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Volume 11 | Issue 4
Inside This Issue
April Edition 2021
From Questions to Confidence: Understanding COVID-19 Vaccines By Arvind Bhandari, M.D. Texas Oncology
Baylor Opens Clinic For COVID-19 Long-Haulers See pg. 11
INDEX Legal Matters........................ pg.3 Mental Health...................... pg.6 Healthy Heart..................... pg.10 Financial Forecast............ pg.12
Paralyzed Veteran Learns To Ski During Pandemic See pg. 13
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or the past year, the pandemic has felt out of our control, and in many ways that’s true. However, COVID-19 vaccines bring new hope – and opportunity for us all to do our part to slow the spread of the virus. As vaccines continue to become available, it’s important to understand how they work, why they’re safe for current cancer patients and survivors, and what to expect at your vaccination appointment. How COVID-19 vaccines work As of spring 2021, there are three COVID-19 vaccines approved under the U.S. Food and Drug Administration’s (FDA) emergency use authorization. Here’s what you should know. • The technologies and techniques used in the COVID-19 vaccines have been studied by scientists and researchers for decades.
• The Moderna and Pfizer-BioNTech vaccines use the body’s own immune system to produce a special type of protein, called a “spike protein,” to prevent infection with COVID-19. • The Janssen/Johnson & Johnson COVID-19 vaccine is different in that it uses a modified version of an adenovirus to deliver a message to our cells. That message allows the body to mount an immune response to the COVID-19 virus
spike antigen. The adenovirus can’t grow inside our cells or cause illness other than flu-like symptoms. • While you may experience side effects such as arm soreness, headache, fatigue, or mild fever, you cannot get COVID-19 from the shots. Why COVID-19 vaccines are safe All vaccines go through rigorous and lengthy processes, including see Vaccines...page 14
St. Luke’s Health Teams Up with Rice University for Vaccination Efforts
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t. Luke’s Health announced that it vulnerable populations, including is partnering with Rice University healthcare workers, seniors, underserved to administer vaccines to the most communities, and school and child care center/adult care center personnel. St. Luke’s Health will opened the new vaccination site at the historic Rice Stadium on March 15 through a partnership with Rice University. Vaccinations are by appointment only, Monday-Friday from 9 a.m. to 6 p.m. through the end of July. Vaccine clinic hours are subject to change based upon vaccine availability. Located adjacent to Metro Red Line light rail corridor and near numerous Metro bus lines
stops within walking distance, the new vaccine site is easily accessible and large enough to support a large-scale vaccination effort. “We are honored and proud to partner with such a historic institution to continue to vaccinate our most vulnerable populations,” said Doug Lawson, Ph.D., Chief Executive Officer, see Team Work ... page 14
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Legal Matters Who Is Going to Cover Covid Hospitalizations – Commercial Health Plans or Workers’ Compensation
By C. Ryan Morgan, J.D. Tish R. Pickett, J.D. Polsinelli, PC
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ommercial health plans are delaying and even denying reimbursement for COVID-19 hospitalizations — especially high-dollar inpatient stays. Plans are attempting to defer these claims to workers’ compensation on the health plans’ assertion that COVID-19 is a work-related illness. Some hospitals defer to health plans, as it relates to these types of claims, because it is plausible that patients could have contracted COVID-19 at work and because workers’ compensation is typically primary for coordination of benefits purposes. But workers’ compensation is notoriously complex, and hospitals may not
understand the nuances of the program enough to know when it is appropriate to challenge this type of health plan denial. Failing to appeal these denials may impact hospital reimbursement, as well as a hospital’s accounts receivable days, known as “AR days,” depending on the number of COVID hospitalizations and the corresponding amount in open balances. A. Demystifying Workers’ Compensation With a Brief Overview It is important to have a general understanding of workers’ compensation coverage. Workers’ compensation is a state-mandated insurance program that protects employers and employees from financial loss when employees suffer job-related injuries and illnesses. Virtually all employers, even small employers, must maintain workers’ compensation coverage. If an employee suffers an occupational injury or illness, an employer through its workers’ compensation carrier may provide missed wage replacement, temporary and permanent disability, death benefits,
and supplemental benefits. But one of the basic benefits in all states is medical and hospital benefits. Each state regulates workers’ compensation coverage differently, which is a critical factor with respect to COVID-19 and whether a health plan may delay or deny payment. In some states, employer premiums for workers’ compensation policies are experience-rated, meaning that employers that file more claims pay more in premium. B. States’ Response to Classifying COVID-19 as an Occupational Illness When it comes to COVID-19 as an occupational illness, states have responded differently. On one hand, 17 states and Puerto Rico have extended workers’ compensation coverage to include COVID-19 as a work-related illness. Within this group of states, there are varying degrees of coverage. The majority of these states have established COVID-19 workers’ compensability presumptions for various
types of workers. In these states, if a designated worker contracts COVID-19, it is generally presumed that the worker acquired the virus during the course of employment thus eligible for workers’ compensation, including medical and hospital benefits. But employers can dispute this presumption and produce evidence to the contrary, if done so within a certain amount of time under state law. Hospitals are often left out of this decision-making process, which is unfortunate because hospitals may have additional information about where the worker contracted COVID-19. On the other hand, some states still consider COVID-19 an “ordinary disease of life,” similar to a cold or the flu, which means the virus is not covered by workers’ compensation. Still other states have taken no action to clarify whether COVID-19 hospitalizations and treatments should see Legal Matters...page 14
