AMPNATION
VOLUME 2 ISSUE 2 FEBRUARY 2020
5th Annual UCSF Amputee Comprehensive Training Program Basketball Clinic
MAGAZINE MAGAZINE
Contents 27 6
Q&A Prosthetic Feet
With Trevor Grimbleby
Better Outcomes People of Color Are Most At Risk
20
5th. Annual UCSF Amputee Comprehensive Training Program Basketball Clinic
29
Health & Fitness Sugar In Your Beverages
12
Stump for Advocacy and Empowerment
2
AMPNATION
GREETINGS AMPNATION!
LIFE IS HARD, GET OVER IT Life is hard no matter who you are but have you ever wonder why? Let’s take a moment to reflect on this question. There’s no doubt about it: life is hard. It’s a given. Life is so hard we don’t even realize how often we walk around complaining about how hard life is and how we poorly we treat other people anymore. I have noticed on social media it’s kind of trending, in fact. But there’s no doubt that life is also amazing and is filled with wonderful moments, and with the bad stuff always comes some form of goodness, even if it doesn’t feel that way at the time. If you’ve ever found yourself crying into your hands or writing some social media post of despair wondering why life is so hard, you are definitely not alone. Understanding the process of life takes time, albeit painfully slowly, but the sooner you start to realize that a lot of the bad things that happen to us do not actually happen to us, they are just things that happen. It’s our negative attitude or disposition that turns neutral circumstances into something full of despair and anger, confusion and frustration. I see this daily on social media post where people are posting without thinking about results of what they just said. Using the excuse “I’m just venting.” In a nutshell: our emotions, thoughts, and feelings. They are what make life so damn hard if we don’t control them. But there are other things too. Here are some reasons why life continues to be so hard for some of you.
A Publication For Amputees
Ampnation Magazine publishes unbiased journalism that seeks to “empower and inform” amputees and those affected by limb loss. The magazine’s audience is primarily amputees and their families and is provided free electronically (digital) to anyone who subscribes subscribe@ ampnationmagazine.com and there is a hard copy available for purchase ass well. Each issue covers health, well-being, better outcomes of amputees living and thriving, O&P News, Vascular News, Tech and products & services.
INSIDE THIS ISSUE 8 Correspondence
Headline News and Opinion
10 Vascular & Ortho News
Transmetatarsal Amputation (TMA) and Toe Amputation
16 O&P News
Nonprofit That Helps People Who Need Prosthetics
19 TECH News
Mobile Closed-Loop Insulin System Lowers Hypoglycemia Risk in Type 1 Diabetes
32 Show Notes
Amp Life Talk Radio Show Notes
You are Selfish. Yikes, below the belt I know, let’s get right down it some of you are, right? If you are an overly selfish person, you might find that life is a lot harder than people who tend to give of themselves to others. Even in tough times. I don’t mean you have to go out of your way to save a family or give someone the shirt off your back, but it is nice to consider others from time to time to take the focus off you. Especially those who care for us. When you take the focus off you, say thanks to those who care for you daily, or consider someone else who has it much worst than you it makes you realize how good your own life is and it helps you to be grateful for what you have in life. Remembering gratitude in everything really helps. When we practice gratitude we are not only saying thank you to the universe for all that we have, but we are thankful for life in general. That makes life suck a whole lot less, trust me.
Feature Contacts
Better Outcomes - Editor@ampnationmagazine.com Correspondence - Editor@ampnationmagazine.com Vascular & Orthopedic - Editor@ampnationmagazine.com Prosthetic & Orthotic - Editor@ampnationmagazine.com Q&A - Editor@ampnationmagazine.com If would like be involved with Amp Nation Magazine please send inquires to: Contact@ampnationmagazine.com 3
You are a Hypocrite. If you are someone who tends to hold others to their words but then goes back on your own words, either to yourself or someone you know, then you’ll find that life is not as fun as it could be. The major reason people go back on their word is because of discomfort. We say we’ll do something and when it comes time to follow through we don’t, because it’s causes require effort, sacrifice, or it’s really hard. When in fact, it’s not hard at all. Don’t get me wrong I have given my word to somethings that turned out to be a nightmare where I had to do all the work. But I’m not a hypocrite. What’s hard are the thoughts we have about doing what we gave our word to or being. That’s what makes life harder than it needs to be. If you do the things you said you would do, you’d live a much easier life, even if it means being uncomfortable from time to time. The only way to overcome adversity and conquer any challenge is through mental toughness. Some people have it and some don’t. Your Thoughts Are Not Yours. We like to think that our thoughts are our own and no one control them, this idea of free will is not necessarily true, the truth is that many factors play into our decision making and choices in life. Many of which you are not even aware of. We carry with us a tremendous amount of information that is not of our own minds, yet we’ve adopted it as truth in our lives. Things we told at a very young age. These thoughts often dictate how we make decisions and how we live our lives. When you examine how you think and feel, you might find that your thoughts has been compromised by a lifetime of information coming from all directions and sources. Perhaps it’s time to consider another viewpoint on life? 4
Some People Suck. Let’s face it, some people really suck at being people. I never thought I would see people fighting over toilet paper but with today’s current situation I witnessed people assaulting elder people and others for freaking toilet paper, “toilet paper!” At the end of the day, no matter how hard you work on yourself, there will always be another person waiting in the shadows to test your human kindness and burst your bubble. One of the greatest burdens of being human and alive is that we cannot control other people. We can only control how we feel and how we react to the neutral circumstances that come our way. Circumstances or events remain neutral until we assign or give a value to them and either blow them way out of proportion or handle them accordingly. Consider that the next time you find yourself face to face with someone who sucks and you don’t like, ask yourself: is it the person you don’t like, or the things they are doing? It might help you see them in a different way and tolerate them for the time being. Consider this; that your frustration with other people, which only causes you discomfort, is about you and not them. Dig a little deeper inside of yourself to find out why someone is driving you crazy before you write them off completely. Once we accept that life is hard, we can uncover some brutal lessons that will help us live better lives. Brutal Lessons About Life 1) Change is uncomfortable. Change will always be strange, weird, and discomforting, but that’s just the way it is. Be patient, and wait for change to become the norm. 2) How you respond to a situation is more important than the situation itself. You are kidding yourself if you believe life should be simple and uncomplicated. There will always be difficult choices and tough situations, and playing your cards right is the best way to move forward in life. 3) You are your own worst critic. You never give yourself the credit that you
deserve, and you need to acknowledge that. You can be too hard on yourself, and you need to feel good about your own strength. 4) You neglect yourself too much. This is something we all do. Take care of yourself, your needs and your wants, and your life will be much better in every aspect. 5) Don’t waste time and energy on things you don’t care about. It can be easy to exhaust ourselves on pointless endeavors. But life is too short doing things that have no intrinsic value to us. 6) Distractions can take over your life if you don’t pay attention. Take a look at yourself: is your life filled with distractions? Could you do without them? Master your focus to master your life. 7) Anxiety is a part of life. You will never feel truly confident, so stop waiting for that elusive imaginary level of confidence, because you are using it as an excuse. 8) Waiting for the right circumstances is wasting your life. We often don’t want to move forward until all the stars have aligned. But guess what? The stars will never align unless you move them yourself. 9) Daydreaming is dangerous. Reminiscing about the past or fantasizing about the future can make you miss out on the only part of your life that matters—the present. 10) You don’t listen to things you don’t want to hear. Many of us surround ourselves in a bubble of opinions and truths that make us feel comfortable. We fail to grow because we never take in what we don’t want to hear. 11) The toughest walls will help you grow the most. Every tense and hard situation will help you grow a little bit higher and a little bit stronger. Embrace challenges for what they are. 12) Even the best chess grandmasters know when to move back. Like chess, life is a game where you have to know when to step forward and step back. It’s all about stepping into the winning position, regardless of where it might be. 13) Pay attention—everyone has something to teach. Don’t take the world for granted. Every obstacle and every interaction can become your teacher.
14) You don’t always get what you want. Deal with it, accept it. Learn to play with what you’ve got, instead of refusing to play at all.
26) “I’m busy” is the worst excuse. We are always “too busy”. But finding the time to do something is showing that you value it.
15) Acting like the victim will have you treated like one. Stop complaining; life isn’t fair. Move on from your tragedies, and let you define your life, not the other way around.
27) You cling onto things that are keeping you down. Evaluate the people and things you have in your life: if they aren’t helping you move forward, then they are keeping you down.
16) Sometimes you don’t need closure. There are times where we have to move on from certain people or parts of our lives. We don’t always need to know “what could have been”; just know what could be.
28) Your greatest superpower is staying calm. Don’t overreact, and don’t take things personally. Learn to be bigger than that; learn to stay calm.
17) Habits are the hardest things in the world to break. Be conscious of your daily habits, especially the negative ones. Don’t constantly fall back into toxic patterns, which will always try to come back into your life. 18) Don’t underestimate your mental strength. Your mind can do whatever you focus on. Use your mental strength to its greatest potential.
29) Negative thoughts are a part of life. Letting your momentum go to waste simply because you had a bad day will forever keep you from reaching your dreams. Don’t let negativity define who you become. 30) Stress comes from within. No matter how tough or difficult a situation may be, the way you respond to it comes from within. Stop yourself from stressing out over everything.
19) You can’t create positive habits overnight. Change takes a while. If you find yourself struggling to better yourself, remember that Rome wasn’t built in a day.
31) Life will give and take, always. When life takes away something important from you, remember that it also gives you new things to appreciate and love. Life is in a constant state of flux.
20) Patience and waiting are different things. Don’t wait for things to happen; patience is about taking yourself forward one step at a time and staying positive about it.
32) Find peace through forgiveness. Holding grudges over others doesn’t hurt them as much as it hurts you. Solve your inner turmoil by forgiving those that have wronged you.
21) People won’t always be honest about their feelings towards you. Their actions are more important than their words, so pay attention.
33) No one stays bad forever. We are always changing. Judging someone by their history no matter how much they have changed is unfair. Give others the chance to grow.
22) Don’t let shallow factors define the way you judge others. Don’t value titles, money, and accomplishments; instead, value humility, kindness, and integrity. 23) Popularity doesn’t matter. Live your life without giving a damn about popularity. Do what you want to do, not for the applause, but for the purpose. 24) Evaluate your sources of validation. Don’t live your life searching desperately for the validation of others. True validation can only come from within. 25) Listen to yourself. Don’t forget what you really feel and what you really want; it can be easy to lose track of your true values in all the noise.
