For Better Health May 2018

For Better Health

THE NEWTOWN BEE, FRIDAY, MAY 18, 2018

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Falls And The Elderly: Potentially Fatal, But Most Are Preventable

By Shannon Hicks The US Preventive Services Task Force (USPSTF) recently published recommendations to prevent falls in older adults.

In a feature published in the April 24, 2018 Journal of the American Medical Association (“Prevention of Falls in Older Adults”), Jill Jin, MD, MPH, says falls “are the leading cause of injury in adults aged 65 years or older.”

William V. Begg III, MD, FACEP, vice chair of Danbury Hospital Emergency Department, concurs.

Danbury Hospital data, he said, indicates that 50 percent of the injured patients who arrive at the hospital are age 65 or older, and they are “most commonly injured from a simple fall from standing.”

Many have a long recovery and struggle to return to their previous level of independence, the local hospital’s data also shows. In her April article, Dr Jin agreed, saying a serious fall can result in decreased functional independence and quality of life.

According to the Centers for Disease Control and Prevention (CDC), more than 25 percent of older people fall each year, but less than half tell their doctor. And falling once doubles the chance of falling again, the agency reports.

The good news is, there are simple steps most can take to reduce the risk of falls.

Injuries & Resulting Concerns According to USPSTF, the risk of falling increases with age for many reasons, including overall weakness and frailty, balance problems, cognitive problems, vision problems, medications, acute illness, and other environmental haz-

ards.

The most common injuries for those 65 and older are hip fractures, head injuries, and rib fractures. More than 95 percent of hip fractures, according to the CDC, are caused by falling, usually by falling sideways.

Nationally, half the people who break their hip die within a year. Many, according to the CDC, are not able to live on their own again.

There are a number of reasons this happens, according to Dr Begg.

“One of the main reason is, when you’re unable to move around like you previously had done, you’re at increased risk for a number of illnesses, including blood clots, because you’re immobile,” Dr Begg said.

Pneumonia — an infection of one or both lungs — often follows a fractured or broken hip, he said, “because you’re not moving around, you’re not using your lungs as much” as you had been before the fall, when breathing was not such an effort.

Patients recovering from that type of injury are also at risk for severe infections, he said, “either from not moving too much, bed sores, skin breakdown, urinary infections, and the like.”

In addition, those who had previous medical issues before a fall that injures their hip have additional concerns.

“When people get hip fractures and they weren’t doing well otherwise,” said Dr Begg, “that can be the final medical issue they have.

“You could have a heart attack and fall down, or a stroke and you went down, or your blood sugar was out of control, or blood pressure out of control — so there’s other medical issues that lead to having a hip fracture, and then those medical issues are out there and still

Dr William Begg, vice chairman of Danbury Hospital Emergency Department, has seen falls ruin the lives of multiple elderly patients during his 25 years of medical practice.

—Photo courtesy Danbury Hospital/Western Connecticut Health Network need to be addressed,” he explained.

Blood thinners do not mix well with falls and the elderly.

Blood Thinner Dilemma Of all the things that have changed in recent years, Dr Begg, said, there has been “a significant [increase] in the number of serious head injuries, including bleeding on the brain, due to blood thinners.”

When someone who is not on blood thinners has a fall and bumps their head, they

will most likely have a bruise on the outside of the head. Falls, according to the CDC, are the most common cause of traumatic brain injury.

For those on thinners, however, “when you fall, you’re probably going to bruise inside your head, and that’s bleeding on the brain, which is in the family of a stroke,” Dr Begg explained.

Normally, people have vessels that move blood to and from their brain.

“When you fall and you’re on blood thinners,” Dr Begg

said, “those vessels can break.”

When the brain swells, it squeezes brain tissues, “and that’s when people cannot think well, or pass out, or actually die from the swelling,” he added.

Rib fractures come into play due to how they affect the lungs.

“Say you’re a high school kid and you’re playing soccer or football, and you fall on your ribs,” Dr Begg said.

“They’re pliable — they bend; they don’t break.”

Fast forward a half dozen decades, and those ribs are no longer pliable.

“They break, and they break in numbers, sometimes four and five at once,” Dr Begg said.

When ribs break, lung tissue is also injured, which increases the risk of pneumonia.

“When your ribs are injured, you don’t want to take a deep breath,” he explained, “and that’s when bacteria sets in. And that’s when you can get pneumonia.”

Many people who fall, even if they do not get injured, become afraid of falling again. This, according to the CDC, may cause a person to cut down on their everyday activities. Ironically, when that happens — when a person becomes less active — they become weaker, and therefore more prone to a fall.

Preventive Steps Fortunately, there are easy ways to prevent falls. There are also things that can be done to lessen the extent of an injury from a fall.

Dr Begg sees at least two different subsets of things people can do to begin fall prevention measures: “Take care of yourself, and take care of your home,” he said.

“As you get older,” said Dr

Begg, “people need to reevaluate their lifestyle choices, whether cycling, hiking, or other activities. Your body changes, and you cannot maintain the exact same activities without realizing that you may not be able to tolerate it all as well.”

Eyesight and hearing also evolve with age, as do dosages for medications.

“If you are on the same blood pressure medication for years, and you don’t need as much as when you began taking it, your blood pressure can be off, and you can fall,” said Dr Begg, who suggests everyone checks in with their physician to reassess prescriptions.

“You may not need the same dose of blood thinners, or cholesterol medications, or any of them,” he said, “and those are good things that need to be evaluated.”

A new generation of blood thinners allows doctors to consider different approaching for bleeding risks, Dr Begg mentioned.

“That’s why a medical evaluation is so important,” he said.

On the flip side, he added, more people are exercising these days, especially stretching, which keeps them limber and decreases the chance for a fall.

A lot of things can be done at home. Danbury Hospital has a list of simple things that can be done around any home to lessen the risk of a fall. (See sidebar.)

“People have a tendency to have cluttered homes, or apartments, and that’s one of the worst things you can have,” Dr Begg said. “Clutter increases the risk for tipping. Or even when you lean over to grab something, you can fall over.”

Falls and injuries from them are not relegated to ( continued on page C - 3 )

Fall Prevention Tips

Many falls do not cause injuries, including for those age 65 and older.

According to the Center for Disease Control and Prevention (CDC), however, one of five falls does cause a serious injury such as a broken bone or head injury.

The CDC and Danbury Hospital offer the following fall prevention tips: *Ask your doctor or healthcare provider to evaluate your risk for falling, and talk with them about specific things you can do. *Ask your doctor or pharmacist to review your medicines to see if any might cause dizziness or sleepiness. This should include prescription and over-the-counter medications.

According to Danbury Hospital staff, blood thinners, including Aggrenox, Brilanta, Coumadin, Effient, Eliquis, Lovenox, Plavix, Pradaxa, and Xarelto, are particularly high risk following a fall. *Have a yearly exam of your hearing. *Ask your doctor or healthcare provider about taking vitamin D supplements. **(see note below) *Do exercises that make your legs stronger and improve your balance.

Tai chi is a good example of this kind of exercise. *Have your eyes checked by an optometrist at least once a year, and update eyeglasses if needed.

