Category Archives: Preventative Medicine

About three years ago I was incredibly lucky: I was diagnosed with pancreatic cancer. Lucky? One of the most lethal forms of cancer, how on earth was that lucky? Well, because it was found incredibly early. No, not before lunchtime, but before it had gone anywhere.

A decade before I had asked my doctor for a quick death. It wasnt for me, it was for a play I was writing called Death The Musical. With all the boomers heading for the final curtain, I thought it was an interesting subject for comedy to examine. Mike Nichols hated it. We would have read-throughs around our dining table, with fine people like Tim Curry, David Hyde Pierce, Tracey Ullman, Rita Wilson, Julian Sands, Jim Piddock, and a young Jordan Peele, where wed read the play and John Du Prez would play the songs wed demoed and people would laugh and be very happy and Mike would invariably say, No. Its crap.

Once, on Mikes birthday, we had a reading, and when I got to David Geffens mansion in Bel Air for his party, Mikes wife, his daughter, and various other friends all congratulated me on the success of the reading.

Theyre all talking about how funny it was.

No, said Mike, its still crap.

My play was about a writer who is writing a musical about death when he discovers he is about to die. Dramatic irony, right? The joke for me was that as he was only a writer and there was a playoff game that weekend in L.A., they were having trouble getting people to attend his memorial.

FATHER NED

When a world-famous star falls under a bus

It makes us feel better that it isnt us.

MADGE

It makes us feel better that no matter who

The rich and the famous must also die too.

But though I loved Freddie and Im his PR

The name of a writer wont go very far.

FATHER NED

Yet though he was kind and no one politer,

Still, in the end, Fred was only a writer.

LUCY

For Stars and their sex lives

The internet hums

But for only a writer

Nobody comes.

For my plot to work I needed to kill my character off quickly, and as part of my research, I asked David Kipper, my doctor friend, the quickest way to die.

He gave me the skinny during a ball game at Dodger Stadium.

What is the quickest, surest, and most sudden cause of death? I asked.

Pancreatic cancer, said Kipper without hesitation. You may only have three weeks.

Perfect, I said.

Flash forward 10 years to 2019 and my same friend Kipper is taking me to a variety of tests at imaging facilities. He specializes in preventative medicine, and I rather reluctantly go through these checks because, while I quite like being alive, as the son of a nurse, I have an inbred fear of hospitals. So this day we are doing an MRI. He has already done blood work and notices a slightly high marker, a dubious blood score on a panel, and on a hunch asks Westside Medical Imaging, while they are examining a couple of other areas, to shoot an isotope into me to highlight and take a look at the pancreas.

Just add a little contrast, he instructs the technician.

It goes into my IV. A slightly warming feeling as the iodine spreads. He disappears into the control booth and I am slid under the banging scanner. Its not long. The banging stops and I meet Kipper in the control area.

Hey buddy, he says, lets just go in here.

I can tell immediately he is serious.

It cant be more serious.

Its pancreatic cancer.

Of course I find it funny. How could I not? Heres Kipper giving me the diagnosis I asked him for 10 years ago. Whats my life motto? Entropy and Irony. Both pigeons limping home to roost. He and the MRI technician gaze at the ghost of a tumor sitting in the middle of my pancreas. It is intact. It is unattached. But it is undeniably, most probably, the C thing. However, this little puppy is still fairly new. It hasnt burst or spread.

Read More: Can Complementary Therapies Ease Cancer Treatment Symptoms? Heres What the Science Says

Heres the good news, Eric, he says, neither the technician nor anyone here has ever seen this at this stage. Its unattached, no nodes, and we have a very good chance of whipping it out.

I break the news to my wife Tania, and even though she will reveal later that she would go into the garden with the dogs and cry, I tell her early on that she is in no way British and that tears, and even other expressions of emotion, are quite acceptable. She can weep. She can come for a hug. Anytime, night or day. She is steadfast, strong, and determined to see me up on my feet again.

We immediately decide that pancreatic cancer is such a scary term and freaks people out so much that we will call my diagnosis Kenny. Kenny is far less threatening. Kenny is manageable. Kenny is something we can talk about publicly. The next day I have an appointment at The Kenny Center. In the Kennyology parking lot, as the valet takes away my car, I say to Tania: This is the Valet of the Chateau of Death.

There is still no cure for the common comedian.

Idle (far right) with members of the Monty Python team on location in Tunisia to film Monty Python's Life of Brian, which features the song "Always Look on the Bright Side of Life," 1978.

Evening Standard/Getty Images

Kipper has cleared his schedule to join us. The Kenny doctor is late. Caroline, his medical assistant, goes through the results. They are as predicted. A cancerous tumor in the middle of the pancreas. Tania asks her how long I have. Caroline says, I honestly cant tell you, weve never had someone at such an early stage as this. Its so early that there are no statistics on it.

Not only is this good news, Eric, says Kipper, but the doctors are going to love this. They rarely get a chance to cure these things, and your diagnosis is so early we have a very good chance of getting it all out.

This optimism is confirmed by the surgeon who now comes down to see me. An air of comedy enters with him as Dr. Nissen is wearing what can only be described as a Monty Python jacket, something Michael Palin or I would have worn as a TV game-show host: a purple floral paisley dinner jacket. He laughs as we all do and excuses himself. He had just come from a reunion lunch at Manhattan Beach. Later he promises to wear the jacket for my surgery.

Kipper discusses the benefits of robotic surgery with him, which is apparently far more accurate than a surgeon.

And a lot cheaper, I point out. To laughter.

They are all keen. The whole team, doctors, nurses, and surgeon. Usually they are fighting a hopeless battle against Kenny. With me they might have a good result. And Im fit and healthy, adds Kipper. Its odd to think that had he not called for that extra test I might have been walking around without knowing this time bomb was ticking away inside me. Just carried on with my year, making plans, looking good and healthy with this growing inside. As I hug him, I say, Theres no doubt you just saved my life.

Read More: What Its Like to Participate in a Clinical Trial for Bladder Cancer

Im hardly home before were booked for my next appointments. Shots Monday. Full-body scan Tuesday. Operation Thursday.

The question now is who to tell. Of course the kids. Id sent my son Carey an email the night before asking him to call over the weekend. Hed called immediately. Taking me by surprise. Tania and I had just toasted Kenny with a glass of Cristal Louis. Im not drinking. But Im not not drinking at moments like this. My son is brave and very encouraging. He immediately offers to fly in from Australia. Now the hardest thing I have left to do, apart from having no tea for 24 hours, is to break the news of Kenny to our daughter Lily. She has been avoiding me as if some instinct is warning her. I suspect she thinks we are going to have a financial talk. She gets married in a year, and I want to reassure her I will be there for her. Long ago I promised I was going to dance at her wedding, but, I warned her, it was going to be an interpretative dance.

Now, I say to my wife, it may have to be a lap dance

Our friends we mostly decide to spare. Better to break the news when it is over. One way or another. But I make my lawyer friend Tom Hoberman laugh when I say that at least its better than boarding school. He is a Kenny survivor of both lung and prostate, so Im lucky to even have him still in my life. And at dinner on the eve of the surgery, I am tempted to tell my old friend Jim Beach that I am heading into hospital for a major op, but his film Bohemian Rhapsody has just picked up four Oscars at the Academy Awards.

Oh, four Oscars, eh? I got awarded Pancreatic Cancer, but theyre still cutting it

No, it seems utterly tasteless to rain on his parade. And we are thrilled for him.

Tania is being very brave, and I remember to tell her the gag I made when Kipper first broke the news to me: Well, Trump and Brexit have certainly made death a far more appealing alternative.