38) Not everyone will respond and act the way you do. You are only setting yourself up for disappointment if you think that people will treat you the way you treat them. 39) Positive people find positive people. The way you think and act determines the type of people who stick to you. If you want good people around you, then you must be good, too. 40) Nothing lasts forever. Look around you and say thanks. Appreciate what you have—love, life, and happiness. Ask Yourself: Which of the points above make the most sense to you? How can you change yourself for the better? If you liked this article, check out my eBook The Art of Resilience: A Practical Guide to Mental Toughness.
34) Don’t let disagreements turn into hatred. We have a tendency to dehumanize people that we don’t share opinions with. Be cautious, and watch yourself when you argue. 35) Learn to be more human. The modern world has taken some of our humanity from us; learn to embrace what it means to be human again. Smile, look people in the eye, and don’t stare at your screens all day. Talk and listen. 36) We don’t have the time to fight. There are only so many years before we say goodbye to everything, so why waste your time arguing and fighting? 37) Placing expectations on others will only leave you brokenhearted. Don’t expect; just appreciate.
Editor’s Message Sean Harrison Contact@ampnationmagazine.com
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Better Outcomes A Man’s New Bionic Eye Lets Him See After an Accident Blinded Him Futurism
Months after being fitted with a bionic eye — a camera hooked up to a neural implant — a man named Jason Esterhuizen was able to see for the first time since he was blinded by a car accident. Esterhuizen is one of six people in the world to be outfitted with the Orion, an experimental device that takes video footage, converts it into electrical activity, and stimulates the pattern onto the visual processing centers of his brain, according to OneZero. It helped him, he told the publication, see the candles on his birthday cake and spot oncoming traffic outside his home for the first time in seven years. The Orion, the latest product from biotech startup Second Sight, fixes a key problem with previous bionic eyes: that almost nobody could use them. That’s because the electrodes in these visual prostheses typically sat in the back of the eye socket, OneZero reports, meaning they would only work if some of the biological eye’s cells were still alive.
“It’s not that the system helps them become completely independent,” Pouratian told OneZero, “but if you can’t see anything, being able to see just a little bit becomes extremely valuable.”
New Study Finds Brain Can Integrate Natural and Artificial Vision for Novel Blindness Treatment The research could lead to a treatment for one of the world’s most common form of blindness. | By
“This will enable the implanted person to see, even if part of the information was coming from an artificial chip.” The study saw rodents implanted with the same artificial retinas as humans are. The researchers then analyzed the brain activity of these rodents. “What we found is that the basic processing (abilities) of the visual cortex are preserved, and it is able to combine the artificial and natural signals, just as it does when both signals come naturally, when people have natural eyesight,” concluded Mandel.
Loukia Papadopoulos
Quad Amputee Is Contour Queen
Macular degeneration (AMD) is one of the most common causes of vision loss By Hannah Stevens @Hannahshewans in the Western world. It affects most notably those aged 50 and over and there A QUADRUPLE amputee is emis no cure for it. Artificial retina implants However, recent advancements in artificial retina implants have the potential to lead to effective treatment. Now, new research is bringing even more hope to those suffering from AMD.
Researchers from Stanford University and Bar-Ilan University have found that the brains of people who get artificial retina implants may be capable of integrating both information from the imThat’s no longer the case, because Second Sight sends the Orion’s implant plant and other parts of the retina. The find may lead to improved treatments directly into the brain. for AMD. “With the current system we’re testing, you don’t even need to have eyes “We wanted to see how the brain is able to combine the two kinds of information, for the device to work,” Nader Pourabecause it can provide us insight which tian, the University of California, Los Angeles neurosurgeon who implanted is important for improving the restoration of sight in blind patients,” told Esterhuizen’s Orion, told OneZero. But that also means undergoing brain The Times of Israel Prof. Yossi Mandel, surgery and facing all the risks — like head of Bar-Ilan University’s Ophthalmic dangerous infections — that the proce- Science and Engineering Lab and the study’s lead author. dure introduces.
bracing her difference through the power of spoken word Hannah Olateju, 18, from London, had all four of her limbs amputated after contracting meningitis, which resulted in gangrene, at just two and a half years old. After hiding behind dark clothes for years, Hannah’s confidence began to transform after a trip to Jamaica helped her to embrace her body. Now she shares her journey with 50,000 followers on Instagram and is using spoken word to share her personal journey with body confidence. She told Barcroft TV: “I would say to people who do have a negative view of amputees and disabled people - get a life.
“Body positivity is being confident with your body regardless of who tries to shame you, or whatever tries to put you down because, at the end of the A human-machine interaction For Esterhuizen, who tells OneZero Mandel explained that he saw this study day, we’re all going to die one day! that he now feels safer navigating everyday life, the added risk was worth as a human-machine interaction, one “We might as well enjoy our time now, where the machine was the artificial it. we should just do what we want to do retina. and forget the rest.” The Orion isn’t the most advanced “The visual cortex in our brain processes bionic eye out there — Stanford scienFollowing a year long hospital stay, tists are developing something similar the information from the retina, and we Hannah had to get used to life with that has enough resolution for people wanted to find out if the brain was able prosthetics and the rest of the family to process and analyze and integrate the using it to read text. But Esterhuizen information coming both from the pros- were there for every step. is happy with the results he’s, well, thetic retina and natural retina,” he said. 6 seeing. Hannah’s brother Byron said: “When
Hannah was diagnosed with meningitis it was a very challenging time for us as a family. I remember the whole journey from her spending a year in hospital, to her coming out bandaged, to her starting to walk, going to college, going to university.
“And some people say I do makeup better than them. So, I feel like it would give them motivation to go for their dreams.” Hannah says the hardest thing to master, however, was the art of contouring, which she has countered by using longer brushes to help her apply make up.
“So, my memories are always, actually, quite positive ones because it just amazes me to see the things that she overcomes.” While at school, several bullies tried to tear Hannah down but she refused to even let them try. She said: “People tried to bully me, but they were not successful. My mum taught me better than that. I would just simply kill them with kindness. “When I get negative comments I just delete them because I know who I am, so I don’t need someone to tell me something when they don’t even know me.”
there’s still a long way to go, as with anything. “A turning point for me and my confidence was one summer when I went to Jamaica, over there everyone is so confident and happy regardless of their body size and what they look like.
She added: “Fashion and makeup has helped me and my confidence in a way that I can express my self more and try and kind of figure out what I like. “For example purple lipstick, I think that makes me feel like a boss, and the hair as well, it makes me feel like a unicorn.”
While Hannah has fully embraced her body, she does not feel any affinity to “I felt like I took a lot of that with me the word ‘disabled’. and brought it back here so when I came back that’s when I started posting She said: “I don’t like using the word my hair, posting makeup.” disabled when I am talking about Although Hannah never lets bullies en- Now that she has amassed thousands myself because I feel like with people, croach on her life, it took a few more of Instagram followers, Hannah intends especially society, they have such a years before she felt completely at to try her hand at make up tutorials on negative connotation onto it. ease with herself. YouTube. “As in disabled, ‘they don’t have a Hannah said: “My confidence was at love life, they can’t do their own thing, She said: “I decided I wanted to post the point where I wouldn’t post selfies, makeup tutorials on to YouTube. I feel don’t go out clubbing, they don’t go I wouldn’t post anything about myself. like it would help other amputees, espe- out drinking’. I would just wear black and not really cially new amputees. And it would also dress well. inspire people to say that, ‘oh, my situa- “I do all of those things and more, so tion isn’t really bad when - not doubting why should I label myself?” “Now, I don’t like wearing black, unless myself or anything - she’s got no arms it’s leather!. I’ve come a long way but and she can do makeup.’
Stroke Alert Signs
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Correspondence
News, Opinion & Information
Prediabetes treatment takes team effort to change lifestyles AMA | To implement a successful type 2 diabetes prevention program, a health system turned to an all-star team of health care staff. Find out more. While studying for his board certification in obesity medicine in 2016, North Mississippi Health Services (NMHS) internist Vernon Rayford, MD, learned about the value of the National Diabetes Prevention Program (National DPP) lifestyle-change program and found it to be an increasingly popular form of obesity therapy. So when he got the chance to be trained as a lifestyle coach for the program, he leapt at the opportunity. One year later, Dr. Rayford joined a physician leadership program where he completed a capstone project that looked at the prevalence of prediabetes at NMHS. He found that about 1,000 employees within his system’s health plan had prediabetes, signaling a need for a lifestyle-change program. From there, he helped develop a diabetes-prevention strategy, which included launching the lifestyle-change program for employees in June 2018. The AMA’s Diabetes Prevention Guide supports physicians and health care organizations in defining and implementing evidence-based diabetes prevention strategies. This comprehensive and customized approach helps clinical practices and health care organizations identify patients with prediabetes and manage the risk of developing type 2 diabetes, including referring patients at risk to a National DPP lifestyle change program based on their individual needs. Located in Tupelo, Mississippi, NMHS serves a population of about 700,000 people in 24 counties in north Mississippi and northwest Alabama. At NMHS, physicians see a lot of complications from diabetes and the cost associated with those difficulties. In terms of safety and quality, diabetes is a significant contributor to many other complications seen at NMHS.
said Dr. Rayford. “It helped to have the primary care perspective, but it also helped to be able to have the data out there—there’s almost $2,700 a year saved for every prevented case of type 2 diabetes. “The AMA has been really instrumental in helping me refine the argument that preventing diabetes is an important aspect in the care of diabetes, and really helping supply data and tools to help me learn more about diabetes prevention,” he added. The main component of success for diabetes prevention at NMHS has been the people. These key team members played a crucial role in the prevention of type 2 diabetes through lifestyle changes. During his capstone project, Dr. Rayford found that the vice president of human resources was very interested in the lifestyle-change program. With her support, they assembled a group to make the diabetes prevention strategy a reality.
