This story also ran on NBC News. See below.

West Virginia’s Public Employees Insurance Agency enrolls nearly 215,000 people — state workers, as well as their spouses and dependents. The new law, which will take effect June 10, will allow plan members who have been approved for a course of treatment to pursue an alternative, medically appropriate treatment of equal or lesser value without the need for another approval from the state-based health plan.

“This legislation is rooted in a simple principle: if a treatment has already been approved, patients should be able to pursue a medically appropriate alternative without being forced to start the process over again — especially when it does not cost more,” Gov. Patrick Morrisey said in a statement after signing the bill into law on March 31.

“This is about common sense, compassion, and trusting patients and their doctors to make the best decisions for their care,” he said.

Delegate Laura Kimble, the Republican from Harrison County who introduced the legislation, told KFF Health News the measure offers “a rational solution” for patients facing “the most irrational and chaotic time of their lives.”

From Arizona to Rhode Island, at least half of all state legislatures have taken up bills this year related to prior authorization, a process that requires patients or their medical team to seek approval from an insurer before proceeding with care. These state efforts come as patients across the country await relief from prior authorization hurdles, as promised by dozens of major health insurers in a pledge announced by the Trump administration last year.

The West Virginia law was inspired by Eric Tennant, a coal-mining safety instructor from Bridgeport who died on Sept. 17 at age 58. In early 2025, the Public Employees Insurance Agency repeatedly denied him coverage of a $50,000 noninvasive cancer treatment, called histotripsy, that would have used ultrasound waves to target, and potentially shrink, the largest tumor in his liver. His family didn’t expect the procedure to eradicate the cancer, but they hoped it would buy him more time and improve his quality of life. The insurer said the procedure wasn’t medically necessary and that it was considered “experimental and investigational.”

Related coverage

After Series of Denials, His Insurer Approved Doctor-Recommended Cancer Care. It Was Too Late.

Eric Tennant’s doctors recommended histotripsy, which would target, and potentially destroy, a cancerous tumor in his liver. But by the time his insurer approved the treatment, Tennant was no longer considered a good candidate. He died in September. Read More

Becky Tennant, Eric’s widow, told members of a West Virginia House committee in late February that she submitted medical records, expert opinions, and data as part of several attempts to appeal the denial. She also reached out to “almost every one of our state representatives,” asking for help.

Nothing worked, she told lawmakers, until KFF Health News and NBC News got involved and posed questions to the Public Employees Insurance Agency about Eric’s case. Only then did the insurer reverse its decision and approve histotripsy, Tennant said.

“But by then, the delay had already done its damage,” she said.

Within one week of the reversal in late May, Eric Tennant was hospitalized. His health continued to decline, and by midsummer he was no longer considered a suitable candidate for the procedure. “The insurance company’s decision did not simply delay care. It closed doors,” his wife said.

Had the new law been in effect, Kimble said, Tennant could have undergone histotripsy without preapproval, because it was a less expensive alternative to chemotherapy, which his insurer had already authorized. The bill was passed unanimously by the state legislature in March.

U.S. health insurers argue that most prior authorization requests are quickly, if not instantly, approved. AHIP, the health insurance industry trade group, says prior authorization acts as an important guardrail in preventing potential harm to patients and reducing unnecessary health care costs. But denials and delays tend to affect patients who need expensive, time-sensitive care, studies have shown.

The practice has come under intense scrutiny in recent years, particularly after the fatal shooting of a health insurance executive in New York City in late 2024. Americans rank prior authorization as their biggest burden when it comes to getting health care, according to a poll published in February by KFF, a health information nonprofit that includes KFF Health News.

Samantha Knapp, a spokesperson for the West Virginia Department of Administration, would not answer questions about the law’s financial impact on the state. “We prefer to avoid any speculation at this time regarding potential impact or actions,” Knapp said.

In a fiscal note attached to the bill, Jason Haught, the Public Employees Insurance Agency’s chief financial officer, said the law would cost the agency an estimated $13 million annually and “cause member disruption.”

West Virginia isn’t an outlier in targeting prior authorization. By late 2025, 48 other states, in addition to the District of Columbia and Puerto Rico, already had some form of a prior authorization law — or laws — on the books, according to a report published in December by the National Association of Insurance Commissioners.

Many states have set up “gold carding” programs, which allow physicians with a track record of approvals to bypass prior authorization requirements. Some states establish a maximum number of days insurance companies are allowed to respond to requests, while others prohibit insurance companies from issuing retrospective denials after a service has already been preauthorized. There are also a crop of new state laws seeking to regulate the use of artificial intelligence in prior authorization decision-making.