But at least now we know where we are: the soap opera aint over and the proverbial fat lady hasnt only not sung yet, she hasnt even ordered her Uber. Theres a chance. We must attempt to bid Kenny goodbye.

Idle shakes hands with Queen Elizabeth II.

Courtesy Photo

I drive myself to Cedars-Sinai before dawn to check in. It has been decided I will use a pseudonym. To keep away the tabloids. I wonder if the tabloids are at all interested in me, but still, it will be safer, they insist. However, what name to choose? I cant think. I finally settle on Mr. Cheeky. Of course the name of the character in The Life of Brian who sings, Always Look on the Bright Side of Life.

Its fine until I hear someone calling this name at check-in.

Everyone looks up.

Mr. Cheeky, they repeat loudly.

Oh sh-t, thats me.

Good thing I didnt choose Biggus Dickus.

Time to face the music.

Cedars at dawn. Warm blankets, and Dr. Nissen is as good as his word and makes me smile as he comes in wearing his paisley dinner jacket. I count backward from 10 and long before 4, I have disappeared into the Propofol-filled world. When I wake up, I am in recovery. A vague gray world of being washed and fed. And painkillers. The surgery went well, I am assured. Five hours, part of it robotic. The ministering angels in the hospital minister through the long nights while I come off the opiates, and my inner Yorick comes up with riffs on Famous Last Words:

Ouch.

F-ck.

Sh-t this hurts.

No, I havent had a bowel movement yet

Finally my surgeon tells me to go home.

Youll get better a lot quicker there.

He is right. A few days later he confirms the results. It was pancreatic cancer. He has cut it all out. It was not attached to anything and my lymph nodes were clear. The cancer is gone. They could find no further trace in my body. I had been a dead man walking. I am going to live.

Only then do I cry.

This summer, after two years of lockdown, I have finally succeeded in making it back to Europe and I am sitting happily in the sunshine eating croissants with a big grin on my face when I get an unexpected offer. The producers of The Masked Singer want me to turn around and go all the way back to California. Really?

Should I?

On the phone they say it is a very silly show and Ive not exactly been a stranger to very silly shows. I have been a singing water rat and a crooning moon. I sang Always Look on the Bright Side of Life as a Japanese maid from Madame Butterfly to the late Queen, as a dying swan in a tutu with an entire corps de ballet to Prince Charles, and once, dressed as Emma Thompson from Angels in America, to Mike Nichols. Even at my proudest moment, singing my own song at the London Olympics, I was lifted up and tossed around by Bhangra dancers. So I have some experience with silly singing in public, but would I still be able to do that?

Idle performs during the closing ceremony of the 2012 London Olympic Games on August 12, 2012.

Adrian DennisAFP/Getty Images

Only one way to find out. I turn right round and come back.

On our first Zoom call, I need to pick an avatar. They show me three costume sketches, and I instantly choose the hedgehog. Its easy to become a prickly old bastard at my age and I do curl up into a ball when attacked, so yes, a hedgehog seems an appropriate identity.

Next I have to choose a song. Recently I have been admiring Love Me Do, but I know its hard to get permission to do a Beatles song so I call my old pal at Apple who tells me that its not actually in the Beatles catalog but in Paul McCartneys.

You might have a chance if you asked him, says Jonathan. I think hes forgiven you by now, he adds, referring to my playing Dirk in The Rutles.

So I pluck up courage and write to Paul. He is kind and helpful. He ends with, Anyway, have fun, good luck and let me know what show it is so I can make sure to give it a miss!

Yes, he is that funny.

On stage, I am in constant danger of tipping forward and face planting, but strong hands always reach out to grab me. The show is the first time I have performed since my operation, and the crowd is happy, the jury funny, the producers pleased. I am proud to have pulled it off.

As I take my place beside him during the filming, moments after being unmasked, William Shatner, dressed as a knight, whispers in my ear, Wasnt that the hardest thing youve ever had to do in your entire life?

Hedgehog in the Season 8 premiere of The Masked Singer.

Michael BeckerFOX

It is then that I begin to reflect on how fortunate I have been, not only to survive but to be able to squash my feet into oversize paws and sing and dance on the telly. I decide to finally ask Kipper how long he thinks I have. I have been testing every six months and doing well, but still, his answer shocks me.

Well, youre in very good shape. The cancer hasnt recurred. You should have about 10 years.

Ten years! Wow.

So, having survived both the disease and the show, I realize I must tell people what happened to me. And apart from thanking Dr. Kipper, Dr. Nissen, and all the amazing people at Cedars, its time to do something to help. Because its good news. And I wish to help spread it. Its early days, but were starting the Bright Side Fund at Stand Up To Cancer to fund pancreatic-cancer research. I want to encourage people in families at high risk of pancreatic cancer to explore the newer tests available for detecting the disease early. Kipper said that if we had delayed by only two weeks, I would not even have seen the surgeon. So please talk to your doctor to understand which screening tests may be right for you and tell your loved ones to do the same. Help me help others like me to survive. And, all together now: Always look on the bright side of life

More Must-Read Stories From TIME

Contact us at letters@time.com.

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Eric Idle on Surviving Pancreatic Cancer - TIME

In a new joint submission to the United Nations Independent International Commission of Inquiry on Ukraine (IICIU), four independent NGOs call on the Commission to investigate the ongoing attacks on hospitals and health workers in Ukraine perpetrated by Russian forces, which are flagrant violations of international human rights and humanitarian law.

The four organizations Ukrainian Healthcare Center (UHC), Physicians for Human Rights (PHR), eyeWitness to Atrocities, and Insecurity Insight spotlight seven health facilities across Kyiv, Chernihiv, Kharkiv, and Sumy that were subjected to particularly egregious and well-documented attacks during the first month of the full-scale invasion. Since February 24, 2022, the World Health Organization has reported more than 500 attacks on health care facilities, personnel, and transports, killing more than 200 people. During the period from March 1 to March 21, UHC reports that five to six health facilities were attacked each day.

The organizations write:

The evident pattern of violence against healthcare will continue to have severe negative implications for the safety, health and rights of Ukrainians for many years. We urge the Independent International Commission of Inquiry on Ukraine to investigate these violations and ensure that attacks on hospitals and healthcare facilities comprise an important part of the Commissions analysis into the events committed in the forementioned regions of Ukraine between late February and March 2022.

The UN Human Rights Council formed the Independent International Commission of Inquiry on Ukraine on March 4, 2022, comprised of three human rights experts working over an initial period of one year. The IICIUs mandate is to investigate all alleged violations and abuses of human rights and violations of international humanitarian law, and related crimes in the context of the aggression against Ukraine by the Russian Federation, and to establish the facts, circumstances and root causes of any such violations and abuses, as well as to make recommendations, in particular on accountability measures, all with a view to ending impunity and ensuring accountability, including, as appropriate, individual criminal responsibility, and access to justice for victims, among several other actions.

All attacks on health care warrant investigation and accountability. In the joint submission, the four organizations highlight seven specific facilities that were violently attacked as a result of Russias full-scale invasion:

See the full submission for additional details and context about each attack. The submission relies on information gathered from a variety of sources, including open-source materials, site visits conducted by the UHC, local witness statements, remote interviews with Ukrainian civil society colleagues, and photo and video footage collected by the UHC with the eyeWitness to Atrocities app.

The organizations also call on the Commission to investigate the gendered impacts of attacks on health, as the destruction of health facilities can lead to limited access to reproductive care, forced pregnancy, mental health issues, and barriers to preventative care and specialized services for women and girls, including for survivors of sexual or gender-based violence.

