Tumor Treating Fields—a review and graphic

Treatment for glioblastoma approved in 2015.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406491/

https://www.ncbi.nlm.nih.gov/pubmed/29349613https://www.ncbi.nlm.nih.gov/pubmed/29349613

https://www.ncbi.nlm.nih.gov/pubmed/28298023

“In 2011, the United States Food and Drug Administration (FDA) approved a tumor treating fields (TTF) device for treatment of recurrent or refractory GBM. More recently, the FDA approved the TTF device as adjuvant treatment for newly-diagnosed patients after completing standard-of-care surgery and chemoradiation. The National Comprehensive Cancer Network (NCCN) added the TTF device as an option for treatment of newly-diagnosed GBM. Despite FDA approval, skepticism remains regarding this therapy. In this review we discuss the current evidence supporting treatment with the TTF device and its limitations.”

TT Fields Treatment https://www.hopkinsmedicine.org/health/conditions-and-diseases/brain-tumor/tt-fields-tumortreating-fields-for-brain-tumors

• The TT fields treatment device is portable and may help people treat their cancer while continuing their normal activities.
  
• People undergoing TT fields therapy use small transducers that are attached to their head with adhesive bandages. Hair must be shaved in order to use the device.
  
• The transducers are connected to wires, which are plugged into a battery that is about the size of a book. The batteries fit into a bag that the person carries with them, either in a backpack, across the body, or over the shoulder like a messenger bag.
  
• The system comes with multiple batteries and a charging station. The user is alerted when batteries need to be changed.
  
• The therapy is continual, but people can unplug the device for short times
  

There’s Good News in the Bible, but also in the economic news

There's a lot of good news out there if only the liberal media would let you in on it. The U.S. Census Bureau’s latest report on income and poverty, which came out in October found real median family income up 1.2 percent from 2017 to 2018, real median earnings up 3.4 percent, the number of full-time, year-round workers increased by 2.3 million, and the poverty rate declined from 12.3 percent to 11.8 percent, with 1.4 million people leaving poverty. That's why Democrats want to impeach the President. The poverty and earnings report combined with the November jobs report could just signal that not as many people need the federal government, and for leftists, that's tragic news.

https://www.nationalreview.com/the-morning-jolt/the-world-is-getting-better-its-just-that-no-one-tells-you-about-it/

There are many items of good news in this article—from medicine to technology to environment.

Old lady learning. . . slowly

             

I am feeling so. . .techie.  Today I unsubscribed to maybe 10 e-mails I never read, and am pretty sure I never signed on to, changed a few passwords, learned to recharge my husband's FitBit and I finally used my MD's message portal so I can look at the results of my exam on Tuesday. But nothing, nothing, feels as nice as a book and a #2 lead automatic pencil.  It seems I'm not going to be able to fix my LiveWriter, a blog publishing application developed by Microsoft which I just love and use for blogging.  It is no longer being supported.

On to the i-pad mini I got for Christmas.

 http://www.hanselman.com/blog/AnnouncingOpenLiveWriterAnOpenSourceForkOfWindowsLiveWriter.aspx

What has NIH done with funding specifically for preparedness and biosurveillance?

The NIH has already been given massive amounts of money beginning with post Katrina funding to handle the situation we have now with Ebola.  Where has the money gone?

Here’s what’s covered in the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013

• National Health Security Strategy
• Assistant Secretary for Preparedness and Response
• National Advisory Committee on Children and Disasters
• Modernization of the National Disaster Medical System
• Temporary reassignment of State and local personnel during a public health emergency
• Improving State and local public health security
• Hospital preparedness and medical surge capacity
• Enhancing situational awareness and biosurveillance
• Enhancing medical countermeasure review
• Accelerating medical countermeasure advanced research and development

“The 2013 law builds on work the U.S. Department of Health and Human Services has undertaken to advance national health security. These include authorizing funding for public health and medical preparedness programs, such as the Hospital Preparedness Program and the Public Health Emergency Preparedness Cooperative Agreement. These programs build the capabilities of communities’ health care and public health systems to support people in need during and after disasters.

Thousands of hospitals and communities across the country participate in these programs, and because of this participation they now have stronger capabilities and better planning to respond to disasters. They regularly exercise and conduct drills. They are building partnerships across their communities so that if parts of the infrastructure are overwhelmed by disaster, the system can still provide care. Using these programs over the past seven years to strengthen health systems and build coalitions, states have been able to handle in a number of disasters on their own without federal responders.”

http://www.hhs.gov/news/press/2013pres/03/20130313a.html

https://www.govtrack.us/congress/bills/113/hr307/text

Aren’t you glad Obamacare is saving health care dollars

According to data released by Senators Orrin Hatch (R-UT) and Chuck Grassley (R-IA), the three major carriers in the D.C. exchange only signed up a few each; a fourth signed up no one.

