Monday, December 31, 2018
New Year's Eve Party in Times Square to Cheer for Press Freedom
By Jonathan Allen
NEW YORK (Reuters) - Reporters will be the guests of honor at the New Year's Eve party in New York's Times Square on Monday, in what organizers said was a celebration of press freedom after an unusually deadly year for journalists at U.S. news outlets.
Two attacks in particular weighed on organizers as they discussed in autumn whom to give the honor of initiating the ceremonial ball drop just before midnight, according to Tim Tompkins, president of the Times Square Alliance.
One was the killing of Jamal Khashoggi, a Saudi columnist for the Washington Post and U.S. resident, inside a Saudi Arabian consulate in Turkey. The other was the mass shooting in June in the newsroom of The Capital, a newspaper in Annapolis, Maryland, in which five employees were killed.
"Throughout the year it's been a big issue," Tompkins said in an interview. "Times Square itself is the ultimate agora and public space," noting that the area was named after the New York Times, and that it was a Times publisher, Adolf Ochs, who began the tradition of the ball drop in 1907.
Joel Simon, executive director of the Committee to Protect Journalists, said the Times Square Alliance approached his group because of "the perception that the journalism and journalists in particular are under threat and their role is being questioned."
Simon, who said he usually spends New Year's Eve playing Scrabble with his wife in New Hampshire's White Mountains, will be in the spotlight at the Times Square festivities, joining Mayor Bill de Blasio to launch the ball drop a minute before midnight.
Simon will be joined onstage by journalists from U.S. and international news outlets, including NBC Nightly News and Dateline NBC anchor Lester Holt, ABC News Chief Global Affairs Correspondent Martha Raddatz, and Karen Attiah, global opinions editor at The Washington Post.
A year ago Attiah recruited Khashoggi to work at the newspaper. Since the writer was killed, she has been among those leading calls for answers about his fate.
The button-pressing honor has in previous years gone to United Nations Secretary-General Ban Ki-Moon, an Iraq War veteran, U.S. Supreme Court Justice Sonia Sotomayor and the singer Lady Gaga.
The Times Square Alliance contacted Simon in November, Simon said, several weeks before Time magazine would devote their annual "Person of the Year" issue to several prominent journalists who have faced attacks and hostility.
Among those journalists were Khashoggi, and Wa Lone and Kyaw Soe Oo, two Reuters reporters imprisoned by Myanmar for investigating how the country's security forces killed members of the country's Muslim Rohingya minority.
U.S. President Donald Trump has become a vociferous critic of parts of the press, routinely chiding reporters and outlets he views as publishing "fake news," calling them "the enemy of the people."
Simon said this was in the background of his discussions with the Times Square Alliance.
"Unavoidably, Trump was the subtext, but not front and center," he said. "We wanted to have a unifying message."
(Reporting by Jonathan Allen; editing by Jonathan Oatis and Diane Craft)
NEW YORK (Reuters) - Reporters will be the guests of honor at the New Year's Eve party in New York's Times Square on Monday, in what organizers said was a celebration of press freedom after an unusually deadly year for journalists at U.S. news outlets.
Two attacks in particular weighed on organizers as they discussed in autumn whom to give the honor of initiating the ceremonial ball drop just before midnight, according to Tim Tompkins, president of the Times Square Alliance.
One was the killing of Jamal Khashoggi, a Saudi columnist for the Washington Post and U.S. resident, inside a Saudi Arabian consulate in Turkey. The other was the mass shooting in June in the newsroom of The Capital, a newspaper in Annapolis, Maryland, in which five employees were killed.
"Throughout the year it's been a big issue," Tompkins said in an interview. "Times Square itself is the ultimate agora and public space," noting that the area was named after the New York Times, and that it was a Times publisher, Adolf Ochs, who began the tradition of the ball drop in 1907.
Joel Simon, executive director of the Committee to Protect Journalists, said the Times Square Alliance approached his group because of "the perception that the journalism and journalists in particular are under threat and their role is being questioned."
Simon, who said he usually spends New Year's Eve playing Scrabble with his wife in New Hampshire's White Mountains, will be in the spotlight at the Times Square festivities, joining Mayor Bill de Blasio to launch the ball drop a minute before midnight.
Simon will be joined onstage by journalists from U.S. and international news outlets, including NBC Nightly News and Dateline NBC anchor Lester Holt, ABC News Chief Global Affairs Correspondent Martha Raddatz, and Karen Attiah, global opinions editor at The Washington Post.
A year ago Attiah recruited Khashoggi to work at the newspaper. Since the writer was killed, she has been among those leading calls for answers about his fate.
The button-pressing honor has in previous years gone to United Nations Secretary-General Ban Ki-Moon, an Iraq War veteran, U.S. Supreme Court Justice Sonia Sotomayor and the singer Lady Gaga.
The Times Square Alliance contacted Simon in November, Simon said, several weeks before Time magazine would devote their annual "Person of the Year" issue to several prominent journalists who have faced attacks and hostility.
