Could an anti-cocaine vaccine help prevent HIV in the process?

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(Photo illustration courtesy of Pixabay)

When I first began to write about PrEP, the HIV prevention pill, I remember someone saying, “Back in my day, we would have been lining up around the block for a pill to prevent HIV. But today’s gay men aren’t.”

Another quipped that gay men “are more interested in ecstasy than a pill to prevent HIV.”

True or not, a brand new medical development raises similar questions. In some ways, it too could be a new tool in HIV prevention. Weill Cornell Medicine and New York-Presbyterian hospitals are now enrolling volunteers for a phase I clinical trial for a cocaine vaccine. That’s right – a vaccine that would prevent you from getting high on cocaine. You could toot up as much as you’d like, but you wouldn’t get high.

Cocaine use among gay men often fuels intense sexual sessions where HIV transmission can become more likely.

“Cocaine addiction is a huge problem that affects more than 2 million people in the United States, and results in more than 500,000 annual visits to emergency rooms,” principal investigator Dr. Ronald Crystal said in a Weill Cornell Medical College news release. “While there are drugs like methadone designed to treat heroin, there aren’t any therapeutics available to treat cocaine addiction. We hope that our vaccine will change that.”

Good cocaine is hard to put down

When I moved back to the Quad-Cities in 2002 to get away from Los Angeles and a raging methamphetamine addiction, and also to care for my dad, for a long time all I did was smoke pot. But when I got back into the bar scene, and was introduced to “good” coke, that became a problem for me too. At one point, most of my paycheck was going to the coke dealer.

At some point in 2012 or 2013, those of us in the coke crowd began to say, “Hey wait a minute. This stuff isn’t coke.”

While dealers often doled out baggies of Calumet, what finally got a lot of us to quit the “coke” wasn’t so much getting ripped off with total crap (as addicts, we were still dumb enough to buy it). Most of us quit using it when it began to keep us up all night, cause us to break down, and generally feel extremely unwell.

It now appears due to certain arrests in the past year or so that we probably were being dealt meth and being told it was coke. Had that good coke continued to flow, I’m not sure I ever would have been able to give it up, and then finally give up cigarettes, alcohol, and marijuana, in that order.

So yay for a potential cocaine vaccine.

How would a cocaine vaccine work?

“While most drugs that target addiction are designed to disrupt some process in the brain, this vaccine, called dAd5GNE, is meant to absorb cocaine in the bloodstream – well before it has had a chance to pass the blood-brain barrier and later produce a dopamine-induced high,” according to the Cornell news release.

The vaccine works by attaching GNE, a cocaine-like molecule, to an inactive virus for the common cold. When the body recognizes the virus and unleashes antibodies, it also will learn to attack cocaine as an enemy, the reasoning goes. The body will respond with a flood of anti-cocaine antibodies, each meant to gobble up cocaine like a Pac-Man, Dr. Crystal said.

While the vaccine has been proven effective on animals, now investigators are looking to enroll 30 active cocaine users. The study is funded by the National Institutes of Health and the National Institute on Drug Abuse.

Before getting the vax, each subject will have to abstain from cocaine for at least 30 days (hard for an addict to do). They’ll be dropped regularly to make sure they are clean during that period.

They’ll get their first vaccine shot in the shoulder, with additional boosters given every four weeks until everyone has had six shots. After the final booster, monitoring will continue for three more months.

“Most people who become cocaine addicts want to give it up, but struggle to kick the habit in the long-term,” Dr. Crystal said. “If this vaccine works, it could represent a lifetime therapeutic for addicts.”

Participants will get $25 per visit – up to $2,400 for those who complete the study. To enroll or for information, contact Aileen Orphilla at 646-962-2672 or email anticocaine@med.cornell.edu.

Pfizer cancer drug may block cocaine memories

Meanwhile, another experimental cocaine addiction treatment recently made headlines. Researchers have found that a drug used in cancer therapy trials treats cocaine addiction “by inhibiting memories responsible for cravings,” according to a Cardiff University news release.

“We have demonstrated that a single administration of a trial drug from the pharmacompany Pfizer can completely obliterate cocaine associated memories and significantly accelerate the end of drug seeking behavior in animals,” said professor Ricardo Brambilla of Cardiff University’s School of Biosciences. “With this drug currently being used in cancer trials, it could be easily repositioned for treatment of cocaine addiction and other drugs of abuse.”

According to the news release, the drug kept mice from progressing to compulsive cocaine users by blocking the creation of long-term memories.

“With drug use recently on the rise, new treatments for breaking addiction are much needed,” said Dr. Stefania Fasano of Cardiff. “The availability of a powerful drug from Pfizer, already validated in humans, could speed up the clinical development of our findings.”