The widespread and systematic nature of Russias assault on the health care system of Ukraine is an extension of the strategy it deployed to devastating effect in Syria and Chechnya. To date, there has been no accountability for these wanton violations of international law. Through its new joint submission, the four organizations call on the IICIU to include attacks on health care within its ongoing investigations and recommendations into broader human rights violations in Ukraine, and that such cases be prioritized for prosecution. The IICIU is expected to publish its first short report on the human rights situation in Ukraine on Friday, September 23. Each of the above incidents is elaborated in the new UHC report Massive, Brutal, Deliberate: Attacks on Hospitals in the Russia-Ukraine War during the First Phase of the Invasion, which offers further documentation and analysis of these and other attacks on hospitals and health care clinics. Individual incidents can also be viewed on Insecurity Insights interactive map on attacks on healthcare.

Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.

Media Contact

Kevin Short

Media Strategy, Senior Managermedia@phr.org1.917.679.0110

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Attacks on hospitals and healthcare in Ukraine: Joint Submission to the United Nations Independent International Commission of Inquiry on Ukraine,...

ByLuke Coutinho,

Lifestyle Medicine or Lifelong Medicine Choose Wisely?

More often than not, when the topic of preventive healthcare arises, it is uncommon for an individual to say, But I am a healthy individual.. Why should we invest in preventive wellness?Spending money on tests when I am asymptomatic makes no sense! It is like wasting resources in preparation for calamities yet to occur!

My advice to them is to sit back, relax, take a trip down memory lane, and remember the age-old maxim that our school taught us Prevention is better than cure.

Spending on health and wellness in a way that adds value to your living is not a cost, it is an investment.

Preventive wellness is not just health care to treat illness, but healthcare to prevent disease onset in the first place. Does this only involve regular screenings? Not at all. Holistic approaches include diagnosing lifestyle diseases, treating them, and making sustainable lifestyle changes.

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It is much easier for us to recover faster when we treat every organ in our body with great care.

Also, it is crucial to consider the quality of the daily products or groceries. Your lifestyle changes are also heavily influenced by this.

Through Integrative and Lifestyle Medicine and Holistic Nutrition, food and lifestyle are powerful tools for alleviating pain in people suffering from severe illnesses and lifestyle diseases. Unfortunately, the quality of products available today is highly questionable. Choosing chemical-free, ethically sourced, organic, sustainably produced products from an honest market is of the utmost importance.

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A conventional farming method involves using harmful chemicals, GMOs, synthetic pesticides, and fertilizers. In contrast, organic foods are grown without synthetic pesticides or artificial fertilizers. While these chemicals are safe to use in conventional farming and are present in food at low levels, they have been found to have adverse health effects. Imagine how pesticides would affect humans if they were used to kill pests.

However, organic is commonly thought to mean pesticide-free. In some cases, it is true but not always. Foods that are organic do not contain genetically modified organisms. While organic pesticides come from natural sources and are not processed, they also contain certain chemicals found in non-organic pesticides.

The benefits of organic and chemical-free meat are also numerous. No antibiotics or synthetic hormones are present in organic meat. Animals raised conventionally can be fed antibiotics to prevent illness, making it easier for farmers to breed them under crowded or unsanitary conditions. There is evidence that these residues contribute to widespread antibiotic resistance, the onset of early puberty, growth of tumors, heightened cancer risk, risk of autoimmune conditions, and genetic problems. Organic meat, produced without antibiotics, is intrinsically safer in this respect.

Organic or ethically sourced foods have higher antioxidants, high levels of vitamins, minerals, and lower saturated fat than their conventional counterparts. It also helps preserve our ecosystem and also prevents us from deadly diseases.

Choosing organic or ethically sourced products should be done with complete and correct knowledge. When buying organic food, go local to avoid possible pesticides.

Though organic foods and chemical-free products might cost more, it is always better to invest in preventative wellness than in medicines. The environment and we deserve a healthier, more sustainable food system for a better overall lifestyle.

(The author is Co-Founder ofyoucarelifestyle.com.Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)

See the article here:
Spending on Food and lifestyle for preventive wellness is better than spending on medicines and treatment - The Financial Express

Before I dive in, let me be clear. Exercise should not be used in place of prescribed medications that you need to manage chronic conditions, such as diabetes, cholesterol, hypertension, irregular heartbeats or anything of the nature. What the science clearly shows though, is that exercise is an effective preventative medicine that can prevent the onset of many of the leading illnesses in the U.S. In fact, the CDC lists lack of physical exercise as one of the four primary risk factors for chronic disease. Incidentally, the others are tobacco use, poor nutrition, and excessive alcoholic consumption.

So, what conditions may be avoidable, or less likely to develop if you engage in regular exercise that includes any combination of cardio, strength training and deep stretching?? The list is long:

Exercise: Specific Ways it Improves Your Health

Exercise is considered pleiotropic, meaning that it has multiple beneficial effects on the body. It positively impacts brain function because it leads to better sleep. It also supports a healthy blood-brain barrier which is the group of blood vessels responsible for keeping pathogens and toxins out of the brain, and letting healthy cells and molecules reach the brain. Regular exercise also helps protect the neurons in the brain from inflammation and damage. Neuron damage has been correlated with Parkinsons Disease, Alzheimers Disease, and Multiple Sclerosis.

Exercise benefits your musculoskeletal system in many ways as well. It strengthens muscles and bones putting you at less risk for low bone density (osteoporosis). It also keeps joints mobile and healthy, reducing the risk of arthritis. This therefore reduces your risk of falling as you age. For those who already have arthritis, exercise can reduce pain and inflammation.

There may be no treatment more underused than exercise when it comes to treating stress, anxiety, and depression. Exercise reduces levels of adrenaline and cortisol in the body. These are the hormones that cause stress and anxiety. At the same time, working out helps to increase your production of endorphins, which are your brains feel good neurotransmitters. As mentioned, exercise is pleiotropic, so this reduction in stress then aids in healthy digestion, better, sleep, and overall better mental health.

Youll do your cardiovascular system a favor by working out regularly as well. Regular fitness routines help improve blood flow in your heart. By increasing the flow of oxygen-rich blood throughout your body, you can prevent the buildup of plaque in your arteries, which is a leading cause of heart disease.

Your respiratory system also benefits from a regular exercise routine. This is because when youre walking, running, jogging, cycling, or lifting weights your lungs and heart are forced to work harder. After all, they must supply the oxygen that your muscles need. So, exercising is not only working your muscles, but also giving your lungs a workout, too.

Regular exercise also helps prevent obesity. Obesity is an epidemic in this country. There is nothing wrong with body positivity. However, being significantly overweight is not healthy. It causes stress on your heart, on your organs, on your joints, muscles, and bones. Obesity rarely occurs in a vacuum. It is almost always found in conjunction with other chronic illnesses or conditions including high blood pressure, heart disease, diabetes, high cholesterol, and more. No one should be ashamed of their body. But the science is clear that carrying extreme amounts of excess weight puts your health, and even your life at risk.

Get Help Starting an Exercise Routine

If youve been a bit of a couch potato, since the pandemic hit, dont beat yourself up. It happened to the best of us. But it is time to get back on track and prioritize health. Reach out to an active friend or family member. Schedule a consultation with a personal trainer, or use a streaming video at home to ease yourself back in. It doesnt matter how you start, its just important that you do start. But dont just take it from me. Even doctors will tell you that prevention is the best medicine. And thats exactly what exercise is: preventative medicine.

