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Thoughtful Communication Can Greatly Enhance Your Quality of life and — It’s Free!


***Note from Bob Aronson. Dr. Priscilla Diffie-Couch is a cousin who understands the power of words. She has contributed several blogs to Bob’s Newheart about a variety of subjects, but all revolve around mental and physical health issues.

Living in the 21st century with all of its stresses like the high cost of healthcare, raising a family and trying to make ends meet has resulted in higher stress levels for many. That stress wears on us and negatively affects our quality of life.  Dr. Diffie-Couch says it doesn’t have to be that way. She offers a partial solution — communication. If you do it thoughtfully you likely will feel a whole lot better and the best part of it all is that it is free. You have nothing to lose by trying what she suggests — and you may have a whole lot to gain. 

By Dr. Priscilla Diffie-Couch

feet off table cartoonHuman communication and health are two topics I have been passionate about most of my life.  So much so that I got three degrees in one and have spent most of my adult life digging deep into the other.  Both are topics of such depth and expanse that no human being could come close to mastering the limitless scope of either.  One facet that has especially fascinated me is the effect one has on the other, particularly, the impact that communication has on human health.

You can’t study the science and art of communication without being exposed to the needs and motives that drive human behavior.  So you’ll find a bit of that as well as my own personal philosophy of life as you read here what flows from mind to page.

Research now tells us that human beings who are most social live the longest.  Once you look into how that happens, you discover that, like everything else of value in life, it is not the quantity but quality of that interaction that has the most pronounced effect on human relationships and thereby on human health.

What it takes too many of us too long to learn in life is that a satisfying understanding cartoonrelationship can never be something one party feels and the other does not.  It can be judged only in the eyes of both beholders.  Just as you cannot make other people love you, you cannot make them feel good about the way you choose to communicate with them.  Discovering how to meet the needs of someone else when you interact often requires a delicate dance until you match your own footsteps with theirs.  But it is never as simple as that.  There also has to be a meeting of minds and a link from the hearts.  Reaching a level that makes for comfortable satisfying communication with people close to you can take years, even a lifetime.  Sadly, if we don’t practice them with each interaction, we too easily forget the steps and we have to relearn them again and again.

We are all aware that uncontrolled stress can take a heavy toll on our health.  It can precipitate heart attacks, suppress our immune system, rob us of rejuvenating restful sleep, and even shorten our lives.  And there is nothing more stressful than unsatisfying communication with people who mean the most to us.

build a bridgeNo two human beings are alike.  The needs they bring into a communication moment will never be the same.  We’ve all known people we care about deeply who are so needy that it strains our powers to provide.  Some spend their lives immersed in such insecurity and unexplained longing that you can never tell them often enough the affirmations they need to hear.  No matter the number of times you praise some people, withhold it or disagree with them once, and you will have failed to meet their needs.  Efforts to interact satisfactorily with those people can extract costs on the health of all parties concerned.

Their constant state of unmet needs leads some to ceaselessly seek ways that they can prove their worth.  The most common of these is to stake a claim on being “right.”  Seldom is something so simple that someone can flip open a book and point to a passage and proclaim, “See. I was right.”  Seldom are matters of fact at the heart of interpersonal disagreements. Shouldn’t you just agree to disagree and let it go?  That is almost never satisfying communication among close friends and loved ones.  Doing that leaves you to talk about things and people and the weather.  The very feature that distinguishes an intimate relationship from one with a stranger is the freedom to express complex, sensitive thoughts.   And express differences of opinion.

Few things in life are easily separated into two distinct categories:  right or wrong.   There is little satisfaction to be derived from being reminded of that.  Butting heads with those you love will result in far fewer bruises, ego included, if you both understand some fundamental principles of persuasion.  Clearly, speaking loudly does not sway minds.  And even the softest ceaseless repetition will not help you prevail.

There are some steps that help increase mutual communication satisfaction.  First, pick the right time and the right place to bring up touchy topics.  Use qualifiers that make your words less bitter in case you have to eat them.  “It bridging differencesseems,” “Based on what I have read,” “Having dealt with this issue many times,” or simply, “My opinion on this issue is.”  Declamations of certainty don’t invite open discussion.  They don’t warmly welcome alternate views.

Pick one issue and stick to it.  Mirror others’ objections.  Work to understand them and see where common ground can be reached.  It may require repeated efforts but don’t give up in pointing out genuine areas of agreement.  If you feel the need to refer to your special knowledge of or experience with an issue, do so without fanfare and without expecting to rule because of it.  The most inexpert among us can sometimes offer the most worthwhile, insightful observations.

Avoid attacking the person’s character with the claim that you are refuting his or her opinions.  When you do, you will not only be side-stepping the real issue, you will be kindling a fire where there should have been nonthreatening illumination.  Ask yourself, if I alienate someone close to my heart, what does it gain me to be right?

Some of us with well-developed social skills settle into a narrow relationship mode with selected others in our lives.  Falling into predictable patterns may be partly due to meeting expectations and partly due to the ease of habit.  You’ve experienced this behavior firsthand or witnessed it in others.  Someone will be a jokester with one cousin and almost austere with another.  Cordial with one aunt and curtly blunt with another.  Open and receptive to differences with one sibling while leaning toward condescension with another.

Behaviors, based on what we think others believe about us or expect of us, can be adjusted.  Though it takes two to establish such patterns, one of them can begin to change their static nature.  What works well for many is to ask a simple question while showing genuine interest to hear the answer.  “If you had to sum up your philosophy of life in ten words or so, what would you say it is?”  The answer can enlighten you both and lift clouds away from a stifling or oppressive atmosphere.

Yet another strange anomaly is too common among intimates.  Some people were born with repair kits in their hand.  Their mission in life is to fix all the imperfect people they know. They see others as covered with lint and they can’t wait to start pick pick picking away.  It can be a little help with our grammar.  Or correcting those niggling little details in our stories we never get quite right.  Especially annoying are those who assure all who will listen that we must be confused about our facts.  Often these well-intentioned folks can be disarmed with a lengthy pause and a warm smile and a simple “Thank you.  I’ll work on that.”  Recognizing my leaning in this direction, I try to keep reminding myself that “It takes only a moment to notice in others what it takes a lifetime to see in ourselves.”

One of my most constant personal goals is to never stop learning, not only about topics of great interest to me but about the most mystifying subject of all:  myself.  Beyond that, I am committed to improve upon what I find when I look Getting-To-Know-Yourself-Checklistdeep inside every day.   Few of us would deny the benefits to be derived from self study, self-improvement or the difficulty of sticking to this task.  Even those of us who relish that challenge too often fail to see the need to do the same with others in our lives.

How often do we interact with others on the false assumption that we know what they want to hear, what their needs are, what their immediate concerns are, even what they are thinking.  As one philosopher warned, “When you try to read others’ minds and motives, you sometimes miss by inches, but mostly by miles.”  Every satisfying encounter is a process of discovery, both about yourself and the one you would hope to impact, inform, impress, amuse, or persuade.

In intimate communication, the demands are even greater than in the world of casual conversation or the kind we rely on at work.  The filters we use with close family and friends when we send and receive messages are fundamentally the same as those we use elsewhere:  our experiences, our knowledge, our environment, our feelings, our needs, our biases, etc.  But these filters have to be much more refined and focused in intimate communication.

All these filters affect the words we choose when we speak and the way we Verbal-and-non-verbal-communication-during-job-interviewsinterpret when we listen.  We cannot ignore these filters if we hope to function as and be perceived as sensitive communicators.  Yes, we have our facial and body expressions to aid us when we interact face-to-face.  Actually, non-verbal carries the bulk of the weight in effective listening:  touching, nodding, laughing, leaning, smiling, tone, volume, pitch, pauses and countless other little things.  Too many people believe they have mastered the art of sensitive listening.  Yet, it is one of the most prized and least developed skills on earth.

When not face-to-face, our obligations to choose our words with care increase multi-fold.  It is especially easy to get careless in this age of electronic media.  It goes without saying that being clear is a challenge when we have no give and take.  Selecting just the right words cannot be done without a view to the reader.

Presentation1Most important of all, when we write messages, we have to give careful consideration to the “tone” of the words we choose.  Cocky and confident have similar meanings but are markedly different in tenor and tone.  Connotations are built into countless words.  In and of themselves, they can be negative, indifferent, condescending, hostile, or irreverent regardless of your intent.  The possibilities are endless when it comes to the ways of skirting around saying someone is lying.  We can refer to their stories, unsupported claims, or disingenuous declamations.  My all-time favorite is “He is practiced in the artistry of shading the truth.”

Regardless of how short the written message, we must allow ourselves sufficient time to read and re-read it with a view as to not only whether it is clear, but how it will make the reader feel.  Far too often, when we relate to close loved ones, we are least attentive to the kind of proofreading that matters most.  Before excusing yourself by saying you were swamped and didn’t have enough time, think about the hours and days and even years it may take to make amends for something said in haste.  I am reminded of my uncle’s clever poem about a speeder who ended up in an early grave:  “But, oh, just think of the time he saved.”

As we age, we tend to limit our circle of close friends to those with whom we can have satisfying communication.  That is wise.  Dealing with family makes such decisions more difficult, but there are some whose world view and basic values are so opposed to our own, we may have to settle for infrequent, even superficial interaction, to save our sanity and avoid unnecessary stress.

We all know that love is not something to which we are entitled.  It is something relationships 2we have to earn every day with word and deed. None of the intimate communication problems I have identified here are simple to correct.  The factors that contribute to each are complex and multi-faceted.  It is too easy to create a new problem in our attempt to eliminate another.  That doesn’t mean we stop trying.  The first thing we have to remember is that none of our interactions have a distinct and separate beginning and end.  Relationships exist on a continuum that cannot be taken out of context and treated as independent events.

The most fruitful approach is to begin by looking into the mirror.  There we see the person closest to us over whom we have the greatest control.  If you have to wonder, “Does this apply to me?” It probably does.  The more successful we are in recognizing and improving on our own shortcomings when we relate to others the more changes we will begin to see in them.  Therein lies the real power of effective interpersonal communication that contributes most profoundly to our own health and to that of the people most precious in our lives.

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P 2015 photo priscillaAn award winning high school speech and English teacher, Priscilla Diffie-Couch went on to get her ED.D. from Oklahoma State University, where she taught speech followed by two years with the faculty of communication at the University of Tulsa.  In her consulting business later in Dallas, she designed and conducted seminars in organizational and group communication.

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

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 Bob Aronson  has worked as a broadcast journalist, Minnesota Governor’s bob 2Communications Director and for 25 years led his own company as an international communication consultant specializing in health care.

In  2007 he had a heart transplant at the Mayo Clinic in Jacksonville, Florida.  He is the Bob of Bob’s Newheart and the author of most of the nearly 300 posts on this site.  He is also the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) support group.

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

From Farm to Fork — How Safe Is Our Food?


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

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

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

1) Leafy Greensleafy greens

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

*Source: The Center for Science in the Public Interest

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

2) Eggs

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

3) Tuna

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

4) Oysters

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

5) Potatoes

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

6) Cheesecheese

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

7) Ice Cream

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

8) Tomatoes

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

9) Sprouts

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

10) Berries

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

The Importance of Temperature

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

Temperature Danger Zone

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

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

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

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

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

The main culprits are familiar. They include:

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

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

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

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

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

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

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

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

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

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

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

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

Physical Hazards

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

What is a physical hazard?

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

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

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

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

Food Safety Myths Exposed

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Prayer — Does It Work to Help Cure Illness?



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

John G. Lake

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

It seems to me there are five groups of people.

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

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

What is faith?

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

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

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

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

Are Prayers Answered?

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • Depression
    • Addiction
    • Divorce

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

This is Your Brain on God

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

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

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

 

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

Dan Hayes

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All the views

Thank you donors and donor families

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

Managing Your Health After an Organ Transplant


A note from Bob Aronson

FacebookWhen you become an organ transplant recipient your life changes.  Not only does the quality of life improve but you have a new awareness of the importance of healthy living.  Transplantable organs are in short supply and those of us who are fortunate enough to get one have a special obligation to take care of it.  It is a gift of life that many never receive and your transplant center will make every effort to help you take care of yourself and your new organ.  Follow their advice, eat healthy, live healthy and by all means, exercise as much as possible.

I have researched and written the great majority of blogs that are published on Bob’s Newheart but not this one.  It was researched and published by the American Society of Transplantation (AST).  I only made some minor editing and formatting changes (the complete post can be found here– http://tinyurl.com/pcteky5).   

This entry is longer than most because it offers critical information that you will need.  It is not only comprehensive in scope,  it is easy to understand and the principles are immediately and easily applicable.  Please take the time to read and thoroughly consider every point.  The information contained here can ensure not only a longer life but one of enhanced quality as well.  And…while this post is meant for transplant recipients, the advice contained here will keep you healthy even if you haven’t had and don’t need an organ transplant.

KEEPING A HEALTHY OUTLOOK ON LIFE

After an organ transplant, there is hope for the future. However, there are a number of health concerns that you will face. For example, there is the chance that your new organ will not always function as well as it should. Transplant recipients also have a higher risk of developing certain conditions such as high blood pressure, high blood lipid levels, diabetes, kidney problems, liver problems, and bone disease. Infection and cancer are also conditions you need to keep in mind. Some conditions can affect any transplant recipient and some conditions are specific to the type of organ transplanted.

CARING FOR YOUR NEW ORGAN

Lab Tests for Measuring Organ Function

It is important to keep all of your scheduled checkups and lab appointments for monitoring organ function. Testing allows your transplantheart of love team to monitor the status of your transplant, detect rejection early, and start effective therapy right away.Common tests for checking organ function are listed below:

Liver function tests — Blood tests are used to monitor liver function (e.g. albumin); damage to liver cells (e.g., alanine transaminase [ALT], Aspartate transaminase [AST]) and some with conditions linked to the path by which bile is produced by the liver (e.g., gamma-glutamyl transferase and alkaline phosphatase)

·    Pulmonary function tests — Tests like spirometry show how well you lungs are working

·    Bronchoscopy — A test that uses an instrument (bronchoscope) to view the airways and diagnose lung disease

·    Chest x-ray

·    Upper and lower gastrointestinal (GI) endoscopies — These evaluations can detect abnormalities of your esophagus, stomach, and intestine
·    Hemodynamic monitoring — Sonar-type echos may be used to detect high blood pressure in your heart and lungs or a catheter may be placed           in the heart for periods of six to 12 hours

·    Echocardiogram — Sonar-type echos can show abnormalities in the heart and lungs

·    Electrocardiogram (EKG or ECG) — Asseses the electrical activity within your heart

·    Renal function studies — Your doctor may ask you to collect your urine (usually for 24 hours) to evaluate if your kidneys are working                         properly. Blood tests such as serum creatinine are performed to measure kidney function

·    Biopsy — A biopsy may also be taken to determine if a rejection episode has occurred. This is done by collecting a small piece of tissue from the       organ and examining it under a microscope

OTHER HEALTH ISSUES

Anti-rejection medications increase your risk of developing certain conditions such as infection and cancer. Other side effects of some anti-rejection medications include high blood pressure, diabetes, high blood lipids, kidney disease, heart attack, stroke, and bone disease. Knowing the risks and taking steps now to prevent them is a good way to keep you and your new organ healthy.

HIGH BLOOD PRESSURE

High blood pressure (hypertension) is a common complication in patients who receive a transplant. High blood pressure can damage the arteries and the heart, increasing the risk of a stroke, a heart attack, kidney problems, or heart failure.For many patients, the cause of hypertension is not known. However, people with kidney disease, diabetes, or high blood pressure before the transplant are at higher risk of high blood pressure after the transplant. Other factors that contribute to high blood pressure after a transplant include a diet high in salt, clogged arteries, high blood lipid levels, smoking, obesity, and some anti-rejection medications such as cyclosporine, tacrolimus, and steroids (prednisone).

Recommended Blood Pressure Levels

People with a blood pressure of 140/90 mm Hg or higher are considered hypertensive. While most transplant recipients should have a blood pressure of 130/80 mm Hg, the ideal blood pressure can vary from person to person. The American Heart Association (AHA) guidelines for the target blood pressure in the general population can also be used as guidelines for organ transplant recipients. Normal blood pressure values for children are based on age, sex and height and in general are much lower than in adults.

  • Normal Systolic (top) 120 Diastolic (bottom) 80
  • Prehypertension Systolic 120-139, Diastolic 80-89
  • Stage 1 hypertension Systolic 140-159, Diastolic 90-99
  • Stage 2 hypertension Systolic 160 or higher, Diastolic 100 or higher

High blood pressure usually does not cause any symptoms so it is important to have your blood pressure checked by your transplant team at regular follow-up exams. Your transplant team may also want you to monitor your blood pressure closely while at home.

Reducing High Blood Pressure

  • Making some lifestyle changes can lower your blood pressure and prevent hypertension
  • Sometimes hypertension can be controlled with lifestyle changes such as diet and exercise, but most patients also require medication.
  • There are a variety of medications for treating and controlling high blood pressure
  • The most commonly prescribed medications include ACE inhibitors, ARBs, calcium channel blockers, beta-blockers, and diuretics. Some of these medications may have interactions with certain anti-rejection medications.

HIGH BLOOD LIPIDS

While lipids (cholesterol and related compounds) in your blood are necessary for good health, too high levels of some lipids can increase your risk of cardiovascular disease, a leading cause of death among transplant recipients. Most transplant recipients develop high blood lipids. Kidney, heart, and liver transplant patients usually display similar elevations in total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol (“bad cholesterol”).Eating the wrong foods, lack of exercise, and being overweight can increase your risk of developing high levels of LDL cholesterol (“bad cholesterol”), high levels of triglycerides, and low levels of HDL cholesterol (“good cholesterol”). Transplant recipients who are obese, smoke cigarettes, or have high blood pressure are more likely to have high cholesterol. Steroids and some of the other anti-rejection medications, such as cyclosporine, sirolimus, and tacrolimus, can also cause high blood lipid levels.

Recommended Blood Lipid Levels

Be sure to ask your doctor what your cholesterol levels should be. In some instances, transplant recipients can follow target levels of blood lipids recommended in the National Cholesterol Education Program (NCEP) guidelines.

Lipid
Low
Optimal
High
LDL Cholesterol

100 mg/dL
160-189 mg/dL
HDL Cholesterol
40 mg/dL

60 mg/dL
Total Cholesterol

240 mg/dL
Reducing High Blood Lipid Levels

not easy but worth itMaking healthy lifestyle changes can lower your chances of developing heart disease. You can help lower your blood lipid levels with a proper diet and regular exercise. A diet low in cholesterol and saturated fats may also help reduce your risk of coronary artery disease. In addition to making healthy changes to your diet, exercising for a minimum of 20 to 30 minutes 3 to 4 times a week can also reduce your lipid levels and lower your risk of heart attack or stroke. If you smoke, it is important that you STOP! If adjustment of your anti-rejection drugs, diet, and exercise are not successful in reducing lipid levels, your doctor may want you to take cholesterol-lowering medications. T

Here are several medications that work to lower blood lipids. The most commonly prescribed medications are called statins, which include atorvastatin (Lipitor®), simvastatin (Zocor®), pravastatin (Pravachol®), fluvastatin (Lescol®), rosuvastatin (Crestor®), and lovastatin (Mevacor®). If your doctor prescribes a statin, you will need to be monitored for side effects because the risk of side effects is greater when taken with anti-rejection medications. You will also need blood tests to monitor liver and muscle function. Other types of medication that your transplant team might prescribe to treat high blood lipids include bile acid sequestrants, nicotinic acid, fibric acids, and cholesterol absorption inhibitors.

DIABETES

High blood glucose can cause many health problems, including diabetes, heart disease, kidney injury, nerve damage, and eye problems.Post-transplant diabetes (PTDM) is more common in transplant recipients who have a family history of diabetes as well as those who are overweight, are taking steroids, or have hepatitis C. Diabetes after a transplant is also more common among African Americans and some other ethnic groups such as Native Americans. Other risk factors for PTDM include older age of the recipient.

Controlling Blood Sugar Levels

Most transplant recipients with diabetes can follow the American Diabetes Association (ADA) guidelines. Patients with PTDM should establish a healthy (weight-reducing, if necessary) diet with a structured exercise program. A healthy diet is needed to prevent diabetes or to help control your glucose if diabetes does occur. For all transplant recipients, it is best to eat a healthy diet and exercise regularly to avoid weight gain and reduce the risk of developing high blood glucose or diabetes. Your transplant coordinator or dietician can help determine your recommended daily calorie intake. Limiting the amount of fats and sugar in your diet can also help to maintain a healthy level of blood glucose.

Treatment Options for Controlling Diabetes

There are several types of medications available for patients with diabetes. Depending on the level of glucose in your blood, treatment with oral hypoglycemic drugs and/or insulin may be indicated. For many transplant recipients, insulin injections or an insulin pump is an option for controlling blood sugar. Or, you may be given an oral medication to control blood glucose levels. Your transplant team will determine which medication is right for you.

KIDNEY DISEASE

Kidney function is often decreased in transplant recipients. This may be caused by a pre-existing condition such as diabetes, high blood pressure, or injury to the kidney before a transplant. Or it may be caused by medications used to prevent rejection after a transplant.The best way to help prevent kidney disease is to keep your blood pressure and blood glucose under control and to maintain a healthy weight. In addition, regular checkups with blood and urine tests will give your doctor important information for detecting early changes in kidney function and allowing appropriate steps to be taken.

BLOOD VESSELS DISEASE

Transplant recipients have a higher risk of developing blood vessel disease. Some anti-rejection medications increase the risk of high lipid levels, which can clog arteries and restrict the flow of blood to the heart and brain. Deposits — called atherosclerotic plaque — can completely or partially block blood vessels resulting in a myocardial infarction (heart attack) or acute coronary syndromes.Likewise, a stroke can occur if an artery that supplies blood to the brain becomes blocked. Partial blockage may temporarily reduce the blood supply to the brain. A complete loss of blood supply to the brain results in a stroke.

BONE DISEASE

Bone disease is a problem for many organ transplant recipients. Organ failure before your transplant may cause bones to become thin and brittle (osteoporosis). Other causes of osteoporosis include use of some anti-rejection drugs (corticosteroids), overactive parathyroid gland, cigarette smoking, and not enough calcium in your diet.

Preventing Bone Disease

There are some basic things you can do to help prevent or treat bone disease.

