www.charlestondailymail.com Health http://www.charlestondailymail.com Daily Mail feed en-us Copyright 2015, Charleston Newspapers, Charleston, WV Newspapers Veterans Affairs to reopen outpatient clinic in Maxwelton http://www.charlestondailymail.com/article/20150224/ARTICLE/150229653 ARTICLE http://www.charlestondailymail.com/article/20150224/ARTICLE/150229653 Tue, 24 Feb 2015 13:53:13 -0500 MAXWELTON, W.Va. (AP) - A veterans outpatient clinic in southern West Virginia that's been closed since last fall is set to reopen Friday.

Media outlets report that Department of Veterans Affairs officials announced the clinic's reopening on Monday.

The VA initially closed the Greenbrier County Community Based Outpatient Clinic in Maxwelton in June 2014 after several employees became ill. The clinic later reopened but closed again in October 2014 after similar problems were reported.

Beckley VA Medical Center director Karin L. McGraw says design corrections to improve the clinic's air quality have been completed.

The clinic serves about 2,400 veterans in Greenbrier, Monroe, Pocahontas and Summers counties in West Virginia and in Allegany County in Virginia.

Healthy hearts the aim of grant money in Va., W.Va. http://www.charlestondailymail.com/article/20150224/ARTICLE/150229662 ARTICLE http://www.charlestondailymail.com/article/20150224/ARTICLE/150229662 Tue, 24 Feb 2015 09:22:22 -0500

CHARLESTON, W.Va. (AP) - More than $644,000 in grant funding aimed at promoting healthier lives in Appalachia is being awarded to care providers in Virginia and West Virginia.

The grants are from the AstraZeneca HealthCare Foundation and are aimed at reducing the risk of cardiovascular disease.

Heart disease accounts for 23 percent of all deaths in West Virginia and 22 percent of all deaths in Virginia.

In Virginia, the grant money will benefit St. Mary's Health Wagon in Wise. It will be used for a program to identify, minimize and prevent heart disease through education, screening and medication management.

Also sharing in the grant will be West Virginia Health Right Inc. and its SCALE program. It aims to reduce the risk of cardiovascular disease among obese patients.

Painkiller rules cause veterans grief http://www.charlestondailymail.com/article/20150218/ARTICLE/150219236 ARTICLE http://www.charlestondailymail.com/article/20150218/ARTICLE/150219236 Wed, 18 Feb 2015 21:00:32 -0500


The Washington Post

WASHINGTON - New federal rules that make it harder to get narcotic painkillers are taking an unexpected toll on thousands of veterans who depend on these prescription drugs to treat everything from missing limbs to post-traumatic stress.

The restrictions, adopted last summer by the Drug Enforcement Administration to curb a national epidemic of opioid abuse, are for the first time, in effect, forcing veterans to return to the doctor every month to renew their medication, although many were already struggling to get appointments at overburdened VA health facilities. And even if patients can get appointments, the new rules pose an additional hardship for many who live a good distance from the health centers.

While the tighter regulation applies to everyone on opioid painkillers, it's hitting veterans especially hard because so many are being treated for horrific injuries sustained during the long wars in Iraq and Afghanistan and have become dependent on the VA's beleaguered health-care system for medical care.

The rules come at a time of turmoil for the Department of Veterans Affairs. The agency's widespread problem with patient backlogs burst into view last year with revelations that employees had covered up how long veterans had to wait for care, even for such pressing matters as cancer and suicide prevention.

In dramatically curtailing access to the highly addictive painkillers, the government is trying to roll back what the Centers for Disease Control and Prevention has termed "the worst drug addiction epidemic in the country's history, killing more people than heroin and crack cocaine." The rules apply to "hydrocodone combination products," such as Vicodin.

More than half a million veterans are now on prescription opioids, according to the VA.

Pain experts at the VA say that in hindsight they have been overmedicating veterans, and doctors at the Pentagon and VA now say that the use of the painkillers contributes to family strife, homelessness and even suicide among veterans. A study by the American Public Health Association in 2011 also showed that the overdose rate among VA patients is nearly double the national average.

But some veterans say they have come to depend on these painkillers to function and now, unable to get a timely renewal of the prescription, are suffering withdrawal symptoms that feel like a panic attack and the flu at the same time.

Craig Schroeder was injured in a makeshift-bomb explosion while serving as a Marine corporal in the "triangle of death," a region south of Baghdad. He suffers from traumatic brain injury, which has affected his hearing, memory and movement, and from pain related to a broken foot and ankle and a herniated disc in his back. He has been on a steady regimen of opioids.

But after the DEA regulations were put in place, he was unable to get an appointment to see his doctor for nearly five months, Schroeder recalled. He stayed in bed at his home in North Carolina much of that time.

"It was a nightmare. I was just in unbearable, terrible pain," he said. "I couldn't even go to the ER because those doctors won't write those scripts."

His wife, Stephanie Schroeder, said getting him a VA appointment turned into a part-time job and her "main mission in life." While part of the problem was a shortage of doctors, she said she also noticed that the VA had become hostile toward patients who asked for painkillers.

"Suddenly, the VA treats people on pain meds like the new lepers," she said. "It feels like they told us for years to take these drugs, didn't offer us any other ideas and now we're suddenly demonized, second-class citizens."

Officials at the Disabled American Veterans (DAV), a veterans service organization, said the VA needs to be more compassionate and help veterans through the changes.

"We're hearing from veterans with life-long disabilities, who never had a problem with addiction issues. They have been on these drugs for decades and then all of sudden it was boom, a total change in attitudes," said Joy Ilem, the group's deputy national legislative director.

Gavin West, a clinical operations chief at the VA, said there has been a systematic effort since the fall to contact veterans to explain the new rules, broader concerns about opioid use and alternative options for treatment. At the same time, he said the agency is working to ensure that veterans get the access to medical care that's required.

"The DEA did a good thing here for opioid safety," he said. But he added, "How do you balance the sensitivity of patients and the new rules when all of a sudden a veteran, who's been treated with this medication for 15 years or 20 years has everything change?"