Among those journalists were Khashoggi, and Wa Lone and Kyaw Soe Oo, two Reuters reporters imprisoned by Myanmar for investigating how the country's security forces killed members of the country's Muslim Rohingya minority.
U.S. President Donald Trump has become a vociferous critic of parts of the press, routinely chiding reporters and outlets he views as publishing "fake news," calling them "the enemy of the people."
Simon said this was in the background of his discussions with the Times Square Alliance.
"Unavoidably, Trump was the subtext, but not front and center," he said. "We wanted to have a unifying message."
(Reporting by Jonathan Allen; editing by Jonathan Oatis and Diane Craft)
Sunday, December 30, 2018
Saturday, December 29, 2018
My dry socket has healed
My dry socket took a week to quit hurting so horribly. I found the salt water rinse or the hydrogen peroxide rinse after brushing, after I ate each time, seemed to help. I also bought a new toothbrush, motrin and some sensitive toothpaste which is when the pain began to be bearable.
It seemed to take so long to heal and trying all sorts of things to even get it to stop hurt so much at night. In the beginning I couldn't sleep unless I had a heating pad on it for at least 30 minutes.
My face all the up to my eye socket has now become better. However, if I do chew on that side of my mouth sometimes it will hurt. So I basically am now learning to chew on the opposite side as my primary.
I also learned one needs to get another toothbrush every 3 months. I was doing it every 6 months and now think that contributed to my infection at the start.
Thanks to all of you who have followed me through this painful journey. I also updated on the original post as I was going through this so you may check it out.
It seemed to take so long to heal and trying all sorts of things to even get it to stop hurt so much at night. In the beginning I couldn't sleep unless I had a heating pad on it for at least 30 minutes.
My face all the up to my eye socket has now become better. However, if I do chew on that side of my mouth sometimes it will hurt. So I basically am now learning to chew on the opposite side as my primary.
I also learned one needs to get another toothbrush every 3 months. I was doing it every 6 months and now think that contributed to my infection at the start.
Thanks to all of you who have followed me through this painful journey. I also updated on the original post as I was going through this so you may check it out.
Thursday, December 27, 2018
Ford Recalling 874,000 Pickup Trucks in North America for Fire Risks
WASHINGTON (Reuters) - Ford Motor Co said Friday it is recalling 874,000 pickup trucks in North America with engine block heaters for fire risks.
The second largest U.S. automaker said the recall covers some 2015-2019 Ford F-150 trucks, along with the 2017-2019 Ford F-250 Super Duty, F-350 Super Duty, F-450 Super Duty, and F-550 Super Duty pick-up trucks.
Ford said water and contaminants may get into the block heater cable's splice connector, causing corrosion and damage and potentially a fire. Ford told U.S. regulators it is aware of reports of three fires in Canada linked to the issue, but unaware of any reports of accidents or injuries.
The recall covers 410,000 vehicles in the United States and about 464,000 in Canada. Ford dealers will inspect and seal the block heater cable, or replace it if necessary. The recall will begin early next month.
(Reporting by David Shepardson; Editing by Chizu Nomiyama and Nick Zieminski)
The second largest U.S. automaker said the recall covers some 2015-2019 Ford F-150 trucks, along with the 2017-2019 Ford F-250 Super Duty, F-350 Super Duty, F-450 Super Duty, and F-550 Super Duty pick-up trucks.
Ford said water and contaminants may get into the block heater cable's splice connector, causing corrosion and damage and potentially a fire. Ford told U.S. regulators it is aware of reports of three fires in Canada linked to the issue, but unaware of any reports of accidents or injuries.
The recall covers 410,000 vehicles in the United States and about 464,000 in Canada. Ford dealers will inspect and seal the block heater cable, or replace it if necessary. The recall will begin early next month.
(Reporting by David Shepardson; Editing by Chizu Nomiyama and Nick Zieminski)
Tuesday, December 25, 2018
Monday, December 24, 2018
Sunday, December 23, 2018
Saturday, December 22, 2018
10 Vinegar Tips to Hack the Holidays Vinegar is the gift that keeps on giving! These easy vinegar tips will help you welcome guests without stress and keep spirits high during the holidays!
1) Avoid holiday tears when your little ones wash up for company! Easily detangle kids’ hair with a quick splash of apple cider vinegar during the final rinse.
2) Don’t be naughty this Christmas! Take 1 tbsp of organic apple cider vinegar 3 times a day by mouth; it may help ease some sinus aches and pains.
3) Don’t let a sore throat sour your holiday parties! Gargling a mixture of warm water and a spoonful of organic apple cider vinegar may help soothe throat pain.
4) Too many candy canes? Calm upset stomachs by putting a few spoonfuls of peppermint vinegar in a glass of warm water. Make peppermint vinegar at home by putting a few leaves of peppermint in a jar of organic apple cider vinegar and letting it sit in a dark cabinet for at least 3 days.
5) Don’t let your cough get in the way of your holiday laughter! Use this special vinegar treatment. Mix ½ cup of organic apple cider vinegar, ½ cup of water, 1 tsp cayenne pepper and ¼ cup of honey. Take one tablespoon of the mixture as soon as a cough appears and again before bed.