Meanwhile, prior authorization bills introduced this year across the country, including in Kentucky, Missouri, and New Jersey, have been supported by politicians from both parties.

“Republicans in conservative states see health care as a vulnerability for the midterm elections, and so, unsurprisingly, you’ll see some action on this,” said Robert Hartwig, a clinical associate professor of risk management, insurance, and finance at the University of South Carolina. “They realize that they’re not really going to get much action at the federal level given the degree of gridlock we’ve already seen.”

Last summer, the Trump administration announced a pledge signed by dozens of health insurers vowing to reform prior authorization. The insurers promised to reduce the scope of claims that require preapproval, decrease wait times, and communicate with patients in clear language when denying a request.

Consumers, patient advocates, and medical providers have expressed skepticism that companies will follow through on their promises.

Becky Tennant is skeptical, too. That’s why she advocated for the West Virginia bill.

“Families should not have to beg, appeal, or go public just to access time-sensitive care,” she told lawmakers. Tennant, who sees the bill’s passage as bittersweet, said she thought her husband would have been proud.

During Eric’s final hospital stay, Tennant recalled, right before he was discharged to home hospice care, she asked him whether he wanted her to keep fighting to change the state agency’s prior authorization process.

“‘Well, you need to at least try to change it,’” she recalled her husband saying. “‘Because it’s not fair.’”

“I told him I would keep trying,” she said, “at least for a while. And so I am keeping that promise to him.”

—–

NBC News health and medical unit producer Jason Kane and correspondent Erin McLaughlin contributed to this report. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

The post After Man’s Death Following Insurance Denials, West Virginia Tackles Prior Authorization appeared first on Medika Life.

How did it happen, and is it happening to too many others, not just in the UK, but worldwide? Medical literature is supposed to guide us, inform us, and help us to maintain patients’ health as best we can. In healthcare, there may not always be apparent charlatans but poorly planned studies and misguided beliefs about psychological illness.

I would refer anyone who wants to keep up on the retractions of fraudulent or improperly concocted science to one place on the Internet—Retraction Watch. The latest shocking revelation in this online publication involves a cancer researcher who used manipulated images in several papers. Although he has had numerous publications retracted now, he still maintains his position at a highly respected hospital in a major city in the United States. Unfortunately, he is not alone in this practice, but we are fortunate to have those willing to ferret them out. Even the famed Karolinska Institute has had its issues.

What Is ME/CFS?

The debilitating effects of myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS) prevent sufferers from leading their regular lives.
It hinders both mental and physical exertion. Difficulty concentrating, extreme fatigue, and other symptoms may be present. Neither a cause nor a remedy has been found. Addressing the most pressing symptoms is common practice when providing care. But what therapy, when, and for how long, especially if we don’t know what causes it?

Limited access to healthcare may contribute to the underdiagnosis of ME/CFS. Additionally, we may require more medical professionals who are familiar with ME/CFS and capable of identifying the symptoms.

A new blood test could differentiate between patients with ME/CFS and healthy people or disease controls with an impressive 91% accuracy rate. How many facilities or healthcare professionals are using it?

Unfortunately, they placed too much emphasis on psychological causes and referred patients for this type of therapy. Negative attitudes toward patients who were upset about their inability to get symptom relief were rife.

How many times have MS patients (usually women) seen as “attention-seeking” or “noncompliant” or labeled with other terms that failed to help and made their lives more miserable? I knew of a woman with MS that the family therapist castigated and engaged the family in viewing her as unwilling to get well. Once her medical diagnosis was established, I never heard how the therapist addressed the damage done to her self-esteem.

How Has the Stigma Been Addressed?

The damage has been done to more patients than we know. Only the case of Ms. O’Neill has risen to the attention of the popular press in the UK. What of the others?

Following Ms. O’Neill’s revealing autopsy report in the UK, new guidelines have been established by the National Institute for Health and Care Excellence in response to the young woman’s tragic death. They rescinded their previous guidelines and set out new ones based on their findings of poor methodology of studies, debunked theories, and inadequate care. Their aim? The prevention of future deaths.

The new guidelines expressly indicate that healthcare professionals not prescribe:

1. exercise-or movement-based treatment for chronic fatigue syndrome
   2. exercise or physical activity programs for all age groups, including those with and without specific medical conditions
   3. a regimen like graded exercise therapy (GET) that involves predetermined progressive increases in physical activity or exercise
   4. sustaining physical activity or exercise programs that are grounded in the theories of deconditioning and exercise intolerance

Would Ms. O’Neill be alive and participating in the normal lifestyle of a 27-year-old woman if her team/teams had adhered to these guidelines? We’ll never know because years of disregard had done the damage. Were the metaphors of her symptoms not understood, or were existing theoretical myths of the origin of her illness stronger than common sense?