About SY Performance

SY Performance offers in-person and hybrid training at Conquer All Things Fitness Studio, located at 1218 Magnolia Blvd in Burbank. SY Performance was founded by Burbank-based celebrity personal trainer Scott Yonehiro. Yonehiro created and launched the first 90 Day Body Transformation Program in 2010. To date, thousands of individuals have completed the program, which utilizes a proprietary combination of science-based techniques coupled with fitness, nutrition, and mindset exercises to help individuals of all ages lose weight, reduce body fat, and increase muscle.

Visit: http://www.syperformanceone.com

Email: Scott@syperformanceone.com

YouTube: https://www.youtube.com/c/ScottYonehiro1

Facebook: https://www.facebook.com/syperformanceone

Instagram: https://www.instagram.com/syperformance/

Twitter: https://twitter.com/SYPerformance

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Exercise is Preventative Medicine - myBurbank.com

Welcome to the Spears ranking of the preventative medicine specialists for high-net-worth individuals in the UK. The list features our Top Recommended companies

Health monitoring and early scanning can help catch potentially serious problems in their early stages, especially some cancers and heart problems. A day a year spent in the comfortable surroundings of one of the clinics on the Spears preventative medicine index will pay dividends any HNW would be happy with.

Let Richard Pisarskis staff at the seven-story Mayo Clinic on Portland Place in London guide you through a series of tests and scans, for example, or attend one of Paul Jenkins pioneering European Scanning Centres.

Spears publishes annual rankings of the top private client advisers, service providers and companies that cater to HNWs. These are drawn up on the basis of peer nominations, client feedback, telephone and face-to-face interviews, data supplied by firms, as well as information gathered by the Spears editorial and research teams.

Click on the individual names to be directed to more detailed profiles on spears500.com. The table is ordered alphabetically by name.

To explore all the Spears indices, and to use our find-an-adviser tool to identify the private client adviser who is right for your specific requirements, go to theSpears 500 website.

To receive relevant research updates from Spears and thereby give you and your firm the best chance of being included in future Spears indices pleaseregister here.

If you are an adviser featured in index and would like to update your profile or provide additional information, please email rasika.sittamparam@spearswms.com.

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Best preventative medicine, health screening and anti-ageing clinics for HNWs in 2022 - Spear's WMS

When victims of rape or sexual violence seek emergency medical assistance following an attack, they may be saddled with hundreds or even thousands of dollars in medical bills, a new study published this week in the New England Journal of Medicine found.

These bills can further traumatize victims, the study authors warn, and deter others from seeking professional help. Only one-fifth of sexual violence victims are estimated to seek medical care following an attack.

Researchers affiliated with Harvard analyzed a nationwide data set of more than 35 million emergency room visits in 2019, the most recent year such information was available. They looked specifically at visits where doctors billed with codes related to care after sexual assault, and found more than 112,000 such patients. Nearly 90 percent of those patients were female, and 38 percent were children under 18.

When victims of sexual violence go to the ER, there are two kinds of care theyd typically receive. The first is a sexual assault forensic exam, or more colloquially, a rape kit. Thats where a medical professional collects evidence from a victim, such as conducting a pelvic, rectal, or throat exam, taking samples for a DNA test, and looking for semen or any other evidence of violent injury.

Under the Violence Against Women Act (VAWA) of 1994, the costs associated with a forensic exam are paid for with public funds, and while survivors are sometimes erroneously billed, the federal law prohibits charging victims for the cost of their evidence collection.

But VAWA does not cover the second category of care and thats therapeutic care, or whatever is medically necessary for a persons health following an attack.

So for instance, doctors frequently give victims preventative medication for STDs, like antibiotics to prevent syphilis, gonorrhea, or HIV medication if thats a possibility, said Stephanie Woolhandler, one of the lead authors of the study. ER physicians may also provide emergency contraception to victims if pregnancy is a concern, and in other cases victims may have vaginal or rectal lacerations that need to be sewn up, other injuries, or broken bones.

The researchers findings on the costs of such care are sobering. Uninsured victims, who numbered over 17,000 in 2019, faced out-of-pocket charges averaging $3,673.

For all the roughly 112,800 patients seen for sexual assault who visited the ER that year, charges averaged $3,551, with even higher averages for pregnant patients ($4,553). Insured patients had lower out-of-pocket bills, but how much lower depends on the structure of their insurance plan. Prior research suggests that even those with private insurance paid about 14 percent of their bill on average, roughly $500. That can be an enormous sum of money given that a disproportionate share of sexual assault victims are low-income women and girls, Woolhandler told Vox.

The findings, published less than three months following the Supreme Courts overturn of Roe v. Wade, come as states move to restrict not only access to abortion but other basic sexual health care treatments, like emergency contraception and drugs used to manage miscarriages.

Samuel Dickman, an abortion provider and lead study author, told Vox that when he used to provide care in Texas (he relocated to Montana in May), he personally encountered patients who came in following sexual attacks who were then vulnerable to catastrophic medical bills. Texas has the highest uninsured rate in the country, and this research is a start towards quantifying that vulnerability, he said.

The vulnerability isnt limited to the uninsured, though. Dickman recalls one of his former patients who had been raped and became pregnant, and was seeking an abortion. She was on Medicaid, and under the Hyde Amendment, rape victims should have had that procedure covered but Texas has made it so hard that we were looking at charging this victim more than $1,000 out of pocket, he said. Those charges were just shocking to her, and on top of having just been raped, frankly, it was haunting.

The study authors are urging policies that ensure affordable access to all essential medical services including abortion and emergency contraception for survivors of rape, and for everyone else who needs that care, said Dickman.

One option they suggest in their paper to help survivors of sexual violence would be to expand VAWA to cover therapeutic services, not just evidence collection. Woolhandler told Vox that that would be a step in the right direction but that ultimately more comprehensive reform, including universal health care coverage, is needed to eliminate barriers.

Sexual health care is health care and we, like other developed nations, ought to be making all health care free at the time of use, Woolhandler added. In a post-Roe world, an unwanted pregnancy can mean an unwanted childbirth, and so the government has the power to force you as someone with a vagina to bear all the consequences of your attack, not just a $500 or $3,000 medical charge, but you have to also bear this child. Its frankly outrageous.

Paying greater attention to privacy concerns of survivors, the study authors urge, is also paramount to ensuring victims feel they can seek the care they need. Emergency department charges may discourage the reporting of rape and seeking of medical care for both short-term and long-term sequelae of sexual assault, the NEJM study states. Incurring such charges may further harm survivors even those with full insurance coverage by serving to disclose a potentially stigmatizing event to parents, partners, or employers.

Dickman said theres no reason we couldnt have a system where every individual has their own insurance card that entitles them to private care. Ive seen insured patients say theyll pay for their care out of pocket even if that means theyll have to skip rent or groceries, because they cant have that kind of disclosure to their family or employer about abortion or sexual assault, he said. If youre a minor seeking emergency room care, theres a good chance the primary insurance policy holder will be getting a list of what services you received, and very plausibly, that person could be the person who committed the assault.

Woolhandler said some of the privacy concerns stem from private insurance, because insurers are entitled to know what procedures were done and diagnoses made. Part of the thing with single-payer is hospitals dont send bills, she said. In Canada, hospitals get a lump sum that they use to pay all their operations; presumably, theres a record at the hospital about who you are and your [medical] record, but it doesnt have to leave the hospital.

We need to not tie people to their jobs or their family members in terms of medical care, added Dickman. Its just a crazy way to structure a system.

Excerpt from:
The high hospital bills we make victims of rape and sexual violence pay - Vox.com

Dr. Ron Moody, Chief Medical Officer, Accenture Federal Services

For an industry that traditionally embraces change at a glacial pace, the pandemic has been a wake-up call for healthcare. Once COVID-19 struck, the shift to video, telephone engagement and remote patient monitoring spiked seemingly overnight.

