Eideard

Warfarin “flower”

Blood thinners and diabetes drugs cause most emergency hospital visits for drug reactions among people over 65 in the United States, a new study shows.

Just four medications or medication groups — used alone or together — were responsible for two-thirds of emergency hospitalizations among older Americans, according to the report. At the top of the list was warfarin, also known as Coumadin, a blood thinner. It accounted for 33 percent of emergency hospital visits. Insulin injections were next on the list, accounting for 14 percent of emergency visits.

Aspirin, clopidogrel and other antiplatelet drugs that help prevent blood clotting were involved in 13 percent of emergency visits. And just behind them were diabetes drugs taken by mouth, called oral hypoglycemic agents, which were implicated in 11 percent of hospitalizations.

All these drugs are commonly prescribed to older adults, and they can be hard to use correctly. One problem they share is a narrow therapeutic index, meaning the line between an effective dose and a hazardous one is thin. The sheer extent to which they are involved in hospitalizations among older people, though, was not expected, said Dr. Dan Budnitz, an author of the study…

As Americans live longer and take more medications — 40 percent of people over 65 take five to nine medications — hospitalizations for accidental overdoses and adverse side effects are likely to increase, experts say…

A common denominator among the drugs topping the list is that they can be difficult to use. Some require blood testing to adjust their doses, and a small dose can have a powerful effect. Blood sugar can be notoriously hard to control in people with diabetes, for example, and taking a slightly larger dose of insulin than needed can send a person into shock. Warfarin, meanwhile, is the classic example of a drug with a narrow margin between therapeutic and toxic doses, requiring regular blood monitoring, and it can interact with many other drugs and foods…

One thing that stood out in the data, the researchers noted, was that none of the four drugs identified as frequent culprits are typically among the types of drugs labeled “high risk” for older adults by major health care groups…

Dr. Budnitz said that the new findings should provide an opportunity to reduce the number of emergency hospitalizations in older adults by focusing on improving the safety of this small group of blood thinners and diabetes medications, rather than by trying to stop the use of drugs typically thought of as risky for this group.

Dr. Budnitz thinks it is critical that patients tell their physicians everything they’re taking. Well, presuming that the digitizing program put in place by President Obama is proceeding at least as quickly as anything else that hasn’t been roadblocked by the Party of NO – seems to me it soon should be practical for that physician to have someone on staff run a database check on his patients for exactly these conflicts and dangers.

Leaving the responsibility up to a patient who may not even be able to spell the crap he’s taking ain’t the most reliable approach. Involving doctor and pharmacy database records makes as much sense or more.

Joe and Kay Peterson, founders of Rainbow’s End

When his vision failed, Ed Spake, 71, was headed south on Route 105 in East Texas, driving a van that pulled a 19-foot recreational vehicle that he and his wife, Rae, had lived in for five years.

“I can’t see out of my right eye,” Mr. Spake told his wife. And with that, his driving days were over. The following year he was declared legally blind, a victim of age-related macular degeneration…

For the Spakes, the usual options for seniors who need care — assisted living, nursing homes, moving in with children — were unattractive or too expensive. So they made an unusual choice.

In Livingston, Tex., a 140-acre R.V. park called Rainbow’s End serves as the national headquarters of the Escapees Club, the largest association of R.V. enthusiasts. Next door sits a smaller park with 33 lots: Escapees Care, the country’s only assisted living facility for seniors in R.V.’s. It is, in many respects, the end of the road…

…The Spakes moved to Escapees Care in order to get the health care they need while remaining in their R.V., surrounded by kindred spirits. “I think of us as an extended family,” said Mrs. Spake, a loud, animated woman with a gravelly voice. The Spakes’ R.V. is now stationary and hosts a wood-stained deck.

For $824 a month per peson, or $1,236 a couple, residents at Escapees Care have access to the Care Center, where registered nurses are on call 40 hours a week. They take regular blood pressure readings, clean and dress wounds, help residents with their medications and schedule doctors’ appointments. The monthly payment also covers laundry, transportation and three meals a day in the Care Center’s dining room…

As the years passed, Kay Peterson, a former nurse, watched physical ailments drive her peers into undesirable living situations. In 1997, with $170,000 in donations from Escapees Club members, she opened the Care Center. Now, residents’ dues cover about 56 percent of operating costs, while the rest is paid for with Escapees’ donations…

The Spakes still talk about taking more trips while Mrs. Spake is still healthy enough to drive. “You miss the sights and sounds of new places,” said Mrs. Spake, sounding a bit wistful. “There’s a lot of places yet to go — if we get there.”