Care First, Blue Cross Blue Shield: two enrollees from Oct. 1, 2013, through Oct. 30, 2013.

Kaiser Permanente: three enrollees from Oct. 1, 2013, through Oct. 31, 2013.

United Healthcare: no enrollment data from the exchange as of Nov. 4, 2013.

Aetna: No enrollment data as of Oct. 24, 2013.

The Centers for Medicare & Medicaid Services have posted the amount of grant money given to the D.C. exchange. The total from these publicly-released figures are $133,573,928: $72,985,333 for an "Establishment Grant Level Two Application Summary," with an "Administrative Supplement Award Amount" of $16,969,089; $8,200,716 and $34,418,790 awarded separately for an "Establishment Grant Level One Application Summary;" and $1 million for s "State Planning Grant."

This means that the cost to the American taxpayers per enrollee in D.C. has been $26,714,785.60 each.

Information link here.

There is nothing government can do cheaper than private industry, but there are a few things it must do according to the Constitution.  Health care isn’t one of them.

Cadillac insurance? Do you have it?

I used to. I worked for Ohio State University, and you just couldn't beat the benefits (salary wasn't great, though). Some I never was able to use (although they were added into my salary deductions). My husband used to say that the reason he went into business for himself was "the wife got tenure, the children left home and the cat died." My job with health benefits saved us a bundle--not on health care, but on insurance. As a partner in his former firm Feinknopf Macioce and Schappa, he was not eligible for the group plan, so his insurance was bought with before-tax dollars before I got on board at OSU--about $6,000 a year 20 years ago.

President Obama promised in September on numerous talk shows and venues that if you loved your health insurance plan nothing would change. Of course, HE LIED, as he has lied about a lot of things (Obama lied; insurance died). The so called "cadillac" option will penalize people who have them, private or job related, by taxing them out of existence. Here are two examples. First the rich guy who is paying $20,000 a year for his insurance out of his own pocket.

"Mitch Stabbe has one of these plans. He's a lawyer in Washington, D.C. Through his firm, he gets a plan that has an annual premium of more than $20,000, which he pays for himself. Stabbe is a partner, and is considered self-employed, so the firm doesn't contribute to his health coverage.

Stabbe says that when he factors in deductibles and co-payments, the family ends up spending close to $30,000 a year on health care. "That's a nice chunk of change," he says. He believes it's worth it, because otherwise the family would have huge medical costs.

Stabbe's 18-year-old son Bryan has Crohn's disease, a chronic illness that attacks the digestive system. Bryan takes a weekly oral medication, and every five to six weeks, gets an infusion of a drug called Remicade. Without insurance, the infusions alone would cost around $40,000 a year."

So maybe he's rich enough to afford the huge tax increase he'll have to pay, but last year, there were a lot of people who thought they were rich. Then the sub-prime melt down; then Bernie Maddof, etc.

Now here's the not so rich family--a secretary and her disabled husband who doesn't work. They have what I used to have--health care through a college.

"Rusty and Deb Lovell live in Concord, N.H. Rusty had to stop working about a year ago and gets Social Security disability payments. Deb earns a little over $30,000 a year as a secretary at a community college.

But her job also comes with something almost as valuable as her salary — employee health coverage from the state of New Hampshire. Deb's share of the premium cost is $60 a month. Yet when combined with what the state contributes, the total premium for her family coverage ranks in the top 4 percent of premiums in the country.

The plan is negotiated by the state employees union, and Deb says the coverage is "so important to us that we have often negotiated for keeping our insurance and foregone raises year after year."

For the Lovells, the benefit has been priceless. Eight years ago, Rusty was diagnosed with chronic myelogenous leukemia. . . Last year alone, Rusty's care cost more than $1 million. Because of their generous health insurance plan, the total cost for the Lovells came to $500 in co-payments. " Kaiser Health News

Remember, the basis for Obamacare is communal sharing, rationing of services and treatments, weighting care toward the younger members of the community instead of the elderly, with everybody being equal, and only using proven efficacious treatments. Obviously, it wouldn't be equal if the rich guy got to buy more than the state afforded a secretary, and they obviously aren't going to be able to offer Deb's insurance (top 4%) to everyone, so she'll have to be a good sport and not waste so much of health-care resources. The CBO says the government will be collecting $10 billion in "cadillac" revenue in just one year--that's why he can say it won't add to the deficit (HE LIES!). Remember, the taxes start a number of years before the changes take place, too.