This surging demand for virtual care resulted, in many cases, in increased provider efficiency, provider-patient interactions, and satisfaction. One national telehealth organization covering 2,000 hospitals and 81,000 doctors, for example, experienced an 86% decrease in time needed to complete the patient onboarding process, and 92% of providers said they expect to continue video visits post-pandemic. Access also improved a Johns Hopkins University study found that Medicare beneficiaries in poor neighborhoods increased their use of telemedicine during the pandemic.

In short, weve learned that virtual care is scalable, trusted, adaptable, and even preferable for many patients and clinicians alike.

No time to rest

But this isnt the time for the industry to go back to the old way of doing business. Healthcare organizations should leverage lessons learned from the pandemic to create fundamental change. That means shifting away from reactive medicine to proactive and preventative care, wellness, population health, and better support for chronic conditions.

We need to think differently because, frankly, incremental change around the same ideas hasnt worked. A recent studyby the Commonwealth Fund found that, despite spending far more of its gross domestic product on health care than 10 other high-income nations, the U.S. ranked last in access to care, administrative efficiency, equity, and healthcare outcomes.

Transforming the healthcare system wont be easy. Structural hurdles such as regulatory constraints and legacy payment models, as well as simple inertia, have conspired to block the path forward. Too often, providers are incentivized to provide direct, in-office care instead of using the best mode available to address a patients specific needs.

Federal agencies: catalysts of change

Federal healthcare providers, such as the Veterans Health Administration (VHA), Defense Health Agency, and Indian Health Service are uniquely positioned to lead this transformation. These agencies serve a large portion of the U.S. population and are dedicated to patient-centered, evidence-based care. Importantly, their financial models are different from those of commercial healthcare providers, enabling them to disrupt the status quo.

Because these federal agencies operate largely as integrated healthcare systems, they can more readily implement policy and procedural changes as well as the enabling technology which can minimize and manage potential disruption, while achieving improved outcomes.

Furthermore, they can more quickly capture cost savings and other efficiencies for reinvestment to expand adoption and improve care quality and convenience. Most agencies have already been making significant investments in virtual care.

VHA leads the way

Consider the VHA, for example. It is the largest integrated health care system in the U.S., providing care at nearly 1,300 health care facilities and more than 1,100 outpatient clinics, serving 9 million enrolled veterans each year. VHAs Connected Care program has been a pioneer and innovator in using video visits at scale, conducting more than 750,000 virtual visits per month in 2021.

Because they have laid the groundwork for virtual care, the VHA and other federal agencies will be able to accomplish more by tying those investments to a broader model we call Virtual First a strategic framework for transforming patient experiences and outcomes using data-driven innovation.

Reimagined approach

A Virtual First approach uses remote, digital engagement as the default care delivery method whenever appropriate to improve patient and provider experiences, reduce costs and improve outcomes.

It does not, of course, replace todays in-person ambulatory and critical care services. Rather, it complements, enhances, and where appropriate, replaces traditional in-person care. A Virtual First strategy matches the means of care delivery to the case, factoring in the specific patient, his or her condition, the urgency, and the needed staff.

Virtual First provides new opportunities for clinicians to consult with patients regularly and outside of traditional care settings. It allows for more effective monitoring and interventions. A providers ability to impact patient health is no longer bound by the limited time spent interacting with patients in medical offices, nor is it constrained by a lack of data.

Private sector innovation

Besides the federal healthcare providers cited above, private sector health organizations have also pioneered patient-centric models driven by technology.

A recent Harvard Business Review article The Telehealth Era Is Just Beginning, describes how two of the earliest telehealth adopters Kaiser Permanente and Intermountain Healthcare leverage sophisticated technology to improve access to care, deliver care more efficiently, and reduce unnecessary emergency room visits.

Kaiser members in some states can access a round-the-clock video health center connecting them with telehealth doctors who resolve the issue 60% of the time, thereby avoiding a costly trip to the ER. The doctor can also schedule an appointment with the members personal physician if follow-up care is needed and provide details of the patients issue before the appointment.

Similarly, using remote home monitoring technology and a telemedicine program during the pandemic, Intermountain avoided more than 1,800 hospital admissions and saved almost 4,800 hospital bed-days, which freed up beds for the sickest patients.

A word of caution

Virtual care has demonstrated its ability to serve as a catalyst and enabler for much-needed improvements of the healthcare system.

However, simply using it as an alternate way to deliver the same type of care wont change outcomes drastically. It will not address the growing doctor and nursing shortage. It may provide another avenue of convenient health access, but it will be yet another innovation that falls short of its promise unless it is accompanied by a true outcomes-based, patient-centric strategy, enabled by technology and data.

About Dr. Ron Moody

Dr. Ron Moody is currently the Chief Medical Officer at Accenture Federal Services. He is a retired Army Colonel who served in the military for more than two decades. Dr. Moody is board-certified in family medicine with a broad background in medicine, clinical operations, Healthcare administration, strategic planning, and health information technology.

See the original post:
Why Now is the Time to Double Down on Virtual Care - HIT Consultant

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CHMP recommends approval of Beyfortus (nirsevimab) for prevention of RSV disease in infants

Paris, September 16, 2022. The European Medicines Agencys Committee for Medicinal Products for Human Use (CHMP) has adopted a positive opinion for Beyfortus (nirsevimab) for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in newborns and infants during their first RSV season. If approved, Beyfortus would be the first and only single-dose passive immunization for the broad infant population, including those born healthy, at term or preterm, or with specific health conditions. Beyfortus is being developed jointly by Sanofi and AstraZeneca.

Jean-Franois ToussaintGlobal Head of Research and Development Vaccines, Sanofi Todays positive CHMP opinion is one of the most significant public health achievements in RSV in decades and has the potential to alleviate the enormous physical and emotional burden that RSV can place on families and healthcare systems. With this endorsement, we are one step closer to achieving our goal of protecting all infants against RSV with a single dose.

Iskra ReicExecutive Vice President, Vaccines and Immune Therapies, AstraZenecaThis positive CHMP opinion underscores Beyfortus potential as a ground-breaking, first-in-class passive immunization that could transform the medical communitys approach to RSV prevention in infants.

The CHMP based its positive opinion on results from the Beyfortus clinical development program, including the Phase 3 MELODY, Phase 2/3 MEDLEY, and Phase 2b trials.1-8 In the MELODY and Phase 2b trials, Beyfortus met its primary endpoint of reducing the incidence of medically attended lower respiratory tract infections (LRTI) caused by RSV during the RSV season vs. placebo with a single dose. 1-6 The safety profile of Beyfortus was similar to placebo. Beyfortus also demonstrated a comparable safety and tolerability profile to palivizumab in the Phase 2/3 MEDLEY trial.7-8

RSV is the most common cause of LRTIs and a leading cause of hospitalization in all infants, with most hospitalizations occurring in infants born healthy and at term.9-13 RSV-related direct medical costs, globally including hospital, outpatient and follow-up care were estimated at 4.82 billion in 2017.14 Currently there is no preventative option available for all infants and treatment is limited to symptomatic relief.15,16

About Beyfortus

Beyfortus (nirsevimab), an investigational long-acting antibody designed for all infants for protection against RSV disease from birth through their first RSV season with a single dose, is being developed jointly by Sanofi and AstraZeneca.