“Having the blessing and guidance of leadership, and the clout to assemble a group across different segments of our system, was instrumental,” said Dr. Rayford, now board certified in obesity “Being able to speak to the far end of the spectrum for diabetes really helped as well as pediatrics. in making the case for prevention,” HR’s help enabled the construction of 8
“an all-star team that has been responsible for planning and implementing the pilot, which we are still continuing, as well as planning for expansion,” he added. The lifestyle-change program at NMHS lasts a year and includes 22 one-hour group sessions. Participants attended 16 sessions during the first six months and six sessions in the last six months with weekly weigh-ins. However, not all participants could commit to the one-year program. For those people, Dr. Rayford suggested a “hybrid model” of the lifestyle-change program that stays true to the curriculum, but offers more flexibility. Lifestyle coaches from diverse backgrounds The pilot group had members from different departments of NMHS, with the Wellness Center serving as both the location and conduit to provide lifestyle change services for participants. This is also where lifestyle coaches are trained, including dietitians, nurse practitioners and exercise specialists. Through the Wellness Center and the Population Health Service, dietitians periodically offer healthy-cooking classes. Sessions include a cooking demonstration and recipe sampling to teach participants how to modify recipes and lower sugar and fat while incorporating portion control. Other topics include food-label education and shopping tips.
Participants can also visit the Wellness Center to work with exercise specialists on improving their physical activity. In a recent session, an exercise specialist showed participants how to use hydraulic exercise machines and how to incorporate them into their physical activity. “What’s great about it is the hydraulic machines are often underutilized and so these machines are the ones that many people don’t use—because they don’t know how to use them—and so it was more than just showing them simple exercises,” said Dr. Rayford. “It ended up being showing them how
to use a set of
provement in functional or blood pressure outcomes between the groups. Heat therapy had excellent adherence and was well tolerated. “Further studies to confirm the clinical benefits of heat therapy will be required along with the refinement of systems to provide heat therapy in a safe and efficient way,” the authors write. Source: CardiologyAdvisor.com
Cocoa Consumption May Improve Walking Performance in PAD
HealthDay News — Cocoa consumption may improve walking performance in if they wanted to use them.” Through a team effort, executive lead- individuals with peripheral artery disease (PAD), according to a study published ership, dietitians, nurse practitioners and exercise specialists, worked togeth- online Feb. 14 in Circulation Research. er to ensure the success of the diabetes Mary M. McDermott, M.D., from the prevention program at NMHS. Northwestern University Feinberg School of Medicine in Chicago, and colleagues Heat Therapy Improves Walking conducted a phase II randomized clinical Distance in Peripheral Arterial Dis- trial to compare the impact of six months of cocoa to placebo for walking perforease mance in participants with PAD. Participants were randomly assigned to either HealthDay News — Heat therapy can a cocoa beverage containing 15 g cocoa improve functional ability and also has and 75 mg epicatechin daily or a placebo potential to be an effective cardiobeverage containing neither cocoa nor vascular conditioning tool for people epicatechin. with peripheral arterial disease (PAD),
machines that would be more available
according to a small study published online June 5 in the American Journal of Physiology-Heart and Circulatory Physiology.
Forty of the 44 participants who were randomized completed follow-up. The researchers found that at six-month follow-up, compared with placebo, cocoa improved six-minute walk distance by Ashley P. Akerman, from the Universi42.6 m (90 percent confidence interval, ty of Otago in New Zealand, and col+22.2 to +∞; P = 0.005) at 2.5 hours afleagues randomly assigned patients ter a final study beverage and by 18.0 m with PAD to either 12 weeks of heat (11 patients; mean age, 76 years; four (90 percent confidence interval, −1.7 to women) or exercise (11 patients; mean +∞; P = 0.12) at 24 hours after a study age 74 years; three women). The heat beverage in analyses adjusted for smoking, race, and body mass index. Comintervention involved spa bathing at 39 degrees C for three to five days per pared with placebo, coca improved mitoweek for ≤30 minutes, followed by ≤30 chondrial cytochrome c oxidase activity, increased capillary density, improved calf minutes of calisthenics. The exercise muscle perfusion, and reduced central intervention involved ≤90 minutes of supervised walking and gym-based ex- nuclei in calf muscle biopsies. ercise one to two days per week. “If our results are confirmed in a larger trial, these findings suggest that cocoa, The researchers found that after 12 a relatively inexpensive, safe and accesweeks, total walking distance during sible product, could potentially produce a six-minute walk test increased and pain-free walking distance increased in significant improvements in calf muscle health, blood flow, and walking perforboth groups. Following heat, systolic blood pressure declined more than fol- mance for PAD patients,” McDermott said lowing exercise (−7 mm Hg [95 percent in a statement. confidence interval, −4 to −10; P < 0.001] and −3 mm Hg [95 percent con- Source: CardiologyAdvisor.com fidence interval, 0 to −6; P = 0.078], respectively). In both groups, diastolic and mean arterial pressure decreased by 4 mm Hg. There were no significant changes in blood volume, ankle-brachial index, or measures of vascular health. There were also no differences
in im-
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Vascular& Orthopaedics Extensive Vascular Surgery Helps Spare Cancer Patient’s Leg A rare type of cancer required a team of vascular, orthopaedic and plastic surgeons to help one man get back to riding the open roads. Anyone who knows Mark Weimer will tell you he was born to ride. His motorcycle of choice: a BMW K1200GT. Over 40 years, he’s racked up thousands of miles in 12 countries, including on Germany’s Autobahn. Riding, he says, is in his blood. So when numbness and swelling in Weimer’s left leg began to impact his rides two years ago, the then 60-yearold decided to get it checked out. At first, doctors suspected a blood clot in his leg, then an aneurysm in his femoral artery and, finally, a growth in the same location. But when surgeons at a local hospital began a procedure to remove the growth, they found a much larger tumor that was ultimately diagnosed as a rare grade 3 sarcoma. The surgical team, unprepared for next steps, ended surgery with a recommendation the Algonac, Michigan, resident and complicated procedure involving a Michigan Medicine team from vascunever expected. lar surgery, orthopaedics and plastic surgery working together for more than Weimer recalls the shocking words when he awoke from surgery: “It’s big- eight hours. ger than what we thought. You need to The first portion of the surgery required have chemotherapy and radiation.” meticulous dissection of the tumor and surrounding blood vessels by Siegel and But he wasn’t convinced. Accustomed Frankel Cardiovascular Center vascular to going with his gut instinct, Weimer sought a second opinion at the Univer- surgeons Andrea Obi, M.D., and Katherine Gallagher, M.D. After the intersity of Michigan Rogel Cancer Center in December 2017. There, he met with twined tumor was removed, the team would begin moving blood vessels and orthopaedic surgeon Geoffrey Siegel, M.D., who took his report to the multi- rerouting blood flow in the left leg. disciplinary tumor board. The consensus was unanimous: surgically remove “We did both an arterial and relatively uncommon venous bypass procedure the tumor, which had now been compromised by the previous failed surgery. to restore blood flow,” says Obi. A vein from the right leg was harvested to replace the affected artery and a non-essential vein in the left leg was used to Although doctors couldn’t promise re-route the venous blood flow returnWeimer would ever ride again, he was hopeful the surgery would spare his left ing to the heart. leg and, more importantly, save his life. Surgery was scheduled for January 17, “Following Siegel’s successful tumor resection, we were able to reconstruct the 2018. arteries and veins using the patient’s own tissue, reducing the possibility of Removal of the tumor, which was developing a dangerous vascular graft entwined in a series of intricate blood or blood borne infection,” Obi says. vessels, would require an extensive 10
Next, the Michigan Medicine plastic and reconstructive surgical team, led by Theodore Kung, M.D., spent several hours covering the vascular repair and repairing the soft tissue defect left behind by the tumor. Weimer says his recovery was far from easy due to an immobilized leg and no shower for three months. “It was a very humbling experience,” says the man who had never needed much assistance from anyone. “I was the person always helping others. I wasn’t used to depending on them to help me.” But his friends, neighbors, wife and daughter got him through it, he says. Weimer is currently on blood thinners, which he’ll be taking for life. He also wears a compression bandage on his leg and is monitored on a regular basis. The scars that run from below the knee to his groin — minimal due to the work of “excellent plastic surgeons” — are a reminder of his frightening
experience.
Who is at risk for DVT
There’s still a risk of his cancer proThere are many risk factors for DVT gressing, but for now Weimer is grateful and PE, says Thomas Wakefield, M.D., to be alive with full use of his leg. head of vascular surgery and a director at the University of Michigan Frankel The coup de gras for Weimer? He Cardiovascular Center. was back on his bike in June for a long-standing traditional ride in upstate Among them: New York. “I’ve done this ride for 35 years,” he says, proud to have taken on • Age. Older individuals are more likethe challenge and happy to be back on ly to have DVT, particularly those with the road with his fellow bikers. poor mobility or a serious illness such as cancer. At first Weimer says it was tough. “I didn’t trust myself on the road.” But • Recent trauma, surgery or hospitaleventually he was back in the saddle ization that causes immobility or paand leading the pack. “There was no ralysis. These can cause blood flow in stopping me,” he says, adding, “No one the veins to be slow, making the blood could keep up. The trip did a lot for my more likely to clot. inner psyche.” • Family history or personal history Source: Michigan Medicine of DVT or PE. • Pregnancy and the period around delivery. How to Reduce the Risk of Deep • Oral contraceptives and hormone Vein Thrombosis While Traveling replacement therapies. Estrogen in these sources can cause the blood to clot more easily. • Obesity, infections and chronic medical conditions. • Inherited and acquired blood clotting abnormalities. • Smoking (according to some studies). • Tips for reducing risk of blood clots while traveling
If you’re planning a long flight or car trip, make sure you know the risks of blood clots and take precautions to prevent them.
Wakefield offers the following tips for individuals that plan to be seated for long periods of time: • •
But for men and women with varicose • veins, traveling long distances in cars or airplanes requires special precautions. • That’s because anyone with varicose veins is at a slightly higher risk for deep vein thrombosis (DVT) during trips that • take 4 hours or longer.
Wear compression stockings. Get up and move about whenever possible. Periodically pump your legs up and down while seated. Drink lots of fluids and wear loose-fitting clothes that do not restrict blood flow. Try not to cross your legs for extended periods of time. Avoid drinking alcoholic beverages while in transit. Taking an aspirin before traveling may be helpful.
