Author Archives: Jessica Alpert

Associate Producer, Here & Now Most recently, Jessica worked as an associate producer at WBUR's daily local program, Radio Boston. Jessica moved to Boston in 2008 and has lived many places since leaving her native Texas. After graduating from college, Jessica worked as a federal employee, documentary film festival producer, oral historian, university teaching assistant, traveling saleswoman and klezmer musician. Her work and projects have appeared in The Washington Post, The Christian Science Monitor, Bust, Barnard Magazine, National Public Radio, Public Radio International (PRI), and the BBC. Jessica's freelance radio work has received various awards including accolades from the Religion Newswriters Association and the Dart Center for Journalism and Trauma. As a Fulbright Scholar in El Salvador, Jessica collected and studied oral histories from the Jewish Community based in San Salvador. Jessica received her B.A. in political science from Columbia University’s Barnard College and her M.A. in history from Indiana University. She learned how to make radio from the phenomenal folks at the Salt Institute for Documentary Studies. Jessica lives in Somerville with her husband, twin son and daughter, and two cats. To learn more about Jessica’s projects, both current and past, please visit www.jessicaalpert.com.

Art As A Conversation About Cancer With ‘Anyone Who Will Listen’

Adjusted Schedule by Dennis Svoronos

Adjusted Schedule by Dennis Svoronos

Art, in its essence, is just another way to tell a story, a way for humans to make meaning out of their experiences. At Health Story Collaborative, a nonprofit founded by Dr. Annie Brewster, a Boston internist and CommonHealth contributor who uses storytelling in a therapeutic context, artists are invited to tell their unique stories.

Here, Dennis Svoronos, a Boston-based sculptor who describes his work as existing “between art and engineering” reflects on his cancer as a force for creativity and social engagement.

By Dennis Svoronos

In September of 2009 – at 26 years of age – I was diagnosed with cancer after experiencing the first of many seizures. Of all the trials I could imagine that lay ahead, I never thought most of them would be exercises in recollection.

Patient name? Dennis Svoronos (thankfully I can always get this one)

Date of birth? 3/8/83 (a palindrome, helps to keep it easy)

Occupation? Artist (maybe not my parents first choice)

Approximate date of last surgery? 11/09 (Who forgets their first brain surgery)

Existing medical conditions? Anaplastic Astrocytoma (a cancerous brain tumor)

Repeat daily, for years.

Just in Case by Dennis Svoronos

Just in Case by Dennis Svoronos

As time progressed; I remember those waiting rooms — questions and ID tags — much more than the operating theatre and injections; trauma is kind of like that.

However, they made me feel intrinsically linked to my disease. What was I, without these suffixes of sickness to identify with? Somehow, all my other unique and admirable qualities were set aside for the identifier of ‘cancer patient’.

It’s easy to resign to the belief that those forms and wristbands define your life, mere statistics, data — you and your cancer. Just as painless is to ignore the process completely, pretending your exams and operations are the bad dreams of another person, your ‘real life’ goes on unaffected.

Either way, it seems you’re not to talk openly about cancer, and it is difficult for most; patients, family and doctors alike. My initial sense was, it would be easier for me — and more comfortable for others — to keep off the topic. Sickness is a surprisingly taboo subject in a very liberal culture.

The artist in me, however, couldn’t stop questioning why we hide from the discussion. Continue reading

Health Connector: Insurance Signups Up, But Many Unpaid

The Massachusetts Health Connector is preparing for a signup surge as the state’s deadline for enrolling in 2015 insurance coverage approaches.

The agency says more than 100,000 residents who must pay some or all of their premiums have registered online, but so far, only 18 percent have chosen a plan and paid.

Still, those 18,000 people are double the number who had paid a week ago.

The deadline is Tuesday for those who want to be covered on the first of the year. The site’s director, Maydad Cohen, is urging residents to take action this weekend.

“Because we expect high, high volumes Monday and Tuesday,” Cohen said. “High volume typically results in longer wait times. And we do want to make sure people can access health insurance, and make sure that they pick and pay for that plan.”

The Connector office will be open during the day for residents who do not have access to a computer.

Earlier:

Pediatric Politics: How Dire Warnings Against Infant Bed Sharing ‘Backfired’

sundaykofax/flickr

sundaykofax/flickr

By Dr. Melissa Bartick
Guest Contributor

Every new parent has heard the dire warning: Never sleep with your baby.