For those who wear bifocal or progressive lenses, consider a pair of glasses with only the distance prescription for outdoor activities such as walking. These types of lenses can sometimes make things seem closer or farther away than they really are. *Get rid of things than can be tripped over. Move items off the floor that can cause trips (shoes, newspapers, books, etc). *Add grab bars inside and outside the tub and shower and next to the toilet. *Use nonslip mats in the bathroom and on shower floors. *Remove small throw rugs or have them taped down. *Have broken or uneven steps repaired. *Put railings on both sides of stairs. *Have plenty of lighting, including brighter light bulbs. *Keep items commonly used in close reach to avoid bending over or standing on a stool to reach them. *Wear shoes at all times, and avoid slippers or going barefoot. *Do not walk while using a cell phone. Doing so can increase the risk of falling, as one hand will be using the phone. *Put a phone near the floor in case you fall and cannot get back up. *Keep emergency numbers in large print near each phone. *Consider a personal alarm device that will bring help in the event of a fall when no one is around to offer help. *Keep in mind that bad weather increases the chance of falling around the home.

Most falls, according to the CDC, are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling. **Interestingly, while Vitamin D has long been thought to be associated with strengthening bones, Dr Jill Jin’s April 24 JAMA article supports research published in December 2017, also by JAMA, that says the use of supplements that included calcium, Vitamin D, or both “was not associated with a significant difference in the risk of hip fractures with placebo or no treatment” (“Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults,” Jia-Guo Zhao, MD; Xian-Tie Zeng, MD; Jia Wang, MD; et al). “Community-dwelling” refers to people who continue to live at home, not in a nursing home or other institutional setting.

The USPSTF, Dr Jin pointed out, did not recommend Vitamin D supplementation. It did recommend exercise and “multifactorial interventions,” dependent on each patient’s situation.

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Is The Way You Sit Causing All That Back Pain?

WEST ORANGE, N.J. — The body’s natural instinct is to move. Yet various studies have found that an American adult spends from eight to ten hours a day sitting.

According to Dr Kaliq Chang, interventional pain management specialist at the Atlantic Spine Center, we are so sedentary that a sixty-minute workout isn’t enough to compensate for that inactivity.

“Our bodies are designed for regular movement,” he says. “Long periods of sitting every day can impact your health and comfort in many ways, not least of which is that you are sure to suffer from a stiff neck, tight shoulders, and back pain.”

Many of us become accustomed to daily aches and pains, and when the pain flares up, we treat it with rest or take an anti-inflammatory pill.

But the problem is cumulative: As the working day stretches beyond eight hours, and the commute becomes longer, and we sit in front of a television or computer screen for hours of our leisure time, our backs suffer from the lack of support and movement and pain becomes chronic.

So why is sitting so bad for your back?

Sitting may naturally feel more comfortable than standing but sitting puts nearly twice the stress on the spine as standing. Hunching in front of a computer increases the pressure even more, as hunching pushes the back into a convex or “C” shape that fatigues and overstretches the ligaments.

When we move, the discs in the back expand and contract, allowing them to absorb blood and nutrients so they can act as shock absorbers. When we don’t move, when we sit locked in one position for hours, the discs are starved of nutrients.

“The discs have no blood supply of their own,” says Dr Chang. “The only way they can absorb nutrients is through spinal movement. Sitting deprives them of nourishment, and they become compressed, lose flexibility over time, and are more easily damaged.”

Sitting makes the back additionally vulnerable by reducing muscle support.

When you sit, the muscles that normally

support the body’s upright standing posture are no longer needed.

They stop supporting the lower back, causing an imbalance in the weight on the discs and precipitating a bulge, which becomes painful when the bulging disc presses on a nerve.

“Considering the damage inflicted on the back by long hours of sitting,” says Dr Chang, “it’s not surprising that eight out of ten Americans suffer from back pain at some point in their lives.”

How can you reduce back pain from sitting?

“You can reduce the back pain caused by sitting by improving your physical conditioning and by altering your sitting habits,” says Dr Chang. “A back that is strong and well-conditioned through exercise can withstand the stresses of sitting and protect the spine better than a back that has not been conditioned. And making some simple changes to how you sit can reduce pain and forestall problems.”

Dr Chang makes the following recommendations: *Engage in a conditioning program that strengthens the spinal column and the supporting muscles, ligaments, and tendons. Make sure your exercises

focuses not only on the back, but also the abdominal, gluteus, and hip muscles. These core muscles provide strong support for the spine, keeping it in alignment and facilitating movements that extend or twist the spine. *Get up from your desk every 20-30 minutes and walk down the hall to get a cup of coffee or visit a colleague or send a fax... Put your hands at the small of your back and bend back slightly to help relieve the pressure and compression on the discs from sitting. *Try a standing desk or, even better, a treadmill desk.

“You can think of lower back pain as a signal that you’re countering the body’s natural instinct to move,” says Dr Chang. “The best way to relieve sittingrelated pain is to move more. You don’t have to run three miles on your lunch hour, but it might be a good idea to set an alert to remind you to get out of your chair on a regular basis. Your back will thank you.”

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Skin And Hair Changes During Pregnancy: Tips On What To ‘Expect’ NEW YORK, N.Y. — Expecting a baby?

You’d better expect the possibility of some fairly noticeable changes in your skin and hair as well — some that should resolve after pregnancy and others that remain, according to Maternal Feta Medicine Specialist, Kecia Gaither, MD. “Most pregnant women focus mainly on that little bundle that awaits them after nine months, even as they realize that pregnancy isn’t usually a breeze for them physically,” says Dr Gaither. “However, they may not anticipate just how pregnancy might impact their hair and skin. The fact is, most women experience changes in both — and even their fingernails — while they’re expecting.”

“The good news is that most of these hair and skin changes go away after the baby arrives,” she added.

Hormonal changes and increased blood flow during pregnancy often prompt one skin change that women are entirely pleased with: a rosy complexion known as that “pregnancy glow.” But some of the other skin changes that might develop are not as welcome, Dr Gaither notes.

These include: *Stretch marks: Known medically as striae gravidarum, stretch marks are perhaps the best-known — and most feared — skin change women experience while expecting. They can develop not only on the belly, but on the breasts, hips and buttocks as your body expands.

“Avoiding excessive weight gain during pregnancy can minimize the possibility of getting stretch marks,” she says, “but you won’t necessarily be able to prevent them entirely. Lotions and oils claiming to reduce them can’t really stop stretch marks from

Got Health News?

Are you a health and wellness practitioner or physician who resides in Newtown? Or do you maintain an office in Newtown or practice locally?

The Newtown Bee’s Health Page is a great place to promote the healing work you do, share your story, wellness advice, or health care tips on a wide variety of issues.

Put The Bee’s Health Page editor on your e-mail distribution list, or contact the newspaper with ideas for features or profiles on health professionals, procedures, events, new technology, and other related news about your practice.

Contact Associate Editor John Voket by e-mailing: john@thebee.com — or call 203-426-3141.

forming.” Appearing red, brown, or purple during pregnancy, stretch marks typically fade afterward and become less noticeable over the years, though they never disappear. *Chloasma: Brownish or yellowish patches that form on the skin around the eyes, cheeks and nose, chloasma is also commonly referred to as the “mask of pregnancy.” These patches are typically triggered by changing hormone levels, but sun exposure also contributes, Dr Gaither says. “Wearing sunscreen and a sun hat are good tactics to protect your skin and may minimize your chances of developing chloasma,” she adds, noting that these spots also tend to fade or disappear after childbirth. *Linea nigra: A dark line extending down the center of the lower abdomen, linea nigra doesn’t appear on every pregnant woman, Dr Gaither says.