I think there's a lot of college and university employees who are going to be surprised to be hit that that great leveling tax surcharge on their health insurance. A little pocket change left over is all they can hope for.

And now they gather and groove at Tea Parties and Obamacare Town Halls

Woodstock. 40 years later. The boomers can get real mad at you when you try to take something away from them, like drugs (the helpful kind), hip replacements, valve repairs, prostate exams, colonoscopies, MRIs, heart monitors, AIDS cocktails, flu vaccines, radiographs, echo cardiograms, insulin, Lipotor, etc. It's nice that recent research continues to find the long term benefits of aspirin, but "take one and call me later," is just not going to fly with this group. They are not their parents' elder generation!

What you can expect with government health care

After Obama succeeds in destroying your current health insurance plan by making it too expensive for small and midsize businesses, what can you expect from the federal government when your employer catches on? It won't be what our elected officials, or civil servants, or even Medicare recipients currently get (although that's about to end). Or even what 3.3 million Native Americans and Alaskan First People get, who have cradle-to-grave care and yet have the highest disease burden and the lowest life expectancy of any U.S. group (how's that plan working). We're about to see one of the biggest give aways to any special interest group (medical technology) from ARRA (stimulus package)--$20 billion--and I know that's just the beginning price tag. I don't know as I'd call those "shovel ready" stimulus jobs or not--the tech field was doing just fine, I thought, with entrepreneurs like Bill Gates and the Google Guys. If you've ever worked with computers, you know the constant upgrading, not talking to each other, and screw ups that can happen. Especially if the government is doing it (I've lost track of the times my identifying information (state of Ohio) has been lost to a hacker or someone taking home a gov't computer that shouldn't and having the computer stolen out of the back seat.)

But back to the Indians and their care givers--I wonder how the IHS will be able to squander the ARRA funds?

"Since June 2008, when Indian Health Service (IHS) officials agreed to implement more stringent controls over property management, the agency has lost about $3.5 million in equipment, according to a Government Accountability Office (GAO) report released on June 2 (http://www.gao.gov/new.items/d09450.pdf).

According to the report, missing items included an ultrasound unit (valued at $170 000), an x-ray mammography machine (valued at $100 795), dental chairs, cardiac and vital sign monitors, and a pharmacy tablet-counting machine.

The GAO criticized IHS for taking few steps to ensure that its employees are aware of and complying with property policies. It also suggested that the agency failed to hold individuals accountable, noting that the executive in charge of the agency's property group and other areas was given a $13,000 bonus after a GAO report issued last year found that an estimated 5,000 items with an acquisition value of $15.8 million were reported lost or stolen in fiscal years 2004-2007. Mike Mitka, JAMA, July 8, 2009, p. 136.

And although the government disapproves of businesses giving out bonuses to executives for incentives if the business is losing money, it doesn't mind giving bonuses through its own agencies and programs which are notorious spendthrifts and seem to have gotten us into this pickle, which the government now claims it is going to solve by throwing more money into the laps of the same people! This is not new to the Obama Administration. Before, Obama Bush was the all-time big spender President--Obama has made him look like a penny pinching piker.

"The federal government plans to kick its purchasing power into high gear by offering Medicare and Medicaid bonuses to physicians and hospitals that demonstrate "meaningful use" of interoperable, certified EHRs starting in 2011. The stimulus package also provides billions of grant dollars to federal and state organizations for research and the promotion of health-IT adoption." Government technology

I'm all in favor of incentives--but only in private hands. But guess what else is wanted with that $20 billion from the tax payers? Your patient data. Ah, yes. They are salivating over that--and not for you, oh no, but for the "common good" . . . "the collection of aggregate patient data that could vastly improve patient safety, public health monitoring, and medical knowledge. Kind of HIPAA in reverse, I think. There is also a proposal being floated that we not have a choice about participating in medical research (as a control, as a donor, etc.) "The Obligation to Participate in Biomedical Research," JAMA, July 1, 2009 p. 67. I thought it was about the scariest thing I'd ever read combined with the med tech rec threat. The authors, Schaefer, Emanuel and Wertheimer, called reluctance or refusal to participate, "free riding." In other words, your DNA, your experience, or your sick child are just so much gravel to pave the road to losing your freedom. It could be a trade off for the charitable deduction which will probably be taken away (Biden and Obama really didn't use those much anyway)--donate at the lab instead of church.

Another medical boondoggle in the ARRA is $1 billion to support comparative effectiveness research. I'd call that a jobs program for researchers who didn't get medical degrees comparing this device to that device, practice A to practice B, therapy Y to therapy X and then filing for more grant money when no one pays attention.