To help them adjust to the changes, Rollin Gallagher, the VA's national director for pain management, said staff are meeting personally with patients. "There is the real anxiety of being in pain and losing control of that pain. We are aware of the fact that we need to pay attention to this," he said.

The agency recently set up a Choice Card program for veterans, which would allow those facing long wait lists or who live more than 40 miles away from a VA hospital to use private clinic visits. Veterans say the initiative is complicated and confusing. VA officials acknowledged this month that veterans have been using this program at a lower rate than anticipated.

DEA officials declined to comment on the specific challenges that the new rules pose for veterans. Barbara L. Carreno, a DEA spokesperson, said in a statement that everyone, including "practitioners employed by the U.S. Veterans Administration," have to follow the new regulations. The officials said the rules are a response to multiple medical studies that have showed that the opioid overdose rate is higher in the United States than anywhere else.

DEA officials offer some flexibility, allowing doctors to write prescriptions for up to 90 days by post-dating them. But many VA doctors will not do that because of concerns over fraud or fatal overdoses and are telling patients they need to come back every month, medical staff say.

Half of all returning troops suffer chronic pain, according to a study in the June issue of the Journal of the American Medical Association. So a new generation of pain doctors are pushing for alternative ways to help veterans cope with chronic pain, from acupuncture to bright light therapy to medical marijuana. As part of a $21.7 million initiative with the National Institutes of Health, the VA is looking for therapies that could substitute for opioids.

"Our hospitals are doing some really exciting things to combat chronic pain and take of our care of veterans. There are VA hospitals that are using alpha-stimulation devices to treat pain and depression," McDonald said. "That's only going to continue and keep getting better. And we are getting there."

In the meantime, however, veterans say they continue to bear the burden of the new restrictions on narcotic painkillers.

A retired staff Army sergeant who served in Iraq, who spoke on the condition of anonymity for medical privacy reasons, can't drive because of shrapnel in his femur and pelvis. So now he has to take the bus nearly two hours for "a one-minute consult" to get his medications. He's been on them for more than nine years and never had an addiction problem, he said.

Mike Davis, a retired Army corporal, said he shattered his left arm from the elbow to the fingertips when he fell off of a Pershing missile during maneuvers in Germany in 1979. Over the years, he has had six surgeries.

After the last one, in 2003, he was prescribed opioids and said he has been on them since. Davis, who now works as a social worker in Illinois, said he feels lucky to have found a combination of painkillers that works for him after years of pain.

"It's just insulting to the veteran to assume they are abusing these drugs," said his wife, Linda Davis, who works as his personal patient advocate. "I'm fully aware that people doctor shop, some docs overprescribe. But I think they need to realize that there's a real difference between addiction and dependence."

But Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing, called the new DEA rules "the single most important change that could happen. The best way to treat any disease, whether it's Ebola or opioid addiction, is to stop creating more people with the disease."

At the same time, he said, the VA needs to do far more to help veterans through the rocky transition.

"Unfortunately, veterans are the victims here," Kolodny said. "The VA created this mess by aggressively jumping onto pills as the solution. But it's not something you can just abruptly stop."

West Virginians signing up for health care http://www.charlestondailymail.com/article/20150218/DM0104/150219261 DM0104 http://www.charlestondailymail.com/article/20150218/DM0104/150219261 Wed, 18 Feb 2015 17:10:53 -0500 By Whitney Burdette More than 33,000 West Virginians have signed up for insurance under the Affordable Care Act.

According to the U.S. Department of Health and Human Services, 33,091 West Virginians have selected a plan or automatically re-enrolled in a plan through the marketplace since open enrollment for this year began in November. Nationwide, 11 million people took advantage of health plans, including 8.6 million who use the healthcare.gov federal marketplace and 2.8 million who use a state-based marketplace.

"The Affordable Care Act is now an important part of the everyday lives of millions of Americans," HHS Secretary Sylvia Matthews Burwell said. "They finally have the financial and health security that comes with affordable health coverage. They now can fill prescriptions and take their children to the doctor. Some no longer have to choose between paying for health care and paying their utility bill. While we have more work to do, the numbers tell the story, and the story is clear. The Affordable Care Act is working, and families, businesses, and taxpayers are all better off as a result."

Burwell said most new consumers waited until the last minute, signing up on Feb. 15, totaling more than any day of the open enrollment period.

According to HHS statistics, 85 percent of West Virginians enrolled in a plan under the Affordable Care Act by Jan. 30 qualified for an average tax credit of $314 per month. Consumers could choose from 14 health plans, up from 12 last year, and 69 percent of West Virginia Marketplace enrollees as of December could have obtained coverage for $100 or less after applicable tax credits.

Contact writer Whitney Burdette at 304-348-5149 or whitney.burdette@dailymailwv.com. Follow her at www.Twitter.com/wburdette_DM.

State tough on immunizations http://www.charlestondailymail.com/article/20150210/ARTICLE/150219896 ARTICLE http://www.charlestondailymail.com/article/20150210/ARTICLE/150219896 Tue, 10 Feb 2015 21:38:06 -0500



The Associated Press

CHARLESTON, W.Va. - With rampant diabetes and obesity, Mississippi and West Virginia have struggled with health crises. Yet when it comes to getting children vaccinated, these states don't mess around.

The states, among the poorest in the country, are the only ones that refuse to exempt school children from mandatory vaccinations based on their parents' personal or religious beliefs. Separate efforts to significantly loosen those rules died in both states' legislatures last week.

Mississippi has the highest immunization rate in the country for children entering kindergarten at 99.7 percent, while West Virginia is at roughly 96 percent, according to the Centers for Disease Control and Prevention. The figures cover vaccines for measles, mumps and rubella; diphtheria, tetanus and pertussis; and varicella, or chickenpox.

Public health officials say a 90 percent immunization rate is critical to minimizing the potential for a disease outbreak.

"Mississippi is not traditionally viewed as a leader on health issues. But in this area, they should be proud of the fact that they have not changed this law. Mississippi and West Virginia could be role models for other states," said Dr. Mark Schleiss, a pediatrician and vaccine researcher at the University of Minnesota.

