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Affiliated with the Rhode Island AFL-CIO “Fighting for the future of our members.” “NOW, more than ever!!!” All Rights Reserved RI ARA 2018©

Publication 2018 Issue 40 Published in house by the RI ARA

October 7, 2018 E-Newsletter House Passes Tax Reform 2.0

The House voted 220-191 on Friday to pass "Tax Reform 2.0" (H.R. 6760), a continuation of the tax scam passed late last year. The bill aims to make all of the individual tax cuts included in the first round of cuts permanent, and establishes a permanent cap on the state and local income tax deductions. Most of the individual cuts reduced taxes for the top 1% of earners, and the bill is projected to increase the national deficit by over $1.9 trillion.

The bill passed the House even without the support of several GOP representatives in high-tax states who are against the state and local tax deduction (SALT) caps. SALT deduction caps can hurt middle income Americans, including seniors, who often have their assets tied to their homestead. This aspect of the bill will also harm many communities that use these taxes to provide services to their residents, often older Americans.

The Center on Budget and Policy Priorities (CBPP) has pushed back on the GOP’s claim that these cuts will help grow the economy and create more jobs. Instead, the CBPP found that revenue loss from Tax Cuts 2.0 will increase the already growing national deficit at a time when baby boomers are reaching retirement age, significantly increasing the need for Social Security and Medicare funds. “Time and again, studies have

proven that the tax scam has lined the pockets of CEO’s, instead Rich Fiesta of helping the hard working American families who would benefit,” said Alliance Executive Director Richard Fiesta. “The Tax Scam 2.0 will exacerbate the harmful effects of placing the interests of the nation’s wealthiest individuals above working people and retirees.”

Drug Prices Continue to Rise Despite President’s Promises The President promised to hold drug manufacturers accountable for skyrocketing prices, and ensured that companies were going to voluntarily reduce their prices when he unveiled his prescription drug blueprint this spring. On the contrary, a new report from the Associated Press shows that while the number of increases has dropped slightly compared to previous years, far more drug

makers continue to raise their prices than cut them. The report looked at thousands of list price changes between January and July of this year, and found price increases for over 4,000 brand name drugs, while only 46 drugs had a price cut. That equates to approximately 96 increases for every cut. In addition, no company stated any future intent to reduce prices. Pfizer, one of the largest companies, raised

prices on over 100 products in both January and July of this year, with some increases as high as 9.5%. Prescription drug prices are an important issue for patients, politicians, and drug makers themselves. Some experts noted that the increased scrutiny surrounding prescription costs could explain the slower rate of increases, but that the administration’s plan itself had no effect on companies’ pricing

decisions. “This report proves that the administration’s blueprint barely Rich Fiesta does anything to protect seniors from the exorbitant and growing costs of prescription drugs,” said Executive Director Fiesta. “We must push to hold drug makers accountable by giving Medicare the ability to negotiate prices.”

U.S. Budget Deficit Swells to $898 Billion, Topping Forecast The U.S. budget deficit widened to $898 billion in the 11 months through August, exceeding the Congressional Budget Office’s forecast for the first full fiscal year under the Trump presidency. The budget deficit rose by a third in the October to August period from $674 billion in the same timeframe a year earlier, the Treasury Department said in a statement on Thursday.

Spending rose by 7 percent to $3.88 trillion, outpacing revenue gains of 1 percent to $2.99 trillion. Revenue from corporations fell to $163 billion, down by $71 billion from a year ago. The U.S. fiscal gap has continued to balloon under President Donald Trump, raising concerns the country’s debt load,

now at $21.5 trillion, is growing out of control. A combination of Republican tax cuts enacted this year -that will add up to about $1.5 trillion over a decade -- and increased government spending are adding to budget strains. The White House says the tax cuts will pay for themselves by creating more revenue through faster

economic growth. The International Monetary Fund has warned the tax reductions risk putting the nation’s debt on an unsustainable path and could cause the economy to overheat. Before the CBO incorporated tax cuts and spending hikes into its projections, the group forecast the U.S. deficit would exceed $1 trillion by 2022.