The new guidelines state that healthcare professionals should: “Recognize that people with ME/CFS may have experienced prejudice and disbelief and could feel stigmatized by people (including family, friends, health and social care professionals, and teachers) who do not understand their illness.”

It is more than unfortunate that change only comes about in healthcare, methodology and diagnosing when tragedy, such as a death, strikes. We can only equate it with neighborhoods that have traffic lights installed after someone is killed by a car speeding through an intersection.

It will not bring that person back, and it illustrates that we should not have to wait for that type of tragedy to occur in order for change to occur. Where is the change that we need now, and in what illnesses or disorders? That is the question that must be posed by researchers in all fields of medical endeavors.

The post Dying Because of Medical Disbelief Shouldn’t Happen in the 21st Century appeared first on Medika Life.

The probability of suicide attempt and suicide death was 1.48 and 1.47 times higher, respectively, for wives of cancer patients compared to those whose spouses never had the disease, according to data from Denmark’s national patient databases.

Some variables affected the severity of that risk. Suicide attempts and fatalities among patients’ spouses were more common among those whose tumors were more aggressive, but this was not the case for cancers with better prognoses. This highlights the seriousness of the situation for cancer caretakers. Suicide attempts and fatalities were more common among people with a history of mental illness following a spouse’s cancer diagnosis. But we need to remember that not all individuals with mental illnesses seek treatment, so not all of them receive a diagnosis, and that means they get left out of the statistical calculations.

Caregiving for a loved one with cancer is fraught with difficulties on many fronts, including the physical, mental, and practical. Cancer treatments have a profound impact on patients, but they also place heavy financial and emotional strains on loved ones, who may already have quite a bit on their plates with which they must contend.

Witnessing a loved one’s suffering, on top of the challenging nature of caring, can induce severe psychological discomfort. Few studies have examined the rates of suicide, suicidal thoughts, and self-harm among cancer patients’ caregivers, even though depression is the leading cause of suicide.

Because of shorter hospital stays, more outpatient therapy, improved survival rates, and patients’ preferences for at-home care, the primary care environment for cancer patients has moved from hospitals to patients’ homes. Therefore, more people will need to pitch in to take care of cancer patients’ day-to-day needs, especially those who are close to the patients, such as friends and family. Caregivers play a crucial role in the treatment journey of cancer patients. Currently, there are an estimated six million of these caregivers worldwide.

Nearly 40.1% of men and 38.7% of women in the nation will develop cancer in their lives. Its effects on poor countries are equally significant and warrant investigation.

What About the Caregiver’s Quality of Life?

For cancer caregivers, the relationship between stress and well-being runs counter to what one would expect. Caring for someone reliant on you increases your chances of anxiety by 86% and sadness by 65%. The majority of unpaid caregivers are women (45–65 years old), who stay at home and are the patient’s daughter or husband, according to studies that have profiled this demographic. Among the 7663 caregivers who made up one overall sample, women made up 66.72%. The majority of research agrees that female caregivers outnumber male caregivers for cancer patients.

If women are the primary caregivers of cancer patients and provide assistance in the home, and research has not adequately assessed their quality of life, what can we learn from the current body of research?

Among all relatives, 11% felt a heavy burden as a caretaker, and the median number of hours spent caring for a loved one each week was 15. Family members who reported a low or medium caregiver load were more resilient and engaged in self-care more frequently than those who reported a high caregiver burden. Caregivers who reported carrying a heavy load were more likely to be younger, better educated, and less knowledgeable about the value of self-care. They also frequently reported acting as an informal caretaker for the patient.

Nearly half (43.5%) of caregivers said they had to deal with high financial costs, and almost a third (35.0%) said they experienced isolation or the loss of friends due to caring for someone else. Comparatively, 33% said they had unfavorable effects on their bodies. Starting at 13%, the percentage of people experiencing overwhelming or severe stress increased to 59.5% as the disease progressed, substantially quintupling from the baseline.

Relatives of people with advanced cancer may cope better with the caregiving load they face if they practice self-care and build resilience. However, little attention has been paid to these ideas. What is the motivation for caregivers of cancer patients?

In a survey asking about their primary drivers, 75% of people mentioned love as a driving element, while 50% cited a sense of duty. While 3.5 percent cited remorse as their driving force, 8% cited financial gain as their primary motivator. Tragic loss accounted for 30.5% of caregivers’ responsibilities, followed by mental health issues at 28.0%, and financial concerns at 15.5%.

Considering the research or lack thereof, caregivers for cancer patients who go through increasing stages of the disease must feel like they are trying to push the ocean back with a broom.

