After months of reading about what a train wreck Part D was, I became somewhat cynical about the media’s coverage of Medicare related issues. The real story wasn’t being told: how the pharmacies are being affected.
What the media wasn’t telling everyone, was that their local pharmacists were going through hell trying to make this new Medicare plan work.
Local pharmacists were doling out medications to people who weren’t paying, and due to all of the confusion at the other end, the pharmacists themselves weren’t being reimbursed in a timely manner from the Part D providers. Not only that, but the pharmacist doesn’t always know clearly what the provider is going to pay him/her for the drug that they just handed out.
Keep in mind that we’re talking about small locally owned, independent pharmacies. I’m not sure how many of you own, or have owned businesses, but I’m sure you can all understand how hard it would be to stay in business when you’ve given most of your inventory away without any payment.
One local pharmacist told me shortly after the onset of the Part D coverage, that he had given out over $30,000.00 in medications, without yet receiving even a penny from any of the providers. They make the process of being reimbursed complicated enough, that it takes forever and a day for the pharmacist to get anything back. The bottom line is: a pharmacist can’t stock the shelves with medicine if he doesn’t have any money to buy it from the manufacturer.

With the very real possibility of all the small pharmacies closing down due to Medicare Part D coverage, some politicians are finally making a move to level the playing field.

Earlier this week a bipartisan group of U.S. Senators sent a letter to CMS encouraging some changes in how things are run. The letter urges CMS to better regulate the providers of Medicare Part D prescription drug coverage, demanding that they make clear up front their reimbursement of the medications they cover. The letter also urges them to make possible EFT (Electronic Funds Transfer) to the pharmacists selling the medications, making reimbursement that much faster. The letter also encourages CMS to insist that providers update the wholesale drug lists daily, to make it easier for the pharmacists.

From the letter:

“We strongly encourage the agency to examine PDP activities that may undermine beneficiaries’ access and to consider the suggestions we offer to promote strong and continued participation of local, community pharmacies in the Medicare prescription drug plan,”

I think this might be a step in the right direction. I for one value my local pharmacy, and would like to see it possible for him to stay in business through all of this. As more and more insurance companies dump their prescription coverage for any of their members who qualify for Medicare, there will be more and more patients joining Part D coverage. This means more medicine that the independent pharmacist is selling at a reduced profit margin.
I’m torn between wanting to support the local guy, and my inability to pay for all of my necessary medications. Hopefully we can find some in between state that will work – and this letter may be a starting point for creating that.
Time will tell.

“In a trendy nightclub in New York City, the bartender tells guests they can only be served bottled water, which costs $5 for each tiny half-pint container. One outraged clubber is
stopped by the restroom attendant as she tries to refill the bottle from the
tap. “You can’t do that,” says the attendant. “New York’s tap water isn’t
safe.”

Interesting read – apparently the bottled water industry is not held to a very high standard. Bottled water is controlled by the FDA, whereas our tap water is held to the EPA’s higher standards.
Regardless – Colorado’s tap water has got to be better than what this “clubber” was going to get in NYC! *grin*
The only bottled water I really drink here is from Eldorado Springs, which is natural Colorado spring water anyway.

I’ve always thought it was odd to pay for bottled water when fresh tap water was at hand.
After reading this article I think I will move beyond thinking it odd, and progress to pointing and laughing.

Blood Type No Longer Matters?

According to this article a “new procedure” helps to remove harmful antibodies pre and post transplant in the recipient. I remember reading something about this being accomplished via plasmapheresis several months ago, but I’m not sure if this is the same thing or not. Unfortunately, the article doesn’t really say.

“There may still be some people whose antibody levels are so high that we can’t overcome them,” he said.

“But for the majority of people who have a donor of the wrong blood group, this will open up a new opportunity.”

The blood filtering treatment was used in the weeks before and after the transplant.

Very interesting, I can’t wait to see how this develops in coming months.
Go Aussies!

About three weeks ago a Motorola Sidekick was left in an NYC cab.
I’m sure this happens all the time. I’m sure that sometimes, someone with character makes an effort to return the phone. Most times however, I’m sure that the person who finds it considers it their lucky day, and just keeps it.
Unfortunately for the “Corona Crew”, the phone they stole belonged to someone with a bit of tech savvy. Within hours drama ensued with thousands of hits generated between the story being dug, and being anointed by Slashdot.

