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Tuesday, 14 June 2016

Princess Health and Potent fentanyl, mixed with heroin, drives 14.7 percent increase in fatal drug overdoses in Kentucky from 2014 to 2015. Princessiccia

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The number of drug-overdose fatalities in Kentucky rose almost 15 percent in 2015, driven by a 247 percent jump in deaths involving fentanyl, a highly potent opioid that some traffickers are mixing with heroin, the Kentucky Office of Drug Control Policy said Tuesday.

The office counted 1,248 fatal overdoses in Kentucky last year, up 14.7 percent from the 1,088 reported in 2014. Fentanyl was a factor in more than a third: 420, up from 121.

"Heroin was detected in 28 percent of cases, consistent with the previous year," the Justice and Public Safety Cabinet said in a press release. "However, as a total, heroin-related deaths increased in 2015, largely because the drug is being laced with fentanyl."

�The introduction of illicit fentanyl into the heroin trade is producing devastating results,� Van Ingram, director of the office, said in the release. �Whether it�s manufactured to resemble heroin or a prescription pill, the cartels have made an already dangerous situation worse.�

Gov. Matt Bevin said, �I am heartbroken for the Commonwealth. More than three families a day are shattered by this epidemic of untimely death. This is unacceptable and will be vigorously addressed with every resource at our disposal.�

The report by Ingram's office listed the eight counties with the most fatal overdoses per person from 2012 to 2015. All were in Eastern Kentucky or Northern Kentucky. Here are the counties, with the number of deaths per 10,000 people: Leslie, 6.86; Bell, 6.12; Gallatin, 5.26; Knott, 4.87; Wolfe, 4.83; Floyd, 4.76; Campbell, 4.72 per 100,000 and Kenton, 4.63 per 10,000.

Counties with big percentage increases in fatal overdoses from 2014 to 2015 included Bell, from 11 to 20; Boyd, from 13 to 24; Butler, from none to eight; Harlan, from six to 10; Kenton, from 71 to 112; and Rowan, from five to 12.

Counties with large decreases included Bullitt, from 22 to 11; Grant, 13 to 6; Russell, from 13 to 7; Laurel, 18 to 10; Leslie, from nine to five; McCracken, 20 to 10; and Marshall, from 12 to fewer than five. The report does not list specific numbers for a county in years when the county had fewer than five fatal overdoses.

The figures above are based on where the death occurred. Based on the residence of the overdose victim, some counties ranked higher; for example, Powell County had 5.84 overdose deaths per 10,000 people, and Russell County had 4.95. This map shows rates based on the county where the overdose victims resided; note that it shows the death rate per 100,000 people, not 10,000 (a figure closer to the population of most counties). Click on the image for a larger version.

Monday, 13 June 2016

Princess Health and June 13th, 2016 Point Of Change. Princessiccia

Princess Health and June 13th, 2016 Point Of Change. Princessiccia

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June 13th, 2016 Point Of Change

I haven't abandoned the plan to post this blog late afternoon, however, I'm discovering that it isn't something my schedule always favors. Now, with that said, it's up to me to fashion my schedule in such a way where it's doable--each day, at an earlier time. It must start with the root cause. I'm learning I can't simply declare-- I'm posting my daily blog page by XX PM, or I'm in bed by whatever time--if I'm not first looking at what I'm doing leading up to these very important things. The earlier posting of the blog certainly opens up the possibility for more consistency in earlier bed times--but if the elements of my schedule aren't given the proper attention and modifications needed, the instability and inconsistency with this important part of my continued success, will continue.

I'm grateful to be at a place where I'm focusing on these types of concerns. It's a sign of progress and I'm choosing to acknowledge it as progress. It's a point of change made possible by the consistent stability in other areas within my plan.

Yesterday was an epic good time with my grandson Noah. No matter what challenges I'm facing, no matter the stress or emotion pressing, when I see him smile and the everything is beautiful look in his eyes, I feel connected to a peace and calm unaffected by outside influences.

I ate well today. I maintained the integrity of my maintenance calorie budget. I remained abstinent from refined sugar. I was active in support connections/exchanges. And with one more water before bed, I'll exceed my water goal for today.

