Monthly Archives: July 2013

Would You Get A Test Now That Confirmed a Fatal Illness Later?

A young Kristen Powers is held by her mother, Nicola, while her father looks on in the background. Nicola was later diagnosed with Huntington’s disease, a fatal illness. (Photo courtesy of Kristen Powers)

A young Kristen Powers is held by her mother, Nicola, while her father looks on in the background. Nicola was later diagnosed with Huntington’s disease, a fatal illness. (Photo courtesy of Kristen Powers)

By Ravali Reddy, Peninsula Press

If you had a 50-50 chance of inheriting a genetic disease, would you get tested to know? Or would you wait for fate to reveal itself years later?

Would your decision change if you knew the disease slowly takes away the ability to walk, talk, and even think?

What if there were no cure?

“I’ve always wanted to travel, and I knew that that was something I’d have to do earlier if I tested positive.”
Kristen Powers posed those questions aloud and then let them hang in the air as she spoke to a dozen middle and high school students. The slender, 19-year-old Stanford University freshman was taking part in a program where undergraduates teach classes on topics of their choosing. Today’s class — “To Test or Not to Test? The Ethics Behind Genetically Inherited disease” — covers a subject that Kristen knows far too much about.

“How many of you know what Huntington’s disease is?” she asked, only to find herself met with a mostly blank faces. Continue reading

Wife’s Illness Spurs Mexican Immigrant to Environmental Activism

Eduardo Guevara became involved in environmental activism after his wife was hospitalized twice for asthma. (Lisa Morehouse/KQED)

Eduardo Guevara became involved in environmental activism after his wife was hospitalized twice for asthma. (Lisa Morehouse/KQED)

Editor’s Note: The unincorporated community of Mecca in Riverside County has a host of environmental concerns, from well water with naturally-occurring arsenic to toxic dump sites. When people talk about environmental justice here, Eduardo Guevara is always cited as a leader in the community. But Guevara says that five years ago, after moving here from Mexicali, Mexico, he wasn’t involved in any kind of activism. After his wife was hospitalized twice for asthma, Guevarra learned that their environment might be contributing to his wife’s health problems. As part of our series “What’s Your Story?” we hear from Guevara about how he, his wife and his son started attending community meetings to get some answers.

Since no one had the [the answers as to why my wife got sick], I  started to try to get them for, not only for me, but for her, and for my son.

I started being the guy that sometimes asked the questions nobody wanted to ask. They saw me and they were like, “Oh my god, this guy again.”
And then we went to a meeting, where the Air Quality Management District was at the panel, and out of nowhere the kid is like, “You know what? I saw a kid reading a letter. I’m going to write one, and then I’m going to read it.” You know, my son.

And he took the letter, went to the microphone, read it aloud. He said, “Hi, I’m Eduardo Guevara. I think that the government has to do something about the toxic things that they throw in Mecca. I am worried for my mom because she had asthma and because of those smells she could get asthma again. Thank you.” Continue reading

Good Read: Undocumented Immigrants Left Out of Health Reform

Undocumented immigrants are not eligible for any of the benefits under the Affordable Care Act, and in California, that’s roughly one million people. When they get sick, they fare as best they can in safety-net providers including community clinics and ERs. Funding care for this population has always been a challenge and will continue to be so after January 1.


Juan Jimenez has kidney disease and his lab results are getting worse. Suzanne Powell, his family physician at La Clinica de la Raza in Concord – about 20 miles east of Oakland – is out of answers. She needs to get Jimenez to a specialist.

Read more at: www.californiareport.org

With Lax Oversight, Fraud Flourishes in California’s Drug Rehab Clinics

A receptionist at Pride Health Services in Inglewood, Calif., said there were no counseling sessions on April 3. But the clinic billed taxpayers about $1,600 for serving 60 clients that day, records show. (Photo/CNN)

A receptionist at Pride Health Services in Inglewood, Calif., said there were no counseling sessions on April 3. But the clinic billed taxpayers about $1,600 for serving 60 clients that day, records show. (Photo/CNN)

By Christina Jewett and Will EvansThe Center for Investigative Reporting

Addiction counselor Tamara Askew discovered something wrong soon after she started working at Pride Health Services, an Inglewood rehab clinic.

Askew grabbed a stack of files and began contacting patients to introduce herself. That was harder than she had figured.

Some were in jail, Askew said. Several never showed up. One was dead.

Her boss, she said, wanted to bill the government anyway, for counseling addicts she never saw.

“He basically said, ‘How do you think you’re going to get paid?’ ” Askew said.

They lure patients in from the street by handing out cash, cigarettes and snacks. They have patients sign in for days they aren’t there.
Pride Health Services specializes in billing for “ghost clients,” fabricating paperwork for patients who don’t actually come in, according to former employees and whistle-blower complaints.