So some of us have been following the drama – and finally it comes to a conclusion. The phone has been returned, and the correct people have been punished.
Awesome

Why do people feel that they have the right to other people’s property? This entitlement attitude always baffles me. The idea that if someone left something somewhere, it somehow no longer belongs to them, and it is fair game.
With this logic, shouldn’t burglary be legal as long as the residents aren’t at home and currently handling the property?

What really baffles me with all of this though, is why people have sidekicks in the first place?

The review of Al Gore’s movie was however quite interesting. It tackles the issue of global warming in a very urgent way, giving the impression that we are all going to see a Hollywood-inspired doomsday scenario in the next ten years if we don’t change our ways.

Talk about an an Inconvenient Truth …..

While it’s hard to find “good” science regarding virtually anything these days, there is some pretty concrete evidence that temperatures are rising. I say that somewhat tongue-in-cheek – but it’s true, right now it appears temperatures are rising. So what? How is this proving a scientific hypothesis? And where does this become something that we as humans try to singlehandedly stop?
We’ve all heard of the “greenhouse effect” – wherein certain gases are being released into our atmosphere that in turn trap the sun’s heat causing a perpetually rising temperature. The “big one” seems to be CO2, which most of you will know as Carbon Dioxide. It’s what we exhale with each breath. It’s also what plants and trees need in order to produce live-giving oxygen for us. Having this atmosphere is what makes this planet inhabitable.

It appears though, that man is responsible for very little CO2 in the atmosphere.
Figures vary a bit, but looking at the total output of CO2 in the atmosphere, anthropogenic CO2 (carbon-dioxide coming from humans and their activities) makes up only about 0.28%. That’s right, 97% of greenhouse-causing CO2 in the atmosphere is due to natural causes. Some large contributors include water vapor from oceans, volcanic activity, and decaying plant and animal life.
What’s true then?
It is definitely true that temperatures and CO2 levels have been on the rise. Not for the last 30 years, but for the last 18000! Yes, this will culminate in another ice-age making the planet uninhabitable for the most part. Glaciers and arid deserts, that’s it. Very few forests, and very little plant (or animal) life. And this global cooling will not get better quickly, as the thickening ice at the South Pole will reflect much of the sun’s energy back out into space, and perpetuate the cooling problem. You can thank continental drift for this, because it’s deposit of Antarctica at the pole is what enables such a large polar ice cap to form (it would not become so thick over open water).

The doomsday scenarios are largely possible, nae, inevitable.

Get ready for this – this might be the warmest the earth’s been in a hundred years, but not the hottest period ever.
The hottest period in human existence was the Holocene Maximum. It occurred between 7500 and 4000 years ago. Well before humans started polluting via fossil-fuels. After this period of warming was another cooling period, followed by another warming period (the Medieval Warm Period), and finally the “Little Ice Age” beginning around 1400 AD.

Another interesting fact you won’t read in any Green Peace literature is that CO2 levels seem to rise and fall correspondingly with solar activity. So, either the sun’s energy affects CO2 levels, or CO2 levels affect the sun’s output (I think not).
Along with these astronomical effects, there are the earth’s own cyclical variations in orbit and angle which affect the atmosphere’s ability to hold heat greatly.

Yes the globe is warming, but looking at the geologic data it appears that humankind has very little to do with the equation.

Why then are we made to be so worried about global warming?
Certainly I feel personally that as stewards of this planet we should treat it well. So I’m not advocating for massive pollution.

So why are certain people shoving this false idea down our throats that our consumption (and expulsion) of fossil-fuels is bringing about total global climatic change?
I found an interesting quote on this treasure-trove of information:

“We have to offer up scary scenarios, make simplified, dramatic statements, and make little mention of any doubts we may have. Each of us has to decide what the right balance is between being effective and being honest.”

Stephen Schneider (leading advocate of the global warming theory)
(in an interview for Discover magazine, Oct 1989)

Whoa – Any other scientists backing up the idea that climate change is due mostly to things outside of human’s influence?

Yes

Awesome, so some pretty conrete science indicates that the Earth has its own agenda with regards to weather – and we still want to teach our kids that they’re part of the problem rather than part of the solution.
As though there is some solution!

FRIDAY, April 28 (HealthDay News) – U.S. scientists say they’ve used bone marrow-derived stem cells to reverse genetic kidney disease in mice.

Reporting in this week’s Proceedings of the National Academy of Sciences, the team said the stem cells were able to regenerate damaged renal cells in a mouse model of Alport syndrome, the second most common genetic cause of kidney failure in humans.

Symptoms of Alport syndrome usually appear in childhood, and the disease typically results in end-stage renal failure by the time a patient reaches the teens, 20s or 30s.