6) If your heating unit is making your rooms dry, make sure you are keeping your humidifiers on! Clean your room humidifiers with equal parts water and white distilled vinegar. Soak each of the parts in the solution overnight and rinse the water reservoir with the solution as well. This will prevent mold and bacteria from growing in the humidifier.
7) Polish wood paneling with a solution of ¼ cup olive oil, ½ cup white distilled vinegar, and 2 cups of warm water. Wipe wood paneling with a soft cloth. Do not use with waxed wood as it can ruin the finish and leave a cloudy mark.
8) Is the family staying over for the holidays? Remove build-up on the guest room showerhead. Pour ½ cup of baking soda and 1 cup of white distilled vinegar into a sandwich bag and tie the bag around the showerhead. Let the mixture set for an hour or until the bubbling has stopped. Remove the bag and turn on water for best results.
9) Get ready for the family reunions to begin! Deodorize the toilet bowl for holiday guests quickly by adding 3 cups of white distilled vinegar to the bowl. Let sit for half an hour before flushing.
10) Did the kids draw on the couch again? Use full strength vinegar to remove ballpoint pen marks on cloth furniture. Blot the area gently until the marks are gone.
From Vinegartips.com
2) Don’t be naughty this Christmas! Take 1 tbsp of organic apple cider vinegar 3 times a day by mouth; it may help ease some sinus aches and pains.
3) Don’t let a sore throat sour your holiday parties! Gargling a mixture of warm water and a spoonful of organic apple cider vinegar may help soothe throat pain.
4) Too many candy canes? Calm upset stomachs by putting a few spoonfuls of peppermint vinegar in a glass of warm water. Make peppermint vinegar at home by putting a few leaves of peppermint in a jar of organic apple cider vinegar and letting it sit in a dark cabinet for at least 3 days.
5) Don’t let your cough get in the way of your holiday laughter! Use this special vinegar treatment. Mix ½ cup of organic apple cider vinegar, ½ cup of water, 1 tsp cayenne pepper and ¼ cup of honey. Take one tablespoon of the mixture as soon as a cough appears and again before bed.
6) If your heating unit is making your rooms dry, make sure you are keeping your humidifiers on! Clean your room humidifiers with equal parts water and white distilled vinegar. Soak each of the parts in the solution overnight and rinse the water reservoir with the solution as well. This will prevent mold and bacteria from growing in the humidifier.
7) Polish wood paneling with a solution of ¼ cup olive oil, ½ cup white distilled vinegar, and 2 cups of warm water. Wipe wood paneling with a soft cloth. Do not use with waxed wood as it can ruin the finish and leave a cloudy mark.
8) Is the family staying over for the holidays? Remove build-up on the guest room showerhead. Pour ½ cup of baking soda and 1 cup of white distilled vinegar into a sandwich bag and tie the bag around the showerhead. Let the mixture set for an hour or until the bubbling has stopped. Remove the bag and turn on water for best results.
9) Get ready for the family reunions to begin! Deodorize the toilet bowl for holiday guests quickly by adding 3 cups of white distilled vinegar to the bowl. Let sit for half an hour before flushing.
10) Did the kids draw on the couch again? Use full strength vinegar to remove ballpoint pen marks on cloth furniture. Blot the area gently until the marks are gone.
From Vinegartips.com
CDC Issues Alert for Polio-like Illness
Infectious diseases continue to surprise physicians, scientists and the general public. In South Dakota, the first case of acute flaccid myelitis, or AFM, has been confirmed by state health officials. This illness resembles polio in its symptoms and progression.
State health officials in South Dakota are working with investigators at the Centers for Disease Control and Prevention to identify risk factors, possible contacts and to trace anyone who might have been exposed.
New South Dakota AFM Case
The confirmed case of AFM in South Dakota occurred in an adult. The patient experienced a course of disease that included a mild respiratory illness and fever. These symptoms were followed by muscle weakness, which lead to the patient's hospitalization and testing of biological specimens.
Epidemiology of National Cases
So far in 2018, there have been 165 confirmed cases of AFM in 36 states. Most of the cases have occurred in children ages 18 or younger. The cases appear to have a cyclical or seasonal distribution, which is also similar to polio. The CDC has been tracking cases of AFM since 2014. More than 90 percent of those cases started with symptoms of a mild respiratory illness before progressing to muscle weakness that required hospitalization. Most cases are diagnosed between the months of August and October.
Symptoms
Most AFM symptoms focus on the central nervous system. The symptoms include weakness of the facial muscles, droopiness of one side of the face and difficulty with moving the eyes in a coordinated way. Patients may also develop droopy eyelids, difficulty with swallowing and slurred speech. The CDC recommends that parents who notice any of these symptoms in their child seek medical care as quickly as possible.
Possible Cause
The CDC has been able to rule out a variety of known viruses, including enteroviruses and poliovirus in stool specimens taken from the patients. It is possible that an as-yet undiscovered enterovirus is responsible for AFM. These viruses are known for causing infectious illnesses that are typically mild.