“It’s less common than stretch marks and chloasma,” she explains. It resolves in the months after delivery. *Rash: An itchy, bumpy, red rash, especially in the last trimester of pregnancy, affects a minority of women, Dr Gaither says. Typically developing on the belly, the rash may also extend to the thighs, arms, and but-

tocks. “Talk to your doctor about safe ways to deal with the itch and relieve your symptoms,” she advises.

During pregnancy, hair typically remains in the “growth phase,” meaning your mane is likely to grow and thicken luxuriously, Dr Gaither says. But this growth phase also extends to other body hair, which isn’t necessarily as desirable. And after delivery, the trend abruptly changes.

“Just after childbirth, many women experience hair loss, since the growth phase stops,” she says. “While worrisome, hair loss tends to taper off within about six months after giving birth.”

Perhaps less noticeable to some women are fingernail changes that occur while expecting.

“Some women find their nails become much stronger, while others report their nails become brittle or softer,” she explains.

In a nutshell, you’re likely to experience some skin, hair and nail changes during pregnancy, but exactly which ones differ for each woman.

“Some women love the way they look during pregnancy, reporting their skin and hair are better than ever,” explains Dr Gaither, who regularly lends her commentary and expertise on issues pertaining to women’s health, pregnancy, and public policy to leading national outlets. “But regardless of any skin or hair changes they experience, most are temporary, and they can expect to resemble their normal selves sometime after giving birth.”

Kecia Gaither, MD, MPH, FACOG, a perinatal consultant and women’s health expert, is a double board-certified physician in OB/GYN and Maternal-Fetal Medicine in New York City.

For more information, visit keciagaither.com

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As demonstrated by this chart, the rate of death following unintentional falls increases exponentially with aging, regardless of gender or race. In 2005, an average of 41 people (left column) per every 100,000 elderly (age 65+) people who fell ultimately died from the fall or resulting issues. By 2014 the average had increased to 58 per every 100,000 elderly fall patients.

—CDC/WISQARS infographic

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Falls And The Elderly: Potentially Fatal, But Most Are Preventable ( continued from page C - 1 ) the elderly, Dr Begg pointed out. Younger generations are also prone to injuries when they lose their balance, especially when something is added to their dietary intake.

“As far as younger folks go, when you mix alcohol or drugs, that also increases your risk for falling,” Dr Begg said. “It’s the weekend, you have a few cocktails, and then you trip and fall. That’s one of the most common injuries we see: nights, holidays and weekends, people will fall when they have alcohol or

drugs in their system.”

Dr William Begg is vice chairman of Danbury Hospital Emergency Department; EMS Medical Director of the hospital; and immediate past president, Danbury & New Milford Hospital Medical Staff.

He earned his medical degree at New York Medical College, did his residency in emergency medicine, at The Johns Hopkins University, and has been in practice for 25 years. He is one of 33 doctors at Danbury Hospital who specialize in Emergency Medicine.

Four Ways To Help Your Child Deal With Stress PLYMOUTH, MINN. — Adults often complain they are “stressed out.” But increasingly, statistics show, American children are stressed out as well, and the effects on their health, emotional state, and cognitive ability can be significant.

It’s well-documented that adult stress can lead to serious illnesses. But many researchers believe that ongoing stress during childhood — from poverty, parents fighting, substance abuse, bullying, violence or other adversity — can harm children’s brains and other body systems and possibly lead to major health issues when they are adults.

Therefore, it is vital for parents to help their children cope with stress.

“Adults can handle more stress than children, because our brains are already formed and we have many more coping skills,” says Alise McGregor, founder of Little Newtons (www.littlenewtons. com), an early education center with locations in Minnesota and Illinois. “Research shows there are lasting effects from stress on a child’s development. Not exposing your child to any stress at home,

of course, is ideal, but in today’s world there is so much affecting kids that parents need to know how to help them through it.”

Statistics cited in a greatschools. org article reflect the higher levels of stress that American children are experiencing: suicides among adolescents have quadrupled since the 1950s; and in the past decade, using pharmaceuticals to treat emotional disorders has increased 68 percent for girls, 30 percent for boys.

Ms McGregor suggests four ways parents can help their children cope with stress: *Listen to them and communicate. “By listening to them, you are acknowledging their feelings but also strengthening the trust/ bond you have with your child,” McGregor says. “Trust is so important in childhood. They feel supported and feel better being able to get it off their chest.” *Exercise. This is easy, fun and often necessary as a coping mechanism. “Children who are physically active release stress as well as build confidence,” McGregor says. “And they sleep better, which in turn makes them better equipped to take on their day.”

*Take care of yourself, slow down. Children are aware of their surroundings and look to their caregiver for support. “If a caregiver is not fully equipped to handle their own stress, they certainly can’t fully support a child,” McGregor says. “We often are in such a hurry that many of the basic necessities of care-giving are rushed through. Children can feel the stress caregivers are experiencing and often will act out.” *Teach them relaxation techniques. Just as parents teach children how to throw a baseball or build a tower with blocks, they should also teach them how to cope with stressful situations in life, McGregor says. “There are ways to do this, such as count down from ten, or ‘breathe in the soup, blow out the soup.’ It slows down their ‘hyperstate’ of accelerated heart rate and fast breathing.”

“Most parents have the skills to deal with their child’s stress.

She said the time to seek professional help for a child’s stress is when any change in behavior persists, or when the stress is causing problems at home or school.

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School eye exams are only screenings and do not test for everything. They may test for distance vision in each eye separately, but do not test for near vision (reading) or how the two eyes work together as a unit. According to Prevent Blindness America, vision problems affect one out of every four school-age children. "If a child is struggling in school, it may well be an indication of a vision problem," says Dr. Joseph Young of Village Eye Care. Dr. Young tests for ocular problems that can impact learning and development. He also stresses the importance of proper eye movements, and the ability to read and comprehend. We have worked with many children whose reading and writing skills have greatly improved.

Another concern for parents is sports vision. According to Prevent Blindness America, there are 40,000 ocular sports related injuries per year. Dr. Young has many solutions for your "sports child", from contacts to REC SPECS Sports Eyewear.

Please visit our web site for more information, and we hope you see that an eye exam is part of "getting your child ready for a great school year!"

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THE NEWTOWN BEE, FRIDAY, MAY 18, 2018

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New Scanner At CT Eye Care Simplifies Retinal Screening

By Andrew Gorosko To keep in step with advancing technology, CT Eye Care has acquired a laser scanner that simplifies the photography of patients’ retinas. Through that diagnostic technique, optometrists learn of possible problems with the retina, the light-sensitive tissue at the rear of the eye that makes vision possible.

The retina has been compared to photographic film in a conventional camera, or the sensor in a digital camera. From the retina, neural impulses are transmitted via the optic nerve to the brain, where visual perception occurs.

Hang Nguyen, OD, is the proprietor of CT Eye Care. Earlier this year, Dr Nguyen took over the optometry practice at 14 Church Hill Road, which formerly was known as Moore & McGlynn Eye Care.

CT Eye Care recently acquired the Optos Daytona Plus, a laser scanner that is used to screen for retinal abnormalities and possible vision problems. From a patient’s perspective, the device simplifies the retinal screening process. The scanner, which uses red and green lasers, captures an ultra-wide 200-degree view of the retina in a single high-resolution image in less than one-half second.