Revolving door from FDA to biopharma industry raises concerns about cronyism

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That darn pharma industry and our nation’s “for sale” faux regulatory agencies. There they go cajoling again.

In a letter published online just moments ago in the always eye-opening British Medical Journal, doctors Vinay Prasad and Jeffrey Bien of Oregon Health and Science University reveal a not-so-shocking truth: A large number of scientists, when they leave the U.S. Food and Drug Administration, go to work for the pharmaceutical industry they once were hired to scrutinize.

“Medical reviewers at the U.S. Food and Drug Administration are vital to effective regulation, interpreting whether a drug’s harm-benefit balance is favourable,” they wrote. “The transition from regulator to advising companies seems logical, but it raises concern as to whether regulators indefatigably act in the public interest.”

Indeed, it allows them to show pharma how to navigate loopholes, cut corners, and, heaven forbid, even work connections with their former employer for the gain of their client. This exact sort of thing is like, oh, I don’t know, former health care executives from hospitals with market dominance being appointed to boards that can effectively keep competition out (i.e., Strategic Behavioral Health’s proposal for a Bettendorf psychiatric hospital).

Monnnney-monnnney-monnnney-monnnney….MONNNNNEY!

The doctors searched the FDA database (drugs@FDA.gov) for medical reviews from 2001 to 2010, focusing on hematology-oncology (life-saving cancer drugs) approvals. The cost of these drugs, known as biologicals, are among the most astronomically priced on the market. But indeed, they save lives.

They identified 55 individual FDA reviewers who assessed the pharma applications for new medicines. Of those 55 during that time period, nearly half (27) continued to work for the FDA exclusively.

But among those who left the FDA, 15 (57.7 percent) landed in the biologics industry or served as consultants for it.

What’s even more concerning is that last month, according to a BMJ news release, “the FDA said it may loosen conflict of interest rules because a shortage of independent experts means that its current rule (no more than 13 percent of advisers with industry ties) is delaying new drug approvals.”

To reporters who have sat through decades of city council meetings in cities across the country like myself, this will ring familiar: City officials who depart the public rolls and then go to work for developers, for example. Nobody knows how to rip through red tape than the guys (and gals) who used to roll it out.

“We are concerned by these findings,” the authors wrote. “If anything, we underestimate the extent of this phenomenon, as not all reviewers’ future careers could be identified.”

Is it any wonder government and healthcare lack both efficiency and adequate oversight? Cronyism is costing this nation more than just billions of dollars, my friends.

First year without dad: When it’s down to just you, you better like you. Thank God I do.

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Dad died a year ago today. For sure it has been the fastest year of my life.

But as I sat at the cemetery bawling yesterday, only then did it really hit me – it’s just me now.

And I mean that in every sense of the word. My dad was my entire life for so long – since the day I moved back to the Quad-Cities in 2002. I made several trips a day to his apartment for many years before moving in with him. And of course I also made several trips per day to the assorted substandard facilities he lived in in his final years, except for 108 days when one of them locked me out.

The void in my life is even bigger than I could have guessed. When you surround yourself with alcoholics and addicts, nobody cares when hard times come. They don’t. They really don’t. If you’re an alcoholic or an addict, you’ll find that out eventually. If you’re an alcoholic or an addict, you know what really matters is the bump, the shot, the tall boy.

“Yeah, yeah, so-and-so’s dad’s died. Hey, let’s get some ding-ding!”

I used to say it myself.

The bar people were gone pretty much from the day I moved in with dad. When he went into a facility, that’s all she wrote.

Thank God they left. It made sobriety easier. I remember once, my friend Scott’s grandma died. She was 100 years old, maybe older. He loved her so much.

We went out that night, to the bar. None of his “friends” showed him any compassion at all. It was as if they were incapable. I’ll never forget the look on his face, or the feeling in the pit of my stomach. “Monsters,” I thought. But I still hung around them for free drugs and alcohol. I was an alcoholic and a drug addict.

And of course, when you’re nearly murdered, that tends to make you pretty much not trust anyone anymore. And that turns people away in droves. And I thought about that, too, as I sat at the cemetery, crying to dad as I had so many times before.

When it’s your family who tries to hurt you? That’s the worst hurt there is, I think.

I told dad at least I had raised hell about the substandard elder care in our community, and at least I educated a whole lot of people about his disease. And hey, I got to report undercover from the Rock Island County Jail, held there on no charges at all!

That truly was a blessing, and I’m being completely serious. I remember, when I heard someone cock a gun, and start shooting blanks “click, click, click” … I remember praising God for helping me become sober, for going back to work and helping people with my writing, and for showing my dad that I could be the man he always knew I was.