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Thank you for reading and your continued support,
Strength,
Sean
Princess Health and Wellness coalition in Perry County, where life expectancy is state's lowest, gets funding from Foundation for a Healthy Ky.. Princessiccia

Princess Health and Wellness coalition in Perry County, where life expectancy is state's lowest, gets funding from Foundation for a Healthy Ky.. Princessiccia

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The Foundation for a Healthy Kentucky has funded the Perry County Wellness Coalition's three-year plan to encourage fitness and better nutrition in school-age children, "Kids on the Move!"

The wellness coalition will receive $144,450 from the foundation this year, matched by $124,944 from the community, to increase access to physical activity and provide healthier food options and nutrition education. Perry County has the lowest life expectancy in Kentucky.

"Our children are the most valuable resource we have," said Gerry Roll, executive director of the Foundation for Appalachian Kentucky, which is serving as fiscal agent for the coalition. "It's the best investment we can make as a community partner."

The health coalition will work with local schools to implement physical activity and nutrition-policy changes, collaborate with local farmers' markets for a strong farm-to-school component, and coordinate with other community agencies to create a lasting and collective impact.

The project also will implement best-practices nutrition and exercise programs in schools, support community gardens, summer feeding programs, and a "Farmacy" program to increase the purchase of healthier produce at farmers' markets and local grocery stores, among other changes to be coordinated by the agencies in the coalition.

The Appalachian Regional Healthcare hospital in Hazard will be the administrative hub for the coalition, providing leadership and sharing its expertise in promoting community health. "We have already begun these efforts by providing fitness fairs and health screenings to over 20 schools in our service area and reaching a little more than 2,500 middle school and high school age kids this year alone," said Hazard ARH Community CEO Dan Stone said.

The coalition is among seven Kentucky communities funded by the foundation's "Investing in Kentucky's Future" initiative, which is spending $3 million over five years to fund communities working to improve the health of their school-aged children. The other groups are in Breathitt, Clinton, Grant, Jefferson and McLean counties, and in Boyd and Greenup counties. Perry County was in the original announcement and recently completed its detailed plan. It shares with Breathitt and Wolfe counties the state's lowest life expectancy, 70 years.
Princess Health and Doctors trying to reverse course on opioid prescriptions can find it difficult because of addiction, shortage of good alternatives. Princessiccia

Princess Health and Doctors trying to reverse course on opioid prescriptions can find it difficult because of addiction, shortage of good alternatives. Princessiccia

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The epidemic of opioid overdoses, 60 percent of which are blamed on abuse or misuse, "is changing prescribing habits, but there's still a lack of other pain medications, access to alternative therapies and knowledge among primary-care providers about multidisciplinary approaches to pain management," Modern Healthcare reports.

"The medical community turned to opioid prescriptions to address a condition many believed had been ignored or undertreated," Steven Ross Johnson writes. "And the dependence on fee-for-service payments also made it easier for providers to whip out their prescription pads rather than spend the time to help patients find alternatives. But experts now say the over-reliance on opioids for chronic pain, despite a lack of evidence on their efficacy and impact, was misguided and has distorted the public's concept of what pain is and what it means to be treated."

But reversing course can be difficult because many patients "have built up resistance to opioids and seek treatment while addicted or at risk of addiction," Johnson reports. He quotes Dr. Neel Mehta, medical director of Weill Cornell Medical College's Pain Medicine Center, which specializes in treating long-term pain as saying many come there because their doctor won't write them another prescription: �So we're sort of left with them expecting to get prescribed an opioid and we have to then calmly redirect that.�

In March the federal Centers for Disease Control and Prevention "recommended doctors prescribe alternative treatments such as over-the-counter medications, cognitive behavioral therapy and exercise before resorting to opioids. Weeks later, the Joint Commission [which accredits health-care facilities] clarified its 2001 standards for pain management and treatment to stress that opioid use was neither required nor specified for treating pain."