The device is used in the detection, evaluation, and monitoring of various types of retinal problems, of which there are many.

In a comprehensive eye examination, the scanner is used to initially detect any retinal problems, Dr Nguyen said. If problems are found, the patient’s eyes would then be dilated as needed to allow further inspection, she added.

Dr Nguyen said that following retinal scans, she shows her patients images of their retinas to illustrate what is happening within their eyes.

“It makes it simpler,” she said, of the new scanner.

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For more information or to make an appointment with Dr. Andrea Russo call:

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Dr Hang Nguyen, the optometrist at CT Eye Care, is seen with a recently acquired retinal scanner known as the Optos Daytona Plus. The device simplifies retinal scanning for patients being examined for possible eye problems.

—Bee Photo, Gorosko

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Care, where the retinal scanner is housed, has a variety of reference photographs and illustrations on display so that patients can compare their retinal images with those of damaged or diseased retinas. The room contains other exam equipment that calculates the surface curvature of an eye’s cornea, and also gauges a person’s field of vision.

Besides conducting comprehensive eye examinations, Dr Nguyen prescribes eyeglasses, contact lenses, and specialty contact lenses. Eye problems addressed include glaucoma, macular degeneration, diabetes, hypertensive retinopathy, red eyes, and dry eyes.

As an optometrist, Dr Nguyen does not perform eye surgery on patients, instead referring patients to medical specialists known as ophthalmologists for surgical procedures.

She finds her work as an optometrist most gratifying by being able to help people with eye problems. “It’s great,” she said.

Dr Nguyen treats patients from age 7 to the elderly. As part of her work, she provides patients with recommendations on how best to care for their eyes. Besides the doctor, the optometry practice is staffed by two medical technicians and one optician.

Dr Nguyen received a Bachelor of Science degree in biochemistry at the University of Nebraska, after which she received her Doctor of Optometry degree at the Rosenberg School of Optometry in San Antonio, Texas, in 2015. After her graduation, she had a one-year residency at VA Connecticut Health Care System, a veterans hospital in West Haven.

During her residency, she trained in areas including ocular disease and low-vision rehabilitation. Dr Nguyen has a special interest in myopia control, corneal refractive therapy, and specialty contact lenses for ocular surface diseases.

Learn more at cteyes2020.com or call 203-426-2727.

Drug-Price Transparency Bill Passes Legislature With No Dissent

By Mackenzie Rigg — Connecticut Mirror A bill designed to help Connecticut officials peer into the black box of drug pricing won final approval from a unanimous state Senate early Wednesday, May 9. Proponents of the measure called it a necessary first step toward curbing expensive prescription drug prices.

Approval also was unanimous in the House, and the bill now heads to Governor Dannel Malloy’s desk.

“One of the issues that we hear time and time again in the insurance committee is the cost of health care,” said Senator Kevin Kelly, R-Stratford, Senate Republican chair of the Insurance and Real Estate Committee, during debate on the bill. “One of the biggest drivers of cost is the prescription health pricing.”

“This bill is designed to bring transparency to that process and, armed with that information, we hope that we will be able to bring the cost of pharmaceuticals in Connecticut under control,” Sen Kelly said.

Two of the bill’s key supporters, Comptroller Kevin Lembo and Rep Sean Scanlon, D-Guilford, House chair of the insurance committee, celebrated its final passage.

“This is an extraordinary victory for Connecticut patients who pay outrageous prices at the counter, while powerful corporations are enriched by big discounts,” Mr Lembo said.

Rep Scanlon added the Senate’s approval brought the state “one step closer to finally holding drug companies accountable for large price increases and attaining our ultimate goal of lowering prescription drug costs for Connecticut families.”

The bill, which goes into effect on January 1 , 2020, requires industry players to disclose a wide range of information to the state. Those affected include drug companies, health insurers, and lesser-known entities called pharmacy benefit managers, known as PBMs, which manage drug benefits for insurers.

Under the bill: *Drug companies will have to justify increases when a drug’s price jumps more than 20 percent in one year or 50 percent over three years to the new Office of Health Strategy (OHS). *Drug companies also will have to report information about drugs going through the US Food and Drug Administration’s approval pipeline, such as the estimated year that the drug will enter the market. *Insurance companies, when filing rate requests for their health plans each spring, will have to tell the state Insur-

ance Department the 25 drugs with the highest cost to the plan; the 25 drugs with the greatest year-over-year price increases; the 25 drugs most frequently prescribed; the premium growth that is attributable to prescription drugs; and more. *PBMs, which negotiate with drug companies for rebates on prescriptions, will have to report to the insurance department how much they collect in rebates and how much of that they keep.

The department will then aggregate that data and find a way to publicly disseminate it, while still protecting proprietary information, such as companies’ names and specific drugs that receive rebates. *Insurers will be required to report to the insurance department whether they use the rebates to offset premiums, which they typically do, or pass the money down to residents at the pharmacy counter.

The information would be published annually by the insurance department. *In return for the rebates PBMs receive from manufacturers, the companies’ drugs are included on the insurers’ formularies, the lists of drugs the insurance companies will cover.

The rebates generally are offered on drugs where there is competition and not on generic drugs, where price inflation has been less. PBMs keep some of the rebate money and pass the rest directly to the insurers, which typically use the revenue to offset the cost of premiums for customers.

The finger-pointing over drug prices has begun to focus more on PBMs because these companies don’t always disclose the full rebate they get from the drug companies, leading to claims that PBMs could be passing on more savings to patients.

The Pharmaceutical Care Management Association, which represents PBMs, opposed the bill, saying in a statement the legislation

would give drug makers “access to competitive information that would empower them to charge higher prices.”

The Connecticut Association of Health Plans was more amenable to the bill. They said they still had concerns but lawmakers had acknowledged their issues and they hoped to work with the legislature “to address the unit costs of drugs, which we believe to be among the biggest price drivers in the market.”

The unit cost of drugs refers to the manufacturers’ prices.

The bill would cost the state about $275,000 in fiscal year 2020 for additional staff in the state Insurance Department and Office of Health Strategy, as well as consulting services for that year. In following years, it would cost about $300,000 for the staffers, according to the legislature’s Office of Fiscal Analysis.

The approved bill differs from the proposal that was voted out of the legislature’s insurance committee. Most notably it doesn’t include a requirement that the majority of rebates from drug companies be passed down to consumers when they buy drugs at pharmacies.

The provision for direct rebates to consumers was challenged by the insurance department and Connecticut Association of Health Plans, which argued it would cause premiums to increase.

Caitlin Carroll, spokeswoman for PhRMA, which represents the pharmaceutical industry, said the organization appreciated the bill’s comprehensive examination of the drug supply chain but was disappointed that the final version didn’t include the direct-to-consumer rebates.

This story originally appeared at CTMirror.org, the website of The Connecticut Mirror, an independent, nonprofit news organization covering government, politics, and public policy in the state.

THE NEWTOWN BEE, FRIDAY, MAY 18, 2018

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Joanne Lockwood of Joanne’s Fitness Studio in Newtown demonstrates how to accomplish a standard plank. Proper technique calls for the head and neck to be aligned with the spine.

—Bee Photos, Silber

Prioritize Your Health With Fitness Moves From A Local Pro

By Alissa Silber It is easy to put everyone else’s needs before your own.

Between packed schedules of countless commitments, often times it is daily exercise that falls by the wayside when other obligations beckon.