Treatment Options
Currently, there is no specific treatment for AFM. However, clinicians can offer supportive care for patients affected by the disease. Clinicians might recommend interventions such as speech therapy for swallowing disorders. Neurologists might recommend physical therapy for patients who experience muscle weakness or a decrease in the ability to ambulate. Occupational therapy may be recommended for patients who develop arm weakness and difficulty with movements of their hands.
Ongoing Research
CDC and other researchers continue to look into the cause of AFM. The researchers are also investigating whether certain environmental triggers may increase a person's risk of developing AFM. Clinicians and researchers together are working to learn more about the disease process and what causes the neurological symptoms to develop. Although there are no specific ways to prevent AFM, the CDC and South Dakota health officials remind people that hand washing and avoiding sick people are key methods of preventing the spread of infectious illnesses.
Prevention
Since we don't know the cause of most of these AFM cases or what triggers this condition, there is no specific action to take to prevent AFM.
Certain viruses are known to cause AFM including enteroviruses, such as poliovirus and enterovirus A71 (EV-A71), and West Nile virus.
You can protect yourself and your children from poliovirus by getting vaccinated. Polio vaccine contains inactivated (not live) virus, and protects against poliovirus. This vaccine does not protect against other viruses that may cause AFM.
You can protect against bites from mosquitoes, which can carry West Nile virus, by using mosquito repellent, staying indoors at dusk and dawn (when bites are more common), and removing standing or stagnant water near your home (where mosquitoes can breed).
You can protect yourself and others from enteroviruses by washing your hands often(https://www.cdc.gov/handwashing/when-how-handwashing.html) with soap and water, avoiding close contact with people who are sick, and cleaning and disinfecting frequently touched surfaces, including toys.
State health officials in South Dakota are working with investigators at the Centers for Disease Control and Prevention to identify risk factors, possible contacts and to trace anyone who might have been exposed.
New South Dakota AFM Case
The confirmed case of AFM in South Dakota occurred in an adult. The patient experienced a course of disease that included a mild respiratory illness and fever. These symptoms were followed by muscle weakness, which lead to the patient's hospitalization and testing of biological specimens.
Epidemiology of National Cases
So far in 2018, there have been 165 confirmed cases of AFM in 36 states. Most of the cases have occurred in children ages 18 or younger. The cases appear to have a cyclical or seasonal distribution, which is also similar to polio. The CDC has been tracking cases of AFM since 2014. More than 90 percent of those cases started with symptoms of a mild respiratory illness before progressing to muscle weakness that required hospitalization. Most cases are diagnosed between the months of August and October.
Symptoms
Most AFM symptoms focus on the central nervous system. The symptoms include weakness of the facial muscles, droopiness of one side of the face and difficulty with moving the eyes in a coordinated way. Patients may also develop droopy eyelids, difficulty with swallowing and slurred speech. The CDC recommends that parents who notice any of these symptoms in their child seek medical care as quickly as possible.
Possible Cause
The CDC has been able to rule out a variety of known viruses, including enteroviruses and poliovirus in stool specimens taken from the patients. It is possible that an as-yet undiscovered enterovirus is responsible for AFM. These viruses are known for causing infectious illnesses that are typically mild.
Treatment Options
Currently, there is no specific treatment for AFM. However, clinicians can offer supportive care for patients affected by the disease. Clinicians might recommend interventions such as speech therapy for swallowing disorders. Neurologists might recommend physical therapy for patients who experience muscle weakness or a decrease in the ability to ambulate. Occupational therapy may be recommended for patients who develop arm weakness and difficulty with movements of their hands.
Ongoing Research
CDC and other researchers continue to look into the cause of AFM. The researchers are also investigating whether certain environmental triggers may increase a person's risk of developing AFM. Clinicians and researchers together are working to learn more about the disease process and what causes the neurological symptoms to develop. Although there are no specific ways to prevent AFM, the CDC and South Dakota health officials remind people that hand washing and avoiding sick people are key methods of preventing the spread of infectious illnesses.
Prevention
Since we don't know the cause of most of these AFM cases or what triggers this condition, there is no specific action to take to prevent AFM.
Certain viruses are known to cause AFM including enteroviruses, such as poliovirus and enterovirus A71 (EV-A71), and West Nile virus.
You can protect yourself and your children from poliovirus by getting vaccinated. Polio vaccine contains inactivated (not live) virus, and protects against poliovirus. This vaccine does not protect against other viruses that may cause AFM.
You can protect against bites from mosquitoes, which can carry West Nile virus, by using mosquito repellent, staying indoors at dusk and dawn (when bites are more common), and removing standing or stagnant water near your home (where mosquitoes can breed).
You can protect yourself and others from enteroviruses by washing your hands often(https://www.cdc.gov/handwashing/when-how-handwashing.html) with soap and water, avoiding close contact with people who are sick, and cleaning and disinfecting frequently touched surfaces, including toys.
