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Tuesday, 12 April 2016

Princess Health and Mary Hass of Louisville gets national brain-injury advocacy award. Princessiccia

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Mary Hass (image
from BIAK Facebook page)
Mary Hass, the volunteer advocacy director at the Brain Injury Association of Kentucky, was one of four medical professionals recognized for their accomplishments in the field of brain injury during the North American Brain Injury Society's 13th annual conference.

Hass, of Louisville, is the first ever recipient of the NABIS Michael Davis Advocacy Award, named in recognition of a board member who passed away last year.

The award was given in honor of her "commitment and dedication to the field of brain injury and her advocacy work to establish programs and service for persons with brain injury in Kentucky, many of which serve as models for similar efforts around the country," says the release.

The conference, recently held in Florida, was attended by almost 400 multidisciplinary brain injury professionals from around North America who gathered to learn and share the latest developments from the field of brain injury. The principal mission of the organization is moving brain-injury science into practice.
Princess Health and Kenton County embraces its once-controversial smoking ban as chances of a statewide ban have dimmed. Princessiccia

Princess Health and Kenton County embraces its once-controversial smoking ban as chances of a statewide ban have dimmed. Princessiccia

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Five years after Kenton County's smoking ban took effect over great opposition, the county has embraced it, Scott Wartman reports for the Cincinnati Enquirer.

"I'm a smoker, but I'm glad we're non-smoking," Justin Meade, a bartender at Molly Malone's in Covington, told Wartman. "I don't want to smell like smoke."

Kenton is the only Northern Kentucky county with any type of indoor smoking ban. Its partial ban allows establishments that don't serve people under 18, like bars, to have smoking.

Wartman reports having trouble finding anyone who didn't support the smoking ban as he walked among the Covington bar scene, and noted that a Northern Kentucky Health Department report cites very few complaints.

"I think what folks should take away from this is comprehensive smoke-free laws are easy to enforce, that most people like them and that they protect everyone," Stephanie Vogel, population-health director for the health department, told Wartman.

"The nonchalant acceptance, and even enthusiasm from some, of the partial smoking ban in Kenton County contrast with the controversy when it was enacted five years ago," he writes, noting that five years ago some bar owners thought the ban would put them out of business and patrons "lamented" that it was "an attack on their rights."

Amy Kummler, owner of Up Over bar, which can still allow smoking because it doesn't serve anyone under 18, told Wartman that she wouldn't mind if indoor smoking were banned statewide, but "feels smoking bans limited to one county or city are unfair," he writes.

"I don't even want to sit in my bar when it's smoky a lot," Kummler said. "I would be thrilled if the state went non-smoking, but I don't think it would be fair unless everybody did it."

Kentucky legislators have tried to pass a statewide smoke-free workplace law for years, but to no avail. Last year a bill passed out of the House, but was not called up for a vote in the Senate. This year, an election year, the bill wasn't even called up for discussion in committee. New Republican Gov. Matt Bevin opposes a statewide smoking ban.

"Last year we thought it was our year," Heather Wehrheim, chairwoman of Smoke-Free Kentucky, told Wartman. "It was the perfect scenario ... the public support was there; we thought we had the votes. It was Senate leadership that blocked it. Their argument, and whether it's true or not, is that it should be left up to local communities to pass smoke-free laws. We know that is going to take years and years and years."

The latest Kentucky Health Issues Poll found that two-thirds of Kentucky adults support a comprehensive statewide smoking ban, and have since 2013. The ban has support from solid majorities in each political party and has majority support in every region of the state. But more than one-fourth of Kentucky adults are smokers.

Monday, 11 April 2016

Princess Health and April 11th, 2016 Pause Daily. Princessiccia

Princess Health and April 11th, 2016 Pause Daily. Princessiccia

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April 11th, 2016 Pause Daily

There's so many things I want to write about tonight--but the return flights and the hour and forty-five minute drive home has left me completely spent. I'll recount the strategies that worked well in maintaining far away from home, tomorrow night. In the meantime--a good rest is in order!

I'm very happy to report: The entire experience was even better than I expected--and throughout it all, I maintained the integrity of my plan. I stayed with my generous maintenance calorie budget, I remained abstinent from refined sugar and I exceeded my water goal for the day. My workout, aside from the small morning routine, was navigating the airports!