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Medicare Rights Opposes Punitive “Public Charge” Proposal for Harm to Families and People with Medicare The Department of Homeland Security recently released a proposed “public charge” rule that could greatly harm families and prevent people with Medicare from accessing the services and supports they need. The proposal would dramatically expand the government’s “public charge” test, which considers whether immigrants are likely to use public benefits when deciding whether or not to grant entry to the United States or permanent resident status. Currently, the scope of what the government considers to be a “public charge” is so narrow that it is

rarely used as grounds to reject an immigration application. Under the expanded definition, however, the government would consider a much wider array of services when making a public charge determination— including whether an individual or someone in their family is or is likely to need help affording prescription drugs under Medicare, food and housing assistance, or Medicaid services. The proposed changes would make it much more difficult for

immigrants— especially older adults and people with disabilities— to pursue citizenship, reunite with their families, and access the supports they need to thrive. Already, there are reports of immigrant families abandoning needed assistance out of fear that accessing these services could jeopardize their immigration status. If this rule were to become final, even more immigrants would likely forego vital care, food, and shelter, leading to poorer health

outcomes and exacerbating economic and social disparities. The Medicare Rights Center opposes this harmful proposal. Policies must be changed to make health care and other essential services more accessible, affordable, and available to those in need—not less so. No one should be forced to choose between their and their family’s health and wellbeing and the stability of their immigration status and family unification. We urge the Administration to immediately withdraw this unconscionable proposal.

Pharmacists May Soon Be Allowed to Proactively Provide People with Medicare Information about Cheaper Medications This week, Congress passed two bipartisan bills aimed at removing barriers that may prevent people from paying the lowest possible price for their prescription drugs. The legislation will prohibit contractual limitations that can stop pharmacists from volunteering information about how consumers may be able to save money on their needed medications. The Patient Right to Know Drug Prices Act (S.2554) bars insurers and Pharmacy Benefit Managers (PBMs) from restricting a pharmacy’s ability to tell consumers when there is a difference between how much they would pay for a drug using their insurance and how much they would pay without it. This bill applies to plans offered through the Affordable Care Act’s exchanges and by private

employers. The Know the Lowest Price Act (S. 2553) provides this same protection for individuals who are covered by Medicare Advantage and Medicare Part D plans. It is unclear how many Medicare Advantage or Part D plans include this practice currently. Where they exist, they allow pharmacists to respond to direct questions about drug price comparisons, but not to preempt such questions by proactively telling people with Medicare that they might benefit from not using their Medicare prescription drug coverage. This legislation, which the president is expected to sign soon, will prevent PBMs and insurers from requiring pharmacists to stay silent unless asked. We applaud these improvements, and thank

Senators Collins (RMaine), McCaskill (DMissouri) and Stabenow (D-Michigan) for their leadership on this bipartisan effort. Though consumers can already ask pharmacists about their cost options, many do not know they need to ask for this information, or that doing so could save them money. Medicare Rights does not support the intentional or inadvertent withholding of drug pricing information from consumers in general, especially when it could empower them to improve the affordability of their health care and prescription drugs in particular. To the contrary, we believe that pharmacists and prescribers should be encouraged to give information freely to people with Medicare that may help

them better manage costs. In addition, we urge practitioners to look into alternatives when drug prices or other health costs are unusually high, or when patients express or exhibit concerns about affordability. Earlier this year in our response to the Administration’s Drug Pricing Blueprint, we agreed that pharmacies should be allowed to proactively provide information about cheaper medications. We appreciate congressional action on this issue, and encourage policymakers to continue to pursue reforms that help people with Medicare better afford their prescriptions. Read more about this issue. Read our comments on the Administration’s Drug Pricing Blueprint. Read this bill.

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Special Report: Recent Changes in Law, Regulations and Guidance Relating to Medicare Advantage and the Prescription Drug Benefit Program Numerous changes were made to Medicare law, regulations and guidance during the first half of 2018.The changes are particularly noteworthy regarding Part C, governing private Medicare plans, known as Medicare Advantage (MA), and Part D, the prescription drug benefit.This report focuses on the impact to Medicare beneficiaries from changes to Parts C and D pursuant to the Bipartisan Budget Act of 2018 (BBA), a final rule issued on Parts C and D (CMS-4182-F), and the Final Call Letter for 2019.[1]