It is part of a rehab racket – a pattern of fraud by rehabilitation clinics that collect government funding to help the poor and addicted, a yearlong investigation by The Center for Investigative Reporting and CNN has found.

Thousands of pages of government records and dozens of interviews with counselors, patients and regulators reveal a widespread scheme – concentrated in the Los Angeles region – to bilk the state’s Medicaid system. Continue reading

A Daughter Struggles to Make Sense of PTSD

A commemorative Army dog tag similar to the one worn by Caitlin's father, was designed by her aunt and passed out at Richard Bryants' funeral service. Caitlin recently had a tattoo artist replicate one on her foot. (Photo by: Margarita Brichkova)

A commemorative Army dog tag similar to the one worn by Caitlin’s father, was designed by her aunt and passed out at Richard Bryants’ funeral service. Caitlin recently had a tattoo artist replicate one on her foot. (Photo by: Margarita Brichkova)

Twenty-one-year old Caitlin Bryant lost her father, Richard Lewis Bryant, to a heart attack in 2008. But she and her brother Mitchell had grown up watching him battle a war within himself after returning from serving in Vietnam. As part of our first-person series What’s Your Story, Caitlin Bryant describes what her family’s life was like, living with her father’s illness.

My dad suffered really badly from PTSD -– post-traumatic stress disorder. And that was due to the traumatic things that he had seen in the war and he never really sought proper treatment.

“He tried committing suicide when I was 11 years old. And we saw it as a huge cry for help because he did it in the parking lot of the VA hospital.”
He just never seemed comfortable. He never seemed at peace. He always seemed like he was trying to relax and he could never fully relax.

He started doing a lot of drugs –- specifically speed -– to kind of alter his reality and see a different side of things from the war.

He tried committing suicide when I was 11 years old. And we saw it as a huge cry for help because he did it in the parking lot of the VA hospital in Loma Linda.

They put him in the psychiatric unit of the hospital for a week. He kind of just tried to laugh it off and play it off with me and Mitchell saying, “Do you really think I belong with these crazy people here?” You know like, “Ha, ha ha.” Continue reading

Cutting Down on Cancer Overdiagnosis: National Panel Weighs In

Ductal carcinoma in situ seen under a microscope. While doctors also call it Stage 0 Breast Cancer, in an article Monday, doctors argue it should no longer be labelled "cancer." (Ed Euthman/Flickr)

Ductal carcinoma in situ as seen under a microscope.  Doctors also call D.C.I.S. “Stage 0 Breast Cancer.” But in an article Monday, a panel of national scientists argue it should no longer be labelled “cancer.” (Ed Euthman/Flickr)

What power does a word have? If the word is “cancer,” for most people it packs a wallop of emotion ranging from general anxiety to abject terror. For the last 30 years, a large industry has grown and developed with a focus on awareness and screening. The goals were laudable: get screened; catch cancer early; early diagnosis means patients dodge a death sentence.

There’s just one problem. It’s not working. This notion of screening was dependent upon the understanding of cancer 30 years ago: that cancer started from a tiny seed and steadily grew and spread until – without treatment – it killed the patient.

But today scientists know that not all cancers behave this way. Some are fast-growing, some may grow slowly, but progressively. But others are “indolent,” so slow-growing, they will never cause the patient harm.

So what certain cancer screening tests have wrought (think mammography, PSA tests) is a dramatic increase in diagnosis of early-stage disease without a corresponding decline in death rates from cancer or diagnosis of late-stage disease. Many of these early stage patients are likely “overdiagnosed” and then “overtreated” — for cancers that may never have grown and spread.

“We terrify (women) with D.C.I.S. thinking they have cancer. We could wait six months to see if something changes without making people hysterical.”
Against this backdrop, the National Cancer Institute called together a group of nationally recognized cancer doctors and researchers to review the evidence on overdiagnosis. In a Viewpoint published Monday in JAMA, the panel calls for major changes in the way the medical world classifies and thinks of “cancer” and the way screening programs are designed.

“This article is really critical for laying the ground work for introducing what I hope will be groundbreaking changes in screening and prevention,” said lead author Dr. Laura Esserman, director of the breast care center at UC San Francisco. Continue reading

Why Mosquitoes Love Us and How We Can Fight Back

(Getty Images)

Mosquitoes are especially attracted to pregnant women and people drinking alcohol. (Getty Images)

The state has confirmed the second West Nile virus case this year, and the Los Angeles Times reports that county officials say two adults are hospitalized there with the virus as well.

Every summer, West Nile moves across California, spread by mosquitoes. The insects pick up the virus when they feed on infected birds — then spread West Nile to humans when they munch on us.

