Take a Break: Honoring Samhain, Dia de Muertos

Samhain begins the evening of Oct. 31 and ends 24 hours later, while Dia de Muertos (Day of the Dead) takes place Nov. 1 and 2.

What is interesting about Oct. 31/Nov. 1 is that it is a “cross-quarter day,” it is halfway between the fall equinox and winter solstice. Cross quarter days have held great significance in many cultures, with Groundhog or Candlemas Day taking place on Feb. 2 and Oct. 31 being Samhain, which has evolved in various parts of the world to become Halloween.

In Celtic Ireland about 2,000 years ago, Samhain (sow-win) was the division of the year between the lighter half (summer) and the darker half (winter). At Samhain the division between this world and the other world was at its thinnest, allowing spirits to pass through.

Dia de Muertos (Day of the Dead) is also the time that ancestors are honored and visit the living. While this custom is very much connected with Mexico, people all over Central and South America celebrate this custom

In both traditions, altars are set up to honor deceased ancestors and loved ones. Special foods and drink are available for both the spirits and the living. It’s a time to dance, make bonfires, feast, clean gravestones, light special candles and remember those who have gone before us.

Life with Chronic Conditions: Coverage for Pre Existing Conditions is Uncertain

In the span of less than 12 hours this past week, the Trump administration took two seemingly contradictory actions that could have profound effects on the insurance marketplaces set up by the Affordable Care Act. Health analysts say that at least one of the efforts, coupled with previous changes initiated by the administration, could help transform the insurance market to be much more like it was before the 2010 federal health law took effect — a time when regulation, coverage and consumer protections varied widely across the United States.

If you haven’t been following this weeks news, you need to be aware that this administrations inability to repeal the Affordable Care Act (ACA) is resulting in their chipping away at it one bill at a time.

In August, the administration released a rule allowing expanded use of short-term health plans, which are less expensive than ACA policies. To get those lower prices, most of these plans do not include insurance coverage for prescription drugs, maternity care, mental health or substance abuse treatments.

The move is unlikely to benefit people who have chronic health problems, because short-term plans are allowed to reject people with pre-existing conditions or decline to cover care for those medical problems.

Under the rule, insurers can sell these short-term policies (which may be sold as soon as next month) to last for up to a year’s duration, with an option to renew for up to three years. That reverses an Obama-era directive that limited the length of such policies to a maximum of 90 days.

What you can do:

• Start by learning about this week’s changes. Check out NPR’s article 2 Moves By Trump This Past Week Could Reshape U.S. Health Insurance in Big Ways 

• Vote!

• Write/call your local and national representatives on issues that concern you.

• Work with condition specific organizations to lobby for health care changes that will make a difference.

• Run for local office and/or support someone who is running and shares your viewpoints.

PREVIOUS POSTS RELATING TO THIS TOPIC

• Life with Chronic Conditions: Affordable Care Act-What to Know, What to Do

• The Importance of Social Capital for those Affected by Chronic Conditions

• What to Do Now that Trump is Elected

• The Overview Effect and the Importance of Connection

• Healing the Whole Person: Ways to Increase Well-Being When Living with Chronic Condition

Take a Break: Halloween 2018: Make a Witch’s Hat

I'm going to a "Witches Night Out" party in a few days and I needed a hat to complete my outfit. The  videos below were very helpful in figuring out how to make a hat. However, not having a large piece of card stock or canvas, I used several layers of newspaper. 

You can make this stronger by making the hat, stuffing the peak with crumbled newspaper and adding a layer of paper mache. A simple paste of flour and water is fine to dip the strips of paper. To give a smoother texture, make the final layer paper towels. This will take longer to dry but gives an interesting finish and helps to insure that the newsprint wont bleed through paint. After the paper mache is dry, remove the crumbled paper.

