Thursday, November 14, 2019

Vaping damage `an evil that I haven't faced before' -- Nov. 14, 2019 column


 By MARSHA MERCER

In case you missed it, with all eyes on impeachment, there was sad and shocking news about vaping.

A 17-year-old boy required a double lung transplant last month after vaping destroyed his lungs, hospital officials in Detroit announced Tuesday.

His parents described their son, who was not identified, as a perfectly healthy high school student who loved sailing and playing video games -- until he came down with pneumonia-like symptoms in September.

His worsening condition became so dire he needed the double lung transplant to survive.

“What I saw in his lungs is nothing that I have ever seen before, and I have been doing lung transplants for 20 years,” Dr. Hassan Nemeh, surgical director of thoracic organ transplant at Henry Ford Hospital, told reporters, describing scarred and dead lung tissue.

“This is an evil that I haven’t faced before. The damage that these vapes do to people’s lungs is irreversible,” he said, adding: “Please think of that – and tell your children to think of that.”

He’s right. We can’t rely on any company or the government to protect us from the ravages of vaping. It’s up to each of us.

More than 2,000 people have become ill since March with e-cigarette or vaping-associated lung injury, known as EVALI. Of these, 39 have died. Many victims had used products containing THC, the active ingredient in marijuana that makes someone high, and some had used only nicotine.

The Centers for Disease Control found an association between vitamin E-acetate, an additive in some THC products, and EVALI.

 E-cigarettes were supposed to be a safe way for smokers to quit. They work by heating a liquid to produce an aerosol that users inhale. The liquid can contain nicotine, THC, chemicals and additives.

The hospital did not say what or how long the boy had vaped. The median survival of people who receive a lung transplant is seven years, although he might beat the odds, medical personnel said.

About 28 percent of high school students and 11 percent of middle schoolers use e-cigarettes, a new study reported. No one knows the long-term health effects.

Facing pressure, Juul, the leading e-cigarette company, stopped selling some of its sweet flavors favored by kids, including mint, paused its marketing campaign, and cut 650 workers or about 16 percent of its workforce.

Congress is moving toward regulating e-cigarettes, along with other tobacco products. While e-cigarettes aren’t technically tobacco, they contain nicotine, an addictive substance that comes only from tobacco.

The House Energy and Commerce Committee’s Health Subcommittee Wednesday sent to the full committee a bill to limit tobacco sales nationwide to those 21 and older, prohibit online sales, ban flavored products, including mint and menthol, prohibit marketing to children and increase health warnings.

The House last month passed another measure raising the age for online sales and delivery to 21, among other things.

The Trump administration said in September it will ban the sweetly flavored nicotine delivery systems kids love, sparking an outcry. Hundreds of vape fans protested Saturday on the National Mall, chanting, “We vape, we vote!”

Amid signs cracking down on e-cigarettes could anger voters in key states of Florida, Michigan and Wisconsin, Trump said he would also consider jobs along with health. As of this writing, he has not acted.

But even if e-cigarettes were banned, kids will find them.

What’s needed is an intensive ad and social media campaign to change attitudes and the culture -- to persuade a new generation that e-cigarettes are no better than the ugly cancer stick of a combustible cigarette.

As someone who began smoking cigarettes in high school and smoked on and off for 25 years, I know how comforting nicotine can be – and how deadly. A close friend died of lung cancer in 2002. She was 52.

I’d already quit smoking by then, less because of health than embarrassment. Smoking was no longer cool, like Bogart and Bacall. It was just a smelly, nasty, old habit.

Smoking still kills nearly 500,000 Americans a year. Adults can make their own mistakes, but we can’t allow young people to believe e-cigarettes are an acceptable alternative. That’s just blowing smoke.

©2019 Marsha Mercer. All rights reserved.
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Wednesday, November 6, 2019

When you're the patient, health care no debate -- Nov. 7, 2019 column


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By MARSHA MERCER

Inspired by a Facebook friend, on New Year’s Day I started walking every day.  

On my 295th consecutive day, Oct. 23, I left my house about 8 a.m., planning to be back in about 75 minutes to get to work. I didn’t get home until Nov. 2.

An hour and nearly 4 miles in, I was in the home stretch when my reportorial instincts kicked in. Distracted only for an instant by a police car across the street, I slipped on one of Old Town Alexandria’s charming, but treacherous, brick sidewalks.

I grasped at the tall brick wall on my left but couldn’t catch hold, nor could I regain my balance or stop. I tumbled down hard and couldn’t move. I hurt.

“Are you all right?” asked a passerby on his way to work, which struck me, even then, as an odd question. But his eyes were sympathetic as he helped me up and held my hands.

“Can you stand?” I didn’t know. He let go, and I crumpled to the ground again. More pain.

And that’s how a freak accident landed me in a crash course on American health care.

I’ve reported for decades on health care policy and the politics of health care, but it’s entirely different to see the medical system through a patient’s eyes. When you, or someone you love, is a patient, all you care about is getting well.

My ordeal could have been far worse. I’m active, have good insurance, and kindness and compassion were manifold from the start.

The policewoman from the cruiser across the street and her ride-along medic assessed the situation and called an ambulance. The driver told me he’d take a longer way to the Inova Alexandria Hospital ER to avoid the city’s potholes and work zones.

In the X-ray department, the technicians who had to lift me by sheet onto the X-ray table were gentle and apologetic for adding to my discomfort.

The x-ray showed I’d fractured my right femur or thigh bone in three places. I’d joined the broken hip club. I was immobilized until surgery the following evening to pin it back together.

A couple of days later, I was moved to Inova Rehabilitation Center at Mount Vernon Hospital, where I spent a week in intensive physical and occupational therapy, learning to coax my right leg to move.

I’m home, beginning an in-home regimen of physical therapy to be followed by a long stint of out-patient physical therapy. I hope for a full recovery.

In the hospital, I kept an eye on impeachment proceedings, President Donald Trump’s twitter attacks and other news of the day, but the contrast between the bitter divisiveness in the nation’s capital and the shared purpose at the hospital across the river was striking.

With all the shouting in today’s meanspirited politics, I’d nearly lost hope decency and moral grounding could prevail in our country, but I was wrong. My accident renewed my confidence in America.  

I am in awe of the cheerful nurses and aides who carry the brunt of medical care on 12-hour shifts. Those long days and overnights are tough duty. The doctors, PTs, OTs and other staffers I met were also unfailingly thoughtful, polite and kind.

The medical team was diverse, with many members born outside America but sharing enduring American values.

We are lucky to have immigrants like Hiwot, a tech who came here from Ethiopia 14 years ago. The single mother of two girls, she works three 12-hour days a week, and, because she has dreams, takes classes and studies the remaining days to become a registered nurse.

“I want my daughters to be proud of me,” she said, quickly adding, “They would be anyway.” But with an education, she said, she’ll be able to help them more later.

When I told Dr. Galina Kolycheva, my rehab physician, I was impressed with the dedication of the staff, she said simply, “They want to help.”

Hiwot rolled me out in a wheelchair for my departure, wished me luck and asked:  “Can I give you a hug?”

Absolutely. I wanted to give them all hugs.

(C) 2019 Marsha Mercer. All rights reserved.