• DVT is a condition that results from the formation of a thrombus, or blood clot, • in a vein deep within the body. Clots that travel to the lungs from the legs are known as pulmonary emboli (PE). “Any and all methods of reducing your risk of DVT are important,” says WakeSymptoms of DVT include pain, tenfield. “If you plan to travel and have derness or swelling of the calf or thigh concerns about your risk of getting a (typically in one leg), and increased blood clot, be sure to talk with your temperature and redness of that same doctor or a health care professional.” body part. If you’re diagnosed with DVT, the main goal is to prevent the blood clot from growing or moving to your lungs as a life-threatening PE, where it can block the flow of blood.
Source: Michigan Medicine
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Stump For
Advocacy and Empowerment We’re In Your Corner amount of money they save you instead of an hourly rate (or, in some instances, on top of an hourly fee). Leibowitz says the average case at his firm takes roughly two hours, spread over days or weeks. The nonprofit Patient Advocate Foundation offers its services free. “We help patients with their entire case,” says outreach director Caitlin Donovan. Although the group deals mostly with lower-income households, anyone can call for help. “It can be hard to get through on the phone lines, but keep calling,” she says. The foundation works in tandem with many other groups, too, such as cancer and diabetes organizations.
How a Patient Advocate Helps You Navigate the Medical Sys-
the system works and how best to sort out medical snafus.
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How to Find One
Sources: HealthAvocate.com
When Richard Crestani had eye surgery three years ago, an error in the medical billing code for the operation resulted in $18,500 in bills his insurance company refused to pay. After trying to correct the error for six months with no luck, Crestani, who lives in Boca Raton, Fla., called Kenneth Klein, a local patient advocate. Klein helps clients negotiate medical bills and resolve billing errors, and he was able to convince the hospital that the medical billing code was incorrect. In the end, the insurance company paid its share, reducing the bill by nearly $15,000. “He was very tenacious and knew just who to contact,” says Crestani.
Patient advocates help you navigate the system, but they don’t provide medical care or make treatment decisions, says Trisha Torrey, executive director of AdvoConnection Directory, a database of independent patient advocates. Rather, they help patients make informed decisions. “Patients often don’t know what questions to ask,” says Torrey. “The advocates do.”
Many Americans already have access to these services through an employee benefits program. Health Advocate Solutions, for instance, works with 11,500 large companies and institutions worldwide, offering advocacy services to 12.5 million employees and their families. “Health care is confusing and difficult for the average person to figure A growing number of patient advocates out,” says Abbie Leibowitz, a founder like Klein can help you untangle med- of Health Advocate Solutions. “We help people who have any problem in health ical bills or insurance coverage snags care.” or assist with care-related questions, such as helping you decide whether to have heart surgery in your hometown If your employer doesn’t offer a benefit like this, you’ll likely have to pay out of or at a specialty hospital in another state. Patient advocates, also known as pocket for an independent advocate. Such professionals typically charge care managers or patient navigators, between $75 and $450 an hour, deare often doctors or nurses, or they may be former employees of insurance pending on the type of service required and your location, says Torrey. Some companies, doctor’s offices, hospitals or other care facilities. That gives them advocates who focus solely on billing 12 an insider’s understanding of how issues charge a commission on the
One caveat: Patient advocates aren’t licensed, credentialed or regulated in any state. A group called the Patient Advocate Certification Board is developing certification criteria and an exam, which may launch in early 2018. In the meantime, if you’re thinking about hiring an advocate, ask your primary-care doctor for a referral, says Linda Adler, a patient advocate in San Mateo, Calif. Then interview the advocate. Ask for personal references, says Leibowitz. Find out what kinds of cases the advocate is used to handling to see whether he or she has experience with cases like yours. And if the advocate tries to sell you something, Leibowitz adds, find another candidate. Types of Patient Advocates and the Services They Provide Some advocates specialize in specific areas of medicine or focus on assisting with a very distinct part of the health care process. For instance, there are registered nurses who offer individualized services like attending doctor’s appointments or researching potential treatment plans. Other advocates work exclusively on the business side of healthcare, focusing on assisting you with the financial issues — such as cost of treatment, medical billing issues, and negotiations. Still others specialize in providing advocacy for patients who go abroad for healthcare, or in assisting with aging life care or geriatrics. The bottom line is there are advocates
out there to assist with just about every handbook or contact the agency that facet of your health care journey, from oversees your plan. attending consultations, to being at your bedside in the hospital. Your right to buy health coverage
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“In some health systems and with some insurance companies and hospitals, patient advocates are offered. But what these people really are is customer service representatives. They’re not independent because they work for the organization,” explains Linden. “What we’re talking about is independent advocates. My clients rely on my being independent. The advice and the guidance and weighing of options that I assist with is all based on my client’s best interests, values, and goals.”
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How to Find a Good Patient Advocate The field of patient advocacy is still growing, but it’s possible to find an advocate in your area by simply conducting a Google search, says Matthew Bahr, the Certified Healthcare Access Associate (CHAA) behind the blog The Patient Financial Advisor.
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There’s also an online directory of pri• vate, independent health care advocates that lists professionals located throughout the United States and Canada. Called the AdvoConnection Directory, the website includes only those people who are members of the Alliance of Professional Heath Advocates. No matter which route you choose to identify an advocate, it’s important to carefully screen the individual before agreeing to work with them. Review their skills, background, and expertise.
Your right to benefits and services •
• “Be sure to ask about their experience and what exactly they’ve done that could help you in your situation,” says Bahr. “I would always ask for references • as well. Experience, in my opinion, is what you want in an advocate.” • Know Your Patient Rights! Use your rights to get the best health care for you and your family. The federal government and California have many different laws that protect patients. Most health care patients in California have the following rights. If you have questions about your rights, look at your plan handbook or contact the agency that oversees your plan. Your Right to Health Care Coverage There are laws that protect people applying for health coverage and health plan members. If you have questions about these rights, look at your plan
Health plans cannot refuse to cover you or charge you more because you have a health problem or are pregnant. Plans cannot charge you more because you are a woman. Plans can only consider your age, geographic region, and family size when determining your monthly premium cost. Children can stay on their parent’s or guardian’s health plan until age 26. Plans must accept you if you apply during an open enrollment period or qualify for a special enrollment period. This is known as guaranteed issue. Plans will deny you if you apply after open enrollment ends, unless you qualify for a special enrollment period after a qualifying life event (such as marriage, birth of a baby, loss of a plan through a job, and other changes). During an enrollment period, plans are only allowed to deny you for a very limited number of reasons. These reasons include if you don’t live in the plan’s service area or if the plan doesn’t have enough doctors in its network to serve any new members.
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You have the right to learn if a service is covered by your health plan and what it will cost you. You can call your health plan to find out if a test or procedure is covered and if it requires pre-approval. You can ask your health plan to help you clearly understand the services it covers. You can ask your plan to explain your bills and make sure the charges are correct. Most plans must cover a complete set of benefits, called essential health benefits. Essential health benefits include doctor and specialist visits, chronic disease management, dental and vision care for children, emergency services, hospital care, lab services, maternity and newborn care, mental health and substance abuse services, many prescription drugs, rehabilitation services and equipment, and preventative and wellness services. If you have an older (“grandfathered”) plan, your plan might not cover all of these benefits.
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Many health plans must offer no-cost preventive care, such as vaccines and cancer screening. You do not pay a co-pay, co-insurance, or deductible for these services. If you go to the emergency room for a health emergency, the plan must pay for that care. You can go to the nearest hospital, even if its not in your health plan’s network. Most plans cannot put an annual limit or a lifetime limit on costs they pay for essential health benefits. This means they cannot put a limit on paying for your care if you get sick. Your plan must let you see a specialist if you need one.
Your right to keep health coverage •
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Health plan cannot cancel your coverage just because you get sick or make an unintentional mistake on your application. Health plans generally cannot cancel your coverage unless you did not pay your premiums or you did not fill out your application truthfully. A health plan has to give you notice if your coverage is ending. Sometimes you also must be given the option to enroll in a different plan. If you lose your coverage, you may qualify for a special enrollment period to get a new health plan. If you lose your plan through your job, you may have the option to keep buying that same plan through COBRA or Cal-COBRA.
Prescription Drug Coverage Most health plans are required to cover prescription drugs. Not all plans cover all medications. The list of prescription drugs that a plan covers is called a formulary. You can check your plan’s formulary to see which prescriptions are covered and how much they will cost. How much you pay will depend on your plan. Some plans have different deductibles or copays for prescription drugs. Check your plan for details. (Source: The SimpleDollar.com)
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O &P News
Nonprofit That Helps People Who Need Prosthetics
Meet the rugby-mad 10-year-old with an artificial limb By Lucy Laing For The Daily Mail
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Jacob Pickering, 10, was born without an arm due to amniotic band syndrome He got his bionic arm three months ago and was invited to be a mascot at match Jacob, who plays for Blackburn rugby club, said: ‘It was the best day of my life’
When rugby-mad Jacob Pickering got his bionic arm three months ago he never imagined that he would be using it to shake hands with the England team at Twickenham. But Jacob, ten, put the arm to good use when he was invited to be a mascot at a Six Nations match. Jacob, who plays for Blackburn rugby club, said: ‘It was the best day of my life. I really enjoyed meeting the players and showing them my arm.’ The boy from Blackburn in Lancashire, was born without an arm due to a condition in the womb called amniotic band syndrome. In December, after years of struggling with NHS prosthetic limbs, he got a 10,000 Hero Arm – the first approved prosthesis in the UK which enables precise and delicate movements. It means he can hold a rugby ball, use a fork and do up a button. And last weekend he used it to shake hands with the England rugby team. His mother, Kathryn Litherland, said: ‘When he was three he asked me when his hand was going to grow back, which was heartbreaking.’ She came across Bristol-based firm Open Bionics when looking for alternatives for Jacob. 16 They were making a high-
tech ‘Hero Arm’ limb where muscles in the upper arm control the fingers. The Tej Kohli Foundation, a non-profit organization founded by London-based investor Tej Kohli, offered to fund the arm. Mrs Litherland said: ‘We couldn’t believe it. It was like a dream come true for Jacob. ‘He has managed to adapt to not having
a left arm, but this Hero Arm was going to massively help him. His NHS arm was heavy and made his arm tired so he didn’t like wearing it. But he thinks this is wonderful to wear, and so much more comfortable – it’s like having a hand for him, rather than just a grip.’ The arm is blue and white, the colors of Jacob’s favorite football team Blackburn Rovers. It weighs less than a kilo and has been completely tailored to Jacob.
