Very Short
By Abby Tallmer
Victory for Medicare Recipients
Despite firm and ongoing opposition by pharmaceutical lobbyists and the Bush administration, on January 12, 2007, the now Democratically-run House of Representatives passed legislation introduced by Rep. John D. Dingell (D-Michigan) mandating that the government negotiate with pharmaceutical manufacturers in order to lower drug prices for Medicare beneficiaries. The vote was 255 to 170, with 24 Republicans joining 231 Democrats in supporting the bill (no Democrats voted against it). The vote came just eight days after the new Congress convened, and has yet to go to the Senate, where it faces opposition and — beyond that — threats of a White House veto. Observers expect that most likely the bill will be watered down, but may well — in some form — survive Senate debates and voting.
Since 2003, Medicare law has explicitly prohibited such negotiations, thanks to the Republicans’ beloved “free market” obsession. After the passage of the Dingell measure, the White House released a statement decrying it on the ground that “[g]overnment interference [with Medicare drug costs] impedes competition, limits access to lifesaving drugs, reduces convenience for beneficiaries, and ultimately increases costs to taxpayers, beneficiaries, and all American citizens alike.”
Representative Lois Capps (D-California), responded to this and like arguments as follows: “We can vote in favor of large drug companies that have raked in record profits under the Medicare drug plan. Or we can vote in favor of our senior constituents. Common sense tells me that the big drug companies would not be so adamantly opposed to this bill if they did not fear that it could result in actual price reductions.”
Stay tuned for the next round in this all important match.
Of Costs and Choice
To no one’s surprise, a new survey by the Henry J. Kaiser Family Foundation has found that people in “consumer-directed” health plans devote much more attention to the costs of various health and medical options than do persons under employer-sponsored coverage. More than half of the respondents who were in consumer-directed plans said their approach to their healthcare had changed as a result, with 57 percent saying their approach has specifically changed because of cost considerations. The same was true of only 49 percent of those with employer-sponsored coverage. From the survey’s conclusions: “Most enrollees in the new [consumer-directed] plans say it is difficult for them to find trustworthy information about healthcare costs, and half say the same about quality information on the providers.”
Of Despair and Diagnosis
Approximately two million Americans over the age of 65 suffer from major depression; another five million suffer milder forms of the disease. Many other older Americans are believed to be afflicted but not yet diagnosed with chronic feelings of sadness, loneliness, and despair (chronic generally being defined as lasting for two weeks or more).
Depression, a debilitating but largely treatable condition, was until recently a relatively overlooked health topic — especially depression among seniors — considered not appropriate for public discourse. Well, times have changed, and like many once-taboo health topics (cancer, AIDS, teenage pregnancy), depression and other mental illnesses are now being discussed and studied more openly both within and outside the medical community.
One measure of this new climate of openness is the addition by the government in early January 2007 of information about depression to its SeniorHealth Website, in the hope that this would encourage older Americans and their health-care providers to recognize the symptoms of senior depression. For more information, visit the National Institute of Health’s Website: www.NIHSeniorHealth.gov.
’Tis the Season to Be SAD
Many people report feeling less alive, less happy during the winter months. But for the estimated 14 million Americans seriously afflicted by Seasonal Affective Disorder (SAD) — intense fatigue, a lowered sex drive, a marked plunge in daily productivity, an almost insatiable appetite for breads, pasta, rice, sweets, and other carbohydrates, all capped by the instinct to hibernate, climb into bed, and remain under the covers until spring arrives — this time of year is nearly unbearable.
Although the symptoms of SAD are close to those of depression and are often misdiagnosed as such, SAD is its own distinct syndrome — one that’s thought to be more physically than emotionally derived. It has been described as “an energy crisis [in which] patients are not depressed in the usual emotional sense, but rather feel as if their batteries have run down.” (Dr. Norman Rosenthal, quoted by Jane Brody, “Getting a Grip on the Winter Blues,” New York Times, December 5, 2006.)
Prevailing medical opinion has it that SAD’s origins lie in the shorter days of winter and the comparative lack of direct sunlight — the cause, in some people, of a disturbance in the circadian rhythm that normally regulates the sleep-wake cycle. What can you do to combat SAD? Exercise regularly, eat a high-protein, low- carbohydrate diet, and — perhaps most importantly — supplement winter’s failing light by exposing yourself to “enhanced” lighting for approximately one hour daily. This practice, referred to as “light therapy,” requires sitting in front of a specially designed box that emits about 10,000 lux from a florescent bulb. Such setups cost around $200, and one of the vendors of those boxes, the Center for Environmental Therapies, posts information about SAD on www.cet.org, a Website that’s well worth checking out.