Most of all, I thanked God for giving me my self-respect back.

And I prepared for the bullet to the head I was certain I was going to take.

“They were f***ing with you,” one healthcare provider told me. “That’s what they do in the Rock Island County Jail. They’re known for it.”

Well, yeah.

But the reason I really thought they were going to kill me was this: I heard one guard, I’ll call him “J.,” say in his classic foghorn voice, “(Blankety Blank) tried to kill him last year, but he woke up on his couch.”

Who did he say that to? A high-ranking politician who was hanging out in the jail. I did not hear her utter a response. But I’ll tell you this: The silence alone was chilling.

I knew the politician and Blankety Blank were an acquaintance, because Blankety Blank boasted to me once or twice that he knew her. But this?

And “J.” feeling chummy enough with her to tell her what “Blankety Blank” allegedly had done? (Through the hands of my cousin and his friends, obviously, if in fact Blankety Blank really did have anything to do with it at all, or if that was just more s@#t talk for me to hear and get upset about)

It was one year prior to that day, at least to the same week, that my cousin and his friends assaulted me, pinned me down, and injected me with a needle. When I woke up, there was a nebulizer in my pocket. Classic (attempted) homicide disguised like an overdose. At least that’s exactly what it looks like to me.

And so very curious that other people who traveled in the same circles I did have indeed died in similar, mysterious ways. “Overdose.” “Suicide.” “Unknown.” “Under investigation.”

I showed my AA sponsor the marks on my arms. He said, “You had the shit beat out of you. Have you had enough?”

Apparently I had because it was the last time I ever took a drink.

And that person “J.” mentioned? Well, he has since been in the news himself for something rather shocking. So now it’s just doubly-triply chilling.

Did I imagine these things? Did I just “hear wrong?” because I was in distress in the jail?

I did dance around naked after all in an attempt to amuse myself. But I remember that. No, that wasn’t “a trip,” that was me using humor to keep going and “stay positive.”

If they find any jail footage at all I’m sure it will be that. The rest will be “missing.”

I suppose I could have imagined the things I heard, but I absolutely don’t believe  for one second that I did. Much of what I heard has since been independently verified. Believe me, I have a big ol’ file.

And it being “all in my head” doesn’t add up by the sheer fact of what history has taught us since, and the fact that I’ve known these people for years and years and knew their voices like the back of my hand. There’s too much detail, too much evidence, too much motive. I think the ones who try to paint me as bonkers are beginning to look guilty themselves, quite frankly.

Somebody knows what happened in there. At least a few people. It only takes one to snitch. I’m counting on that one.

The moral of my story today? I truly believed they were going to kill me in that jail, and the motive (my big mouth) was quite clear and had been for some time. Yet as I prepared and fully expected one of them to walk in and shoot me in the head, I thanked God for having my self-respect back.

That, my friends, is priceless. And for now, worth every lonely moment.

What happened in jail while I was kept from my sick dad? Finally, my tell all

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I’ve struggled a long time over whether to write this piece. Ultimately, I’ve decided I’m never going to “get past it until I blast it.”

So buckle up.

My dad has been in the ground almost a year now. And I still wrestle daily with the pain and anger of what I call caregiver PTSD. I do have a PTSD diagnosis of course, stemming from an assault by a family member that nearly left me for dead a little more than two years ago (an event made even more curious given what we know now about the size of my dad’s estate), and then a year later, being jailed on no charges at all, right around the anniversary date of that assault (for reporting an intruder at dad’s assisted living facility).

For three years, you saw the pictures of my dad and I – sometimes funny, other times heartbreaking. Terribly heartbreaking. Like this one.

I visited my dad multiple times a day for 13 years, picked him up off the floor, fed him, but most of all, just sat and talked with him. The day this picture was taken, I had to beg him to eat three bites of coconut cream pie, and I spoon-fed it to him myself. That was the last meal he ever would eat.

When I visit my dad at the cemetery, almost every day, I praise God that his suffering is over. I also find great satisfaction in knowing that I finally got him the diagnosis he always was looking for. Hopefully people understand now why he acted the way he did, and others all over America and the world have an explanation for why their loved ones with FTD act the way they do.

I am very, very proud of how I cared for my dad, who already was living in an assisted living facility (Comfort Harbor in Milan, Ill.) when I moved back here from Los Angeles in 2002. My brother took him back out of the facility upon my arrival, and I began to care for dad in his apartment. My brother thought that was a walk in the park. My brother thinks it was all fun and games, and that I got lots of free stuff.

John was almost never around. Period. And he doesn’t really believe it was fun and games. Do you still John? Because if so there is not a brain in your head.