Current efforts and proposals will privatize Medicare and increase costs. While the BBA made a changes that impact both Against the wishes of most number of significant changes programs. Part II of the report Americans, some lawmakers to Medicare beyond Parts C and considers the potential impact of want to cut Medicare benefits, D, those changes are not some of these changes, driving up costs to you, and generally discussed here.[2] particularly with respect to MA making health care and Instead, this report highlights benefits, consumer decisionprescription drugs even less many of the changes to MA and making and informed choice, affordable. Part D most relevant to and the impact of the changes We need to improve Medicare beneficiaries and on the traditional Medicare Medicare, not cut it. Let's those supporting or assisting program. renew it and strengthen it for them. Part I of the report generations to come. Protect provides a summary of these Print the full report Medicare. Don’t make changes, along with relevant America sick again. citations, and is organized by Medicare as we know it is Act Now! changes to MA, Part D and under attack.

Social Security FAQs Why is Social Security so important? Is Social Security just for seniors? Why are Social Security’s protections irreplaceable? How important is Social Security for retirement? How is Social Security funded? Isn’t Social Security the cause of our large federal deficit? Where does Social Security’s surplus go? Isn’t the trust fund just a bunch of IOUs? Is Social Security going bankrupt? What’s the best way to solve Social Security’s long-range funding gap? Why shouldn’t the retirement age be raised? Should rich people continue to collect Social Security, or should it be “means-tested”? Some politicians say that Social Security’s COLA is too generous. Should it be reduced? What are the values that underlie Social Security?

VA Adding Opioid Antidote To Defibrillator Cabinets For Quicker Overdose Response It took more than 10 minutes for paramedics to arrive after a housekeeper found a man collapsed on the floor of a bathroom in a Boston Veteran Affairs building. The paramedics immediately administered naloxone, often known by its brand name Narcan, to successfully reverse the man’s opioid overdose. But it takes only a few minutes without oxygen for brain

damage to begin. Pam Bellino, patient safety manager for the Boston VA, read that incident report in December 2015 with alarm. “That was the tipping point for us to say, ‘We need to get this naloxone immediately available, without locking it up,'” she said. The easiest way to do it quickly, Bellino reasoned, would be to add the drug to the

automated external defibrillator, or AED, cabinets already in place. Those metal boxes on the walls of VA cafeterias, gyms, warehouses, clinic waiting rooms and some rehab housing were installed to hold equipment for a fast response to heart attacks. Now the VA, building on the project started in Boston, is

moving to add naloxone kits to the AED cabinets in its buildings across the country, an initiative that could become a model for other health care organizations. It took more than 10 minutes for paramedics to arrive after a housekeeper found a man collapsed on the floor of a bathroom in a Boston Veteran Affairs building…..Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Trump health chief: Premiums to drop for popular ACA plan WASHINGTON (AP) — Premiums for a popular type of “silver” health plan under the Affordable Care Act will edge downward next year in most states, the Trump administration’s health chief announced Thursday. Health and Human Services Secretary Alex Azar said premiums for a so-called “benchmark” silver plan will drop by 2 percent in the 39 states served by the federal website. The number of marketplace insurers will grow for the first time since 2015, he added. Azar’s numbers were in line with a broader independent analysis earlier this month by Avalere Health and The Associated Press, which found premiums and markets stabilizing nationwide. But his claim that the Trump administration deserves credit for “Obamacare’s” turnabout was quickly challenged. “The president who was supposedly trying to sabotage the Affordable Care Act has proven better at managing it than the president who wrote the law,” Azar bragged in his speech to a health policy group in Nashville. Azar cited

regulatory actions to improve the inner workings of the ACA marketplaces and increase consumer choice among insurance plans that don’t comply with health law rules. The earlier AP analysis had found that average premiums across all types of plans under the Obama health law will rise 3.3 percent, with 12 states seeing declines. That study crunched data from 47 states and Washington, D.C., with publicly available information on proposed and final rates for 2019. Reacting to Azar’s claims, Larry Levitt of the nonpartisan Kaiser Family Foundation said it’s likely that premiums for 2019 would have gone down even more but for other administration actions last year that roiled the markets. Those included President Donald Trump’s abrupt cancellation of a major stream of payments to insurers — which triggered sharp 2018 premium increases. Also, Trump and congressional Republicans spent much of last year in a fruitless quest to repeal “Obamacare,”