Friday, December 21, 2018
Dry Socket
I had a tooth extracted in pieces since it split down the center and small pieces were coming out as I ate. There was the one side that didn't loose any pieces of the tooth so it was higher on the outside then the inside. Pain has been persistent and it has now been a week.
Update on 12/27/2018= below
Dentist is out of town but nurse told me, after she spoke with him, that it sounds like dry socket. Holy moly it is worse then the days following the procedure. Today makes day 8 but the pain got so much worse last night on day 7. I tried ice and a heating pad, aspirin, orajel, another type of oral toothache remedy, I even rubbed my gums and the socket with whiskey. Alas, nothing worked as it woke me up at 1 a.m. this morning not allowing me to go back to sleep until 4 a.m. Dentist said get some Motrin, Alleve is the same and you use less pills so I got there.
No matter what I eat, cold or hot or soft food it begins hurting all over again. I must drink my water warm not cold nor hot. Same with taking my medications. And the pain radiates all the way up the side of my face into my eye socket too.
So I have almost given up. I came up with an idea for a poultice so I made it and have it in my mouth now. I am using Kratom mixed with whiskey into a paste and put it into the socket and gauze on top of that. Right now it is working but it's only been about an hour. Hope and pray it does let me sleep better tonight.
Whether it works or not I will update this tomorrow.
Update: The poultice helped relieve the pain for about an hour. When I tried putting on another poultice it hurt too bad to keep it on. Bummer.
Today I am going to try some Hydrogen Peroxide to rinse my mouth in case there could be some infection. I will do this after eating and brushing my teeth each time. Let's see if this trial is a good one.
Update 12/23/2018:
The hydrogen peroxide has helped after eating but it only lasts for a few hours. Which is better then being in pain all day. However, when I eat, even soft or liquids, I have the intense pain and have to treat it with all the above items I listed on day one. This is not going to be a great Christmas dinner. Actually today we are having a Holiday Dinner since my Uncle doesn't celebrate on actual Christmas.
Finally, today the 24th of December 2018 my pain has been less frequent and less pain. Glad I got a break from it today.
Update on 12/27/2018: Got some Motrin and have been using it with the oragel and being careful to eat on opposite side. Even though I eat on opposite side I still feel pain when I eat and for awhile afterwards. The pain right now is lessening.
Update on 12/27/2018= below
Dentist is out of town but nurse told me, after she spoke with him, that it sounds like dry socket. Holy moly it is worse then the days following the procedure. Today makes day 8 but the pain got so much worse last night on day 7. I tried ice and a heating pad, aspirin, orajel, another type of oral toothache remedy, I even rubbed my gums and the socket with whiskey. Alas, nothing worked as it woke me up at 1 a.m. this morning not allowing me to go back to sleep until 4 a.m. Dentist said get some Motrin, Alleve is the same and you use less pills so I got there.
No matter what I eat, cold or hot or soft food it begins hurting all over again. I must drink my water warm not cold nor hot. Same with taking my medications. And the pain radiates all the way up the side of my face into my eye socket too.
So I have almost given up. I came up with an idea for a poultice so I made it and have it in my mouth now. I am using Kratom mixed with whiskey into a paste and put it into the socket and gauze on top of that. Right now it is working but it's only been about an hour. Hope and pray it does let me sleep better tonight.
Whether it works or not I will update this tomorrow.
Update: The poultice helped relieve the pain for about an hour. When I tried putting on another poultice it hurt too bad to keep it on. Bummer.
Today I am going to try some Hydrogen Peroxide to rinse my mouth in case there could be some infection. I will do this after eating and brushing my teeth each time. Let's see if this trial is a good one.
Update 12/23/2018:
The hydrogen peroxide has helped after eating but it only lasts for a few hours. Which is better then being in pain all day. However, when I eat, even soft or liquids, I have the intense pain and have to treat it with all the above items I listed on day one. This is not going to be a great Christmas dinner. Actually today we are having a Holiday Dinner since my Uncle doesn't celebrate on actual Christmas.
Finally, today the 24th of December 2018 my pain has been less frequent and less pain. Glad I got a break from it today.
Update on 12/27/2018: Got some Motrin and have been using it with the oragel and being careful to eat on opposite side. Even though I eat on opposite side I still feel pain when I eat and for awhile afterwards. The pain right now is lessening.
Thursday, December 20, 2018
Stress, Sadness Really Can Break Your Heart
Dec. 17, 2018 -- The loss of a spouse. The loss of a pet.
Researchers have confirmed in recent years what people long suspected: Extreme stress can literally break your heart. And as they learn more about the relatively rare condition, they are finding that it’s not only caused by the loss of a loved one. Medical treatments, job loss, and other major life stressors have been linked to the condition.
The syndrome, known medically as takotsubo cardiomyopathy, mainly affects women. While the medical literature on broken heart syndrome is sparse, more cases are coming to light, with additional information about how it happens and how long-term the risks are.
Earlier this year, Canadian researchers reported a case of broken heart syndrome in a 63-year-old woman on treatments for metastatic breast cancer.
