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magnetictapedatastorage · 3 years

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I’ve started keeping a list of questions, remnants of a past life that I now need a beat or two to remember, if I can remember at all: What time do parties end? How tall is my boss? What does a bar smell like? Are babies heavy? Does my dentist have a mustache? On what street was the good sandwich place near work, the one that toasted its bread? How much does a movie popcorn cost? What do people talk about when they don’t have a global disaster to talk about all the time? You have to wear high heels the whole night? It’s more baffling than distressing, most of the time.

Full text of the (excellent) article is under the cut. (The Atlantic, March 8th, 2021)

I first became aware that I was losing my mind in late December. It was a Friday night, the start of my 40-somethingth pandemic weekend: Hours and hours with no work to distract me, and outside temperatures prohibitive of anything other than staying in. I couldn’t for the life of me figure out how to fill the time. “What did I used to … do on weekends?” I asked my boyfriend, like a soap-opera amnesiac. He couldn’t really remember either.

Since then, I can’t stop noticing all the things I’m forgetting. Sometimes I grasp at a word or a name. Sometimes I walk into the kitchen and find myself bewildered as to why I am there. (At one point during the writing of this article, I absentmindedly cleaned my glasses with nail-polish remover.) Other times, the forgetting feels like someone is taking a chisel to the bedrock of my brain, prying everything loose. I’ve started keeping a list of questions, remnants of a past life that I now need a beat or two to remember, if I can remember at all: What time do parties end? How tall is my boss? What does a bar smell like? Are babies heavy? Does my dentist have a mustache? On what street was the good sandwich place near work, the one that toasted its bread? How much does a movie popcorn cost? What do people talk about when they don’t have a global disaster to talk about all the time? You have to wear high heels the whole night? It’s more baffling than distressing, most of the time.

RECOMMENDED READING

There’s No Real Reason to Eat 3 Meals a DayAMANDA MULL

The Pandemic’s Future Hangs in SuspenseTHE COVID TRACKING PROJECT

A Quite Possibly Wonderful SummerJAMES HAMBLIN

Everywhere I turn, the fog of forgetting has crept in. A friend of mine recently confessed that the morning routine he’d comfortably maintained for a decade—wake up before 7, shower, dress, get on the subway—now feels unimaginable on a literal level: He cannot put himself back there. Another has forgotten how to tie a tie. A co-worker isn’t sure her toddler remembers what it’s like to go shopping in a store. The comedian Kylie Brakeman made a joke video of herself attempting to recall pre-pandemic life, the mania flashing across her face: “You know what I miss, is, like, those night restaurants that served alcohol. What were those called?” she asks. “And there were those, like, big men outside who would check your credit card to make sure you were 41?”

Read: Sedentary pandemic life is bad for our happiness

Jen George, a community-college teacher from Cape Elizabeth, Maine, told me she is losing her train of thought in the middle of a sentence more and more often. Meanwhile, her third grader, who is attending in-person school, keeps leaving his books, papers, and lunch at home. Inny Ekeolu, a 19-year-old student from Ireland, says she has found herself forgetting how to do things she used to do on a regular basis: swiping her bus pass, paying for groceries. Recently she came across a photo of a close friend she hadn’t seen since lockdown and found that she couldn’t recognize her. “It wasn’t like I had forgotten her existence,” she told me. “But if I had bypassed her on the street, I wouldn’t have said hi.” Rachel Kowert, a research psychologist in Ottawa, used to have a standing Friday-night dinner with her neighbors—and went completely blank when one of them recently mentioned it. “It was really shocking,” Kowert told me. “This was something I really loved, and had done for a long time, and I had totally forgotten.”

This is the fog of late pandemic, and it is brutal. In the spring, we joked about the Before Times, but they were still within reach, easily accessible in our shorter-term memories. In the summer and fall, with restrictions loosening and temperatures rising, we were able to replicate some of what life used to be like, at least in an adulterated form: outdoor drinks, a day at the beach. But now, in the cold, dark, featureless middle of our pandemic winter, we can neither remember what life was like before nor imagine what it’ll be like after.

To some degree, this is a natural adaptation. The sunniest optimist would point out that all this forgetting is evidence of the resilience of our species. Humans forget a great deal of what happens to us, and we tend to do it pretty quickly—after the first 24 hours or so. “Our brains are very good at learning different things and forgetting the things that are not a priority,” Tina Franklin, a neuroscientist at Georgia Tech, told me. As the pandemic has taught us new habits and made old ones obsolete, our brains have essentially put actions like taking the bus and going to restaurants in deep storage, and placed social distancing and coughing into our elbows near the front of the closet. When our habits change back, presumably so will our recall.

That’s the good news. The pandemic is still too young to have yielded rigorous, peer-reviewed studies about its effects on cognitive function. But the brain scientists I spoke with told me they can extrapolate based on earlier work about trauma, boredom, stress, and inactivity, all of which do a host of very bad things to a mammal’s brain.

“We’re all walking around with some mild cognitive impairment,” said Mike Yassa, a neuroscientist at UC Irvine. “Based on everything we know about the brain, two of the things that are really good for it are physical activity and novelty. A thing that’s very bad for it is chronic and perpetual stress.” Living through a pandemic—even for those who are doing so in relative comfort—“is exposing people to microdoses of unpredictable stress all the time,” said Franklin, whose research has shown that stress changes the brain regions that control executive function, learning, and memory.

That stress doesn’t necessarily feel like a panic attack or a bender or a sleepless night, though of course it can. Sometimes it feels like nothing at all. “It’s like a heaviness, like you’re waking up to more of the same, and it’s never going to change,” George told me, when I asked what her pandemic anxiety felt like. “Like wading through something thicker than water. Maybe a tar pit.” She misses the sound of voices.

Prolonged boredom is, somewhat paradoxically, hugely stressful, Franklin said. Our brains hate it. “What’s very clear in the literature is that environmental enrichment—being outside of your home, bumping into people, commuting, all of these changes that we are collectively being deprived of—is very associated with synaptic plasticity,” the brain’s inherent ability to generate new connections and learn new things, she said. In the 1960s, the neuroscientist Marian Diamond conducted a series of experiments on rats in an attempt to understand how environment affects cognitive function. Time after time, the rats raised in “enriched” cages—ones with toys and playmates—performed better at mazes.