Other alternative treatments chiropractic care and the use of anti-inflammatory and neuropathic medications and even vitamin supplements, Johnson notes. "The problem is that few carry the punch or, for some, the pleasure of opioids. . . . The use of medical marijuana, meanwhile, has increased in several parts of the country. It's approved in 38 states and the District of Columbia for patients with illnesses such as cancer and HIV. But only some of those states allow the use of marijuana to relieve chronic pain." Kentucky does not.

Sunday, 12 June 2016

Princess Health and June 12th, 2016 Couldn't Have Done It. Princessiccia

Princess Health and June 12th, 2016 Couldn't Have Done It. Princessiccia

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June 12th, 2016 Couldn't Have Done It

We've had the most wonderful Noah Day! After two very busy weeks, getting away and doing something fun with my little grandson was pure joy. It's past my bedtime. Little Noah is with me overnight. I've tucked him in his bed. Now, it's time for me to hit the pillow!

This is almost a "Tweets Only" blog post.

I will write this-- I maintained the integrity of my maintenance calorie budget, I remained abstinent from refined sugar, I was active in support communications and I exceeded my daily water goal. 

I often write and speak about the non-physical transformation being the biggest part--clearly, the mental and emotional elements, in my opinion, are the biggest, because when those transform, the physical follows. Still, nothing brings the physical transformation front and center like keeping up with a three year old all afternoon and evening. I couldn't have done it at five hundred pounds.

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

Princess Health and Health ranking of Kentucky seniors moves up, but they are still last in health outcomes, says America's Health Rankings. Princessiccia

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By Melissa Patrick and Al Cross
Kentucky Health News

Kentucky moved up three spots, from 48th to 45th, in the fourth annual Senior America's Health Rankings Report. But the state ranked last in health outcomes and 44th in determiners of those outcomes, so it remains one of the least healthy places in the nation for seniors to live.


Among negative measures, Kentucky seniors ranked first in preventable hospitalizations, second in tooth extractions and premature death; and third in physical inactivity and hospital re-admissions within 30 days of discharge.

Among positive measures, the state also ranked poorly: for example, 46th in the percentage (34%) of seniors who reported that their health status was good or excellent and 48th in the percentage (56.9%) who reported having no disability.

The state's best ranking was No. 3 in influenza vaccinations, reflecting an increase to 70 percent from 62 percent of seniors vaccinated in the past two years. It was No. 8 in the percentage of seniors with arthritis who self-report arthritis or joint pain does not limit their usual activities. It tied for 10th in the percentage of seniors with a "creditable prescription-drug plan" and was 17th in the percentage of senior who reported having a mammogram or a colonoscopy or similar screening.

Kentucky ranked low in volunteer activity by seniors (45th) and nursing home quality (43rd) but has fewer people in nursing homes who perhaps shouldn't be there. Only 7 percent of its nursing-home residents, the No. 7 ranking, were considered "low care" and thus candidates for living in less restrictive environments. However, it was 46th in the number of personal-care and home-health aides per 1,000 adults aged 75 or older.

The state tied for 44th in the percentage (32.1) of seniors who reported falling in the previous 12 months. It was 44th in the percentage (42.8) of seniors who were enrolled in hospice during the last six months of life after being diagnosed with a condition that carried high probability of death.

It was also 44th in a related measure, the percentage (16.6) of seniors who spent seven or more days in an intensive- or critical-care unit during their last six months. Generally, use of an ICU correlates with the number of ICU beds, which "could indicate a supply-induced remand," the report says. "Overusing the critical care system often goes against the wishes of dying patients and is costly. Research indicates many patients receive care they would not choose in their final days."

The rankings are based on 35 measures of health, as well as supplemental measures such as education and mental health. Combined, they paint a picture of how individual behavior, our communities and their environments, health policy and access to care influence health.

One area that Kentucky consistently ranks low in is government support for seniors in poverty. It was 45th again this year, spending $382 per senior when federal, state and local funds were all counted. Massachusetts, which ranked first in overall senior health this year, spends $4,053 per senior in this category, more than any other state but Alaska, which has many rural elderly. The national average, which has been declining, is $811.

Kentucky leads the nation in smoking, so it's no surprise that its seniors also rank in the bottom five states for this negative category (47th). Kentucky seniors' smoking rate is 12.4 percent; the national average is 8.8 percent. Both have declined about 40 percent in the last 15 years.