Exercise regularly, including weight lifting or strength training — be sure to discuss weight limits with your transplant team beforebones beginning an exercise program
Eat foods that are high in calcium, including low-fat yogurt, cheese, and milk
Choose foods and juices with calcium added
Get plenty of dietary protein (unless restricted by your doctor)
Take calcium supplements if directed by your doctor
Take vitamin D only as directed by your doctor
Stop smoking
Your doctor or transplant dietician will tell you if you need to take calcium or vitamin D supplements. Your doctor may also want you to take medications that prevent bone thinning, including bisphosphonates such as alendronate (Fosamax®), etidronate (Didrocal®), and risedronate (Actonel®) or calcitonin.

STAYING FIT

Diet – Things are shaping up

The recommended diet for transplant patients consists of 30% fats, 50% carbohydrates and 20% protein.

Your transplant dietician will give you specific instructions about your recommended daily allowance of specific nutrients. Some tips for following a healthy diet include:

Eat high-fiber foods such as raw fruits and vegetables
Increase your calcium intake by eating low-fat dairy products and green leafy vegetables or by taking calcium supplements (if directed by your doctor)
Eat less salt, processed foods, and snacks
Use herbs and spices to add flavor instead of salt
Drink plenty of water (unless you are told to limit fluids)
Eat as little fat and oil as possible
Eat high-protein foods such as lean meat, chicken (without the skin), fish, eggs, nuts (unsalted), and beans
Select healthier condiments such as mustard, low-fat mayonnaise, and low-fat salad dressing
Instead of frying, try baking, broiling, grilling, boiling, or steaming foods
Instead of using oil to cook, use nonstick, fat-free spray
Exercise

Exercise is a great way to help increase your energy and strength after a transplant. A regular exercise routine will also help you maintain your ideal weight, prevent high blood pressure and high lipid levels, and keep your bones strong. It also helps relieve stress and overcome feelings of depression.Soon after your transplant, you’ll want to start slow with a low-impact activity such as walking. With time, you can increase your workout with more demanding activities such as bicycling, jogging, swimming, or whatever exercise you enjoy. Training with dumbbells, cuff weights, or weights will increase strength and help prevent bone loss, but check with your transplant team first to determine how much weight is safe for you to lift. Stretching exercises are also important for muscle tone and flexibility. Be sure to check with your doctor before beginning or changing your exercise routine.

STOP Smoking

smokingSmoking also contributes to already high risk of cardiovascular, particularly in patients with diabetes and may be detrimental to kidney function. Transplant recipients who smoke should to STOP smoking as soon as possible.

Dental Care

Routine dental care is important both before and following transplantation as oral infections can cause significant medical problems and even death. According to the American Heart Association (AHA), pre-treatment with antibiotics is not needed for routine dental care unless the patient has an underlying heart condition that increases the risk of developing a heart infection. These include patients with heart transplants with graft valvulopathy (or a previous history of endocarditis, prosthetic valves, and certain forms of congenital heart diseases.)Gingival overgrowth (hypertrophy) is a dental issue that can arise in transplant patients especially those using cyclosporine. This occurrence of gingival overgrowth can be reduced by practicing good oral hygiene.

ROUTINE FOLLOW-UP EXAMS

All people should have regular exams to help prevent illness.

As we get older, there are some specific tests that should be done on a regular basis

Self-Monitoring

In addition to the tests that your transplant team will perform at regular follow-up visits, you will need to do some self-testing at home. Here are some things you will need to monitor:

Weight – Weigh yourself at the same time each day, preferably in the morning. If you gain 2 pounds in a day or more than 5 pounds total, call your transplant team.
Temperature – You should take your temperature daily, especially when you feel like you have a fever. Call your transplant team if your temperature is too high.
Blood pressure – Check your blood pressure as often as your transplant team recommends.
Pulse – You should check your pulse daily. A normal heart rate when not exercising should be 60 to 100 beats per minute. (If you have had a heart transplant, your resting heart rate may be as high as 110 to 120 beats per minute.)
Blood sugar – If you have high blood sugar or diabetes, you will need to monitor your blood sugar using a glucometer.
Do not take any pain medication (for example, Tylenol®, Motrin®, or Advil®), cold remedy, antacid, herbal medication, or any over-the-counter medication unless your transplant team tells you to.

PREGNANCY: BENEFITS AND RISKS

For female transplant recipients of child-bearing age, fertility is usually restored immediately after a transplant.

There have been thousands of births among women with transplanted organs.

Although pregnancy is now an expected part of the benefits afforded to women by organ transplantation, there are also a number of considerations. Getting pregnant is generally not recommended within the first year after a transplant because the doses of anti-rejection medications are highest; there is a greater risk of rejection; and many other medications are prescribed that are toxic to the developing fetus. Female transplant recipients of child-bearing age should continue using birth control until the doctor says that it is okay to get pregnant. Male transplant recipients may also be concerned about their ability to have children. Men may have fertility problems related to some transplant medications, but many men have been able to father healthy children after a transplant. If you are interested in, or thinking about, becoming pregnant you must talk to your transplant team first. Pregnancy should be planned when organ function and anti-rejection therapy are stable and there are no signs of rejection, high blood pressure, or infection.

High Risk Pregnancy

According to National Transplantation Pregnancy Registry (NTPR) over 70% of births to female transplant recipients are live births and most have favorable outcomes for child and mother. Although this success is encouraging, these pregnancies are still considered high risk. There are risks of complications during pregnancy for the transplant recipient as well as risk of infection and exposure to anti-rejection drugs for the fetus.For example, there is a greater risk of high blood pressure during pregnancy in the woman who has received a transplant. The risk of infection is higher for all transplant recipients, and urinary tract infections are the most common infections during pregnancy.

Other infections that may cause concern during pregnancy include herpes, hepatitis, toxoplasmosis, and cytomegalovirus. Other risks include preeclampsia and preterm delivery. The fetus is also at risk for infections such as cytomegalovirus and herpes simplex virus related to the suppression of the mother’s immune system by anti-rejection drugs. A common question is whether the baby born to a woman with a transplanted organ will be normal. We know that some babies are born premature to mothers with transplants and that they have low birth weights. It is not known whether there are long-term effects on the baby’s development. You should inform your baby’s pediatrician that your baby was exposed to anti-rejection drugs in the womb.

pregnancyThere is a higher risk of birth defects with some anti-rejection drugs especially mycophenolate mofetil and azathioprine. The levels of anti-rejection drugs in the mother’s blood must be monitored closely. Monitoring of blood levels is particularly important in the third trimester, when fetal metabolism may increase the clearance of anti-rejection drugs from the blood. Ask your transplant team whether or not you should breast-feed. It is not known whether breast-feeding while on certain anti-rejection medications can harm the baby.

A major concern for transplant recipients is whether pregnancy will lead to organ rejection or decreased function of the transplanted organ. In general, pregnancy does not affect organ function or patient survival as long your organ is working very well. But, it is very important to discuss with your transplant team whether or not a pregnancy will be too risky. Because pregnancy is considered high risk for transplant recipients, your transplant team may recommend and work with an obstetrician who specializes in high-risk pregnancies.

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

Sugar Could Be Killing us Physically and Financially


 By Bob Aronson

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

This blog is not meant to be a condemnation of sugar.  It is a condemnation of our addiction to it.  We all love a sweet taste and frankly, we deserve it from time to time.  Often,there is no better reward, but we have to learn to limit our intake.  Like so many things in life it is the abuse of any substance that can cause us to suffer.  Sugar is particularly tough because it is unavoidable.  It is in almost everything and often is a naturally occurring substance.  We would all be a lot healthier if we would just read food labels and limit our excesses.  Having established this little disclaimer, we can now discuss sugar and its potential and real dangers.

 Women’s Health Magazine says that the typical American now swallows the equivalent of 22 sugar cubes every 24 hours. That means the average woman eats 70 pounds—nearly half her weight—of straight sugar every year. Women’s Health Magazine. http://www.womenshealthmag.com/health/dangers-of-sugar

In a major story on sugar Women’s Health goes on to say: When eaten in such vast quantities, sugar can wreak havoc on the body. Over time, that havoc can lead to diabetes and obesity, and also Alzheimer’s disease and breast, endometrial, and colon cancers. One new study found that normal-weight people who loaded up on sugar doubled their risk of dying from heart disease. Other research pinpoints excess sugar as a major cause of nonalcoholic fatty liver disease, which can lead to liver failure.

The magazine characterized the use of sugar this way, “The instant something sweet touches your tongue, your taste buds direct-message your obesity graphicbrain: deee-lish. Your noggin’s reward system ignites, unleashing dopamine. Meanwhile, the sugar you swallowed lands in your stomach, where it’s diluted by digestive juices and shuttled into your small intestine. Enzymes begin breaking down every bit of it into two types of molecules: glucose and fructose. Most added sugar comes from sugar cane or sugar beets and is equal parts glucose and fructose; lab-concocted high-fructose corn syrup, however, often has more processed fructose than glucose. Eaten repeatedly, these molecules can hit your body…hard.

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

 GlucoseGlucose graphic

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

FructoseFructose graphic

  • It, too, seeps through your small intestine into the bloodstream, which delivers fructose straight to your liver.
  • ​Your liver works to metabolize fructosei.e., turn it into something your body can use. But the organ is easily overwhelmed, especially if you have a raging sweet tooth. Over time, excess fructose can prompt globules of fat to grow throughout the liver, a process called lipogenesis, the precursor to nonalcoholic fatty liver disease.
  • ​Too much fructose also lowers HDL, or “good” cholesterol, and spurs the production of triglycerides, a type of fat that can migrate from the liver to the arteries, raising your risk for heart attack or stroke.
  • ​Your liver sends an S.O.S. for extra insulin (yep, the multi-tasker also aids liver function). Overwhelmed, your pancreas is now in overdrive, which can result in total-body inflammation that, in turn, puts you at even higher risk for obesity and diabetes

Robert Lustig, an endocrinologist from California gained national attention after a lecture he gave titled “Sugar: The Bitter Truth” went viral in 2009.  www.youtube.com/watch?v=dBnniua6-oM

Lustig’s research looked at the connection between sugar consumption and the poor health of Americans came to a conclusion that startled many.  The Doctor has published twelve articles in peer-reviewed journals identifying sugar as a major factor in the epidemic of degenerative disease that now afflicts our country.  Lustig’s data clearly show that excessive sugar consumption is a key player in the development of some cancers along with obesity, type II diabetes, hypertension, and heart disease. As a result he has concluded that 75% of all diseases in America are brought on by our lifestyle and are entirely preventable.

While most in the medical profession seem to accept Lustig’s assessment of sugar at least one MD David Katz the director of the Yale Prevention Center, disagrees.  http://www.huffingtonpost.com/david-katz-md/sugar-health-evil-toxic_b_850032.html  Katz says, among other things, “So those most motivated to get the sugar they need wind up getting the most sugar. They, in turn, benefit from this by having more of the needed food energy — and thus are more likely to survive. In particular, they are more likely to survive into adulthood, and to procreate. And thus they become our ancestors, who pass traits along to us.”

Lest you think I am making a mountain of a molehill allow some of the body of evidence that sugar can cause health problems.   The claims about the ill health effects of sugar are not just those leveled by Dr. Lustig, they are backed by a solid body of research.  Here are just a few of the research headlines.

  • Consumption of Sugar-Sweetened Drinks Linked to Heart Disease
  • How Fructose Causes Obesity and Diabetes
  • Fructose intake connected with an increased risk of cardiovascular illness and diabetes in teenagers
  • Fructose consumption increases the risk of heart disease.
  • The Negative Impact of Sugary Drinks on Children.
  • Sugar and High Blood Pressure
  • Sugar Consumption Associated with Fatty Liver Disease and Diabetes
  • The Adverse Impact of Dietary Sugars on Cardiovascular Health
  • Rats Fed High Fructose Corn Syrup Exhibit Impaired Brain Function
  • High Fructose Corn Syrup Intake Linked with Mineral Imbalance and Osteoporosis.
  • Diet of Sugar and Fructose Impairs Brain Function

 To be healthy and avoid sugar or at least limit your intake you simply must read labels.  Unfortunately those who seek to force sugar into our systems have found many ways of complying with the law and telling us there’s sugar in their food but they do it in a manner that sounds less menacing.  

SWEET SYNONYMS
Watch for these sneaky ingredients when reading food labels. Some sound scientific, some almost healthy—but in the end, they all mean “sugar.”

Agave Nectar
Barbados Sugar
Barley Malt Syrup
Beet Sugar
Blackstrap Molasses
Cane Crystals
Cane Juice Crystals
Castor Sugar
Corn Sweetener
Corn Syrup
Corn Syrup Solids
Crystalline Fructose
Date Sugar
Demerara Sugar
Dextrose
Evaporated Cane Juice
Florida Crystals
Fructose
Fruit Juice
Fruit Juice Concentrate
Galactose
Glucose
Glucose Solids
Golden Sugar
Golden Syrup
Granulated Sugar
Grape Juice Concentrate
Grape Sugar
High-Fructose Corn Syrup
Honey
Icing Sugar
Invert Sugar
Lactose
Malt Syrup
Maltodextrin
Maltose
Mannitol
Maple Syrup
Molasses
Muscovado Syrup
Organic Raw Sugar
Powdered Sugar
Raw Sugar
Refiners’ Syrup
Rice Syrup
Sorbitol
Sorghum Syrup
Sucrose
Table Sugar
Treacle
Turbinado Sugar
Yellow Sugar

PICK YOUR POISON
Ultimately, added sugar is added sugar—it all affects you roughly the same way, regardless of where it comes from. Below you will find a short list of the most active and dangerous evil doers. .

High-Fructose Corn Syrup (HFCS)

High fructose corn syrup

Derived from corn starch, syrupy HFCS might be the scariest sweet. Much of it contains mercury, a by-product of chemical processing. But another danger is its high artificial fructose content, not to mention that it can be 75 times sweeter than white sugar. (Listen up, agave eaters: The processed nectar can be up to 85 percent fructose and possibly more damaging to your liver than HFCS!)

Honey (http://tinyurl.com/ogge3r6

Honey sugar comparison

Often touted as far healthier than refined sugar, these do contain fewer chemicals and a better glucose-fructose balance (plus a few helpful antioxidants). However, says Anne Alexander, author of The Sugar Smartdiet even if the unique flavors of maple syrup and raw honey may lead people to use less, these sweeteners can still spike the body.

Natural Sugar

sugar

Sweet news! Unless it’s all you eat, it’s hard to go overboard on truly natural sugars that come directly from fruits and some veggies. Here’s the trick: You have to actually eat the produce. Fruit juices, even those without added sweeteners, will still sugar-bomb your bloodstream. The key is in the fiber, which slows sugar’s absorption in your body, preventing an insulin spike. Any fruit is fair game. “Ones with the most natural sugar have the most fiber,” says Robert Lustig, M.D.

So what’s the bottom line?  Should we avoid sugar completely?  Is that even possible?  Are sugar substitutes a healthy alternative?

First, you probably cannot avoid sugar completely and still eat because it appears naturally in so much of our daily diet.  Additionally, sugar is added to almost every product on the supermarket shelves so the best you can do is severely limit the amount you consume.  Here’s what the Mayo Clinic says. http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/added-sugar/art-20045328

How to reduce added sugar in your diet

To reduce the added sugar in your diet, try these tips:

  • Drink water or other calorie-free drinks instead of sugary, nondiet sodas or sports drinks. That goes for blended coffee drinks, too.
  • When you drink fruit juice, make sure it’s 100 percent fruit juice — not juice drinks that have added sugar. Better yet, eat the fruit rather than juice.
  • Choose breakfast cereals carefully. Although healthy breakfast cereals can contain added sugar to make them more appealing to children, plan to skip the non-nutritious, sugary and frosted cereals.
  • Opt for reduced-sugar varieties of syrups, jams, jellies and preserves. Use other condiments sparingly. Salad dressings and ketchup have added sugar.
  • Choose fresh fruit for dessert instead of cakes, cookies, pies, ice cream and other sweets.
  • Buy canned fruit packed in water or juice, not syrup.
  • Snack on vegetables, fruits, low-fat cheese, whole-grain crackers and low-fat, low-calorie yogurt instead of candy, pastries and cookies.

The final analysis

By limiting the amount of added sugar in your diet, you can cut calories without compromising on nutrition. In fact, cutting back on foods with added sugar and solid fats may make it easier to get the nutrients you need without exceeding your calorie goal.

Mayo concludes it’s summary on sugary by saying, “Take this easy first step: Next time you’re tempted to reach for a soda or other sugary drink, grab a glass of ice-cold water instead.”

Artificial sweeteners

artificial sweeteners

“So if I am supposed to avoid sugar, but I like sweets what are my alternatives?”  Well, there’s a lot of controversy surrounding this topic so we’ll turn to Web MD for an answer. http://www.webmd.com/food-recipes/features/best-sugar-substitutes

Thanks to the newest sugar substitutes, it’s becoming easier (and healthier) to bake your cake and eat it too!

There are so many alternative sweeteners available now that they seem to be elbowing sugar right off the supermarket shelf. But what’s so wrong with sugar? At just 15 calories per teaspoon, “nothing–in moderation,” says Lona Sandon, R.D., an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas. “The naturally occurring sugar in an apple is fine, but if we can reduce some of the added sugar in our diet, we can remove some of the empty calories.” Less than 25 percent of your daily calories should come from the added sugar in foods like cookies, cereal, and ketchup, she says. To satisfy your sweet tooth–especially if you’re counting calories, limiting carbs, or dealing with diabetes–try these options:

SWEETLEAF AND TRUVIA

What they are: These sugar alternatives are the latest made from stevia, an herb found in Central and South America that is up to 40 times sweeter than sugar but has zero calories and won’t cause a jump in your blood sugar. Stevia was slow to catch on because of its bitter, licorice-like aftertaste, but makers of Truvia and SweetLeaf have solved this problem by using the sweetest parts of the plant in their products.

Where to find them: In grocery stores and natural-food stores throughout the country and online at sweetleaf.com and truvia.com.

 How to use them: Both work well in coffee and tea or sprinkled over fruit, cereal, or yogurt. You can’t substitute stevia-based products for sugar in baked goods, though, because these products are sweeter than sugar and don’t offer the same color and texture. Makers of SweetLeaf promise to come out with a baking formulation soon.

Health Rx: “Truvia’s one of the most promising alternatives out there,” says nutritionist Jonny Bowden, Ph.D., author of The Healthiest Meals on Earth . “Right now, it looks safe. It tastes just like sugar and has almost no glycemic index, which means it won’t spike your blood sugar.”

WHEY LOW

What it is: Three naturally occurring sugars–fructose, the sugar in fruit; sucrose, or table sugar; and lactose, the sugar in milk–are blended to create this sweetener. While individually the sugars are fully caloric, when blended in Whey Low they interact in such a way that they aren’t completely absorbed into the body. As a result, at four calories per teaspoon, Whey Low has one quarter of the calories and less than one third of the glycemic index of sugar, so you’re less likely to crash after consuming it. It’s available in varieties similar to granular sugar, brown sugar, maple sugar, and confectioners’ sugar.

 

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

 

Vitamin Supplements — May Not Be Necessary and They Could Harm You


By Bob Aronson

vitamin b from bagelsThe National Institutes of Health (NIH) says Americans have been taking multivitamin/mineral (MVM) supplements since the early 1940s, when the first such products became available. MVMs are still popular dietary supplements and, according to estimates, more than one-third of all Americans take them. MVMs account for almost one-fifth of all purchases of dietary supplements.

“You have to get your vitamins.”  I’ve heard that phrase since I was a child, but why?  What are Vitamins and are vitamin pills or supplements the same as the vitamins found naturally in what we eat and in sunshine?  Vitamins are not all the same.  There can be a huge difference between those that are naturally contained in our food and the sometimes “smelly” things that come in a bottle from your Pharmacy.

Over the past several years there have been a number of news reports about vitamins. Some experts support their use, some say the supplements are worthless and others say they can actually cause harm.  What’s true?  All of the above!  We’ll try to shed some light on the subject so let’s start with their importance to our health.

Vitamin deficiencies lead to a wide range of problems spanning from anorexia to obesity, organ malfunction, confusion, depression and fatigue.  We need vitamins.  The question that must be answered is; how do you know which ones?  We’ll provide an answer.

Tough question when you consider the fact that the NIH says, “No standard or regulatory definition is available for an MVM supplement—NIH LOGOsuch as what nutrients it must contain and at what levels. Therefore, the term can refer to products of widely varied compositions and characteristics. These products go by various names, including multis, multiples, and MVMs. Manufacturers determine the types and levels of vitamins, minerals, and other ingredients in their MVMs. As a result, many types of MVMs are available in the marketplace.”

It is entirely possible that there are no standards because the vitamin industry is huge and can afford heavy lobbying to ensure that they remain free of government regulation.  The NIH says that sales of all dietary supplements in the United States totaled an estimated $30.0 billion in 2011. This amount included $12.4 billion for all vitamin- and mineral-containing supplements, of which $5.2 billion was for MVMs.  If the government set standards, every single manufacturer would have to reformulate their products to meet them.  Doing so would be costly so there is no wonder that the industry would rather not rock their very profitable boat.

vitaminsWhether your vitamins are hurting you is another story. What people are not aware of is that all vitamins are not created equal, and most are actually synthetic and the synthetic vitamins are rarely like the real thing.

The type of vitamins that benefit us most is murky but there are some.  However, a healthy diet should provide most of the nutrients our bodies need.  Sometimes, though, supplements can help. The problem is, which ones?  How do you know what to buy?

For the most part, medical science has made it clear that most vitamin supplements are either useless or cause harm and we’ll elaborate on those claims shortly.  First, though, you ought to know what’s good for you and what seems to work for some conditions.

This article in Smithsonian.com lists five supplements that can be helpful. http://www.smithsonianmag.com/science-nature/five-vitamins-and-smithsonian.com2supplements-are-actually-worth-taking-180949735/#VsZOfYrBAkvtVYvY.99

Of all the “classic” vitamins—the vital organic compounds discovered between 1913 and 1941 and termed vitamin A, B, C, etc.—vitamin D is by far the most beneficial to take in supplement form. Researchers found that adults who took vitamin D supplements daily lived longer than those who didn’t.

Other research has found that in kids, taking vitamin D supplements can reduce the chance of catching the flu, and that in older adults, it can improve bone health and reduce the incidence of fractures.