Their sentiments are understandable, but there is help available, and I am listing both groups and other available resources for these individuals. We cannot leave them feeling hopeless and helpless. We must employ all our abilities, too, in a larger sense, to support these individuals in their valiant efforts.

I understand the demands and the difficulties, the strain, and the stress of caring for someone with metastatic cancer that marches on to become ever more ravaging because my mother died of cancer. She was fortunate because she had four daughters, including a granddaughter who, in managerial fashion, set up a schedule for each person’s involvement.

We were all given a shift (day and night) and time for respite care and self-care so we would not burn out. It was a time of great stress, but we are all proud of our involvement. Fortunately, this was when hospice care was in its infancy in the US, but we could find a major hospital that had cobbled together a knowledgeable cancer hospice team. They provided both care and medication for us, and we are forever grateful to them and the wonderful oncologist who took care of my mother in the hospital.

Groups and Resources

The American Cancer Society: downloadable guide

National Coalition for Cancer Survivors

Cancer Care Resources

National Cancer Institute

Cancer Support Community (Gilda’s Club)

National Comprehensive Cancer Control Program

Cancer Hope Network

Ovar’s Coming Together (ovarian cancer)

Colon Cancer Foundation

Cancer care can be overwhelming for anyone, so don’t think you are in any way weak if you are feeling the task is grinding you down and you are having suicidal thoughts.

If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.

The post Cancer Patient Caregivers Are Being Forgotten in Suicide Risk appeared first on Medika Life.

Years ago, just after my mother had died in hospice care for her metastatic cancer, a nurse from the unit at the hospital called me. She inquired about my well-being and then expressed shock, annoyance, and a hint of shame (for me) that I hadn’t started going through the traditional—and completely incorrect—stages of grieving. The nurse was, in fact, lecturing me as though I were a child, which was quite a long time ago. It was disrespectful.

I was not only taken aback, I was angry. Here I was, totally wrecked after my mother died after months of our caring for her at home, and she was lecturing me on how I was doing it all wrong. I will never forget that phone call and cutting her off. After that, I never responded to the few calls that came from the hospice unit in the hospital. I’d had enough shaming from her. The point here, and one I want to make for anyone who is grieving, is that there is no formula for grieving, and any health professional who adheres to it has been misled.

Grieving is an unavoidable aspect of being human. When a loved one passes away, a relationship ends, or you lose your job, it is a process that happens after a loss. Many individuals think that in order to grieve and heal, there are specific actions that must be taken. I and others, however, refute the idea of a predetermined series of stages and exhort readers to abandon this thinking. I’d like to present a different viewpoint on sorrow and inspire people to accept their individual path to recovery.

As Kubler-Ross explained her unscientific method of devising these alleged stages of grief, she explained it this way. “I was to do the interview while they [her students] stood around the bed watching and observing. We would then retire to my office and discuss our own reactions and the patient’s response. We believed that by doing many interviews like this we would get a feeling for the terminally ill and their needs which in turn we were ready to gratify if possible.”

The idea of stages of grief, or as Kubler-Ross later called it, stages of loss, relates to her own grief surrounding the death of her father and her anger related to it. It’s an unrecognized bias on her part. Also, the stages were based on interviews with dying patients, not individuals who were experiencing loss. And grief or bereavement waxes and wanes over periods of time and is not necessarily a progression to acceptance.

But scientists have an affinity for putting quantifiable numbers on research. It has happened with most research in the early 20th century when psychology was attempting to wrest validity from the “hard” sciences since it was seen as a “soft” one. Critical reviews have not agreed with Kubler-Ross and have found it may not be in such favor among healthcare professionals today.

Grief is a highly individualized experience. Each person’s experience of sorrow is unique and influenced by their personality, life experiences, and the particulars of the loss. Realizing that there is no one-size-fits-all method of grieving is crucial. Following an exact set of instructions can be restrictive and may not be consistent with everyone’s experiences. It is essential to respect and validate your own feelings instead, and to let yourself grieve in a way that is true for you.

And grieving is difficult. A wide range of feelings, from sadness and rage to confusion and remorse, describe it. It doesn’t follow a straight line with a definite start, middle, and end. With the ebb and flow of deep emotions, grief can be unpredictable. You can give yourself permission to experience all the feelings that come up without condemnation or expectation by accepting the messy nature of grieving. Grieving can be done in any way, right or wrong.

The idea of going through a sequence of steps suggests a straight path to recovery. But sadness doesn’t progress in a straight line. It is more like a jumbled web of feelings and encounters. The notion that one must go through particular phases or steps oversimplifies the complexity of grieving. It is crucial to recognize that healing is a journey rather than a destination.