I have no use for my brother in my life whatsoever and I hope I never have to see his face ever again. Everything that came out of his mouth from the day I moved back here to the present has been nothing but lies. I do not think he is capable of telling the truth about anything anymore, quite frankly. My dad called it “Fordham’s disease.”

So why was I really jailed in May 2015? Well, I had given police some very good information regarding some criminal activity just a few days prior. There no longer is any doubt about the quality of the information I gave them.

‘It’s almost like Dave’s clairvoyant’

While I was inside the jail, a high-ranking politician whom I have known for many, many years (and used to be great friends with) was hanging out in there trying to decide what to do with me. I could hear almost every word she said, as I was held in “the hole” on the main floor — the suicide cell. I was not charged and booked with anything, so I was not in the general population. (I wasn’t remotely suicidal either, as the official from Robert Young Center quickly determined, explaining I would be released shortly)

At one point I even heard the politician say, “How can he hear us?” and “It’s almost like Dave’s clairvoyant.”

At the urging of a Rock Island County Republican board member, I have since shared that entire story with the Illinois State Police.

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At the urging of the county coroner, whose wife was one of my best friends for many years (in fact, the coroner’s wife, the high-ranking politician and myself frequently enjoyed post-deadline cocktails when we all worked at the local newspaper in the 1980s and 1990s), I also shared the story with Chicago attorney Kenneth Flaxman. The coroner pointed out to me that he also represented a woman who claimed she was assaulted inside the jail.

Mr. Flaxman told me I already had told so many people that “you may end up in the river, and I don’t want that responsibility.” I did find another attorney to take the case, but what I really want is an explanation, an apology, and assurance that the jail is going to finally clean up its act if it hasn’t already. This story is not uncommon, according to people who work in Quad-City healthcare.

In fact, it’s the local healthcare sector who cheers me on when I write these pieces. They’re tired of seeing people come out of that jail forever changed, haunted by what went on inside.They end up being the ones who have to treat them for life.

While I was in “the hole,” I heard this politician say, “Give him Dave’s phone, he won’t know whose phone it is.” I had no idea who she was talking about. But I did recognize the voices of two people working in the jail as former bartenders from Mary’s on 2nd. These employees had been fired from the bar for coming to work drunk and such. Apparently Bobby Stansberry puts up with a hell of a lot less nonsense than Sheriff Gerry Bustos does.

When I finally got out of the jail, and later the hospital (which forgave the portion of the bill that my insurance did not pay, despite the fact I did not qualify for financial assistance, and even wrote a letter of apology) I opened the Metro app on my phone to catch the bus. I was riding the bus at the time and did not own a vehicle.

‘Plant malt liquor in Dave’s car at Amber Ridge’

I had heard the high-ranking politician say, ‘‘Plant malt liquor in Dave’s vehicle at Amber Ridge. Is his car still at Amber Ridge?”

You would have thought a politician of her caliber and background would have done her research. I didn’t even own a vehicle and rode the bus and walked to Amber Ridge, like I did every day.

When I first opened my Metro bus app after spending two days in the jail, here’s what I saw.

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I have never visited any of these places on the bus, or had been to any of them period in at least a year-plus prior. Some of them I never had been to in my life and have no idea where they are. Some recently had been visited by cops for drug busts, a quick review of news reports revealed.

Later, my (now former) pastor decided to confide in me that when she called my phone while I was in the jail, “A Spanish-speaking person kept answering it.” She kept her phone records in case they someday are needed, as did I.

What else went on in the jail? Well, one guard had another examine my penis, and she told me if I would agree to be part of her “Davenport prostitution ring” she would release me. She kept dangling the keys over the tiny window of the cell where I was kept, stripped naked, under a blaring light, nothing but concrete on which to lie – on no charges at all.

Well, for being a snitch. Let’s face it. I was jailed for being a snitch.

What my bloodwork showed

When I was finally released from the hospital, my bloodwork showed nothing in my system other than a trace of marijuana. Meanwhile, a former friend who herself appears to be in the throes of a substance abuse problem continues to run around town telling even my relatives that she searched my home with the Rock Island Police Department and found meth and crack.

A bare-faced lie.

I’m smart enough to know that when life is good, sometimes you should just keep your mouth shut, especially when time passes with no further offenses, even after you’ve been wronged. I make a damned good living writing branded content that hopefully helps others recover from drug and alcohol addiction. Indeed, I have a good life.

But I also did not get into journalism to pass up a chance to exploit being real-life “undercover” in the Rock Island County Jail. Believe me, I have plenty more stories I can tell!

