Health and Disability

Schulte, 64, was living an engaged life — staying in touch daily with her daughter, Stephanie Sinclair, a photojournalist, and taking afternoon drives with her husband, Joe. When she suffered an unexpected bout of seizures in August 2012, doctors said she would need only a short hospital stay until the drugs kicked in to remedy things.

Instead, her treatment triggered a cascade of medical mistakes.

A fall from bed broke her hip and wrist — injuries that went undiagnosed for days. A hip replacement became infected, requiring another surgery. A displaced IV pumped a caustic drug into her arm until it ballooned to the size of a melon.

Schulte died as a rare syndrome, thought to be triggered by a reaction to medication, blistered her eyelids and attacked her internal organs. Doctors said it was the type of condition they had only read about in textbooks.

A close examination of Schulte’s care shows that for all the errors contributing to her decline, neither physicians nor hospitals were held accountable for any of them. Little was done to protect other patients from similar mistakes.

Medicare coverage for wheelchair components such as seat and back cushions is safe for another year thanks to a lightning-quick act that was introduced into Congress yesterday, Dec. 17, and passed today, Dec. 18. “The average time for a bill to pass is seven years,” says Alexandra Bennewith, vice president government relations for United Spinal Association. “This shows that advocacy does work. It’s hard, it’s not easy, you have to be persistent and committed like crazy, but it works.”

The Patient Access and Medicare Protection Act was expedited through the Senate using what is called the “hot line” process, meaning each senator had 24 hours to object and if there were no objections then it automatically passed. “United Spinal activated many advocacy groups over the course of a year and this week it got down to the wire, but finally yesterday late afternoon Sen. Portman and others introduced the act. It went so quickly. We were pushing, making sure everyone’s questions were answered so they wouldn’t object and it passed in the Senate today,” says Bennewith. “We had already set it up so Speaker Ryan and others on the House side were ready to just accept it once it passed the Senate, and then it passed in the House in a matter of minutes.”

Michigan, in agreeing to accept federal funding to expand Medicaid coverage, tailored the state plan to include personal accountability measures. Those provisions helped win over some Republicans who were otherwise opposed to the Affordable Care Act but required approval from the Centers for Medicare and Medicaid Services.

"We're a leader when it comes to states. It was a very innovative model," Nick Lyon, director of the Michigan Department of Health and Human Services, said Wednesday before the waiver approval, which his team had been working on with CMS. "And anything we can do to build a more preventive mindset really goes a long way towards saving costs in the future."

Healthy Michigan, as originally designed by state lawmakers, included a soft coverage cap. After 48 months, recipients would have to pay higher out-of-pocket costs or purchase private insurance through an Affordable Care Act exchange.

The waiver approval appears to allow for a modified model. All recipients who earn between 100 and 133 percent of the poverty level will have a coverage choice beginning in April 2018, which is four years after Healthy Michigan began.

To qualify for Healthy Michigan, they'll have to meet healthy behavior requirements. If they enroll in the federal marketplace option, they will pay premiums but would still have the opportunity to enroll in Healthy Michigan if they later meet behavior requirements.

The pathology results came in four days later. Penny learned that he had peritoneal mesothelioma — a rare cancer of the lining of the abdomen almost always tied to asbestos exposure. He concluded, after consulting with a lawyer, that he'd inhaled microscopic asbestos fibers about a decade earlier while installing fiber-optic cable underground. He sued telecommunications giant AT&T.

Physicians, scientists and union officials had people like him in mind when they convened in New York in 1990 to discuss what they called the looming "third wave" of asbestos disease.

In his lawsuit, Penny alleges that BellSouth, now part of AT&T, never told him or other Danella workers that the conduit contained asbestos, even as it cautioned its own employees not to use compressed air or break the pipe without wetting it down. Such warnings were being delivered "by the mid-'90s at the latest, years before Kris ever got into a manhole," said his lawyer, Jonathan Ruckdeschel.

"BellSouth claims that they stopped installing new asbestos conduit in the early '80s, so any pipe he was working with had to have been in the ground for at least 20 years by the time he got there," Ruckdeschel said. "And yet there's nothing inside the manhole to tell the worker, 'Don't do the things that are going to cause you to get exposed. Be careful — this is asbestos-cement pipe. Invisible amounts of asbestos dust can cause you to die.' "

Tinnitus, otherwise known as ringing in the ears, affects nearly one-third of adults over age 65. The condition can develop as part of age-related hearing loss or from a traumatic injury. In either case, the resulting persistent noise causes varying amounts of disruption to everyday.

The researchers reported that, in contrast to those without tinnitus, patients with mild tinnitus showed greater engagement of different areas in the brain when processing emotional sounds.