Probiotics

A mounting pile of research is showing how crucial the trillions of bacterial cells that live inside us are in regulating our health, and how harmful it can be to suddenly wipe them out with an antibiotic. Thus, it shouldn’t come as a huge surprise that if you do go through a course of antibiotics, taking a probiotic (either a supplement or a food naturally rich in bacteria, such as yogurt) to replace the bacteria colonies in your gut is a good idea.

In 2012, a meta-analysis of 82 randomized controlled trials found that use of probiotics significantly reduced the incidence of diarrhea after a course of antibiotics.

All the same, probiotics aren’t a digestive cure-all: they haven’t been found to be effective in treating irritable bowel syndrome, among other chronic ailments. Like most other supplements that are actually effective, they’re useful in very specific circumstances, but it’s not necessary to continually take them on a daily basis.

Zinc

Vitamin C might not do anything to prevent or treat the common cold, but the other widely-used cold supplement, zinc, is actually worth taking. A mineral that’s involved in many different aspects of your cellular metabolism, zinc appears to interfere with the replication of rhinoviruses, the microbes that cause the common cold.

This has been borne out in a number of studies

Niacin

Also known as vitamin B3, niacin is talked up as a cure for all sorts of conditions (including high cholesterol, Alzheimer’s, diabetes and headaches) but in most of these cases, a prescription-strength dose of niacin has been needed to show a clear result.

At over-the-counter strength, niacin supplements have only been proven to be effective in helping one group of people: those who have heart disease. A 2010 review found that taking the supplement daily reduced the chance of a stroke or heart attack in people with heart disease, thereby reducing their overall risk of death due to a cardiac

​Garlic

Garlic, of course, is a pungent herb. It also turns out to be an effective treatment for high blood pressure when taken as a concentrated supplement.

A 2008 meta-analysis of 11 randomized controlled trials (in which similar groups of participants were given either a garlic supplement or placebo, and the results were compared) found that, on the whole, taking garlic daily reduced blood pressure, with the most significant results coming in adults who had high blood pressure at the start of the trials.

On the other hand, there have also been claims that garlic supplements can prevent cancer, but the evidence is mixed.

Vitamin Supplements are unnecessary and may cause harm.

In December of last year, the Annals of Internal Medicine reported that, “Not only are the pills mostly unnecessary, but they could actually doAnnals of internal medicine logo harm those taking them. We believe that the case is closed—supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful.  These vitamins should not be used for chronic disease prevention. Enough is enough.”  http://www.cbsnews.com/news/multivitamin-researchers-say-case-is-closed-supplements-dont-boost-health/

Based on three studies examining multivitamins’ links to cancer prevention, heart health, and cognitive function, the research is a blow to the multi-billion dollar industry that produces them and to the millions of Americans who religiously shell out their dollars for false hope.

The doubts about vitamin supplements are not new.  In his 2013 book Do You Believe in Magic, Dr. Paul Offit pointed to a handful of major studies over the past five years that showed vitamins have made people less healthy. “In 2008, a review of all existing studies involving more than 230,000 people who did or did not receive supplemental antioxidants found that vitamins increased the risk of cancer and heart disease.”

Last year, researchers published new findings from the Women’s Health Initiative, a long-term study of more than 160,000 midlife women. The data showed that multivitamin-takers are no healthier than those who don’t pop the pills, at least when it comes to the big diseases—cancer, heart disease, stroke. “Even women with poor diets weren’t helped by taking a multivitamin,” says study author Marian Neuhouser, PhD, in the cancer prevention program at the Fred Hutchinson Cancer Research Center, in Seattle.

That said, there is one group that probably ought to keep taking a multi-vitamin: women of reproductive age. The supplement is insurance in case of pregnancy. A woman who gets adequate amounts of the B vitamin folate is much less likely to have a baby with a birth defect affecting the spinal cord.

The problem is that many vitamin and mineral supplements are manufactured synthetically. Some estimates place the amount at 90 percent and higher and while they are made to mimic natural vitamins they are not the same. Natural vitamins come directly from plants and animals, they are not produced in a lab and — most synthetic vitamins lack co-factors associated with naturally-occurring vitamins because they have been “isolated.”

Isolated vitamins can’t always be used by the body, and are either stored or excreted. Most synthetic vitamins don’t have the necessary trace minerals either and must use the body’s own mineral reserves which can then cause mineral deficiencies.

Most synthetic supplements contain chemicals that do not occur in nature. The history of the human race is such that our bodies have grown accustomed to consuming the food we grow and gather naturally, from the earth, not food that is synthesized in a lab.

web md logoWeb MD offers this assessment.

What Vitamin and Mineral Supplements Can and Can’t Do

http://www.webmd.com/vitamins-and-supplements/nutrition-vitamins-11/help-vitamin-supplement 

 By Kathleen M. Zelman, MPH, RD, LD

Reviewed By Elizabeth Ward, MS, RD

Experts say there is definitely a place for vitamin or mineral supplements in our diets, but their primary function is to fill in small nutrient gaps.  They are “supplements” intended to add to your diet, not take the place of real food or a healthy meal plan.

 WebMD takes a closer look at what vitamin and mineral supplements can and cannot do for your health.

Food First, Then Supplements

Vitamins and other dietary supplements are not intended to be a food substitute. They cannot replace all of the nutrients and fruits and veggiesbenefits of whole foods. 

 “They can plug nutrition gaps in your diet, but it is short-sighted to think your vitamin or mineral is the ticket to good health — the big power is on the plate, not in a pill,” explains Roberta Anding, MS, RD, a spokesperson for the American Dietetic Association and director of sports nutrition at Texas Children’s Hospital in Houston. 

 It is always better to get your nutrients from food, agrees registered dietitian Karen Ansel.  “Food contains thousands of phytochemicals, fiber, and more that work together to promote good health that cannot be duplicated with a pill or a cocktail of supplements.”

 What Can Vitamin and Mineral Supplements Do for Your Health?

 When the food on the plate falls short and doesn’t include essential nutrients like calcium, potassium, vitamin D, and vitamin B12, some of the nutrients many Americans don’t get enough of, a supplement can help take up the nutritional slack. Vitamin and mineral supplements can help prevent deficiencies that can contribute to chronic conditions.

 Numerous studies have shown the health benefits and effectiveness of supplementing missing nutrients in the diet.  A National Institutes of Health (NIH) study found increased bone density and reduced fractures in postmenopausal women who took calcium and vitamin D.

  Beyond filling in gaps, other studies have demonstrated that supplemental vitamins and minerals can be advantageous. However, the exact benefits are still unclear as researchers continue to unravel the potential health benefits of vitamins and supplements. 

 Web MD offers these tips to guide your vitamin and mineral selection:

  • Think nutritious food first, and then supplement the gaps.  Start by filling your grocery cart with a variety of nourishing, nutrient-rich foods.  Use the federal government’s My Plate nutrition guide to help make sure your meals and snacks include all the parts of a healthy meal.
  •  Take stock of your diet habits. Evaluate what is missing in your diet. Are there entire food groups you avoid? Is iceberg lettuce the only vegetable you eat? If so, learn about the key nutrients in the missing food groups, and choose a supplement to help meet those needs. As an example, it makes sense for anyone who does not or is not able to get the recommended three servings of dairy every day to take a calcium and vitamin D supplement for these shortfall nutrients.
  • When in doubt, a daily multivitamin is a safer bet than a cocktail of individual supplements that can exceed the safe upper limits of the recommended intake for any nutrient.  Choose a multivitamin that provides 100% or less of the Daily Value (DV) as a backup to plug the small nutrient holes in your diet.
  •  Are you a fast food junkie?  If your diet pretty much consists of sweetened and other low-nutrient drinks, fries, and burgers, then supplements are not the answer.  A healthy diet makeover is in order. Consult a registered dietitian.
  •  Respect the limits. Supplements can fill in where your diet leaves off, but they can also build up and potentially cause toxicities if you take more than 100% of the DV.
  •  Most adults and children don’t get enough calcium, vitamin D, or potassium according to the 2010 Dietary Guidelines.  Potassium-rich foods, including fruits, vegetables, dairy, and meat are the best ways to fill in potassium gaps. Choose an individual or a multivitamin supplement that contains these calcium and vitamin D as a safeguard.
  •  The best way to judge any supplement or medication is by reviewing clinical trials. There aren’t a lot of them done on vitamins, vitamin clinical trialbut those that have been conducted are quite revealing.  The NIH concluded that most supplements not only don’t work as intended, they actually make things worse. They examined the efficacy of 13 vitamins and 15 essential minerals as reported in long-term, randomized clinical trials and there were some positive results like:
  • A combination of calcium and vitamin D was shown to increase bone mineral density and reduce fracture risk in postmenopausal women.
  • There was some evidence that selenium reduces risk of certain cancers.
  • Vitamin E maydecrease cardiovascular deaths in women and prostate cancer deaths in male smokers.
  • Vitamin D showed some cardiovascular benefit.

Those few positives are overwhelmed by the negative findings.

  • Trials of niacin (B3), folate, riboflavin (B2), and vitamins B6 and B12 showed no positive effect on chronic disease occurrence in the general population
  • There was no evidence to recommend beta-carotene and some evidence that it may cause harm in smokers.
  • High-dose vitamin E supplementation increased the risk of death from all causes.

So what’s the bottom line?  Our research indicates that most medical authorities pretty much dismiss the usefulness of most vitamin supplements. Most revealing, though, and also dangerous is the fact that there are no standards for vitamin supplements.  The companies that make them can each have their own formulations and there is no approval process so the consumer may be at great risk.  Buyer beware.  Don’t believe the advertising.  If you are determined to take these supplements, though, google them and look for clinical trials.  If there are none, don’t buy.  If there are, read them carefully.  For the most part the best advice is, save your money because most of us don’t have a clue as to what we are buying.

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant
My new hat April 10 2014Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Retirement Means You Quit Working — Not Living.


By Bob Aronson

“Working people have a lot of bad habits, but the worst of these is work.” 

Clarence Darrow

Preparation for old age should begin not later than one’s teens.  A life which is empty of purpose until 65 will not suddenly become filled on retirement.

Dwight L. Moody

Retirement: It’s nice to get out of the rat race, but you have to learn to get along with less cheese.

Gene Perret

 pot gardenHow many times have you heard about “Uncle Joe” who retired from his 50 year long career to a recliner chair and died an unhappy man?   That story is all too common and totally unnecessary.  Take  it from this 75 year old retired guy who is busier and happier than at any other time of my life.

At some point all of us retire from our chosen profession or trade and you should know early on that retirement from a job does not mean retirement from life.  Frankly, retirement should mean new opportunities and exciting new experiences that serve to restore your old enthusiasm for life.  Retirement is not a sentence it is a destination and you can write your own ticket.

Often retirement is not by choice but by necessity.  In my case the need for a heart transplant made it a necessity, but so what?  While everyone knows they will retire few are ready for it.  Retirement is a drastic change in lifestyle, one in which you have to change some major habits and behaviors and learn new ones.

Prior to retirement I was a communications consultant who traveled a great deal. I absolutely loved mrunning through airportsy work.  I trained and coached executives, was a frequent keynote speaker at conventions and wrote extensively about communication.  My days started at 5 AM and often didn’t end until midnight.  I had a closet full of suits, ties and freshly pressed shirts and rarely wore anything else, there wasn’t time.

When I retired all of that came to a sudden and screeching halt and the shock was as intense as if I had been shot head first from a cannon into a brick wall target.  I was used to getting up and meeting with the captains of industry, but now in retirement I got up to Captain Crunch and an empty day.  I knew for a very long time, 12 years to be exact, that this day would come.  I had been told I would need a heart transplant and would get weaker and weaker until I got one.  The prediction came true in 2006.  Reluctantly I retired and late that year we moved from Eagan, Minnesota (a twin cities suburb) to Jacksonville, Florida because the Mayo clinic there had a great record of obtaining transplantable organs.

My first rescue from boredom came two months after I got a new heart from the very people who had saved my life, the Mayo Clinic.  One of my Mayo friends called to ask if I would like to write a blog (this one, Bob’s Newheart) and start a Facebook group with a focus on organ donation and transplantation (Organ Transplant Initiative).  This required some learning because I knew nothing about social media or blogging.  Both were in their infancy.  I dove headfirst into cyberspace and found it fascinating and fun because it called upon many of my old skills.

Manother booth shoty second rescuer was my wife Robin.  She ran two businesses out of our home one of them was
designing and making anodized aluminum jewelry.  She sold her colorful creations at art shows all over the south, and southeastern U.S.  In order to do that she not only needed a tent but the furnishings, too.  Items like display cases, necks for necklaces, pedestals, pictures and frames, and other items used to display her work are necessities and can be expensive.  She knew I had an interest in woodwork so she asked if I’d like to build some of those things.

“Oh fun,” was my first thought, but I had few tools.  Slowly and with great deliberation I built a woodworking shop and began to build what she needed to furnish her booth.  It became a never ending job because as styles and tastes changed so did the need for new and different furnishings.

That takes me to today.  This blog, Bob’s Newheart, is my 222nd since November 3, 2007 and the Facebook group, Organ Transplant Initiative (OTI) now has nearly 4,000 members.  I have branched out in the woodworking department as well and have built a number of items for gifts for friends and family.  When I am not at my keyboard I am In my shop and have found that I am at least as busy now as I was when working and even happier.

So I got lucky, I stumbled into avocations that interested me and kept me busy to the point where I don’t miss the job from which I retired at all.  Now…what should you do?  How do you keep your mind and body active and engaged and avoid all the fears every spouse or partner has about retirement?  How do you avoid becoming a couch potato,couch potato 2 the stereotypical old person who sits in front of the TV all day eating unhealthy food and feeling sorry for him (her) self?  It’s really pretty easy and I can sum it up in one word –planning, but you have to do it now!  Check out this link. “http://health.howstuffworks.com/wellness/aging/retirement/10-tips-for-adjusting-to-retirement.htm

Whether you retire through necessity or choice you will retire and, as I said earlier, it can be a major shock to the system. Going from working a full-time job to having nowhere specific that you “have” to be each day may sound wonderful but it doesn’t always work out that way.  Some retired people feel bored and unproductive and when that happens, the days can seem endlessly long and empty. It doesn’t have to be that way.

Options for Action

Teaching

senior citizen teacherHave you considered teaching?  Even if that wasn’t your profession, it’s still something that you can do when you retire.  Teaching others what you’ve learned in the years spent in your chosen trade or profession can be very rewarding and some colleges and technical schools like to employ people with real-world experience.  You will also find that some companies employ speakers to share their knowledge and often those engagements result in contracts for more speeches or even training sessions.

 Speaking and/or Training

Speaking and training could be a paying gig, or you could do it simply for the joy of helping others.  One organization that might be of help is SCORE, the Service Corps of Retired Executives. SCORE bills itself as “counselors to America’s small business.”   Volunteers with the organization mentor small business owners, provide counseling, create and lead workshops, and write articles.

Move to an exotic location

I have a friend and former boss, Rick Lewis, who retired big time.  He moved to Cotacachi, Ecuador.
He sold almost all his earthly possessions and took with him only what he could carry, which wasn’t muc13654641373_736dfa7d31_nh.  He lives in the shadow of some beautiful mountains.  He walks everywhere, has lost a some extra pounds, buys food at open air markets at wonderfully low prices, has a much healthier diet, writes blogs about his experience and started a company that will help South American women be more independent.  He travels extensively and is enjoying life to the fullest and  while he has access to all the modern conveniences he uses few other than his computer and cell phone.

Go Back to School

I am convinced that to really enjoy your retirement years you must keep your brain actively engaged and what better for that than the learning environment.  Taking classes ins something that interests you can keep your mind razor sharp but even more importantly it could give you the opportunity to learn more about a lifelong passion, or the start of aSenior studentnother career.  Maybe you wanted to play a musical instrument or learn woodwork or how to write a book…the possibilities are endless.

Best of all…you can go to school again at little or no cost.  There are grants and scholarships available y for senior citizens to attend college but often you don’t even need them.  Some colleges, universities and trade schools provide tuition waivers or discounts for seniors.

And…you can always audit a class, if you have no interest in getting a degree.   Auditing simply means that you attend and participate in the classes, but don’t take exams or receive a grade or credit for taking the class.  Check with the college or university of your choice.  You likely will find several Audit opportunities.

Hobbies

ow about a hobby? Yeah, I know everyone who counsels retirees says the same thing, “Get a hobby,” but it is good advice.  When I was a kid I used to play the harmonica.  At age 70 I took it up again.  Robin is already an accomplished musician and we often practice together.  Better yet, we are now involved in a once a week local jam session and my hobby has morphed into ownership of 15 harmonicas.

If you are at a loss as to what kind of hobby suits you, don’t give up. Keep looking.  Hobby and craft stores conduct free or inexpensive classes in knitting, scrapbooking, leatherwork, jewelry making and more.  You’ll also fin
harmonica collectiond that places like Home Depot and Lowes have classes in carpentry and other woodwork skills along with instruction on gardening.  Stores that sell kitchenware often have cooking classes.  There’s no end to what you can learn, but you have to look.  . Maybe you don’t want to learn how to do anything, but you’re interested in starting a collection. Whether you want to collect autographs or antique dolls, there are plenty of online groups and forums dedicated to your new hobby. Some of them meet in person or even hold conventions. No matter what your interest, you can find others out there with whom to discuss it.

Ok..you don’t want to take classes, free or not,  you just want a hobby that’s fun.  How about starting a collection?  As a youngster I always carried a pocket knife, they can come in very handy for a whole lot of reasons.  I remember, too, seeing a movie starring Allan Ladd called, “The Iron Mistress.”  It was about Jim Bowie of frontier and Alamo fame and how he developed the Bowie Knife.  Ever since then I wanted one of them.  At age 72 I started a knife collection (you can get some very nice knives at a very low cost through Amazon and other internet sites).  Today I have seven fixed blade knives (variations on the Bowie theme) and ten folding pocket knives.

Volunteer

aliensThen there is Volunteering.    God knows we need volunteers in almost any pursuit.  The University of Michigan conducted a study of retirees who were active volunteers and found that 40 percent were more likely to be alive at the end of the study than people who did not volunteer. [Wheeler]. If that isnt’ reason to consider volunteering for something I don’t know what is and — it keeps you moving and engaged.

Other volunteer opportunities include, helping out at local schools, animal shelters, museums and churches.  And…the area in which you can likely land a volunteer job right way…HealthCare.  Hospitals and nursing homes always need volunteers and you could be in on the ground floor of making a significant contribution  in those two areas alone.

I know, too, that there are organizations that specifically recruit senior citizens, such as Senior Corps where the Foster Grandparents program matches exceptional children with adults ages 60 and older who mentor them and help them with reading and schoolwork.  Talk about a rewarding experience…that one alone could give your ego a much needed boost.

Travel

If you like to travel and see the country consider an RV, the come in a wide variety of shapes and sizes from trailers to bus2012 traceres and in every price range.  We own a 30 foot travel trailer so when we go to art shows (we do about 20 a year) we bring our home and our dogs with us.  Of course that means you have to do some serious research into how you want to use your RV.  This can be a major purchase and it pays to take your time and thoroughly investigate every angle.  We love our RV and are old hands at it now and can highly recommend it if you like to travel, meet new people and live, “on the road.”

Become an employee again

Yep…that’s another term for work.  Maybe you need it so keep the door open to returning to the world of the retired but employed ranks.  It doesn’t have to be a full time job and it doesn’t have to be as a Wal Mart Greeter, although there is nothing wrong with that.  I have a 75 year old friend who works part time at a Menards store.  Menards is a Home Depot type story in the Midwest and they employ a good many senior citizens as do many companies. Here are some ideas on what you could do:

  • Hire out as a consultant on based on the expertise you gained while employed
  • Do research in your field for colleges and universities
  • Check city, county, state and federal government listings for openings that might appeal to you
  • Maybe you only want money for special occasions if so try seasonal work.  Companies are always seeking help during holiday seasons.
  • Entertainment venues like ball parks and theaters may need ushers to lead patrons to their seats
  • Customer service reps.  You could get a job answering the phone, working in sales or returns or even store security.
  • If you are handy with tools and can fix things around your home perhaps you can hire out as a handyman or woman on specific projects.
  • Tutor a student.  The money may not be great but there is some to be made tutoring both college and high school students.
  • Make things at home and sell them on line through Craigs list or by opening your own website.
  • Home care.  If you have some medical or therapy credentials you might quality to help care for either an adult or a child in their home
  • If you have bookkeeping or accounting skills many a small business could use you and chances are you could work from home.
  • Clerical work. If you can type and if you are computer literate you might get a part or full time job doing just that.

Essential skills.  

computerIt’s the 21st century and almost any job you take on is going to require computer literacy.  If you don’t know how to type it would be to your advantage to take a typing class and to learn basic word processing and even PowerPoint.

There is virtually no job anywhere today that is not going to require some computer skills so if volunteering or becoming employed again is an option you want to consider then by all means brush up on your computer and typing skills.

Mental and Physical Health

So far we’ve talked about what you can do to keep from being bored and to feel as though you have some value.  What’s missing from this blog, though, is how you take care of your health.  That issue beings with a word few like — Exercise.

No matter what the state of your health you must find ways to be active and to exercise.  Health expenses can be not only a huge financial burden, they can destroy your quality of life.  There are two kinds of exercise I recommend. One is mental and the other is physical.   You should read, research and write as often as possible and social media offers incredible opportunity to do all of that. Even games of solitaire or crossword puzzles can keep you mentally engaged and fit.

When it comes to physical exercise it is important to do what you can when you can.  A brisk walk every
day can do wonders for you and if that sounds boring, try Mall walking where at least you will see other people and iPeople walkingnteresting displays in stores and in the hallways.  If you play golf or tennis all the better, but any kind of activity that will exercise your muscles and elevate your heartbeat and respiration is good for you.