Optimists Live Longer
As if pessimists need another thing to be down about, a new study suggests that optimists have a 55 percent lower risk of death from all causes and a 23 percent lower risk of death from heart failure, as compared with those of less upbeat outlook. It was already known that major depression was a potential risk for heart irregularities, but this study headed by Erik Giltay of the Psychiatric Center GGZ Delfland, The Netherlands, is the first that seems to document a possible correlation between optimism and longevity. From the November 2006 issue of the Archives of General Psychiatry, as reported on the Website Live Science: “A predisposition toward optimism seemed to provide a survival benefit in elderly patients with relatively short life expectancies otherwise.”
Nobody is quite sure what’s behind the apparent increased chances of longevity for upbeat folks, but some experts believe, with the Gilkay team, that pessimistic people “may be more prone to developing habits and problems that cut life short, such as smoking, obesity, and hypertension.” For more details, go to: http://www.livescience.com/humanbiology/041101_optimist_heart.html.
C’mon, Be Happy
All this talk about depression vs. optimism leads to the question of what pessimists — those who see the glass as half empty, not half full — are supposed to do. Is it within our control to turn a “negative” mindset into a “positive” one? The count is not in on this, and there are no easy answers for those predisposed towards cynicism, but we do have a few hints gleaned from current research. It is suggested, for instance, that merely anticipating mirth will bring it on to some extent. Scientists at Loma Linda University in California divided subjects into two groups. All were told they were going to watch a movie. One batch was informed that it was going to see a comedy, the other was not. “Blood drawn from experimental subjects just before they watched the [comedy] video has 27 percent more beta-endorphins [endorphins are believed to play a large part in giving humans a quick surge of feelings of power and cheerfulness, viz. the ‘endorphin high; many report experiencing after sex or strenuous exercise] and 87 percent more human-growth hormone, compared to blood from the control group, which didn’t anticipate the watching of a humorous video.” So said Lee Berk of Loma Linda U. as reported on the Live Science Webpage. Berk said that these results, combined with previous research into the positive effect of laughter on mood, “would appear to carry important, positive implications for wellness, disease-prevention, and most certainly stress-reduction.” (see “Don’t Laugh: Just Think About It,” at http://www.livescience.com/humanbiology/060331_laughter_good.html).
So with some people, at least — those with a focused mindset and a lot of mental control — the power of suggesting happiness seems to bring it on. This sounds simple enough: Think happy, be happy. But what about the other folk, those of us who cannot suspend our instinctual or learned or at times realistic pessimism?
For one thing, a form of psychiatry called “positive” or “cognitive” therapy may (along with medication as needed, and the help of a competent psychiatrist or therapist) prove very valuable. The gist of it is to consciously retrain yourself to turn “bad” thoughts into “good” ones, i.e., literally rephrasing your thoughts to yourself. For instance, instead of telling yourself: “I’m a loser. It was my fault my ex-partner left, and I’ll never have anyone and be alone forever,” turn this into: “Oh well, that relationship didn’t work. But it takes two to tango, and I know I did my best. I know that there are so many other fish in the sea, and soon I’ll meet somebody with whom I click and who appreciates me.”
Many patients engaged in positive or cognitive therapy report that this sort of reprogramming can feel very forced at the beginning, and they find themselves saying cheery things to themselves that they simply do not believe. However, after many months (or in some cases, years) of cognitive/positive therapy, subjects do often come to embrace and accept the positively rephrased internal monologues that they initially said by empty rote or ridiculed.
For a detailed look at this therapy and its effects, simply Google “positive therapy and/or cognitive therapy” and you’ll find more articles than you ever dreamed of.
Enough With the Sadness, Take Care of Your Eyes
Having exhausted (in every sense) the topic of happiness and its antithesis, we turn now to an equally vital health matter of special concern to seniors: glaucoma and its prevention.
What is glaucoma, and why is it of concern? Here are some stark answers:
Glaucoma refers to a group of eye diseases that attack the optic nerve. They destroy eyesight in a slow but insidious fashion. This usually starts with a loss or diminishment of peripheral vision, and if left untreated often leads to total blindness. It is the second leading cause of blindness in the world, and often a marker for other chronic conditions like diabetes and hypertension which, if left untreated, can also be deadly.
Seniors are particularly at risk: Glaucoma usually strikes one in 200 people by age 50, and as many as one in ten by age 80. Other people of any age at high risk for glaucoma include those with diabetes, and/or with a family history of glaucoma, and — most especially — African-Americans. It tends to develop ten years earlier in African Americans than in Caucasians, and is the leading cause of blindness in African-Americans nationwide.
The good news is that glaucoma is treatable. If caught early enough, it can be controlled and its effects minimized.
The key to preventing and managing the effects of glaucoma? Early detection and early treatment. So if you haven’t already done so, put going to the eye doctor for a glaucoma screening at the top of your list.