This publication is brought to you from donations to
Each piece was individually printed and put together by hand, making sure the sensors were correctly placed and the socket was shaped exactly to Jacob’s limb. Jacob, who plays for Blackburn rugby club, said: ‘It was the best day of my life. I really enjoyed meeting the players and showing them my arm’. Source: Daily Mail
Dream come true: Jacob with the England team. The boy from Blackburn in Lancashire, was born without an arm due to a condition in the womb called amniotic band syndrome.
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Correspondence
Nearly 3 in 5 Medicare beneficiaries oppose Medicare for All, eHealth CEO says •
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Most Medicare recipients oppose “Medicare for All” or a Medicare-like plan to extend health insurance to all Americans, eHealth CEO Scott Flanders told CNBC. “They just don’t think that those under 65 should be able to participate, and you can’t really blame them,” he said in a “Mad Money” interview one day before an eHealth survey of Medicare beneficiaries is set to release. “What’s going on, really, when [Sen.] Elizabeth Warren published her plan, it became common knowledge that it’s not an affordable solution,” he said.
American health-care system known as Obamacare, against Sen. Bernie Sanders, I-Vt., whose signature campaign policy “Medicare For All” would replace Obamacare with a system fully funded by the public. Rep. Tulsi Gabbard, D-Hawaii, remains a distant contestant in the primary race. Sanders’ plan is to transform the country’s private health-care industry, replacing it with a single-payer program. Sen. Elizabeth Warren, D-Mass., who dropped out of the nominating contest last week, had a similar plan to transition to Medicare for All, which would have cost $20.5 trillion in new federal spending.
Support to expand Medicare coverage to all Americans has fallen among cur“What’s going on, really, when Elizabeth rent beneficiaries of the federal health Warren published her plan, it became insurance program, eHealth CEO Scott common knowledge that it’s not an afFlanders told CNBC on Monday. fordable solution,” Flanders said. About 37% of the Medicare recipients surveyed support the idea that Medicare or Medicare-like coverage should be extended to all Americans, according to an eHealth survey set to be released Tuesday. That number is down from 41% a year ago, according to eHealth, a digital health insurance marketplace company. EHealth surveyed 1,000 Medicare beneficiaries.
Warren had surged to front-runner status late last year, but she faced criticism for the price tag, and her position in the polls began to dwindle until she ended her campaign after Super Tuesday.
Sanders has refused to outline how he would pay for his version of a universal health-care system, though he argues that existing federal taxes already cover a large part of what his plan would “They just don’t think that those under include. 65 should be able to participate, and you can’t really blame them,” FlanAnalysts project that Sanders’ Medicare ders said in an exclusive interview for All proposal would cost $32 trillion with “Mad Money” host Jim Cramer. over 10 years. “They’ve been paying into Medicare all their lives and it’s like: ‘Wait a min“I like her,” Flanders said of Warren. ute, we don’t want [to be] flooded by “She’s smart and, you know, she works people who haven’t paid into it.’ And so to actually be able to explain what she that number is up to 58% of Medicare offers. But when it was explained it was beneficiaries who say we should not rejected, and it’s because it truly — at have Medicare for All.” this stage of our GDP — it’s not affordable.” The U.S. government launched Medicare more than five decades ago to inEHealth shares fell almost 3% during sure people 65 and older. The program Monday’s market-wide sell-off. The also supports some people with disabilstock is up 36% to $130.70 per share ities who do not meet the age threshsince the beginning of 2020. old, along with those with permanent kidney failure, according to its website. Source: CNBC The report will come out in the thick of the Democratic Party’s presidential primary race as voters in six states, including Michigan, get to cast their ballots in the contest Tuesday. The tight race pits former Vice President Joe Biden, who says he 18 wants to expand on the current
Eufy Smart Scale C1 With Apple Health Support For $17 Only By Apple Byte
TECH
Regular scales are not an accurate measurement of your body’s health – Not even close. Many people focus on scales to “lose weight” and want to see the weight decrease. However, losing fat and building lean muscle does not work like that. This is because when you are trying to lose weight, this almost always includes exercise. Exercising will help to build lean muscle. As you are burning fat and becoming healthier your weight may not change (depending on your body). The Eufy Smart Scale C1 is available in two This is why you need to focus on is body- colors black or white. It is on par with the fat percentage as opposed to total body other more expensive models. weight. Some people will get discouraged when they start working out only to see the number on the scale increase. The number on the scale is not an accurate representation of your health or weight loss progress. To understand your body’s composition and health, you will be better off if you had a way to measure your muscle mass, fat percentage, etc. These measurements are not possible with traditional scales, but with smart scales, you can not only measure these essential body composition metrics, but new smart scales use Bluetooth technology to help you visualize this data, present you with trend graphs and help you understand how your body works.
your weight. Your weight is the only measurement that will be displayed directly on the scale. To view your other measures, you can open the App. I like that the design is modern and stylish. I feel like this scale smoothly goes with any bathroom decor.
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BMI: (Body Mass Index) Calculated by your height and weight. • Water: This is the percentage of your body composition of water to weight. Having a healthy water ratio can help promote a healthy metabolism. • BMR: (Basal Metabolic Rate) This is the amount of energy your body uses just to perform it’s basic functions day to day. BMR is based on your age, gender, height, and weight. • Visceral Fat: This type of body fat is stored in the abdominal cavity. • Body Fat Mass: This is the total body fat mass in your body. • Lean Body Mass: This is the amount of your body weight that is not fat. • Bone Mass: The total mass of bones in the body, also known as bone density. • Bone Mass %: This is the percentage of bone mass compared to the total body mass. The average bone mass percentage for adults is between 3% and 5%. Bone mass can decline slowly as we age so this is a useful metric to keep track of over long periods of time. • Muscle Mass: The total mass of muscle in your body. • Muscle Mass %: Calculated by taking the total muscle mass divided by the total body mass. Source: TheFitnessJunkie
The scale is water resistant, so you don’t have to worry about steam during hot showers or small splashed. Be careful not to step on the scale with super wet feet as you might split.
This smart scales runs on 3 AAA batteries that are included in the box! Smart Scales are a new fitness tech that The batteries should last about one is significantly changing how we measure year. You can switch from lbs to Kg and understand our health. Smart Scales by pressing the UNIT button on the are a fantastic tool to measure your back of the scale. body composition and understand the numbers behind your weight. Wit smart Some of the metrics you can view scales we are now able to measure, in the app are your lean body mass, track, and record our body composition body fat mass, bone mass, and data identify pattered and track our muscle mass. The Eufy app can conoverall health! nect with third-party apps like Apple health, Google Fit, and Fitbit. Eufy is a smart scale I thought stood out from the rest because it has just as 12 Key Body Measurements: many features and metrics with the sleek design and for a much lower price! • Weight: Your total body weight in lbs or kg. The top of the scale has a smooth tem• Body Fat %: This is the total pered glass surface. At the top of the mass of your fat divided by the scale is a large display that will read total body mass.
Pick up a copy on Amazon.com 19
5th Annual UCSF Amputee Comprehensive Training Program Basketball Clinic
I remember as a kid how it felt to wake on a Saturday knowing I was going down to the local gym to play hoops with other kids. The feeling of excitement and joy that overcame me was something I will never forget. I found myself feeling just that as I parked my car and started my walk towards the gym on this Saturday in February. I was invited to attend the to attend the 5th Annual UCSF Amputee Comprehensive Training Program Basketball Clinic which was on Saturday, February 22nd 2020 at the Bakar Fitness and Recreation Center at UCSF. UCSF ACT Team The mission of the UCSF Amputee Comprehensive Training (ACT) Program is to assist those affected by limb loss in maximizing their physical and functional mobility. They sup20 port a community of individuals
motivated to engage in activities they enjoyed prior to amputation and recover a healthy and active lifestyle. The UCSF ACT Program hosts this an annual amputee basketball and mobility clinic every year and this was my first one. The Department of Orthopaedic Surgery at the University of California, San Francisco, Amputee Comprehensive Training (ACT) Program and the Golden State Warriors teamed up for this great event. The ACT Team and the Golden State Warriors came together on an amputee basketball and mobility clinic led by the Warriors Basketball Academy and the AMP1 Basketball Team, the clinic teaches fundamentals of the game in a supportive team environment. The clinic is designed to focus on skill development and mobility for those affected by limb loss while encouraging
a healthy and active lifestyle. Participants of all activity levels and experience were encouraged to attend. The AMP1 Basketball Team is comprised of amputee athletes who connected while seeking opportunities to play competitive stand-up basketball. AMP1 demonstrates that all you need is courage, motivation, and heart to follow your dreams. As I watched the attendees participate in this one of kind basketball camp here in the Bay Area, I people of all ages, sizes and sex using cutting edge technology to push their boundaries and engage in physical activities. People with disabilities often think or feel they are not able to do or be involved with such activities but never try. I think most people here at this clinic today found themselves doing
With the help of high-tech prosthetics from their sponsor, Irvine, California based Freedom Innovations, the AMP1 players have overcome lower limb amputations (due to traumatic accidents, birth defects or cancer) to go on and compete against able-bodied, non-amputee teams in action-packed basketball games. AMP1 won three hotly contested games in the tournament, further building upon their incredible, against-the-odds reputation. AMP1â&#x20AC;&#x2122;s message is one of sheer determination and hope for everyone, especially those who have lost a limb, dealt with physical challenges and anyone who has faced adversity or wants to change their lives.
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5th Annual UCSF ACT Program Basketball Clinic
Photos by Sean R. Harrison
somethings they never though possible. This was the perfect environment for learning a new skill set and learning what possibilities can be achieved.
Photos by Sean R. Harrison
As some of the members of the AMP1 Basketball clearly showed that having a disability does not limit or hold you back from living a active lifestyle. They are the only organized group of amputees playing stand-up basketball in the country, according to UCSF officials. The players have overcome lower limb amputations caused by traumatic accidents, birth defects and cancer to compete against able-bodied, non-amputee teams, according to their Facebook page. People of all ages and backgrounds came to participate in this clinic. I heard some of their stories and why they came to participate. The overriding theme is that the participants enjoyed meeting other people like themselves- other people with prosthetic legs or disabilities. They felt that they could really benefit from being in a supportive community that makes them feel safe while trying new things or things they havenâ&#x20AC;&#x2122;t done in a long time. What an awesome event! 22
For more information on our program and monthly clinics, please email act@ ucsf.edu.