Remember above all else that you have great value.  Your years of service have given you invaluable experience from which others can learn.  Studies indicate that the years beyond midlife are one of life’s most creative, innovative and entrepreneurial periods for many and that us older people can be incredibly creative when given the opportunity. Check out this link for more information.

http://www.usatoday.com/story/money/personalfinance/2013/10/22/preparing-mentally-retirement/2885187/

When I was working I believed I had a mission and a purpose for being and that feeling was reinforced daily by clients who continued to hire me for my advice.  My fear was that upon retirement I would no longer have a purpose and that I would become irrelevant.  Well, that’s possible if you only think of yourself in terms of what you used to do, but what if you change the paradigm?  For example, I am no longer a communication consultant. I am an advocate for organ donation and transplantation and that has become my new relevancy, my new purpose and my new identity.  More and more there are people who know me for my new purpose and know nothing about what I used to be and do.  That’s an old life and frankly, I don’t miss it at all.

Relationships
Finally, the most important consideration of all, your relationship with your spouse or significant other.  Many of us who have worked outside the home for an entire lifetime are a pain in the butt when we are home all the time.  Our life partners aren’t used to it either and both have to make a concerted effort to work on strengthening this new retured couplerelationship.  In my case Robin has her business and I do what I can to help her, but otherwise am pretty much involved in my own activities.  We enjoy each other a great deal and often plan outings or dates when we can spend time together talking about and doing things unrelated to business or hobbies.

Retirement can be very rewarding, if you plan for it, but if you view retirement as the end of life you will be in for a miserable time because it can be the beginning and it should be.  It’s all in your attitude.  You can choose to quit or you can choose to explore new frontiers.  I am not a quitter and I’ll be most of you aren’t either and if that’s the case…get out and find those new frontiers.

Last Resorts

And….if all else fails try some of these:

  • Make a bucket list and start doing all the things on it
  • Make bird houses
  • Become a master gardener
  • Become an expert Starcraft player
  • Sail, backpack, walk[1] or cycle around the world[2]
  • Enter ham radio competitions (contact every state, etc.)
  • Read trashy novels
  • Have a lot of sex while your body is still in full working order
  • Fix up cars or motorcycles
  • Build a boat
  • Build a log cabin
  • Research your family tree
  • Watch birds
  • Amateur astronomy
  • Finally get adequate sleep
  • Become as healthy as possible
  • Save the world
  • Rebuild civilization from scratch
  • Live very well without money for a year
  • Go to the top of a high building and throw away $100.000
  • Burn $100.000 on a public place
  • Spend the last day in the job speaking all the truth to clients

You can find more here http://earlyretirementextreme.com/wiki/index.php?title=Long_list_of_things_to_do_when_you_retire

I always try to practice what I preach so let me recap where I am today at age 75 after a career that I absolutely loved.  My life has changed completely and I love every minute of it.  I am not only not bored, I don’t have time to be bored.  I am having too much fun doing the following:

  1. I took up the harmonica after a 60 year hiatus from it.  Now I own 15 of them and once a week my the Fig Newtonswife and I play in an old time music jam session.  Robin plays several instruments and often we spend an evening playing together.
  2. Woodwork. I’ve always loved working with wood but never had time.  Now I make fixtures and furnishings for Robin’s Art show booth.  I make jewelry boxes for friends and family, front with keyboard and buttonsand recently completed making a CD storage unit that looks like an accordion.
  3. Social media.  As you know I started and run Facebook’s nearly 4,000 member Organ Transplant Initiative group (OTI) and recently wrote my 223rd blog on Bob’s Newheart for WordPress.
  4. I am in the process of writing two books.  One is just a look at life from my earliest memories until now .  So far I have written about 145 pages, and that only got me to when I was 23 years old.  There’s a lot more to write.  The other book is fiction, it is about the first Hispanic President of the United States and the challenges he faces.  It’s part SCI FI, part  James Bond type action and heavy on political intrigue.
  5. I do the grocery shopping, some cooking a little housework and very little sitting.
  6. We travel the country going to art shows in which Robin sells he Jewelry creations.

I think you can tell, by that list that at age 75 I am a very busy guy.  Rarely do I sit still for long.  I absolutely refuse to be bored.  I think I lead a rather exciting life and I’m enjoying every moment of it.  You can do the same.  Retirement can be like being born again because it is what you make it.

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My new hat April 10 2014Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

 

The Incredible Healing Power of Pets


By Bob Aronson

Cat cartoon

There’s something about petting a dog or having a cat nestle in your lap that brings one a certain serenity or at least a warm feeling. It’s been shown medically that the company of a pet can bring blood pressure down, lessen depression, calm frayed nerves and even help to settle an upset stomach.

Is there anything cuter than a puppy or kitten? Even at their destructive worst they are cute. When we got Reilly, our Soft Coated Wheaten Terrier as a puppy she loved to shred paper and those razor sharp puppy teeth can do that in a split second.

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Reilly and the toilet paperLook at this mess. She had gotten a hold of some toilet paper and made a mess of our living room, there were shreds of paper everywhere. And…when we found her amidst that pile of blowing and drifting tissue, she looked up and wagged her tail, proud of her accomplishment and willing to destroy even more if it would please us. Look at this picture, how could you possibly do anything but laugh upon seeing this mess.

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Besides the laughs, the warm fuzzy feelings and the love what can pets do for you?  According to the Centers for Disease Control and Prevention, the company of a pet can help people who are living with depression. Why is that? I think it’s because they ask for very little and Reilly and Ziggy sleeping in basket togethergive unlimited affection and companionship. Maybe it’s because cats, dogs and other companion creatures offer unlimited affection and nonjudgmental companionship. They lift our spirits and lower our stress. They counteract symptoms such as isolation, rumination and lethargy.  Even just looking at our two dogs Reilly and Ziggy (mini schnauzer)  and how much they like each other gives one a warm all over feeling.

 

People who study human behavior tell us that caring for animals is an ego boost, a shot in the self-esteem department that gives people a sense of purpose, of being needed and necessary. Knowing that another living being depends on us for sustenance and protection gives our self-worth a good shot in the arm.

 

According to a 2009 study published in the American Journal of Orthopsychiatry.Jennifer P. Wisdom, PhD, an associate professor of clinical psychology at Columbia University Medical Center and several of her colleagues surveyed 177 nearly 200 patients with varying degrees of mental illness to determine how the recovery process works. The study concluded that besides offering the boost in self-worth, Pets can serve as either substitute or additional family members. Yes, family. If you’ve ever had a pet you know that you consider them family— because they are.

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For some people the only love in their lives is the love shared between them and cat cuddlingtheir companion animals. Now, I don’t know who invented the term companion animal but it is perfect because they are more than possessions, they are friends, companions, confidants and you could even say, therapists. If you can find a single human being who is a better listener that your dog or cat or bird or whatever I’ll buy you lunch. They never object, they don’t interrupt they just listen very carefully and wag their tails or curl up close to you. Their affection washes over you like a hot shower after a long run and all the troubles of the day run into the drain.

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Our dogs are happy to see us at least a dozen times a day. If I leave to go the store, I get a reception when I come home that is as though I had been gone for a year. I get the same reception if I go to the mail box and come back in a minute later. Open the door and Ziggy is running in circles with joy and Reilly is licking my hand. They are always glad to see me and you know there is nothing phony about it…they really are glad to see you every time they see you.

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Here’s a classic video…it’s a must see and it’s short.  A soldier returns from a tour of duty in Afghanistan and the first one to greet him is his dog.  This will bring tears to your eyes.  https://www.youtube.com/watch?v=ysKAVyXi0J4

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Not only are pets good for your mental health, they can be of immeasurable assistance in maintaining your physical health as well.  Dogs need to be walked and that means you need to walk with them. You may not think of it this way but your dog is helping you It's time for your walkget exercise you might not get otherwise. Every medical study done on the value of exercise says the same thing, even a casual walk is good for you. You don’t have to sprint or run or jog, just walk with Fido and you are getting a health benefit. I haven’t seen any studies on the matter but I’ll bet that dog owners walk more than people who don’t have them. And…I’ve read that people who have pets, or companion animals also have lower blood pressure and decreased cortisol…that’s the stuff that causes stress.

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Most nursing homes or extended care facilities allow visits from animals. When my mom was in a nursing home we used to bring our terrier/Chihuahua mixed dog Lady with us. Mom loved seeing her and lady, who could be a cranky little dog, loved seeing mom. I think they both loved all the attention they got. Other nursing home residents always stopped and wanted to pet Lady. One little 12 pound dog could make a whole nursing home happy at least for a few minutes.

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“Okay,” you say, “I’ll buy all the benefits of having a pet but I can’t. I’m not home much, I travel a lot, I just can’t care for one.” Well, you can benefit from animals anyway. Alan Beck who is the Director of the Center for Human-Animal Bonding at Purdue University suggests the following:

Visit a zoo. Farms that open their barns to visitors and even petting zoos can also be an entrée into the animal world.

  • Put up a birdfeeder in your backyard or outside your apartment window. You could also get out to a park to enjoy birds, chipmunks and other critters in their natural setting.
  • Set up a home aquarium. It may take a little work to get the pH levels balanced, but an established fish tank is fairly easy to maintain.
  • Walk a friend’s dog. You could also offer to pet-sit for dogs, cats, fish and so forth when friends and family members go on vacation, but be sure you’re ready to take on the responsibility.
  • Volunteer at an animal shelter. This is a win-win-win. The shelter gets extra hands to groom, play with or clean up after their charges; you get the feel-good effects of being around animals, and the abandoned pets benefit from your attention.

If none of that appeals to you how about a good movie. One that tugs at your heart strings and makes you feel good. Try any one of these.
1. Beethoven

beethoven

 

 

 

 

 

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This giant but adorable St. Bernard’s real name was Chris.
2. Buddy

buddy

 

 

 

 

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Buddy — from the “Air Bud” movies — was his real name, and he also played Comet in Full House!
3. Marley

Marley and Me

 

 

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Marley, of “Marley and Me” was played by 18 different dogs. All really freaking cute.

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You can find more great “Feel good” dog movies at http://www.buzzfeed.com/lyapalater/30-of-the-greatest-movie-dogs

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Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – spread the word about the immediate need for more organ donors.  On-line registration can be done at www.donatelife.net  Whenever you can, help people formally register.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.  

You are also invited to join Facebook’s Organ Transplantation Initiative (OTI) a 3,500 member  group dedicated to providing help and information to donors, donor families, transplant patients and families, caregivers and all other interested parties.  Your participation is important if we are to influence decision makers to support efforts to increase organ donation and support organ regeneration, replacement and research efforts. 

 bob half of bob and jay photoBob Aronson is a 2007 heart transplant recipient, the founder and primary author of the blogs on this site and the founder of Facebook’s Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

Kidney Disease — What You Need To Know


kidney cartoon 2

Blog by Bob Aronson

My last blog was about kidney disease and so is this one.  “Steering Toward Hope” told about Johnny Racine the Canadian father of 16 year old twin boys and how they turned their 2007 Ford Mustang into an 800 horsepower fire breathing showpiece named “The Kidney Hope Car.”  Racine, his boys and the rest of the “Steering” team will travel the width of Canada to promote organ donation and to raise money for kidney research.

This post will take a different but complimentary approach.  The law of supply and demand applies to human organs as it does to many other commodities.  While we must work harder than ever to increase the supply we must concurrently do everything we can to reduce the demand.  It is the only way we will ever arrive at anything even close to resembling a balance of the two. 

The following paragraphs will examine kidney disease from several angles — from listening to how patients describe their illness to prevention, treatment and what the future holds.

Before I get into the real life, real people part of this blog, let me first lay out the facts about Chronic Kidney Disease (CKD).  It is a major health problem that affects more than 26 million Americans.  It is the ninth-leading cause of death in the U.S.   While the numbers are different elsewhere every country is having the same experience.  Whether you are from Singapore, New Zealand, Canada or Peru you will find that kidney disease is on the rise and there are not enough organs for the number of people who need transplants.

Of the 26 million Americans with kidney disease, about half a million face kidney failure, the condition that requires dialysis. Dialysis, though, is not a cure and in many cases is a stop gap effort while the patient awaits an organ transplant — but transplants are hard to get. 

At this writing in November of 2013 there are almost 100,000 people on the list awaiting kidney transplants but 5-6,000 of them die while waiting because the supply of organs not only does not meet demand it is falling farther and farther behind.  Unlike other transplants though, one can also get a kidney from a living donor but there aren’t enough of them either in fact the number of living kidney donors has fallen steadily for the past several years, to 13,040 in 2012, despite the growing need.  Regardless of the source the average wait time for a Kidney Transplant in the U.S. is 1,121 days. 

I’m hoping this blog will help people understand two things. 1) how to prevent kidney disease and 2) what to expect if you get it.  But first, I think it is important to discuss what causes CKD.

Causes of Kidney Disease

The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases. Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys and heart, as well as blood vessels, nerves and eyes. High blood pressure, or hypertension, occurs when the pressure of your blood against the walls of your blood vessels increases. If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.

Other conditions that affect the kidneys are:

  • Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney’s filtering units.
  •  Inherited diseases, such as polycystic kidney disease, which causes large cysts in the kidneys that damage the surrounding tissue
  • Repeated urinary infections.
  • Pregnancy problems. Sometimes a narrowing of the womb can occur that prevents normal outflow of urine causing it instead to flow back up to the kidney causing infections and kidney damage.
  •  Lupus and other immune system diseases
  • Obstructions caused by kidney stones, tumors or, in men, an enlarged prostate gland.

High risk groups include those with diabetes, hypertension and family history of kidney failure.  African Americans, Hispanics, Pacific Islanders, American Indians and senior citizens are at increased risk.

Before we get into the details of kidney disease and what to do if you have it, let us first discuss how to avoid it.  While there is no sure fire way to prevent kidney problems there are many very effective steps you can take because lifestyle can be a great contributor to the development of all diseases.

Avoiding Kidney Disease

national kidney foundation logoThe National Kidney Foundation has the following guidelines to reduce the risk of developing kidney disease:

  • Reduce sodium intake: Americans consume too much sodium (salt)
  • Limit red meat: Diets high in protein – especially those with animal protein – may harm the kidneys. Red meat is also high in saturated fat.
  • Avoid soda: Sugar-sweetened drinks, like sodas, are high in calories and contain no nutritious value. Additionally, colas have phosphorus additives which can damage kidneys.
  • Give up processed foods: Potato chips, crackers, cheese spreads, instant potato mix, and deli meats are all examples of processed foods that are high in phosphorus additives and sodium – both of which can have a damaging effect on the kidneys.
  • Reduce sugar intake: Consuming too much sugar can result in diabetes or obesity – both linked to kidney disease.
  • Sit less and stand more: Recent research has linked sitting for 8 hours or more a day with developing kidney disease.
  • Exercise and lose weight: Diabetes is responsible for 44 percent of all new cases of kidney failure. Obesity and Type 2 diabetes are on the rise and can often be treated and reversed.
  • Manage high blood pressure: Both considered silent killers, many people don’t realize high blood pressure and kidney disease are linked. Controlling blood pressure levels can prevent kidney damage and failure.
  • Avoid long term use of kidney-toxic drugs: Over-the-counter (OTC) pain medications, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen brand names (Motrin, Advil, and Nuprin).
  • Get tested: Ask your doctor for an annual urine test to check for protein in the urine, one of the earliest signs of kidney disease, and a blood test for creatinine

But…there’s a whole lot more to preventing kidney disease.  The Correct Diet Can Help Avoid Kidney Disease  http://www.medicalnewstoday.com/articles/259203.php (See this link for the full story.)

Bad diet choices and habits like smoking and obesity are linked to ajkd logoan increased risk for kidney disease, suggests a new study published in the American Journal of Kidney Disease.

A group of investigators, led by Alex Chang, MD, of Johns Hopkins University, discovered that people with regular kidneys whose diet quality was bad – high in processed and red meats, sodium, and sugar-sweetened beverages, and low in fruit, nuts, legumes, whole grains, and low-fat dairy – were more likely to develop kidney disease.

Just one percent of people without unhealthy diet or lifestyle choices developed protein in their urine – an early sign of kidney damage. On the other hand, 13% of participants who had at least three unhealthy factors such as obesity, smoking, and poor diet developed protein in their urine.

Obese people, i.e. those with a body mass index (BMI) of at least 30, were twice as likely to develop kidney disease, the authors reported. A poor diet independently influenced risk for chronic kidney disease after adjusting for weight and other influential factors.

In total, those who ended up with kidney disease were more likely…

  • to be African American
  • to have high blood pressure
  • to have diabetes
  • to have a family history of kidney disease
  • have a higher intake of soft drinks, fast food, and red meat compared to those who did not have kidney disease.

How it Feels to Have Kidney Disease

Now let’s get to the disease itself. The medical profession can describe it in terms no one can understand but I prefer to hear from patients.  What does it feel like to have kidney disease, how does your body change?  That’s a tough question to answer because so many people have no symptoms or symptoms that are so mild they don’t notice them but we did find some clear, understandable and frightening explanations.

We are going to look at symptoms of kidney failure from two perspectives. First the little tell-tale signs that something might be amiss and secondly the more specific complaints as told by patients.  Fist the little signs that indicate you might have kidney disease but don’t diagnose yourself.  See your physician.  You might have kidney disease if you:

  • feel more tired and have less energy
  • have trouble concentrating
  • have a poor appetite
  • have trouble sleeping
  • have muscle cramping at night
  • have swollen feet and ankles
  • have puffiness around your eyes, especially in the morning
  • have dry, itchy skin
  • Need to urinate more often, especially at night

Now let’s look at more serious conditions. If you are feeling anything like any of the following people you probably should see your doctor as soon as possible.

  • “I feel like I have the flu and am cold most of the time and. When I take my temperature, it is normal. I feel sort of dizzy, have a loss of appetite, food doesn’t have any taste, I have shortness of breath, no energy, and am nauseous.  It’s pretty miserable.”
  • “When I first got sick I really thought it was a normal cold. I had a fever, was sneezing, runny nose etc. Then it got worse to where I was throwing up, had blood coming out in spits, vomit, urine, etc. Then it became really hard to breath and I couldn’t lay down anymore as it would cause me to suffocate. I ended up in the hospital where they told me both my kidneys failed and liquid was pushed up to my lungs which was causing me to suffocate. I don’t want to scare anyone but please learn from my mistake of not going to the hospital for about 3 weeks after I first got the cold like symptoms. Get a check up even if you think it is a cold!”
  • “My kidney failure was discovered by accident through routine blood work at the time of my yearly physical. The first red flag was a high potassium level on two different blood draws over a two month period of time. I had observed several symptoms too,  The first symptom strangely was an “itchy back,” another one was an “ill feeling” — not being very hungry – sweating — breathlessness — a rapid heart rate — and discomfort (pain) in the location of the left kidney. These “symptoms” did not appear all at once or I would have seen a doctor. I now know that all of these are symptoms of chronic kidney failure. It is vital to be informed and educated.” 
  •  “I was diagnosed about three years ago with stage 3 kidney failure. I had no signs that I was aware of as I also have congestive heart failure.  Now, I itch alll over my body, perspire excessively and have extreme pain in my back, neck,shoulders and legs, as well as increased ankle swelling.”
  • “I did not realize I had quit urinating until my husband and I went on a long road trip. I didn’t feel the need to stop to urinate at all. I paid no attention at the time but now I remember that I was very nauseous, vomiting, and had horrible leg cramps. On the third day I went to the ER and was admitted to the ICU. After five dialysis treatments I started to recover.   I now measure my output just to be sure.”

For the sake of education let’s assume you have been diagnosed with kidney disease. What are your options?  There really are only two.  1) you can choose to allow your medical team to treat it with medication and ultimately dialysis.  2) a kidney transplant but you must qualify and only a medical team at a transplant center can determine if you are a candidate for a transplant.

If Dialysis is Ordered

Chronic kidney disease continually gets worse and eventually leads to end-stage renal disease, also known as kidney failure.

\Your doctor might recommend you begin dialysis treatments once you reach the point where you have only 10 to 15 percent of kidney function left.

With kidney failure, the toxins and excess fluid that your kidneys should be releasing begin to build up in your body. People suffering from kidney failure begin dialysis to help their bodies remove these wastes, salts and fluid.

Two kinds of Dialysis

  1. Hemodialysis and
  2. Peritoneal dialysis.

Hemodialysis is typically performed at dialysis centers or hospitals but some clinics offer smaller devices for home use.

Hemodialysis, patients generally have an access point  in their arm to which the dialysis machine is connected.  On average It takes aobut four hours for the blood that is drawn from your body to be cleansed and returned.

Peritoneal dialysis is more likely to be done at home after you have a catheter placed in your stomach (a minor surgery).

There are two kinds of Peritoneal dialysis, 1) continuous ambulatory and 2) continuous cycling

Continuous cycling peritoneal dialysis is usually done at night. Before retiring you attach the dialysis machine tube to your catheter which pumps a solution into your stomach.  It stays there for a few hours so your stomach can act as a filter allowing waste and other fluids to pass through it into the solution.

Continuous ambulatory peritoneal dialysis is much different because you don’t need a  machine. You simply run dialysis solution into your abdomen through the catheter and after 4k to 6 hours drain it into a bag.  A physician can tell you how often during the day you need to do this

Risk Factors

There are several.  They include anemia, bone disease, high blood pressure and depression. Some patients on hemodialysis might have also have problems with low blood pressure.

Patients undergoing peritoneal dialysis are at risk of developing peritonitis which is an infection in the stomach lining. Your doctor will likely prescribe antibiotics to treat the problem.

 Got questions?  Many answers can be found here.

http://www.nwkidney.org/dialysis/startingOut/basic/faqs.html

 A Kidney Transplant

If it has been determined that a Kidney transplant is your only option this information may prove to be invaluable. 

KidneyBuzz.com encourages patients to stay as healthy as possible by managing stress, eating well, and staying active. It is important for patients to remain as well as possible during this time, so they are ready for kidney transplant surgery as soon as a donor organ becomes available. For patients who have a living organ donor, scheduling transplant surgery can take into account the health status of the recipient as well as other factors.

Manage your stress. Many patients constantly worry about their treatments, blood work results, future surgeries, etc. Education and support groups both online such as KidneyBuzz.com, and offline provide patients with tools and support to manage their stress and cope with the challenges associated with their condition. Recommended Reading: Will You be Ready when Your Time Comes for a Kidney Transplant? (this link and links below from KidneyBuzz)

There are other strategies that you can employ to expedite obtaining a Kidney Transplant including listing at more than one transplant center (Multi-Listing). Research has consistently shown that patients who are strategically Multiple Listed will greatly increase their chances of receiving a Kidney Transplant faster.   Nevertheless, only a mere 4.7% of individuals with CKD utilize the Multiple Listing technique.

