Hands to Help Seniors

One more bit of drama at Salinas Valley Memorial Hospital has finally come to an end.  Last week, the Fair Political Practices Commission approved a deal whereby former SVMH board member Jim Gattis will pay a $2,500 fine for voting on the termination of an office lease in which he had a financial interest.  It’s a small thing, Gattis says he made the vote unintentionally and since he did not intend to benefit the fine is small.  However, it’s just one more piece of bad press that the hospital has struggled to get away from over the last several years.  Hopefully this will be the end of it.

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Knee and hip replacement has become commonplace with seniors, and now ankle replacements are becoming in vogue.  Historically, those with ankle problems have gone for ankle fusion surgery, which restores lost range of motion and flexibility.  However, new artificial joints with mobile bearings can give patients even more mobility particularly with climbing stairs and doing strenuous exercise like hiking and skiing.  The more recent models last about ten to 15 years and Medicare or private insurance typically will pay for most of the cost of the surgery.   Most seniors want to remain active and this is a great way to be able to enjoy hobbies you aren’t able to now because of a bad ankle.

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Basal-cell carcinoma is the most common type of cancer in the U.S.  Although it’s rarely fatal, if it does progress to an advanced stage it can be life threatening.  Until recently, there wasn’t much which could be done for advanced basal-cell carcinoma.  However, new drugs are coming to market which can help those that get into this unfortunate situation.  Melanoma only occurs in about 76,000 cases out of the 2.3 million skin-cancer diagnoses each year, according to the American Cancer Society.  About 80% of the 2.3 million are basal-cell carcinoma.  Melanoma results in 9,700 deaths per year versus 2,000 deaths a year for non-melanoma skin cancer.   In 2012, the Food & Drug Administration (FDA) approved the first drug for basal-cell carcinoma (Erivege), although at $8,600 a month, treatment is pricey to say the least.  However, Novartis AG has applied to the FDA for approval of another drug called sonidegib, so hopefully this will drive prices down.

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Food labeling has come a long way in this country and the Food & Drug Administration (FDA) is moving it another step forward.  After a three year delay for new food labeling to come into effect which was part of the Affordable Care Act but was fought vehemently by pizza parlors and movie theater chains, they have finally arrived.  Rules were announced today which will require chain restaurants, pizza parlors and even movie theaters to post calorie counts on their menu or at their snack bar.  Even drink menus in bars will be required to post their calories.  Roughly one-third of the calories that we take in are consumed outside of the home, so the FDA is hoping that this ruling will be one more step in the direction of reducing obesity in this country.  "This is one of the most important public health nutrition policies ever to be based nationally, Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, told The New York Times.  I think it's a great policy.  Obesity is a huge problem in this country and can lead to diabetes, stroke, heart disease and many other chronic problems.  Hopefully, no one goes into cardiac arrest the next time they go to the movies and see the calorie count on a large tub of buttered popcorn, a large coke and a big box of thin mints.

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Millions of Americans who have had stents placed in them to fight heart disease should stay on an aggressive course of blood thinners for a long period of time, according to a new research report. The study looked at 10,000 patients with stents that were treated with aspirin plus a second anticlotting drug for 30 months. They showed a sharp reduction in heart attacks versus those that stopped using the blood thinners after just one year. However, the flip side is that prolonged use of blood thinners can result in significant bleeding problems. Some patients complain of easy bruising and nose bleeds as well. These side effects, however, may be worth it if the alternative is having a massive heart attack. Current guidelines in the U.S. call for the dual-antiplatelet therapy for 12 months and some cardiologists have argued for an even shorter time frame. After this study (which was conducted at Harvard associated Brigham and Young Hospital and published in the New England Journal of Medicine), however, this plan may have to be revisited. Those staying on the medicine longer were 53% less likely to have a heart attack. Also notable is that 55% of the avoidable heart attacks were due to clots in arteries without the stent, suggesting the blood thinners were helping in arteries in which the patient and doctor may not even have been aware that there was a problem.

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