Beyfortus has been developed to offer newborns and infants direct RSV protection via an antibody to help prevent LRTI caused by RSV. Monoclonal antibodies do not require the activation of the immune system to help offer timely, rapid and direct protection against disease.17

In March 2017, Sanofi and AstraZeneca announced anagreementto develop and commercialize Beyfortus. Under the terms of the agreement, AstraZeneca leads all development and manufacturing activities and Sanofi will lead commercialization activities and record revenues. Under the terms of the global agreement, Sanofi made an upfront payment of 120m, has paid a development milestone of 30m and will pay up to a further 465m upon achievement of certain development and sales-related milestones. The two companies share all costs and profits. Revenue from the agreement is reported as Collaboration Revenue in the Companys financial statements.

Beyfortus has been granted designations to facilitate expedited development by several major regulatory agencies around the world. These include Breakthrough Therapy Designation by The China Center for Drug Evaluation under the National Medical Products Administration;Breakthrough Therapy Designationfrom the US Food and Drug Administration; access granted to the European Medicines Agency (EMA)PRIority MEdicinesscheme; Promising Innovative Medicine designation by the UK Medicines and Healthcare products Regulatory Agency; and named a medicine for prioritized development under the Project for Drug Selection to Promote New Drug Development in Pediatrics by the Japan Agency for Medical Research and Development (AMED). The safety and efficacy of Beyfortus was evaluated under an accelerated assessment procedure by the EMA. Beyfortus has not been approved by any regulatory authority.

About the clinical trials

The Phase 2b trial was a randomized, placebo-controlled trial designed to measure the efficacy of Beyfortus (nirsevimab) against medically attended LRTI through 150 days post-dose. Healthy preterm infants of 2935 weeks gestation were randomized (2:1) to receive a single 50mg intramuscular injection of Beyfortus or placebo. The primary endpoint was met, reducing the incidence of medically attended LRTI, caused by RSV by 70.1% (95% CI: 52.3, 81.2) compared to placebo. Between November 2016 and December 2017, 1,453 infants were randomized (Beyfortus, n=969; placebo, n=484) at the RSV season start. Studies were conducted in both hemispheres, at 164 sites in 23 countries.3,4Data was publishedin theNew England Journal of Medicine(NEJM)in July 2020. The dosing regimen was recommended based on further exploration of the phase 2b data.3 The subsequent Phase 3 study, MELODY, applied the recommended dosing regimen.2

The Phase 3 MELODY trial was a randomized, placebo-controlled trial conducted across 21 countries designed to determine efficacy of Beyfortus against medically attended LRTI due to RSV confirmed by reverse transcriptase polymerase chain reaction testing through 150 days after dosing, versus placebo, in healthy late preterm and term infants (35 weeks gestational age or greater) entering their first RSV season.1,2The primary endpoint was met, reducing the incidence of medically attended LRTI, such as bronchiolitis or pneumonia, caused by RSV by 74.5% (95% CI 49.6, 87.1; PNEJMin March 2022.

Findings from Beyfortus clinical trial program include a pre-specified pooled analysis of the Phase 3 MELODY trial and the recommended dose from the Phase 2b trial, in which an efficacy (relative risk reduction versus placebo) of 79.5% (95% CI 65.9, 87.7; PNEJMin March 2022.1,5

MEDLEY was a Phase 2/3, randomized, double-blind, palivizumab-controlled trial with the primary objective of assessing safety and tolerability for Beyfortus in preterm infants and infants with congenital heart disease (CHD) and/or chronic lung disease of prematurity (CLD) eligible to receive palivizumab.7,8 Between July 2019 and May 2021, approximately 918 infants entering their first RSV season were randomized to receive a single 50mg (in infants weighing NEJM in March 2022.

The results of MELODY, Phase 2/3 MEDLEY and the Phase 2b trials illustrate that Beyfortus helps protect infants during their first RSV season against RSV disease with a single dose.1-8 This all-infant population includes preterm, healthy late preterm and term infants, as well as infants with specific conditions.

These trials form the basis of regulatory submissions that began in 2022.

About RSV

RSV is the most common cause of LRTI, including bronchiolitis and pneumonia, in infants.9It is also a leading cause of hospitalization in all infants, with most hospitalizations for RSV occurring in healthy infants born at term.10-13 Globally, in 2019, there were approximately 33 million cases of acute lower respiratory infections leading to more than three million hospitalizations, and it was estimated that there were 26,300 in-hospital deaths of children younger than five years.18 RSV-related direct medical costs, globally including hospital, outpatient and follow-up care were estimated at 4.82 billion in 2017.14

About SanofiWe are an innovative global healthcare company, driven by one purpose: we chase the miracles of science to improve peoples lives. Our team, across some 100 countries, is dedicated to transforming the practice of medicine by working to turn the impossible into the possible. We provide potentially life-changing treatment options and life-saving vaccine protection to millions of people globally, while putting sustainability and social responsibility at the center of our ambitions. Sanofi is listed on EURONEXT: SAN and NASDAQ: SNY

Media RelationsSandrine Guendoul|+ 33 6 25 09 14 25 |[emailprotected]Sally Bain|+ 1 617 834 6026 |[emailprotected]Nicolas Obrist|+ 33 6 77 21 27 55 |[emailprotected]Kate Conway|+ 1508364 4931 |[emailprotected]

Investor RelationsEva Schaefer-Jansen|+ 33 7 86 80 56 39 |[emailprotected]Arnaud Delpine|+ 33 6 73 69 36 93 | [emailprotected]Corentine Driancourt|+ 33 6 40 56 92 21 | [emailprotected]Felix Lauscher|+ 1908612 7239 | [emailprotected]Priya Nanduri | + 1 617 764 641 |[emailprotected] Nathalie Pham|+ 33 7 85 93 30 17 | [emailprotected]

Sanofi Forward-Looking StatementsThis press release contains forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995, as amended. Forward-looking statements are statements that are not historical facts. These statements include projections and estimates and their underlying assumptions, statements regarding plans, objectives, intentions and expectations with respect to future financial results, events, operations, services, product development and potential, and statements regarding future performance. Forward-looking statements are generally identified by the words expects, anticipates, believes, intends, estimates, plans and similar expressions. Although Sanofis management believes that the expectations reflected in such forward-looking statements are reasonable, investors are cautioned that forward-looking information and statements are subject to various risks and uncertainties, many of which are difficult to predict and generally beyond the control of Sanofi, that could cause actual results and developments to differ materially from those expressed in, or implied or projected by, the forward-looking information and statements. These risks and uncertainties include among other things, the uncertainties inherent in research and development, future clinical data and analysis, including post marketing, decisions by regulatory authorities, such as the FDA or the EMA, regarding whether and when to approve any drug, device or biological application that may be filed for any such product candidates as well as their decisions regarding labelling and other matters that could affect the availability or commercial potential of such product candidates, the fact that product candidates if approved may not be commercially successful, the future approval and commercial success of therapeutic alternatives, Sanofis ability to benefit from external growth opportunities, to complete related transactions and/or obtain regulatory clearances, risks associated with intellectual property and any related pending or future litigation and the ultimate outcome of such litigation, trends in exchange rates and prevailing interest rates, volatile economic and market conditions, cost containment initiatives and subsequent changes thereto, and the impact that COVID-19 will have on us, our customers, suppliers, vendors, and other business partners, and the financial condition of any one of them, as well as on our employees and on the global economy as a whole. Any material effect of COVID-19 on any of the foregoing could also adversely impact us. This situation is changing rapidly and additional impacts may arise of which we are not currently aware and may exacerbate other previously identified risks. The risks and uncertainties also include the uncertainties discussed or identified in the public filings with the SEC and the AMF made by Sanofi, including those listed under Risk Factors and Cautionary Statement Regarding Forward-Looking Statements in Sanofis annual report on Form 20-F for the year ended December 31, 2020. Other than as required by applicable law, Sanofi does not undertake any obligation to update or revise any forward-looking information or statements.