KidneyBuzz Recommended Reading: “Ins-and -Outs” of Increasing your Chances of Getting a Kidney Faster

There are also website resources available that assist people with CKD to find Kidney Transplant Centers with the lowest average wait times that are the closest to where they live. These free user friendly website tools can be particularly helpful to people who are on a Kidney Transplant Waiting List in a high wait time area because it can significantly increase their access to  Kidney Transplant Centers options with far lower wait times. You can email KidneyBuzz.com at contact@kidneybuzz.com for more information and direct links to discussed sites.

Once you have determined the treatment track you will take the next logobig question most people have is, “How do I pay for the it?”  Well, if you have regular health insurance that might cover it.  If not the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) http://kidney.niddk.nih.gov/kudiseases/pubs/financialhelp/ offer this information”

In 1972, Congress passed legislation making people of any age with permanent kidney failure eligible for Medicare, a program that helps people age 65 or older and people with disabilities pay for medical care, usually up to 80 percent. The remaining 20 percent can still pose a significant financial burden on patients. Fortunately, other public and private resources can help. Anyone with permanent kidney failure who does not have adequate insurance coverage should seek the help of a certified or licensed social worker. Every dialysis and transplant center has a social worker who can help people with kidney failure locate and apply for financial assistance. Social workers who specialize in helping kidney patients are called nephrology social workers.

Patients can also enlist the assistance of the State Health Insurance Assistance Program (SHIP). The SHIP is a national program that provides free counseling and assistance to Medicare beneficiaries on a wide range of Medicare and supplemental insurance matters. Patients can find a state program by visiting shipnpr.shiptalk.org/shipprofile.aspx click to view disclaimer page.

Medicarecms logo

To qualify for Medicare on the basis of kidney failure, a person must require regular dialysis or have had a Medicare-covered kidney transplant and must have paid into Social Security through an employer-or be the child or spouse of someone who has or have worked under the Railroad Retirement Board, or as a government employee-or be the child or spouse of someone who has or already be receiving Social Security, Railroad Retirement, or Office of Personnel Management benefits.

The Original Medicare Plan has two parts: Part A is hospital insurance, and Part B is medical insurance. Part B covers most outpatient services, including kidney dialysis, doctors’ services, outpatient hospital services, and many other health services and supplies. While Part A has no premiums, most Part B services require premiums, deductibles, and coinsurance.

Some people who are not eligible for Medicare because they have not worked at a job that pays into Social Security may still be eligible to buy Medicare coverage by paying premiums for Part A.

For more information check with the NKUDIC (link posted above)

935503_10201217871274032_357839664_nJay Robare is a friend and a member of my Facebook group Organ Transplant Initiative.  He is the talent behind the design of the OTI logo.  Jay is legally blind and has been on the kidney transplant list for about four years.  He wrote this about two years ago when he lived in Fort Lauderdale, Florida.  He is now a resident of Philadelphia, Pennsylvania.  Here’s Jay’s story….he’s still waiting.

The Jay Robare Story

Waiting for a Kidney

By the time that I was approved for Medicare, I had gone through all my savings and my limited insurance coverage. I had to quit working because my endurance was gone and because I was not working, I could not afford my apartment anymore and I had to start living with others that helped me out. I lost all my furniture and most of my art equipment.

I finally got disability insurance and was qualified for Medicare but not Medicaid since I was making too much money from disability; I got enough to pay rent and had some money for paper products, which costs a lot. I have to dry my hands on paper towels to stay sterile.

I was blessed with $200 in food stamps last year but that has been decreased too; I am out of food by the third week of the month. I keep asking for rides to the various food banks but people are too busy. I am not the only one going through this; most people just can’t understand the magnitude of what we are going through in our lives and in our bodies. I know everyone is having problems for I hear that all the time but when I got sick and started working to get on the waiting list, all my doctors and nurses treated me like I was given a special gift which it is…the gift of life but many people would rather worry about their financial or relationship problem that they will outlive. We won’t outlive our problems, they are literally killing us.

****Editors note.  (When Jay lived in fort Lauderdale he was on Peritoneal Dialyisis…he is no longer but I included it because patient should know about it.)

I didn’t even talk about having to do dialysis every night. The type of dialysis that I do is called Peritoneal Dialysis where I store 2,500 milliliters of sugar saline solution for 2 and a half hour cycles 4 times which is all carbohydrates. I have gained 30 Lbs and I look very well fed; my fried Dirk said I looked like I had a beer belly…my last beer was a Heineken last Christmas. One nice thing about PD instead of hemo dialysis is that I have no liquid restraints. On hemo, I could only have 60 Oz a day or I would risk cramping and THAT was a bitch. Cramps formed in muscles that I thought I never had and the pain was so bad it made me yell out for Jesus…made my tech laugh at me.

Speaking of techs, I had clowns that would not listen to me and do the treatment their own way ending up hurting me. For you on Hemo, THIS IS YOUR TREATMENT AND YOUR BODY, don’t take any crap from these people; make sure that your nurse knows and the director knows that you do not want this person touching you again. Another thing that I like about PD is that it is robbing my body of potassium and this lets me eat things that hemo would never let me eat like bananas, mashed potatoes, spinach, hummus, vegetables and fruits. I do have to take something called a binder every time that I eat something. This medicine absorbs all the phosphorus in the food. The binder can be nasty at times, it is very dry and tastes like I am eating chalk. The chalk does a good job but sometimes it is difficult to take. The meds are a chewable but I think they are coming out with a powder soon.

Another med that I have to take because of PD and a bad parathyroid, caused by ESKD is a drug called Zemplar and Sensipar. Both keep my calcium land my PTH levels down. The only problem is that Sensipar has made me nauseous for the last 4 years; I have been throwing up every time I took this drug for 7-8 months. I guess my body has had enough. The doctors, dietitians and I have been playing games for years. I have finally decided to have a perthyroidectomy. After this surgery, I will need to start taking calcium supplements, including eating more pizza and lasagna…LOL I

I get extremely tired sometimes during the day from either walking to the bus stop and going to Publix to get some noodles or walking from the bus stop to my Davita dialysis clinic to get labs done every Monday or Tuesday; I need to send a vile of blood to my transplant hospital every week so they can keep an eye on my health and changes in my DNA.

*** Editors Note (Jay is now living in Philadelphia and is on hemodialysis which limits his liquid intake.  He is desperately trying to find a living donor.  This journey has been very hard on Jay yet somehow he manages to keep his spirits up.

The Kidney Transplant

kidneysEveryone has two kidneys, each the size of a fist and they have a very important job to do. They filter waste and remove extra water from your blood to make urine.  But…there’s more.  Your kidneys also control your blood pressure and make hormones that your body needs to stay healthy. 

During a kidney transplant

Kidney transplants are performed with general anesthesia, so you’re not aware during the procedure. The surgical team monitors your heart rate, blood pressure and blood oxygen level throughout the procedure.

During the surgery:

  • The surgeon makes an incision and places the new kidnKidney transplantey in your lower abdomen. Unless your own kidneys are causing complications such as high blood pressure or infection, they are left in place.
  • The blood vessels of the new kidney are attached to blood vessels in the lower part of your abdomen, just above one of your legs.
  • The new kidney’s ureter — the tube that links the kidney to the bladder — is connected to your bladder.

Kidney transplant surgery usually lasts about three to four hours.

After a kidney transplant

After your kidney transplant, you can expect to:

  1. Spend several days to a week in the hospital. Doctors and nurses monitor your condition in the hospital’s transplant recovery area to watch for signs of complications. Your new kidney will make urine like your own kidneys did when they were healthy. Often this starts immediately. In other cases it takes several days. Expect soreness or pain around the incision site while you’re healing.
  2. Have frequent checkups as you continue recovering. After you leave the hospital, close monitoring is necessary for a few weeks. Your transplant team will develop a checkup schedule for you. During this time, if you live in another town, you may need to make arrangements to stay close to the transplant center.
  3. Take medications the rest of your life. You’ll take a number of medications after your kidney transplant. Drugs called immunosuppressants help keep your immune system from attacking your new kidney. Additional drugs help reduce the risk of other complications, such as infection, after your transplant.]

http://www.mayoclinic.org/kidney-transplant/kidney-transplant-procedure.html

The Future

What does the future hold?  It is easy to speculate about what the future holds and absolutely impossible to be accurate.  We just don’t know.  Is there promise? Yes! There are many promising developments taking place in laboratories around the world every day.  We won’t go in to all of them because if history is any indicator most of those experiments will fail.  There are some, though, that hold some promise at least for now…like this one.

Intravenous Kidney Cell Transplant Experiments Raise Hope for Future Human Kidney Failure Treatments

May 31, 2012 — Indiana University School of Medicine scientists have successfully transplanted primary kidney cells intravenously to treat renal failure in rats, pointing the way to a possible future alternative to kidney transplants and expensive dialysis treatments in humans.

The researchers, Katherine J. Kelly, M.D., associate professor of medicine, and Jesus Dominguez, M.D., professor of medicine, genetically modified the cells in the laboratory to produce a protein — called SAA — that plays an important role in renal cell growth, embryonic kidney development and kidney regeneration after an injury. Modified cells found their way to the appropriate locations of the damaged kidneys, resulting in regeneration of tissue and improved function in the kidney.

The researchers’ work has been accepted for publication in the American Journal of Physiology — Renal Physiology, which published an advance online version of the paper on May 16.  You can read more here http://www.sciencedaily.com/releases/2012/05/120531135645.htm

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Bob_Aronson at Mayo Jax tight shot 2008-01-30DJH--02Bob Aronson is a heart transplant recipient.  He got his new heart on August 21,2007 at the Mayo Clinic in Jacksonville, Florida where he now lives with wife Robin and their two dogs Reilly, a soft coated Wheaten, and Ziggy a Mini Schnauzer.

For some 25 years before his transplant Bob was an international communications consultant and owner of the Aronson Partnership which became the  Aronson Communications Group after the surgery.  Today he is semi retired and also assists his artist wife Robin with her Jinglers Jewelry art show business.

Prior to starting his consulting firm in the 1980s he served as the Communications Director for a Minnesota Governor;  was the first Anchor of Morning Edition on the Minnesota Public Radio Network; worked as a journalist at several Midwest broadcast facilities and from 1965 to 1974 was one of the first radio talk show hosts in the country.   

Aronson founded Bob’s Newheart and Facebook’s Organ Transplant Initiative (OTI) on November 3, 2007.  OTI is a 3,000 member transplant patient, recipient, caregiver and donor/donor family support and education group. 

Readers are welcome to Join OTI with the only requirement being that you support our mission which can be found in the “About” section of OTI.  We seek to grow our membership because by so doing will have more influence with decision makers as we pursue those issues which would most benefit our members.

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. 

Thank you for reading our Bob’s Newheart blogs and please leave a comment or contact Bob directly at bob@baronson.org.  We intend to continue to expand the number of issues we cover and the availability of information to the public.  You’ll find scores of other posts on Bob’s Newheart, just check the index for topics, click and read.

If you are an organ donor we thank you.  If not you can become one by going to www.donatelife.net it only takes a few minutes.  Then, tell your family what you have done so there is no confusion later.

 

What’s In That Prescription Bottle and What Does It Do? Generic V. Brand


pay more get weel quicker By Bob Aronson

What’s In That Prescription Bottle and What Does It Do?

The question asked by our headline would seem to have an obvious answer but it doesn’t because there isn’t one.  We may know the medication that’s in the bottle but what It does is another story. Each drug has a primary effect and many side effects.  Side effects can be minimal or dangerous and we are left to trusting our physicians.  But, do they really know what they are prescribing?

According to Dr. Ben GoldacreDr. Ben Goldacre they don’t because they don’t have all the information they need.   Goldacre is a best-selling author, broadcaster, campaigner, medical doctor and academic who specialises in unpicking the misuse of science and statistics by journalists, politicians, quacks, drug companies, and more.

bad scienceHis first book “Bad Science” (4th Estate) has sold over 500,000 copies to date, is published in 18 countries, and reached #1 in the UK paperback non-fiction charts. bad pharmaBad Pharm, just out, is on bad behaviour in the pharmaceutical industry and medicine more broadly: it is now a top ten UK best seller.

Here’s what Goldacre says about, “What’s in that Bottle?”

“Doctors need the results of clinical trials to make informed choices, with their patients, about which treatment to use. But the best currently available evidence estimates that half of all clinical trials, for the treatments we use today, have never been published. This problem is the same for industry-sponsored trials and independent academic studies, across all fields of medicine from surgery to oncology, and it represents an enormous hidden hole for everything we do. Doctors can’t make informed decisions, when half the evidence is missing.

Most people react to this situation with incredulity, because it’s so obviously absurd. How can medics, academics, and legislators have permitted such a huge problem to persist? The answer is simple. This territory has been policed — and aggressively — by the pharmaceutical industry. They have worked hard to shut down public discussion on the topic, for several decades, with great success.

They say, for example, that the problem is modest, and that critics have cherry picked the evidence: but this is a lie. The best evidence comes from the most current review of all the literature, published in 2010. It estimates that half of all completed trials are left unpublished, and that trials with negative results are about twice as likely to be buried.

Then they pretend that the problem is in the past, and that everything has been fixed. But in reality, none of these supposed fixes were subjected to any kind of routine public audit, and all have now been well-documented as failures. What’s more, they all shared one simple loophole: they only demanded information about new trials, and this is hopeless. Anything that only gets us the results of studies completing after 2008 does nothing to fix medicine today, because more than 80% of all treatments prescribed this year came to the market more than ten years ago. We need the results of clinical trials from 2007, 2003, 1999, and 1993, to make informed decisions about the medicines we use today. This isn’t about catching companies out for past misdemeanors, it’s a simple practical matter of making medicine optimally safe and effective.” (You can watch Dr. Ben in action here  http://tinyurl.com/opvzsjn )

OK…having established that we need to force the FDA and big Pharma to release more information let’s turn to the subject of Generic drugs.  Are they really the same as he band name?  The answer is, “No, not entirely!”  Did you know they aren’t even tested?

busting the myths

For more on the generic story let’s turn to Dr. Tod Cooperman.  He is not only an MD but also the President of Consumerlab.com.  Here’s what he says,

“More than 80Dr. Todd Cooperman% of the drugs we take in the US are now generic versions of brand name medications. You may think that these drugs are equivalent to their branded counterparts, but that’s not always the case. Here are some important facts and tips to stay safe with generic drugs.”

Fact: You may get more or less active drug from a generic.

The FDA only requires that you get 80% to 125% of the drug into your bloodstream from a generic medication compared to the original drug. What’s even more concerning is that there are often many different generic versions of the same drug, and each of these may be different as well.  rx logoConsider this: If you take a generic which only meets the minimum requirement and refill that prescription with one that’s at the maximum limit, you’ve potentially increased the amount you get into your body by as much as 45% percentage points – and you would have no way of knowing this from the labels, but it could certainly affect you. The opposite could also happen, and you would be getting a lot less drug than you were previously – which could also affect you.

This is particularly troubling for medications for which blood levels must be kept in a narrow range in order to be effective and/or to avoid toxicity. These can include:

Thyroid medication

Anti-seizure medication

Blood thinners

Antidepressants

Antipsychotics

Asthma medications

Immunosuppressants

Fact: Other than the active ingredient, a generic may contain very different other binders and fillers.molecules

Most of the ingredients in a pill are not the active ingredient but other ingredients needed to hold the pill together, coat it, and control the way the pill delivers its drug in your body. These other ingredients can be different in a generic version of a drug. It is possible to have an allergic reaction or sensitivity to one of these ingredients. With some extended-release products, the brand name formula is still patented, so the generics may be completely different in their formulation. This can affect how fast or slow they release their drug and how this is affected by things like whether you take the pills with food or not. http://www.doctoroz.com/videos/what-you-need-know-about-generic-drugs

Fact: Generics are not tested like brand name medication.

While brand name medication is tested for safety and efficacy before being approved, generics are not. The only human test in people that is required is a bioequivalence test, conducted by the manufacturer in a small number of healthy individuals. This test must show that the product delivers approximately the same amount of drug into your blood stream and approximately the same rate.

Fact: Labels on most generic drugs are incorrect.FDALOGO

The FDA requires that the package inserts for generic drugs show the data (the “pharmacokinetic” data) from the brand name medication as if it is were based on the performance of the generic drug. In actuality, the data for the generic is typically different, but the FDA does not release this information.

Fact: In 2012, the FDA conceded that several generic antidepressant medications had never been tested and one was pulled from the market.

These were generic versions of Wellbutrin XL 300. One of them, called Budeprion XL 300 (Teva), had been on the market since 2006. Four others remain on the market. ConsumerLab.com drew attention to problems with this group of drugs in 2007 when it showed the Teva product did not dissolve like the original drug and many people switched to the drug reported that it was not working and some reported becoming suicidal. (Access to ConsumerLab.com’s report is available through a 24-hour free pass to Dr. Oz viewers. Visit ConsumerLab.com/DoctorOz now and get immediate access.)

So, given all that information, what do you do with it. Here’s what Dr. Cooperman suggests.

Guidelines if you are going to take Generic drugs

Guideline 1: Consider brand names for extended-release generic drugs.

While the active ingredients may be identical, the pills and their other ingredients in extended-release medications may not be. This makes extended-release generics, which typically have XL, ER, or SR in their names, more susceptible to delivering lower or higher amounts of the drug into your blood stream and at faster or slower rates than the brand name medication. As noted, this has been an issue with generic Wellbutrin XL 300. Concerns have also been reported with generic versions of Toprol XL. ConsumerLab.com has published reports on these products.

Guideline 2: Identify the manufacturer for generic drugs.

Not all generics behave the same way. If your generic is working, you should request the same manufacturer each time you refill that prescription. You can find the name (sometimes an abbreviation) on the bottle. Don’t be shy. You can call around to try to find the same product. Pharmacists will tell you which version they are currently selling and may be able to get the version you want.

Guideline 3: Find out if an “authorized” generic exists for your drug.

These are generics typically made by the same manufacturer of the brand name medication but sold under a generic brand name. They are not “similar” to the brand name drug – they are identical to it. They just have a different imprint on them. Ask your pharmacist if one exists for your medication.

Guideline 4: When switching to a generic, monitor your condition carefully.

When switching from a brand name to a generic drug, or from one generic to another, note any changes you feel and tell your doctor immediately. It could be a difference in the medication causing the changes in you.

If you have experienced an unexpected and adverse change in your condition after being switched to a generic medication, you or your doctor may also want to report this to the FDA though its MedWatch program. You can also report this to ConsumerLab.com, which may choose to investigate the issue.

Bob’s Newheart will be watching closely as more brand names become generic and we’ll report significant developments to you as we discover them.

Bob informal 3Bob 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.

Pay Up or Die. The High Cost of Prescription Drugs


By Bob Aronson

At the onset of this post it is important to point out that capitalism (or the desire to make money) works.  If the public demand for any product real or imagined is high enough, someone, somewhere will invest the dollars to develop it and in return they expect a profit.  There is absolutely nothing wrong with that.  If they are taking the risk, they deserve a profit, even a healthy profit.

As a business owner myself I always sought to make a healthy profit.  I could easily justify my pricing because it took years of learning and investing my own money to develop a detailed and highly effective method of persuasive communication that would result in helping my clients increase their profit margins. So, on to the question we are addressing.

Every physician, nurse practitioner, pharmacist and insurance company is familiar with this oft heard question, “Why do drug companies charge so much for my medications?”

Well, the answer can be either complex or simple.  This blog tries to provide a glimpse of the complex answer but the simple answer to the question may be, “Because they can.”

Simple answers always sound good but they are seldom accurate so let’s begin by taking a good look at the problem.

Prescription drug prices are very high, higher in the United States than any other developed country in the world. 

It is estimated that about 48 percent of Americans take at least one prescription drug but the high cost of drugs hits older people the hardest.  It is a fact of life that as you age you need more medical attention and must take more prescribed drugs to stay healthy. 

The cost of drugs for people with chronic diseases, transplant patients, and mental illnesses is in some cases prohibitive.  Many patients are faced with making tough choices about how they spend their money and often the choice is between medicine and food, but rather than allude to the problem I will address it head on with examples.

Cancer is a condition into which billions of dollars has been poured.  The disease offers a great example of research that sometimes results in medication and/or therapy that effectively treats and sometimes even cures the patient.  But, and this is a huge but, those who need the drugs the most may also be unlikely to afford them.

Overall, cancer drug prices are skyrocketing. Of the dozen drugs approved by the Food and Drug Administration for various cancers in 2012, eleven were priced above $100,000 for a year of treatment. Writing in an op-ed in the New York Times in October 2012, three physicians at New York City’s Memorial Sloan Kettering Cancer Center noted that “the typical new cancer drug coming on the market a decade ago cost $4,500 per month (in 2012 dollars); since 2010 the median price has been around $10,000.” 

$10,000 a month for one drug? That is beyond outrageous, right? Detractors would strongly suggest that the price borders on obscene.  Well, if you think that is bad, chew on this one. There is now an approved prescription drug that costs $295,000 a year.

Let’s digest that piece of information for just a moment. There is now a prescription drug that costs twice as much as a college education and because it keeps you alive you might need to take it for years. There’s a lot of money to be made in treating diseases, probably a whole lot more than in curing them (that’s a topic for another day).

Some might say, “That $250,000 figure is an extreme example” and they would be correct, but extreme does not mean uncommon.  According to Fox News, Gattex, which is prescribed for short bowel syndrome, is the fourth drug approved in 2012 that was priced above $200,000 per patient, per year. http://tinyurl.com/lnmr353

NPS pharmaceuticals in Bedminster, New Jersey, the company that makes Gattex says, no patient will have to pay out of pocket for the drug. Instead, it will be covered by a patchwork of insurance, coupons and charitable organizations. They say that commercial insurers will pay for part of the drug, around 70%. The remaining co-pay will be covered by NPS Pharmaceutical’s co-pay assistance plan or–in the case of Medicare patients–by rare disease organizations that get funding help from NPS Pharmaceuticals. About 15% of patients who can’t pay anything will get it for free. But the cost ultimately is paid by everyone through your insurance premiums, taxes or co-pays.    

NPS would like to have you believe that a quarter of a million dollars for a pill is ok as long as you don’t get the full bill.  But is it OK?  Read on about how drug companies make and spend their money.