Over a 6-year period, researchers from MD Anderson Cancer Center in Houston found 30 patients having cancer treatment fit the criteria for broken heart syndrome. Fortunately, none had a recurrence, but the researchers say the diagnosis should be considered in cancer patients who get chest pain.
In another report, a doctor presented case histories of two older women, one treated for chronic lung disease and the other for gastritis, who had broken heart syndrome.
When a patient’s heart “breaks,” the main pumping chamber, the left ventricle, weakens, leading to pain and shortness of breath. The condition is reversible and temporary but can lead to complications similar to those after a heart attack. Experts think it’s caused by a flood of hormones (such as adrenaline) produced during a stressful situation that stuns the heart.
That’s what happened to Joanie Simpson, 63, who had broken heart syndrome 2 years ago after the death of her beloved Yorkshire terrier, Meha.
Meha’s death was just one of many challenges Simpson had at the time. Her husband was about to retire, she recalls. The sale of some property wasn't going smoothly. Her son was dealing with worsening back problems. Her son-in-law lost his job.
Then little Meha, whom the couple had adopted when she was just a year old, was diagnosed with congestive heart failure.
Her decline was difficult to watch. And after she died, Simpson thought she was coping, but a few days later, she woke up with chest and shoulder pains, fearing the worst -- a massive heart attack. At the hospital, her doctor, Abhijeet Dhoble, MD, a cardiologist at Houston's Memorial Hermann Heart & Vascular Institute, did too.
After running some tests, he found a different cause of her pain: a broken heart.
More than 6,200 cases of broken heart syndrome were reported in 2012 in the United States, up from about 300 in 2006, says Dhoble. Most patients are women. The increase, he says, is likely because more people know about the condition.
Often, a patient has many things happening at once, "and something trips them over," Dhoble says. "There is almost always a very distinct stressor. If you ask patients carefully, they will tell you that."
Dhoble published a study in The New England Journal of Medicine about Simpson’s case, which happened in May 2016.
The condition doesn't just happen after a person or a pet dies, says Jeffrey Decker, MD, section chief of clinical cardiology at Frederik Meijer Heart & Vascular Institute of Spectrum Health in Grand Rapids, MI. Nor is it always centered on a health issue.
"I had a lady who was frustrated with the cable company present with this," he says. Another was a woman who found out her daughter lost her job, says Decker, also an assistant professor of medicine at Michigan State University.
Severe pain can trigger the syndrome. So can an asthma attack, a fierce argument, a surprise party, or even public speaking.
Symptoms mimic a heart attack -- most often, chest pains and shortness of breath. Nausea, vomiting, and palpitations can also happen. But only testing can show the diagnosis, says Dhoble.
"Takotsubo" means “octopus pot" in Japanese. Decker says it got that name because when it happens, certain portions of the heart muscle do not move well. Other parts make up for that lack of movement, making the heart look like a pot used by Japanese fishermen to trap octopuses.
About 95% of patients recover within a month or two. "Usually the prognosis is quite favorable," Decker says. Patients usually get the same medications used to treat congestive heart failure to support and strengthen the heart. Death is uncommon in people who don't have complications, with less than a 3% fatality rate.
What’s the Risk?
The news is not as good for people who get complications, which affect about 1 in 10 cases. One example is cardiogenic shock, which happens when the heart can't pump enough blood to the body.
A team of researchers studied the records of about 198 people with broken heart syndrome who got cardiogenic shock, comparing them to 1,880 people with the syndrome who did not. Davide Di Vece, MD, a researcher at the University Hospital Zurich, says that while only 2.3% of those without the complication died while in the hospital, 23.5% of those with it did. Those with the complication were also more likely to die within 5 years of the event than those who had no complications, he says.
There is no specific guideline for treating these patients, Di Vece says, so each needs to be evaluated individually and monitored closely long-term.
Prevention Is Key
Stopping stress, or managing it, before the overwhelming stage is, of course, the best advice.
But doing that can be complicated and difficult. Joanie Simpson acknowledges that she learned that the hard way.
At her 1-year follow-up, she checked out fine. Now, more than 2 years later, she is following medical advice closely to stay healthy. "I'm still taking the meds prescribed by Dr. Dhoble and doing very well," she says. "Other than the aches and pains of a 63-year-old grandmother, I am feeling really good and enjoying retirement with my husband out here in the Texas Hill Country."
And has another tiny dog stolen her heart? Not yet, she says. "But we still have Buster, our cat." She and her husband talk about getting another dog, but right now, they plan to do some more traveling. "We are not sure what our next destination will be," she says. "We are just looking forward to what God has in store for us next."
WebMD Article Reviewed by Brunilda Nazario, MD on December 17, 2018
Sources © 2018 WebMD, LLC. All rights reserved.
Researchers have confirmed in recent years what people long suspected: Extreme stress can literally break your heart. And as they learn more about the relatively rare condition, they are finding that it’s not only caused by the loss of a loved one. Medical treatments, job loss, and other major life stressors have been linked to the condition.
The syndrome, known medically as takotsubo cardiomyopathy, mainly affects women. While the medical literature on broken heart syndrome is sparse, more cases are coming to light, with additional information about how it happens and how long-term the risks are.