“They will fly towards carbon dioxide, and so in a lot of cases in the backyard that’s you and me.”
Avoiding mosquito bites is ideal for lots of reasons besides West Nile. What repellents are best? And why do mosquitoes seem to prefer some people over others? NPR’s Shots blog posed those questions and more to Dr. Roger Nasci, chief of the branch of the Centers for Disease Control and Prevention that tracks insect-borne viruses. Here’s the Shots Q&A: Continue reading

Binge Drinking on Rise in American Women

(Getty Images)

The Centers for Disease Control defines binge drinking in women as 4 or more drinks during one occasion. (Getty Images)

Over on Facebook, the group Moms Who Need Wine has more than 660,000 likes. While most of the posts there seem pretty darn cheerful, they point to a darker reality. Alcohol abuse in women is on the rise. And a specific problem for them is binge drinking, as the Centers for Disease Control reported earlier this year.

In the report, the CDC found that 1 in 8 women over age 18 — that’s 14 million women — binge drink about three times a month. Binge drinking is defined as four or more alcoholic beverages in a two to three hour period. One in 5 high school girls binge drink.

Dr. Bob Brewer who leads the Alcohol Program at the CDC’s National Center for Chronic Disease Prevention framed the public health costs of alcohol consumption for a KQED Forum audience recently. It’s the third leading cause of preventable death in the U.S., with an estimated 80,000 deaths and 2.3 million years of life lost every year linked to excess drinking, he said.

But within that excess drinking, it’s the binge drinking that is really taking a toll. “We know that binge drinking is by far the most common pattern of excessive drinking in the United States,” he said, responsible for half of those 80,000 deaths. Continue reading

No Wonk: How Obamacare Subsidies Work for Consumers

By Julie Appleby, Kaiser Health News

subsidies key 300Tax credits to help low- and moderate-income Americans buy health insurance will become available in January under the health law, when for the first time, most people will be required to have coverage or pay a fine.

The process could be complicated for some consumers, but information about how the system will work may help.

Cathy Livingston, a lawyer in Washington, D.C., who specializes in tax issues involving the federal health law, spoke recently with KHN about how to find out if you’re eligible for a premium subsidy and how the process will work. Before joining the law firm, Livingston worked in the Office of Chief Counsel for the IRS.

The credits are available to people who don’t get what is considered affordable, comprehensive coverage through their jobs, and whose household income is less than 400 percent of the federal poverty level, which this year is about $46,000 for an individual, or about $78,000 for a family of three. (Families USA has a great chart so you can match up your household size and income to see if you are under 400 percent of poverty.)

Most of the 7 million people projected to shop for coverage in new online health insurance marketplaces, also called exchanges, will be eligible for the subsidies, expected to average $5,290 per enrollee.

People who don’t have insurance coverage could face fines, which are $95 per adult and $47.50 per child the first year, or 1 percent of family income, whichever is greater. The fines will rise in later years.

Here is an excerpt, edited for length and clarity, of Livingston’s conversation with KHN staff writer Julie Appleby.

Q: The law bases eligibility on household income. What does that include? Continue reading

How Watsonville Program Helps Latino Immigrants Manage Their Diabetes

By Vinnee Tong, KQED

Abel Corona having dinner in his Watsonville home. He is more careful about his diet since he was diagnosed with diabetes. (Vinnie Tong/KQED)

Abel Corona having dinner in his Watsonville home. He is more careful about his diet since he was diagnosed with diabetes. (Vinnee Tong/KQED)

Abel Corona sat down to dinner and scrutinized the steak his wife had cooked for him.

“It’s hard to measure the portions,” he says in Spanish. The steak was extremely thin but still, he seemed to have a sense of guilt about it.

The focus on portion sizes comes, in part, as a result of his new efforts to manage his diabetes.

Corona, a Watsonville resident, was diagnosed about a dozen years ago, but didn’t do much to improve his health until 18 months ago when he started seeing a new doctor and, perhaps most importantly, started attending weekly group classes in diabetes education.

That’s where he’s been hearing a lot about portion sizes.

In Santa Cruz County, home to Watsonville, diabetes rates are 75 percent higher for Latinos than than they are for whites.
The class is run by a Watsonville health clinic, Salud Para la Gente – Health for the People — as part of a program called Project Dulce. On a recent Thursday evening, Abel joined about a dozen others in a multi-purpose conference room at the nearby Muzzio Community Center.

Nick Sandoval conducts the classes in Spanish. Sandoval blends cultural references, like folk tales, with a dash of humor to teach the classes. One recent class touched on a variety of subjects, from hypertension to cholesterol and basic nutrition. Continue reading