Ultimately, said Natasha Rajah, a psychology professor at McGill University, in Montreal, our winter of forgetting may be attributable to any number of overlapping factors. “There’s just so much going on: It could be the stress, it could be the grief, it could be the boredom, it could be depression,” she said. “It sounds pretty grim, doesn’t it?”

The share of Americans reporting symptoms of anxiety disorder, depressive disorder, or both roughly quadrupled from June 2019 to December 2020, according to a Census Bureau study released late last year. What’s more, we simply don’t know the long-term effects of collective, sustained grief. Longitudinal studies of survivors of Chernobyl, 9/11, and Hurricane Katrina show elevated rates of mental-health problems, in some cases lasting for more than a decade.

I have a job that allows me to work from home, an immune system and a set of neurotransmitters that tend to function pretty well, a support network, a savings account, decent Wi-Fi, plenty of hand sanitizer. I have experienced the pandemic from a position of obscene privilege, and on any given day I’d rank my mental health somewhere north of “fine.” And yet I feel like I have spent the past year being pushed through a pasta extruder. I wake up groggy and spend every day moving from the couch to the dining-room table to the bed and back. At some point night falls, and at some point after that I close work-related browser windows and open leisure-related ones. I miss my little rat friends, but I am usually too tired to call them.

Read: The most likely timeline for life to return to normal

Sometimes I imagine myself as a Sim, a diamond-shaped cursor hovering above my head as I go about my day. Tasks appear, and I do them. Mealtimes come, and I eat. Needs arise, and I meet them. I have a finite suite of moods, a limited number of possible activities, a set of strings being pulled from far offscreen. Everything is two-dimensional, fake, uncanny. My world is as big as my apartment, which is not very big at all.

“We’re trapped in our dollhouses,” said Kowert, the psychologist from Ottawa, who studies video games. “It’s just about surviving, not thriving. No one is working at their highest capacity.” She has played The Sims on and off for years, but she always gives up after a while—it’s too repetitive.

Earlier versions of The Sims had an autonomous memory function, according to Marina DelGreco, a staff writer for Game Rant. But in The Sims 3, the system was buggy; it bloated file sizes and caused players’ saved progress to delete. So The Sims 4, released in 2014, does not automatically create memories. PC users can manually enter them, and Sims can temporarily feel feelings: happy, tense, flirty. But for the most part, a Sim is a hollow vessel, more like a machine than a living thing.

The game itself doesn’t have a term for this, but the internet does: “smooth brain,” or sometimes “head empty,” which I first started noticing sometime last summer. Today, the TikTok user @smoothbrainb1tch has nearly 100,000 followers, and stoners on Twitter are marveling at the fact that their “silky smooth brain” was once capable of calculus.

This is, to be clear, meant to be an aspirational state. It’s the step after galaxy brain, because the only thing better than being a genius in a pandemic is being intellectually unencumbered by mass grief. People are celebrating “smooth brain Saturday” and chasing the ideal summer vibe: “smooth skin, smooth brain.” One frequently reposted meme shows a photograph of a glossy, raw chicken breast, with the caption “Cant think=no sad .” This is juxtaposed against a biology-textbook picture of a healthy brain, which is wrinkled, oddly translucent, and the color of canned tuna. The choice seems obvious.

Some Saturday not too long from now, I will go to a party or a bar or even a wedding. Maybe I’ll hold a baby, and maybe it will be heavy. Inevitably, I will kick my shoes off at some point. I won’t have to wonder about what I do on weekends, because I’ll be doing it. I’ll kiss my friends and try their drinks and marvel at how everyone is still the same, but a little different, after the year we all had. My brain won’t be smooth anymore, but being wrinkly won’t feel so bad. My synapses will be made plastic by the complicated, strange, utterly novel experience of being alive again, human again. I can’t wait.

ELLEN CUSHING

is the special-projects editor at The Atlantic.

#health

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purplesurveys · 4 years

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989

Bring it around town

Post Office: When’s the last time that you mailed a letter or a package to someone, and who was it to? I don’t think I’ve ever sent out a package. I’ve written letters to friends, but I’ve always given it directly to them.

Library: The last book that you checked out from the library? Was a book on Philippine history; needed it for a history class. I actually spilled some soup on the cover just before I needed to return it because there was one time I put a packed lunch in my bag, and apparently the oils from that managed to slither on over to the book. The book was old and yellowing so the oils eventually looked indistinguishable when I dried it out, but it was definitely not my finest moment.

Veterinarian: What was your pet’s last visit concerning? I wasn’t able to bring Cooper to the vet last weekend...so our last visit, which was last month, was for a couple of shots. I’ve forgotten what they were for.

Pet Store: Which animals do you tend to go check out first? I don’t go to pet stores. When I do spot them in malls, the first animals I see are dogs. And then I immediately feel bad seeing them in their tiny cages.

Drugstore: Last medication or item that you picked out from here? It was a couple of medications for the tooth extraction I had last December. One of them was for pain relief and the other was to stop bleeding just in case the area in my mouth that was worked on started to bleed profusely.

Grocery Store: Do you usually have a big list or a small list when you go? My parents do the grocery shopping; but speaking for them, I think the list is always big since we’re a family of five and we’re constantly running out of supplies lol. They certainly take a while every time they go to the grocery, so it’s a safe bet.

Church: Do you attend church every Sunday? Do you believe in God? We watch a livestream every Sunday; but no, I don’t believe. I’ve said this a thousand times but my mom is the most aggressive Catholic I know and she forces our entire family to attend/watch mass with her, even though she’s the only one who’s into the whole thing.

I will say that the priest that we normally watch has very good insights and the things he says are applicable, relevant, and helpful even in my own little atheist life, so I've found myself looking forward to his homily every week. That’s the furthest I’ll go, though.

Bank: How much was the last check you deposited? How about the last amount that you took out? I just opened an account last month so the only money that’s in there so far is the minimum amount that my bank requires for someone to start an account. I did just finish my first month interning, so I’m now waiting to receive my cut from that and FINALLY GO ONLINE SHOPPING

Hospital: Have you ever been admitted into the emergency room? For what? Other than when I was being delivered, no. I’ve been to the hospital before but they were all non-emergency cases.