Earlier this year, Canadian researchers reported a case of broken heart syndrome in a 63-year-old woman on treatments for metastatic breast cancer.
Over a 6-year period, researchers from MD Anderson Cancer Center in Houston found 30 patients having cancer treatment fit the criteria for broken heart syndrome. Fortunately, none had a recurrence, but the researchers say the diagnosis should be considered in cancer patients who get chest pain.
In another report, a doctor presented case histories of two older women, one treated for chronic lung disease and the other for gastritis, who had broken heart syndrome.
When a patient’s heart “breaks,” the main pumping chamber, the left ventricle, weakens, leading to pain and shortness of breath. The condition is reversible and temporary but can lead to complications similar to those after a heart attack. Experts think it’s caused by a flood of hormones (such as adrenaline) produced during a stressful situation that stuns the heart.
That’s what happened to Joanie Simpson, 63, who had broken heart syndrome 2 years ago after the death of her beloved Yorkshire terrier, Meha.
Meha’s death was just one of many challenges Simpson had at the time. Her husband was about to retire, she recalls. The sale of some property wasn't going smoothly. Her son was dealing with worsening back problems. Her son-in-law lost his job.
Then little Meha, whom the couple had adopted when she was just a year old, was diagnosed with congestive heart failure.
Her decline was difficult to watch. And after she died, Simpson thought she was coping, but a few days later, she woke up with chest and shoulder pains, fearing the worst -- a massive heart attack. At the hospital, her doctor, Abhijeet Dhoble, MD, a cardiologist at Houston's Memorial Hermann Heart & Vascular Institute, did too.
After running some tests, he found a different cause of her pain: a broken heart.
More than 6,200 cases of broken heart syndrome were reported in 2012 in the United States, up from about 300 in 2006, says Dhoble. Most patients are women. The increase, he says, is likely because more people know about the condition.
Often, a patient has many things happening at once, "and something trips them over," Dhoble says. "There is almost always a very distinct stressor. If you ask patients carefully, they will tell you that."
Dhoble published a study in The New England Journal of Medicine about Simpson’s case, which happened in May 2016.
The condition doesn't just happen after a person or a pet dies, says Jeffrey Decker, MD, section chief of clinical cardiology at Frederik Meijer Heart & Vascular Institute of Spectrum Health in Grand Rapids, MI. Nor is it always centered on a health issue.
"I had a lady who was frustrated with the cable company present with this," he says. Another was a woman who found out her daughter lost her job, says Decker, also an assistant professor of medicine at Michigan State University.
Severe pain can trigger the syndrome. So can an asthma attack, a fierce argument, a surprise party, or even public speaking.
Symptoms mimic a heart attack -- most often, chest pains and shortness of breath. Nausea, vomiting, and palpitations can also happen. But only testing can show the diagnosis, says Dhoble.
"Takotsubo" means “octopus pot" in Japanese. Decker says it got that name because when it happens, certain portions of the heart muscle do not move well. Other parts make up for that lack of movement, making the heart look like a pot used by Japanese fishermen to trap octopuses.
About 95% of patients recover within a month or two. "Usually the prognosis is quite favorable," Decker says. Patients usually get the same medications used to treat congestive heart failure to support and strengthen the heart. Death is uncommon in people who don't have complications, with less than a 3% fatality rate.
What’s the Risk?
The news is not as good for people who get complications, which affect about 1 in 10 cases. One example is cardiogenic shock, which happens when the heart can't pump enough blood to the body.
A team of researchers studied the records of about 198 people with broken heart syndrome who got cardiogenic shock, comparing them to 1,880 people with the syndrome who did not. Davide Di Vece, MD, a researcher at the University Hospital Zurich, says that while only 2.3% of those without the complication died while in the hospital, 23.5% of those with it did. Those with the complication were also more likely to die within 5 years of the event than those who had no complications, he says.
There is no specific guideline for treating these patients, Di Vece says, so each needs to be evaluated individually and monitored closely long-term.
Prevention Is Key
Stopping stress, or managing it, before the overwhelming stage is, of course, the best advice.
But doing that can be complicated and difficult. Joanie Simpson acknowledges that she learned that the hard way.
At her 1-year follow-up, she checked out fine. Now, more than 2 years later, she is following medical advice closely to stay healthy. "I'm still taking the meds prescribed by Dr. Dhoble and doing very well," she says. "Other than the aches and pains of a 63-year-old grandmother, I am feeling really good and enjoying retirement with my husband out here in the Texas Hill Country."
And has another tiny dog stolen her heart? Not yet, she says. "But we still have Buster, our cat." She and her husband talk about getting another dog, but right now, they plan to do some more traveling. "We are not sure what our next destination will be," she says. "We are just looking forward to what God has in store for us next."
WebMD Article Reviewed by Brunilda Nazario, MD on December 17, 2018
Sources © 2018 WebMD, LLC. All rights reserved.