According to the Department of Health and Human Services’ Physical Activity Guidelines for Americans, adults should do at least 150 minutes of moderate-intensity aerobic physical activity each week.

As daunting as that number may sound, dividing up that exercise time into smaller increments each day can add up and create long-term healthy habits.

With May being National Fitness and Sports Month, there is no time better than the present to start including some simple and quick fitness moves into even the busiest of days.

How To Begin Newtown resident and personal trainer Joanne Lockwood, who owns Joanne’s Fitness Studio in Newtown, says incorporating exercise into a daily routine is crucial for all ages to ensure having healthy muscles and bones.

Making small adjustments, like taking the stairs instead of an elevator, can be a great start. What is going to make a workout stick, though, is enjoying the activity. If something is enjoyable, people are far more inclined to continue doing it, she explained.

One of the most important things to remember is that if a fitness move is too difficult, do not push yourself.

“Listen to your body,” she said.

If someone is working out past what they are capable of, it can result in injuries.

People can also hurt themselves by not following proper technique.

To avoid rushing through repetitions of a move to reach a specific number, Ms Lockwood recommends setting a timer for 30 seconds to help with pacing. As time goes on and the moves become easier

For those looking to target specific arm muscles, personal fitness trainer Joanne Lockwood shows how bicep curls can be done using a resistance tube. For a modified version, place one foot on the resistance tube instead of two feet. to do, the timer can be increased to 45 seconds, then a minute, and so on.

Moves To Try Think of muscles as being like saltwater taffy, Ms Lockwood said. The muscles need

to be warmed up properly before a workout in order to move the most efficiently and without tears. Warm-ups can be done a variety of ways, like lying on the ground and doing lower back hamstring stretches or side stretches.

A popular move that people can do without any equipment is a standard plank. Ms Lockwood says this move in particular helps with core and ab strength.

“When you have a strong core,” she said, “it can help you with everyday activities.”

Planks are done by holding a push-up position for an extended period of time and keeping the head and neck aligned with the spine. Modified versions can be done by resting the forearms on the ground or by placing both hands on a medicine ball.

To target specific arm muscles, Ms Lockwood recommends doing chair dips to work the triceps and using resistant tubes or bands to do bicep curls.

Dips can be done by sitting on the edge of a chair and placing both hands shoulder width apart behind the hips.

While keeping both legs either bent or straight out, the person must support their weight to bring their body up and down.

Standing bicep curls can be done using everyday workout equipment like resistant tubes or bands. Place one foot on the center of the band (or two feet for more resistance) and slowly pull the bands up, while keeping both elbows tucked to the side of one’s body.

Another quick and simple move that can be accomplished during a busy day is a wall sit. A wall sit is an isometric exercise, done through a static position, that strengthens the quadriceps femoris “quad” muscles.

The move gives the illusion of sitting on a chair with the back pressed against the wall and the legs positioned at a 90-degree angle, holding up the person’s body weight.

Even though just May is considered National Fitness and Sports Month, Ms Lockwood says people should enjoy incorporating fitness into their lives each and every month.

For more information, visit joannesfitnessstudio.com.

State’s Hospitals Saw 3,090 Suspected Drug Overdoses Since January HARTFORD — During the first four months of 2018, 3,090 visits for suspected drug overdoses were made to the emergency departments at Connecticut’s 27 acute care hospitals, according to preliminary estimates released May 7 by the state Department of Public Health (DPH).

These data are being made available through DPH’s syndromic surveillance system, EpiCenter, which provides near real-time estimates of emergency department (ED) utilization for suspected drug overdoses in order to quickly detect and respond to changes in patterns of both fatal and nonfatal opioid overdoses.

“While the currently available data are preliminary and should be interpreted with caution, we are working to improve syndromic surveillance capabilities to provide real-time information to better understand the types of opioids, including fentanyl and associated substances, in combination with other emerging drugs, causing or contributing to unintentional overdoses and deaths,” added Dr Pino. “We will be able to use the information that we gather through this system, in coordination with our colleagues in the Chief Medical Examiner’s Office, state agencies, local officials, and community organizations to more effectively and rapidly respond to the opioid crisis.”

According to DPH’s preliminary data, Connecticut’s EDs saw an average of 180 suspected drug overdose visits per week during Janu-

ary-April.

The system provides information on the number of adolescent and adult ED visits for suspected drug overdose by county of residence. Hartford County saw a total of 1021 suspected drug overdose visits, followed by New Haven County (907), Fairfield County (416), New London County (178), Middlesex County (176), Tolland County (150), Litchfield County (129) and Windham County (113).

Syndromic surveillance is the use of prediagnostic data to understand diseases and conditions of public health importance. Limited patient information is collected, including demographics and the reason for the ED visit; however, patient identifying information, such as patient name, address, or phone number is not collected.

Starting in January 2018, DPH added syndromes related to “drug and alcohol, including drug/opioid/heroin overdoses” to the list of reportable Emergency Illnesses and Health Conditions, allowing DPH to use data sent to the agency’s EpiCenter Syndromic Surveillance System to better monitor overdoses.

“The real-time nature of the data will allow us to respond more quickly to changes in patterns of nonfatal and fatal opioid overdoses and to design, target, implement and monitor more effective interventions to break the cycle of overdose and death and curtail opioid addiction in Connecticut,” Dr Pino said.

“The collection of overdose data is a work in progress, and we continue to collaborate with

the hospitals to ensure that the data we are collecting provides enough detail to understand why individuals are seeking care in our emergency departments,” he added. “Once we know the whys, we can all work on the appropriate responses to help spare future individuals and families from the pain, heartache, and loss caused by opioid addiction and overdose.”

In the fall of 2017, DPH received funding from the Centers for Disease Control and Prevention’s (CDC) Enhanced State Surveillance of Opioid-Involved Morbidity and Mortality grant in order to monitor fatal and nonfatal overdoses.

This funding enables DPH to make enhancements to EpiCenter to monitor suspected overdoses related to all drugs, opioids, and heroin and develop automated alerts to identify changing trends in ED utilization for suspected overdoses.

Currently, only county-level data are available, but DPH plans to train local health departments/districts to access data for their jurisdiction during the summer once these new features are available to inform local decision making and to share with community partners.

Visit the DPH Opioid and Prescription Drug Overdose Prevention Program website for additional information: http://portal.ct.gov/ DPH/Health-Education-Management—Surveillance/The-Office-of-Injury-Prevention/Opioids-and-Prescription-Drug-Overdose-Prevention-Program

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C-SIX

THE NEWTOWN BEE, FRIDAY, MAY 18, 2018

Doctors Weigh In On Migraine ‘Triggers’ — Ways To Approach Solutions

By Eliza Hallabeck For people who get migraines, driving in the bright early morning sunlight or consuming certain foods can induce throbbing pain — sometimes accompanied by other side effects. Even changes in the weather can affect migraine sufferers.

Naturopathic physician Dr Robert Brody who runs Newtown’s Personalized Natural Medicine (PNM), at 33 Church Hill Road, explained that the cause of migraines is unknown, and they can be different for each person. It is generally thought, however, that inflammation in the body and hormone imbalances are the underlying cause of migraines.

Roughly 70 to 80 percent of migraine patients are female, and migraines may have some connection to a woman’s menstrual cycle.

Understanding a person’s blood type, Dr Brody explained, can further help. People with blood type A and AB have increased chances of having migraines, but that does not mean other people cannot get them.