Doctor’s Office: What was the last doctor’s appointment that you had? Which type of a doctor? I honestly have no idea what his specialization is; my parents just brought me to him because he’s a good family friend. We went to him so that he can prescribe the proper medication for my UTI at the time. His recommendation did end up being wrong and I only got sicker so that was kinda disappointing, but I’ve mostly forgiven the whole thing lol.

Police Station: Have you ever been arrested before? Ridden in the back of a police car? No to both of those, thank fuck.

Fire Station: Have you ever been a victim of a house fire? Not me, but I know of several people who have been.

School: When did you graduate high school? 2016.

Gas Station: How much gas can fit in your gas tank? If my tank is nearly empty and I’d want to fill it all the way up, I have to pay a little over P1000 for it.

Mechanics: Does your vehicle break down a lot? Nope. Other than the battery dying a couple of times throughout the time I’ve had it, it’s never broken down on me *while* I’m driving. That used to be one of my biggest anxieties as a student, but fortunately it never happened.

Clothing Store: What’s the last clothing item you bought from a store, and which store was it? I got several colors of the same top with puffed sleeves from an ukay-ukay. Ended up only wearing one of them outside once because the lockdown was passed down a week after.

Bookstore: Do you prefer to get your books new or used? It doesn’t really matter to me. If I spot a book I’ve been looking for/a book I find interesting whether I’m in a bookstore or in a used book store, I get my hands on it as long as I can afford it. The feeling of owning a fresh new book is always nice, but it’s also just as satisfying if I buy a book that’s like P500 down from its original price.

Coffee Shop/Cafe: What do you typically order when you go here? Iced caramel macchiato and a pastry, usually a chocolate doughnut, croissant, or flatbread.

Fast Food Restaurant: What are a few of your favorites? KFC, McDonald’s, Jollibee, Mang Inasal, Popeye’s.

Sit-Down Restaurant: What’s the longest you’ve ever had to wait before being seated? It was like 5 or 6 hours, I don’t remember anymore. But it was for Popeye’s grand opening in the Philippines and we didn’t anticipate how many people were gonna go for it on a weekday haha. We were all so grumpy by the time we got our food.

Dentist: Have you ever had a cavity before? How about a root canal? A tooth pulled? Braces? I’ve had three of those - I’ve had braces (and need them again), a tooth extracted, and a cavity. Idk what a root canal is but I’ve never heard a dentist use that term around me.

Movie Theater: Last movie you saw in theaters before the pandemic hit? Knives Out.

Art Gallery: Which art forms do you appreciate the most? I can look at oil paintings all day. I also love dioramas, especially if they’re illustrating historical events or historical places/cities. One of my favorite museums showcases Philippines’ entire history through dioramas (I think they have around 60 in total) and I have never gotten sick of going through them.

Zoo: What is your favorite zoo animal that you would like to set free? All of them. I’ve never felt nice visiting zoos, especially if the living conditions for the animals obviously suck, or if the cages are small, etc (which is the case for the most part). I prefer safaris or eco-parks, because even though they have the same concept at least the animals there have more space to move around.

Aquarium: Favorite kind of fish? I don’t really have one. I suppose stingrays look cool, but I’ll always remember them as the fish that killed Steve Irwin, so there’s that.

Museum: What kinds of artifacts fascinate you? Anything that shows everyday life of people from the past. I don’t really care for grander exhibits like replicas of galleon ships, but if you can show me the kind of plates people ate from, belts and jewelry that they wore, utensils they used, older bills and coins, etc., I’d be all over those. Animal fossils and bones are also always fun to see.

Amusement Park: Favorite ride to go on? Octopus, because that’s the only daring ride I’m willing to go on.

Courthouse: Have you ever gone to court before? Nopes.

Hotel/Motel: Where were you, the last time you stayed at a hotel? Cavite was my last hotel stay; but the last time I was at a hotel in general, it's the hotel my mom works in, somewhere in Metro Manila.

Club: What is the last song that you danced to? Caught In the Middle by Paramore. I think.

Bar: What’s your favorite alcoholic drink? Zombie and Long Island Iced Tea are my favorite cocktails. As for hard drinks, I usually go for tequila but I’m down to take any shot lol.

County Jail: Is there anyone that you’ve visited in jail? I’ve never done that.

Airport: Are you more likely to fly in an airplane, or pick people up/drop them off at the airport? Pick someone up/bring them to the airport. That’s literally how it is with my dad every few months because he works overseas.

Train Station: Have you ever ridden a train before? Just the once.

Concert Venue: What’s the last concert you saw? Paramore.

Sports Arena: Which sporting event would you be most likely to sit through? Pro wrestling or volleyball. Basketball is also fun to watch, but me never learning how the rules work has always ruined the viewing experience for me.

[bionic-beth]

#survey #surveys

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lgbtqueeries · 4 years

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A School Project as an Ode to Larry Kramer --32 Million and Counting

TLDR; This speech was a project for a Queer Studies class that I participated in. It is a speech in the form of Larry Kramer’s speech about AIDS activism in 1983 called “1,112 and Counting” I also wanted to bring into awareness what has changed in the 37 years since his original speech. The audience is meant to be the queer community, just like his was, but also to be open to those that would listen. Due to its nature, it encompasses public health, politics, humanity, and activism. I didn’t intend for this to be the case but as the project progressed we were diagnosed to be going through a pandemic much like that of what those in the 80s experienced. To this degree, I didn’t mean to scare but frustrate the reader, much like Larry Kramer. I wanted my speech to be uniquely mine, but be reminiscent of the effect that he garnered. I plan to post this to my Tumblrs LGBTQueeries and the-unending-kerfuffle as well as my Instagram @one_steph_from_death. I want to place this speech out into the world. Please feel free to reblog and share and comment and chat with me in the comments!

Larry Kramer started his count when the number was 1,112 and counting. In 1983. Think about that again. In 1983. Thirty-seven years ago. He screamed for help then, knowing full well we’d be obliterated as a group unless we stood up. He refused to be forced to die.