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April 2021
Texas Heart Institute Announces New President and CEO Duke University Health System Chief Medical Officer and cardiologist Dr. Joseph G. Rogers Will Take the Helm at THI in May
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oseph G. Rogers, M.D. – Chief Medical Officer of Duke University Health System and Professor of Medicine in Cardiology at Duke University School of Medicine – has been named President and Chief Executive Officer of the Texas Heart Institute in Houston, Texas. Texas Heart Institute (THI) Board Chairman Eric D. Wade announced Rogers’ appointment following a national search. “Dr. Rogers possesses the skillful leadership and expertise that the Texas Heart Institute needs during a pivotal moment in its history. With the recent launch of Joseph G. Rogers, M.D. the Texas Heart Medical Group, seminal discoveries in cardiovascular care in the COVID Chief for Clinical Affairs in Duke’s era, and our responsibility to educate Division of Cardiology when it was and train the best and brightest ranked number five in the country. Today, Rogers serves as the fellows in cardiology, Dr. Rogers brings experience to lead THI’s Chief Medical Officer at Duke’s mission to reduce the devastating preeminent health care system, toll of cardiovascular disease through which educates and trains thousands innovative programs in research, of physicians and health care education, and improved patient professionals. It attracts more than 69,000 annual patient stays and two care,” said Wade. “I am honored to have been million outpatient visits and is ranked chosen to lead THI, arguably the most as a top 20 hospital in the country. storied and influential cardiovascular Rogers has authored more than 230 institute in the United States. I look publications and has maintained a forward to building upon the strong research portfolio with NIH funding foundation laid by the teams of throughout his career. He remains clinicians, researchers, and educators deeply involved in leading-edge at THI to increase the Institute’s LVAD research, including serving as impact on cardiovascular disease,” Dr. the principal investigator on several national studies. Rogers stated. In addition to clinical and At Duke University and in his earlier career at Washington research roles, Dr. Rogers oversees University, where Rogers received graduate medical education, with more training as both a clinical and than 1,000 trainees currently enrolled. research fellow, he led clinical program He has led initiatives to guide quality development in transplant, heart care and safety, and he has focused failure, and mechanical circulatory on the development of diversity and support. At Washington University, inclusion programs. He understands Rogers oversaw and expanded the the importance of outreach programs cardiac transplant program, developed and community engagement. Rogers is expected to begin his the disease management program, and started its LVAD program. At Duke, new duties at the Texas Heart Institute Rogers led its heart failure program on May 17, 2021. . from 2004 to 2013. He served as Vice medicaltimesnews.com
Houston Medical Times
Collagen Plays Protective Role During Pancreatic Cancer Development Findings Suggest the Protein Helps Slow Tumor Progression, Pointing To New Cancer Therapeutic Strategies
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ontrary to long-held beliefs, Type I collagen produced by cancer-associated fibroblasts may not promote cancer development but instead plays a protective role in controlling pancreatic cancer progression, reports a new study from researchers at The University of Texas MD Anderson Cancer Center. This new understanding supports novel therapeutic approaches that bolster collagen rather than suppress it. The study finds that collagen works in the tumor microenvironment to stop the production of immune signals, called chemokines, that lead to suppression of the anti-tumor immune response. When collagen is lost, chemokine levels increase, and the cancer is allowed to grow more rapidly. The research was published today in Cancer Cell. “Collagen has been the most highly studied component of the tumor microenvironment for decades, but
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in which collagen is not produced by cancer-associated fibroblasts during pancreatic cancer development. After genetically deleting collagen from these cells, called myofibroblasts, more than 50% of the total collagen was absent in the tumor microenvironment. its precise role has remained unclear,” With collagen reduced, pancreatic said senior author Raghu Kalluri, M.D., cancer growth accelerated, and the Ph.D., chair of Cancer Biology. “Now, overall survival of the mice significantly we understand that it is part of a cancer decreased, suggesting that collagen plays defensive strategy of the body. If we can an important role in blocking cancer better understand progression. that strategy, even if The researchers looked it may be suboptimal, further to understand how we can work to shore collagen was impacting up our body’s natural tumor development. In defenses to have tumors with reduced therapeutic impact.” collagen, the cancer cells Collagen, the produced higher levels most abundant protein of chemokines known to in the human body, is attract myeloid-derived produced by a class of suppressor cells (MDSCs), cells called fibroblasts Raghu Kalluri, M.D., Ph.D. a type of immune cell and is found mostly in that dampens anti-tumor bones, tendons and skin. The protein immune response. also tends to accumulate in and around Indeed, the researchers found tumors during cancer development that collagen-deficient tumors had more and growth, leading researchers to MDSCs present and fewer immune cells, hypothesize that it helps promote tumor such as T cells and B cells, that could growth, metastasis or drug resistance, mount an effective anti-tumor response. Kalluri explained. Interestingly, blocking chemokine To investigate these possibilities signaling activity with targeted therapies and clarify the role of collagen, the reversed the immune profile in these research team created a mouse model tumors and slowed tumor progression,