A recent measles outbreak that has sickened more than 100 people has brought attention to policies in 48 states that allow parents to opt out of vaccinating their children because of their religious beliefs or personal beliefs, or both.

But in West Virginia and Mississippi the rules are firm: Barring a significant medical reason, kids who haven't been vaccinated can't attend school - public or private.

Dr. Rahul Gupta, West Virginia's state health officer, said the limit on exemptions is the reason his state has been spared from any measles outbreaks for decades. And the policy has been relatively uncontroversial.

"The overwhelming majority of the public ... support having more of their children protected through vaccinations than less," he said.

Some parents in West Virginia are perplexed that people wouldn't vaccinate their kids.

"I don't think it's a big deal," said Paula Beasley, whose daughter attends fifth grade in Cross Lanes, West Virginia. "Everyone needs to. It's all for the greater good."

Mississippi lawmakers are considering a proposal to let doctors grant medical exemptions that would allow children to skip or delay a vaccination. Currently, only the state Department of Health can grant an exemption. Though all 135 requested exemptions were granted for this school year, a group called Mississippi Parents for Vaccine Rights said the department has ignored its concerns that the state requires too many immunizations too early in life. The activists' demand for a philosophical exemption was stripped from the bill last week.

Tracey Liles of Grenada, Mississippi, who has a 13-year-old daughter and a 3-year-old son, is among those pushing for the change because she thinks the health department has been too stingy in granting medical exemptions. Liles said her daughter is fully vaccinated but ran a high fever and slept for two days after a round of vaccinations about 10 years ago. Her daughter, who is now in eighth grade, had to get a state-mandated booster shot for diphtheria, tetanus and pertussis before entering seventh grade.

"Obviously, I wasn't going to pull her out of school, being a cheerleader and everything. So, we did it," Liles said. "Basically, I feel like I was forced to do it, but I didn't have a choice."

Dr. Mary Currier, the state health officer in Mississippi, has urged legislators not to weaken the immunization requirements, particularly with measles spreading in other states.

Mississippi enacted a strong vaccination law in the 1970s. In 1979, the Mississippi Supreme Court blocked a father's request not to vaccinate his son because of religious beliefs.

The protection of students "against the horrors of crippling and death resulting from poliomyelitis or smallpox or from one of the other diseases against which means of immunization are known and have long been practiced successfully, demand that children who have not been immunized should be excluded from the school community until immunization has been accomplished," the court wrote.

Republican Dean Kirby, chairman of the Mississippi Senate Public Health Committee, said that when proposals to create a philosophical exemption arose in recent years, he received calls mostly from one side - those wanting the change. With the measles outbreak this year, Kirby said he's now hearing from parents who want to keep the law as it is.

"They don't want their children going to school with people who have not had the shots," Kirby said.

West Virginia's school vaccination law has its roots in the 1880s and has been repeatedly changed. But the trend toward expanding exemptions never gained traction.

Last week, a proposed religious exemption was removed from consideration without debate in the legislature.

Dr. Ron Stollings, a state senator, said lawmakers may tweak which state officials can grant medical exemptions, but public safety demands exemptions be kept to a minimum.

"Without this mandate, we'd be in the 60 to 70 percent vaccinate rate and not 90 percent," he said.

Role of genetics in health grows http://www.charlestondailymail.com/article/20150208/DM01/150209420 DM01 http://www.charlestondailymail.com/article/20150208/DM01/150209420 Sun, 8 Feb 2015 00:01:00 -0500 By Charlotte Ferrell Smith As research continues regarding the role of genetics in health care, officials are doing more screening and counseling in that area.

"A lot of research is going on," said Lisa Muto, registered nurse at Edwards Comprehensive Cancer Center at Cabell Huntington Hospital. "The whole field of genetics is exploding. What we do now is different from 20 years ago."

Muto is the only nurse in West Virginia to hold the title of advanced practice nurse in genetics. She holds a doctorate of nursing practice with a focus on hereditary cancer syndromes and high-risk women. She is an oncology certified nurse.

She said a blood test is used to test for breast and other hereditary cancers. The test means checking for a mutation of the BRCA1 or BRCA2 genes. Those who have a mutation in either of these genes have a higher risk of developing breast cancer. Also, mutation carriers previously diagnosed with cancer have an increased risk of developing a second cancer.

She noted such test results do not mean a patient will have cancer, but can point to a higher risk factor.

"For someone who has a mutation, there are many options, including increased surveillance, risk reducing medications, and/or surgery, depending on the individual's personal or family history," she said.

In 2013, actress Angelina Jolie announced she had undergone a double mastectomy after learning she was a BRCA1 gene mutation carrier, putting her at high risk for breast and ovarian cancer. She also had a family history of both cancers.

If a patient is considered at-risk and is recommended for testing, some insurance companies will cover the cost, Muto said. Some patients who do not qualify for insurance coverage choose to pay about $4,000 out of pocket to have the blood work done, she said.

Questions regarding a patient's medical and family history are used to determine whether a patient is considered to be at-risk. For more detailed information, go to the website http://www.myriad.com/patients-families/disease-info/breast-cancer/

Muto listed a number of things that may make a patient a candidate for additional testing: a personal or family history of breast cancer diagnosed before age 50; ovarian cancer at any age; triple negative breast cancer diagnosed at or before age 60; male breast cancer; bilateral breast cancer; three family members with breast cancer; any combination of breast, ovarian, prostate, or pancreatic cancer in three family members; Ashkenazi Jewish ancestry.

The list is not all inclusive and Muto is happy to answer any questions. She can be reached at lisa.muto@chhi.org or by calling 304-399-6572. There is no charge for a consultation. The office does not charge for a blood draw.

"The lab will call the patient with any out of pocket cost and they have the option to cancel testing," she said.

Meanwhile, at Charleston Area Medical Center, Elizabeth Monast is a genetic counselor in the Breast Center.

Typically, a genetic counseling session takes an hour with the patient asked about medical and family history.