To frame this, a former entertainment star had been elected to the most powerful political seat in government. His staunch political and religious opinions led to the death of innocent people. He could have saved them by using his voice and asserting a need for research, laws, and education, but instead, let them die impoverished and discriminated against. If the hate and violent crimes didn’t get them, the sickness creeping in would.

Worst of all, as a community, we knew that he didn’t speak for us. We knew that this hate would kill us, yet we still remain silent. We remained silent as the hate trickled into the deepest pores of our community. We let the hate fester, building up and attaching to the difference among us until it finally separated us and dismantled us. We let the bigotry we so desperately try to run from infiltrate our ranks and break us apart into factions.

They were treated like lepers and untouchables (Barker & Cran, 2006). Hospital workers were nearly absent, just present enough to not be liable for neglect. Visitors were few and gay lovers, if they stayed, were sent away. Imagine that, slipping away in pain as you lose your vision and ability to breathe, your body starts deteriorating as it is filled with cancer and opportunistic infections. Alone. All alone.

And when you (inevitably) died your casket wasn’t lined in silk with cushions and roses. Yours was lined with plastic and biohazard material. Your brittle, thin body was crumpled up in the discarded sheets and hospital gowns and thrown into a garbage bag. No one was going to claim you, so no point in going to the morgue. Your toes, if you still had them, weren’t tagged, just set aside with all your other hospital belongings.

But the pain didn’t end there. Like the weekly garbage men, bags were taken to empty spaces and distributed into large, unmarked graves (Kilgannon. 2018). A secluded hole lost to history. A supposed bygone of the middle ages, but here to dispose of Jane and John Does.

If I was to scream like Larry Kramer, to these separated groups, I’d go hoarse within hours. As of 2018, 35 years after his speech, we have lost 32 million people to HIV/AIDS (CDC, 2020). That doesn’t include the people from the last 2 years.

We lost 32 million innocent people.

Yes, we lost gay men and IV drug users but they are still human. They still had the same dreams and aspirations as everyone else. They could have lived to be designers and playwrights just as well as becoming doctors and lawyers. We lost everyone one from, every walk of life. We lost painters, poets, magicians, musicians, surgeons, dentists, lawyers, physicians, firefighters, police officers, farmers, framers, parents, children. Their blood is on the hands of those that slowly took the life from them. The government is not free from their crimes.

But honestly, that’s not where the frustration and anger ends. Our history is being erased. Purposefully and eagerly. This situation that I’ve laid before your eyes seems to be that of 1983 and the pain of Ronald Reagan. The horror sounds painfully identical to what we deal with today.

Our current administration has continued some of these misinformed ideas and hateful actions. The Ryan White Fund, a fund specifically created to create a money source for HIV/AIDS research and treatment have received cutbacks and other plans set in motion like PEPFAR aren’t fairing well either. They are better in this term than in the past, but frankly, that’s not too comforting. This fund was the lifeblood for many organizations and they soon will be bled dry (Forsyth, n.d.). This does not take into account the other actions towards queer people in general. This takes into account only one facet of the government that is working against us. What about the judicial branch and the possibility to be tried for attempted murder for not disclosing your status to your partner (CDC, 2019)? It’s not like you have to do the same for other STIs. “On the count of giving chlamydia to your partner without disclosing your last date of testing, how does the jury find the defendant?” This doesn’t take into account the possibility you didn’t know of your own status.

And what if you wished to give blood? Say you’re gay and we’ll even go so far as saying you’re HIV-. They’d turn you away. They’d send you back for 12 months for not being able to prove you didn’t have sex with your male partner for 12+ months. May I remind you that lesbians and heterosexual men and women have gotten HIV and therefore can pass it along? This is possibly a law of Reagan’s 80s, but it’s still in effect TODAY (“LGBTQ Donors”, n.d.).

But I digress. The government is still not free from their crimes and institutionalized hate. I don’t wish to get too political but it is inevitable with the fact we’re all stuck in the past. Again, it’s not where my frustration lies.

My frustration is formed in the same disappointment that Larry Kramer had. In 37 years not much has changed and that the voice that we have as a community. We gained it with protests through organizations like ACT UP but we’ve apparently been diagnosed with laryngitis because we’ve become oddly silent. HIV/AIDS is not a disease of history. We haven’t cured the earth of this disease. It’s here and stuck to us like your legs to a hot vinyl seat. It affects everyone and intersectionality can increase your risk (CDC, 2019). There’s a reason it’s no longer called “Gay Related Immune Disease”. Yet where the hell are we?

It affects the young and the old. Yet we remain silent, pretending it’s not occurring.

We can blame it on the straight, cis majority but we are complicit in our own erasure, assimilation, and silencing.

We let our history fall by the wayside and be covered up with rainbows and pride flags used by businesses in marketing. We let our history be encapsulated by a month handed to us by the majority.

We let the atrocities that happened be forgotten along with many of the names.

We isolate those now that are HIV+ from queer-friendly functions, both blatantly and subtlely.

But most importantly we lost our gusto to fight for a better future for the generations that come after us. That’s what stings the most.

It’s important to remember that this disease is no longer a death sentence. You no longer have to feel the weight of shackles weighing you down towards the underworld. Provided, that is, you have insurance and can pay for your medications. But that is another government issue for another speech. With one pill a day, just like your Flintstones vitamins, you can live a normal life. You can date and with proper precautions, have sex and not pass it along to your partner. Undetectable = Untransmissable (UNAIDS, 2018).

While this may be a reality for us in our modern-day. I refuse to let those that sacrificed themselves for this cause be forgotten. We lost 32 million people and while I can’t list them all here or scream them to the heavens, I’ll damn well try. Those that came before us, despite their flaws, paved the way for us and I refuse to let them slip away because our government doesn’t like it. Join me in sharing the stories. If you want to see face to face, the humans that we lost, follow accounts like @theaidsmemorial on Instagram. End our silence. If it’s painful for you, imagine how it must feel for the friends and families of those that lost someone of the 32 million. They need your help to speak up.

We started this with 1,112 and counting. Now we’re at 32 million and counting. Let’s end the counting and start the protesting.

Works Cited

Barker, G., & Cran, W. (2006, May 30). Retrieved from https://www.pbs.org/wgbh/frontline/film/aids/

Centers for Disease Control. (2020, January 16). U.S. Statistics. Retrieved from https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics

Forsyth, A. D. (n.d.). Powerpoint presentation.