bringing it back to a level similar to that of controls. “This was somewhat surprising because we think of pancreatic cancer as a cancer with poor immune surveillance – with an immunosuppressive tumor microenvironment,” Kalluri said. “However, this study shows that the immune system actually is controlling pancreatic tumor growth to some extent, and we see an even more detrimental immune suppressive tumor microenvironment when collagen is lost.” Noting that pancreatic cancer is one of the most aggressive tumor types with poor outcomes overall, Kalluri acknowledged that collagen by itself may not be a particularly effective defense mechanism, but it shows that our bodies are doing what they can to control cancer development. He likens the body’s response to a car with faulty brakes. The car cannot stop as efficiently as it might with good brakes, but it is better than a car with no brakes at all. The challenge now, Kalluri explained, is to identify a therapeutic strategy to fix those brakes, by increasing collagen levels or boosting collagen’s downstream effects to further strengthen the anti-tumor response. Exploring these strategies will be the focus of future work by Kalluri’s team.
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Mental Health Weathering the Storm: Focus On Your Mental Health
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isaster after disaster often leads to distress. Following the winter storm in Texas, many re-experienced the traumatic effects of Hurricane Harvey, as well other floods and natural disasters. The added stress of the ongoing pandemic made this increasingly challenging for individuals. A Baylor College of Medicine expert explains the behavioral challenges people endure as a result of natural disasters. Psychological challenges after disasters can manifest in the form of post-traumatic reaction, which is characterized by different experiences: • Re-experiencing the event • Nightmares • Flashbacks • Intrusive thoughts • Considerable anxiety / distress especially when reminded of the event • Physical symptoms of stress and anxiety (pain, shortness of breath, etc.) • Fear of recurrences of these types of events “You see a significant increase in anxiety, which can lead to other
problem s, i ncludi ng depre s sive sy mptom s, somatic complaints like sleep problems, and increased substance abuse,” said Dr. Eric Storch, professor and vice chair of psychology in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor. “People are already struggling with the pandemic but natural disasters on top of this are adding additional fuel to the fire.” Other cognitive symptoms of post-traumatic stress include dissociated experience, feeling numb or detached, and exhibiting an increased startle response. Behaviorally, people struggle when coming into contact with triggers that remind them of the trauma in question. This becomes challenging with the continual stress of COVID-19. Individuals suffering from mental health issues already may be particularly vulnerable. Additional risk factors may include economic challenges, their own health, the health of loved ones and loss. They face an increased risk of a worse behavioral health outcome after traumatic events due to compounded stress and disruption in care or the
ability to access care. Those who ordinarily cope well during traumatic events and do not struggle with behavioral issues often deal with stressors in various ways, such as seeking out loved ones, exercising or other forms of self-care. Currently, people are being challenged to confront stressors without the coping tools normally at their disposal due to the risk of COVID-19 exposure. Storch stresses the importance of seeking professional help for those experiencing distress and impairment. Signs that you should seek help may include significant distress (e.g., sadness, anxiety, not enjoying things you used to enjoy), work and relationship impairment or other problematic behaviors, such as increased substance use. In addition to professional help, people can seek out resources from your community, religious organizations and behavioral health providers “When you’re in a situation you can’t change, you might try to change your perception of the situation. Focus on the things you can control. Help other people by providing food or helping repair areas of their home that were damaged. Try to focus on the positive glimmers of hope,” Storch said. “We want to make sure we’re thinking about the lives we want to lead and engaging in healthy lifestyle behaviors,
while being realistic about limitations due to COVID-19. On top of that, reaching out for mental health help is important when you need it.” Children also are prone to issues with behavioral health when it comes to trauma. Parents and guardians must model adaptive behavior, as children are impressionable. While parents are not immune to behavioral health problems, poor coping responses by parents can exacerbate the child’s response. If a child can look at their parent as a pillar of strength, this is more beneficial as opposed to the absence of response. Parents should focus on shifting their perception and upholding confidence. In the middle of a natural disaster, neighbors or loved ones may seek shelter in your home. Display confidence to your children by explaining that things may be chaotic, but that the family has things under control and there is a light see Mental Health...page 13
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Researchers at UTMB Find That Frustration is an Additional Factor of Addiction Based on Studies with Rats
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team from The University of Texas Medical Branch at Galveston (UTMB) focused on drug addiction research have pioneered a new way to study frustration as a factor in substance use disorders. The study was published in the medical journal Psychopharmacology. Traditional addiction research has focused on three aspects of substance use disorders: craving, impulsivity, or habit. Scientists hypothesized that a fourth factor, frustration, could also lead to escalation of drug use and addiction. The Psychopharmacology paper noted that research into the role of frustration and substance use disorders is sparse, but a number of studies suggest that persons with substance use disorders have lower frustration tolerance. Studies have shown that sensitivity to frustration correlates with relapse among those with substance use disorders.