with the president repeatedly pronouncing it “dead.” “The premium stability on tap for 2019 is primarily because insurers overshot with their premium increases for this year, reacting to an environment of tremendous uncertainty,” Levitt said. Under the design of the ACA, premium increases automatically boost taxpayerprovided subsidies to consumers. Big premium increases last year allowed many insurers to return to profitability as subsidies flowed from federal coffers. The average total premium for an individual covered under the health law is now close to $600 a month. In previous election years, health law premiums have provided plenty of material for Republican attack ads. That issue has been taken away this year by market stability. Instead, the debate has shifted to Democratic charges that the Trump administration and Republicans want to undermine the ACA’s protections for people with pre-existing health

conditions. Azar’s speech also took aim at the “Medicare for All” national health plan sought by Sen. Bernie Sanders, saying it would undermine access for seniors and pile huge costs on taxpayers. The Trump administration is stepping up its criticism of the Vermont senator’s plan as many Democratic candidates in the midterm elections voice support for his vision of a governmentrun health care system. “The main thrust of ‘Medicare for All’ is giving you a new government plan and taking away your other choices,” Azar said. As proposed, the Sanders plan would cover all Americans. Taxes on individuals and employers would replace premiums, deductibles, and copays, and the government would set payment rates for hospitals and doctors. Sanders says his approach would uphold quality and gradually bring costs under control, but studies show it would translate to a historic expansion of the federal government’s role in health care. Critics doubt promised savings could be delivered.

Drugmakers Play The Patent Game To Lock In Prices, Block Competitors David Herzberg was alarmed vultures,” said patent, it will not be patent law expert at Stanford when he heard that Richard Herzberg, an associate commercialized for University, said the Sackler, former chairman of professor at the profit.” pharmaceutical industry gets a opioid giant Purdue Pharma, was University of Buffalo. Yet, the patenting of a greater financial return from its listed as an inventor on a new James Doyle, vice small change in how an patent strategy than that of any patent for an opioid addiction president and general existing drug is made other industry. treatment. counsel of Rhodes or taken by patients is part of a AztraZeneca in 2001 famously Patent No. 9861628 is for a Pharmaceuticals, the Purdue tried-and-true pharmaceutical fended off generic versions of its fast-dissolving wafer containing subsidiary that holds the patent, industry strategy of enveloping blockbuster heartburn buprenorphine, a generic drug said in an email statement that products with a series of medicine Prilosec by patenting a that has been around since the the company does not have a protective patents. tweaked version of the drug and 1970s. Her zber g, a histor ian developed or approved product Drug companies typically have calling it Nexium. When Abbott who focuses on the opioid and “therefore no money has less than 10 years of exclusive Laboratories faced multiple epidemic and the history of been made from this rights once a drug hits the generic lawsuits over its big prescription drugs, said he fears technology.” marketplace. They can extend moneymaker Tricor, a decadesthe patent could keep prices high “The invention behind the their monopolies by layering in old cholesterol drug, it lowered and make it more difficult for buprenorphine patent in question secondary patents, using tactics the dosage and changed it from a poor addicts to get treatment. was developed more than a critics call “evergreening” or tablet to a capsule to win a new “It’s hard not to have that dozen years ago,” he wrote. “If a “product-hopping.” patent….Read More reaction of, like … these product is developed under this Lisa Larrimore Ouellette, a Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

RI ARA HealthLink Wellness News


National Breast Cancer Awareness Month 2018 October 1 - 31, 2018 in the USA National Breast Cancer Awareness Month is obser ved in October 2018. Breast Cancer Awareness Month,is an annual international health campaign organized by major breast cancer charities every October to increase awareness of the disease and to raise funds for research into its cause, prevention, diagnosis, treatment and cure. A variety of events around the world are organized in October, including walks and runs, and the pink illumination of landmark

buildings. In the United States, the National Football League promotes breast cancer awareness by incorporating pink on and off the field, and comic strip artists use pink on one day in October This text has been taken from Breast cancer is a type of cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from

ducts are known as What Are My ductal carcinomas, Treatment Options? while those Glossary originating from Personalize Your lobules are known as lobular Cancer Care Decisions carcinomas. (With material from: My Cancer Coach provides Wikipedia) This text has been information about personalized taken from www.cutebreast cancer treatment options to help manage your Breast Cancer 101 cancer care. Get started with Overview the breast cancer app today! DOWNLOAD ON APPLE Understanding My APP STORE Pathology Report Understanding My Diagnosis