HIV and STD Criminal Laws. (2019, July 1). Retrieved from https://www.cdc.gov/hiv/policies/law/states/exposure.html

HIV by Group. (2019, October 25). Retrieved from https://www.cdc.gov/hiv/group/index.html

Kilgannon, C. (2018, July 3). Dead of AIDS and Forgotten in Potter's Field. Retrieved from https://www.nytimes.com/2018/07/03/nyregion/hart-island-aids-new-york.html

LGBTQ Donors. (n.d.). Retrieved from https://www.redcrossblood.org/donate-blood/how-to-donate/eligibility-requirements/lgbtq-donors.html

UNAIDS Explainer. (2018). UNAIDS Explainer. Retrieved from https://www.unaids.org/sites/default/files/media_asset/undetectable-untransmittable_en.pdf

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seymour-butz-stuff · 4 years

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"Want to hear the joke about insulin?" goes the bleak gag about America's drug prices. "You have to go to Canada to get it."

But even that's not an option anymore.

Pandemic travel restrictions have made Americans prisoners of their country. Even within North America, Mexico and Canada have closed thousands of kilometres of border to all but essential travel, roiling plans for vacation, work, and school. For cash-strapped Americans, it has also cut off access to medicines and health-care services that they can't afford at home -- at a time when money is tighter than ever.

Stephanie Boland's nine-year-old son was diagnosed with diabetes in December. Travelling to Canada to fill his insulin prescription took a half-day's drive from where they live in Brainerd, Minnesota, but it was worth it -- the purchase was a simple, over-the-counter affair. One pack of injection pens, which would last several months, cost less than a hundred dollars, she says, compared to a list price of $530 at home.

As their son's disease began to rewrite the routines of daily life, the Bolands planned to cross into Canada again to restock. Then the pandemic hit.

Boland, a masseuse, was forced to stop working. Her husband, a self-employed financial adviser, found his income hit by pandemic-related turbulence in the markets, too. Then their source for affordable insulin vanished behind a border that had never been closed before in the history of U.S.-Canada relations.

"We were going to make a trip north, one more trip in March, but then they closed the border," she said.

BUYING INSULIN ABROAD

Only 1.5% of American adults who take prescription medications buy their drugs abroad, according to a June analysis by researchers at the University of Florida Gainesville, based on a 2015-2017 National Health Interview Survey.

But that's still an estimated 2.3 million people.

Many medicines and medical services are cheaper in neighbouring Canada and Mexico, thanks to price controls and the power of the U.S. dollar. The difference is great enough that U.S. insurer PEHP, which covers Utah's state employees, offers partially paid trips to Vancouver and Tijuana "to help you save money on your prescriptions."

In popular Mexican resort towns like Cabo San Lucas on the West Coast, or Tulum on the East Coast, pharmacies, doctors and dentists targeting U.S. clientele dot the main drag, their prices on bright display. And the difference between those prices and the costs of the same drugs at U.S. pharmacies can mean life or death.

No drug is a better-known example of that calculus than insulin, a vital hormone in the body's metabolism. Seven million American diabetics don't produce it naturally -- or not enough of it -- and need to inject it throughout the day. Without it, dangerous levels of glucose build up in the blood, damaging organs and producing a painful stupor. In a worst case scenario, lack of insulin can kill within three days.

Americans have been going to Canada for insulin since scientists learned how to produce it in labs at the University of Toronto in 1921. One of the first patients to try it was an American: Elizabeth Hughes, the teenage daughter of then-U.S. Secretary of State Charles Evans Hughes.

"I'm so happy and elated," she wrote in a letter to her mother from Canada, describing her first self-injection and the "enormous" meal she enjoyed afterward. Before crossing the border, the 15-year-old had managed her condition by starving herself -- the only life-prolonging trick available to diabetics before insulin. Five feet tall, she weighed only 45 pounds.

A hundred years later, and after national soul-searching over the soaring cost of insulin, some Americans are still starving themselves. Daniel Carlisle, a Type 1 diabetic in Texas, has sometimes tried not to eat for days at a time, in an attempt to ration insulin. When he was 18 and short on cash, he even contemplated robbing a pharmacy, he says.

"I always do the math about how many days' supply of insulin I have in the refrigerator," the 60-year-old Texan says.

"That's how I know my lifespan at that point. My lifespan is measured in exactly how many days' worth of insulin I have in hand -- plus three days."

“How much could insulin cost? $20?”

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gordonwilliamsweb · 4 years

Text

New Dental Treatment Helps Fill Cavities and Insurance Gaps for Seniors

DENVER ― Dental hygienist Jennifer Geiselhofer often cleans the teeth of senior patients who can’t easily get to a dentist’s office. But until recently, if she found a cavity, there was little she could do.

“I can’t drill. I can’t pull teeth,” said Geiselhofer, whose mobile clinic is called Dental at Your Door. “I’d recommend they see a dentist, but that was often out of the question because of mobility challenges. So visit after visit, I would come back and there would be more decay.”

But now Geiselhofer has a weapon to obliterate a cavity with a few brushstrokes.

Silver diamine fluoride is a liquid that can be painted on teeth to stop decay. Fast, low-cost and pain-free, the treatment is rapidly gaining momentum nationwide as the cavity treatment of choice for patients who can’t easily get a filling, such as the very young or the very old.

“It has been life-changing for my patients,” said Geiselhofer, who has been using the treatment for about 18 months.

Geiselhofer has not been able to go into nursing homes during the COVID-19 pandemic, but she uses the liquid on the older adults she visits in private homes. She also uses it to treat the cavities of patients in homeless shelters, jails and Head Start programs ― now wearing greater protective gear, including gloves, a surgical mask, an N95 mask and a face shield.

The topical medication is an especially good option for seniors, dental industry experts say, because dental care has remained a major gap in health insurance coverage despite poor dental hygiene being linked to heart disease and other health problems like diabetes and pneumonia. Medicare doesn’t cover most dental care, and patients on a fixed income often can’t afford treatment. But because of the effectiveness and low cost of silver diamine fluoride, more state Medicaid programs now cover it — and older adults who pay out-of-pocket can afford it outright.