Behind the scenes at TODAY on NBC!
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With fellow Joy Fit Club inductee, Hope Church

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Backstage prep with Hope and Joy

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Post segment visit

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More visiting post segment!

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Going over pre-segment details

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Remember the story from yesterday's edition, about my 51st Street conversation with Jay Leno? It turns out, the people Jay was visiting with prior to his conversation with me was Hope and her husband Jeremy! Hope actually got the picture!

Special thanks to Hope's husband, Jeremy Church, for snapping all of these shots. Joy also took several--and I'll have those very soon!

The video segment on TODAY:
         

I was absolutely overwhelmed with gratitude for being inducted into The Joy Fit Club! I can't thank Joy Bauer and the Today Show enough. So much has changed in the last two years!! I must pause daily to give thanks for every single blessing!

Today's Live-Tweet Stream:










































Thank you for reading and your continued support,
Strength,
Sean

Sunday, 10 April 2016

Princess Health and April 10th, 2016 Tomorrow, It's TODAY on NBC. Princessiccia

Princess Health and April 10th, 2016 Tomorrow, It's TODAY on NBC. Princessiccia

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April 10th, 2016 Tomorrow, It's TODAY on NBC

I couldn't sleep last night. Like an excited kid the night before a big trip--I tossed and turned and finally, after less than an hour of sleep--and restless sleep, I jumped up. The flight out of Oklahoma City this morning was set for 6am. I needed to be parking my car by 4:30am at the very latest!

In a situation like this, it's important for me to tighten my embrace of the fundamental elements I make important each day, not loosen them in the name of the trip. Traveling and experiencing stunningly surreal happenings isn't a reason to relax my plan. Of course, it was my reason to do just that on so many past occasions throughout my lifetime of morbid obesity. Recently, someone commented something to the effect of, allow yourself a good meal while you're in New York. The thing is, I allow and enjoy good meals every single day! If I didn't genuinely enjoy my food choices, I wouldn't be here, today.

I can't tell you how many trips I've taken in my life where I was convinced the food and quantity of food was the key element in making it a great time. Being out of the food fog opens me up for new perspectives to come through. Now, I realize some of the greatest things about a trip like this--and usually, they're things I wouldn't have appreciated any other time in my life. Please don't get me wrong--there's not a single thing wrong with a passionate appreciation of good food, especially on a trip--and New York has good food wherever you look!! Remember, I'm referring to boundaries specific to me, developed in consideration of my experience/history.

Maintaining the integrity of the plan away from home requires a higher awareness and a willingness to plan well. I was cutting fruit, weighing it and bagging it for my carry-on bag very very early this morning. If I have what I need, I won't fall for what I don't.

I stayed in close contact with support friends today. And I even had a chance to meet up and enjoy lunch with Eileen, a member of our support group conference calls!

By the time I took a nap this evening--I was toast. And it was truly one of the best naps I've experienced in a very long time. It was solid.

Oh--almost forgot-- The first person I ran into after exiting the car at the hotel this afternoon was Jay Leno!! He just finished a fast Oh wow--it's Jay Leno conversation with some others, so I almost didn't say anything--but then I couldn't help myself. We talked about stand-up--he asked me where I was from and what I was doing here. I told him--then a few more seconds about comedians we both know and what they're up to these days. It sounds like a lot--but seriously, I'm pretty sure we crammed it in quick, within 30-45 seconds. And I didn't ask for a picture with him--because don't you know he likely gets that constantly, wherever he goes, every single day... but as he walked away, I immediately wished I had politely asked for a selfie. Given how much influence his career had on me as a young kid and helped encourage me towards stand-up---I can't believe I missed the opportunity. But on the other hand, I was proud of myself for keeping my fandom in check!

Tomorrow's a big big day. I'll wrap this post with some pictures and the Live-Tweet Stream from today's traveling experience. Thank you for reading. It's TODAY on NBC, tomorrow!!!!

Oh--and by the way--please don't worry if you miss it LIVE (it'll be in the last hour of the program)--because a link to the entire segment will be up not long after it airs live. It'll be on my facebook, twitter and this blog, later--tomorrow night or early Tuesday morning!

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Radio City Music Hall is right across the street!! Fascinating to me! I'm super excited--can you tell? :)

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This was very cool. I've never had someone hold my name up at the airport! He was such a nice man. What a wonderful experience visiting with him on the way to the hotel. Great first interaction with a native New Yorker!