Belief in “steps” can lead to the bereaved person having irrational expectations. If you don’t follow the set timeline or experience emotions out of the intended order, it may result in feelings of inadequacy or failure. You can release yourself from these expectations and allow your grieving journey to develop spontaneously and authentically by letting go of the belief in steps.

Lift the curtain of awareness and look at how the idea of these steps for grieving came to be. For one, it is based on extremely limited and flawed research by Dr. Kubler-Ross and her students, who studied a very limited number of grieving people and then put their own beliefs on what they felt was happening. What type of research is this? It’s not research, but self-reflection that is highly biased and, arguably, lacks any type of research acumen. But, because of the highly respected psychiatrist, the idea of the steps took hold and quickly became the standard for how grief develops over time after a loss.

There is no one solution that works for everyone because grieving is such a personal emotion. While some people might feel more comfortable going through a given process, it’s crucial to understand that these procedures aren’t applicable to everyone. It’s important to respect your specific journey through grief because it’s complicated and personal.

The type of loss experienced, the person’s support network, and their coping mechanisms all play a role in how long the mourning process lasts from person to person. It’s crucial to give the time and room required for healing.

Getting professional assistance, such as therapy or counseling, can be helpful when grieving. A qualified expert can offer assistance, direction, and resources to help people through the difficult feelings and difficulties that come with grieving.

Talking to a close friend or trusted relative, exercising, using relaxation techniques like deep breathing or meditation, writing, or joining a support group are all good ways to deal with loss.

Even after a long period of time has passed since the loss, grief might reappear. Anger-inducing occasions such as anniversaries, holidays, or triggering incidents might do this. Sorrow is not something that has fully passed or been dealt with. Integrating the loss into one’s life may take a lifetime. For some, there will always be the element of grief for a loss, and that simply means the love was strong.

Grieving is a difficult journey that cannot be broken down into a series of actions or phases. And there is no shame in not grieving according to any formula for it. As one research paper noted, “If there are no typical responses to loss and no typical losses, and not everyone goes through them or in order, how can there possibly be stages that universally represent people’s reactions to loss? The fact is, no study has ever established that stages of grief actually exist, and what are defined as such can’t be called stages.”

The post Grieve As You Must, and Break Free of Believing in the “Steps” appeared first on Medika Life.

Studies show that widowed women who work are more likely to feel sad and anxious than widowed women who don’t work. They also may have a higher risk in terms of their mortality.

Widowhood can be more challenging for women in their professional lives, and their depression adds to their physical vulnerability regarding their health. For many reasons, career-working women tend to have fewer personal relationships than their nonworking counterparts. After a spouse dies, they may have fewer close friends and acquaintances to turn to for comfort.

A woman’s professional life may also have additional demands on her time and energy. They may feel rushed to return to work after a loss, so grieving is put on hold. Working women, especially those in executive positions, may experience more stress and anxiety than the general population because of the demands of multiple roles they must assume. This may make it harder for them to accept their spouse’s death.

For women, the mental health hazards associated with widowhood can devastate their professional lives. Being a widow can be mentally wrenching and can affect the immune system. There is some evidence that women who have lost a loved one are more likely to get heart disease or high blood pressure when widowhood enters their lives.

The problem with the current state of research is that it doesn’t seem to have caught up with women’s roles in corporations and, instead, looks at elderly widows who haven’t been involved in management positions. The paucity of research in this area screams out for attention. Who will answer the call?

We have a book on Hemingway’s widow, a best-selling book on personal widowhood by a publishing insider, and Sheryl Sandberg’s book about sudden death and resilience, but what about the typical woman professional who is suddenly widowed? Who’s writing about her?

Of course, there are actions these women can take, like focusing on expanding their support system. Having dependable friends and family members can be a comfort in difficult times. But do they have time and suppose they have young children? They must put their sense of loss and the new burden of taking on a larger role in the home and their jobs on hold; the children come first.

Working women should prioritize self-care or they can’t care for others, their jobs or their children. Exercising, taking time off, and participating in hobbies may fall into this category. Will they be able to handle yet another demand on their time, a demand that entails keeping their health intact?

The post Widowhood and a Career Bring Double Trouble to Women appeared first on Medika Life.

Facing the fact that death is inevitable can be overwhelming, making end-of-life planning an unpleasant but important task. Digital twin technology is an emerging concept that may be an effective tool to help individuals prepare for end-of-life care and financial matters in a more efficient, organized, and even in a more compassionate way.

A digital twin, or virtual replica of oneself, provides an individual with the ability to plan end-of-life care. Through this technology, patients can access detailed information about their medical history, current treatment plans, and end-of-life wishes. This data can then be used to create a personalized end-of-life directive specific to each patient’s needs. It’s a technology-empowered living will that leverages artificial intelligence to foster very very human discussion. Further, the role of the digital twin can also generate scenario planning that can quickly and easily provide options with less emotional pain that can be commonly associated with these tasks.