Poor diabetes control may increase the risk of serious infections New UK research has found that diabetes patients with have poor control of their blood sugar may have a higher risk of hospitalization due to infection, and possibly even death. Carried out by researchers at St George's, University of London, the large-scale study looked at more than 85,000 English adults aged 40 to 89 years with a diabetes diagnosis and a measurement of glycated hemoglobin, also known as longterm blood sugar, which is a marker of diabetes control. Medical records on infection rates were also analyzed to compare diabetes patients with poor control to those with good control, and to people without

diabetes. The findings, published in the journal Diabetes Care, showed that the risk for most types of infection, particularly those caused by bacteria, increased for those with the worst diabetes control, with diabetes patients with the worst control almost three times as likely to need hospital treatment for an infection compared to those with good control. Patients with good diabetes control also had a higher risk of getting an infection compared to patients without diabetes, but the risk was lower in this group. The risk of infection appeared to be highest in patients with type

1 diabetes and very poor control, with these patients showing an 8.5 times higher risk of needing hospital treatment compared to those without diabetes. The researchers also found that it is the risk of rare but serious infections that seemed to increase the most by having poor control of diabetes. "Across England as a whole, we found that poor diabetes control accounted for about 20 to 46 percent of some of the most serious types of infections (sepsis, bone and joint infections, tuberculosis and endocarditis) seen in diabetes patients," added study author Professor Julia

Critchley. Also among the findings was that poor diabetes control accounted for 15 percent of pneumonia infections and 16 percent of all deaths related to infections. "Pneumonia is very common and often causes death in older people, and we demonstrated a clear link to blood sugar control," said Professor Critchley. People with diabetes can control their blood sugar levels better through regular exercise, diet and maintaining a healthy weight, and taking medication when needed. Health experts can also help by carefully increasing dose of any medicines or adding new medications as required.

Half of women at risk of dementia, Parkinson's, stroke: study Nearly half of women and one in three men are at risk of developing stroke or degenerative neurological diseases such as dementia and Parkinson's during their lifetime, according to a study published Monday. Dutch researchers considered all three conditions "in order to grasp how big the problem of incurable brain diseases in late

life really is," said the study's senior author Arfan Ikram. "We grouped these diseases together not only because they are common but also because there are indications that these often co-occur and might share some overlapping causes," Ikram, of the Erasmus MC University Medical Center

Rotterdam in the Netherlands, told AFP. This could mean there are also overlapping ways to delay or avoid getting the diseases, and the research found that some preventative strategies may cut the risk by between 20 and 50 percent. For the study, published in the

Journal of Neurology Neurosurgery and Psychiatry, researchers tracked more than 12,000 healthy people over the age of 45 from 1990 to 2016. Over the 26 years, 5,291 people died. Nearly 1,500 were diagnosed with dementia -- 80 percent with Alzheimer's -- while 1,285 had a stroke and 263 developed Parkinson's…..Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

What Is a Geriatric Emergency Department? Older adults may receive care more attuned to their needs in specialized hospital ERs. NOBODY LOVES AN emergency room visit, least of all older patients. Everything about the ER experience can be more challenging for older adults. Time in the waiting room is harder to tolerate: You're cold and they've run out of blankets. If you're confused or disoriented, the harsh lighting, bursts of yelling and constant noise make it worse. If you're

unsteady on your feet and need the bathroom, navigating cramped ER quarters is difficult. If your joints are painful or your skin is thin and delicate, "resting" on a cot or stretcher is tough. If you're alone, without a friend or family member, it's frightening. When older patients are admitted to the emergency department, vague-sounding symptoms ("I feel dizzy." Or "I

just don't feel right.") may actually be more serious than for someone younger. Common conditions like urinary tract infections can present themselves quite differently depending on age, and treatments may vary. For these reasons and more, some emergency departments are making changes to tailor their care and better meet the needs of older adults.