Here’s the thing: I have been sober (and sane!) since Memorial Day 2014, the night I was assaulted by my cousin and his fiends. A year after that — the Amber Ridge incident — I stopped smoking pot too, even though with a PTSD diagnosis it is legal for me to smoke it in the state of Illinois.

I am not going to let the corrupt establishment try to propagate LIES about what happened leading up to and in that jail to fit their needs. I know the truth, the cops in my town know the truth, and the truth is going to set me free. It hopefully will set this whole community free and send some dirty politicians and their minions straight to the big house.

I write this story because there are documents that support all of this, and because none of these people – not the people in the jail, not even the politician who apparently likes to hang out there for lack of better things to do, not even the family members who tried to hurt me – NONE OF THEM have been punished. Most people wouldn’t be able to just grin and bear it as long as I have.

Let alone not touch a drink! I often wonder if they’re just waiting for me to get drunk and act nuts. Sorry folks. You’ll be skeletons in your taxpayer-paid, gold-plated rocking chairs by the time that happens.

When a community’s ties to organized crime are obviously as strong as they are in Rock Island County, the people deserve to know. The journalist in me just can’t keep quiet.

I have spent nearly $3,000 with my attorney so far just to get what my dad left me in his will. Not only is the estate still not settled, it has turned even uglier than one could have possibly imagined.

So as the one year anniversary of dad’s death draws near, I’m grateful his suffering is over, and I’m hella grateful to have the kind of self-respect I never thought I’d have again.

But I’m also hurting, I’m angry, and I won’t give up on doing all I can to make sure the criminals among us are brought to justice. I did not purchase the family home in this community to live in a town so corrupt it makes Chicago politicians blush.

Scientific analysis of Tweets quantifies Pokémon Go! dangers

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Reports of Pokémon Go! being hazardous for those who don’t pay attention have a definite “duh” factor.

But despite that, some people continue to put their lives and the lives of others in danger at times while playing the mobile virtual reality game. As the old saying goes, “It’s all fun and games until someone gets killed.”

A fascinating report breaking in JAMA Internal Medicine this morning reveals that 18 percent of people tweeting about Pokémon Go! from July 10 to 20 indicated they were playing and driving. Another 11 percent said they were playing the game while riding in a car with someone else behind the wheel (but barking out rapid-fire orders to the driver) and 4 percent indicated they encountered risk of injury simply by playing the game while walking.

Read more: Where to hunt for Pokémon in the Quad-Cities

The public health experts analyzed a random sample of 4,000 Tweets out of a whopping 345,433 Tweets about Pokémon Go! during the 10-day period. That number only includes Pokémon Go! Tweets including “Pokémon” and “driving,” “drives,” “drive” or “car.”

Further analyses categorized phrases such as “omg I’m catching a Pokémon and driving,” “just made sis drive me around to find Pokémon” and “almost got hit by a car playing Pokémon Go!”

“Our findings can help develop strategies for game developers, legislators, and the public to limit the potential dangers of Pokémon Go! and other augmented reality games,” the researchers reported. “For instance, passengers using mobile devices are typically not considered a driving risk, but given its augmented reality feature, gaming passengers may implore drivers to take risks to aid their play.”

Read more: Pokémon Go! maps of the Quad-Cities

Scientists recommend game restrictions

The authors recommend:

Changing the game’s software to restrict play at any driving speed. Currently, the game stops working at speeds over 10 mph.

Disabling the game near roadways in parking lots to protect pedestrians.

The authors admit the game theoretically has a health benefit by getting a younger generation made less active by technology to move again. But they say those benefits are negated by the hazards of the game.

Read more: Where to find rare Pokémon in the Quad-Cities

“Motor vehicle crashes are the leading cause of death among 16- to 24-year-olds, whom the game targets,” they reported. “Moreover, according to the American Automobile Association, 59 percent of all crashes among young drivers involve distractions within six seconds of the accident.”

I wrote a few stories about Pokémon Go! for MapQuest that have been among my best performing MapQuest stories (and I’ve sprinkled them throughout this piece). I have friends who enjoy playing the game safely with their children.

However, none of us can deny the distractions. I have a terrible tendency to want to Facebook while driving. I know it’s dangerous and I try to stop myself.

And as someone who didn’t have a car for two years, I also know all too well about walking and Smart phoning, and have suffered a ton of bumps, bruises and scrapes to prove it.

Be careful out there, and “catch ‘em all!”

Read more: Top 5 Pokémon gyms in the Quad-Cities

This lady lost her caregiver son because the VA was too slow. Then she died right behind him.

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Some encouraging news published today in JAMA Surgery is coming too late for my next door neighbors.