Digital twins also have the potential to improve end-of-life financial planning. Through their digital twin, individuals can create a detailed financial blueprint that includes end-of-life expenses such as funeral and burial costs, medical bills, estate taxes, and more. This information can then be shared with family members or other trusted advisers to ensure that end-of-life finances are handled in an organized and responsible manner.

In short, digital twin technology is making end-of-life care more accessible and less intimidating for individuals who want to take control of the process that is often shunned by family and physician alike. By providing detailed data about both medical and financial matters at end of life, digital twins make it easier for people to create personalized plans that meet their individual needs and wishes — empowered by artificial intelligence.

The post Rethinking End-of-Life Planning With The Digital Twin appeared first on Medika Life.

I live in Seattle, a wonderful verdant environment. It is also a place where a glass of wine or a cocktail is ubiquitous. A new study reminds us to be mindful of our alcohol consumption.

Drinking too much alcohol is linked with numerous leading causes of death among young adults in the USA, including heart disease, cancer, unintentional injury, and liver disease.

Unfortunately, deaths due to causes fully attributable to alcohol (such as alcoholic liver disease) have risen over the last decade, including among young folks.

However, a United States-based assessment of alcohol-attributable deaths among this population accounting for partially alcohol-attributable causes (such as cancers) is lacking.

Today we explore a study published in JAMA Network Open examining some of the perils of alcohol use in excess. Researchers examined the average annual deaths secondary to too much alcohol use among adults aged 20 to 64.

“[I]t is the wine that leads me on,
the wild wine
that sets the wisest man to sing
at the top of his lungs,
laugh like a fool — it drives the
man to dancing… it even
tempts him to blurt out stories
better never told.”
― Homer, The Odyssey

Alcohol and mortality

I will begin with a striking observation from Dr. Marissa Esser, the US Centers for Disease Control and Prevention’s alcohol program leader. Speaking to CNN, she observes this:

“While the percentage of deaths attributed to alcohol use varies state by state, it’s a leading cause of preventable death in the USA.” She adds that “alcohol is often overlooked as a public health problem.”

While the percentage of deaths attributed to alcohol use varies state by state, it’s a leading cause of preventable death in the USA. She adds that “alcohol is often overlooked as a public health problem.

Approximately one in five deaths of young adults appeared secondary to excessive alcohol use. For those 20 to 64, drinking-related deaths accounted for one in eight.

The researchers examined national and state mortality data from 2015 to 2019 and noted deaths fully (or partially) attributable to excessive drinking.

The causes included deaths from motor vehicle accidents, alcohol poisoning, and other health impacts (for example, liver disease or pancreas failure). They obtained mortality data from the National Vital Statistics System.

Such deaths have been on the rise, increasing by up to seven percent annually in the two decades before the COVID-19 pandemic.

Alcohol and mortality — My take

The study reminds us to limit our alcohol consumption to a reasonable level. The alcohol-attributable death estimates in this study are likely underestimates. The researchers did not estimate alcohol-attributable deaths due to partially alcohol-attributable conditions — the Behavioral Risk Factor Surveillance System does not collect the prevalence of former alcohol consumption.

The numbers are disturbing, with one in five deaths among adults 20 to 49 attributable to excessive alcohol consumption. Moreover, the study data showed that deaths due to alcohol have gone up in the past decade.

I do not know the solution, but the study authors note that some have proposed increased implementation of evidence-based alcohol policies (for example, increasing alcohol taxes and regulating alcohol outlet density), alcohol screening, and brief intervention.

Be careful

The Centers for Disease Control (CDC) defines moderate drinking as two drinks or less daily for men or one drink or less for women. The organization notes that two-thirds of adults consume more than moderate amounts at least once per month.

The CDC also estimates that one in six adults binge drink — women consuming four or more drinks in one sitting and men drinking five or more — with a quarter of those doing so at least weekly.

Thank you for joining me in this brief look at how one in five deaths among young adults is due to alcohol. One more thing:

A Centers for Disease Control tool can help individuals evaluate their drinking and devise a plan to make healthier alcohol choices.

The post One in Five Deaths Among Young Adults is Due to Alcohol appeared first on Medika Life.

Yes, some seek the wonders of cryonics in the hope their illness will be cured in the future and they will come back to life. The medical community is not optimistic about this prospect.

But for those who are not seeking such extraordinary interventions, there is the legal constraint of a DNR (do not resuscitate) and an advance care directive for anyone who wishes to avoid unnecessary, possibly painful medical interventions when death is inevitable. The purpose is restraint in medical procedures, but not everyone will have their wishes met.