State and local health departments in Massachusetts and around the U.S. have prioritized this message. Millions of dollars have been invested in promoting it, and millions more spent on giving away cribs to poor families. It all comes from the official recommendations of the influential American Academy of Pediatrics published in 2011.

Some localities have even backed this message up with scary ads: a baby in an adult bed with a meat cleaver, stating “Your baby sleeping with you can be just as dangerous,” and another ad that says “Your baby belongs in a crib, not a casket.”

Studies Misrepresented

The problem with this widespread advice is that the AAP’s statement from which it comes is based on just four papers. Two of the studies are misrepresented, and actually show little or no risk of sharing a bed when parents do not smoke, and two of the studies do not collect data on maternal alcohol use, a known and powerful risk factor.

In addition, the AAP statement ignores many other more recent excellent papers that are not even mentioned or cited. My colleague, Linda J. Smith, and I recently published an analysis of all AAP’s statement and all the literature to date, “Speaking out on Safe Sleep: Evidence-Based Sleep Recommendations.” Along with this dissection of the AAP statement, we found that that any risk of death from a parent sharing a bed with an infant is greatly overshadowed by other risks that get far less attention.

Dangerous Sofas

We concluded that the only evidence-based universal advice to date is that sofas are hazardous places for adults to sleep with infants; that exposure to smoke, both prenatal and postnatal, increases the risk of death; and that sleeping next to an impaired caregiver increases the risk of death.

Formula feeding increases the risk of Sudden Infant Death Syndrome. No sleep environment is completely safe. But public health efforts must address the reality that tired parents must feed their infants at night somewhere and that sofas are highly risky places for parents to fall asleep with their infants.

The fact is, across the United States and the world, across all social strata and all ethnic groups, most mothers sleep with their infants at least some of the time, despite all advice to the contrary, and this is particularly true for breastfeeding mothers.

When You Avoid Bed Sharing

Unfortunately, we also know that parents who try to avoid bed sharing with their infants are far more likely to feed their babies at night on chairs and couches in futile attempts to stay awake, which actually markedly increases their infants’ risk of suffocation. Continue reading

Armpit Fat? There’s A YouTube Video For That

By Jessica Alpert

Did YouTube kill the video star?

That’s what some fitness-types are saying. Consumers can access exercise programs of all stripes. From old-world Jack LaLanne to ’80s Jane Fonda, from Insanity to the current YouTube HIIT (high intensity interval training) sessions — the American fitness diet continues to evolve. At the moment, it’s all about free and on-demand.

When Cassey Ho made her first YouTube exercise video, she had her pilates students in mind. Thirty of them. It was 2009 and Ho had recently moved from California to Boston to try a career in fashion buying. A few months later, she checked in on that YouTube video and there were thousands of views.

So she decided to make more.

The Blogilates App allows users to search for fellow "POPsters" in their area. (Courtesy of Cassey Ho/Blogilates)

The Blogilates App allows users to search for fellow “POPsters” in their area. (Courtesy of Cassey Ho/Blogilates)

By 2011, Cassey Ho was posting one video a week, calling her unique brand of pilates “POP Pilates,” essentially pilates to pop music. She named her channel “Blogilates” and an empire was born. Today, Cassey Ho was 1.8 million subscribers to her YouTube channel — 60,000 page views a day and 8 million views a month.

Ho credits humility as key to her success. “I think the reason for it’s [Blogilates] growth is the fact that I love teaching. I genuinely want to help people.”

Reach people she does — Blogilates is now the top fitness channel on the network. Ho also has a book deal, a DVD release and more original designs from her clothing line in the works for 2015.

YouTube has become the DIY video destination, from cupcakes to cosmopolitans, appliance repairs and yes — ab workouts — there’s a video for every problem. Even armpit fat. Huge audiences combined with social media savvy has made the everyday people who dole out this advice into celebrities. “People cry and shake and get crazy when they see me,” says Ho. She occasionally does tours to give live classes around the country. “When you go to Blogilates meet-ups, there are hundreds of people there and I get to hear their stories…and how these videos helped them battle eating disorders, lose a ton of weight. They are so positive and kind — they don’t mind having to wait five hours in line to meet me. They make me want to work harder.”

And it’s these young enthusiastic fans that are driving the YouTube content bonanza. In the first quarter of 2014, according to Nielsen, consumers aged 18-24 viewed 2 hours and 28 minutes of online videos per week — that’s nearly an hour more than the average for all adults.