"This information is critical in order to provide an accurate genetic risk assessment," Monast said. "During their appointment patients are provided with information about cancer genetics, inheritance, testing, risk management, prevention and resources."

If a patient decides to pursue testing, two tubes of blood are drawn.

"Genetic counseling is recommended for any person who is considering testing for a genetic or hereditary condition," she said.

Genetic testing and counseling are available for numerous medical conditions, she said. She suggests anyone with concerns about a personal or family history of cancer ask a doctor about a referral for genetic risk assessment.

Monast holds undergraduate degrees in biological sciences and psychology from Virginia Tech. She received her master's in genetic counseling from Long Island University Post.

Thomas Health System names new Foundation director http://www.charlestondailymail.com/article/20150205/DM01/150209503 DM01 http://www.charlestondailymail.com/article/20150205/DM01/150209503 Thu, 5 Feb 2015 12:03:05 -0500 By Charlotte Ferrell Smith Sandy Zando will retire in April from her position of executive director of the Thomas Memorial and Saint Francis Hospitals Foundation.

"Sandy has been an exceptional leader and she will be greatly missed," Paula Vineyard, board president of the foundation said in a news release. "We appreciate the years that Sandy has led and further developed this foundation to what it is today."

The new executive director will be Sally Noakes Barton, who is the current executive director and chief executive officer for Tamarack Artisan Foundation. Barton is a graduate of the University of North Carolina at Greensboro where she earned a bachelor's degree in media studies. She has worked for the Washington, D.C., bureau of CNN and Charleston Area Medical Center. She has served on numerous community boards.

An earlier news release announced the retirement of Stephen Dexter, president and chief executive officer with Thomas Health System.

He is to retire July 31 after 21 years of leadership with the organization, according to an announcement by the Thomas Health System Board of Trustees.

Dexter will remain a senior executive with Thomas Health System through January of 2017 as president of TMH Services, a wholly owned subisidiary of Thomas Health System.

The new president and CEO of Thomas Health System is Dan Lauffer, who will transition into the role over the next six months. He is currently the executive vice president and chief operation officer of Thomas Health System Inc.

Lauffer is a graduate of Alderson-Broaddus College and is a certified physician assistant. He holds a master of science and health care administration from Marshall University. He is a fellow of the American College of Healthcare Executives and a board member of the West Virginia Hospital Association.

Contact writer Charlotte Ferrell Smith at charlotte@dailymailwv.com or 304-348-1246.

Raleigh General investigates doctor's heart procedures http://www.charlestondailymail.com/article/20150204/ARTICLE/150209645 ARTICLE http://www.charlestondailymail.com/article/20150204/ARTICLE/150209645 Wed, 4 Feb 2015 12:07:18 -0500 WHITE HALL, W.Va. (AP) - Raleigh General Hospital is investigating whether heart procedures performed by a doctor were warranted.

Raleigh General CEO David Darden tells The Register-Herald that the investigation was prompted by an ongoing internal review. He says the review identified cases in which a patient's condition might not have warranted the placement of a stent.

Darden says the hospital has enlisted national experts to review cases involving procedures performed by the doctor.

The hospital is providing follow-up care to affected patients.

Darden says the doctor no longer works at the hospital.

Attorney Ben Salango, who represents a patient, identified the doctor as Dr. D. Kenneth Glaser.

A residential telephone listing for Glaser could not be found. A woman who answered the telephone at a business listing said he no longer works there.

Repairs underway at W.Va. vets clinic to address air quality http://www.charlestondailymail.com/article/20150202/ARTICLE/150209862 ARTICLE http://www.charlestondailymail.com/article/20150202/ARTICLE/150209862 Mon, 2 Feb 2015 10:56:25 -0500 MAXWELTON, W.Va. (AP) - Repairs are underway to address air quality concerns at a Veterans Affairs outpatient clinic in southeastern West Virginia.

Employees at the Greenbrier County Community Based Outpatient Clinic in Maxwelton have complained of headaches, dizziness and a burning sensation in their eyes since last June. The clinic has been closed for much of the past eight months.

The clinic is located in a building owned by the Greenbrier Valley Economic Development Corporation. Steve Weir, the corporation's executive director, tells The Register-Herald that the repairs could be completed next week.

The clinic serves veterans in Greenbrier, Monroe, Pocahontas and Summers counties and in Alleghany County in Virginia.

CAMC sets date for public dedication of Cancer Center http://www.charlestondailymail.com/article/20150128/DM01/150129233 DM01 http://www.charlestondailymail.com/article/20150128/DM01/150129233 Wed, 28 Jan 2015 13:01:55 -0500 By Charlotte Ferrell Smith Dedication of the new Charleston Area Medical Center Cancer Center is set for April 17 and 18, said David Ramsey, CAMC president and chief executive officer.

While details are yet to be announced, plans call for CAMC employees to tour the new center on April 17 while the new facility is to be open to the general public noon to 4 p.m. April 18.

The upcoming event was announced on Wednesday morning during the regular monthly meeting of the CAMC Board of Trustees.

The 110,000-square-foot, $50 million facility will house the David Lee Cancer Center, CAMC Breast Center and Charleston Radiology Therapy Consultants. Construction began in July of 2013.

Ramsey added that for the second consecutive year, CAMC was named among the nation's top 5 percent of hospitals for overall clinical excellence by Healthgrades. The national health care ratings company made the determination due to an independent study of mortality and complication rates for about 4,500 hospitals. CAMC is the only hospital in West Virginia and one of 261 hospitals nationwide to receive the Distinguished Hospital Award for Clinical Excellence. Go to healthgrades.com/quality for more information about the award.

A question was raised regarding a recent newspaper article naming hospitals that Centers for Medicare and Medicaid Services found to have high rates of potentially avoidable "hospital acquired conditions" due to things such as falls, bed sores and some infections. Each hospital received a score of 1 to 10 with the lowest number being the best score. CAMC received a 9.

Dale Wood, chief quality officer for CAMC, said looking at a particular category can be misleading. While there is always room for improvement, he noted that CAMC often gets patients that are the sickest. For example, patients are frequently transported from other facilities where central lines and catheters have already been placed.