The UTMB studies used a rat model to focus on frustration-related behavior. Rats can be trained to press a lever for food or drugs (reinforcers), and frustration is defined as when a subject is unable to achieve a reinforcer, receives less of a reinforcer than anticipated, or has to work harder to achieve a reinforcer. “An example of frustration behavior is when someone can’t get the channel on the TV to change or when an elevator takes too long to arrive. People will often respond to both situations by pressing the button repeatedly or holding the button longer with repeated attempts. This typical human response to frustration is the same in rats. In our study, rats were trained to press a lever for delivery of either a sucrose pellet or an intravenous infusion of a synthetic opioid. If they didn’t get what they expected, they would press the lever more frequently and for longer periods
of time,” said Dr. Thomas A. Green, of UTMB’s Department of Pharmacology and Toxicology. “When a rat presses a lever repeatedly that was supposed to deliver a banana-flavored sucrose pellet, but the pellets never arrive, they hold the levers down longer as the frustration builds,” he said. Tileena Vasquez, a doctoral candidate in UTMB’s Department of Pharmacology and Toxicology and the lead author of the paper, said the study showed all rats would press a lever for intravenous infusions of fentanyl, a synthetic opioid, but about 10% of rats would escalate their intake of fentanyl to about double that of the average rat. “Even as the escalating rats take massive amounts of drug, their bar presses get longer (in some cases up to 10 minutes long), even though long bar presses do not increase the amount of drug delivered,” Vasquez
said, adding that the conclusion is that these susceptible rats, even though they are taking as much fentanyl as their bodies can handle, are frustrated that they are still not getting enough drug to satisfy them. Green says the study has obvious implications for future studies of opioid use disorder and will help scientists understand how frustration, as well as craving, impulsivity and habit can lead to opioid escalation.
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Healthy Heart During Move More Month this April, Fit in Walking: Morning, Noon or Night By Verónica Sánchez, The American Heart Association
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alking is one of the most versatile forms of exercise, because you can do it just about anytime, anywhere. During the Houston and Gulf Coast Heart Walks in November, we encouraged participants to “walk where you are.” Just because we weren’t gathering in large groups didn’t mean you couldn’t be physically active in your own neighborhood. This April, during Move More Month, the American Heart Association is reminding Houstonians to sit less and stay in motion no matter where you are. Here are some tips to get your walk on. Like to move as soon as your feet hit the floor?