That’s because Monica, a Scottish immigrant, and her son, Paul, both are now dead. Paul, who was in his early 50s, cared for his mom in the house they rented next door to me. Like myself, Paul clearly had troubles of his own and at times was overwhelmed by his mother, who also had dementia, like my dad, albeit in a much milder form (at least at first). Plus, Monica was about 90 years old.

And even though Paul and I never got along in the beginning, when he began to lose a lot of weight I asked him what was going on. He told me he had not been feeling well but could not get into the VA right away due to long wait times.

Finally, he got in there and they discovered he had a cancerous tumor in his colon. Then they scheduled the surgery – for several weeks out.

By the time they opened Paul up, he was full of cancer. He went into Hope Creek Nursing Home and died a short time later.

His mother, her heart broken that her only child was dead so young, began to exhibit worsening dementia. Daily home care wasn’t enough. She was coaxed from her home by the police (for her own safety), never to return. After a short stint at Galesburg Cottage Hospital (where unruly elderly people are taken from the Quad-Cities to be heavily medicated and made “manageable”) she returned to Hope Creek, and died.

A sad, sad story. She had become a ward of the state after Paul died; the state got every little thing she owned to pay she and Paul’s Hope Creek bills.

The house still has not been rented, and some of her belongings are still there. It’s a big old mess. His death, her death, the fact the landlord still can’t rent the house – all examples of multiple disgraces in the Illinois Quad-Cities elder care system and the state of Illinois in general, too numerous to mention. And to anyone who rolls their eyes at that comment, I say, go right ahead. Maybe you’ll find a brain up there.

But here’s the good news

The study released today in JAMA Surgery shows how reforms put in place at a VA pilot location in Indianapolis drastically reduced delays. Using Richard L. Roudebush Veterans Affairs Medical Center as a test site, “Multidisciplinary teams identified systemic inefficiencies and strategies to improve interdepartmental and patient communication to reduce canceled consultations and cases, diagnostic rework, and no-shows,” according to a JAMA news release. “High-priority triage with enhanced operating room flexibility was instituted to reduce scheduling wait times. General surgery department pilot projects were then implemented mid-fiscal year 2013.”

Wait times were shaved from 33 days in FY2012 to 12 days by FY2014. The number of patients operated on increased from 931 in FY2012 to 1072 in FY2014.

“This study demonstrated a significant reduction in patient wait times for surgical procedures and an improvement in access in the clinical and operative settings when implementing lean processes,” the authors wrote. “The improvement gained was noted over multiple areas and seen during the implementation of new technologies. The changes in the measured outcome categories occurred early, and the differences were sustained across the entire observation period.”

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The authors reported that a “systems redesign” involving “personnel, clinicians and surgical staff to reduce systemic inefficiencies” could work throughout the VA.

In an accompanying editorial, Drs. June Ray Juliet and Seth A. Spector of Miami wrote, “Widespread negative media attention targeting patient access and wait times at the U.S. Department of Veterans Affairs institutions has prompted evidence-based reform to improve health care access and delivery.”

There goes that darned media, saving lives again.

“The stakes are high, and process, organization, and infrastructure must be reformed to ensure that health care delivery, research, education, and training proceed at the highest standard,” the editorial concludes. “This crisis provides the private and public sectors with an opportunity to consider lean transformations to expand access, reduce cost, and, most importantly, improve health outcomes and the patient experience.”

Grandma’s fan may be doing her more harm than good

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I remember going to visit my grandma (my mom’s mom) on Sundays. We went every Sunday, like clockwork, to watch “Wonderful World of Disney” and “The Muppet Show.”

Sometimes in the summer, it was insanely hot in grandma’s house. She only had a fan in the window – no air conditioning. My mother would beg her to come stay at our house, but she would refuse.

On top of all of this, grandma only had one lung. Still, she wouldn’t budge, and it always worried my mother deeply during heat waves.

A research letter published today in JAMA shows that electric fan use by elderly people during extreme heat could in fact be harmful. While I personally find it outrageous that every elderly person in America is not furnished with air-conditioning no matter where they are, I realize that some just don’t like it, or they believe they cannot afford the electric bill.  I’m sure many can’t, sadly, but many communities do have air conditioning assistance programs for the elderly, both through the power company to pay the bill, as well as local charities that will provide refurbished air conditioners to elderly people who cannot afford to buy one.

The study admittedly was tiny – three men and six women, average age of 68.

There’s a reason why the sample was small. Wearing  only shorts (men) or shorts and a sports bra (women), the volunteers sat in a 108-degree chamber. After 30 minutes of humidity at 30 percent, the humidity went up 2 percent every five minutes until it reached 70 percent. Such conditions are not uncommon in summers in the Midwestern and Southern states, or even in the Northeast. The study was conducted by University of Texas Southwestern Medical Center, Dallas.