Journal Watch October 2018

CHRONIC PAIN

Simple, cost effective treatment following failed back surgery shows promise: Failed back surgery (continued low back and leg pain after surgery) is relatively common. With each reoperation, success, as defined by pain reduction, becomes less likely and most patients do not improve. However, preliminary studies using a simple procedure to remove scar tissue or adhesions suggests a new treatment could help those with post-surgical, chronic low back pain. Pain Medicine 

Can chiropractic care disrupt vision? In rare occurrences, forceful manipulation of neck is linked to damaging side effect. For those in the habit of getting their neck adjusted by a chiropractor, there's an interesting case to know about: High velocity neck manipulation has been shown to create stress on the eye and lead to spotty vision. American Journal of Ophthalmology Case Reports

Sex differences in brain activity alter pain therapies: A female brain's resident immune cells are more active in regions involved in pain processing relative to males, according to a recent study. The study, published in the Journal of Neuroscience, found that when microglia, the brain's resident immune cells, were blocked, female response to opioid pain medication improved and matched the levels of pain relief normally seen in males. Women suffer from a higher incidence of chronic and inflammatory pain conditions such as fibromyalgia and osteoarthritis. While morphine continues to be one of the primary drugs used for the treatment of severe or chronic pain, it is often less effective in females. 

New hope for people with fibromyalgia: A novel psychological therapy that encourages addressing emotional experiences related to trauma, conflict and relationship problems has been found helpful for people with the chronic pain condition fibromyalgia. Pain 

Migraine can be treated without medicine, pilot study finds: Some migraine patients can cut down on medication or stop using it completely by using a newly developed inhaler which changes the composition of the air we breathe, according to results of a recent pilot study. By slightly changing the body's own molecules using a small inhaler, certain migraine patients can either cut down on medication or do without it completely. Cephalalgia 

Payer Policies May Discourage Non-Pharma Tx for Low Back Pain: Physical therapy, psychological counseling, other alternatives not consistently covered. There is a need for public and private insurers to broaden their coverage policies for non-drug pain treatments for low back pain, according to a study published online Oct. 5 in JAMA Network Open. 

Prevalence of Anxiety, Depression Up for Adults With Arthritis: The age-standardized prevalences of symptoms of anxiety and depression among adults with arthritis are 22.5 and 12.1 percent, which are considerably higher than those among adults without arthritis, according to research published in the Oct. 5 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Inflammatory Back Pain Resolves in Many Patients: Inflammatory back pain (IBP) often resolves, while in 30 percent of patients it progresses to spondyloarthritis (SpA) within 10 years, according to a study published in a recent issue of Arthritis & Rheumatology.

COMPLEMENTARY & ALTERNATIVE MEDICINE

Alternative Medicines May Aid in the Treatment of Psoriasis: Some complementary and alternative medicines (CAMs) may be helpful in the treatment of psoriasis, according to a review published online Sept. 5 in JAMA Dermatology. Compared with placebo, topical indigo naturalis showed significant improvements in psoriasis. Curcumin showed statistically and clinically significant improvements in psoriasis plaques. Twenty studies evaluated fish oil treatment, with most RCTs showing no significant improvement in psoriasis; however, most uncontrolled studies showed benefit with daily use. There was modest efficacy associated with meditation and guided imagery therapies. Acupuncture showed significant improvement in one meta-analysis of 13 RCTs versus placebo. 

Even mild physical activity immediately improves memory function People who include a little yoga or tai chi in their day may be more likely to remember where they put their keys. Researchers at the University of California, Irvine and Japan's University of Tsukuba found that even very light workouts can increase the connectivity between parts of the brain responsible for memory formation and storage. Proceedings of the National Academy of Sciences 

Weight Loss Can Be Boosted 5-Fold With Novel Mental Imagery Technique: Overweight people who used a new motivational intervention called Functional Imagery Training (FIT) lost an average of 5 times more weight than those using talking therapy alone, according to a study published in the International Journal of Obesity.

FDA ACTION

• Approves PK Papyrus Covered Coronary Stent System, a device intended to treat acute coronary artery perforations, or tears in the blood vessels of the heart.