Understanding Medicare Coverage Q. Do I have to enroll in Medicare if I continue to have health coverage after age 65 from my own or my spouse’s employer? A: No — if the employer has 20 or more employees. Probably — if the employer has fewer than 20 workers. Q. I’m about to retire. My employer has offered me 18 months of COBRA coverage. Can I delay signing up for Medicare until the COBRA runs out? A: No, you can’t delay Medicare enrollment until COBRA expires — not without facing a gap in coverage and late penalties.
Q&A
Q. I receive health insurance from my domestic partner’s employer. Can I delay Part B enrollment after I become eligible for Medicare, without risking late penalties? A: No, if you’re not formally married you can’t delay Part B enrollment without penalty, except in some limited circumstances. Q. I will continue to work after turning 65. My employer’s health insurance is a high-deductible health plan paired with a health savings account. How would this fit in with Medicare? A: Under IRS rules, you cannot contribute to a health savings account (HSA) at work in any month that you are enrolled Editor & Host of Amp Life Talk Radio in any part of Medicare. But there are steps you can take to keep your HSA work for large employers after age 65, without being penalized. you can delay signing up for Medicare until you retire. If you’re married and your Q. I’m retired and receive comprehensive health insurance from a former em- FEHB plan covers your spouse, he or she ployer. Do I need to sign up for Medicare can also delay Medicare enrollment until your employment ends. Part B when I turn 65? A: Part B enrollment is not compulsory. Q: I will be retiring soon from my job in You don’t need to sign up if you don’t want to. But if you change your mind at the federal government. I will continue to receive good health coverage from a later date, Medicare will always cost the Federal Employees Health Benefits you far more than if you sign up at 65. Program (FEHB). So do I need Medicare Q: What if I have prescription drug cov- Part B? erage from a current or former employ- A: The FEHB program does not require er? Can I keep it or will Medicare make you to sign up for Medicare Part B, but you may want to consider some factors me drop it and enroll in a Part D drug before making the decision. plan? A: You always have the option to keep Q: I will continue on active duty with the other drug coverage you may have instead of taking Part D. But to avoid late military after I turn 65. I have health insurance under the TRICARE program. Do penalties you need to find out whether I need to sign up for Medicare Part B? the employer coverage is “creditable.” A: No, you need not sign up for Part B Q: I am a federal employee and will con- while you’re still on active duty in one of tinue to work for the government after I the U.S. military services. turn 65, with health care coverage from Q: If I have TRICARE, do I need to have the Federal Employees Health Benefits Part D? Program (FEHB). Do I have to do anyA: Generally, if you have TRICARE, you thing about Medicare? don’t need to enroll in Medicare Part D. A: No, not yet. Like other people who
Sean R. Harrison
Q. I get my prescriptions filled through the VA. Do I need Medicare Part D prescription drug coverage as well? A: You are not required to take Part D coverage. But having drug coverage from both the VA and Part D gives you more choice and convenience. Q. I will soon retire and I’ll be eligible for three types of health insurance: TRICARE For Life due to my service in the military; retiree benefits from my current employer; and Medicare. How will these work together? A: In this specific situation, Medicare pays first, the retiree plan second, and TFL third. Q. If I receive health care from the Indian Health Service, do I need to enroll in Medicare? A: Yes, you are required to sign up for Medicare Parts A and B, though not necessarily for Part D. Q. I have been receiving health care through Medicaid. Will I lose this coverage when I become eligible for Medicare? A: Eligibility for Medicaid depends entirely on your income, according to the rules of your state. If you still qualify for Medicaid when you become eligible for Medicare, you’ll have both at the same time. Q: What is the difference between Medicare and Medicaid? A: Medicare is a federal health insurance program for people age 65 and over and younger people who qualify due to disability. Medicaid, a state-run program, provides health coverage for people with low incomes. Q: Can I get help to pay for my prescription drugs if my income is low? A: Yes. You can apply to the Extra Help program, which provides Medicare Part D prescription drug coverage at low or reduced cost for people with incomes under a certain level. Q: What are the basic rights and responsibilities of people with Medicare? A: No matter what type of Medicare coverage you have, you have certain rights and responsibilities. You have a right to: •
Be treated fairly and not
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LIMB LOSS AWARENESS EVENT
Run, Walk & Kick SATURDAY, APRIL 18, 2020 | 8:00 A.M. – 4:00 P.M. Encompass Health | 1303 Mable Avenue | Modesto CA, 95355 April is limb loss awareness month, and Encompass Healthcare and Hanger Clinic have partnered up to bring you Run, Walk & Kick, an event aimed at raising awareness for the limb loss and limb difference community, their families, and caregivers. The day will be filled with expert knowledge and education for those affected by limb loss as they build their independence through increased mobility. This event is open to anyone in the limb loss and limb difference community, family members, therapists, caregivers, and volunteers. EDUCATION + ACTIVITIES + PEER SUPPORT •
Gait training and assessments
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Prosthetic evaluations, assessments and physical therapy tips
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Walking clinic and walking course Two mile fun run & walk Nutritional advice for diabetics
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Virtual Reality: MiGO peer support Amputee classes: Putting on & cleaning liners, socks, prosthetic sleeves, etc.
FOR QUESTIONS OR TO VOLUNTEER, CONTACT: Sean Harrison, Hanger Clinic | (209) 672-7347 Lisa Clawson, Encompass Health | (209) 404-9876
CONNECT WITH US (877) 442-6437
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HANGERCLINIC.COM
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Understanding Medicare Coverage With Sean R. Harrison
experience discrimination Have access to doctors and hospitals Get emergency and urgently needed care when you need it Know what Medicare will and will not cover Appeal certain decisions about your coverage or payment File complaints about your care Have your personal information kept private
ered drugs (formulary) changes? A: Your drug plan is required to notify you of changes in its coverage and costs in specific circumstances.
Q. My doctor told me he doesn’t accept assignment. Can you explain what this • means? A: A doctor who doesn’t accept assign• ment can charge you up to 15 per• cent more for a medical service than a doctor who accepts assignment. If you’re enrolled in the original Medicare Q. Is my doctor required to file my program, it’s important to ask any docMedicare claims or do I file them with tor you see whether he or she accepts Medicare directly? “assignment” — before you receive care A: In most situations, doctors and other — because this can have an impact on providers that accept Medicare are rewhat you pay. quired by law to submit claims to Medicare. Medicare providers (for example, A doctor who accepts assignment hospitals, skilled nursing facilities, home has agreed to accept the Medicare-aphealth agencies and physicians who ac- proved amount as full payment for any cept assignment) are required by law to covered service provided to a Medicare submit directly to Medicare any claims patient. The doctor sends the whole for covered services that they have pro- bill to Medicare. Medicare pays the 80 vided to Medicare patients. percent of the cost that it has decided is appropriate for the service, and you However, there are situations in which are responsible for the remaining 20 you may be asked to pay a physician percent. who does not accept assignment and A doctor who doesn’t accept asthen submit your own claim for reimsignment can charge up to 15 percent bursement to Medicare, using form above the Medicare-approved amount CMS-1490S. for a service. You are responsible for the additional charge, on top of your Q: What does it mean when doctors regular 20 percent share of the cost. “opt out” of Medicare? The doctor is supposed to submit your A: If you go to a doctor who has opted claim to Medicare, but you may have out of Medicare, you are responsible for to pay the doctor at the time of service the full bill. The vast majority of doctors and then claim reimbursement from choose to participate in Medicare, but Medicare. some do opt out. Opted-out doctors cannot bill Medicare for treating you, If you have Medigap insurance, all poland you cannot claim recompense from icies cover Part B’s 20 percent copays Medicare either, so you end up paying in full or in part. Two policies (F and G) the full cost of whatever the doctor cover excess charges from doctors who charges. don’t accept assignment. If you go to a doctor who’s opted out, he or she should ask you to sign a form, which is essentially a private contract between the two of you, in which you agree to pay the entire bill out of your own pocket.
cause anybody to pay higher premiums or copays than somebody who is in perfect health. However, if you have advanced kidney failure (known as end-stage renal disease or ESRD) you cannot enroll in a Medicare Advantage plan. Nonetheless, you can still get the appropriate treatment — regular dialysis or a kidney transplant — through the original Medicare program. Also, if you develop ESRD while enrolled in a Medicare Advantage plan, you can remain in it. Q. How do I find an insurance company that is approved to sell Medicare supplemental plans (Medigap) in my area? A: You can find a complete list online on Medicare’s website. Or you can call Medicare’s help line or your state department of insurance. — Read Full Answer Q: Is there anyone I can go to for personal help in choosing a Medicare plan or to resolve other issues with Medicare — even if I have to pay for assistance? A: You don’t have to pay to get personal help with Medicare issues. Your state health insurance assistance program (SHIP) provides this service free of charge. Q: Whom do I contact to report Medicare fraud? A: The office of Medicare’s inspector general investigates Medicare fraud and welcomes tip-offs from Medicare beneficiaries. Medicare is often confusing because its rules affect different people in different circumstances. Hopefully this Q&A offers some practical and comprehensive information to help you navigate the program according to your own situation.