Cassey Ho isn’t alone. There’s the two friends behind “Tone It Up,” Elliot Hulse who creates videos like “Exercise for Heartbreak and Pain,” and the husband and wife team behind “Fitness Blender” (known simply as Daniel and Kelli). Daniel and Kelli started their channel in their garage — in fact they still record videos there.

According to OpenSlate, a video analytics platform that analyzes all ad-supported content on YouTube, Fitness Blender averages around 8 million views per month. In an introduction video, Daniel explains that they started their channel because they “there weren’t any fitness websites out there that actually focused on fitness — they were all about make-up, all about clothes, all about what you look like — not about what you do.” Kelli adds that “everyone should have access to health fitness information regardless of their income or access to a gym.”

Tolga Ozyurtcu, a clinical assistant professor in the department of kinesiology and health education at the University of Texas at Austin, says the YouTube brand of exercise is more “personalized and more personal.

“In the past, the marketplace of exercise television or videos had to be more middle-ground…the new stuff is hyper-focused.” Continue reading

Doctors In Massachusetts Now Required To Offer End-Of-Life Counseling

With a new state law taking available, this information will be offered for end-of-life care. (Robin Lubbock/WBUR)

Under new state regulations, patients with a terminal condition will be offered end-of-life information like this sample brochure, as well as counseling about their options. (Robin Lubbock/WBUR)

About nine months ago, John Polanowicz was in a hospital room at Brigham and Women’s watching his 44-year-old brother-in-law Bobby struggle to breathe. Bobby had advanced lung cancer. Now, with a tube down his throat, he was trying to respond to questions about his end-of-life wishes using a marker on a white board.

“We were all trying to decide,” Polanowicz recalled, “would we keep him trached and vented, and hope against hope that there would be some change in the disease process?”

Bobby was losing the battle with cancer. He had wanted to fight to the end, but no one had talked to Bobby about how to deal with the end.

“It would have been much easier for the family to have had some of these conversations before 4 in the afternoon on the day that he passed,” Polanowicz said.

On Friday, Polanowicz, Massachusetts’ secretary for health and human services, posts regulations designed to help patients like his brother-in-law avoid describing their final medical wishes with an erasable marker. Doctors, hospitals, nursing homes and other health providers in Massachusetts are now required to offer end-of-life counseling to terminally ill patients. The requirement, part of a 2012 law, takes effect Friday with the posting of rules about how it will work.

Continue reading

Related:

Persistent Stigma, Skepticism About Mental Illness Causes Real Harm

By Dr. Steve Scholzman
Guest Contributor

Profound misunderstanding about mental illness — its causes, its legitimacy and its treatment — permeate our culture. And the stigma that accompanies this lack of understanding hurts, a lot. Take this example — hardly original or rare.

Imagine a 15-year-old adolescent girl with fairly severe depression. She may be a classmate of your child, or the daughter of a friend. Let’s call her Sally.

Sally’s not so ill that she needs to be in the hospital, but she’s close. Her family and I — her psychiatrist — are doing our best to get her better as quickly as possible so she can get back to school. She’s been out now for about three days. Why? She literally lacks the capacity to think clearly. It’s all she can do to drag herself out of her bed and run a toothbrush across her teeth.

(Michael Summers/Flickr)

(Michael Summers/Flickr)

There’s a big family history of depression so Sally’s parents are both familiar with and frightened by her struggles.

“Can you call the school and ask them to give her more time on some work?” the parents ask.

“Sure,” I say, and I get in touch with the school administrator.

“Well,” I’m told by the very well-meaning administrator, “It IS a tough time of year. The other kids are getting through it somehow. I don’t see why she should get special treatment.”

“Because she has the equivalent of the flu,” I say. I like to use analogies at these crossroads.

“But the flu feels awful. Does she have a fever? Because if she does, she shouldn’t come to school…”

“No, she doesn’t have a fever,” I say. I try another analogy. “What if she had been in a car accident, God forbid?”

“Well, that’s pretty different, isn’t it?”

“How?” I ask.

“She’d be hurt,” I’m told. “This is an entirely different thing. You’ll need to get her pediatrician to call.”

I ask the pediatrician to call, and I can feel his discomfort over the phone. “I’m not very good at making this case,” he acknowledges. “It’s probably better if you just call them back.”