Silver diamine fluoride has been used in other countries for decades, and studies have proved it safe. Its biggest downside is that it permanently turns the decayed area black — a turnoff, in particular, for people with decay on a front tooth.

Dental providers say the black spots can be covered by tooth-colored material for an extra cost. For older adults, Geiselhofer said, a dark spot is a small price to pay for a treatment that stops cavities quickly, with no drilling, needle prick or trip to the dentist required.

Oral Care a Problem for Older Adults

Silver diamine fluoride was approved by the Food and Drug Administration in 2014 for reducing tooth sensitivity. But its off-label use to treat cavities was quickly adopted. It made headlines as a trauma-free treatment for tooth decay in children under age 5.

Pediatric dentists have embraced it as a solution for kids who can’t sit still for treatment and whose parents want to avoid general anesthesia. In 2018, the then-president of the American Academy of Pediatric Dentistry, James Nickman, said that, aside from fluoridated water, the topical cavity fighter “may be the single greatest innovation in pediatric dental health in the last century.”

But today, with more older Americans keeping their natural teeth than in decades past, the treatment is also serving as a boon for a different generation. Because of insurance gaps and the prohibitive cost of most dental treatments, many seniors miss out on preventive care to stave off dental decay, putting them at risk for dental disease that can trigger serious health problems. About 27% of Americans age 65 and older have untreated cavities, according to the Centers for Disease Control and Prevention.

Residents in long-term care facilities are at especially high risk, studies show. Medications cause their mouths to dry, promoting decay. They also may have cognitive issues that make it difficult to practice good oral care. And many are either too frail for traditional dental treatment or too weak to be transported.

Dental Hygienists Lead the Way

Take 87-year-old Ron Hanscom, for example. A patient of Geiselhofer’s, he has been in a Denver nursing home since he had a stroke six years ago, and needs a mechanical lift to get into and out of his wheelchair.

On a visit to Hanscom’s nursing home earlier this year, before the pandemic, Geiselhofer spotted a cavity under one of his crowns. After checking in with his dentist, she used a small brush to paint on the silver treatment.

“It’s a good thing she had the silver, because I couldn’t get to a dentist’s office — no way,” Hanscom said. “She did it right in my room.”

Across the country, dental hygienists provide much of the care to patients like Hanscom who otherwise might never see a dentist. They also see patients in homeless shelters, schools, jails and low-cost medical clinics. Since the pandemic hit, Geiselhofer said she has received a flood of requests for in-home care from seniors who are too nervous to go into a dentist’s office, but she has turned them down because she is too busy caring for underserved populations.

Many states allow hygienists to work directly with patients in public health settings without a dentist’s supervision, and Colorado is one of a few that allows them to set up a completely independent practice.

Because the silver treatment is relatively new in this country and can leave a stain, the Colorado state legislature passed a law in 2018 that says hygienists must have an agreement with a supervising dentist to apply it. The law also requires them to get special training on how to use the liquid, which at least 700 hygienists from across the state have completed.

Other states, including Maryland and Virginia, have no special requirements for applying the cavity treatment but require some supervision by a dentist, said Matt Crespin, president of the American Dental Hygienists’ Association. In those places, hygienists apply it under the same rules that govern the application of other fluoride products.

Preventing New Cavities, Too

Studies show silver diamine fluoride stops decay in 60% to 70% of cases with one application. A second application six months later boosts the treatment’s long-term effectiveness to more than 90%.

In addition to killing cavity-causing bacteria, the treatment hardens tooth structure, desensitizes the tooth and even stops new cavities from forming. Applying the liquid on the exposed root surfaces of older adults once a year is “a simple, inexpensive, and effective way” to prevent cavities, a 2018 study concluded.

One of the most important benefits of the application on older patients is that the liquid can reach decay that forms under existing dental work such as crowns and bridges, said dental hygienist Michelle Vacha, founder of Community Dental Health, which runs clinics in Colorado Springs and Pueblo, Colorado.

Previously, a dentist would have had to remove the crown, drill out the cavity and make a new crown — a traumatic, time-consuming procedure with a typical cost of $1,000 or more, Vacha said. Unable to afford the cost, many patients would instead have the tooth pulled.

The paint-on liquid is significantly cheaper than traditional treatment. Estimates vary, but a private dentist may charge $10 to $75 for one application, compared with $150 to $200 for a filling. Hygienists often have lower fees. At Vacha’s community clinics, the cost is $10 a tooth.

About half of state Medicaid programs now reimburse for the treatment, said Steve Pardue, scientific officer of Elevate Oral Care that distributes Advantage Arrest, the main brand of the topical medication used nationally. Reimbursement rates range from $5 to $75 per application.

More private insurers — about 20% to 30% of them — have also started covering it, Pardue said.

Coming Soon to a Dentist Near You?

A small but growing number of mainstream dentists have begun to offer the treatment to all patients, not just the youngest and oldest.

It’s a good option for those who have anxiety about dental work or concerns about cost, said Dr. Janet Yellowitz, director of geriatric and special care dentistry at the University of Maryland School of Dentistry.

A 2017 survey by the American Dental Association found that almost 8 in 10 dentists had never used the treatment. The ADA doesn’t have more recent statistics, but ADA spokesperson Matthew Messina said anecdotal reports indicate usage is increasing dramatically.

Yellowitz noted that dentists still have a financial incentive to drill and fill. She has made presentations highlighting the benefits of the silver solution at national conferences.

“We’re trying to get everyone to use it,” she said. “It’s a slow process because we’re asking dentists who have been trained for their whole careers to do things one way to completely change their mentality. It’s like asking them to go to another country and drive on the other side of the road.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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New Dental Treatment Helps Fill Cavities and Insurance Gaps for Seniors published first on https://nootropicspowdersupplier.tumblr.com/

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stephenmccull · 4 years

Text

New Dental Treatment Helps Fill Cavities and Insurance Gaps for Seniors

But now Geiselhofer has a weapon to obliterate a cavity with a few brushstrokes.

“It has been life-changing for my patients,” said Geiselhofer, who has been using the treatment for about 18 months.