 

There are still millions of uninsured Americans, millions more are underinsured and millions more even with good insurance might not be able to afford the co-pay.  So the question that needs an answer is, “What good is a new, effective drug if those who need it can’t afford it?”

So, back to the topic of this blog. Why do prescriptions cost so much?  Let’s first examine the question from the perspective of the pharmaceutical companies. I want to be fair and honest here so I am going to provide some necessary details.  Here’s what they say, “Prescription drugs cost a lot because we spend a lot to develop them.”  Some examples:

·         A single clinical trial can cost $100 million at the high end, and the combined cost of manufacturing and clinical testing for some drugs has added up to $1 billion and even then there is no guarantee that the U.S. Food and Drug Administration (FDA) will approve it.”

·         While the United States has only 5% of the world’s population, it accounts for 36% of worldwide research and development of pharmaceutical drugs.  The industry says that in the next quarter century drug research will save almost three fourths of a trillion dollars in treatment costs for just five Illnesses (Aids, heart disease, cancer, Alzheimer’s and arthritis). As a further example the industry says that drugs developed to treat Schizophrenia which cost the patient about $4,500 a year save patients about $70,000 a year by keeping them out of the hospital.

·         The drug companies also justify their high prices by explaining that only about ten percent of drugs that go through the clinical trial process get approval from the U.S. Food and Drug Administration (FDA).  0Overall, the case made by the pharmaceutical companies sounds convincing.   Drug development is an expensive process and each year scores of companies spend millions to develop promising drugs that either fail to get into trials, fail the trials or complete the trials and are turned down by the FDA.  Investors lose many billions of dollars each year on promising drugs that simply don’t live up to their expectations.

So, do the pharmaceutical companies make a good case for their high prices?  Certainly one could say it is compelling in the manner and context in which it is presented.  The icing on the drug company argument might be that because so many foreign governments place a cap on prescription prices American consumers wind up paying the freight for the rest of the world.  And…while drug companies blame R&D costs for their high prices insiders also readily admit to pressure to increase profits before drug patents expire with the resultant generic drugs selling for far less with slimmer profit margins. So, in a rather large nutshell, that’s the case made by the pharmaceutical companies to explain the high price of prescription drugs.

As former journalist my genetic makeup dictates that I cannot present the pharmaceutical company argument and end the blog.  Balance is what makes the teeter–totter a pleasant ride.  Without it one end will hit the ground with a resounding, “thump.”   Most people assume that a story is balanced when both sides are presented.  But, what if there is more to the story?  What if there are more than two sides?  In the previous paragraphs I offered several angles for justifying high drug prices.  Now, let’s try to offer some balance…a few judgments, of course, but mostly balance.

The above justification for drug prices makes sense when you don’t have a corporate balance sheet in front of you because we are being told only part of the story.  What happens when we ask this question?  Do research and development costs comprise the majority of corporate expenditures?  If they do, then their argument may be justified but if not it is suspect.

Critics of pharmaceutical companies point out that only a small portion of the drug companies’ expenditures are used for research and development, with the majority of their money being spent on marketing and administration. A recent report indicates that pharmaceutical companies spend nineteen (19) times more on self-promotion than on basic research.  http://tinyurl.com/bzrpsg6

According to a report in BMJ, a medical journal based in London it is more profitable for drug companies to create a products that are only slightly different from drugs already on the market.

“Pharmaceutical research and development turns out mostly minor variations on existing drugs,” the authors write. “Sales from these drugs generate steady profits throughout the ups and downs of blockbusters coming off patents.”

The authors go on to say that for every dollar pharmaceutical companies spend on “basic research,” $19 goes toward promotion and marketing and the strategy seems to be working.  According to the website MinnPost http://tinyurl.com/mywen48drug company revenues climbed more than $200 billion in the years between 1995 and 2010.

MinnPost says that in recent years more than one in five Americans age 50 and up had to cut down on dosages, switch to cheaper generic drugs (if they are available) or quit taking their drugs completely.  Often the choice is between medication and food.

The argument that R and D costs account for the high cost of prescription drugs erodes when one considers that promotion not R&D is what they really spend their money on. But…the dam begins to spring a whole bunch of leaks with the knowledge that not all, in fact a majority of new drugs come from non-American companies.

 

Here’s a little more water to add to the bursting price dam.  As I noted earlier, the U.S. is the only nation that does not have price controls and negotiate our drug prices, so it is true that in a sense, we are bearing the cost of the world’s R&D.   But, even conceding that point American drug prices still appear to be excessive — and in fact, drug companies are increasingly pocketing their huge profits rather than reinvesting them.

 

In 2002, 78 new drugs were approved by the FDA. Of those, only 17 were deemed by the FDA to have new active ingredients, and only seven were found to be improvements over the older drugs. On top of that, of the seven found to be an improvement over the older drug, not one of them came from U.S. companies.  Not a single drug.  Now, to be fair, that is not true in every year but it is true often enough to destroy the defense of high drug prices the manufacturers continue to offer.

Back to the MinnPost story and we quote;

“For the past decade or so, we’ve been hearing repeatedly about an “innovation” crisis in pharmaceuticals. Big Pharma and its friends in government and elsewhere have claimed that research into new drugs is slowing down, primarily, they say, because of onerous regulatory demands.

“With the growing difficulty of getting drugs through the [Food and Drug Administration] labyrinth and the rising cost of drug approval, Pfizer must produce revenue for continued research — the lifeblood of pharmaceutical companies,” lamented the president of the Galen Institute, an industry-funded and free-market public policy organization, in Forbes last December. “Without this research, the pipeline would run dry, delaying or even killing new medicines for Alzheimer’s, Parkinson’s, and countless other diseases.”

But is it true? Is there really an innovation crisis? “No,” according to an analysis published on BMJ.com. The real crisis is in a system that rewards drug companies for developing new products that offer few, if any, therapeutic benefits over existing ones, argue Donald Light, a professor of social medicine and comparative health care at the University of Medicine and Dentistry of New Jersey, and Joel Lexchin, a professor of health policy and management at York University in Toro.”

Let us rely even further on the BMJ report and this startling fact.  Most funds for basic research are public funds!   So not only is R and D not responsible for high prices, the companies aren’t even paying for the R &D.  That money comes primarily from taxpayer dollars funneled through publicly supported research institutions.

A cutback on public money for basic research, therefore, would seem to be a key threat to drug innovation.  And, yes, research and development costs have risen significantly for drug companies (by an estimated $34.2 billion between 1995 and 2010), but revenues have risen faster (by $200.4 billion within that same time period).

Suddenly, that very air-tight case presented by the drug companies that justifies what some call price gouging — suddenly the case is full of holes and not a few distortions.

Here, though, is the capper and it is a big one. In the United States, the priciest medicines aren’t necessarily the ones that cost the most to develop, nor are they the ones that save the most lives. The most expensive drugs are those that have no competitors. It’s as simple as that.  When there is no competition and the government refuses to intervene the pharmaceutical companies are free to molest the consumer’s bank account.

When a real blockbuster drug hits the market, there is very little to guide manufacturers and insurers as they negotiate prices.  The largest constraint is public perception. Yes, public opinion still has some effect, not much but some.  Insurers fear that, if they refuse to pay at least something, their sick customers will be outraged.

Manufacturers don’t want the public or lawmaking bodies to see them as price gougers (I think we are smarter than that) so negotiators eventually settle on a price between two extreme poles. This, however, is not a common problem.  Few pharmaceutical companies face it. Most newly developed and introduced drugs find the market already crowded with competition and it is the competition that ultimately sets the prices.

Earlier I said there are rarely just two sides to a story and this story is no different than any other about which I’ve written.  The final side is the seedy side, the illegal, greedy and immoral side, the side that should result in people going to jail.  It has to do with kickbacks and while there may be very few medical and business professional people involved there are some. 

This headline got a lot of attention and still is.

Pay to Prescribe? Two Dozen Doctors Named in Novartis Kickback Case

http://tinyurl.com/mecleg5

From the New YorkTimes:

Less than three years ago, Novartis settled criminal and civil investigations into whether it had illegally promoted drugs to health care professionals for uses not approved by the Food and Drug Administration. The company was accused of providing illegal kickbacks to doctors through such mechanisms as entertainment, travel, and appointment to advisory boards or speaker programs. It paid $422.5 million to settle the case and signed a “corporate integrity agreement” to ensure that its promotional functions would comply with a federal anti-kickback statute.

Last week Preet Bharara, the United States attorney for the Southern District of New York, announced the filing of a lawsuit accusing the company of providing even more blatant kickbacks to pharmacies to generate sales of one of its better-selling drugs. The suit charged that Novartis provided illegal rebates and discounts to 20 or more influential pharmacies based on their success in persuading institutions and doctors to switch patients from other drugs to Myfortic, an immune suppressant used to prevent rejection of kidney transplants. (If prosecutors want to send an even stronger message, they should also pursue the corrupt pharmacies, which are suspected of pocketing tens or hundreds of thousands of dollars in illegal kickbacks.)

http://www.justice.gov/usao/nys/pressreleases/April13/NovartisLawsuitPR.php

And Pharmacists are not immune from corruption either.

http://www.dailynews.com/opinions/ci_23150510/samuel-i-fink-improper-pharmacist-kickbacks-threaten-health

 

Efforts to reduce health care spending have given rise to questionable financial arrangements that may be jeopardizing the health of California patients.

Some health insurers are improperly incentivizing pharmacists to switch patient medications to older, cheaper, non-chemically equivalent drugs from those originally prescribed by their doctor, often without patients’ or physicians’ knowledge.

As a former businessman I do not begrudge any company a profit…even a good profit but I also expect honesty in reporting how they spend their money and in the case of health care there should be some compassion — just a smidgen of concern for the patient.  Just how much compassion is there in a $10,000 per treatment cancer bill?  The message is, “Either pay the price or die.”

 

That leaves us with the question, “What do we do about this situation?  How do we make drugs affordable and accessible to patients?  That doesn’t seem to be a topic that the U.S. congress is willing to deal with.  In fact, many of our elected officials have great health care plans and don’t have to worry about the high prices.  Then of course there are the millions of dollars the pharmaceutical industry spends on lobbying elected officials to resist consumer protection and if the lobbying doesn’t work, they’ll spend millions more on financing the campaigns of those who will, if elected, support them.

 

In closing let me refer to a point made earlier.  Companies do respond to public opinion, more accurately phrased, they respond to outrage.  The greater the outrage the greater the hazard to their existence so if you want change you must generate outrage and that outrage has to reach two key audiences 1) the congress of the United States and 2) the drug companies.  Go for it!

 

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 new 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. 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.

En Espanol

Puede comentar en el espacio proporcionado o por correo electrónico 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 usted convence a una persona de ser donante de órganos y tejidos puede salvar o afectar positivamente a más de 60 vidas. Algunas de esas vidas pueden ser personas que conoces y amas.

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

Si quieres correr la voz acerca de la donación de órganos personalmente, tenemos otra presentación de PowerPoint para su uso libre y sin permiso. Sólo tienes que ir a http://www.organti.org y haga clic en “Life Pass It On” en el lado izquierdo de la pantalla y luego sólo tienes que seguir las instrucciones. Esto no es un espectáculo independiente, sino que necesita un presentador pero es profesionalmente producida y sonido hechos. Si usted decide usar el programa le enviaré una copia gratuita de mi libro electrónico, “Cómo obtener un pie” O “que le ayudará con habilidades de presentación. Sólo tiene que escribir a bob@baronson.org y por lo general usted recibirá una copia del mismo día.

Además … hay más información sobre este sitio de blogs sobre otros donación / trasplante temas. Además nos encantaría que te unas a nuestro grupo de Facebook, la Iniciativa de Trasplante de Órganos Cuantos más miembros que obtenemos mayor será nuestra influencia con los tomadores de decisiones.

 

Post-Transplant Depression — What It Is and What To Do.


This is a compilation of information from various sources.  It does not constitute medical advice.  Please consult your physician about your condition and base your treatment decision on his or her advice, not on what you read here.

Post-transplant depression is real.  There are no statistics of which I am aware that indicate the percentage of organ recipients that suffer from the malady but there are enough reports of the problem to suggest it is no small number.

The extent to which your emotional health is affected by a transplant depends on a complex interplay of your health status and personality, genetic factors, social support, financial situation, and other concerns.

For most people, emotions about their experience change and evolve over time. Typically, feelings of sadness or anxiety are transient. For some, however, these feelings may persist and interfere with daily life.

According to the Mayo Clinic Depression is more than just a bout of the blues.  It isn’t a weakness, nor is it something that you can simply “snap out” of. Depression is a chronic illness that usually requires long-term treatment, like diabetes or high blood pressure. http://www.mayoclinic.com/health/depression/DS00175

Depression is a complex disease and sometimes it is difficult if not impossible to find a reason for the problem.  One that I hear most often is guilt.  Some recipients feel guilt because, they say, someone had to die in order for them to live. Others feel guilt because they are doing well while other transplant recipients may not be so fortunate.  Those feelings sometimes proves to be a very heavy burden for many transplant recipients but it may be only one potential cause of their feelings. There are some other factors that may contribute to post transplant depression as well:

  • Anger or depression, because they don’t feel better as soon as they expected.
  • Frustration, because of chronic or lingering fatigue that keeps them from things they want to do or accomplish.
  • Mood changes caused by the drugs that must be taken following a transplant.
  • Dissatisfaction with old plans and goals. Identifying new priorities and making lifestyle changes may feel good, but can also be stressful.
  • Fear that the old illness might return and affect the new organ

Symptoms of depression include:

  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

Despite the feelings of gloom and doom, though, there is reason to be optimistic because most people with depression will eventually  feel better with medication, psychological counseling or other treatment.

Still another reason for post-transplant depression is Post Traumatic Stress Disorder (PTSD).  Post-traumatic stress disorder is a type of anxiety disorder. It can occur after you’ve seen or experienced a traumatic event that involved the threat of injury or death.  Obviously getting an organ transplant falls into that definition. http://health.nytimes.com/health/guides/disease/post-traumatic-stress-disorder/overview.html

Symptoms of PTSD fall into three main categories:

1. “Reliving” the event, which upsets day-to-day activity

  • Flashback episodes, where you re-live the event so it seems to be happening again and again
  • Repeated traumatic memories of the event
  • Frequent nightmares of the event
  • Strong, uncomfortable reactions to reminders of the situation

2. Avoidance

  • Emotional “numbing,” or feeling as though you don’t care about anything
  • Feeling detached
  • Being unable to remember important aspects of the trauma
  • Lack of interest in normal activities
  • Hiding your moods
  • Avoiding places, people, thoughts or things that remind you of the trauma
  • Feeling as though you have no future

3. Arousal

  • Difficulty concentrating
  • Startling easily
  • An exaggerated response to things that startle you
  • Feeling more aware of negative things
  • Irritability and angry outbursts
  • Difficulty falling or staying asleep

If you have severe depression, a doctor, loved one or guardian may need to guide your care until you’re well enough to participate in decision making. You may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve. http://www.mayoclinic.com/health/depression/DS00175/DSECTION=treatments-and-drugs

Here’s a closer look at your depression treatment options.

Medications
A number of antidepressant medications are available to treat depression. There are several different types of antidepressants. Antidepressants are generally categorized by how they affect the naturally occurring chemicals in your brain to change your mood. You can view the entire section on medications by following the above link to the Mayo clinic.

Types of antidepressants include:

  • Selective serotonin reuptake inhibitors (SSRIs). These medications are safer and generally cause fewer bothersome side effects than do other types of antidepressants. SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). The most common side effects include decreased sexual desire and delayed orgasm.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications include duloxetine (Cymbalta), venlafaxine (Effexor XR) and desvenlafaxine (Pristiq). Side effects are similar to those caused by SSRIs.
  • Norepinephrine and dopamine reuptake inhibitors (NDRIs). Bupropion (Wellbutrin) falls into this category. It’s one of the few antidepressants that doesn’t cause sexual side effects.
  • Atypical antidepressants. These medications are called atypical because they don’t fit neatly into another antidepressant category. They include trazodone (Oleptro) and mirtazapine (Remeron). Both of these antidepressants are sedating and are usually taken in the evening. In some cases, one of these medications is added to other antidepressants to help with sleep. The newest medication in this class of drugs is vilazodone (Viibryd).
  • Tricyclic antidepressants. These antidepressants have been used for years and are generally as effective as newer medications. But because they tend to have more numerous and more-severe side effects, a tricyclic antidepressant generally isn’t prescribed unless you’ve tried an SSRI first without an improvement in your depression.
  • Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine (Parnate) and phenelzine (Nardil) — are usually prescribed as a last resort, when other medications haven’t worked. That’s because MAOIs can have serious harmful side effects. They require a strict diet because of dangerous (or even deadly) interactions with foods, such as certain cheeses, pickles and wines, and some medications including decongestants. Selegiline (Emsam) is a newer MAOI that you stick on your skin as a patch rather than swallowing. It may cause fewer side effects than other MAOIs.
  • Other medication strategies. Your doctor may suggest other medications to treat your depression. These may include stimulants, mood-stabilizing medications, anti-anxiety medications or antipsychotic medications. In some cases, your doctor may recommend combining two or more antidepressants or other medications for better effect. This strategy is known as augmentation.

Finding the right medication
everyone’s different, so finding the right medication or medications for you will likely take some trial and error. This requires patience, as some medications need eight weeks or longer to take full effect and for side effects to ease as your body adjusts. If you have bothersome side effects, don’t stop taking an antidepressant without talking to your doctor first.

Antidepressants and pregnancy
If you’re pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk to your doctor if you become pregnant or are planning on becoming pregnant.

Antidepressants and increased suicide risk
Although most antidepressants are generally safe, be careful when taking them. The Food and Drug Administration (FDA) now requires that all antidepressant medications carry black box warnings. These are the strictest warnings that the FDA can issue for prescription medications.

The antidepressant warnings note that in some cases, children, adolescents and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting an antidepressant or when the dose is changed. Because of this risk, people in these age groups must be closely monitored by loved ones, caregivers and health care providers while taking antidepressants. If you — or someone you know — have suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help.

Psychotherapy
Psychological counseling is another key depression treatment. Psychotherapy is a general term for a way of treating depression by talking about your condition and related issues with a mental health provider.

Through these talk sessions, you learn about the causes of depression so that you can better understand it. You also learn how to identify and make changes in unhealthy behavior or thoughts, explore relationships and experiences, find better ways to cope and solve problems, and set realistic goals for your life.

Hospitalization and residential treatment programs
In some people, depression is so severe that a hospital stay is needed. Inpatient hospitalization may be necessary if you aren’t able to care for yourself properly or when you’re in immediate danger of harming yourself or someone else. Getting psychiatric treatment at a hospital can help keep you calm and safe until your mood improves.

In this blog we have attempted to give you an overview of depression and its causes along with known effective treatment options.  Please remember, this is only a blog, it is not medical advice and we strongly suggest that you take no action based on what you read here.  See a qualified physician, ask a lot of questions and then make a decision.

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.

Help Your Caregiver — Get Your Own Glass of Water


When you are very ill or recovering from a serious illness or surgery our caregivers (spouses, partners, friends, relatives) have a most difficult task.  Being a caregiver can be physically and emotionally draining and strange as it may seem the patient may sometimes have to offer care to the caregiver.  Care in the form of consideration and gratitude.  Remember the expression, “When mamma’s happy, everybody’s happy?”  Same goes for caregivers.

As a heart transplant patient with a wife who would do anything for me and did, I can now reflect on my recovery period and easily see the number of mistakes I made as she tried so hard to meet my every need, and take care of the house while running two businesses.  To this day I have no idea how she did it and I will be forever grateful.  My ruminations on the subject led me to write the following advice to others who may be in the same situation now or who could be in the future.

Make it easy on your caregiver if you want to do what’s best for you.

  1. Do as much for yourself as you possibly can. If your physician says you can get up and walk around do it as often as possible. Get your own glass of water.
  2. Learn your meds. Know what they look like, what they do, how often you take them and when they must be refilled and do all of it yourself.  Plan ahead for refills and find a pharmacy that will deliver to you on short notice so no one has to go running after prescriptions at the last minute.  You can do it sitting and you don’t need a caregiver to do it for you.
  3. Know your condition.  When you talk with your doctor or coordinator take notes.  It is your job to know about your health you cannot and should not depend on someone else to “remember what the doctor said.”
  4. Make your own meals but be sure they are nutritious. You either just got a new organ or you are about to get one. Don’t cause further problems by eating and drinking the wrong things.
  5. Only ask your caregiver for things you absolutely can’t do for yourself. If you can’t drive, you may need a ride or the caregiver may have to run errands for you.  If you are on medication that causes some mental confusion or fatigue your caregiver should be involved such as in dealing with legal papers, insurance etc.  But you should take over these responsibilities as soon as you possibly can.
  6.  If you have children, especially young ones, you may not be able to get involved in strenuous activities. The Children need to know this and your caregiver may have to take on some of this responsibility…for awhile.
  7.  Before making any request of your caregiver ask yourself this question, “Am I taking advantage of my caregiver by asking — is this something I can do myself?”
  8. Show gratitude and consideration. Taking care of another person can be emotionally and physically exhausting. Tell that person how grateful you are and ask what you can do to make it easier on them.  Every once in a while, get a glass of water for the caregiver.

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.

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.  

Donation to Transplantation — How it Works


It is only fitting that on the eve of the fourth anniversary of my heart transplant that blog 100 on this site addresses  the donation/transplantation process.   My undying thanks to my donor, his family and my caregiver wife for giving me these extra years.  Bob Aronson

Joel Newman is the Assistant Director of Communications for the United Network for Organ Sharing (UNOS).  UNOS coordinates all organ transplants in the United states and is located in Richmond, Virginia.  In response to my request for a guest blog on how the donation/transplantation system works, Joel wrote the following.  Our sincere thanks to him and all the dedicated people at UNOS for their life saving work and for allowing us to use them as a resource.

How It Works

By Joel Newman, UNOS

Since the first successful organ transplant in 1954, more than 500,000 transplants have been performed in the United States.  About 250,000 transplant recipients are alive today, and most enjoy a greatly enhanced quality of life as a result of this life-giving therapy.

Under federal contract, UNOS (United Network for Organ Sharing) maintains an extensive national transplant network to assist medical professionals in the recovery and allocation of donated organs.  This network is called the Organ Procurement and Transplantation Network (OPTN).