(I have to wonder whether he’d be so uncomfortable if I were a gastroenterologist asking him to call the school about a patient with ulcerative colitis?) Continue reading

Vermont Gov. Won’t Pursue Single Payer Health Care This Year

Gov. Peter Shumlin earlier this year (Wilson Ring/AP)

Gov. Peter Shumlin earlier this year (Wilson Ring/AP)

Gov. Peter Shumlin of Vermont announced on Wednesday that his state would not pursue single payer health care in this coming legislative session.

Shumlin blamed a sluggish economy for his decision. The taxes required for single payer would prove too burdensome for Vermont, a state that has downgraded its revenues twice this year.

The taxes required to implement single payer would include an 11.5 percent increase in payroll taxes and up to a 9.5 percent increase in income taxes for every Vermonter.

Shumlin added: “Making fundamental changes in our health care system — nearly 20 percent of our economy — is a huge undertaking, and one that must be done with care.”

You can read Shumlin’s prepared remarks here.

Related:

The Art Of Surgery: Painting The Operating Room On Canvas

Coronary Bypass Operation at Brigham and Women's, Boston 2010 oil 40 x 70. A painting by Joel Babb. (Courtesy of Joel Babb)

Coronary Bypass Operation at Brigham and Women’s, Boston 2010 oil 40 x 70. A painting by Joel Babb. (Courtesy of Joel Babb)

When I walked into Joel Babb’s studio a few years ago, I was immediately drawn to a large painting in the middle of the room.  Propped on an easel and framed by the gaze of the sun, the painting transported me to an operating room.  Honestly, not a place I wanted to go.  But when I looked closely, I realized it was an open heart surgery — the life-saving procedure I had done when I was 10-months old. I looked closer and noticed the instruments, the placement of the patient’s head, the colors.

“I had that surgery,” I said to Joel.

“So did I.” he smiled.

That painting has stayed with me and it’s not the first medical painting Babb has finished.  I asked him to share some reflections on the art of medical painting — especially when the featured subject is so close to home. Here’s what he wrote:

In 1995-6, I painted a recreation of the first successful organ transplant which was done by Dr. Joe Murray at Brigham and Women’s Hospital in 1954.  I love to paint landscapes but when I was asked me to do a painting of a famous surgical procedure I was immediately interested.

As part of the process of doing that painting Dr. Joe Murray, who received the Nobel Prize for the transplant surgery, took me around the operating rooms of the Brigham so I could observe and photograph operations while understanding the organization of the operating room. For this specific painting, I was working with the advice and cooperation of three doctors to recreate an event which happened 40 years before.

The operating room no longer existed, and there were only two black and white photographs taken from an observation gallery above on that day. So the doctors had to remember the configuration of the room, the people present, and I had to draw that room from a different perspective, and pose models in surgical gowns under both artificial and natural light. This required a whole series of drawings over several months to come to a final composition. This painting was conceived as complementing the Countway’s painting of the first use of anesthesia (ether) in surgery by Hinckley.

First Successful Organ Transplantation in Man 1996 oil 70 x 88. A painting by Joel Babb (Courtesy of Joel Babb)

First Successful Organ Transplantation in Man 1996 oil 70 x 88. A painting by Joel Babb (Courtesy of Joel Babb)

The painting of the first use of anesthesia by Hinckley hangs in the Countway Library of Medicine at Harvard Medical School.  The doctors told me that anesthesia was the greatest surgical innovation of the 19th century, and they regarded transplantation as the greatest innovation of the 20th century. 

I envisioned my painting as a pendant to the Hinckley — the figures are the same size as those in the Hinckley, but my painting is somewhat smaller because the rooms depicted are smaller. I tried to make the style contemporary, but subdued and historical.  To me there is a feeling of transition as Dr. Moore carries the kidney from the donor operation to the recipient just as one moves from awareness through unconsciousness to awareness when you undergo surgery experience anesthesia.  To Dr. Moore the transplant operation suggests the dawning of a new day of surgery.

After completing the transplant painting, I asked Dr. Moore if he could arrange for me to observe and photograph further surgeries with the intention of doing a contemporary surgical painting without the constraints of doing a commission. He agreed.

I remember photographing a mastectomy, a breast reduction, a complicated breast reconstruction, removal of a formerly transplanted kidney, and a lung cancer operation. But what I really wanted was to observe a heart operation — I had open heart surgery myself as a boy of 13 in 1960. The idea of a saving surgical intervention has been part of my development ever since.