References

Excerpt from:
Press Release: CHMP recommends approval of Beyfortus (nirsevimab) for prevention of RSV disease in infants - StreetInsider.com

Pickleball is Americas favorite emerging recreational sport at the moment. The game that was first developed on Washingtons Bainbridge Island in 1965 is taking the country by storm for its ease of access, fun, quick action, and social attraction.

Whats lost in the hype, however, is that the sport is leading to numerous injuries. An analysis of pickleball-related injuries using data from the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission found the annual estimated number of injuries rising precipitously from 2013 to 2017.

Even though the court is much smaller, and requires much less ground to cover, numbers show that pickleball-related emergency room visits are quickly catching up tennis-related traumas, especially for seniors. Using data from 2001 to 2019 (as reported by the NEISS), analysts found a weighted total of 28,984 pickleball injuries as compared with 58,836 tennis injuries.

Although pickleball-related injuries have many similarities with those associated with other racquet sports, there were various differences (e.g., increasing trend and older patient age) that may need to be considered for the prevention and management of injuries related to the sport, concluded the article.

This was especially true for seniors as 85% of medical stresses occurred in people over 60. Still, all players risk any number of athletic impairments including ankle sprains, muscle strains, tendon pulls/tears, shoulder problems, rotator cuff injuries, and lower back problems such as disc injuries and strains.

No need to stress, though. The Manual is here with a guide on how to prevent devastating pickleball injuries.

Any sport that you play, youre going to want to support that condition with cross-training. The United States Office of Disease Prevention and Health Promotion recommends 150 minutes of moderate-intensity aerobic physical activity per week. High-impact cardiovascular exercise includes running, jogging, and sports like basketball, or skiing. While these will work wonders for physical shape, they can be hard on limbs and joints. Lower impact activities such as biking, elliptical machines, pool walking, or swimming can promote fitness with less destructive contact with the ground and other bodies.

Sleep is key to mental and physical recovery.

The ODPHPs Physical Activity Guidelines note that moderate to vigorous activity improves the quality of sleep in adults.

You break your body down with activity, which leads to improved physical conditioning and a mental calm that encourages healthy, healing sleep. Its a beautiful system.

For optimal health, the American Academy of Sleep Medicine and Sleep Research contends that adults should get at least seven hours of sleep. This varies, of course, from person to person and according to the sleepers age, but the body will rest as it should as long as you keep a regular schedule of proper diet and exercise. In turn, youll be actively promoting quicker recovery, better blood flow, and improved focus, all from under the covers.

Warming up is an obvious preventative step. At the same time, it can be a big pain in the butt.

Everybody remembers those half-hearted first 10 minutes of gym class and/or practice, lackadaisically limbering body parts before the real play could begin. Dedicate yourself to active stretching, and you can flip that half-assed practice and not only help avert injury, but improve performance.

Elite movement coaches have found increased athletic achievement in concert with fewer injuries with targeted, non-repetitive, and dynamic stretching before, during, and after workouts. Straining muscles by elongating instead of flexing will have the same effect: youll get better movement and stronger, more defined musculature.

In turn, this can level up your pickleball game. A broad 2010 comprehensive analysis found that warming-up enhanced athletic execution in 79 percent of the criteria examined over several studies.

Core muscles your abs, inner and outer obliques, the diaphragm on top, and pelvic floor on the bottom stabilize your body as you bend, stretch, jump, and leap toward, say, yellow Wiffle balls on the pickleball court. It stands to reason that the more control you have over your extremities, the better shape your body is going to be in at the end of the activity.

Stabilizer, mobilizer, and load transfer core muscles assist in understanding injury risk, assessing core muscle function, and developing injury prevention programs, a National Library of Medicine paper concluded. Moderate evidence of alterations in core muscle recruitment and injury risk exists. Exercise programs to improve core stability should focus on muscle activation, neuromuscular control, static stabilization, and dynamic stability.

Similar to stretching, core workouts not only can help you prevent a strained back or pulled hamstring, but they can also boost your athletic capacity.

Whacking a plastic ball with a short, wood and graphite paddle might seem easy enough to do without practice, but that repetitive, chaotic motion can take a serious toll, especially if youre not doing it right.

Tennis elbow tendinitis that flares up when you dont warm and swing your arm correctly can affect pickleball players just as much as their hardcourt brethren. Seeing as tennis elbow can linger for six to 12 months, this is a common injury youre going to want to avoid. Knowing how to properly swing your paddle is key. For new players, break into the sport easily. Its no fun waking up with sore elbow tendons that could signal stepping away from the sport for a half or full year.

Mount Sinai Hospitals orthopedic department suggests balanc(ing) your body weight without over-extending your arms, legs, or your back. Use proper footwork to help you avoid injuries to the ankle and the Achilles tendon. Play with the proper equipment for your size and ability.

Pickleball, like any sport, can be a blast. Competition fires adrenaline, endorphins, testosterone, and other critical hormones. Whats good for the body is just as good for the mind. Theres no reason to get too excited, though. Youve got a lifetime to smack balls around. Make sure that youre prepared and on point to not only prevent injury, but give the game the best you got.

See the rest here:
Pickleball injuries are on the rise: 5 preventive tips to keep you on the court - The Manual

Four stretcher-bearers and three replacements carry a wounded man through the shattered Passchendaele landscape.Four stretcher-bearers and three replacements carry a wounded man through the shattered Passchendaele landscape./CEF official photograph

Tim Cooks most recent book is Lifesavers and Body Snatchers: Medical Care and the Struggle for Survival in the Great War.

When I was diagnosed with Hodgkins lymphoma cancer in 2012 at the age of 40, I was told to down tools and concentrate on my health. It seemed like good advice, so I did just that. I stopped writing and instead focused on being well. I did some yoga. I tried breathing exercises. I practised mindfulness. I sent mantras out into the universe.

After a short period, I went back to research and writing, something I had been doing for almost 20 years as a public historian. I had concluded that cancer takes and takes, often until there is nothing left. I did not want it to extinguish the writer in me.

So I researched, and read and wrote as I was being poisoned and irradiated, losing myself in the past to give myself a future. Over a two-year ordeal that included multiple rounds of chemotherapy and radiation, and two stem-cell transplants, the cancer was destroyed.

During this test, as I read history books in the cancer ward in preparation for a two-volume history of Canada and the Second World War, I found that many of my oncologists at the General Hospital in Ottawa were not only interested in my research, but they had their own stories about medical practices that came about during wartime. Memorably, one doctor gave me an impromptu lecture on how mustard gas in the Great War had led to the development of certain chemotherapies. I was both fascinated and horrified.

I was also intrigued that so many medical practitioners saw themselves as part of a long continuum of caregivers, and I thought, in a vague way, that it might be nice to write a book about military medicine and one day present it to some of the doctors and nurses as a gesture of thanks. But I had other books to write, and it was not until 2020 that I returned to the subject of military medicine.

Lifesavers and Body Snatchers: Medical Care and the Struggle for Survival in the Great War, by Tim CookHandout

All books have their own history, and my latest history book is no different. I started what would become Lifesavers and Body Snatchers: Medical Care and the Struggle for Survival in the Great War in April, 2020. While research takes us into many unexpected places, I began with the devastating pandemic of 1918 to 1920, and how Canadians dealt with the invisible death 100 years ago.

How could I not as everyone was living through, and struggling with, the current pandemic that was sweeping the globe? The virus from 1918 to 1920 killed about 55,000 Canadians but had been largely forgotten until we faced our own iteration of this life-changing crisis. It was a topic worthy of study.