This is a brief overview of the processes involved in listing transplant candidates, organ donation and organ allocation.  We at UNOS are glad to address more specific questions.

 

Transplant Evaluation and Listing

To be considered for a transplant, a person approaching end-stage organ failure must be evaluated at one of roughly 250 transplant hospitals nationwide.  A transplant program’s medical team will address issues such as:

  • Will a transplant effectively treat his or her disease?
  • Does this person have other medical conditions that would complicate his or her care?
  • Can this person participate in his or her own care by taking medications on time, following medical advice, keeping appointments, etc.?  Does he or she have family or caregiver support to assist if needed?
  • Does this person qualify for insurance for transplant costs?  If not, can he or she raise funds to defray expenses?

The transplant team makes individual decisions according to its medical judgment.  If the program agrees to accept the person as a transplant candidate, it will submit a set of basic data to the OPTN.  The OPTN maintains a highly secure, continuously operated computer database to compare medical and logistical information about transplant candidates at hospitals with that of available organs from deceased donors.

An issue sometimes raised is whether a person’s past history of substance abuse, non-compliance with medical care or other self-destructive behavior may count against the possibility of listing.  While this remains a medical judgment of the transplant team, their emphasis is not on past behavior but current and likely future status.  If the team is reasonably assured that the person has ended harmful behavior and is not likely to resume that behavior once transplanted, they would be more likely to list the person as a transplant candidate.  UNOS is not involved in any program’s decision to list a transplant candidate or remove a candidate once listed.

Organ Donation and Recovery

Organ transplantation depends entirely upon the generosity of one human being to help others through the gift of organ donation.  While this gift may involve a living donor, we will focus here on donation from those who have recently died in a hospital and who meet criteria for donation.

An organ procurement organization (often called an OPO) is responsible for several key functions in the donation process, including:

  • identifying potential donors
  • documenting donation consent
  • collecting key medical history and lab test results to assess organ function and risk of any diseases that might be transmitted to recipients
  • entering donor information and organs available for matching into the OPTN database
  • assuming a transplant center accepts the organ offer, arranging for logistics of organ recovery, preservation and transportation

Most deceased organ donors in the U.S. encounter brain death (a complete and irreversible loss of brain function, determined by physicians not involved in the donation process).  For such potential donors, respiration and circulation can be maintained artificially for some time (commonly 24 to 48 hours) after brain death has been pronounced.

In other instances, donation may be possible for some people who die in a hospital setting from cardiorespiratory failure.  The person’s treating medical team (in no way involved with organ donation) must conclude that he or she cannot survive but will die of cardiac failure instead of brain death.  The next of kin must agree that death is imminent and that they will agree to end supportive care.  Only then, if the individual meets other criteria for donation, would donation be considered.

Surgeons with specific training and experience remove the organs to be transplanted.  Each organ is packaged in sterile conditions and carefully labeled with a unique identification number to be matched with the recipient when it arrives at the transplant hospital.  The organ cannot be frozen, as this would cause permanent damage to the blood vessels supplying it.  It is preserved in a series of sterile containers that are then surrounded by a solution of wet ice.

Transportation arrangements for deceased donor organs will differ according to the type of organ, the circumstances of the donation, and the distance between donor and recipient hospital.  If they are to be used within a local area, ground transportation (ambulance or chartered vehicle) may be used.  Hearts, lungs and livers, commonly used within a few hundred miles of the donor location, often travel by charter air flight along with a team from the receiving transplant center.  Kidneys have the longest preservation time (commonly up to 36 hours from recovery).  If they are being transported over long distances, they may travel on commercial flights and be delivered to and from the airport by a courier service.

Organ Allocation

Federal law and regulation charge the OPTN to maintain an allocation system that promotes equity and efficiency, minimizes wastage of transplantable organs, and allows individual medical judgment in evaluating and accepting organ offers.

Candidates do not have a designated “ranking” on a waiting list until the OPO enters data for a given organ offer.  The characteristics of each offer may be different in terms of donor size, blood type and location, thus the rank-order of potential recipients will be unique to each offer.

The OPTN computer system generates a “match run” list.  This displays which potential recipient is to be offered each organ in sequence.  Using the match run results, a specialist at either the OPO or UNOS notifies the medical teams for the highest-ranked candidates and provides additional detail to help the team evaluate the organ offer.  This initial notification is usually sent electronically via computer or text message, but the transplant program may request additional information by phone.

Once the transplant team for the highest-ranked patient is notified, they have one hour to review detailed information about the donor and the organ and either accept or refuse the offer.  If the organ is accepted, arrangements are made for recovery and transportation.  If the transplant program declines the offer, it will note a refusal reason back to UNOS.  The offer process will continue either until the organ is accepted or until no one can accept it in time to arrange a successful transplant.

The OPTN matching system is programmed to reflect many factors.  These include medical data known to affect the likelihood of a successful transplant and ethical principles to promote fairness and public trust in the transplant system.  Public trust is especially vital, for if people perceive that the system is unfair they may choose not to support it through organ donation.

In general, OPTN organ allocation policies seek to balance two overarching principles.  One is equity – ensuring that each candidate has an equivalent opportunity to be considered for organ offers according to his or her specific need.  The other is medical utility – ensuring that the system is able to transplant as many people as possible and with the best possible survival.

In theory, the candidate who is first on the match run list for a given organ should be both in great need of the transplant and have a reasonable chance for long-term survival and quality of life afterward.  The specific policies used to generate the computerized match run are weighted statistically to maintain a balance of equity and utility.

While the specific weight of each factor varies according to each organ type, common factors considered in the match run include:

  • how well the donor and potential recipients match in terms of blood type, body size and immune system compatibility
  • (for heart, lung, liver and intestinal organs) the candidate’s medical urgency, with sicker patients getting highest priority
  • the relative distance between donor and recipient (local recipients are considered before more distant patients, to minimize time the organ must be preserved and provide the best chance for a successful transplant)
  • if all other factors are equal, priority is given to patients younger than age 18 if the donor is younger than 35 (for kidneys) or 18 (for all other organs)

The matching system does not consider social factors that do not affect medical need or prognosis, such as a person’s wealth, celebrity status or cause of his/her organ failure.

All donation and transplantation professionals work to save and enhance as many lives as possible through the selfless gift of organ donation.  We share in the hope that in the future, no one will suffer or die needlessly because an organ was not available in time.

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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 lovePlease view our two brand new video “Thank You From the Bottom of my Donor’s heart” on You Tube at http://www.youtube.com/watch?v=ifyRsh4qKF4  This video was produced to promote organ donation so it is free and no permission is needed for it’s use.

Another important video is “A Transplant for Nurse Lori” this brave woman has Multiple Sclerosis and needs help paying her share of the bill for a procedure that can halt the disease in its tracks and even reverse some of it.  Watch the video at http://www.OrganTI.org.

Also…there  is more information on this blog site about other donation/transplantation issues.

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.

Stop the Insanity Now!


(The writer, Bob Aronson, got a new heart on  August 21, 2007 at the Mayo Clinic in Jacksonville, Florida.  He has been an outspoken advocate for blood, organ and tissue donation, transplantation and related issues)

Due to several economic and political factors America’s health care safety net is in danger of disintegrating leaving millions of people with only emergency rooms for their primary care 

As the economy worsened the cost of health care and health insurance continued to rise and millions of Americans whether employed or not found themselves with little or no coverage even if their conditions were life threatening.  A good number of these people were critically ill, jobless, had exhausted their financial resources and could only turn to Medicaid for help (Medicaid is partially funded by the U.S. Government but administered by the individual states).

Many officials were elected by promising tax cuts and deficit reduction.  Then, just a few weeks after the last election, their legislatures went into session and members of the bodies knew their promises were still fresh in the minds of voters.  Unlike the federal government the law does not allow states to end the year with a deficit.  So as the budget disparity grew tax increases were considered to be political suicide even if such moves would have helped solve the problem.  That left legislators with only one way to address the state’s deficit — cut programs.

The top revenue eaters in all states are education and Medicaid.  There have been or will be drastic spending cuts in both areas.   While several states like California, New York, Texas and Florida are considering Medicaid cuts, Arizona took the first step by eliminating the program’s coverage of most organ and tissue transplants. The move immediately affected 98 legal pre-approved Arizona citizens who were promised that Medicaid would cover their procedures.  Texas, threatens to go even farther and some powerful people there want to eliminate Medicaid completely

Experts agree that anyone who is approved to be on the transplant list has a life-threatening illness that requires treatment beyond what standard medical procedures and treatments can provide and that means tissue and/or organ transplants which are highly effective but expensive.   A person can only be “listed” if a physician who specializes in their disease is convinced there is no other way to save the patient’s life.  Then, that same expert must convince a hospital transplant committee, also made up of experts, that the patient’s name should be submitted for listing.  At that point the name and condition of the patient is forwarded to the United Network for Organ Sharing (UNOS) in Richmond, Virginia for placement on the national waiting list.  UNOS coordinates all organ and tissue transplants in the United States.  Currently there are over 110,000 people on that list. 

When Arizona decided to break their promise to the 98 patients they knew that without the promised transplants every one of these terminally ill people would die. Two have passed on already and a Phoenix transplant surgeon says as many as 30 more may die in 2011. 

To make matters worse, the legislature and Governor Brewer used outdated and erroneous data to justify the action saying “Transplants are Cadillac options and aren’t very effective anyway.”  The truth is that the only option to a transplant is death; there are no other medical remedies for these patients  and — organ and tissue transplants do work.  Hearts have a 90-95% success rate (this writer is one of them) kidneys have an 85-90% success rate and lung transplants are successful about 75% of the time.  The American Society of Transplant Surgeons, the American Transplantation Society and UNOS have together protested the use of incorrect information and have provided the Governor and the legislature with the latest data which shows beyond a doubt that the procedures are not only successful but save money in the long run.  Governor Brewer and the Legislative leadership has ignored that information and continue to use the same old incorrect data in order to justify their unconscionable actions.  

The Arizona lawmakers insist that the transplant cuts will save $5 million but the state’s own research indicates the figures are lower — $800,000 in 2010 and $1.4 million in 2011.  Governor Brewer has $30 million in discretionary federal stimulus funds that she could use to save these lives.  She says the money is spoken for but won’t say where it’s going.  In the meantime she found $2 million to conduct algae research and another nearly $2 million to fix a roof. 

Steven Daglas a 30-year-old Republican from Illinois with whom I’ve talked studied the Arizona budget carefully and found 26 ways to cover the cost of the transplants without raising taxes and without negatively affecting other programs.  Acting in a respectful, responsible and helpful manner he presented his findings to the Governor.  He, too, has been ignored.

Now Arizona wants to cut almost 300 thousand people from Medicaid which will place a burden on hospital Emergency Rooms that are required by law to treat anyone who comes in, insured or not.  That most certainly will cause a hike in the cost of healthcare and penalize hospitals and patients at the same time.   If you think ER waiting times are long now wait a few months, it will get much worse.

Governor Brewer in a game of smoke and mirrors has stated that she is setting up a fund for critical cases that should help the Arizona 98 get their transplants.  But the fact is this action may make it even less likely because by removing nearly 300 thousand people from Medicaid the fund will be depleted almost immediately and the likelihood of the transplant patients getting the care they need is below minimal.

Unfortunately this is only the beginning.  Other state legislatures are meeting, too and most of them are watching Arizona very carefully to see what the Grand Canyon State is going to do.

I believe, as do many Americans, that allowing the critically ill to die in order to balance a budget or achieve political gains is wrong and criminal in nature.  This is a civil and human rights issue and no one should have the right to decide who lives and who dies.  In the case of Medicaid those who die will be mostly poor who have exhausted all other alternatives.  We can find absolutely no justification for this cruel and unconscionable action.  It must be stopped, you can stop it.  Let your voices be heard.  Join Facebook’s Organ Transplant Initiative (OTI) and/or Dream of Life Coalition (DLC).and become a volunteer to stop this insanity.

On March 5, 2011 The Dream of Life Coalition will hold a rally at the state capitol in Phoenix, Arizona to send a strong message to Arizona about the immorality of denying Medicaid coverage to transplant patients.  It will start at 9 AM at St. Mathew church. Walk with us and show your support.  There’s a hole in the dam and we have an opportunity to patch it.  Can you stand by and do nothing?

Please view our 7 minute video “A Promise Broken” on www.savethearizona98.com.  Also…there is more information on this blog site about other donation/transplantation issues.  We would love to have you join our Facebook pages, Organ Transplant Initiative  and The Dream of Life Coalition  The more members we get the greater our impact on increasing life saving organ donation

Please 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 a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.

Save Arizona Lives, Make This Video Viral


The campaign to save the lives of the Arizona citizens who were promised and then denied Medicaid coverage for their terminal illnesses is picking up steam.  Organizations from all over the United States and the world are joining the effort to get the Arizona legislature and Governor Jan Brewer to reverse their inhuman decision. 

Two of our Allies, Transplant Recipients International (TRIO) and The FAIR Foundation have thrown their significant weight behind this effort and they are having a huge impact.  

Visible cracks in the Brewer administration foundation are appearing daily.  Arizona legislative leaders are now saying they want to review the decision, even Governor Brewer has indicated she might, might be willing to discuss the issue but that will only happen if they really feel the pressure.

To this point Governor Brewer has defended her decision by using inaccurate and, in some cases, totally false data but it is being challenged daily by prominent physicians, medical associations and even, the United Network for Organ Sharing (UNOS) which usually steers clear of controversial subjects (UNOS coordinates all organ transplants in the United States). 

All of the Television networks, have been reporting on the issue as have newspapers and radio stations.  Our Video, “A Promise Broken” which was released yesterday January 6, 2011 has been watched by thousands from all over the world but we are just getting started.  We need to continue to build the pressure the Arizona politicians are beginning to feel. 

“A Promise Broken” is a powerful six minute PowerPoint slide show that exposes the misinformation campaign that has resulted in the deaths of two Arizonans already.  You can view this compelling presentation at www.savethearizona98.com  or on You Tube at http://www.youtube.com/watch?v=yq5cGoRMne4  Permission is granted for appropriate use of this production to advance the cause of reversing the Arizona decision to deny transplants. 

On You Tube http://www.youtube.com/watch?v=yq5cGoRMne4 you can find it under “Save the Arizona 98” but because we have little in the way of financial resources we had to upload an evaluation copy created by some free internet software so please be patient as you watch it if it slows down a bit. 

As noted we have no funding to promote this video and we won’t make any from its release because it viewing is free, that’s why we need your help to make it viral.  Please view it and if you like it pass on the URL to others. Post it wherever you can because every time you do we get one step closer to saving lives. 

Because of the Arizona decision to deny organ transplants to Medicaid patients two people have already died.  The longer it takes to change the law, the more deaths we will see.  That’s just not acceptable, so join the cause, and make “A Promise Broken” viral.  Do it now, the lives you save could be someone near and dear to you.  If Arizona gets away with this, it will begin to happen in other states.  The video should become viral…not the program that causes the deaths.

Please help, now.  Your fellow Americans are counting on you. www.savethearizona98.comhttp://www.youtube.com/watch?v=yq5cGoRMne4

If you go to www.savethearizona98.com you’ll find some links on the left side of the page that not only take you to the video but also offer you an opportunity to buy T-shirts and other products (all the profits go to the National Transplant Assistance Fund (NTAF) or there’s a link where you can contribute directly to NTAF and purchase nothing. 

When you click “Play” on “A Promise Broken” let it roll.  The slides will change automatically.  When you’ve finished viewing it you are invited to tell others about it. No permission is needed for it to be used in a manner appropriate to the cause.  Also, we’d appreciate if you returned to Bob’s NewHeart and commented about what you’ve seen.

Please visit and join my Facebook site, ORGAN Transplant Initiative http://www.facebook.com/group.php?gid=152655364765710  OR — my Facebook home Page http://www.facebook.com/?sk=messages&tid=10150094667020070#!/ . 

 The more members we get the greater our impact on increasing life saving organ donation

Please 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 a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.

Waiting for a Kidney — The Jay Robare Story


Jay Robare of Florida  designed the Save the Arizona 98 poster. Jay, is waiting for a kidney transplant. I offer these stories in order to get people to join the Save the Arizona 98 movement.  In case you missed it Arizona first promised then denied 98 of its pre-approved citizens that Medicaid would pay for their organ transplants.  These people will die without the procedure. 

“Save the Arizona 98” is a two fold program.  1) to work to reverse the decision to disallow Medicaid payment for transplants and 2) to raise money for the transplants in case the decision is not reversed.  If the decision is reversed the money raised can go to other transplant patients in need.  Please read my blogs about the issue and use the links provided below  to join our group. Here’s Jay’s story in his own words.

Jay Robare’s story
Waiting for a Kidney

By the time that I was approved for Medicare, I had gone through all my savings and my limited insurance coverage. I had to quit working because my endurance was gone and because I was not working, I could not afford my apartment anymore and I had to start living with others that helped me out. I lost all my furniture and most of my art equipment.

I finally got disability insurance and was qualified for Medicare but not Medicaid since I was making too much money from disability; I got enough to pay rent and had some money for paper products, which costs a lot. I have to dry my hands on paper towels to stay sterile.

I was blessed with $200 in food stamps last year but that has been decreased too; I am out of food by the third week of the month. I keep asking for rides to the various food banks but people are too busy. I am not the only one going through this; most people just can’t understand the magnitude of what we are going through in our lives and in our bodies. I know everyone is having problems for I hear that al the time but when I got sick and started working to get on the waiting list, all my doctors and nurses treated me like I was given a special gift which it is…the gift of life but many people would rather worry about their financial or relationship problem that they will outlive. We won’t outlive our problems, they are literary killing us.

I didn’t even talk about having to do dialysis every night. The type of dialysis that I do is called Peritoneal Dialysis where I store 2,500 milliliters of sugar saline solution for 2 and a half hour cycles 4 times which is all carbohydrates. I have gained 30 Lbs and I look very well fed; my fried Dirk said I looked like I had a beer belly…my last beer was a Heineken last Christmas. One nice thing about PD instead of hemo dialysis is that I have no liquid restraints. On hemo, I could only have 60 Oz a day or I would risk cramping and THAT was a bitch. Cramps formed in muscles that I thought I never had and the pain was so bad it made me yell out for Jesus…made my tech laugh at me.

Speaking of techs, I had clowns that would not listen to me and do the treatment their own way ending up hurting me. For you on Hemo, THIS IS YOUR TREATMENT AND YOUR BODY, don’t take any crap from these people; make sure that your nurse knows and the director knows that you do not want this person touching you again. Another thing that I like about PD is that it is robbing my body of potassium and this lets me eat things that hemo would never let me eat like bananas, mashed potatoes, spinach, hummus, vegetables and fruits. I do have to take something called a binder every time that I eat something. This medicine absorbs all the phosphorus in the food. The binder can be nasty at times, it is very dry and tastes like I am eating chalk. The chalk does a good job but sometimes it is difficult to take. The meds are a chewable but I think they are coming out with a powder soon.

Another med that I have to take because of PD and a bad parathyroid, caused by ESKD is a drug called Zemplar and Sensipar. Both keep my calcium land my PTH levels down. The only problem is that Sensipar has made me nauseous for the last 4 years; I have been throwing up every time I took this drug for 7-8 months. I guess my body has had enough. The doctors, dietitians and I have been playing games for years. I have finally decided to have a perthyroidectomy. After this surgery, I will need to start taking calcium supplements, including eating more pizza and lasagna…LOL I

I get extremely tired sometimes during the day from either walking to the bus stop and going to Publix to get some noodles or walking from the bus stop to my Davita dialysis clinic to get labs done every Monday or Tuesday; I need to send a vile of blood to my transplant hospital every week so they can keep an aye on my health and changes in my DNA.

Last month I had weird liver numbers and they ordered a full set of tests including a liver biopsy which scared me. My local doctors were thinking that I had a liver disease which stored too much copper in my system; they called it Wilson’s disease. Before I got the biopsy, I thought that I was going to have to get a liver transplant as well as a new kidney…I was a wreck! The day of the biopsy came and I wanted to get knocked out but before I knew it, I herd a clink and it was done. I worried for a week but the results came back and I was clean, no Wilson’s disease. Within a week Ann, my transplant coordinator took me off hold and I was back on the waiting list.

I met Bob Aronson about 3 months ago on Facebook. I used to read all his stuff and I, being a troublemaker, would contradict the man. I soon learned that the guy not only knew his stuff but he was a good writer too, we buried the axe and became friends.

This thing with the Arizona 98 has got me drawing again; I used to be so bummed out about not having a life, I gave up drawing but thanks to Betsy, one of my very good friends and Bob, I am drawing caricatures and designing flyers again.

Life is tough sometimes but with my friends, my faith in God and His son Jesus and now that I am drawing again, I can think I can make it through the storm until I get my kidney. I hope this has helped someone.

Don’t forget the Arizona 98 campaign.  there is more information on this blogsite and you can offer futher support by visiting www.savethearizona98.com.  You can also visit and join my Facebook site, ORGAN Transplant Initiative http://www.facebook.com/group.php?gid=152655364765710  OR — my Facebook home Page http://www.facebook.com/?sk=messages&tid=10150094667020070#!/ . 

 The more members we get the greater our impact on increasing life saving organ donation

Please 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 a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.

Arizona –The Rich Get Richer, The Poor Get Poorer and the Sick Get Dead.


 NEWS RELEASE   December 14, 2010

For more information contact Bob Aronson bob@baronson.org

In early October, 2010 Bob Aronson, heart transplant recipient and founder of Organ Transplant Initiative (OTI), started a nationwide drive to reverse the Arizona decision that denies Medicaid patients vital organ transplants.  http://www.facebook.com/#!/group.php?gid=152655364765710   He also has a very popular blog site devoted to donation/transplant issues with recent posts aimed at the Arizona issue https://bobsnewheart.wordpress.com.

 “Everyone on the transplant list is dying,” says Aronson, “And Governor Brewer’s claim that transplants are an optional treatment is totally without foundation.  The only option to a transplant is death. I know, I would have been dead three years ago if I had not received a new heart.” 

Aronson a former Minnesota Governor’s Press Secretary and now living in Jacksonville, Florida says, “I understand how serious budget problems can be, but you don’t solve them by killing your citizens.”  