Oral Care a Problem for Older Adults

Dental Hygienists Lead the Way

“It’s a good thing she had the silver, because I couldn’t get to a dentist’s office — no way,” Hanscom said. “She did it right in my room.”

Preventing New Cavities, Too

Studies show silver diamine fluoride stops decay in 60% to 70% of cases with one application. A second application six months later boosts the treatment’s long-term effectiveness to more than 90%.

More private insurers — about 20% to 30% of them — have also started covering it, Pardue said.

Coming Soon to a Dentist Near You?

A small but growing number of mainstream dentists have begun to offer the treatment to all patients, not just the youngest and oldest.

Yellowitz noted that dentists still have a financial incentive to drill and fill. She has made presentations highlighting the benefits of the silver solution at national conferences.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

USE OUR CONTENT

This story can be republished for free (details).

New Dental Treatment Helps Fill Cavities and Insurance Gaps for Seniors published first on https://smartdrinkingweb.weebly.com/

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dinafbrownil · 4 years

Text

New Dental Treatment Helps Fill Cavities and Insurance Gaps for Seniors

But now Geiselhofer has a weapon to obliterate a cavity with a few brushstrokes.

“It has been life-changing for my patients,” said Geiselhofer, who has been using the treatment for about 18 months.

Oral Care a Problem for Older Adults

Dental Hygienists Lead the Way

“It’s a good thing she had the silver, because I couldn’t get to a dentist’s office — no way,” Hanscom said. “She did it right in my room.”

Preventing New Cavities, Too

Studies show silver diamine fluoride stops decay in 60% to 70% of cases with one application. A second application six months later boosts the treatment’s long-term effectiveness to more than 90%.

More private insurers — about 20% to 30% of them — have also started covering it, Pardue said.

Coming Soon to a Dentist Near You?

A small but growing number of mainstream dentists have begun to offer the treatment to all patients, not just the youngest and oldest.

Yellowitz noted that dentists still have a financial incentive to drill and fill. She has made presentations highlighting the benefits of the silver solution at national conferences.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

USE OUR CONTENT

This story can be republished for free (details).

from Updates By Dina https://khn.org/news/new-dental-treatment-helps-fill-cavities-and-insurance-gaps-for-seniors/

0 notes

gordonwilliamsweb · 4 years

Text

New Dental Treatment Helps Fill Cavities and Insurance Gaps for Seniors

But now Geiselhofer has a weapon to obliterate a cavity with a few brushstrokes.

“It has been life-changing for my patients,” said Geiselhofer, who has been using the treatment for about 18 months.

Oral Care a Problem for Older Adults

Dental Hygienists Lead the Way

“It’s a good thing she had the silver, because I couldn’t get to a dentist’s office — no way,” Hanscom said. “She did it right in my room.”

Preventing New Cavities, Too

Studies show silver diamine fluoride stops decay in 60% to 70% of cases with one application. A second application six months later boosts the treatment’s long-term effectiveness to more than 90%.

More private insurers — about 20% to 30% of them — have also started covering it, Pardue said.

Coming Soon to a Dentist Near You?

A small but growing number of mainstream dentists have begun to offer the treatment to all patients, not just the youngest and oldest.

Yellowitz noted that dentists still have a financial incentive to drill and fill. She has made presentations highlighting the benefits of the silver solution at national conferences.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

USE OUR CONTENT

This story can be republished for free (details).

New Dental Treatment Helps Fill Cavities and Insurance Gaps for Seniors published first on https://nootropicspowdersupplier.tumblr.com/

0 notes

dinafbrownil · 4 years

Text

What Seniors Should Know Before Going Ahead With Elective Procedures

Navigating Aging

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

Join the Navigating Aging Facebook Group.

See All Columns

For months, Patricia Merryweather-Arges, a health care expert, has fielded questions about the coronavirus pandemic from fellow Rotary Club members in the Midwest.

Recently people have wondered “Is it safe for me to go see my doctor? Should I keep that appointment with my dentist? What about that knee replacement I put on hold: Should I go ahead with that?”

These are pressing concerns as hospitals, outpatient clinics and physicians’ practices have started providing elective medical procedures — services that had been suspended for several months.

Late last month, KFF reported that 48% of adults had skipped or postponed medical care because of the pandemic. Physicians are deeply concerned about the consequences, especially for people with serious illnesses or chronic medical conditions.

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To feel comfortable, patients need to take stock of the precautions providers are taking. This is especially true for older adults, who are particularly vulnerable to COVID-19. Here are suggestions that can help people think through concerns and decide whether to seek elective care:

Before you go in. Give yourself at least a week to learn about your medical provider’s preparations. “You want to know in advance what’s expected of you and what you can expect from your providers,” said Lisa McGiffert, co-founder of the Patient Safety Action Network.

Merryweather-Arges’ organization, Project Patient Care, has developed a guide with recommended questions. Among them: Will I be screened for COVID-19 upon arrival? Do I need to wear a mask and gloves? Are there any restrictions on what I can bring (a laptop, books, a change of clothing)? Are the areas I’ll visit cleaned and disinfected between patients?

Also ask whether patients known to have COVID are treated in the same areas you’ll use. Will the medical staffers who interact with you also see these patients?

If you’re getting care in a hospital, will you be tested for COVID-19 before your procedure? Is the staff being tested and, if so, under what circumstances?

Hospitals, medical clinics and physicians are offering this kind of information to varying degrees. In the New York City metropolitan area, Mount Sinai Health System has launched a comprehensive “Safety Hub” on its website featuring extensive information and videos.

Mount Sinai also encourages physicians to reach out to patients with messages tailored to their conditions. People “want to hear directly from their providers,” said Karen Wish, the system’s chief marketing officer.

Don’t hesitate to press for more details, said Dr. Allen Kachalia, senior vice president of patient safety and quality at Johns Hopkins Medicine: “Where people get in trouble is when they’re afraid to bring their concerns forward.”

Seeking care. Wendy Hayum-Gross, 57, a counselor who lives in Naperville, Illinois, had been waiting since mid-March to get blood tests that would help doctors diagnose the underlying cause of a new condition, a goiter. A few weeks ago, she decided it was time.