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Studio 1A-- This is where Today on NBC happens!

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30 Rock Selfie

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Eileen Watkins-Dunne lost an incredible amount of weight before experiencing a relapse/regain. She's now lost 97.5 as she works back toward her healthiest weight!! Eileen is a proud member of the support groups I co-facilitate with Life Coach Gerri and Kathleen Miles! It was wonderful to meet Eileen in person! Thank you for making that happen, Eileen!

I'm surprising not beside myself silly-nervous. I feel a nice calm. I hope and pray that calm continues!

Today's Live-Tweet Stream:














































Thank you for reading and your continued support,
Strength,
Sean
Princess Health and Rural drug-overdose rates, high in Kentucky, blamed partly on limits on treatment medication and mental-health services. Princessiccia

Princess Health and Rural drug-overdose rates, high in Kentucky, blamed partly on limits on treatment medication and mental-health services. Princessiccia

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"People in rural areas of Appalachia are more likely to die early deaths than in other parts of the country," and a big reason is that they "die from drug overdoses at greater rates than the rest of the country," writes Kery Murakami, the Washington, D.C., reporter for Community Newspaper Holdings Inc.'s CNHI News Service.

Murakami notes that in Leslie County, Kentucky, 7.9 of every 10,000 residents overdosed each year in 2012-14. "That�s six times the national rate," and third in the nation, he writes, citing the annual County Health Rankings done for the Robert Wood Johnson Foundation by the University of Wisconsin Population Health Institute. Several other Appalachian counties in Kentucky and West Virginia rank high.

The rates are high partly because "addicts in some parts of the country get turned away by doctors and are not given a drug called buprenorphine that is used to kick opioid addictions," Murakami reports, citing addiction experts. "Buprenorphine causes less euphoria and physical dependence and can ease withdrawal and cravings."

However, "Federal law caps the number of patients to whom a doctor is allowed to prescribe the drug, out of concern of creating places where large numbers of addicts receive opioid-based medication. Such treatment hubs, much like methadone clinics, bring unwanted community opposition, said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence. That limits treatment choices in rural areas, where one doctor might be the only one licensed to prescribe buprenorphine for hundreds of miles."

The Department of Health and Human Services is moving to ease the limits, and Sens. Ed Markey, D-Mass., and Rand Paul, R-Ky., want to go even further. "But some addiction experts are concerned that raising the caps on buprenorphine will nudge the country toward treating addiction with medication rather than counseling, Murakami reports. The department�s proposed rules would require mental-health care, which is often hard to get in rural areas. The senators� bill would not.

�Turning people away from the most evidence-based treatment we have for a chronic, life-threatening disease is heart wrenching for a doctor,� Dr. Kelly Clark, president-elect of the American Society of Addiction Medicine, told CNHI. �Rural areas have been hit hardest by this round in overdoses, which is the worst round of overdose deaths in our country.� She said medication is especially important in rural areas because opioid use spreads among families. �In rural areas, you�re treating the person, their parents and grandparents,� she said. �Entire families are addicted. It�s not like saying, �Stay away from certain friends,� if they�re shooting up with their sister and their mother.�

Princess Health and In Pineville, a new administrator from a Texas management firm is shaking up the local hospital in an effort to save it. Princessiccia

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Kentucky Health News

The crisis in rural hospitals is driven not only by changes in federal reimbursement and patients' increasing preference for larger hospitals, but in some towns by managerial shortcomings that may follow local tradition but hurt the bottom line. Changing those practices can be difficult, but the new administrator of the Pineville Community Hospital appears to be having success as he grabs the bull by the horns.

Stace Holland (Modern Healthcare photo by Harris Meyer)
Longtime rural hospital administrator Stace Holland has put PCH "on the road to recovery by cutting costs, bringing in more federal funds and getting staffers to change their ways," Modern Healthcare reports in a long story than delves into the details, from specific expense cuts to clashes with physicians.

The 120-bed hospital is staffed for only 30 (not counting a 26-bed nursing unit) and was losing $6 million a year. Eight months after taking over as CEO, "Holland is well on the way to turning around a struggling not-for-profit facility that still expects to lose $3 million this year. With support from the Plano, Texas-based Community Hospital Corp., which took over management of the hospital in October 2014, Holland already has made significant progress toward stabilizing its finances," Harris Meyer reports.