In some instances, the concern that a patient’s wishes will not be adhered to has led to their having “DO NOT RESUSCITATE” tattooed onto their chest. But does that work?

The laws regulating healthcare and DNR vary by state, and a physician must sign a DNR. How do you do that with a tattoo? The body paint is supposed to be an extra incentive for medical staff to read the patient’s chart and see if they did sign the document. It’s similar to surgeons marking a limb scheduled for an operation. Too many people have had the wrong limbs amputated, and that led to this extra measure of care.

Until a national DNR becomes reality, healthcare professional should continue to help people become aware of the need for and best way to communicate end of life wishes. The real question comes under “risk management,” which means lawsuits and ethical obligations to most consumers. Anyone wishing a DNR form for their state can download one.

I am not without some experience in meeting people who have had relatives die and who had DNRs that were not honored. Helplessly, one woman had to watch as her father was intubated, his body became a grotesque form of his former self, and he lay dying for days.

And she felt guilty because there was nothing she could do. It was like the famous “Terms of Endearment” scene where Shirley MacLaine screams for her daughter’s pain meds and is ignored.

My patient was angry because as much as she pleaded with the medical personnel and pointed to his DNR, she received no attention; the staff kept doing what they had been doing. What might the problem be, you ask? How about legal concerns of being sued for not intervening and, as a result, disregarding the DNR? It doesn’t sound like a robust legal document, does it? Does the question now remain how we remedy this?

But the DNR has also been used unlawfully in some instances of persons with disabilities. A more insidious practice has also been brought to light in which some doctors have been placing unlawful DNR orders on the records of individuals with learning disabilities without prior consultation with the person’s family or carers.

In one study, 65% of the respondents who were disabled feared they would not receive needed treatment if they became seriously ill. It was unclear if they believed DNRs would be the cause or if they had DNRs in their files.

The patient’s wishes are, in some instances, a function of a physician’s experience, training, and life experience. Ability to participate in goals of care discussion is an important skill to be honed by physicians in both inpatient and outpatient setting for ensuring appropriate management of patients in accordance with their value. The lack of training in such discussion can lead to a lack of guidance for the patients in settings of terminal illness and inappropriate use of healthcare resources.

Is “value” something to be considered? Are they writing about how a patient values their life or how the staff values the patient’s life? Two very different perspectives and the tendency can be to be too proactive or too willing to decline to follow the directive. The will of the patient should prevail, but does it? And, if not, what might the consequences be for healthcare professionals?

The intent of writing DNRs was to provide a sense of control of our bodies over medical interventions according to the patient’s wishes. It can provide a degree of comfort in a difficult situation. When we see a total lack of regard for the patient’s wishes where the personnel assumes a godlike attitude, healthcare facilities assume a mental patina of fear.

The post When Death Is Inevitable, Why Is Our DNR Ignored? appeared first on Medika Life.

Almost every day, I am witness to one of my critically ill patients “losing the battle” with their critical illness. This was especially true in the Spring and Summer of 2020, where we witnessed patient after patient “losing the battle” with COVID-19. It is part and parcel of my job, and when I recognize that my patient will more than likely “lose the battle” with their illness, it then becomes my job to try and minimize their suffering as much as possible, along with helping the family minimize their grief as much as possible.

While it may be uncomfortable to reflect upon, it is nevertheless inevitable that all of us – every single one of us – will, one day, “lose the battle” with some sort of illness, condition, or accident. One day, someone will say that we will have “lost the battle” with this or that. That should not be our main concern. The main question be this: will we have won the war?

The human condition is full of battles: battles against its hypocrisies, battles against its vicissitudes, battles against its difficulties, battles against its contradictions. There are also battles against personal moral struggles and physical illnesses. All of those battles constitute the overall war, and it is one that is waged each and every day by each and every person.

If we can conquer the hypocrisies, vicissitudes, difficulties, and contradictions of the human condition; if we can conquer our personal moral struggles, then we will have won the war, even if we lose a battle against a physical illness, condition, or accident. And, to me at least, winning the war is much more important in the overall scheme of things. The reward of winning the war, to me at least, is eternal, and that is my ultimate goal in life.

Now, some of the battles against illness can be quite brutal. I do not dismiss them in the least. My daughter suffered tremendously in the six months she received chemotherapy before she died. Almost every day, I witness the brutality of critical illness and what it can do to the human body and human psyche. Sometimes, many times, “winning the battle” against critical illness can actually be worse than death itself. This was especially true with COVID-19. I pray none of us suffers the casualties of a particularly difficult battle with illness.

At the same time, if we lose the war of the human condition, the consequences can be devastating and eternal in nature. That must be avoided – in my belief, at least – at all costs.