Organ Transplant Initiative has rallied people from all over the country with their “Save the Arizona 98” campaign.  Additionally the group has a website www.savethearizona98.com where people or organizations can buy T-shirts and other products bearing the slogan, “Save the Arizona 98.”  All profits go to the National Transplant Assistance Fund and there are no administrative fees or expenses charged to the proceeds.  The site also offers the option of donating directly to the fund and designating the specific person or persons you want to help.

“Governor Brewer blames so-called Obamacare for the Medicaid problems,” states Aronson, “But Arizona approved cutting transplants before the Obama bill passed congress.”  He notes that, “While Americans have a guarantee of Life, Liberty and the Pursuit of Happiness, Arizona has opted to deny life and liberty in favor of the Pursuit of Mexicans, because,” he says, “The Governor has diverted millions of Federal stimulus and other dollars, to her border protection program.  Those dollars could have been used to save and enhance lives.  They weren’t.

Permission is granted to copy and use this release in any appropriate manner to help save the Arizona 98. 

From Bob Aronson

If you would like to donate money to help these Arizona patients pay for their transplants, should organs become available, you can do so through the National Transplant Assistance Fund (NTAF).  You can either call 1-800-642-8399 or make your donation on-line at http://www.ntafund.org/contribute/  

Please 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 a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.

Also…visit and join my Facebook site, ORGAN Transplant Initiative http://www.facebook.com/group.php?gid=152655364765710  OR — my Facebook home Page http://www.facebook.com/?sk=messages&tid=10150094667020070#!/ . 

 The more members we get the greater our impact on increasing life saving organ donation

Arizona Governor, “No Transplants for Medicaid Patients (the poor)”


Let’s start this blog with this undeniable medical fact,  “Everyone on the transplant list is dying.”  They are suffering from organ failure and that means sure death unless they get an organ transplant.  I know of what I speak because until August 21, 2007, when I got a new heart, I was dying from end-stage dilated cardiomyopathy. 

By way of this blog I am asking readers to make every effort to help save the 98 people in Arizona who were approved for transplants but have now been denied the life saving procedure.  You’ll find a donation link at the end of this posting.

The Decision by Arizona Governor Jan Brewer and the state legislature to cut Medicaid coverage for most organ transplants is arbitrary, cruel in the extrreme and, I believe, in violation of both the Arizona and U.S. constitutions. 

As of October 1, 2010 Arizona Medicaid stopped covering heart transplants for non-ischemic cardiomyopathy, lung transplants, pancreatic transplants, some bone marrow transplants and liver transplants for hepatitis C patients.  That means that about 98 people who had previously been approved for transplants will not be eligible unless they can raise the money on their own. Transplants can cost from $150 thousand to $500 thousand which does not include the anti-rejection drugs transplant patients must take for the rest of their lives. 

Arizona will save approximately $5 million by cancelling Medicaid organ transplant coverage.   So — not only have the state’s politicians decided to let 98 people die, they have also decided that human life in the state is worth exactly $51,020.41.  Don’t be surprised if in the future some life insurance company uses that figure to attempt to reduce jury awards in cases of personal injury and death.    

The Arizona Health Care Cost Containment System (AHCCCS) spokeswoman Monica Coury said her agency had the “horrible task” of putting together benefit reductions, and that the transplants affected represent a small number of patients (so that makes it Ok to let them die?).”

“Patients with cystic fibrosis who get a lung transplant might get extra time with a good quality of life, but inevitably the CF will re-infect the new lung,” she said. “Not everyone on that list is going to get an organ anyway.  There is a shortage of viable organs for these folks waiting on the list (so if there are not enough organs why save a few?  We should just let all of them die). ”

Read the story of a 27 year old Cystic Fibrosis patient who was depending on a transplant (but, of course, according to spokesperson Coury, it would only “give her extra time with a good quality of life.” So why bother?). http://azstarnet.com/news/science/health-med-fit/article_c8288a3a-8135-5cc9-bf0d-0745071bd74a.html    

Almost every American political organization agrees that the U.S. Constitution was created to form a government whose sole purpose is to serve the People as stated in the Declaration of Independence.  “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights. That among these are Life, Liberty and the pursuit of Happiness.” 

The preamble to the Constitution states: “We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.”

Founding father Alexander Hamilton maintained that the clause, “Promote the general welfare” granted Congress the power to spend without limitation for the general welfare of the nation.  So I ask, why is it more acceptable to limit spending on general welfare but to give defense an almost open checkbook, especially when both items are given the same emphasis in the same sentence of the preamble to our constitution?

The Constitution of the state of Arizona says, in Section 3 of Article ll in the Declaration of rights, “The Constitution of the United States is the supreme law of the land.”  That means Arizona must adhere to the guarantee of the General welfare in the U.S. Constitution.  Their own constitution gives them no options on the matter.. 

Article ll of section 4 of the Arizona constitution declaration of rights also says, “No person shall be deprived of life, liberty, or property without due process of law.”  Due process of law usually meaning the right to be heard in court, has been denied here, too.  Some say the Governor and the legislature have acted as vigilantes in sentencing 98 Arizona citizens to death.  

If we allow Arizona and perhaps other states to arbitrarily sentence people to die (mostly poor people by the way)  where will it end?   During congress’ deliberations on a health care bill it was charged that the Obama Administration would set up “Death Panels” to decide who would live or die if the new health care bill was passed.   Interestingly, “Death Panels” have been established, not by Obama, but by the very people who condemned them. 

Please make your most vigorous protest to the Governor of Arizona by calling her office at 602 542 4331 emailing her at http://www.governor.state.az.us/Contact.asp or sending a letter to Honorable Governor Jan Brewer 1700 West Washington Phoenix, Arizona 85007. 

Additionally I suggest you express your outrage by getting the facts out to Radio talk shows, Facebook Friends, Tweeters, newspaper comment pages, news agencies and anyone else you think could influence the decision makers in Phoenix.  This is not a frivolous matter, 98 lives are at stake here and we must do everything in our power to save them.

If you would like to donate money to help these Aizona patients pay for their transplants, should organs become available, you can do so through the National Transplant Assistance Fund (NTAF).  You can either call 1-800-642-8399 or make your donation on-line at http://www.ntafund.org/contribute/  

Please 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 a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.

Also…visit and join my Facebook site, ORGAN Transplantation Initiative http://www.facebook.com/group.php?gid=152655364765710  OR — my Facebook home Page http://www.facebook.com/?sk=messages&tid=10150094667020070#!/ . 

 The more members we get the greater our impact on increasing life saving organ donation.

Organ Donors Are Heroes, Are You?


  (Bob Aronson, the author of this blog, received a new heart on August 21, 2007)

April is National Donate Life Month in the U.S.  It is a time for us to not only become donors but to also encourage others to do the same.  The 18 people who die every day while waiting for an organ is a national disgrace.

Brotherly love is a concept repeated often not only in the old and new testament http://www.eliyah.com/brother.html but in every other religion as well.  How does the concept apply to your life, do you pay lip service to it, or do you live it?

If you were dying from organ failure would you accept a new organ from a total stranger?  If you answered, “Yes,” then it seems logical that a total stranger would accept an organ from you. 

The greatest ethical code ever written consists of just ten words, “Do unto others what you would have done unto you.”  A variation of these words exists in almost every religion http://www.religioustolerance.org/reciproc.htm .  With that in mind, how can anyone possibly choose not to be an organ donor?  It is the neighborly thing to do, it is the right thing to do and, it is the ethical thing to do. 

Polls show that over 90% of us are in favor of organ donation but only about 35% actually become donors.  By not “Getting around to it” you have checked the “No” box on the registration form.  In light of “Brotherly love,” and, “The Golden Rule,” is “NO” really your preference?  Do you really want to take your organs and tissue to the grave while thousands of people die waiting for them?

Organ donors are among the real heroes of our society. They have made a conscious decision to help others live.  Living donors make a tangible sacrifice; they give up a part or parts of their bodies and undergo many inconveniences and some expense to do so.  Donor families often make their decision in the presence of a dying loved one. 

All too often people who are not registered organ donors die and their families must make the donation decision under great emotional stress.  Among these families are parents who agree to share their loved one in order to save lives.  Sometime the loved one is a child.  I cannot even begin to empathize with the rush of emotion they must feel.  Saying, “No” would be the easy thing to say. 

I have a Facebook page called, Organ Transplant Initiative a site with thousands of members who share their thoughts, emotions and opinions with the rest of us.  Following are some comments (edited for brevity) from people who willingly gave permission to recover life-giving organs.

  •  My daughter (December 16, 1983 to December 10 2006 was an organ an tissue donor she saved lives.  I know you are in heaven, you are my angel.  Rest in peace.  Love an miss you sweetie every day.  Please be an organ donor. 
  • We make a great family don’t we.  My daughter 29th Oct 1983 -6th Sept 2004, saved 4 lives here in Australia.  
  • She is in heaven…She’s in the same place as my husband, he too was an Organ Donor saving 4 people here in Illinois. 
  • I am also the mother of an organ donor…my son, Patrick saved 7 lives and made a difference in 3 others.
  • My daughter was also an organ donor. By giving, our daughter made a difference in someone’s life. 
  • I… donated a kidney to my friend 6 weeks ago and it was the absolute most life-changing experience of my life. It was amazing! The Lord is the One who set the whole plan in motion and ordered every step throughout the evaluation process and surgery. God bless you.

 And — there are grateful organ recipients, too.

  •  Thank you for your wonderful gift of life.  If it wasn’t for generous people like you…I wouldn’t be here today:) I am a liver transplant recipient and waiting for a kidney. Love & God Bless 
  • I am very, very sorry for the loss of your daughter. It is so scary for me to even think about. THANKS SO MUCH for making the decision to donate all of her organs. She’s definitely an angel living on in many. My aunt is waiting on a lung transplant…which, of course, is bittersweet. Bless you and your family! 
  • My daughter was killed in a car accident 17 years ago at the age of 14. She was an organ and tissue donor, too. We can help others to understand the importance of making the decision to become an organ and tissue donor.  
  • You are my hero for donating her organs.  My husband and I are waiting for our hero. My husband has been… on the liver transplant list for 3 years now. Words will never be enough for what you have done. May God bless you and your family. Love and prayers. 
  • May god continue to bless your family. My brother received the gift of a kidney many years ago. We never knew the circumstances as to how we received it but we give many thanks to the family out there who made the conscious decision to donate. Thank You.

Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – spread the word about the immediate need for more organ donors.  On-line registration can be done at http://www.donatelife.net  Whenever you can, help people formally register.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may save or positively affect over 50 lives.  Some of those lives may be people you know and love.  

 You are also invited to join Facebook’s Organ Transplantation Initiative (OTI)  a group dedicated to providing help and information to donors, donor families, transplant patients and families, caregivers and all other interested parties.  Your participation is important if we are to influence decision makers to support efforts to increase organ donation and support organ regeneration, replacement and research efforts. 

Are You an Alcoholic? Here’s the Test


By Bob Aronson

devil cartoonAlcohol, Drugs and Tobacco can have deadly effects on your organs and constitute one of the leading contributors to the need for organ transplantation.  I have long contended that while organ donation is important we just aren’t making enough headway under the current system.  Too many people are dying because of the organ shortage.  One way of reducing the organ shortage is to diminish the demand.   Healthier living could help achieve that goal. Look at this listing of the short and long term effects of alcohol.

Depending on how much is taken and the physical condition of the individual, alcohol can cause:

  • Slurred speech
  • Drowsiness
  • Vomiting
  • Diarrhea
  • Upset stomach
  • Headaches
  • Breathing difficulties
  • Distorted vision and hearing
  • Impaired judgment
  • Decreased perception and coordination
  • Unconsciousness
  • Anemia (loss of red blood cells)
  • Coma
  • Blackouts (memory lapses, where the drinker cannot remember events that occurred while under the influence)

Long-term effects of alcohol

Binge drinking and continued alcohol use in large amounts are associated with many health problems, including:

 

  • Unintentional injuries such as car crash, falls, burns, drowning
  • Intentional injuries such as firearm injuries, sexual assault, domestic violence
  • Increased on-the-job injuries and loss of productivity
  • Increased family problems, broken relationships
  • Alcohol poisoning
  • High blood pressure, stroke, and other heart-related diseases
  • Liver disease
  • Nerve damage
  • Sexual problems
  • Permanent damage to the brain
  • Vitamin B1 deficiency, which can lead to a disorder characterized by amnesia, apathy and disorientation
  • Ulcers
  • Gastritis (inflammation of stomach walls)
  • Malnutrition
  • Cancer of the mouth and throat
  • More info available at http://www.drugfreeworld.org/drugfacts/alcohol/short-term-long-term-effects.html

I am a recovering alcoholic (since 1982) and know first hand how Alcohol another drunk cartoonprobably caused me to need a heart transplant and cigarettes left me with serious Chronic Obstructive Lung Disease (COPD).   Since I began Blogging in November of 2007, I have published six posts on alcohol’s deadly effects on internal organs.  They are Alcohol and Drugs – Cunning, Mysterious, Deadly; Alcohol May Have Ruined My Heart, How Much Do You Drink; Think Outside the Bottle; Should Alcoholics Get Liver Transplants and How Alcohol Can Kill Your Liver and You. 

These posts have generated numerous responses and questions.  The most common question, though, is, “How can I tell if I am an alcoholic?  A simple answer  is, “If Alcohol is causing problems you  have an alcohol problem!” 

The “Gold Standard” of the treatment industry is the Michigan Alcoholism Screening Test (MAST).  The National Council on Alcoholism and Drug Dependence at  http://www.ncadd-sfv.org/downloads/mast_test.pdf  is a great resource  if you want more information.   I have copied the test and printed it below.  You can take it in the privacy of your home and grade yourself according to the instructions which follow the test.

In order for the results to be accurate your answers must be absolutely truthful, you do no good by lying to yourself so BE HONEST!  I hope you find this information helpful.  

If you take the test and determine that you  need help a good starting point is the Substance Abuse and  Mental Health Services Administration of the U.S. Government (SAMHSA)  http://ncadi.samhsa.gov/links/

 MICHIGAN ALCOHOLISM SCREENING TEST (MAST)

 

Please check one response for each item.

 

1. Do you feel you are a normal drinker? (“normal” – drink as much or less than most other

Yes

No

2. Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening?

Yes

No

3. Does any near relative or close friend ever worry or complain about your drinking?

Yes

No

4. Can you stop drinking without difficulty after one or two drinks?

Yes

No

5. Do you ever feel guilty about your drinking?

Yes

No

6. Have you ever attended a meeting of Alcoholics Anonymous (AA)?

Yes

No

7. Have you ever gotten into physical fights when drinking?

Yes

No

8. Has drinking ever created problems between you and a near relative or close friend?

Yes

No

9. Has any family member or close friend gone to anyone for help about your drinking?

Yes

No

10. Have you ever lost friends because of your drinking?

Yes

No

11. Have you ever gotten into trouble at work because of drinking?

Yes

No

12. Have you ever lost a job because of drinking?

Yes

No

13. Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking?

Yes

No

14. Do you drink before noon fairly often?

Yes

No

15. Have you ever been told you have liver trouble such as cirrhosis?

Yes

No

16. After heavy drinking have you ever had delirium tremens (D.T.’s), severe shaking, visual or auditory (hearing) hallucinations?

Yes

No

17. Have you ever gone to anyone for help about your drinking?

Yes

No

18. Have you ever been hospitalized because of drinking?

Yes

No

19. Has your drinking ever resulted in your being hospitalized in a psychiatric ward?

Yes

No

20. Have you ever gone to any doctor, social worker, clergyman or mental health clinic for help with any emotional problem in which drinking was part of the problem?

Yes

No

21. Have you been arrested more than once for driving while under the influence of alcohol?

Yes

No

22. Have you ever been arrested, even for a few hours, because of other behavior while drinking?

Yes

No

About Scoring this Alcoholism Test Questionnaire

This quiz is scored by allocating 1 point to each ‘yes’ answer — except for questions 1 and 4, where 1 point is allocated for each ‘no’ answer — and totaling the responses.

So in other words, please score one point if you answered the following:

1) No

2) Yes

3) Yes

4) No

5-22) Yes

(Note that this is the current revised version of the MAST; the original MAST included 25 questions and used a more complex scoring method.)

Your Alcoholism Test Score

0-2 = No Apparent Problem

3-5 = Early or Middle Problem Drinker

6+ = Problem Drinker

Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – spread the word about the immediate need for more organ donors.  On-line registration can be done at www.donatelife.net  Whenever you can, help people formally register.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.  

You are also invited to join Facebook’s Organ Transplantation Initiative (OTI) a 3,400 member  group dedicated to providing help and information to donors, donor families, transplant patients and families, caregivers and all other interested parties.  Your participation is important if we are to influence decision makers to support efforts to increase organ donation and support organ regeneration, replacement and research efforts. 

 bob minus Jay full shotBob Aronson is a 2007 heart transplant recipient, the founder and primary author of the blogs on this site and the founder of Facebook’s over 3,000 member Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

 

In Honor of Organ Donors and their Families


We read and hear a great deal about the shortage of organs, incredible stories about “nick-of-time” transplants, multiple transplants and innovations in transplantation but we don’t hear much about the donors who make this all possible.  Being an organ donor is one of the most unselfish, compassionate and noble gestures one can make.  It is particularly noble because in most cases the donor will not be around to hear the praise and thanks.  Paying tribute to donors and their families is one of the most important things we can do.  These mostly anonymous people deserve to be in our thoughts and prayers every minute of every day. 

As you know I am a heart transplant recipient, I only know that my donor was a 30 year old male from South Carolina, nothing more.  I have written to the donor family expressing my gratitude but, like many donor families, they have chosen to remain anonymous.  There are many more, however, who choose to be public about their experience and how we support and honor them is the subject of this blog. 

Prior to my retirement I was honored to have as a client, LifeSource, an organ procurement organization (OPO) that serves Minnesota, the Dakotas and part of Wisconsin.  They were not only a valued client but also became dear, dear friends.  Rebecca (Becky) Ousley is one of the many dedicated people who help to further the LifeSource mission.  Like most OPOs LifeSource does a wonderful job of promoting organ donation and coordinating transplants.  But they are so much more than that, they offer heart felt support to the living, too, especially donor families.  Below is a reprint of their latest blog.  Please read and comment either to this blog or directly to LifeSource at http://www.life-source.org/

From “The Source” by Becky Ousley, LifeSource

One of the things I find remarkable about the work we do at LifeSource is the extent to which we are committed to supporting donor families, both at the time of donation and for years afterward.  Donor families are the cornerstone of the work that we do – without them there would be no transplants.  It is an incredibly generous gift.

I’m always so excited to tell people about this, as many people don’t realize that donor families receive this kind of support in the months and years following donation.  At LifeSource donor families are part of our aftercare program for as long as they wish; we have some families that have been coming to our events for nearly 20 years!   In addition to receiving support and remembering their loved ones, these long time donor families are also able to provide hope and perspective to our families that are more newly bereaved.  That too, is a wonderful gift.

Part of our aftercare program involves facilitating letters between transplant recipients and donor family members.  Either party can write to the other; often, recipients want a chance to say thank you for their gift of life or donor family members may want to share memories about their loved ones.  Donor families and recipients can request to have direct contact with one another and, sometimes, they even meet.  These are often very rewarding relationships.

This was the case today, when I was honored to attend a donor family and recipient meeting with my colleague Jill, whose job it is to support these families.  She connected this pair after some persistent detective work, as the donation and transplant took place more than 40 years ago in 1966!  It was an incredible meeting and I think we were all touched when Steve, the kidney recipient, immediately hugged the donor’s sister and told her he had been waiting for 43 years to give her that hug.

KARE-11 was there to document this wonderful meeting and I encourage you to watch the story by clicking here.

Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – spread the word about the immediate need for more organ donors.  On-line registration can be done at http://www.donatelife.net/index.php  Whenever you can, help people formally register.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may save or positively affect over 50 lives.  Some of those lives may be people you know and love.  

You are also invited to join Organ Transplantation Initiative (OTI) http://www.facebook.com/#!/group.php?gid=152655364765710 a group dedicated to providing help and information to donors, donor families, transplant patients and families, caregivers and all other interested parties.  Your participation is important if we are to influence decision makers to support efforts to increase organ donation and support organ regeneration, replacement and research efforts. 

23% of Donors Can’t Pay For A Transplant


.

I have written before about the inequality of the organ transplant system but the following information caused me and I hope you, too, to consider the topic again.  It is particularly important now because it is an election year and now is the time to put pressure on candidates to make changes in the current health care system.  Here is but another short chapter. 

 

According to a study by Southern Methodist University, http://www.smu.edu/newsinfo/excerpts/cardiac-donation-ethics.html)

“Twenty three (23) percent of organ donors are uninsured.” That means that despite being donors, they would not be eligible for transplants because they could not afford the cost of the procedure. The study goes on to say, “Financing an organ transplant out-of-pocket is prohibitive for all but the wealthiest of Americans. The estimated costs for a heart transplant during the first post-operative year is $478,900, according to the health-care consulting firm Milliman USA. Liver transplant patients typically incur about $393,000 in expenses during the first year”  (Important note…There is no cost associated with being a donor, the recipient’s insurance pays for all charges.  The recipient, though, must have the financial resources to pay for the procedure or he/she will likely be denied a new organ).

 

As an aside, this information makes LifeSharers claims of equity even more absurd, unless LifeSharers will pay the cost of a transplant for the approximately 23 percent of its 11,000 plus members (2,530 people) who presumably lack the finances to afford a transplant..

 

One approach that would make the system more equitable is a national healthcare system that would provide funding for those people who otherwise would fall through the cracks.  At this point, the United States is the only industrialized western nation that does not provide the kind of health care of which I speak.

Additionally, under a national or universal health care system we might be able to address the following sorry statistics: (http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm

  • The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990
  • The United States ranks 20 in life expectancy for women down from 1 in 1945 and 13 in 1960
  •  The United States ranks 21 in life expectancy for men down from 1st in 1945 and 17 in 1960.

If you really care about an equitable health plan in the U.S. write to your Congressperson or Senator now.  Election years are about the only time elected officials really listen…well, kind of.

Please 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 a donor you may save or positively affect over 60 lives.  Some of those lives may be people you know and love.

Please visit and join my Facebook site, ORGAN Transplantation Initiative http://www.facebook.com/group.php?gid=152655364765710  OR — my Facebook home Page http://www.facebook.com/?sk=messages&tid=10150094667020070#!/ .   The more members we get the greater our impact on increasing life saving organ donation.

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