He said there are classic migraine symptoms, but something is triggering those symptoms in the body of migraine sufferers. Removing things that are causing the inflammation in the body can help reduce or mitigate symptoms, Dr Brody explained.

Monosodium glutamate — better known as MSG — and nitrates are just two examples of additives or compounds in food that can trigger migraines.

Processed meats, cheeses, and wine can also trigger a migraine.

Overall, Dr Brody said, the underlying cause of migraines needs to be addressed, and focusing on a healthy diet can help.

“No matter what medication or

supplement you take, the symptoms will come back,” said Dr Brody.

He generally recommends going the “natural route” by focusing on supplements that will help address migraines.

One of the cheapest options, he said, is to take magnesium as a supplement.

However, he advises people to consult a physician to determine the proper dose of any supplement. Magnesium, he added, will relax a spasm in the head.

An herb called feverfew can also be used for long term migraine prevention.

Consulting A Physician Ultimately, Dr Brody recommends consulting a doctor in case “something more” is happening. A neurologist may check for a tumor or bleeding in the brain, he said.

“It is definitely important to be checked out,” said Dr Brody.

When suffering from a migraine, Dr Brody recommended to “get out of the light,” destress, drink plenty of water, get comfortable, and take an antiinflammatory like Aspirin or Ibuprofen and a pain reducer like Acetaminophen.

A new product, MigraineX, has started being sold at CVS and Walgreens across the country that is designed to help people who have migraines caused after a drop in barometric pressure. Medical Advisor to MigraineX, Dr Susan Hutchinson, a migraine specialist, said recently that she was approached by MigraineX to work with the company based on her previous work and interest in looking for natural solutions.

While Dr Hutchinson lives in Irvine, Calif., the product is available at local CVS and Walgreens stores right here in Newtown, according to MigraineX.

The product is an earplug that, according to Dr Hutchinson, “in a sense smooths out and filters out the drop in the barometric pressure, so the patient doesn’t feel that change.”

The idea, she said, is for people to wear them before a change in barometric pressure occurs. A downloadable app helps notify users before a change.

“It certainly can make a difference,” said Dr Hutchinson.

To know if a migraine was triggered by the weather, Dr Hutchinson recommended tracking weather patterns when migraines occur. She encourages anyone who has migraines to live a healthy lifestyle by eating healthy, getting enough sleep, and never skipping meals.

Dr Brooke Pellegrino, the director of behavioral health at the Hartford HealthCare Headache Center, also recommended making healthy lifestyle changes. Sleep disturbances can be a triggering factor for a migraine and can also result from having migraine, Dr Pellegrino explained.

“A lot of people have problems with sleep but do not know how to improve it, other than taking a medication. Long-term use of sedative medication, even overthe-counter, can be problematic,” Dr Pellegrino said responding to an e-mail query.

“However, there is a behavioral (non-medication) treatment called Cognitive Behavioral Therapy for Insomnia that has shown to be just as effective as medication in the short-term and more effective in the longterm at improving sleep,” she added. “This is an intervention offered by some clinical psychologists. I think this is a great place to start if people are looking to improve their sleep, for example, but do not know where to start.”

Seek Treatment, Optimize Results Maintaining a regular sleep schedule, maintaining a healthy diet, and managing stress can all be natural ways to proactively fight off migraines, according to Dr Pellegrino.

Migraines, Dr Pellegrino explained, can coexist with other medical conditions, such as hypertension, stroke, sleep apnea, and epilepsy.

“So, it is very important to seek treatment for these other conditions in order to best optimize headache treatment and overall health,” Dr Pellegrino said.

She recommended seeking medical help “the earlier the better.”

“My main hope for those who have migraines, including myself, is to live healthy, full lives with little migraine-related disability. I think early treatment and education are keys to this success,” Dr Pellegrino said.

According to Dr Pellegrino, most of the research in the area of migraines is based on selfreports and correlational studies.

“This is an area where further research is needed. However, trigger avoidance is not always the answer,” Dr Pellegrino explained. “This can increase anxiety upon trigger exposure and desensitize migraineurs from living a world where these triggers may often be encountered. The idea of gradual exposure or tolerance is often preferred, especially when we are talking about triggers you would not want to avoid such as sexual activity or exercise.”

More information about Dr Brody and his practice can be found on his website, brodynd. com. More information about the Hartford HealthCare Headache Center is available on its website, hartfordhealthcare.org.

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according to Dr Plancher.

So how does an athlete know when to continue battling through some pain or taking a step back?

“Age matters, prior injury — you want to make sure you’re stronger than before — and awareness. If it goes away in two days, three days, that’s okay,” Dr Plancher said.

The old adage that “practice makes perfect” doesn’t take into account that too much practice can actually be a bad thing when it comes to sports, especially for young athletes, according to Dr Plancher.

“It’s wise for athletes to take a combined six weeks to three months off per year from a specific sport, even if that’s divided through the year in monthlong periods,” Dr Plancher said. “And don’t ramp up too quickly when a new sports season begins.

Take it slowly and cross-train to include multiple activities.

By being prudent, athletes of all ages can stop overuse injuries from happening and enjoy their sports participation even more.”

Ms Byrne says her advice to athletes is to take some time off. “After your sport’s over shut down for three to four

weeks,” Ms Byrne said.

“Playing the same sport all year long, instead of just for a season, is often too much for the body, leading to tissue breakdown,” Dr Plancher said.

“Don’t stay to one sport all the time, all year round. We’re doing it because it’s supposed to be fun. It’s not the only reason for the future.”

Single sport athletes are becoming more and more prevalent, according to Ms Byrne.

“It’s completely grown,” said Ms Byrne, adding that there are less and less three-sport athletes. “It’s usually one sport all year round.”

There are ways for athletes to stay active all the while improving their chances of avoiding injuries.

“I think it helps you in the one sport you’re dominant in,” Ms Byrne said of switching from one sport to another during the course of the year.

She added that, as an example, playing spring lacrosse may help bring quickness to a football player’s game in the fall; and football, in turn, helps bring strength to the lacrosse athlete.

“A lot of times playing other sports makes you overall bet-

ter physically,” Ms Byrne added.

Swimming is recommended by both Ms Byrne and Dr Plancher as a way to stay fit and active while avoiding overuse injuries.

“Swimming’s a great thing that builds up lung capacity for the soccer player,” said Dr Plancher, adding that getting into the pool is an option for a soccer player to benefit his or her game while getting off the field for a few months to give their bodies a break.

“Overuse injuries can be avoided by cross-training, great equipment, and rest. You just have to do it,” Dr Plancher said.

The proper equipment can include properly weighted baseball bats depending on the size of the athlete, as well as proper footwear, which, in the case of runners as an example, should be replaced every three to four months, Dr Plancher said. “You have to adjust,” he added.

“Organized athletics is fantastic because it keeps kids out of trouble,” Dr Plancher added.

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By Andy Hutchison There is a perceived payoff for athletes who go hard at one specific sport year-round. But local and regional experts point out that overuse injuries can also occur and strongly advise against overdoing it in a particular sport.

Newtown High School Athletic Trainer Sabrina Byrne said she notices over-use injuries resulting from athletes who overlap their main sport with another, increasing their running and practice time too much between high school and club sports at the same time, for example.

“I can see a complete weardown of their bodies,” Ms Byrne said. “At the end of the day your body will become prone to injuries of that sport.

Your body’s physically telling you that it needs a break.”