• Approves Moxetumomab Pasudotox-tdfk for hairy cell leukemia

• Approves new dosage strength of buprenorphine and naloxone sublingual film as maintenance treatment for opioid dependence

• Approved Libtayo injection for intravenous use for the treatment of metastatic cutaneous squamous cell carcinoma or locally advanced CSCC who are not candidates for curative surgery or radiation

• Permitted marketing of ClonoSEQ assay, a next generation sequencing (NGS)-based test for minimal residual disease (MRD) in patients with acute lymphoblastic leukemia (ALL) or multiple myeloma.

• Approved Arikayce (amikacin liposome inhalation suspension), for the treatment of lung disease caused by a group of bacteria, Mycobacterium avium complex (MAC) in a limited population of patients with the disease who do not respond to conventional treatment (refractory disease).

• Approved Gardasil 9 human papillomavirus (HPV) vaccine being expanded to include people ages 27 through 45

• Approved marketing of Bose Hearing Aid, a user-fitted device for people 18 and older with mild-to-moderate hearing loss

PREVENTION

Effect of Aspirin on Disability Free Survival: Aspirin use in healthy elderly persons did not prolong disability-free survival over a period of 5 years but led to a higher rate of major hemorrhage than placebo. NEJM

Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly: The use of low-dose aspirin as a primary prevention strategy in older adults resulted in a significantly higher risk of major hemorrhage and did not result in a significantly lower risk of cardiovascular disease than placebo. NEJM

Effect of Aspirin on All-Cause Mortality in the Healthy Elderly: Higher all-cause mortality was observed among apparently healthy older adults who received daily aspirin than among those who received placebo and was attributed primarily to cancer-related death. In the context of previous studies, this result was unexpected and should be interpreted with caution. NEJM

Low-Dose Aspirin May Reduce Ovarian Cancer Risk: Low-dose aspirin use is associated with a reduced risk for ovarian cancer, according to a study published online Oct. 4 in JAMA Oncology. 

Long-Term Aspirin Use Linked to Reduction in Liver Cancer Risk: Regular long-term aspirin use is associated with a dose-dependent reduction in the risk for hepatocellular carcinoma (HCC), according to a study published online Oct. 4 in JAMA Oncology.

Exercise May Delay Cognitive Decline in People With Autosomal Dominant Alzheimer’s Disease: For individuals carrying a genetic mutation that causes Alzheimer’s disease, engaging in at least 2.5 hours of physical activity per week may have beneficial effects on markers of Alzheimer’s disease brain changes and may delay cognitive decline, according to a study available online by Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association as an article in press. According to the authors, the results support the benefit of physical activity on cognition and dementia progression, even in individuals with autosomal dominant Alzheimer’s disease (ADAD).

Indoor HEPA filters significantly reduce pollution indoors when outside air unhealthy, study finds:Outdoor air pollution is a major contributor to indoor air pollution -- but high-efficiency particulate air (HEPA) filters used in the home significantly reduce fine-particulate matter in the air compared with non-HEPA air filters, according to a new study. Science Daily 

Cooking with wood or coal is linked to increased risk of respiratory illness and death: Burning wood or coal to cook food is associated with increased risk of hospitalization or dying from respiratory diseases. American Thoracic Society

Web-Based Lifestyle Program Works for Liver Disease Patients: Web-based programs may be effective in helping patients make lifestyle changes to control non-alcoholic fatty liver disease (NAFLD), according to a study published in the November issue of the Journal of Hepatology.

Weight Loss May Cut Breast CA Risk in Postmenopausal Women: Postmenopausal women with weight loss have a reduced risk for breast cancer, according to a study published online Oct. 8 in Cancer. 

Sexual Harassment, Assault Tied to Women's Health Issues: Sexual harassment and sexual assault among midlife women are associated with poorer physical and mental health, according to a study published online Oct. 3 in JAMA Internal Medicine.