I was able to observe Dr. John Collins and his team do a bypass operation. During the procedure the anesthesiologist let me stand in her place near the head of the patient, on a little foot stool which enabled me to see over the “ether screen,” giving me an incredible view of what the surgeons were doing. Continue reading

New Spending Bill Adds Abortion Coverage For Peace Corps Rape Victims

File this under: “About #$@%&*! Time.

Tucked away in the recently passed $1.1 trillion federal spending bill is a provision that, according to women’s health and abortion rights advocates, is long overdue, ending a 35-year-old ban. The new measure offers abortion coverage to Peace Corps volunteers victimized by rape, incest or facing a life-threatening pregnancy; similar coverage is already provided to federal employees.

Bryan Dwyer, director of Peace Corps and Training in Kigali, Rwanda, and a Peace Corps volunteer in El Salvador from 2000-2002, expressed his strong approval for the new measure:

As both an RPCV [Returned Peace Corps Volunteer] and staff member, I am very pleased that PC [Peace Corps] Volunteers will now be afforded this protection, even as I earnestly hope that no one ever needs to avail herself of it.

Another former Peace Corps employee I talked to was a bit more blunt:

In a long overdue concession to reality, conservative members of Congress no longer forced their abusive “no choice no matter what” policy on women in the Peace Corps. For far too many years, they had prevailed in insisting that women who choose to serve our country who had been raped and impregnated should be repaid with no health care coverage to end those pregnancies. I am glad this truly appalling policy is finally at an end.

Edson Chilundo/flickr

Edson Chilundo/flickr

Here are more details and background in a Glamour magazine report:

Over the weekend, the Senate passed a $1.1 trillion spending bill that includes a provision to provide abortion coverage for Peace Corps volunteers in cases of rape, incest, or life endangerment.

It’s an important win for reproductive rights advocates in a year plagued by restrictions on abortion and other women’s health measures. President Obama is expected to sign the bill into law, granting Peace Corps volunteers and trainees the same type of abortion coverage offered to federal employees….

Currently, just over 60 percent of Peace Corps volunteers are female, and many of them work in areas with little to no access to safe, reliable health care. Continue reading

Where Does Fat Go When You Lose Weight? Mostly Into Thin Air

(Phoney Nickle/Flickr)

(Phoney Nickle/Flickr)

By Richard Knox

A couple of years ago, Ruben Meerman took off 40 pounds. And that got him wondering: What exactly happened to all that fat?

Conventional wisdom was that he “burned” it off. Or sweated it off. Or excreted it. None of that satisfied Meerman, who has a physics degree and makes his living explaining science to schoolkids and for the Australian Broadcasting Corporation.

So Meerman tackled the problem and eventually came up with a surprising answer: Most of the lost fat disappears into thin air.

More specifically, 84 percent of those fat molecules get exhaled as colorless, odorless carbon dioxide. The other 16 percent departs the body as H-2-O — plain old water.

Meerman says the discovery “got me really excited because I’d stumbled onto a gap in the knowledge. It struck me as remarkable that no one had thought this was interesting enough to pursue.”

The British Medical Journal thought so too. It has published a paper, co-authored by biochemist Andrew Brown of the University of South Wales, in its annual Christmas issue, which features off-beat (but peer-reviewed) research.

Weight Loss Realism

Meerman hopes the work will dispel misconceptions held by health professionals as well as the general public. And, he hopes it will provide a helpful dose of realism to counter the impossible expectations millions have about weight loss.

If people understand where the fat goes (and how), they’ll get “why there’s a limit to how quickly you can lose weight,” Meerman said in a Skype interview from Sydney. “And if you understand the limit, you won’t be so quickly depressed if you don’t lose 20 pounds in the first two weeks.”

First, the misconceptions. Meerman and Brown surveyed 150 professionals — split equally among family doctors, dietitians and personal trainers — about where they think the fat goes during weight loss.

By far the most common answer was that the fat was transformed into energy or heat — that is, “burned off.” About two-thirds of doctors thought so. A slightly higher proportion of dietitians did too, and about 55 percent of personal trainers.

But that would violate the Law of Conservation of Mass. It’s a basic precept of chemistry, formulated in 1789 by the French scientist Antoine Lavoisier, which holds that mass is neither created nor destroyed in chemical reactions. The total mass at the end must equal the mass at the starting point — even if matter is quite transformed in the process, from solid to liquid or gas.

The Energy Of A Bomb

Meerman points out that if fat were transformed into pure energy during weight loss, the results would be cataclysmic. Continue reading