And yet the medical battles of the Great War went far beyond the virus and Canadian doctors and nurses played a crucial role in the terrible attritional war of 1914 to 1918. Half of all Canadian doctors and a third of the countrys nurses served in uniform, caring for the 620,000 Canadians who also left their loved ones to fight against the Kaisers forces.

So many medical practitioners were drawn into the vortex that Canadians at home suffered shortages of doctors by the midpoint of the war an intolerable doctor famine, as it was labelled in one medical journal. There was talk of conscripting doctors for service in Canada and redistributing them against their will across the nation. It did not happen, but the situation was desperate as the war overseas drew in medical personnel like a sucking chest wound.

And we needed every single one of them. Throughout centuries of warfare, almost every army saw more soldiers die from bacteria and viruses than from bullets and shells. During the Great War, doctors helped keep the fighting forces from withering away from disease and illness, a crucial act of force protection as thousands of Canadians fought amid the slurry of mud and filth in Western Front trenches populated with rats and rotting corpses.

Doctors impressed on the military high command the need to instigate mandatory vaccines against smallpox and typhoid. These vaccinations saved lives. The British, who initially had a voluntary system of vaccination, suffered comparatively more losses to disease. As a Canadian doctor wrote of those soldiers who refused vaccination and were removed from service: He was not allowed to endanger the health of his comrades.

Several thousand Canadians still died from disease in the putrid mire, but the great killer during the war was the devastating effects from artillery, machine guns, rifles, mortars and chemical weapons.

Canadian surgical team of two nurses, a surgeon, and an anesthetist work on a wounded soldier from the Battle of the SommeCanadian surgical team of two nurses, a surgeon, and an anesthetist work on a wounded soldier from the Battle of the Somme/Courtesy of Tim Cook

A Canadian doctor, Lieutenant-Colonel Walter Langmuir Watt, wrote of the carnage: Wounds here, wounds there, wounds everywhere. Legs, feet, hands missing; bleeding stumps controlled by rough field tourniquets, large portions of the abdominal walls shot away; faces horribly mutilated; bones shattered to pieces; holes that you could put your clenched fist into, filled with dirt and mud, bits of equipment and clothing, until it all became like a hideous nightmare.

To meet the horror, doctors devised new surgical treatments. The nefarious effects of infection that seethed in most wounds killed countless thousands in the age before antibiotics, with French, British, German and all other surgeons experimenting with means to eradicate the infections. A solution was to remove great swaths of flesh from ripped-open bodies, hoping to cut out the infection, while irrigating wounds with saline and chemical solutions.

If that did not work, amputation was often the only alternative. Colonel J.M. Elder, a prewar surgeon in Montreal, noted that he and other doctors overseas struggled to strike a just balance between the saving of a limb and the saving of a life.

Nine out of 10 wounded Canadians who reached a surgeon survived. Obscured in those statistics are the many tens of thousands of wounded who died in a smoking shell crater or disappeared into the mud of the many battlefields, dying alone and in agony.

To save lives required a constant learning process. When a study revealed soldiers dying of shock, doctors experimented with blood transfusions, with Canadian practitioners acting as pioneers among the Allied forces. By 1918, the last year of war, it was common to infuse the grievously wounded, in patient-to-patient transfers of life-giving blood.

X-rays were used extensively for the first time in war, assisting surgeons as they navigated the savagely pulped organs peppered with metal and shattered bones.

Invisible wounds to the mind, labelled broadly as shell shock, were particularly troubling to the high command that watched with concern as soldiers broke under the strain. The medical services were ordered to reduce losses and return soldiers to the front. New psychiatric approaches, including rest and talk therapy were mixed with electric shock therapy.

As I research and wrote the book, reading about our contemporary caregivers within the hard-pressed medical system in Canada, I was more aware of the emotional burden that lay heavy on the nurses and doctors of the Great War.

I am witnessing terrible suffering, wrote nursing sister Sophie Hoerner of the patients in her Canadian hospital behind the Western Front. Nursing sister Elizabeth Paynter recounted the agony of administering care to young men with terrible wounds, hoping they would recover: Another patient died, and another still was very low, while there were at least four other delirious head cases, who seemed to take turns pulling off their dressings or getting out of bed.

Other nurses wrote last letters to next of kin, telling them of a son, father or husband who would not be returning home, seeking to soften the blow with a personalized note or in sharing a last sentiment.

How could one read of the nurses who held the hands of young Canadian soldiers whispering for their mothers as they breathed their last breath and not weep from thinking about what was happening in our COVID-19 wards patients dying without their loved ones, usually with only nurses and doctors to bear witness?

Through 2020 and early 2021, writing history that was connected to the contemporary medical crisis kept me going, a shield against the sheer awfulness of COVID with its physical threat and mental attrition that seemed to have no end.

Of course, for the generation that lived through the Great War, they too could see no end to the slaughter. They too believed it would be a forever war.

But the guns finally went silent on Nov. 11, 1918, and, like all great catastrophes, there were powerful legacies. In the field of medicine, as thousands of doctors and nurses returned to their communities, battlefield innovations were mapped on to civilian care.

X-rays were employed to assist those with tuberculosis, the great killer of Canadians aged 18 to 45 in the early 20th century.

Blood transfusions saved lives, with pioneers like Lawrence Bruce Robertson taking the lessons of infusing dying soldiers on the Somme to assist burn patients at Torontos Hospital for Sick Children.

To engage more fully in preventative care, a new Department of Health was created in 1919. It aligned with the desire of Canadians and medical practitioners to prevent disease instead of simply treating it. The success of soldiers wartime vaccinations in reducing losses to disease and the revelations of the poor health of tens of thousands of malnourished men turned away from service further drove the need for change.

There is nothing like a war to discover the steps that should be taken for the protection of public health, mused one influential Canadian senator.

There were advances in physiotherapy for the thousands of veterans who were grievously wounded, developments in psychology (although treatment remained deeply contested), and even a new emphasis on maternal care with the message of needing to save the lives of babies to replace the 66,000 Canadian soldiers killed during the war. In Montreal at the turn of the century, for instance, one in four babies had died before their first birthday, a horrendous indictment of the lack of public health in Canada.

Out of the welter of this terrible war, wrote one Canadian physician, with all its misery and suffering, will emerge as some small measure of compensation a fuller knowledge of the prevention of disease, the treatment and cure of sickness and wounds and general surgical conditions, which knowledge will be used by the medical profession to the great benefit of living humanity and generations yet unborn.

Lifesavers and Body Snatchers is not about our current pandemic, but, as with most history books, the present bleeds into its pages.

I was excited about a book tour in September to speak about my findings and to hear the reaction from readers. Those plans were laid to waste when cancer struck again.

It is a different cancer than 10 years ago. And after a brief pity party, I prepared for battle. I told myself that I was, perhaps, better equipped than some for the trial ahead, a veteran of past fights and grounded in the long view provided by history.

I marched forward, head down, hoping to make the hard yards. The battle plan saw radiation and chemo in the summer, and then surgery some time in September.

I met daily the doctors and nurses who treated me with care, compassion and skill. Some were interested in the new book; others looked too harried to have much time to read. I hope they do. There are lessons from the Great War on what nurses and doctors did in a time of great crisis and mass death, with no end in sight for those caught in the storm. It might bring some comfort to those medical workers today as our health care system is on the brink of breaking under unyielding strain.

For me, I hope to survive and be on the road again talking about my work. In the meantime, I will keep writing to cope and endure, and to find meaning in the past to provide guidance in the present, and some hope for the future.

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Opinion: From the Great War to the pandemic, doctors and nurses have always carried a heavy burden - The Globe and Mail