Note that these rules apply only to the original Medicare program. If you’re enrolled in a Medicare Advantage plan, such as an HMO or PPO, you pay the specific copays for doctors’ services that You can find more information and your plan requires. more details on this subject at AARP Medicare Question and Answer Tool However, if an opted-out doctor does Q. Can I be denied Medicare coverage, not get you to sign this agreement or if or asked to pay more, because of my For a PDF with Medicare inforyou’re in no position to sign one — for current health problems or preexisting mation please visit: https:// example, if you’re unconscious in the medical conditions? www.medicare.gov/sites/default/ emergency room — you are not respon- A: No. Medicare does not discriminate files/2018-07/11386_-medicare-quessible for paying the bill. between people in poor or good health. tions-answered.pdf Q: Will my Medicare Part D prescription Current and past health problems don’t 26 drug plan notify me if its list of cov- bar anybody from Medicare coverage or
HEALTH & FITNESS How to boost your immune system
Helpful ways to strengthen your immune system and fight off disease Published: September, 2014 | Image: lzf/ Getty Images How can you improve your immune system? On the whole, your immune system does a remarkable job of defending you against disease-causing microorganisms. But sometimes it fails: A germ invades successfully and makes you sick. Is it possible to intervene in this process and boost your immune system? What if you improve your diet? Take certain vitamins or herbal preparations? Make other lifestyle changes in the hope of producing a near-perfect immune response? What can you do to boost your immune system? The idea of boosting your immunity is enticing, but the ability to do so has proved elusive for several reasons. The immune system is precisely that — a system, not a single entity. To function well, it requires balance and harmony. There is still much that researchers don’t know about the intricacies and interconnectedness of the immune response. For now, there are no scientifically proven direct links between lifestyle and enhanced immune function. But that doesn’t mean the effects of lifestyle on the immune system aren’t intriguing and shouldn’t be studied. Researchers are exploring the effects of diet, exercise, age, psychological stress, and other factors on the immune response, both in animals and in humans. In the meantime, general healthy-living strategies are a good way to start giving your immune system the upper hand. Healthy ways to strengthen your immune system Your first line of defense is to choose a healthy lifestyle. Following general good-health guidelines is the single best step you can take toward naturally keeping your immune system strong and healthy. Every part
of your body, including your immune system, functions better when protected from environmental assaults and bolstered by healthy-living strategies such as these: • • • • • • • •
Don’t smoke. Eat a diet high in fruits and vegetables. Exercise regularly. Maintain a healthy weight. If you drink alcohol, drink only in moderation. Get adequate sleep. Take steps to avoid infection, such as washing your hands frequently and cooking meats thoroughly. Try to minimize stress.
Increase immunity the healthy way Many products on store shelves claim to boost or support immunity. But the concept of boosting immunity actually makes little sense scientifically. In fact, boosting the number of cells in your body — immune cells or others — is not
necessarily a good thing. For example, athletes who engage in “blood doping” — pumping blood into their systems to boost their number of blood cells and enhance their performance — run the risk of strokes. Attempting to boost the cells of your immune system is especially complicated because there are so many different kinds of cells in the immune system that respond to so many different microbes in so many ways. Which cells should you boost, and to what number? So far, scientists do not know the answer. What is known is that the body is continually generating immune cells. Certainly it
Nutrition, Exercise & Healthy Living Tips for Amputees produces many more lymphocytes than it can possibly use. The extra cells remove themselves through a natural process of cell death called apoptosis — some before they see any action, some after the battle is won. No one knows how many cells or what the best mix of cells the immune system needs to function at its optimum level. Immune system and age As we age, our immune response capability becomes reduced, which in turn contributes to more infections and more cancer. As life expectancy in developed countries has increased, so too has the incidence of age-related conditions. While some people age healthily, the conclusion of many studies is that, compared with younger people, the elderly are more likely to contract infectious diseases and, even more importantly, more likely to die from them. Respiratory infections, influenza, and particularly pneumonia are a leading cause of death in people over 65 worldwide. No one knows for sure why this happens, but some scientists observe that this increased risk correlates with a decrease in T cells, possibly from the thymus atrophying with age and producing fewer T cells to fight off infection. Whether this decrease in thymus function explains the drop in T cells or whether other changes play a role is not fully understood. Others are interested in whether the bone marrow becomes less efficient at producing the stem cells that give rise to the cells of the immune system. A reduction in immune response to infections has been demonstrated by older people’s response to vaccines. For example, studies of influenza vaccines have shown that for people over age 65, the vaccine is much less effective compared to healthy children (over age 2). But despite the reduction in efficacy, vaccinations for influenza and S. pneumoniae have significantly lowered the rates 27 of sickness and death in older
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HEALTH & FITNESS people when compared with no vaccination. There appears to be a connection between nutrition and immunity in the elderly. A form of malnutrition that is surprisingly common even in affluent countries is known as “micronutrient malnutrition.” Micronutrient malnutrition, in which a person is deficient in some essential vitamins and trace minerals that are obtained from or supplemented by diet, can be common in the elderly. Older people tend to eat less and often have less variety in their diets. One important question is whether dietary supplements may help older people maintain a healthier immune system. Older people should discuss this question with a physician who is well versed in geriatric nutrition, because while some dietary supplementation may be beneficial for older people, even small changes can have serious repercussions in this age group. Diet and your immune system Like any fighting force, the immune system army marches on its stomach. Healthy immune system warriors need good, regular nourishment. Scientists have long recognized that people who live in poverty and are malnourished are more vulnerable to infectious diseases. Whether the increased rate of disease is caused by malnutrition’s effect on the immune system, however, is not certain. There are still relatively few studies of the effects of nutrition on the immune system of humans, and even fewer studies that tie the effects of nutrition directly to the development (versus the treatment) of diseases. There is some evidence that various micronutrient deficiencies — for example, deficiencies of zinc, selenium, iron, copper, folic acid, and vitamins A, B6, C, and E — alter immune responses in animals, as measured in the test tube. However, the impact of these immune system changes on the health of animals is less clear, and the effect of similar deficiencies on the human immune response has yet to be assessed. So what can you do? If you suspect your diet is not providing you with all your micronutrient needs — maybe, for instance, you don’t like vegetables — taking a daily multivitamin and mineral supplement may bring other health benefits, beyond any possibly beneficial effects on the immune
system. Taking megadoses of a single vitamin does not. More is not necessarily better. Improve immunity with herbs and supplements? Walk into a store, and you will find bottles of pills and herbal preparations that claim to “support immunity” or otherwise boost the health of your immune system. Although some preparations have been found to alter some components of immune function, thus far there is no evidence that they actually bolster immunity to the point where you are better protected against infection and disease. Demonstrating whether an herb — or any substance, for that matter — can enhance immunity is, as yet, a highly complicated matter. Scientists don’t know, for example, whether an herb that seems to raise the levels of antibodies in the blood is actually doing anything beneficial for overall immunity. Stress and immune function Modern medicine has come to appreciate the closely linked relationship of mind and body. A wide variety of maladies, including stomach upset, hives, and even heart disease, are linked to the effects of emotional stress. Despite the challenges, scientists are actively studying the relationship between stress and immune function.
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For one thing, stress is difficult to define. What may appear to be a stressful situation for one person is not for another. When people are exposed to situations they regard as stressful, it is difficult for them to measure how much stress they feel, and difficult for the scientist to know if a person’s subjective impression of the amount of stress is accurate. The scientist can only measure things that may reflect stress, such as the number of times the heart beats each minute, but such measures also may reflect other factors.
But it is hard to perform what scientists call “controlled experiments” in human beings. In a controlled experiment, the scientist can change one and only one factor, such as the amount of a particular chemical, and then measure the effect of that change on some other measurable phenomenon, such as the amount of antibodies produced by a particular type of immune system cell when it is exposed to the chemical. In a living animal, and especially in a human being, that kind of control is just not possible, since there are so many other things happening to the animal or person at the time that measurements are being taken.
Most scientists studying the relationship of stress and immune function, however, do not study a sudden, shortlived stressor; rather, they try to study more constant and frequent stressors known as chronic stress, such as that caused by relationships with family, friends, and co-workers, or sustained challenges to perform well at one’s work. Some scientists are investigating whether ongoing stress takes a toll on the immune system.
Despite these inevitable difficulties in measuring the relationship of stress to immunity, scientists are making progress. Does being cold give you a weak immune system? Almost every mother has said it: “Wear a jacket or you’ll catch a cold!” 29 Is she right? So far, researchers
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who are studying this question think that normal exposure to moderate cold doesn’t increase your susceptibility to infection. Most health experts agree that the reason winter is “cold and flu season” is not that people are cold, but that they spend more time indoors, in closer contact with other people who can pass on their germs. But researchers remain interested in this question in different populations. Some experiments with mice suggest that cold exposure might reduce the ability to cope with infection. But what about humans? Scientists have dunked people in cold water and made others sit nude in subfreezing temperatures. They’ve studied people who lived in Antarctica and those on expeditions in the Canadian Rockies. The results have been mixed. For example, researchers documented an increase in upper respiratory infections in competitive cross-country skiers who exercise vigorously in the cold, but whether these infections are due to the cold or other factors — such as the intense exercise or the dryness of the air — is not known. A group of Canadian researchers that has reviewed hundreds of medical studies on the subject and conducted some of its own research concludes that there’s no need to worry about moderate cold exposure — it has no detrimental effect on the human immune system. Should you bundle up when it’s cold outside? The answer is “yes” if you’re uncomfortable, or if you’re going to be outdoors for an extended period where such problems as frostbite and hypothermia are a risk. But don’t worry about immunity. Exercise: Good or bad for immunity? Regular exercise is one of the pillars of healthy living. It improves cardiovascular health, lowers blood pressure, helps control body weight, and protects against a variety of diseases. But does it help to boost your immune system naturally and keep it healthy? Just like a healthy diet, exercise can contribute to general good health and therefore to a healthy immune system. It may contribute even more directly by promoting good circulation, which allows the cells and substances of the immune system to move through the body freely and do their job efficiently. Some scientists are trying to take the next step to determine whether exercise directly affects a person’s susceptibility to infection. For example, some researchers are looking at whether extreme amounts of intensive exercise
HEALTH
can cause athletes to get sick more often or somehow impairs their immune function. To do this sort of research, exercise scientists typically ask athletes to exercise intensively; the scientists test their blood and urine before and after the exercise to detect any changes in immune system components. While some changes have been recorded, immunologists do not yet know what these changes mean in terms of human immune response. But these subjects are elite athletes undergoing intense physical exertion. What about moderate exercise for average people? Does it help keep the immune system healthy? For now, even though a direct beneficial link hasn’t been established, it’s reasonable to consider moderate regular exercise to be a beneficial arrow in the quiver of healthy living, a potentially important means for keeping your immune system healthy along with the rest of your body.
One approach that could help researchers get more complete answers about whether lifestyle factors such as exercise help improve immunity takes advantage of the sequencing of the human genome. This opportunity for research based on updated biomedical technology can be employed to give a more complete answer to this and similar questions about the immune system. For example, microarrays or “gene chips” based on the human genome allow scientists to look simultaneously at how thousands of gene sequences are turned on or off in response to specific physiological conditions — for example, blood cells from athletes before and after exercise. Researchers hope to use these tools to analyze patterns in order to better understand how the many pathways involved act at once. Source: Harvard Health Publishing
3 Vitamins That Are Best for Boosting Your Immunity
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FITNESS
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vitamin C is in so many foods that most people don’t need to take a vitamin C supplement unless a doctor advises it. Vitamin B6 is vital to supporting biochemical reactions in the immune system. Vitamin B6-rich foods include chicken and cold water fish such as salmon and tuna. Vitamin B6 also is found in green vegetables and in chickpeas, which is the main ingredient in hummus. Vitamin E is a powerful antioxidant that helps the body fight off infection. Foods rich in vitamin E include nuts, seeds and spinach.