"We are still in the top 5 percent in clinical outcomes," Wood said.

Wood also stepped in to present reports on behalf of the quality committee for Ed Welch, University of Charleston president and head of that committee. He said Welch was unable to attend Wednesday's meeting due to an accident in which he suffered a broken rib.

Wood gave good reports regarding patient care and safety, but added health officials are always striving to improve.

"Each hospital looks at multiple areas in efforts to strive for the highest performance," he said.

In other business, Karen Price, chair of the planning and public policy committee, asked the board to support legislation requiring a prescription for medications containing pseudoephedrine, a key ingredient in making methamphetamine. She cited reports showing steep declines in meth labs in other states that have enacted such laws.

Meanwhile, the board approved a bylaw amendment that would include psychologists with doctoral degrees and podiatrists as full voting members of the medical staff.

Several CAMC staff members were presented with "Heart and Soul" awards by Ramsey for going above the call of duty in patient care.

A group from Memorial Hospital who dubbed themselves "the dream team" helped coordinate complicated care for an employee's daughter while the staff member attended a funeral. Employees recognized and their respective departments included Denny Jones, food services director; Mark James, respiratory care; and Kara Garren and Margaret Graley, both clinical dietitians.

Melissa Appleton, a nurse at Women and Children's Hospital, was recognized for her efforts in working with pediatric cancer patients and their families. Aside from medical care, she often is found spending time with families after work hours to offer emotional support, Ramsey said.

"I am really blessed to take care of these kids," Appleton said.

Contact writer Charlotte Ferrell Smith at charlotte@dailymailwv.com or 304-348-1246.

State health official says vaccinations are important http://www.charlestondailymail.com/article/20150127/DM01/150129294 DM01 http://www.charlestondailymail.com/article/20150127/DM01/150129294 Tue, 27 Jan 2015 21:04:56 -0500 By Andrea Lannom West Virginia health officials say a measles outbreak resulting from exposure at Disneyland brings up the importance of vaccines.

Between 1995 and 2014, only two cases have been reported in West Virginia with the last case reported in 2009, said Dr. Rahul Gupta, state health officer and commissioner for the Bureau for Public Health.

Measles is a highly contagious respiratory disease that can spread through the air and infected surfaces, according to the Centers for Disease Control and Prevention. It can cause conditions including encephalitis, which can lead to deafness or mental retardation, pneumonia and death.

"Measles is a very serious disease across the world," Gupta said. "Globally, easily tens of thousands, if not hundreds of thousands of children contract this. More importantly, there are complications with this disease ranging from pneumonias to central nervous system problems. Kids die from this. I've treated and unfortunately seen deaths as a result of measles. It's not only a rash. It's complex and serious and often fatal across the world."

Recently, more than 80 people, many of whom were not vaccinated, were infected with measles linked to an initial exposure from Disneyland in California, according to national media reports.

Officials said the outbreak began when an infected person visited the resort between Dec. 15 and Dec. 20.

After the most recent outbreak in California, the American Academy of Pediatrics, the CDC and the American Academy of Family Physicians urged people to get children vaccinated for measles, mumps and rubella.

The CDC, American Academy of Family Physicians and the American Academy of Pediatrics recommend children to get the measles, mumps and rubella vaccine at 12 to 15 months and again at 4 to 6 years old.

Gupta said these two doses of the vaccine are more than 98 percent effective in preventing measles.

He said two doses are required for school entry. However, current laws allow children to be exempted if there are justified medical reasons. Gupta said in these cases, it would be more of a benefit for the child to be exempted than immunized.

Gupta said if an adult only got one of the vaccines when he or she was younger, then that person wouldn't necessarily need to get the second dose. However, it might be more important for health care workers to get the second dose in that scenario.

Gupta said measles was eradicated in the country in 2000, primarily through the efforts of vaccines. Since then, he said the country has seen the importation of the disease.

"As we know, diseases are only a plane flight away," he said. "Often what we've seen is the importation of these diseases and they're re-introduced to the community. As we've seen in Disney in California, San Diego in 2008 and more recently in the neighboring state of Ohio."

In the Ohio outbreak last year, there were a total of 382 measles cases resulting in nine hospitalizations, according to data from the Ohio Department of Health. The earliest onset of symptoms began in March and latest onset began in July. Cases ranged from six months to 53 years-old.

Gupta said what health officials saw is that most of the people who contracted measles were people who were previously not vaccinated.

"When we have this introduction of a disease that is no longer in the community, then other people are at risk of acquiring that disease as well. Often, it's the children. What research shows us is that on average, children exempt from immunizations are 35 times more likely to contract diseases like measles than vaccinated persons - not just children, overall persons."

Contact writer Andrea Lannom at Andrea.Lannom@dailymailwv.com or 304-348-5148. Follow her at www.twitter.com/AndreaLannom.

Legislation focuses on healthy living http://www.charlestondailymail.com/article/20150127/DM0104/150129317 DM0104 http://www.charlestondailymail.com/article/20150127/DM0104/150129317 Tue, 27 Jan 2015 17:21:21 -0500 By Whitney Burdette A Kanawha delegate has introduced two pieces of legislation he says will help improve the health and fitness of West Virginians.

Chris Stansbury, a Republican, is the sponsor of House Bill 2441 and House Bill 2443. Both bills will, he says, help the state's residents improve their quality of life by allowing for increased fitness opportunities and life saving education.

"Shared use is a concept that's designed to encourage recreation in communities, to encourage health and fitness among adults and children," Stansbury said. "It allows for county school boards and the local school administrators to allow their properties to be used for unorganized recreation without concern of liability."

State code already allows for organized recreation to take place on school property that covers organized sports teams. But this legislation will allow the playground, track or gymnasium to be used for things like pickup basketball games or fitness classes.

Stansbury, an eye doctor, identified health and fitness as one of his campaign platforms.