Geriatric emergency departments incorporate specially trained staff, assess older patients in a more comprehensive way and take steps to make the experience more comfortable and less intimidating. However, not all geriatric EDs are the same. Below, clinical experts spell out basic criteria for geriatric emergency departments and describe what patients and families should look for and expect….Read More

4 Common Lies Depression Tells You A teacher debunks the common lies that depression can tell you. In good conscience, I cannot idly stand by watching others continue to struggle. Depression is a deadly disorder that affects millions of teenagers and adults. According to the National Institute of Health, 2.2 million adolescents experienced a depressive episode in 2016. These episodes sometimes lead to deaths, and I want it to stop. To begin, we cannot perpetuate the lie that mental health issues should remain hidden in the dark, unspoken and ignored. The truth is, we need to talk about them. Truth, honesty, and openness are needed to help others overcome depression and the lies depression tells. Lie 1: You are worthless. This lie attacks one’s selfesteem and rocks the inner core. Whether the inner voice is a whisper or a scream, it is a constant refrain reminding those with depression that they have no value to anyone, anywhere, at any time. This is false. Even if you have depression, you must understand you have value. Being a teacher myself, I know the reason we teach is

because of our belief in our students. You are worth the 60-hour work weeks of grading, teaching, and planning. We are here because each of you is worth it. As children’s television icon Mr. Rogers stated, “There is no one else in the world exactly like you.” Lie 2: You are unlovable or unlikeable. Love, friendship and community are the enemies of depression. If you feel loved, worthy of love or even cared for, then that love becomes the single candle bright enough to banish the darkness and the cold. But depression lies. It takes any and every opportunity to say no one loves or could love you. You are lovable and worthy of love. You have a place in the community even if you haven’t found it yet. As a community, we need to remind each other that someone cares. Someone with depression may need the reminder that there’s someone who loves them. Lie 3: No one knows how you feel, no one has problems like you and no one could understand. If any variations of these

phrases were actually true, then I could not write this article. I know about depression intimately. I suffer from depression and have since the fifth grade. I know the lies well. I also know the feeling of emptiness and isolation that is difficult to describe. I know how cold it feels on the inside when you are desperate to feel anything other than depressed. You are not alone. There are other teens, adults and children who suffer from the same thing. There are so many individuals out there who can be trusted to listen to you, care for you and to help: your teachers, friends, parents, counselors and so many others. Lie 4: It’ll never get better; you will always feel this way. This is the most dangerous lie, especially during the teenage years. Depression wants you to feel hopeless. Depression tricks you into seeing despair. I have been struggling, fighting, losing and winning this battle for over a quarter of a century, yet I’m still here. I will not lie and say one day, depression will magically disappear. My depression can be a daily struggle of emotionally treading water, like being capsized in the

ocean without a life jacket. I still have days when I leave my job believing I have failed miserably as a teacher, a colleague or a friend. But I have also learned to cope, and so can you. I’ve gotten better at handling it. I know when I need to talk to a friend, relative or counselor. I’ve learned to find joy in everyday moments. You learn to laugh at yourself and at the absurdity of life. You learn to surround yourself with the people who love you unconditionally, support you and hold you accountable. For me, my faith is an essential component. You may find your solace in a myriad of different people, places or pursuits. Why the lies are dangerous: If left unchecked, these lies lead to the thinking, “It’d be easier if…” or “The world would be better off…” which can quickly escalate to suicidal thoughts. I know what it’s like to want to give up or to just quit. I know there are days when you feel like life is pointless. In the end, you would rather feel nothing than what you do feel. Please do not dwell on or give in to those thoughts and lies. Talk to a counselor, parent, trusted adult, teacher or friend.

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Lewy body dementia: The neurological disorder suffered by Ted Turner, Robin Williams CNN founder Ted Turner has revealed that he is suffering from Lewy body dementia, the same form of dementia that Robin Williams battled in the last few years of his life. According to the website for the Lewy Body Dementia Association, LBD affects 1.5 million Americans. It is a progressive neurological disorder that affects a patient's memory, cognition (especially decision making), mood, behavior and balance and is often misdiagnosed as Parkinson's, as Williams' case was, or bipolar disorder, as Turner's was. In an interview with Ted Koppel set to air on "CBS Sunday Morning" this weekend (9 a.m. EDT/PDT), Turner, 79, likened his case to a "mild case of Alzheimer's ... but not nearly as bad ... Thank goodness, I don't have that." Displaying some of the memory problems characterized by LBD, he struggled to

