 percent of those who donate after death. Even though organ allocation does not take race or ethnicity into account, the chances of a “good match” are increased within groups with genetic similarities.

An interesting study published last month in Annals of Internal Medicine offers some hope of increasing the number of people who consent to donation on their driver’s license, one of the easiest and most popular ways to register donors. Unlike previous initiatives that have tried appealing language like the “gift of life,” offering educational programs at workplaces or churches, promoting a YouTube video reminiscent of a popular soft drink jingle and, most recently, tapping into the power of Facebook, this approach takes advantage of the obvious – the wait at the D.M.V.

For six months, a group of researchers stood outside branches of the Bureau of Motor Vehicles in northeastern Ohio and stopped anyone arriving to apply for or renew a driver’s license. They then asked half of these people to watch a five-minute iPod video on organ donation before entering the office, and they asked everyone to show their new driver’s licenses when they left the building.

In the video, family members, donors, transplant recipients and people whose friends and relatives died while on the waiting list discuss their experiences. They also answer common questions about the personal impact of donation, religious views and the level of care a patient might receive once it is known that person is a potential donor. Most significant, the video also encourages viewers to begin thinking about donation, so most people who watch the video as they enter the D.M.V. will contemplate the decision while they are waiting to get their licenses.

The video resulted in an increase of more than 10 percent in consent for donation. And the increase was even greater among African-Americans; nearly 25 percent more consented to organ donation after watching the short film.

“Video is very powerful, particularly among minority communities where health care literacy is an issue,” said Dr. J. Daryl Thornton, the lead author and an assistant professor of pulmonary and critical care medicine at the MetroHealth Campus of Case Western Reserve University School of Medicine in Cleveland. “If you give people time to think and contemplate right before you ask them, you can have an impact on their decisions.”

Those who watched the video felt better informed, had fewer conflicts about the idea of donating and were less likely to want to be buried with all their organs. But there were limitations. Regardless of whether they watched the video, some people continued to believe, for example, that carrying a donor card would mean they would receive less emergency medical care in case of an auto accident.

“There are probably some deep-seated beliefs about organ donation and the health care system that a five-minute video is unlikely to change,” Dr. Thornton said.

It is still unclear whether the increased number of consents that resulted from the video will mean more available organs in the future, but Dr. Thornton and his colleagues are heartened by their findings and are continuing their research. The video is already playing as a public service announcement in some D.M.V.’s throughout the Washington State, and there are plans to try to link it to state motor vehicle Web sites for those who are renewing a license online.

“Even though the majority of people support organ donation, it’s hard for them to envision becoming the donor themselves,” Dr. Thornton said. “We’re trying to create a bridge that makes it easier for those people to cross over.”

Bob Aronson of bobsnewheart is a 2007 heart transplant recipient, the founder of Facebook’s 1800 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs. 

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

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show, it needs a presenter but is professionally produced and factually sound.  If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills.  Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

Too Few Organ Donors — Inadvertent Terrorism


Each day 19 people die because there are not enough transplantable human organs to fill the need.  The United Network for Organ Sharing (UNOS) which coordinates all transplants in America maintains a list of people who need life-saving transplants.  As of today, January 2, 2012 the numbers are:

Waiting list candidates                                 112,702

Transplants January – Sept. 2011              21,354

Donors January – Sept. 2011                       10,558

Right now, as you read this a patient, maybe a child, is near death.  She needs a heart but there won’t be one. As the electronic monitors beep and chirp, the family is devastated, inconsolable in the frustration over the lack of organ donors and the imminent death of their loved one.  The best medical care in the world is at their fingertips but they are helpless without an organ donor.  The patients vital signs are dropping more rapidly now, the Doctors aren’t holding out much hope.

Right now as you read this, another patient not too far away has already been declared brain dead as the result of an auto accident.  He is surrounded by a grieving family.  It is not known if the patient is or wanted to be an organ donor.  The family is considering a request to donate his organs but the decision must be made soon and they don’t know what to do, their loved one never told them of his wishes.  Through tears and indescribable grief they discuss, they argue and then decline.  Both patients die.

Each year Americans bury or cremate more than 20,000 transplantable organs – 20.000.  Surveys continually indicate that over 90 percent of Americans approve of organ donation but in one of the greatest mysteries ever, only 46 percent actually make the commitment to do so.  This inaction, this procrastination is causing people to die, families to grieve and patients who are awaiting transplants to live their lives in absolute terror.  People who are not organ donors are not evil, they are not bad, they just don’t understand that their lack of action causes terror among patients as great as that caused by the real terrorists of the world.

Most people who aren’t donors, “Just haven’t gotten around to it.”  After all, there’s no rush for them.  Organs are recovered after a person dies and most potential donors are in pretty good health.  The problem is that the patients who need the organs are not in good health.  Everyone who is on that UNOS list mentioned earlier, is dying.  Without a transplant they will die.  Period. End of story.

Well, let’s make the donation process really simple, so simple you can do it from home, your office, on your I-pad or Kindle in your doctor’s waiting room anywhere.  You don’t even have to get up.  Just go to www.donatelife.net and follow the instructions then tell your family what you have done.  It only takes minutes.  Then make very sure they clearly understand that you want to be an organ donor.  “That means when I die I want the medical people to take as much of my tissue and as many of my organs as they need to help save or enhance the lives of others.”  Those are my distinct wishes please respect them should the time come.

That’s the first step to saving lives by helping to increase the number of donors.  The second step, just in case you like this cause and want to do more, is to spread the word to convince others to do the same.  “So,” you say, “How do I do that, how do I spread the word?”  Here are ten easy tips, I’m sure that if you think real hard you might be able to come up with ten more.

  1. 150 words is about a minute’s speaking time.  Write out about 150 words on why organ donation is important to the donor…the donor and then post it everywhere you can think of on the internet.
  2. Call your local Organ Procurement Organization (OPO) and volunteer to speak on behalf of donation.
  3. Buy the green “Donate life” wristband at www.donatelife.net and wear it every day.  If someone admires it give it to them and ask them to wear it.  What’s a few bucks to save  some lives?
  4. Ask your pastor to give a sermon on organ donation…offer to help gather the information for him/her.
  5. Write a letter to the editor…actually send it to every editor you can think of.
  6. When some radio talk show host least expects it…call about the importance of organ donation
  7. Offer to speak to a local service club about donation/transplantation issues (Kiwanis, Rotary, Lions etc).
  8. Add a short note about organ donation to the signature of every email you send “Did you know that one organ/tissue donor can save or positively affect up to 60 lives?”
  9. Talk to a public school class about donation/transplantation
  10. Start a blog…it’s really easy.  Just Google “free blog sites” and go for it.

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or  positively affect over 60 lives. Some of those lives may be people you know and love.  Please view our video “Thank You From the Bottom of my Donor’s heart.” Just go to www.organti.org and click on the title.  This video was produced to py romote organ donation so it is free and no permission is needed for it’s use.  You’ll also find other useful information on this web site about other donation/transplantation issues.

We would love to have you join our Facebook group, Organ Transplant Initiative (OTI) The more members we get the greater our clout with decision makers and the more clout we have the more likely it  is that we’ll be able to increase not only organ donation but the many alternatives that science and technology people are working on.

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