Conventional wisdom in the medical community has been to discourage fan use at temperatures above 95 degrees, “due to theoretical risks of accelerated heat gain and dehydration,” the authors wrote. “However, empirical data to support or refute their use during heat wave conditions are sparse.”

Researchers observed the participants on randomly assigned days with and without a 16-inch fan located about three feet from them. They could not drink any fluids during the experiment. Their heart rates, core temperatures and sweat loss were monitored.

Surprisingly, when the fan was in use, core temperature and heart rate spiked. “Although differences were small, their cumulative effect may become clinically important with fan use during more prolonged heat exposure,” the researchers concluded. “Fan use elevates sweat loss in young adults. This was not observed in elderly adults, suggesting that age-related impairments in sweating capacity possibly limit the effectiveness of electric fans. Overall, this preliminary study indicates that electric fans may be detrimental for attenuating cardiovascular and thermal strain of elderly adults during heat waves.”

Grandma lived down the hill from us, in a housing project known back then as the Arsenal Courts. Originally, the projects were built to house soldiers working at the nearby Rock Island Arsenal during World War II. They were not equipped with even window units.

It was a very dangerous place back then, quite frankly, but grandma was very poor. My grandpa, Grant, died in a car accident when my mom was only 16. Grandma then spent many years in a tuberculosis sanitarium. She never really developed workplace skills as a farm wife, and when her husband died, she became sick with tuberculosis.

As if TB wasn’t bad enough, she also had several bouts of cancer. Grandma suffered many years, but was a devout Christian woman and always maintained a smile. She lived to be 81, my longest living relative next to my dad’s sister, who is 83. My dad came in third (God bless him!) at 77.

At any rate, if you know of an elderly person who just refuses to come out of the heat when it’s uncomfortable even for young people, you might want to share this study with them and see what you can do to help them get an air conditioner, if they will agree to one. A fan just isn’t enough, and is in fact harmful during heat waves, or so at least it appears in this very small (albeit interesting to me) study.

For doctors, EHRs are a four-letter word, study shows

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Research published online tonight in Annals of Internal Medicine shows what doctors already know – EHRs, or electronic health records, are causing physicians to burn out.

Although the study was small – 57 physicians from four states – it showed that they spend almost twice as much time maintaining patients’ electronic health records as they do face to face with the patient.

The study was funded by the American Medical Association and looked at doctors in family practice, internal medicine, cardiology and orthopedics. They practiced in Illinois, New Hampshire, Virginia, and Washington. The study used direct observations as well as self-reported diaries (for time spent working after office hours).

“During the office day, physicians spent 27 percent of their total time on direct clinical face time with patients and 49.2 percent of their time on HER and desk work,” according to the study abstract. “While in the examination room with patients, physicians spent 52.9 percent of their time on direct clinical face time and 37 percent on EHR and desk work. The 21 physicians who completed after-hours diaries reported one to two hours of after-hours work each night, devoted mostly to EHR tasks.”

While I would not consider these findings particularly newsworthy in and of themselves, the topic of EHRs and doctor burnout in general is a hot one.  One of the most interesting stories I ever reported during my three years at Healthline, at least to me, was a story headlined, “Is technology costing doctors time with their patients?” You can read it by clicking here.

From Google Glass to information overload

I had the pleasure of interviewing Dr. John Halamka, chief information officer at Beth Israel Deaconess Medical Center in Boston, who at the time also served on Healthline’s medical advisory board. He explained that at Beth Israel Deaconess, ER doctors use Google Glass.

When they enter the exam room, the glasses they are wearing scans a bar code on the wall. “Instantly, the patient’s medical information appears in the doctor’s line of vision, and he or she can refer to it while examining and speaking with the patient,” I wrote.

Pretty cool. Of course, Google Glass-wearing doctors are not yet the norm.

He talked about his father dying in the ICU of a Los Angeles Hospital, yet, even with all the data EHRs can collect, “Nobody could tell me how my father was doing.”

At the same time, when his wife was diagnosed with breast cancer, he was able to comb data from 10,000 patients with similar diagnoses to determine the best treatment for her. Of course, not everyone is an IT director at a hospital and has such access, he admitted.

He said then that when it comes to the EHR, “We are in the biplane era. We haven’t invented the jet engine yet, but we’re not in the era of the Wright brothers either.”

Time to stop complaining, start doing, editorial says

In an editorial accompanying the Annals research, Dr. Susan Hingle of the Southern Illinois University School of Medicine, Springfield, said, “Now is the time to go beyond complaining about EHRs and other practice hassles and to make needed changes to the health care system that will redirect our focus from the computer screen to our patients and help us rediscover the joy of medicine.”