remember the name of his disorder, "I also have got, let's – the one that's – I can't remember the name of it ... dementia." Turner said it leaves him "tired" and "exhausted," adding that the other symptom that bothers him most is "forgetfulness." Williams' case was far more severe, according to his widow, Susan Schneider, who called it "the terrorist inside my husband's brain." Worse, they didn't know what the comedian had in the final year before he died by suicide in August 2014 at age 63. As early as the fall of 2013, he began displaying what at the time seemed like unrelated symptoms: "Constipation, urinary difficulty, heartburn, sleeplessness and insomnia, and a poor sense of smell — and lots of stress," according to Schneider. There is no definitive test for LDB, according to Rachel Dolhun, a doctor who wrote an explanatory article about the disease on the website of

the Michael J. Fox Foundation for Parkinson's Research. Rather, doctors arrive at the diagnosis using a patient's imaging scans, physical exam, medical history and blood work. Once diagnosed, cases are usually managed by neurologists. (They may refer patients to cognitive specialists and psychologists to help address the mental symptoms.) Williams' LBD diagnosis was only determined after an extensive autopsy, Schneider revealed in an essay in the medical journal Neurology. "All four of the doctors I met with afterward and who had reviewed his records indicated his was one of the worst pathologies they had seen," she recalled. "He had about 40 percent loss of dopamine neurons and almost no neurons were free of Lewy bodies throughout the entire brain and brainstem." Schneider said that while anxiety was not new for the actor, who had long suffered

from depression, the way he now handled it was "markedly out of character for him," to the point of alarming her. "Not until after Robin left us would I discover that a sudden and prolonged spike in fear and anxiety can be an early indication of LBD," she explained. In the weeks before he was misdiagnosed with Parkinson's in the summer of 2014, Williams arrived home from a movie shoot like "a 747 coming in with no landing gear." In hindsight, she realized that this was the point at which her Julliard-trained, Oscar-winning husband was no longer able to hide his illness. The Parkinson's misdiagnosis made things worse because people with LBD respond badly to drugs prescribed for that disorder, Schneider wrote. "I will never know the true depth of his suffering, nor just how hard he was fighting," she lamented. "But from where I stood, I saw the bravest man in the world playing the hardest role of his life. Robin was losing his mind and he was aware of it."

Suicide rates up among younger veterans, VA says The number of suicides among younger veterans has increased “substantially,” according to a report released Wednesday by the Department of Veterans Affairs. (VA) The latest statistics show that 45 of every 100,000 veterans ages 18-34 committed suicide in 2016 – up from around 40 a year earlier. “These findings underscore the fact that suicide is a national public health issue that affects communities everywhere,” the VA said in a statement obtained by The Wall Street Journal. “Our goal is to prevent suicide among all veterans — even those who do not and may never seek care within VA’s system.” The VA found that there were

more than 6,000 veteran suicides each year from 2008 to 2016. Veterans accounted for 14 percent of all suicides in the United States in 2016, yet veterans comprise just 8 percent of the population, the report said, according to the newspaper. In the report, the VA described veteran suicide as an “urgent crisis” that it can't address by itself. Still, some advocates say the department has not devoted enough resources to this issue. “If any other population of 20 million people were exposed to these threats, it would be considered a public health priority,” Paul Rieckhoff, chief

executive of Iraq and Afghanistan Veterans of America, told the newspaper. “There has never been a national call to action.” Last year, the VA’s inspector general found the department’s suicide hotline had routed a high percentage of calls to backup centers, a major flaw the department says it has resolved. On Tuesday, the inspector general also released a report after a veteran killed himself less than 24 hours after his departure from a VA facility in Minnesota. The report accused the facility of not providing followup care for the veteran, who was taken into the hospital over suicidal

ideation. “Because many veterans do not use VA services and benefits, we must build networks of support, communication and care across the communities where veterans live and thrive,” the report states. The data was released a day before a scheduled hearing by the House Committee on Veterans’ Affairs. At the Thursday hearing, lawmakers are to discuss veteran suicide prevention efforts. The VA’s confidential Veterans Crisis Line is open 24/7 for vets and those concerned about them. The telephone number is 1-800-2738255.

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RI ARA October 7, 2018 E-Newsletter  

RI ARA October 7, 2018 E-Newsletter  

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