"We've got a lot of health issues here in West Virginia," he said. "We're No. 1 in a lot of the bad categories - heart disease, diabetes, obesity - and a lot of these things can be improved just by getting people more active. We have an issue, especially in the rural parts of the state, where we don't have enough opportunity for opeople to get out and be active. We don't have walking trails, rails-to-trails or parks like we have in Charleston. It's nice to open the schools which are typically clean and safe and modern so that maybe somebody can teach a Zumba class in the gym if they wanted to or the local kids can get together and play pickup basketball."

The legislation wouldn't require county school boards to offer their facilities for after-hours use, but would instead give them some flexibility and decide if that's something they want to do. Stansbury said most school administrators he's spoken with are supportive of the idea. They often field questions from locals asking why they can't use school facilities for unorganized recreation.

"The thing that kept popping up was the fear of liability," Stansbury said.

"It's something they've wanted to do for the community, they just didn't feel like they were able to do that," he added.

House Bill 2443 would require students in grades 8 through 12 to have some hands-on CPR training. State code suggests CPR instruction already, but doesn't specify the hands-on training Stansbury said will better stick with students.

"Studies have shown if you just talk about the broad concept of CPR, students retain less than if they do hands-on training because they develop those psycho-motor skills, that muscle memory, to do the CPR itself," Stansbury said.

His legislation would require students to learn the Heimlich maneuver and 30 minutes of hands-on CPR instruction. Schools would be able to partner with local police, fire, EMS or hospitals to provide training to students at no cost to the school.

"It's not necessarily something we're going to have to add a line-item in the budget for," Stansbury said. "Through a partnership with somebody who is already a certified instructor, we're going to be able to bring those folks in and teach the students CPR without incurring any additional cost."

Stansbury said the legislation will mean more people have the skills to do CPR in the instances of stroke or other medical emergencies that may require it.

"You could save a life," he said."

Contact writer Whitney Burdette at 304-348-5149 or whitney.burdette@dailymailwv.com. Follow her at www.Twitter.com/wburdette_DM.

Conference addresses cervical cancer in W.Va. http://www.charlestondailymail.com/article/20150126/DM01/150129386 DM01 http://www.charlestondailymail.com/article/20150126/DM01/150129386 Mon, 26 Jan 2015 21:33:52 -0500 By Charlotte Ferrell Smith Ten women die from cervical cancer every day in the United States and most of those deaths could be prevented through screenings and vaccines, according to health officials.

A news conference on "Preventing Cervical Cancer" was held Monday morning at Charleston Area Medical Center's Women and Children's Hospital. As part of National Cervical Cancer Awareness Month, the hospital teamed up with the state Department of Health and Human Resources to spread the word about help available in West Virginia to prevent cervical cancer.

Among those on hand to offer information were Karen L. Bowling, DHHR cabinet secretary; Dr. Rahul Gupta, Bureau for Public Health commissioner and state health officer; and Stephen H. Bush, associate professor and chairman of the West Virginia University Division Department of Obstetrics and Gynecology. A cervical cancer survivor was also among the speakers.

Statistics show more than 12,000 women in the U.S. are diagnosed with cervical cancer each year. Last year, 107 women in West Virginia were included in that number.

"It's important to remember that half of all cervical cancers occur in women rarely or never screened for cancer, and another 10 to 20 percent of cancers develop among women who were screened, but did not receive adequate follow-up care," Gupta said.

Women diagnosed with breast or cervical cancer have a much better chance of survival when those conditions are caught early, he said.

"Cervical cancer is preventable with pap screening tests and vaccines to combat human papillomavirus (HPV), which is the main cause of cervical cancer," Bush said. "Cervical cancer deaths decreased 70 percent between 1955 and 1992, and continue to decline each year due to increasing use of the pap test. The HPV vaccine is nearly 100 percent effective in preventing the most common types of HPV-related cervical cancer."

More than 50 percent of cervical cancer is found in women who do not have pap smears, he said.

Pap smears are recommended annually for women age 21 to 65. Medical opinions vary on how long a woman over 65 may go between pap smears with some saying three years. Bush recommends regular annual health exams while frequency of pap smears may depend upon the evaluation of each patient.

Gardasil (HPV) vaccine is recommended for males and females age 9 to 26. In girls and young women, the vaccine guards against cervical cancer and genital warts. For males, the vaccine guards against genital warts.

The vaccine is administered in a series of three shots. Bush said studies show no adverse reactions among thousands of patients receiving the vaccine.

The U.S. has a 33 percent rate of administering the vaccine, Bush said.

Meanwhile, cervical cancer survivor Shelly Dusic told her powerful personal story.

She was a 19-year-old college student when she was diagnosed with cervical cancer and given a bleak prognosis for survival.

"I was told I needed a biopsy," she said. "I had no insurance. I checked on the cost of a biopsy and the cost of cremation. I prepaid for my funeral so my parents wouldn't have to."

Her struggle with cervical cancer lasted six years, including time in a wheelchair in pain. She was 23 when she had a complete hysterectomy in 2003 and doctors were able to remove a large cancerous tumor.

While she has no children of her own, she is grateful for two teenage stepdaughters and a supportive husband.

She recalls as a child awaking from a nightmare about stomach pain and clutching her pink teddy bear. She wishes she had known then that she could have had an HPV vaccine to prevent cervical cancer. She is now 35 and a health information specialist with the West Virginia Breast and Cervical Cancer Screening Program.

The program offers free or low-cast pap tests for low-income women as well as those who are not insured or under-insured.

"More than 300 providers statewide offer this service to program-eligible women," Gupta said. "An uninsured woman with a family of four can have a total household income of $59,628 and still be eligible for the program."

For more information, go to www.wvdhhr.org/bccsp, stop by the local health department, or call 1-800-642-8522.

Jeff Neccuzi, director of immunization services with the Bureau for Public Health, said the Vaccines for Children program provides free vaccines for eligible children up to age 19, including those with no insurance, those enrolled in Medicaid, and those with plans that do not cover vaccines. For more information, check with the local health department.

For those over age 19, Merck, which makes Gardasil vaccine for HPV, partners with many health providers to make the vaccine free for those unable to afford it, he said.