April 2021
• Before you go to bed, get your walking clothes and shoes ready so it’s easy to put them on quickly and head out the door. • Eat a piece of fruit or a few spoonfuls of yogurt for a quick fuel-up. • Walking to your favorite jams may help get you moving. Just make sure you can still hear traffic. • If it’s still dark, wear reflective clothing or carry a light. • Be sure to stretch a bit at the end of your walk. Is lunchtime the only break in your busy day? • Schedule your lunchtime walk in your work calendar. Think of it as an important appointment. • Recruit some coworkers to join you virtually. You can keep each other on track. • In cooler weather, you might need a jacket, hat, or gloves. If you’re walking briskly, you’ll heat up in a few minutes, so don’t overdress. • Bring your lunch or pick a route where you can grab a quick healthy
meal at the end of your walk. Is working out after work your idea of happy hour? • Have a light snack about an hour or two before you leave so you don’t experience an energy dip and talk yourself out of walking. • Pick a route without heavy traffic because rush hour can increase air pollutants. • Do some shoulder rolls and other warm-ups to release the stress of the day before heading out. • If it’s already dark, wear reflective clothing or carry a light. Every Step Counts Most adults should try for at least 150 minutes (2.5 hours) a week of moderate intensity activity. 30 minutes of brisk walking on at least five days a week is one way to meet this goal. And, for every one hour of vigorous exercise you complete, you can gain back two
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hours of your life! Staying physically active while we’re in a period of social distancing is so important to maintain our good health. Walking helps lower blood pressure, maintain cholesterol and diabetes, and it also lowers the risk for cardiovascular disease, such as potentially having a heart attack or stroke. You can also soak up some Vitamin D on a sunny day. Any activity is better than none. Even light-intensity activity can offset the serious health risks of being sedentary. Physical activity is linked with better sleep, memory, balance, and cognitive ability, as well as less risk of weight gain, chronic disease, dementia, and depression. For more information on how to Move More this April, go to heart.org/ en/healthy-living/fitness/walking
Houston Medical Times
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Baylor Opens Clinic For COVID-19 Long-Haulers
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OVID-19 has affected many lives, especially those who experienced the disease and are still in recovery. Many people think of the negative health impacts of COVID-19 as coming during the active infection, but the aftereffects of the virus can be serious as well, resulting in long-term health issues that may affect daily function. Baylor College of Medicine is providing care for long-haul COVID-19 through the Post COVID Care Clinic, where patients can receive treatment for the lingering symptoms or new side effects after having the virus. “We believe that patients experiencing long-term symptoms of COVID-19 need a dedicated, multidisciplinary approach to their care that will help them on the path to recovery,” said Dr. Fidaa Shaib, associate professor of medicine in the
Long-term symptoms of COVID-19 can affect several organ systems in the body, but the most concerning are those that affect the lungs, heart and brain. Shaib adds that it is important to be evaluated by a physician if new side effects or persistent symptoms occur so that they can assess which organs could be affected. “Patients who had COVID are at an increased risk to develop pulmonary fibrosis, heart failure, renal failure or blood clots and pulmonary embolism in the future,” Shaib said. The Post COVID Care Clinic will provide a questionnaire that will assess how COVID-19 has affected the patient. This is followed by a visit with a pulmonary specialist who will provide an evaluation and a management plan personalized to each case. Baylor’s Post COVID Care Clinic
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section of pulmonary, critical care and sleep medicine at Baylor. “This clinic will provide care that is comprehensive but personalized by focusing on each patient experience and condition to facilitate meaningful recovery.” People who experience long COVID-19, also known as long-haulers, often have symptoms that are continuations of the initial infection. Some never experience major symptoms while having the virus but can develop new symptoms after recovery. Common side effects of long COVID-19 include: • Fatigue and shortness of breath • Headaches, memory and concentration difficulties • Loss of taste and smell • Cough and chest pain • Joint and muscle pain • Heart palpitations • Depression and anxiety
is located at the Baylor Medicine McNair Campus. While the clinic offers both in-person and virtual appointments, in-person is recommended so clinicians can perform a thorough assessment and exam. “The clinic is a collaborative effort of Baylor Medicine specialists whose goal is to alleviate the pain and suffering associated with the COVID-19 pandemic,” Shaib said. “Our mission is to deliver care with empathy and compassion while dedicating the knowledge and expertise of our providers in the different specialties in our practice. We are also focused on continuing to gain knowledge and develop new options for the care of our patients.” Those interested in the Post COVID Care Clinic can make an appointment by calling 713-798-2400.
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Financial Forecast Is Now the Right Time to Pay Off Your Mortgage? Measuring the Pros and Cons Of Eliminating Your Home Loan Balance By Grace S. Yung, CFP® , Managing Director Midtown Financial Group, LLC.