To further understand this altered brain activation, Husain conducted a new fMRI study to see if there were any differences among tinnitus patients. Because some patients adjust to the ringing in the ears while others do not, the severity of the condition can vary greatly. Husain's team measured the severity of tinnitus, or tinnitus distress, with a series of surveys and questionnaires assessing hearing, attention, emotion and sleep.

Patients with lower tinnitus distress used an altered pathway to process emotional information. The path did not rely on the amygdala, commonly believed to play an important role in emotion processing in the brain. Instead, patients who had adapted to their tinnitus symptoms used more of the brain's frontal lobe, a region critical for attention, planning and impulse control. The researchers suggested that the greater activation of the frontal lobe might be helping to control emotional responses and reduce tinnitus distress.

Neurologists prowling the popular video-sharing website have identified 33 videos that show how to perform the Epley maneuver, a simple procedure used to treat benign paroxysmal positional vertigo (BPPV), a common type of vertigo caused by tiny particles trapped in the inner ear.

In a study published today in the journal Neurology, the doctors determined that two-thirds of the videos were accurate in their portrayal of the procedure, which entails a sequence of sitting and standing positions along with eye and head movements designed to move particles trapped in one part of the inner ear, where they cause dizziness, into another part, where they do not.

The researchers were pleased to learn that the most popular video was produced by the American Academy of Neurology and demonstrates the organization’s guidelines for the maneuver:

The results of the study, which were published in the December 2015 issue of Health Affairs, included these major findings:

• Doctors’ views of practice preparedness to manage the care of these patients decline steeply when patients have severe mental illness or substance abuse-related problems.
• Primary care practice capacity to provide enhanced access and care management depend heavily on the use of allied health professionals and technology solutions, such as email access and patient portals.
• Primary care physicians’ ability to coordinate care for these patients is hampered by lack of communication with specialists, hospitals and emergency departments, home care providers, and social services organizations.
• Uptake of electronic medical records (EMRs) has been steep over the past three years, especially in Canada and the United States, but interoperability remains a significant challenge.

Their research team evaluated 154 dry eye patients from the Miami Veterans Affairs Hospital. "Dry eye patients in our study reported higher levels of ocular and non-ocular pain associated with multiple chronic pain syndromes, and had lower scores on depression and quality-of-life indices consistent with a central sensitivity disorder," said Levitt, a professor and Vice Chair of Translational Research and Academic Affairs in the Department of Anesthesiology, Perioperative Medicine and Pain Management. "We also suspect that neuropathic ocular pain may share causal genetic factors with other overlapping chronic pain conditions."

The American Eye Institute estimates that dry eye affects about 3 million Americans every year. When the eyes do not produce an adequate supply of tears or the tears evaporate too quickly from the surface of the cornea, patients develop an "itchy" or painful sensation. Left untreated, dry eye can lead to inflammation, ulcers or scars on the cornea.

"Patients' eyes may become hyper-sensitive to stimuli, such as wind or light, or have spontaneous pain such as a feeling of burning, which is typically associated with nerve injury," said Levitt.

"Traditionally, eye specialists have treated dry eye with artificial tears or topical medications for the surface of the cornea," said Galor. "However, even if these treatments improve some dry eye symptoms, many patients continue to report underlying ocular and non-ocular pain."

The study was conducted by The University of California, San Diego and the Department of Veterans Affairs. The study results, also published in the Society for Neuroscience (SfN) annual meeting and poster program, indicated the 28 day AVACEN follow-up study exhibited a statistically significant reduction of over 40% in the widespread pain index and a decrease in tender point count to a level below the value typically used for the clinical assessment of fibromyalgia.

These results were derived from a treatment process that uses the palm to noninvasively transfer heat into the circulatory system while the body is at normothermia (approximately 98.6 degrees F). The Company refers to this process as the AVACEN Treatment Method.

Muehlbauer added, "Our patented AVACEN Treatment Method is an entirely new concept in chronic pain treatment through whole-body muscular relaxation. This is accomplished by bathing the skeletal muscles with warm oxygenated and nutritious blood. Our FDA-Cleared AVACEN 100 uses the AVACEN Treatment Method."

"The key is the continued infusion of heat into the circulatory system through the palm when the body is at normothermia, approximately 98.6 degrees F. The heat acts as a catalyst to reduce the thickness of the blood. The result is the body must dissipate the unwanted heat by pumping the warmed and thinner blood through the skeletal muscles to reach the heat exchange capillary network where it can be cooled by the ambient air. It should be noted that the level of heat is precisely controlled so that it cannot induce heatstroke. Actually, the level of infused heat normally doesn't even engage the sweat glands."

ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world. Learn more about clinical studies and about this site, including relevant history, policies, and laws.