House bills seek to curb overdose deaths http://www.charlestondailymail.com/article/20150122/DM0104/150129666 DM0104 http://www.charlestondailymail.com/article/20150122/DM0104/150129666 Thu, 22 Jan 2015 21:10:59 -0500 By Whitney Burdette The House of Delegates is working on two pieces of legislation that could save lives.

The House Health Committee on Thursday considered two pieces of legislation. House Bill 2009 would permit first responders to administer Naloxone, an opioid antagonist, to people experiencing overdoses, while House Bill 2045 would grant immunity to people who seek medical attention, for themselves or on behalf of someone else, for drug or alcohol related incidents.

Dr. Rahul Gupta, commissioner of the state's Bureau for Public Health, told members of the committee both bills could lead to a decrease in the number of deaths associated with drug overdoses.

"We have over 460 opioid overdose deaths in 2013," Gupta said. "This would help save lives."

House Bill 2009 passed out of the committee unanimously.

A bill similar to House Bill 2009 died at the end of the 2014 legislative session. The bill seeks to allow initial responders, including paramedics, EMS, policemen and others, to administer the drug after consulting with medical professionals unless the responder meets certain qualifications. The person administering the drug would not be held liable or in violation of any professional licensing statutes if he or she acted in good faith.

The bill also seeks to collect data on each opioid prevention and treatment program offered, including the number of people trained to administer Naloxone or similar drugs and the number of people who receive treatment.

Gupta said Naloxone is "a relatively benign" drug, and that it won't harm patients who hadn't overdosed on opioids. Gupta said the drug usually is effective for up to 20 minutes.

Under House Bill 2045, people who report drug overdoses or alcohol related incidents, such as alcohol poisoning, will receive immunity provided they cooperate with law enforcement.

The committee's lawyer offered several examples of incidents that could be covered by the legislation, including underage drinking in college dorm rooms. For example, if students under the age of 21 are drinking and someone experiences alcohol poisoning and another underage person calls 911, the caller wouldn't be subject to misdemeanor charges, although the person experiencing alcohol poisoning would be cited for underage drinking. The same logic applies to adults who are drinking, but no one would be cited because they are over the legal drinking age.

The bill also would extend immunity to those drinking in public places and those possessing or attempting to deliver a controlled substance.

"The overdose death problem needs a host of solutions," Gupta said. "There are many being offered, and this is one of those solutions."

Although some delegates said they were uncomfortable with the legislation, noting a widespread drug abuse problem, it passed the Health Committee unanimously. Delegate Barbara Fleischauer, D-Monongalia, is a cosponsor of the bill and said she, too, has seen the effects of substance abuse. She noted the death of 18-year-old Nolan Burch, a WVU student who died late last year in a drug and alcohol related incident.

"The students and the administration are very concerned, as every college should be," she said. "We have binge drinking among students experimenting with alcohol. It was very sad we lost that young student. If it can save one life, it's important."

Both bills will now go to the House Judiciary Committee.

Contact writer Whitney Burdette at 304-348-5149 or whitney.burdette@dailymailwv.com. Follow her at www.Twitter.com/wburdette_DM.

Lab tests imply formaldehyde risk in some e-cigarette vapor http://www.charlestondailymail.com/article/20150122/ARTICLE/150129745 ARTICLE http://www.charlestondailymail.com/article/20150122/ARTICLE/150129745 Thu, 22 Jan 2015 11:16:26 -0500


AP Chief Medical Writer

Using certain electronic cigarettes at high temperature settings could potentially release more formaldehyde, a cancer-causing chemical, than smoking traditional cigarettes does, new lab tests suggest.

The research does not prove a health risk - it involved limited testing on just one brand of e-cigarettes and was done in test tubes, not people. It also does not mean e-cigarettes are better or worse than regular ones; tobacco smoke contains dozens of things that can cause cancer.

But it does highlight how little is known about the safety of e-cigarettes - battery-powered devices that heat liquid to deliver nicotine in a vapor rather than from burning tobacco.

"It's a potential red flag," one independent expert - Stephen Hecht, a chemist and tobacco researcher at the University of Minnesota - said of the study. "Under some conditions, e-cigarettes might be generating more formaldehyde than you'd want to be exposed to. But I don't think we know enough yet. There's a huge variety in the makeup of these cigarettes and how they are used."

The study was published Wednesday as a letter in the New England Journal of Medicine. The journal said it had been reviewed by experts in the field.

Formaldehyde is found in many things - certain building materials, disinfectants and embalming fluid. An earlier study found e-cigarettes generated less formaldehyde than regular cigarettes do, but that study looked at just the gas portion of the vapor. The new one looked at the liquid particles in the vapor, like the spray from an aerosol can.

Some tank system e-cigarettes let users turn up the voltage to increase the heat and the amount of liquid, which contains the nicotine and flavorings, in the vapor. David Peyton, a chemist at Portland State University, and colleagues tested one brand with two voltage settings. They used a syringe to collect vapor from 10 samples, each one representing several puffs, at both voltage levels.

They measured formaldehyde hemiacetal - a compound created during the vaping process that under certain conditions can release formaldehyde - in the liquid portion of the vapor.

At low voltage the chemical was not detected. But at the high voltage setting, levels of that compound were five to 15 times greater than the amount of formaldehyde users would get from traditional cigarettes.

Virtually all e-cigarettes use similar materials in the heated liquid, so the finding on formaldehyde "is not brand-dependent," said Peyton, who plans more extensive tests.

However, Gregory Conley, a lawyer with the American Vaping Association, an advocacy group for e-cigarettes, criticized the study methods.

"They use the device in a manner that no one does," he said.

Using the high voltage for as long as the researchers mimicked in the study "creates a burning, acrid taste" called a "dry puff" that would cause users to adjust the e-cigarette, Conley said.

What the researchers did is like leaving a steak on a grill all day - many cancer-causing substances might be formed but no one would eat such charred meat, he said.

Eric Jacobs, a biologist at the American Cancer Society, said a biochemist at the society looked at the work and "was reasonably convinced" that the chemical researchers measured would break down into formaldehyde in the user's lungs.