"Holland faced a challenge that is all too familiar to rural hospital leaders around the country: declining patient volumes; a preponderance of low-paying Medicare, Medicaid and uninsured patients; public and private rate squeezes; high incidence of chronic disease and drug abuse; difficulty in recruiting physicians; and a shortage of funds to invest in new equipment and services. . . .  To save the hospital, whose previous CEO served nearly 40 years, Holland, Chief Nursing Officer Dinah Jarvis, and CHC knew they had to take tough steps that would unsettle physicians, staffers and local residents accustomed to the old comfortable ways."

The new ways included a partnership with the Baptist Health hospital in Corbin to help PCH compete with the Appalachian Regional Hospital in nearby Middlesboro, partly with a 12-bed geriatric psychiatry unit; a federal rural health facility license that significantly boosted Medicare and Medicaid payments," and "clinical protocols to improve quality of care and reduce readmissions," which were so frequent in 2013 and 2014 that they drew Medicare's maximum penalty, Meyer reports. But the new protocols, such as "pre-discharge education of congestive-heart-failure patients about medication use and weight monitoring," riled some physicians.

Dr. Steven Morgan told Meyer, �They want to pound square pegs into round holes.� Dr. Shawn Fugate said he had to fight with CHC for "what he thought were adequate nurse staffing levels, and that CHC is making too many important decisions from afar," Meyer reports. As an employee of CHC rather than the hospital, Holland can "speak frankly," Meyer writes. "He recently told an older surgeon who serves on the board that it was time for him to retire."

Pineville is on the old Wilderness Road (in red) and US 25-E.
Pineville Mayor Scott Madon told Meyer, �Stace has an unbelievable task in what he's dealing with. He's trying to reinvent the rural hospital. He has to change the whole thinking, and people don't like it.� But longtime hospital board member David Gambrell, a real-estate agent whose son will start as a family physician there soon, said Holland's approach has been �refreshing. . . . We need that kind of honesty. It's taken Stace coming here to see we needed a new vision.�

Meyer reports, "Local leaders see the Pineville hospital's survival as pivotal to the future of the town and Bell County, which has no other hospital and has lost many coal-mining jobs. They say the hospital, the city's largest employer, is key to their economic redevelopment efforts. . . . The Pineville hospital has strong customer loyalty. Its staff�most of whom are local residents who have worked there for many years�have deep ties to the patient population." Wilma Sizemore, a 70-year-old disabled woman who was admitted in mid-February for bronchitis and dizziness, told him, �I wouldn't doctor nowhere else but this hospital. They treat me like family here.�

Princess Health and Is pervasive pornography the newest public-health crisis?. Princessiccia

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Gail Dines, a professor of sociology at Wheelock College in Boston and author of Pornland: How Porn has Hijacked our Sexuality, argues in an essay for The Washington Post that "porn is a public health crisis rather than a private matter."

The internet has made pornography generally accessible, to the point that porn sites get more visitors than Netflix, Amazon and Twitter combined" (a Huffington Post headline from 2013), some researchers estimate the average age of first viewing porn at 11, and "free and widely available pornography is often violent, degrading and extreme."

Gail Dines
Dines notes studies that have found correlations between porn viewing and sexual harassment and toleration of sexual assault, and that college-age women whose partners use porn "suffered diminished self-esteem, relationship quality and sexual satisfaction."

"As the evidence piles up, a coalition of academics, health professionals, educators, feminist activists and caregivers has decided that they can no longer allow the porn industry to hijack the physical and emotional well-being of our culture," Dines writes. "Culture Reframed, an organization I founded and currently chair, is pioneering a strategy to address porn as the public health crisis of the digital age. We are developing educational programs for parents, youth and a range of professionals that aim to help shift the culture from one that normalizes a pornographic, oppression-based sexuality to one that values and promotes a sexuality rooted in healthy intimacy, mutual care and respect."

Dines concludes, "Parents and educators at every level need to know that if porn is not discussed in a research-based, age-appropriate sexual health curriculum, its effects will surely show up as sexual harassment, dating violence and inadvertent �child pornography� on students� phones. Pornography can cause lifelong problems if young people are not taught to distinguish between exploitative porn sex and healthy, safe sex. As the research shows, porn is not merely a moral nuisance and subject for culture-war debates. It�s a threat to our public health."
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