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or many people, the monthly mortgage payment is the biggest monthly expense in the budget. So, if you’re in a position to pay off this debt obligation, does it make sense to do so? Or should you instead allocate funds to other financial goals? Wipe Away Debt or Increase Savings? Consumers and financial advisors don’t all agree on whether it is better to pay down debt or add to savings and investments – and there is really no clear-cut answer that works for everyone. For instance, if a key financial goal you have is to maximize wealth, adding money to your investment or retirement portfolio may be the better alternative. This could also help you to build up a “cushion” for emergencies, because accessing money from a bank
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or brokerage account is typically much faster and easier than pulling money out of the equity in a property. Taking a home equity loan will cost you in interest and closing costs that could range from 2% to 5% of the loan amount. A mortgage payoff could also take away one of the largest tax deductions available to consumers who are homeowners. In 2021, you may deduct interest expenses on up to $750,000 of mortgage debt on your income tax return. If you want to reduce the bills you pay every month, though, paying off your mortgage could give you more breathing room in your budget. So, be sure to weigh out all of the potential pros and cons. Pros and Cons of Paying Off Your Mortgage: Advantages of Paying Off Your Mortgage • Eliminates a large monthly expense • Could save thousands of dollars in total interest charges • May use income to pay off other
debt(s) and/or increase savings Disadvantages of Paying Off Your Mortgage • Eliminates the mortgage interest tax deduction • If the value of your home goes down in the future, funds used for paying off the mortgage could “disappear” • The amount that you save by eliminating your mortgage payment and its corresponding interest may not exceed what you could earn in an investment account Items to Consider Before You Make a Decision Before you move forward with a mortgage payoff, there are some items to consider, such as: −− Do you have an emergency fund in place? −− Do you have other high-interest debt balances (such as credit cards) that are still in place? −− Have you made your annual IRA (Individual Retirement Account) contribution for the current year? −− Are you contributing the maximum amount to your employer-sponsored retirement plan, such as a 401(k)? −− Would it make more sense to
• Integrating the Montessori method into the public school curriculum • Currently offering Pre-K thru 4th • Open enrollment until positions fill
refinance your mortgage (and possibly take some cash out), as interest rates are currently at historical lows? −− Will the return on other investments beat the cost of interest that you’re paying on your mortgage? −− Will you still have ample cash available, or will paying off your mortgage drain your available savings? −− Is there a pre-payment penalty for paying off the mortgage balance early? Taking the Next Step Before you commit to paying off your mortgage – or alternatively, adding to your investment portfolio – it is recommended that you discuss all of your potential options with a CERTIFIED FINANCIAL PLANNER who can review your overall situation and objectives. That way, you will be better able to compare both the shortand long-term benefits (or drawbacks) of either scenario.
• Comprehension Stem Program • Character & Leadership Development • High Tech – 7 computers per classroom
2319 N. GRAND BLVD., PEARLAND, TX. 77581 www.hmps.net | 281-485-2500 April 2021
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Paralyzed Veteran Learns to Ski During Pandemic Paralyzed Veteran Regains Excitement and Adrenaline of Being an Athlete During Pandemic
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rmy Veteran Thomas “Nate” Turner, Jr. grew up participating in just about every sport you can think of. He was a four-sport varsity letterman at a very large Texas high school and went on to Midwestern State University where he participated in both football and track. But one horrible summer day, Turner’s life drastically changed. In 2012, Turner was cooling off with friends and family at a nearby lake. One second, he was enjoying the breeze on a swing. The next, Turner was crashing to the ground, shattering his L-1 vertebrae, damaging his spinal cord, and losing all feeling and function from the waist down. After two surgeries and two weeks in the hospital, Turner moved to a rehabilitation hospital where he spent the next three weeks learning how to walk again. He regained most of the feeling in his legs but lost nearly all the plantar flexion in both feet. “I can no longer run, jump, or even stand on my tippy toes,” said Turner, who
served as an Army counterintelligence special agent from 2001 to 2007 and deployed to Iraq in support of Operation Iraqi Freedom. “I am what you call a walking paraplegic.” After his injury, Turner and his wife moved back home to the Houston area. There, he was introduced to the Spinal Cord Injury Clinic at the Michael E. DeBakey VA Medical Center. “During my orientation, I met Recreation Therapist JeMarques Handy and was told that if there was anything athletic that I needed or wanted, he was the person to contact,” said Turner. “I had been riding a recumbent trike regularly but needed something a little more comfortable and challenging.” “VA Recreation Therapy promotes wellness through leisure and physical activity,” said Handy. “Mr. Turner was a pleasure to work. He is an avid cyclist and I am glad to see him explore and excel at other adapted sports. Our Recreation Therapy department strives to encourage and support all
Five Tips to Stay Ahead of Allergy Season
Veterans, no matter where they are in their physical therapy journey.” After a VA Cycling Clinic, Handy introduced Turner to a more advanced tadpole recumbent trike. “My wife and I went on a trip to the Grand Canyon and took the trike with us. I got to ride on some beautiful trails and then some off-road mountain trails in Colorado Springs with a cousin,” said Turner. “The trike gave me new-found adrenaline rush and sense of freedom as I was zooming down the mountain. The Army Veteran Nathan Turner skiing in Breckenridge, CO trike is definitely something that I with his wife and son. Turner learned to ski during the pandemic. am very, very grateful for and can’t thank JeMarques and the Houston VA Sports Clinic or search the App store enough.” for “Veterans Winter Sports Clinic” and After the successful riding sign-up before March 1. adventure, Turner turned his focus to A world leader in rehabilitation, skiing, discovered an adaptive bi-sit-ski, the National Disabled Veterans Winter and signed up for lessons. Sports Clinic provides nearly 400 “This was the first time since I profoundly disabled Veterans with broke my back that I felt the excitement training and rehabilitation every year. and adrenaline of being an athlete. I was Veterans with traumatic brain injuries, hooked on adaptive skiing from that spinal cord injuries, visual impairments, point on. I told my wife that I wanted to amputations, and other severe disabilities go skiing every year,” said Turner, who are challenged to overcome perceived is looking forward to participating in limitations through adaptive skiing, sled VA’s National Disabled Veterans Winter hockey, scuba diving, rock wall climbing, Sports Clinic. education, and other activities. While VA was forced to cancel For more information about the this year’s event because of the National Disabled Veterans Winter COVID-19 pandemic, a virtual event Sports Clinic, VA adaptive sporting will take place March 29 – April 2. events, or Houston VA’s Recreation Download the app at Veterans Winter Therapy, call 713-791-1414, ext. 23537.