Smoking is the leading cause of preventable death in the United States," says the report. "Cessation, even in older smokers, can have profound benefits on current health status as well as improve long-term outcomes."

Kentucky was fifth from the bottom in dental visits by seniors, but the good news is that the share of seniors having such visits rose to 57 percent from 53 percent last year.

"Poor oral health is associated with such chronic diseases as diabetes and cardiovascular disease, and can have a large impact on quality of life resulting in pain and affecting the ability to chew or speak," says the report.

Kentucky improved its senior obesity ranking, another negative measurement, to 24th from 41st. About two out of every seven Kentucky seniors are obese, or 27.5 percent, the same as the national average. Last year the rate was 29.6 percent.

"Obese seniors experience more hospitalizations, emergency department visits, and use of outpatient health services than non-obese seniors, leading to higher health care costs," says the report. "Physical activity, healthy diet, supportive communities and social networks, and an environment that encourages exercise all play a role in reducing obesity in older adults."

The report says that between 1999 and 2014, Kentucky's middle-aged population (50-64) saw a 34 percent increase in in obesity and a 68 percent increase in diabetes. These findings were similar across the nation.

The report says Kentucky's senior population is expected to increase 44 percent by 2030. "Over the next 15 years, the health of this population will be challenged by large numbers of new people becoming seniors and the additional health challenges, such as diabetes, that this groups brings with them," it says."These higher rates of diabetes and obesity are expected to put significant strains on the Medicare program and the overall health-care system."

The report, sponsored by the United Health Foundation, is a call to action for states, offering specific benchmarks that can be changed to improve health.

Louisiana again ranked last for overall senior health, followed by Oklahoma. Kentucky, West Virginia, Arkansas and Mississippi had similar scores. The top six states for overall senior health are Massachusetts, Vermont, New Hampshire, Minnesota, Hawaii and Utah. Click here for the full report. (Click on chart for another version that may be clearer)

Princess Health and UK pays big to settle a health-care debacle but keeps almost all details under wraps; Herald-Leader says trustees should worry. Princessiccia

Princess Health and UK pays big to settle a health-care debacle but keeps almost all details under wraps; Herald-Leader says trustees should worry. Princessiccia

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"The University of Kentucky has spent more than $5 million in the last year to fix federal billing issues involving a Hazard cardiology practice it acquired three years ago, but UK officials have declined to provide documents detailing problems that led to the payments," including an audit of the Appalachian Heart Center that UK calls "preliminary" though the issue has been resolved, Linda Blackford reports for the Lexington Herald-Leader.

Most of the money went to Medicare and Medicaid, but $1 million went to a Washington lawyer whose billing records the university largely refused to release, citing attorney-client privilege. The university's trustees were told about the matter at a dinner meeting, which the Herald-Leader said it didn't cover because the agenda for the meeting did not include the matter. UK says no minutes were taken at the meeting, normally a social event that precedes formal meetings the next day.

The Herald-Leader said it would file an appeal with the attorney general, whose decisions in open-records and open-meetings matters have the force of law unless a court rules to the contrary. �We have strong concerns about the overall lack of transparency by the university in this case,� Editor Peter Baniak said. �Records about the issues involving this clinic should be public, as should the information presented and discussion that took place in an open meeting of the board of trustees.�

In an editorial, the newspaper attacked UK officials' secrecy about the case and other health-care issues, such as appealing an AG's decision that that the Kentucky Medical Services Foundation isn't a public agency. "Their imaginative legal arguments and bizarrely incomplete responses to requests for information by the Office of the Attorney General, this newspaper and a private individual should embarrass and trouble the trustees," it said, noting that a UK official said the university paid back "more than what was required."

"Who pays an attorney $1 million to settle a dispute by paying more than was owed?" the editorial asked. "If this were a one-off we might think that UK HealthCare and KMSF, which handles billing for UK physicians, are just muddling around to avoid admitting their deal went bad. But it�s only the latest in a series of stories that indicate a pattern of secretiveness in UK�s vast health-care empire."
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