As the years have passed since my daughter’s death, my goal has been singular: put my head down and live a life of righteousness to the best of my ability. That way, when I lift my head up, I will see the Face of the Lord and once again see the smiling face of my daughter. I am trying, to the best of my ability, to win the war of the human condition, with the help of the Precious Beloved.

I pray that I am ultimately successful. I pray that, one day, people will say about me that I “lost the battle” but ultimately won the war.

The post Every Single One Of Us Will “Lose The Battle” One Day appeared first on Medika Life.

Now it is time to put the fake news to bed regarding who are the individuals holding these weapons of death and slaughtering the innocents. No, they do not have a mental health condition, and to say that they are all mentally ill is incorrect and further stigmatizes persons with a mental health disorder. Statistics have shown us where the mayhem has been perpetrated regarding the states and who has been pulling the triggers.

The states with the highest incidence of firearms mortality include Alabama, Alaska, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, New Mexico, Oklahoma, South Carolina, Tennessee, and Wyoming. If you live in any of those states IMHO, you can be assured that you are at higher risk of encountering an individual with a gun who will kill you without hesitation. Then, there are the “stand your ground” laws.

Don’t chalk these murders up to mental illness. If you do, you are refusing to recognize that legally these murderers have the right to carry a gun, not just a gun, a military-quality assault rifle, anywhere they wish.

Don’t be in their fire line if you want to live. Perhaps, at some point, you’ll hesitate to leave your home. Indeed, you won’t want your children to go to school because you’ll wonder if they will ever return. No, this is not an advertisement for homeschooling, but that might realize an uptick in its popularity now.

And now, “open carry” is legal, so anyone wishing to have a sidearm with them when they go shopping, to the movies, or anywhere can have a firearm at their disposal. How many more instances of untamed violence, foolish behavior, or unintended slights will result in death for the intended and those who will be collateral damage?

If before we told people to “let the buyer beware,” now it’s “let everyone beware.” The genie is out of the bottle, and getting it back may prove nearly impossible.

A Brewing Death Storm

Usually, people don’t “snap” and become violent suddenly. There is a steady buildup of anger and a wish to get even many times, and some of the evident signs are frightening.

According to a friend, the killer in Uvalde, Texas, at the elementary school had a drug-addicted mother. His grandmother was evicting the latter from an apartment that the grandmother had rented for her.

The friend also told the media that the shooter had a pronounced speech problem, making him the target of bullies. On one occasion, he was seen by this friend with cuts all over his face and admitted that he had done it to himself. The situation was highly distressing, but nothing seems to have been done to remediate the problems.

The killings in Columbine also have roots in depression, suicidal thoughts, and lack of discovery by parents and schools. Blaming isn’t the way to come to some resolution of violent actions, as Sue Klebold, mother of one of the shooters, said in an interview.

She also noted that mental illness itself isn’t a risk factor for violence. It’s only through a combination of risk factors — including alcohol and drug abuse — that a person with a mood disorder is likely to hurt others.

What We Know About Guns

In the healthcare community, as I have known it, the thinking is that if guns are available, guns will be used. Responsible gun owners know that their guns must be secured and not always loaded.

But persons who fear for their safety, whether reasonable or not, may keep handguns in an area where they are easily accessible and loaded. Other gun owners, who use their weapons as intimidation, are a danger to everyone. I know someone who was never raised around guns and now sleeps with a loaded handgun under their pillow each night.

Overall, I believe that the mental health community understands that guns are a part of many American homes, especially in rural communities. There is no wish to outlaw guns, but there is a need for responsible use of guns, training in the use of guns, and careful consideration of gun ownership.

Legal gun owners are not those who are ordering ghost guns over the internet or trying to protect the interstate movement of Saturday night specials. There are legal gun activities used for sport, historic recreation events, and hunting. I once had a patient who belong to a historic events group. All the members loaded their own bullets and used historic guns in target practice contests.

But we do have to question the purchase of military-grade rifles by young persons or giving them a gift of such a weapon. These guns are a means to kill, not when hunting, but to inflate poor self-esteem IMHO. They are intimidating, and that’s the purpose. It is not only a foolish purchase or gift but a deadly one.

I am very concerned that loosening open carry as it relates to guns is a terrible precedent. It can only increase gun violence. We know that domestic violence begins with the first slap and then progresses to worse violence.

The same is true of the “peeping tom” who peers into windows and then goes on to rape and, possibly, murder his victims. These slow progressions are a danger to the entire community, and I think carrying a handgun wherever you go cannot end well.

The post The Subtle Signs of Brewing Violence May Be Seen, But Not Always appeared first on Medika Life.