A simple rule can help you when choosing fruits and vegetables at the grocery store or farmers market: The more colorful the fruits and vegetables are, the better. Try to eat a wide variety foods, and aim to eat fruit and vegetables from every color of the rainbow. Your plate should be more enticing to look at, and you will ensure that you’re getting as many health-boosting vitamins and nutrients as possible. It’s also important to know that you build a strong immune system by maintaining healthy eating habits over time. You can’t eat four oranges at breakfast and expect to be protected that day against catching a cold. Note: Experts say it’s best to get vitamins through food rather than supplements.
What foods you can find them in and how they can help keep you healthy. Here’s what foods to look for: •
Vitamin C is one of the biggest immune system boosters of all. In fact, a lack of vitamin C can even make you more prone to getting sick. Foods rich in vitamin C include oranges, grapefruits, tangerines, strawberries, bell peppers, spinach, kale and broccoli. Daily intake of vitamin C is essential for good health because your body doesn’t produce or store it. The good news is that
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Transcripts from Amp Life Talk Radio - The Podcast INTRO - Welcome to Amp Life Talk Radio - The Podcast Living with limb loss can be challenging. You have questions, concerns, and can feel alone in the process. I’m Sean Harrison, a certified peer visitor for the Amputee Coalition and the host of this show, I be will your guide as you go through this process. Having someone along with you as you become acquainted to living with limb loss is why I am here. Empowering Amputees to Reach Their Full Potential through Communication, Education, & Inspiration. Amp Life Talk Radio is a talk show for amputees and those affected by limb-loss. If you’re an amputee I want you to know you’re not alone. HOOK It is normal to have strong emotional or physical reactions following a distressing event. On most occasions though, these reactions subside as part of the body’s natural healing and recovery process. Family members who experience a shared distressing event often become closer and appreciate each other more. A traumatic experience is any event in life that causes a threat to our safety and potentially places our own life or the lives of others at risk. As a result, a person experiences high levels of emotional, psychological, and physical distress that temporarily disrupts their ability to function normally in day-today life. Examples of potentially traumatic experiences include natural disasters such as a brushfire or flood, experiencing violence in the community, having a serious car accident, or being assaulted. SEGMENT ONE Reactions to trauma In a family, each member will react to the traumatic event in their own way. If family members don’t understand each other’s experience, then misunderstandings, communication breakdowns and other problems can result. Even if you cannot understand exactly what another member is going through, being aware of common reactions and their effect on family life can help everyone cope better in the long run. Examples of common reactions 32 to trauma are:
ShowNotes • • • • • • •
feeling as if you are in a state of ‘high alert’ and are ‘on watch’ for anything else that might happen feeling emotionally numb, as if in a state of ‘shock’ becoming emotional and upset feeling extremely fatigued and tired feeling very stressed and/or anxious being very protective of others including family and friends not wanting to leave a particular place for fear of ‘what might happen’.
Also, it is important to remember that despite the above traumatic reactions, many families look back and see that crises have actually helped them to become closer and stronger. However, don’t hesitate to seek professional help if you are uncertain or think your family is struggling to recover. SEGMENT TWO Family life following the event Every family is different but, generally speaking, common changes to family life soon after the event include: • Parents may fear for each other’s safety and the safety of their children away from home. • Family members may experience nightmares or upsetting dreams about the event. • Fear of another distressing expe-
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rience happening may affect family life. • Anger at whoever is believed to have caused the event can often flow on to the affected loved one or the family in general. • Family members may feel overwhelmed by insecurity or lack of control, or at the thought of having so much to do. • Family members may not know how to talk to each other. Each person is struggling to understand what has happened and how they feel about it. If talking makes people upset, they will often avoid it. • Impatience, misunderstandings, arguments over small things and withdrawal from each other can all impact on family life and relationships. Disruption to family relationships Family relationships can also be affected by a traumatic event – for example, parents may feel unsure about how to help their children after the crisis. Communication breaks down as each family member struggles in their own way to come to terms with what has happened. Children don’t want to go to school. Parents don’t want to go to work. Household schedules tend to lapse – for example, chores are missed, regular mealtimes are disrupted or recreation is neglected. The usual arrangements for household responsibilities change. Children may cook meals for a time, parents may feel unable to do tasks, or children may not want to be alone.
Family life – weeks or months later Family relationships may change weeks or even months after the event. Because time has passed, family members sometimes don’t realize how changes are directly linked to the event. Every family is different but, generally speaking, common changes in the weeks or months after the event include: • Family members may become short-tempered or irritable with
• • • • • • • •
each other, which can lead to arguments and friction. They may lose interest in activities or perform less well at work or school. Children may be clingy, grizzly, demanding or naughty. Teenagers may become argumentative, demanding or rebellious. Individuals may feel neglected and misunderstood. Some family members may work so hard to help loved ones, they neglect to look after themselves. Individual family members may feel less attached or involved with one another. Parents may experience emotional or sexual problems in their relationship. Everyone feels exhausted and wants support, but cannot give much in return.
Family life – years later Sometimes, the response to a distressing or frightening event may take a long time to show. In some cases, it may take years for problems to surface. This can happen if the person is very busy helping others or dealing with related issues, such as insurance, rebuilding, relocation, legal processes or financial problems. When things have returned to normal, their reactions may show up. Every family is different but, generally speaking, changes to family dynamics can include: • The experience may be relived when faced with a new crisis. • Problems may seem worse than they are and be more difficult to handle. • Changes to family life that occurred in the days, weeks or months after the event may become permanent habits. • Family members may cope differently with reminders of the event. Some may want to commemorate the anniversary or revisit the scene of the event, while others may want to forget about it. • Conflict in coping styles can lead to arguments and misunderstandings if the family members aren’t sensitive to each other’s needs. SEGMENT THREE People react differently to trauma It is important to remember that it is normal for people to respond in different ways to distressing events. However, sometimes people’s responses can clash. One person may withdraw and need time to themselves, while the other needs company and wants to talk about it. Although this can
seem quite confusing at times, giving a person the necessary space to work through their own reaction can be extremely helpful. With families, common reactions may include: • strong feelings – include anxiety, fear, sadness, guilt, anger, vulnerability, helplessness or hopelessness. These feelings will not just apply to the event, but to many other previously normal areas of life as well • physical symptoms – include headache, nausea, stomach ache, insomnia, broken sleep, bad dreams, changed appetite, sweating and trembling, aches and pains, or a worsening of pre-existing medical conditions • thinking is affected – include difficulties with concentrating or thinking clearly, short-term memory problems, difficulty planning or making decisions, inability to absorb information, recurring thoughts of the traumatic event, thinking about other past tragedies, pessimistic thoughts or an inability to make decisions • behavior changes – include a drop in work or school performance, turning to changed eating patterns, using drugs or alcohol, being unable to rest or keep still, lack of motivation to do anything, increased aggressiveness or engaging in self-destructive or self-harming activities. SEGMENT FOUR Helpful strategies for recovery from trauma Some things you can do to reduce complications and support family recovery include: • Remember that recovery takes time. Prepare the family members to go through a period of stress and cut back on unnecessary demands to conserve everyone’s energy. • Don’t just focus on the problems. Make free time to be together and relax, or else the stress will not subside. • Keep communicating. Make sure each family member lets the others know what is going on for them and how to help them. • Plan regular time out and maintain activities you enjoyed before – even if you don’t much feel like it. You probably will enjoy yourself if you make the effort. Enjoyment and relaxation rebuild emotional energy. • Keep track of your family’s progress in recovery and what has
•
been achieved. Don’t just keep thinking about what is still to be done. Stay positive and encouraging, even if at times, everyone needs to talk about their fears and worries. Remind yourself that families get through the hard times and are often stronger.
TAKE CALLS ( 1 - MINUTE PER CALL ) LIMIT TO 10 MAX. CONCLUSION Seeking help from a health professional Traumatic stress can cause very strong reactions in some people and may become chronic (ongoing). You should seek professional help if you: • are unable to handle the intense feelings or physical sensations • don’t have normal feelings, but continue to feel numb and empty • feel that you are not beginning to return to normal after three or four weeks • continue to have physical stress symptoms • continue to have disturbed sleep or nightmares • deliberately try to avoid anything that reminds you of the traumatic experience • have no one you can share your feelings with • find that relationships with family and friends are suffering • are becoming accident-prone and using more alcohol or drugs • cannot return to work or manage responsibilities • keep reliving the traumatic experience • feel very much on edge and can be easily startled. WRAP-UP I would like to thank everyone for tuning into another episode of Amp Life Talk Radio a show for amputees and by an amputee. I hope you found the information shared tonight useful. Please leave me a comment on our Facebook Page: Amp Life Talk Radio good or bad. Remember the show is every Wednesday at 5:30 PM, the “LIVE” call-in show Toll-Free Line is (888) 979-9334, Goto http://amplifetalkradio.com
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INFLUENZA (FLU) Cleaning to Prevent the Flu Cleaning to Prevent the Flu
48 hours
How long can the flu virus live on objects, such as doorknobs and tables? The flu virus can “live” on some surfaces for up to 48 hours. Routine cleaning of surfaces may reduce the spread of flu.
What kills flu viruses? Flu viruses are killed by heat above 167° F [75° C]. Common household cleaning products can also kill the flu virus, including products containing: • chlorine • hydrogen peroxide • detergents (soap) • iodophors (iodine-based antiseptics) • alcohols
How should a caregiver handle a sick person’s tissues or other items? Make sure to wash your hands after touching the sick person. Also wash after handling their tissues or laundry.
For more information call CDC info at 1-800-CDC-INFO (232-4636) or go to www.cdc.gov/flu.
PUBLIC SERVICE ANNOUNCEMENT U.S. Department of Health and Human Services Centers for Disease Control and Prevention CS 290778-A/2018
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