I’m too teary-eyed to comment much about this piece. I have dear friends and family, grayheads who live the RV life. It’s easy enough to picture folks making this decision – or having to.

I worked to get the very first hospice established in the United States almost 40 years ago. Hopefully, we can get to where it’s just one more decision to make at the end of a long life.

The health-reform law is changing the health-insurance marketplace in big ways. The first changes—those that happen right away—take effect Sept. 23, 2010, six months after the health-reform bill was signed.,, Consumer Reports offers a free health-insurance guide [.pdf] to how the new law affects you.

Preserves job-based coverage

If you get health insurance through work, your coverage will likely remain pretty much the same, but with some new consumer protections. Lifetime caps on coverage are banned, for example, and insurers will have to adopt new procedures allowing workers to appeal coverage denials.

Offers new protections for consumers

According to the new Patient’s Bill of Rights insurers can no longer do the following: Cancel your coverage if you get sick; set lifetime limits on coverage; put annual dollar limits on coverage (this is phased in over three years); deny coverage to children under age 19 who have pre-existing conditions; and impose barriers to or refuse to pay for emergency care even if it’s at a hospital outside the insurer’s network.

Read the rest of this entry »

Reps. Eric Cantor (R-VA; 47 years old), Paul Ryan (R-WI; 40 years old), and Kevin McCarthy (R-CA; 45 years old) have authored a self-aggrandizing new book set to be released next month titled “Young Guns: A New Generation of Conservative Leaders.”

The book’s marketing campaign comes with a comical ad trailer, featuring a lofty soundtrack and soaring accolades (“They are ready to make history. Together, they are ‘The YOUNG GUNS!’ Innovative, energetic, forging new solutions.”)

All the egotistical self-praise from the “young guns” was too much for former Republican congressman and MSNBC host Joe Scarborough. He and his crew incessantly mocked the new marketing campaign, debating whether it was a “parody.” “Never make up your own nickname,” cautioned co-host Willie Geist. Scarborough joked that the three congressmen “were” the future of the Party until their latest ego trip. Calling the ad “awful,” Scarbrough said it was “the worst idea ever.”

Hotline reports that House Minority Leader John Boehner (R-OH) receives only 3 mentions in 191 pages. Former President George W. Bush “earns just 4 references, the same number as TN 08 candidate Stephen Fincher (R)…”

Recall, Ryan’s “roadmap” includes privatizing Social Security and Medicare, while at the same time repealing the estate and corporate taxes. The Ryan roadmap would lose $2 trillion over a decade, while requiring 90 percent of taxpayers to pay more, according to an analysis by the Citizens for Tax Justice.

This is the truth of Tea Party politics. It just happens to be a sect within the Republican Party for a change. But, the lemmings who try to run and hide in the 19th Century – or earlier – are perfectly willing to screw retirees, working people, students and families to save their idols in corporate America from paying their share of taxes.

Along the way, if they can manage to diminish any opportunities for minorities – as defined by skin color, religion or sexual preference – all the better.

Toronto wanted to charge them to walk in the park

City Hall appears to be backing down on a draconian policy that requires organized walking groups to get a permit to stroll through city parks…

The review comes after a group of 12 Etobicoke seniors — first revealed in the Sunday Sun — were accosted by a bylaw officer on Sept. 21. That officer, Tony Pacheco, demanded to see their city permit for using the public trails in Humber Bay Park.

When they couldn’t produce a permit, pictures were snapped of the group.

He then followed them to the neighbouring Polish Alliance Hall — where the group participated in an hour-long exercise class — and took more pictures of vehicle licence plates…

Ward councillor Mark Grimes, who originally told the Sun the woman running the seniors group must have a $30 per hour permit, is now asking for the review as well, according to the statement.

While there may be “excellent reasons” for requiring some parks users to purchase a permit, Green acknowledged that “discretion and flexibility” must be exercised.

There also are excellent reasons to kick stupid politicians and bureaucrats out of office.