NUTRITION/SUPPLEMENTS/VITAMINS

High-Dose Vitamin DSupplementation May Have Beneficial Effect on Bone Microarchitecture in Seniors: Long-term, high-dose vitamin-D supplementation of 2,000 IU daily may have a slight beneficial effect on bone microarchitecture in seniors, according to results of a double-blind study presented at the 2018 Annual Meeting of the American Society for Bone and Mineral Research (ASBMR).

Cases Show Periodic Fasting May Cut Medication Use in T2DM: Medically supervised, therapeutic fasting regimens can help reverse type 2 diabetes (T2D) and minimize the need for pharmacological interventions, according to a case series published online Oct. 9 in BMJ Case Reports.

Active Pharmaceuticals ID'd in >700 Dietary Supplements: Dietary supplements often include active pharmaceuticals, even after warnings from the U.S. Food and Drug Administration, according to a study published online Oct. 12 in JAMA Network Open. The researchers found 776 FDA-identified adulterated dietary supplements, with 146 companies implicated. Most of the products were marketed for sexual enhancement, weight loss, or muscle building. 

Consuming Caffeine From Coffee Reduces Incident Rosacea: Caffeine intake from coffee is inversely associated with the risk for incident rosacea, according to a study published online Oct. 17 in JAMA Dermatology. There was no correlation between increased caffeine intake from foods other than coffee and decreased risk for rosacea. 

Daily Drinking Associated With Increased Mortality Risk: Daily drinking, even at low levels, may be detrimental to one's health, according to a study published online Oct. 3 in Alcoholism: Clinical & Experimental Research. Minimum risk of low-level drinking frequency for all-cause mortality found to be about three times weekly.

Modest Alcohol Consumption May Reduce Mortality in Nonalcoholic fatty liver disease: For patients with nonalcoholic fatty liver disease (NAFLD), modest alcohol consumption is associated with a reduction in all-cause mortality, while drinking 1.5 or more drinks per day may increase mortality, according to a study recently published in Hepatology.

Increasing Water Intake Can Cut Cystitis Recurrence: For women at high risk for cystitis recurrence who drink low volumes of fluid daily, increasing water intake prevents recurrence, according to a study published online Oct. 1 in JAMA Internal Medicine.

TREATMENT

Inhaled Steroids May Increase Risk of Non tuberculous Mycobacteria Lung Infections: Patients using inhaled steroids to control asthma and other breathing problems may be at greater risk for developing nontuberculous mycobacteria (NTM) lung infections, according to new research published online in the Annals of the American Thoracic Society. Although they cannot be spread from person to person, NTM are difficult to treat and can cause serious illness, and even death.

Patients Report Myriad Side Effects With Use of Oral Corticosteroids for Severe Asthma: In response to an online survey, 1,210 people with severe asthma who had used oral corticosteroids reported quality of life (QoL) issues that are often overlooked by conventional assessment tools, according to findings presented here at the 2018 International Congress of the European Respiratory Society (ERS). Side effects mentioned included weight gain, anxiety, and heightened emotional moods. 

Severe Asthma Exacerbations Controlled with Dupilumab in Patients With Comorbid ChronicRhinosinusitis and/or Nasal Polyposis: Dupilumab consistently reduced the rate of severe

exacerbations in moderate to severe asthma and showed comparative efficacy in patients with and without comorbid chronic rhinosinusitis or nasal polyposis (CRS/NP), according to a post hoc analysis of the phase 3 Liberty Asthma QUEST trial presented here at the 2018 International Congress of the European Respiratory Society (ERS).

Eradicating Helicobacter pylori Infections May Be a Key Treatment for Parkinson’s Disease: A study published in the Journal of Parkinson’s Disease suggests that Helicobacter pylori may play a role in Parkinson’s disease (PD) as well. A literature review to explore the association between H pylori and PD.uncovered 4 key findings: People with PD were 1.5 to 3 times more likely to be infected with H pylori than people without PD. Patients with PD and H pylori displayed worse motor functions than patients with PD who did not have H pylori. Eradication of H pylori improved motor function in patients with PD compared with patients whose infection was not eradicated.Eradication of H pylori improved levodopa absorption in patients compared with those whose infection was not eradicated.