he recent winter storm may have abruptly disrupted routines, but not even that can stop the trees from pollinating in the spring. Along the Gulf Coast, March brings with it an excitement for blue skies, pleasant temperatures, and the enjoyment of the great outdoors. But, for those who suffer from allergies, even the most beautiful spring day is diminished by what may seem like an endless allergy season in the Greater Houston area. Here are five ways to make seasonal allergies less taxing on individual sufferers. Track pollen reports Keeping an eye on pollen levels is one of the keys to preparing for seasonal allergies. Many local television stations
offer pollen reports as part of their weather segments. Alternatively, those seeking pollen counts may track them on smartphone weather apps or online weather sites. The City of Houston posts excellent daily pollen counts on their website. Understanding the risk for exposure to allergens on any given day may help sufferers plan for outdoor activities. Spring cleaning Removing dust and pollen that has made its way into the house helps reduce exposure to allergens in the home. Dusting fan blades, windows, and light fixtures, sweeping out the garage, and maintaining a clean household helps reduce the triggers that cause allergy symptoms. Cleaning out
the garbage disposal, as well as other wet areas such as the shower, bathtub, or sinks, may help reduce exposure to mold spores. Changing indoor air filters may also help reduce the allergens in the air. If you suffer from allergies, consider wearing a mask – and maybe even protective eye wear if the task is particularly dusty – when undertaking these cleaning projects. Prepare for the day ahead Allergens are sneaky and may hitch a ride home on hair, especially if the hair has been treated with styling products such as hairspray. For allergy sufferers who typically wear contact lenses, wearing eyeglasses instead on high-pollen-count days may help reduce the amount of pollen irritating the eyes. Hygiene habits If an allergy sufferer spends time outside on a high-pollen-count day, showering quickly after returning
Mental Health
Symptoms can be physical ones, such as a headache or stomachache without any explanation. Watch for changes and regressions in behavior. If your child begins speaking in a more negative tone, was previously adept in certain domains and has a change in performance or experiences social withdrawal, try to
engage them in conversation about it. For additional support, contact a behavioral health provider who is experienced in working with children or contact your child’s pediatrician for additional consultation. “Find meaning even though the world has shifted. The present
T
Continued from page 6 at the end of the tunnel. In addition, be mindful of warning signs for children post-disaster.
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home may help reduce exposure and prevent pollen stuck to clothes, shoes, and hair from transferring to furniture and home textiles like carpets and bed sheets. See a physician Allergies in the Greater Houston area are particularly difficult because allergy season never really ends. Schedule an appointment before the season is in full swing to work with a doctor in developing a treatment plan. circumstances force you to challenge the way you seek out meaning and happiness in life. Focusing on the future and maintaining a hopeful and optimistic perspective are critical in coping with adversity from disasters,” Storch said.