The study offers the first example of how stem cells may prove useful in repairing defects and restoring organ function and also provides a potential new strategy for treating Alport syndrome.

“This is one of 31 human diseases that occur because of genetic defects in the body’s extracellular matrix and basement membrane proteins,” study senior author Raghu Kalluri, chief of the division of matrix biology at Beth Israel Deaconess Medical Center and associate professor of medicine at Harvard Medical School, explained in a prepared statement.

The extracellular matrix (ECM) is present throughout the body and is made of collagens, proteogylcans, noncollagenous glycoproteins and, in some tissues, elastin fibers. The ECM helps maintain the structural integrity of many tissues by constructing a “scaffold” for cells.

“In normal kidneys, a specialized form of extracellular matrix known as the glomerular basement membrane (GBM), composed primarily of type IV collagen, is the key component of the blood filtration apparatus,” Kalluri said.

Genetic mutations in people with Alport syndrome cause structural damage to the GBM, which results in a breakdown of the kidneys’ filtration system. There is no cure for Alport syndrome. Kidney transplantation or lifelong dialysis are the only treatment options.

About four weeks after the bone marrow-derived stem cells had been transplanted into the mice, about 10 percent of the cells had incorporated into damaged areas of the kidneys and emerged as healthy renal cells. This resulted in improvements in kidney function and repair to GBM damage.

More information

The U.S. National Library of Medicine has more about Alport syndrome.

Wow! This is some exciting news for sure. So perhaps in 17 years after enough R&D this will be usable – but of course by then nano-machines will be building fresh kidneys for everyone from their own genetic material anyway.

OK, I’m not for sure on the second part of that – or the first part for that matter.
This is one of those pieces of news that keeps some of us going. The thought that everything we think we know about medicine is about to change. I know that many patients (myself included) think: “Just endure until you get a transplant, and then by the time you need dialysis again in 20 or 30 (or 2) years everything will be totally different!”
While I know that these things take quite awhile to come to market, I do firmly believe that medicine as we know it will be very different in the not-to-distant future.

Anyone have any other really cool stem-cell research to toss my way?

NEW YORK (Reuters Health) – A lot of misconceptions about organ donation are
being fed by the entertainment industry, warns Susan Morgan, a Purdue
University health communications expert who is tracking how organ donation is
portrayed on TV and trying to dispel myths about organ donation in the workplace.

Emotionally charged television shows have featured fictitious stories about a
black market for organs, doctors who murder their patients for their organs,
or who declare death prematurely to take their organs, Morgan told Reuters
Health.
“Until we can persuade writers and producers to stop deliberately using
false, medically and logistically impossible plot lines involving organ donation,
the public will continue to believe in so many myths about donation — and
too many people will refuse to donate” as a result, Morgan said.
Surveys Morgan and others have conducted confirm that people very often
believe that what happens on their favorite TV show is real, especially medical
and crime dramas.
Compounding the problem, Morgan said, there is “a huge amount of distrust” of
both the medical system and the organ allocation system. For example, many
people are thoroughly convinced that rich, famous or well-connected people are
much more likely to get organ transplants than ordinary people, she said.
“We’ve learned that we have to counter the most prevalent myths in order to
get people to consider donating their organs after they die,” Morgan said.
She’s working with the New Jersey Workplace Partnership for Life, which provides
tailored health campaigns in workplace settings, to dispel myths about organ
donation in some 45 New Jersey companies and organizations. The project is
supported by a $1.67 million grant from the US
“Our primary goal is not simply to persuade people to become organ donors;
it’s to make sure they have all of the accurate information they need to make a
decision based on the facts,” Morgan said.
There are over 90,000 people waiting for transplants right now and the number
grows every day. Fewer than 40 percent of Americans have signed organ donor
cards and only about half of their families consent to the donation of a
loved one’s organs.
“If everyone who was eligible to donate did donate, we could nearly wipe out
the entire transplant waiting list,” Morgan said.

If you’re afraid to donate your ogans after you die because of some computer animated slow-mo sequence from CSI:Vegas – you’re dumb.
Period.
Keep your kidney

Forget the “you’re dead” part. Let’s look at all donors, including living ones.
Are people honestly no longer able to separate Law & Order storylines from reality? Is someone out there really choosing not to donate a kidney to a person in need because they’re afraid that they will fall asleep in a hospital, and wake up in some seedy Vegas hotel in a tub of ice?
I don’t get it.
I believe it – I just don’t get it.