Baloxavir Marboxil Appears Safe and Effective for Treatment of Acute Influenza: Baloxavir marboxil (BXM), an oral selective cap-dependent endonuclease inhibitor, is safe and effective for treating acute influenza in otherwise healthy patients, according to a study presented here at ID Week 2018, the 56th Annual Meeting of the Infectious Diseases Society of America (IDSA). 

Oral Vaccination for Influenza Is Protective: An oral vaccine to a prevalent influenza strain is protective and induces a mucosal immune response at least as good as a commercial injectable quadrivalent influenza vaccine, according to a study presented here at ID Week 2018, the 56th Annual Meeting of the Infectious Diseases Society of America (IDSA). 

Triple Combo Regimens May Address Cause of Cystic Fibrosis: Triple therapy with VX-659 or VX-445 combined with tezacaftor-ivacaftor shows promise for the treatment of adult patients with cystic fibrosis who have mutations in the cystic fibrosis transmembrane conductance regulator (CFTR), according to two studies published online Oct. 18 in the New England Journal of Medicine. The studies were published to coincide with presentation at the annual North American Cystic Fibrosis Conference, held from Oct. 18 to 20 in Denver. 

Limited Evidence for OTC Preps to Treat Nasal Symptoms of Colds: Limited evidence is available for over-the-counter (OTC) treatments for nasal symptoms of the common cold, according to a report published online Oct. 10 in The BMJ. For adults, low-quality evidence suggests that decongestants may have a small effect on nasal symptoms; however, harms include increased risk for insomnia, drowsiness, headache, or gastrointestinal upset, and long-term use can lead to chronic nasal congestion. No evidence of nasal symptom relief was seen for other commonly used OTC treatments. Evidence for common cold treatments is more limited in children, with trials lacking for children younger than 12. Low-quality evidence suggests that saline irrigations or drops may be effective and safe in young children. Evidence for decongestants is limited, and their safety is unclear, especially in young children. Serious harms have been linked to decongestant use in very young children. Adequate evidence is not available to support other commonly used OTC and home treatments. 

Hormone Therapy Not Beneficial in Subclinical Hypothyroidism: No benefit regarding quality of life or thyroid-related symptoms found for thyroid hormone therapy. Thyroid hormone therapy is not associated with improvements in general quality of life or thyroid-related symptoms in non-pregnant adults with subclinical hypothyroidism, according to a review published in the Oct. 2 issue of the Journal of the American Medical Association. 

Zoledronate Lowers Fracture Risk in Women With Osteopenia: The risk for fragility fractures is significantly lower in women with osteopenia who receive zoledronate than in those who receive placebo, according to a study published online Oct. 1 in the New England Journal of Medicine. 

ADA, EASD Issue New Recommendations for T2DM: Recommendations for the management of type 2 diabetes have been updated, according to a consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published online Oct. 5 in Diabetes Care.

Digital Cognitive Therapy Eases Daytime Effects of Insomnia: Digital cognitive behavioral therapy (dCBT) is effective in improving functional health, psychological well-being, and sleep-related quality of life in people reporting insomnia, according to a study published online Sept. 25 in JAMA Psychiatry. 

Albiglutide Beats Placebo for Cardiovascular Events in T2DM: For patients with type 2 diabetes and existing cardiovascular disease, albiglutide results in fewer cardiovascular events, according to a study published online Oct. 2 in The Lancet. In 2017, GlaxoSmithKline withdrew the glucagon-like peptide 1 (GLP-1) receptor agonist albiglutide for commercial reasons.

Gastric Banding, Metformin Similar for Improving Glycemia: In adults with moderate obesity and either impaired glucose tolerance (IGT) or recently diagnosed mild type 2 diabetes (T2D), gastric banding and metformin are similarly effective for slowing disease progression over a two-year period, according to a study published online Oct. 3 in Diabetes Care. Cataract Surgery Tied to Drop in Cognitive Decline in Seniors: Cataract surgery is associated with a reduction in the rate of cognitive decline among older adults, according to a study published online Oct. 11 in PLOS ONE. h Halobetasol Propionate Lotion Shows Efficacy for Tx of Psoriasis: Halobetasol propionate 0.01 percent lotion (BRYHALI Lotion) appears safe and effective for the treatment of moderate-to-severe plaque psoriasis, according to the results of two phase 3 trials published in the October issue of the Journal of Drugs in Dermatology.