“It’s important to know when pain should be your guide,” said orthopaedic surgeon Kevin D. Plancher, MD, founder of Plancher Orthopaedics & Sports Medicine, which has offices in Greenwich and New York City.

If pain, fatigue, discomfort, or restricted performance last for more than a few days, an overuse injury might be suspected,

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Newtown and Masuk High School lacrosse players are pictured converging the ball during a recent game. NHS Athletic Trainer Sabrina Byrne suggests that cross-training between lacrosse and football — or mixing the types of sports people choose to play — can benefit an athlete in each of those sports individually, while keeping them in shape and reducing overuse injuries.

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FDA Answers Blumenthal Call To Ban Deadly Powdered Caffeine WASHINGTON, DC — US Senators Richard Blumenthal (D-CT), Sherrod Brown (D-OH), and Dick Durbin (D-IL) recently announced that the Food and Drug Administration (FDA) will finally act to ban the retail sale of pure and highly concentrated bulk caffeine products in both powder and liquid forms.

In guidance issued April 13, the FDA has clarified that dietary supplements containing pure or highly concentrated caffeine in powder or liquid forms are unlawful when sold in bulk quantities directly to consumers. Given the fact that powdered caffeine even in small doses can be deadly, the FDA has announced that it will initiate steps to remove these dangerous products from the market right away.

“The FDA has rightly heeded our call to take swift action to get highly concentrated bulk

caffeine products off the market. Pure caffeine is simply unsafe and has long posed dangerous — even deadly — risks to unsuspecting consumers.

Robust enforcement action will go a long way towards stopping senseless and tragic caffeine overdoses,” Sen Blumenthal said.

“Nearly four years ago, Ohioan Logan Stiner unnecessarily lost his life to a dangerous and unregulated product.

Today’s announcement out of the FDA will finally help ensure other Ohio families never have to suffer the same way the Stiners did. The FDA’s decision to ban the direct sale of pure, lethal powdered caffeine will finally bring about the consumer protections we have been demanding for years,” Sen Brown said.

“Pure powdered caffeine is dangerous. When sold in bulk, it is nearly impossible for con-

sumers to tell the difference between a safe dose of pure powdered caffeine and a lethal one,” said Sen Durbin. “I am glad to see that the FDA is heeding our call to action by taking concrete steps to ban highly concentrated and pure caffeine products and help prevent the potentially deadly consequences of this drug.”

The trio of lawmakers led the charge to ban the sale of bulk powdered caffeine starting in 2015. The Senators penned a letter to the FDA alongside Senators Chuck Schumer (D-NY), Ed Markey (D-MA), and Kirsten Gillibrand (D-NY) urging the agency to ban the sale of this lethal substance back in 2015.

Sens Blumenthal, Brown, and Durbin renewed their call in 2016 while standing with families whose loved ones had died after using powdered caffeine.

During their press confer-

ence, the Stiner family from Ohio and the Sweatt family from Alabama shared personal stories on the potentially deadly impacts of powdered caffeine. Logan Stiner — who was a senior at Keystone High School in LaGrange, Ohio — died just three days before his high school graduation from ingesting too much powdered caffeine. Logan passed away on May 27, 2014.

Wade Sweatt died at the age of 24 after being in a coma caused by powdered pure caffeine. Wade passed away on June 24, 2014.

According to the FDA, a single teaspoon of pure caffeine is roughly equivalent to the amount in 28 cups of coffee.

Risk of overuse and misuse is high when highly concentrated caffeine is sold in bulk quantities, and therefore present a significant and unreasonable risk of illness or injury to the consumer.

THE NEWTOWN BEE, FRIDAY, MAY 18, 2018

Take A Poison Ivy Prevention Tip From Butterflies: Don’t Touch It! EAST SETAUKET, N.Y. — “If butterflies land there, don’t put your hand there” — unless you are just “itching” to touch it.

That’s the caution from Robert Levine, DO, of Advanced Dermatology PC. He was quoting an old children’s rhyme about the dangers of touching poison ivy and related outdoor plants like poison oak and poison sumac, whose oily substance can cause serious — and, sometimes, severe — skin reactions.

In fact, allergic contact dermatitis, which promotes intense itching, burning sensation, painful skin rash, and even skin infection if a person exacerbates the affected area by repeated scratching, is most commonly the result of contact with poison ivy, says Dr Levine, a dermatologist and family practice specialist.

Butterflies land on poison ivy because they are not sensitive to the plant’s resin but are protected there from predators that avoid the plant.

Although temporary, contact dermatitis can distress patients for several weeks or more. The recommended application of calamine lotion, corticosteroid creams or cool, wet compresses to the affected skin area may lessen symptoms, but usually do not shorten the course of the disease, Dr Levine says.

His warning about environmental allergens comes as warm weather approaches, and outdoor plants begin awakening from hibernation.

More than 10 million Americans annually are infected by urushiol, the toxic oil of poisonous plants, and that number is expected to grow, according to scientists, who say the increasing carbon dioxide in the air due to climate change is fostering the growth of poison ivy and related flora.

“Urushiol is readily spread,” Dr Levine says. “You don’t have to touch plants directly to become infected. Simply walking through an area of poison ivy and then later rubbing your clothes or shoes can cause an allergic skin reaction.” Even the smoke from the burning of plant waste that includes poison ivy carries urushiol particles that may prompt facial swelling and skin reaction in exposed areas of the body.

For those unlucky enough to encounter poisonous ivy or

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Robert Levine, DO, of Advanced Dermatology PC says you don’t have to touch plants directly to become infected. Simply walking through an area of poison ivy and then later rubbing your clothes or shoes can cause an allergic skin reaction. any of its relatives, Dr Levine offers these tips: *Rinse off the exposed skin immediately in warm — not hot — soapy water, and wash under your nails. Even if you are unable to remove enough of the plant oil to prevent a reaction, you can limit its spread to other parts of the body. *Wear gloves and wash off clothing, garden tools and anything else in contact with the plant. *If contact dermatitis develops, do not scratch the affected area. Scratching only worsens the condition and leads to potential infection. Cool, wet compresses placed on the skin help reduce the itch.

*Take lukewarm baths of short duration and apply calamine lotion or hydrocortisone cream to the affected skin. *Go to a hospital emergency room if you have trouble breathing, experience swelling on any part of the face and genitals or develop a generalized skin rash.

“The best medicine, of course, is prevention,” Dr Levine says.

“If gardening or walking through brush or forested areas, wear long-sleeved shirts and pants, socks and shoes that completely cover your feet.

“And, if it has ‘leaves of three, let it be.’”

Learn more at: advanceddermatologypc.com.

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“I particularly want to thank Office of Policy and Management Secretary Ben Barnes for his efforts to cooperatively meet with these workers, hear their concerns, and develop a resolution that, in the end, avoided a strike and provides a much-need and long-overdue wage increase.”

“These aides and advocates are doing critical jobs that preserve our social safety net,” Lt. Governor Nancy Wyman said. “This legislation supports that work and ends more than a decade of waiting for meaningful action on wages. I join Governor Malloy in appreciating all of these caregivers, and thank them for their commitment to their clients and the families that depend on them.”

The legislation is House Bill 5460, An Act Concerning Minimum Employee Wages for Providers of State-Contracted Human Services.

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Governor Dannel P. Malloy announced that he has signed into law legislation that will provide wage increases for thousands of workers in Connecticut who care for people with intellectual disabilities at group homes and day programs. (HB 5460).