Tuesday, December 18, 2018
Saturday, December 15, 2018
CDC Reveals Deadliest Drug in the US
According to the latest numbers from the US Centers for Disease Control and Prevention's National Center for Health Statistics, Fentanyl is now the most commonly used drug that is involved in drug overdoses.
The new report says that the rate of drug overdoses involving the synthetic opioid increased by about 113% each year from 2013 through 2016.
What is fentanyl?
Pharmaceutical fentanyl is a synthetic opioid pain reliever, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.
However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl. It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product--with or without the user's knowledge--to increase its euphoric effects.
Illicitly-made fentanyl use is on the rise
The rate of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl, doubled from 2015 to 2016. Roughly 19,400 people died from overdoses involving synthetic opioids other than methadone in 2016.
Reports from law enforcement indicate that much of the synthetic opioid overdose increase may be due to illegally or illicitly made fentanyl. According to data from the National Forensic Laboratory Information System, confiscations, or seizures, of fentanyl increased by nearly 7 fold from 2012 to 2014. There were 4,585 fentanyl confiscations in 2014. This suggests that the sharp rise in fentanyl-related deaths may be due to increased availability of illegally made, non-pharmaceutical fentanyl, and not prescribed fentanyl.
The number of states reporting 20 or more fentanyl confiscations every six months is increasing. From July to December 2014, 18 states reported 20 or more fentanyl drug confiscations. By comparison, six states reported 20 or more fentanyl drug confiscations from July to December 2013.
What can be done?
CDC suggests the following actions in response to increases in fentanyl-related overdose deaths:
Improve detection of fentanyl outbreaks
Public health departments:
Explore methods for more rapidly detecting drug overdose outbreaks, including fentanyl.
Medical examiners and coroners:
Screen for fentanyl in suspected opioid overdose cases in regions reporting increases in fentanyl confiscations, fentanyl-related overdose fatalities or unusually high spikes in heroin or unspecified drug overdose fatalities. Not all jurisdictions routinely test for fentanyl.
Law enforcement:
Law enforcement can play an important role identifying and responding to increases in the distribution and use of illegally-made fentanyl.
Expand Use of Naloxone
Naloxone is a safe and effective antidote to opioid-related overdoses, including heroin and fentanyl, and is a critical tool in preventing fatal opioid overdoses. Depending on state and local laws, this medication can be administered by EMS, law enforcement, other drug users, or family and friend bystanders who have obtained the medication.9
Health Care Providers:
Multiple doses of naloxone may need to be administered per overdose event because of fentanyl's high potency relative to other opioids.10
Harm reduction organizations:
Conduct trainings on naloxone use to persons at risk for opioid-related overdose and their friends and family members.
CDC
The new report says that the rate of drug overdoses involving the synthetic opioid increased by about 113% each year from 2013 through 2016.
What is fentanyl?
Pharmaceutical fentanyl is a synthetic opioid pain reliever, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.
However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl. It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product--with or without the user's knowledge--to increase its euphoric effects.
Illicitly-made fentanyl use is on the rise
The rate of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl, doubled from 2015 to 2016. Roughly 19,400 people died from overdoses involving synthetic opioids other than methadone in 2016.
Reports from law enforcement indicate that much of the synthetic opioid overdose increase may be due to illegally or illicitly made fentanyl. According to data from the National Forensic Laboratory Information System, confiscations, or seizures, of fentanyl increased by nearly 7 fold from 2012 to 2014. There were 4,585 fentanyl confiscations in 2014. This suggests that the sharp rise in fentanyl-related deaths may be due to increased availability of illegally made, non-pharmaceutical fentanyl, and not prescribed fentanyl.
The number of states reporting 20 or more fentanyl confiscations every six months is increasing. From July to December 2014, 18 states reported 20 or more fentanyl drug confiscations. By comparison, six states reported 20 or more fentanyl drug confiscations from July to December 2013.
What can be done?
CDC suggests the following actions in response to increases in fentanyl-related overdose deaths:
Improve detection of fentanyl outbreaks
Public health departments:
Explore methods for more rapidly detecting drug overdose outbreaks, including fentanyl.
Medical examiners and coroners:
Screen for fentanyl in suspected opioid overdose cases in regions reporting increases in fentanyl confiscations, fentanyl-related overdose fatalities or unusually high spikes in heroin or unspecified drug overdose fatalities. Not all jurisdictions routinely test for fentanyl.
Law enforcement:
Law enforcement can play an important role identifying and responding to increases in the distribution and use of illegally-made fentanyl.
Expand Use of Naloxone
Naloxone is a safe and effective antidote to opioid-related overdoses, including heroin and fentanyl, and is a critical tool in preventing fatal opioid overdoses. Depending on state and local laws, this medication can be administered by EMS, law enforcement, other drug users, or family and friend bystanders who have obtained the medication.9
Health Care Providers:
Multiple doses of naloxone may need to be administered per overdose event because of fentanyl's high potency relative to other opioids.10
Harm reduction organizations:
Conduct trainings on naloxone use to persons at risk for opioid-related overdose and their friends and family members.
CDC
Monday, December 3, 2018
Subscribe to:
Posts (Atom)