I suspect both patients and doctors will agree with that. And organizations such as the American Medical Association and American College of Physicians have various initiatives working toward that goal.

“Many studies have documented lower patient satisfaction when physicians spend more time looking at the computer and performing clerical tasks,” Hingle wrote. “Patient satisfaction can affect health outcomes via adherence to the care plan and can also affect physician and hospital reimbursement, so the stakes are high.”

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Improving your life – even saving lives – is as easy as taking a walk

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Even before I became sober (which is the best thing I ever did for myself), my life began to improve when I began walking.

When I sold my clunker to a junkyard when dad entered a memory care facility in 2013, I had no choice but to start walking. Once, I walked all the way home from the grocery store carrying a 25-pound box of cat litter (well over a mile).

It didn’t take long before I got over my hang-ups about using public transportation, but usually I chose walking over riding the bus even then. At one point, about a year after I became sober, I no longer felt safe riding the bus and returned to just walking.

We know that walking is incredibly good for your health. Even before I stopped drinking, weight began to fall off of me when I started walking.

In February I decided to buy a Toyota Prius, so I haven’t been walking as much as I once did. I go to the gym now instead.

But when my therapist suggested a few weeks back that I start participating in charity walks to meet new people, I thought, “Why didn’t I think of that?”

Why have so many Q-C LGBT people died?

A couple of weeks ago I participated in the Overdose Awareness Walk and blogged about that. I’m sure you all also have seen my pleas for sponsorship in the upcoming Out of the Darkness Walk benefiting the American Foundation for Suicide Prevention (Oct. 29 in Bettendorf) as well as the NAMI Walk benefiting the National Alliance on Mental Illness (Sept. 24 in Davenport).

I’m proud to say that as I write this column, I have raised $175 so far for the NAMI Walk and $170 for the Out of the Darkness suicide prevention walk. Thank you from the bottom of my heart to all who have donated.

What’s even more meaningful to me, even beyond the fact that walking has greatly improved my health (my blood pressure is perfect these days!) and the fact that I’m helping raise money for good causes by participating in the charity walks, is that all three of these causes are near and dear to me.

In the Quad-Cities, the number of gay and lesbian people who have died of drug overdoses is staggering. I lived in Los Angeles for 12 years (and was a wild party boy) and only knew two people who OD’d. Here in the Quad-Cities – and we’re talking as far as back as six or seven years ago, even before the nation’s opioid crisis reached full tilt – I can think of several LGBT people who have OD’d.

Of course, overdose, suicide and, I’d surmise, even foul play sometimes are blurred when you don’t have the complete story. And on many of these people, I don’t. Simply put, there are lots of moms and dads who have lost children in this town; and lots of children who have lost moms and dads.

Brandon Ketchum puts a face to “20 per day” stat

And of course we know that 20 service people per day are committing suicide, which is not excusable. Our country needs to do a much better job of taking care of our service men and women, and that includes accommodating their mental health needs. That point finally was driven home locally with the untimely death of Brandon Ketchum, which even has caught the attention of local lawmakers, as reported here by Quad-City Times columnist Barb Ickes.

I know what suicidal thoughts feel like, although thankfully it is not something I have experienced since 2003. Many years ago, after returning to the Quad-Cities from Los Angeles, my depression was so bad that simply being awake was painful. I just wanted to sleep.

In June 2015, when I raised my voice after not being taken seriously when reporting an intruder at my dad’s memory care facility, I was thrown in the Rock Island County Jail on no charges at all. The reason they gave? They said I was suicidal.

Please start paying attention, folks!

While many of those who govern and have governed out of the county of Rock Island are famous for their lies and corruption, saying I was suicidal may in fact be the tallest tale they ever told. And everyone who was in the jail knows that whether they have chosen to tell the truth about it or not. Even the local mental health center deemed me “not suicidal” after one of their clinicians evaluated me inside the jail, but now those records are “missing.” The hospital also forgave the portion of my bill that Blue Cross Blue Shield did not pay (and not because of financial need).

What was going on that day was a PTSD-fueled anxiety attack that occurred nearly to the day of the one-year anniversary of an assault that could have killed me.

Sure, after two days in there I was weeping, but mostly for my community, and for the fact I thought they were going to kill me in there and that I would never see my dad or my cat again. Prior to that, I banged on the cell door and screamed for help for hours and hours and hours and hours. It was a horrifying experience I will never forget nor ever stop talking about so long as I can make a difference by sharing my story.

Watch for my book coming out next year. In the meantime, please consider supporting me in the NAMI Walk, or the Out of the Darkness Walk for suicide prevention.

Thanks, and happy Labor Day!