The hospital lab she went to, operated by Edward-Elmhurst Health, told Hayum-Gross to wear a mask and gave her a number to call when she arrived in the parking lot. Outside the front door, she was met by a staffer who took her temperature, asked several screening questions and gave her hand sanitizer.

“Once I passed that, a phlebotomist met me on the other side of the door and took me to a chair that was still wet with disinfectant. She wore a mask and gloves, and there was no one else around,” Hayum-Gross said. “When I saw the precautions they had put in place and the almost military precision with which they were carrying them out, I felt much better.”

Marjorie Helsel DeWert, 67, of Athens, Ohio, was similarly impressed when she visited her dentist recently and noticed circular yellow signs on the floor of the office, spaced 6 feet apart, indicating where people should stand. Staffers had even put pens used to fill out paperwork in individual containers and arranged to disinfect them after use.

DeWert, a learning scientist, came up with a patient safety checklist and distributed it to family and friends. Among her questions: Can necessary forms be completed online before a medical visit? Can I wait in the car outside until called? What kind of personal protective equipment is the staff using? And is the staff being checked for symptoms daily?

Bringing a caregiver. Some medical centers are allowing caregivers to accompany patients; others are not. Be sure to ask what policies are in place.

If you feel your presence is necessary — for instance, if you want to be there for a relative who is frail or cognitively compromised — be firm but also respectful, said Ilene Corina, president of the Pulse Center for Patient Safety Education & Advocacy.

Be prepared to wear a gown, gloves and mask. “You’re not there for yourself: You’re there to support the health care team and the patient,” said Corina, whose organization offers training to caregivers.

In Orland Park, Illinois, debi Ross, an interior designer, and her sister live with her 101-year-old mother. Eight years ago, when her mother had a tumor removed from her colon, Ross and her sister wiped down every electric socket, cord, surface and door handle in her mother’s hospital room.

“Unless Mom absolutely needs [medical] care, we’re not going to take her anywhere,” Ross said. “But I assure you, if she does have to go see somebody, we’re going to clean that place down from top to bottom, I don’t care what anybody says.”

If you are not allowed into a medical facility, get a phone number for the physician caring for a loved one and make sure they have your number as well, Merryweather-Arges said. Ask that you be contacted immediately if there are any complications.

Afterward. Patients leaving hospitals are fearful these days that they may have become infected with COVID-19, unwittingly. Ask your physician or a nurse what equipment you’ll need to monitor yourself. Will a pulse oximeter and a thermometer be necessary? Will you need masks and gloves at home if someone is coming in to help you out with the transition? Can someone provide that equipment?

“Family caregivers need instructions that are clear,” said Martin Hatlie, chief executive of Project Patient Care. “They need to know who to call 24/7 if they have a question. And they need clear guidance about infection control in the home.”

If home care is being ordered, ask the agency whether they have trained staff to recognize COVID symptoms. And have home care workers been tested for COVID-19 or had symptoms?

If follow-up care is being provided via telehealth, make sure the setup works before your loved one comes home. Ask your physician’s office what kind of equipment you will need, which service they use (Zoom? Skype?) and whether you can arrange a test in advance.

Finally, as you resume activities, help protect others against COVID-19 as well as yourself. When you go out into the world again, “mask up, socially distance and wash your hands,” said Kachalia of Johns Hopkins. “And if you’re sick or have symptoms, by all means, let your doctor’s office know before you come in for a checkup.”

from Updates By Dina https://khn.org/news/what-seniors-should-know-before-going-ahead-with-elective-procedures/

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gordonwilliamsweb · 4 years

Text

What Seniors Should Know Before Going Ahead With Elective Procedures

Navigating Aging

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

Join the Navigating Aging Facebook Group.

See All Columns

For months, Patricia Merryweather-Arges, a health care expert, has fielded questions about the coronavirus pandemic from fellow Rotary Club members in the Midwest.

Recently people have wondered “Is it safe for me to go see my doctor? Should I keep that appointment with my dentist? What about that knee replacement I put on hold: Should I go ahead with that?”

These are pressing concerns as hospitals, outpatient clinics and physicians’ practices have started providing elective medical procedures — services that had been suspended for several months.

Email Sign-Up

Subscribe to KHN’s free Morning Briefing.

Please confirm your email address below:

Also ask whether patients known to have COVID are treated in the same areas you’ll use. Will the medical staffers who interact with you also see these patients?

If you’re getting care in a hospital, will you be tested for COVID-19 before your procedure? Is the staff being tested and, if so, under what circumstances?

Bringing a caregiver. Some medical centers are allowing caregivers to accompany patients; others are not. Be sure to ask what policies are in place.

If home care is being ordered, ask the agency whether they have trained staff to recognize COVID symptoms. And have home care workers been tested for COVID-19 or had symptoms?

What Seniors Should Know Before Going Ahead With Elective Procedures published first on https://nootropicspowdersupplier.tumblr.com/

0 notes

stephenmccull · 4 years

Text

What Seniors Should Know Before Going Ahead With Elective Procedures

Navigating Aging

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

Join the Navigating Aging Facebook Group.

See All Columns

For months, Patricia Merryweather-Arges, a health care expert, has fielded questions about the coronavirus pandemic from fellow Rotary Club members in the Midwest.

Recently people have wondered “Is it safe for me to go see my doctor? Should I keep that appointment with my dentist? What about that knee replacement I put on hold: Should I go ahead with that?”

These are pressing concerns as hospitals, outpatient clinics and physicians’ practices have started providing elective medical procedures — services that had been suspended for several months.

Email Sign-Up

Subscribe to KHN’s free Morning Briefing.

Please confirm your email address below:

Also ask whether patients known to have COVID are treated in the same areas you’ll use. Will the medical staffers who interact with you also see these patients?

If you’re getting care in a hospital, will you be tested for COVID-19 before your procedure? Is the staff being tested and, if so, under what circumstances?

Bringing a caregiver. Some medical centers are allowing caregivers to accompany patients; others are not. Be sure to ask what policies are in place.

If home care is being ordered, ask the agency whether they have trained staff to recognize COVID symptoms. And have home care workers been tested for COVID-19 or had symptoms?

What Seniors Should Know Before Going Ahead With Elective Procedures published first on https://smartdrinkingweb.weebly.com/

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