The media certainly has some fault in this. It is true that transplantation gets way more negative press than positive. We as a society don’t pay as much attention to news when it is positive, and like any smart business they have learned to give the customer what they want.
Face it, the media sells stories and emotion, not fact.
We see this when celebrities receive transplants. The story almost always goes something like “… narrowly avoiding a slow and certain death due to kidney failure, SoandSo received an emergency kidney transplant yesterday with only minutes to spare.”

Forget relying on the meda to get the message out that people need organs, and that the process is very doable. Forget relying on the media to make heroes out of people who do choose to donate life to others.
Forget all of this.
The media is not the answer.
The answer is in legislation. A movement to abolish motorcycle helmet laws.
more ‘donorcycles’ = a faster moving UNOS list
I cheer for every shorts-and-flipflops clad motorcycle rider not wearing a helmet. I cheer that they make it home safely – but should they not, I pray that many people in need will receive organs and tissue.

I found this link on Fark and couldn’t pass it up. We as a nation are seemingly interested in every facet of our politician’s lives. To the point that we know when and where they are hunting, and how much they’ve reported as income on their individual tax returns.
Interestingly it seems that our unbiased media decided for some reason that the American people might not be interested in knowing that their Vice President gave over 6 Million dollars last year to charity. This is over 3/4 of the Cheney’s reported income. I’m waiting for the inane “yeah, 3/4 of what they reported” argument.

Dick Cheney has not been one to pander to the masses in order to save face. Amidst serious criticism of his job performance, and previous business affiliations VP Cheney has not been one to apologize, or run. Why do I bring this up you ask? Because it’s safe to assume that people will brush this news off saying that he’s simply doing it to look good. It seems though that he hasn’t cared too much about appearances. I would suggest that perhaps he has given to charity in an effort to do good.
Why can’t that be looked at as positive?
From the article:

Of interest, the AP story referred to Cheney’s adjusted gross income as “largely padded” with income he received by exercising stock options that had been set aside for charity. Here’s a guy that sets up a gift arrangement for charity with Halliburton when he took office in 2001 and the AP elects to describe his return as being “padded” — this was income earmarked for charity in 2001.

Seems like it may be pretty difficult to convince the American people you’re doing anything good, when the media refuses to tell them.

It also seems that the L.A. Times writers don’t understand that overpaying the IRS results in a refund with this headline: “Bush pays taxes, Cheney awaits refund” . As if the V.P. is sitting around waiting for money to materialize in his pocket that doesn’t belong to him.

What’s the problem with the media? Have people lost the ability to see things for what they are? (that’s a rhetorical question – because clearly they have)
If our politicians are screwing up then tell us about it – but just give us data.
I’m not looking for a media that lies and shapes the news to their own agenda.

Words have meaning, and the media choose theirs carefully. When they implant pejorative terms into news it slowly desensitizes us to the meaning of specific words. Over time we begin to see things from their viewpoint, rather than simply receiving data that we can then plugin to our own perspective.

We’re seeing this problem big time right now with the immigration issue, and how the media is choosing to report it.
That’s another issue though – perhaps a bit later.

Kudos to Vice President Cheney for giving – for doing something for others rather than self. And I l-l-l-l-love that it was done with Halliburton stock options – for those that thought he was “padding” his own pocket.

I gleaned this from CubicleDeath – quite possibly the BEST blog in the blogosphere.

Ode to Ace

Basically, Ace is a top notch guy. His actions speak volumes, and we’re sorry to see him out of the running.

Ace, Ryan, it was a good run – we’re sorry to see it come to an end, but I’d like to think it is in a way a new beginning. May now be the start of something fantastic for you!

Perhaps for you too Ryan … what with all that free publicity! :)
For those who don’t know, Ace is the brother of a buddy of mine (aquaintance really – I don’t want to appear as though I’m dropping names where I shouldn’t).

We’ve all been pulling for him, and are sad to see his reign on Idol end.

As an aside, I just realized what a frightful place myspace is. While looking for a decent picture of Ace, I wound up reading through half of the crazy fan postings here.

Wow

Canada is taking a stride forward this week, announcing the first successful transplant as part of their “paired kidney” program.

In what might help Canadians waiting for kidney transplants, doctors from St Michael’s Hospital and Toronto General Hospital carried out their first kidney transplant under the Paired Kidney Exchange Program, which helped two patients receive kidneys from each other’s spouse.

This is great – seriously. This is what we need, people willing to donate organs to people in need. A program like this is a huge step towards getting people the transplants need.

Kudos to you Canada – keep up the good work!