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Vaccines
Continued from page 1 evaluation by an independent review board, before reaching the FDA’s stringent scientific and regulatory process. For example, COVID-19 vaccines were administered to patients as part of clinical trials. As a cancer patient, you may have heard about or participated in a clinical trial focused on innovative new cancer therapies or procedures. Before COVID-19 vaccines were authorized by the FDA, data from large-scale clinical trials confirmed that the benefits of the vaccines are safer than becoming infected with COVID-19. While the process was swift, no steps were skipped. The science is clear: COVID-19 vaccines are safe and recommended for most people, including patients with cancer. What to expect when you get the
Team Work
Continued from page 1 St. Luke’s Health, and Senior Vice President of Operations, Texas Division, CommonSpirit Health. “The iconic Rice Stadium is large and functional and conducive to an efficient clinic operation. We are looking forward to collaborating with the leadership at Rice University to continue to vaccinate our communities as quickly and safely as possible.” “We’re pleased to provide Rice Stadium as a vaccination clinic site for Baylor St. Luke’s Medical Center,” said Kevin Kirby, Rice’s vice president for administration. “We consider Baylor St. Luke’s and all of the other institutions in the Texas Medical Center our partners and neighbors, and this is one way we can contribute to each other’s missions. We’re especially pleased that
Legal Matters
Continued from page 3 or should not be covered by workers’ compensation. Workers’ compensation laws were difficult to navigate prior to the pandemic, which makes the recent patchwork of legislation and executive orders classifying COVID-19 as an occupational illness even more difficult to understand. As a result, health plans may accidentally or intentionally delay or deny reimbursement. It is important for hospitals to review all claims when health plans seek to delay or deny payment for COVID hospitalizations. C. Takeaways It is complicated to determine if April 2021
Houston Medical Times COVID-19 vaccine Every patient with cancer responds to treatment a little differently – the same is true of COVID-19 vaccines. Here’s what you should know before you’re vaccinated: • Patients with cancer should talk to their physician before getting the vaccine. Immunocompromised patients may have a diminished response to all three vaccines. • Everyone is asked screening questions before getting the vaccine. • For the Moderna and Pfizer-BioNTech vaccines, two vaccine shots, given several weeks apart, are needed to provide the best protection against the virus. Both shots are given in the upper arm. The Janssen/Johnson & Johnson vaccine is given as a single dose. • Everyone who gets a COVID-19 vaccine is required to be monitored
on-site for a minimum of 15-20 minutes after each shot. • If you have a history of allergic reactions after getting shots, contact your primary care physician to discuss whether the vaccine is safe for you. • You will receive a vaccine card. Keep it in a safe place for your records and share a copy with your oncologist. Texas Oncology encourages patients and their families to get vaccinated as soon as possible. Talk to your physician if you are unsure about getting the vaccine based on your personal health history. It’s understandable to have questions and concerns. Your physician can provide evidence-based guidance from leading infectious disease experts and discuss whether COVID-19 vaccines are right for you. Together, we can slow the spread of COVID-19.
this clinic will focus on vaccinating underserved populations in our city as part of our commitment to the Houston community. “ St. Luke’s Health is prioritizing individuals who meet the state’s criteria for distribution at all its vaccine sites, including adults ages 65 and older, individuals with chronic conditions that increase the risk of severe COVID 19 illness, and people who work in school and child care/adult care operations. St. Luke’s Health is proactively reaching out to area schools/districts and care centers to develop plans for vaccinating eligible staff. The Rice Stadium vaccine clinic, located at 2200 University Blvd. (South Stadium Entrance), is not a drive-through clinic and is by appointment only. Individuals who qualify for the current distribution phases and are interested in receiving the vaccine must fill out an online
form at stlukeshealth.org/CovidVaccine to be placed on the waitlist for future vaccine appointments. Individuals without Internet access can register for the waiting list by calling 281-407-8137. It is required that all visitors wear a face covering and maintain a physical distance while on campus and within the vaccination clinic. To date, St. Luke’s Health facilities have administered more than 100,000 doses of the vaccine to individuals who meet the state’s guidelines for distribution. Vaccine supply remains limited, so we urge the community to be patient and continue to follow CDC guidelines for the pandemic. Vaccines are just one tool in our toolkit to prevent the spread of COVID-19. Please remember to wash your hands regularly, always wear face coverings in public, and follow social distancing guidelines and government quarantine directives in your area.
a patient’s stay is covered by workers’ compensation when faced with a health plan that attempts to delay or deny payment. If faced with this scenario, hospitals should consider the following: • Understand your state workers’ compensation laws and the coverage available for COVID-19 hospitalizations. Determine if the state where the hospital is located designates COVID-19 as an occupational illness and whether the patient’s occupation falls within the state’s definition of a “covered worker.” • If the patient is not eligible for coverage under workers’ compensation, then the hospital should appeal the health plan’s delay in or denial of reimbursement.
In addition, the hospital should consider contacting the patient’s employer to jointly assess whether to dispute any state presumptions that a worker contracted COVID-19 on the job. • If workers’ compensation denies all or part of a claim, the hospital should submit the remainder of the bill to the health plan. • As an employer, the hospital should understand whether its own workers’ compensation policy is experience-rated. If so, the hospital may want to be more diligent about ensuring the hospital’s health plan or health plan administrator does not inappropriately delay or deny claims based on workers’ compensation coverage.
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