OTHER

Sharp Drop in U.S. Life Expectancy Rankings by 2040: U.S. expected to fall from 43rd in 2016 to 64th by 2040, with an average life expectancy of 79.8. Drug-related deaths and obesity are believed to be major factors in the decline, CNN reported. There were 63,600 accidental drug overdose deaths in 2016, and nearly 40 percent of adults and 18.5 percent of children are obese. 

Violent Video Games Tied to Physical Aggression: A meta analysis, including multiple ages, nationalities and ethnicities found that playing violent video games is associated with subsequent increases in physical aggression. Proceedings of the National Academy of Sciences. 

Aetna-CVS Merger Approved: Under the approval, Aetna must sell off its private Medicare drug plans

Price Hikes Noted in Small Subset of Generic Drugs: A small but growing subset of generic drugs experienced sudden large price increases from 2007 to 2013, according to a study published in the October issue of Health Affairs. Most of these medications were initially low or medium in price and were not among the most widely used generics. There were modest changes in out-of-pocket spending for these drugs. The price elevation lasted for two to five years. Similar trends were seen with data for 2011 to 2015.

Take a Break: Halloween 2018 Make Spooky Candles

Candles are a must for Halloween. Below are lots of ways to spookify them.

Hand Candles 

Cut out Halloween themed items (pumpkin, black cat, bat) from sheets of colored wax (can be called Decorative Sheet Wax) and press onto a candle. Soften the wax sheets by warming them between your hands. You can use tiny cookie cutters to cut out the wax shapes. Warm them up a little bit before sticking them on the candle. 

Spooky Tall Glass Candles 

                                                    Paint them: You can use acrylics.

Make floating candles via Harry Potter, use the video above. You can also save time by wrapping the candle in white paper.

If you've been following the new series of Christine McConnell's Curious Creations on Netflix you may have seen her make a candle, then drip white wax onto it, ultimately carving a face into it. If not, check it out here. You don't have to start by making your own candle, just use a store bought one and cover with melted wax.

Decorate with napkins: While this video is for Christmas, the technique is the same. There are some great Halloween paper napkins out there. 

Life with Chronic Conditions: Vote!

With registration closing in, it’s important that people register and vote in the upcoming November 6th election. Research shows that people with chronic conditions, with the exception of cancer, are less likely to vote. With so much at stake that will directly impact people affected by chronic conditions it’s important to :

Register to vote: While all states but North Dakota require that you register to vote, there are differences in how states run elections. Voting rules vary by state. Register online at 37 states plus the District of Columbia. Register by mail by downloading the National Mail Voter Registration Form, which is available in nine languages  or go to the government’s Register to Vote” website.

Note that a number of states are blocking web traffic from foreign countries to their voter registration websites. This is being done to avoid “foreign interference” after Russia’s efforts leading up to the 2016 elections. NPR conducted a test and found that At least nine states — Kansas, Vermont, Oregon, Massachusetts, Tennessee, Kentucky, New Mexico, Georgia, and Pennsylvania — did not allow access from the international IP address, but allowed access from a U.S. IP address. NPR

Know how candidates are likely to vote on everything from Affordable Care to legalization of marijuana

Use Absentee Balloting: If you are concerned about not being well enough the day of the election to cast your vote, get an absentee ballot and turn it in. You can learn more about how to vote in your state by mail or absentee ballot by visiting your state or territorial election office and look for “Absentee Voting” or “Voting By Mail.” If you don’t see either term quickly, try using the site’s search tool. If your state requires a valid excuse to vote in this manner, know that having an illness, injury or disability

Vote and Encourage Others to Vote!