HARTFORD – Governor Dannel Malloy has signed into law legislation that will provide wage increases for thousands of workers in Connecticut who care for people with intellectual disabilities at group homes and day programs.

The bill, which was negotiated by the administration and received final legislative approval, helps avert a costly strike would have cost the state an estimated $1 million per day. The care workers planned to strike beginning on Monday, May 7; however, it was called off following the legislature’s passage of the bill and the Governor’s pledge to sign it.

“We are grateful to the hardworking human services employees who provide care to our most vulnerable neighbors and for too long have been underpaid, especially considering the critical work they deliver,” Governor Malloy said. “These caregivers voiced their concerns and unified their efforts, and by

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THE NEWTOWN BEE, FRIDAY, MAY 18, 2018

Sandy Hook Resident Is ‘Crushing’ Kidney Disease, With A Little Help From Brother-In-Law

By Kendra Bobowick “I never dreamed I’d grow up to be a super cool kidney transplant survivor, but here I am crushing it,” says the large print on Sandy Hook resident Timothy Miller’s T-shirt he wore following his transplant operation April 17.

Standing by his side is his brother-in-law Jim Hinckley of Danbury, wearing a similar shirt that read: “I never dreamed I’d grow up to be a super cool living donor, but here I am …”

Mr Miller, as of April 17, has Mr Hinckley’s kidney.

The two men have a close relationship, Mr Miller said.

They are “Good buddies, especially now. I have to take care of his kidney.”

Since the transplant, Mr Miller said, “I feel really good — excellent, actually.

Things seem to be getting better.”

Mr Miller has been seeing a nephrologist for about 20 years, he said. He had polycystic kidney disease, which is hereditary.

“My father had it as well.”

His father’s kidney function “went bad at about 80,” he said. His father “did dialysis for about 7 years,” before he died in December, 2017, around the time Mr Miller realized he would need a transplant. “I figured a transplant would happen eventually, but I thought it would happen when I was older.” He is 58. “I thought it might not happen until 80, like my dad.”

His kidney function “has slowly been going down for about 20 years,” and at end of last year, his nephrologist told him the time had come to start talking to Yale about a transplant. Yale New Haven Transplantation Center (YNHTC) is a destination center for patients from around the world who are candidates for liver, kidney, and heart transplantation, according to ynhh.org.

Timothy Miller, left, received a kidney from his donor and brother-in-law Jim Hinckley, Living organ donor Jim Hickley, left, on April 17 donated his kidney to transplant surright. vivor and Sandy Hook resident Timothy Miller.

—Photos courtesy Jim Hinckley “Immediately after that I started talking to people, and my brother-in-law stepped right up, and here we are …”

Mr Miller’s wife Nancy “must have talked to her sister, [MaryLee] and within a day or two, I got a call from Jim and asked what he could do, and that was it,” Mr Miller said.

If he had not found a match, “the wait for my blood type is about 6 ½ years. I got very lucky.”

Because his father’s death and his own need for a transplant coincided, Mr Miller said, “I was afraid to tell my mother.” He waited a couple weeks before telling her about his health. “She wanted to be my donor,” but for several reasons, was not a match.

However, his mother drove him to and from Yale twice a week, he said. “When I had surgery, she came in almost every day. She had something to do after my father died.”

When he got out of the operating room, he said, “I was walking right away,” on the same afternoon as his surgery. “The pain was minimal … I go out walking as much as I can; I get tired, but I am still walking.”

For now, “I just take care of myself,” he said. A financial advisor, Mr Miller was able to get back to work from home. “I start work next week and go back to a somewhat normal life.”

He said, “Everything has gone so well from the beginning. I am a positive person in first place, but everything

went right.” His doctor, David C. Mulligan MD, FACS, “could not have been any nicer. I remember going to the operating room, and he was holding my hand and talking to me, telling me it would be fine — it’s the last thing I remember.” The doctors and nurses were “fantastic,” he said.

Considering his kidney disease, he said, “I can’t say it stopped me from doing things, but I had to watch what things I ate. There were certain things high in potassium that I was supposed to stay away from.

Potatoes, tomatoes, bananas…I didn’t eat a lot of.”

Offering a “funny story,” Mr Miller said, “My brotherin-law doesn’t like eggs; he has never had an egg. So my first meal after surgery was

an omelet.” He sent Mr Hinckley, just a few doors down in the hospital, a picture of the omelet. “I had been teasing him about it for years. Then he told me he wants his kidney back.”

For next six months to a year, Mr miller has to be “very careful of bacteria,” because he is taking medications to suppress his immune system, “so my body does not reject,” his new kidney.

A Donor’s Perspective Thinking of his brother-inlaw, Mr Hinckley said, “His dad was fine until 80, but Tim unfortunately learned he needed a transplant, and I heard about it.” He called Mr Miller, offering to contact the Yale New Haven Transplantation Center to

be tested for compatibility as a match. “Two weeks ago,” he said on May 2, “they took my kidney out and gave it to him.” He was happy to do this for him, he said.

“I’m glad everything worked,” Mr Hinckley said.

He is feeling good, and already back at work “and taking no pain medications,” he said.

“I just got lucky,” as a good match for Mr Miller, and “everything worked,” Mr Hinckley said. “I was happy to do it.” Joking, he said, “I remind him constantly that he owes me.”

He finds it “strange, interesting that my organ is in another person, but satisfying and a piece of me that I can give. If it extends his life, then God bless.”

About the omelet: “I have

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never eaten an egg in my life and was quite disturbed and I saw the picture and said that it was disturbing.

The hard part of the process was watching him eat eggs after the surgery with my kidney…and my kidney had gone almost 60 years,” he joked.

Mr Miller “is a good man,” Mr Hinckley said. “And here we are two weeks later, a little sore, but no lifestyle changes or anything to worry about.”

Mr Hinckley’s doctor from Yale was Sanjay Kulkarni, MD. Become A Donor Joyce Albert, senior clinical transplant coordinator, and living donor coordinator said people interested in becoming a donor should

call the referral line, 866925-3897 — or reach Living Donor Center manager, April Capone at 203-2003832.

“We take referrals, and someone will call them back to do a screening,” she said.

Callers can be altruistic donors, which are people who “could be tested for a match to anyone — they call to donate out of the goodness of their heart to someone in need.” When Yale has an altruistic donor, “it starts a chain.” Their information is entered into a pool to find a match.

Also, like with Mr Hinckley and Mr Miller, “There is the option for a donor to say they want to donate to a person specifically, that’s a choice,” Ms Albert said.

Regarding the brothers-inlaw, she said, “they were compatible and Mr Hinckley decided to donate to Mr Miller.”

She said, “Donors have to meet certain criteria, they have to be healthy, cannot have diabetes, cannot have a history of active cancer or substance abuse, and cannot be overweight.”

Learn more at ynhh.org.

The website states, “We have a thriving living donor program for kidney and liver transplants, offering our patients excellent outcomes and long-term quality of life.”

YNHTC is a major referral center for other transplant programs facing particularly challenging cases and the region’s leader in evaluating and treating advanced liver disease.

Patients have access to innovative treatments and research trials at Yale Center for Clinical Investigation for a wide range of conditions, including heart, kidney, and liver diseases.

Learn more at: www.ynhh. org/services/transplantation/center-for-living-organdonors.aspx

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