"No one should conclude from this that e-cigarettes used at high voltage are worse than combustible tobacco cigarettes," because of all the other toxins in tobacco smoke, Jacobs said.

The society's advocacy affiliate, the Cancer Action Network, said the research "should raise serious concerns" about the lack of regulation of e-cigarettes, and urged the Food and Drug Administration to quickly finalize the proposal announced last spring to do so.

Report: W.Va. makes little progress on tobacco control http://www.charlestondailymail.com/article/20150121/ARTICLE/150129866 ARTICLE http://www.charlestondailymail.com/article/20150121/ARTICLE/150129866 Wed, 21 Jan 2015 09:57:08 -0500 CHARLESTON, W.Va. (AP) - West Virginia got failing grades on tobacco control from the American Lung Association, which reported Wednesday that funding for prevention programs has declined and an attempt to increase tobacco taxes was unsuccessful.

The report gave the state F's for tobacco prevention and control program funding, access to cessation services and tobacco taxes, and a D for smoke-free air.

"Tobacco use in any form is one of the biggest threats to public health in West Virginia, claiming more than 3,821 lives each year," Deborah Brown, CEO of the American Lung Association of the Mid-Atlantic, said in a news release. "Tobacco use continues to have a substantial negative effect on the health of West Virginia citizens and the economy of the state. We must act now to end this epidemic."

West Virginia spends 25 percent of the funding level recommended by the Centers for Disease Control and Prevention for tobacco prevention and cessation. State funding for these programs fell from $6.5 million in fiscal 2012 to about $4.8 million fiscal 2015, according the lung association's "State of Tobacco Control" report.

Private insurers operating in West Virginia are not required to provide tobacco cessation services. The state's Medicaid program limits the duration of these services and annual limits on attempts to quit. The Medicaid program also requires counseling to obtain medications, the report said.

West Virginia has made progress in reducing exposure to secondhand smoke, the report said. All 55 counties have secondhand smoke regulations and 22 prohibit smoking in most public places and workplaces, including bars and restaurants.

The report recommended that the state increase funding for tobacco prevention and cessation and raise taxes on cigarettes and other tobacco products. It also recommended passing laws or regulations to increase the number of residents protected from secondhand smoke.

CAMC bars children from visiting hospital due to flu outbreak http://www.charlestondailymail.com/article/20150119/DM01/150119181 DM01 http://www.charlestondailymail.com/article/20150119/DM01/150119181 Mon, 19 Jan 2015 21:37:15 -0500 By Marcus Constantino To keep the flu virus from spreading, Charleston Area Medical Center is asking parents to keep children away from the hospital unless necessary.

CAMC said in a press release that additional restrictions on visitation have been implemented due to "above-normal flu activity" in the area and the probability that the flu virus will remain elevated for several weeks. The policy restricts children 12 or under from visiting patients the hospital until further notice.

The advisory says children should either be left in the lobby with an adult or kept at home until further notice, unless the child is in need of medical attention.

"Younger people tend to have a greater chance of exposure at schools etc. Therefore they are at risk of spreading viruses to loved ones, other patients and visitors," the hospital release said.

The restriction on children comes in addition to other visitor guidelines announced in December in response to the flu. Only two visitors per patient are allowed at any given time, and those who are running a fever of more than 100 degrees or are showing symptoms of illness, such as sore throat or coughing, are asked to not visit the hospital unless they are seeking medical care.

The hospital said signs have been placed at the hospital's entrances to notify visitors of the restrictions.

More than 330 cases of flu were confirmed statewide during the first week of January, according to data from the West Virginia Department of Health and Human Services. Around 6,000 patients reported "influenza-like illness" at West Virginia hospitals and referral laboratories during that week.

Contact writer Marcus Constantino at 304-348-1796 or marcus.c@dailymailwv.com. Follow him at www.twitter.com/amtino.

Thomas Health System CEO announces retirement http://www.charlestondailymail.com/article/20150119/DM01/150119218 DM01 http://www.charlestondailymail.com/article/20150119/DM01/150119218 Mon, 19 Jan 2015 10:55:30 -0500 By Charlotte Ferrell Smith Stephen P. Dexter, president and chief executive officer of Thomas Health System, will retire July 31 after 21 years of leadership with the organization.

His retirement was announced Monday by the Thomas Health System Board of Trustees through a news release.

"We appreciate the years of Steve leading this organization and developing the Thomas emergency room, beginning the clinical pavilion, overseeing the acquisition of Saint Francis Hospital thus forming Thomas Health System and significantly, his role in healthcare policy government relations," said Thomas McHugh, chairman of the Board of Trustees.

Dexter will remain a senior executive with Thomas Health System through January of 2017 as president of TMH Services, a wholly owned subsidiary of Thomas Health System.

The new president and CEO of Thomas Health System is Dan Lauffer, who will transition into the role over the next six months. He is currently the executive vice president and chief operation officer of Thomas Health System Inc.

"I'm excited to be turning the reins over to Dan Lauffer," Dexter said. "I have known Dan for 20 years. He is an exceptional individual and a true leader in the healthcare community. Under Dan's guidance, the best days are ahead for Thomas Health System."

Lauffer is a graduate of Alderson-Broaddus College and is a certified physician assistant. He holds a master of science in health care administration from Marshall University. He is a fellow of the American College of Healthcare Executives and a board member of the West Virginia Hospital Association.

"I'm excited for the opportunity to be the president and CEO of this organization where I first started my healthcare career," Lauffer said. "This transition comes at a time when the healthcare industry is undergoing great change," Lauffer said. "The Thomas Health System is positioned well to take on these challenges because of the talent of its Board of Trustees, the medical staff, department leaders, the dedicated employees and the senior executive team. I appreciate Steve Dexter's leadership in influencing my career and I will work hard to ensure our community continues to value the Thomas Health System to be the first choice of those in need of quality healthcare in our region."

Scholarship to honor retired Cabell Huntington Hospital CEO http://www.charlestondailymail.com/article/20150116/ARTICLE/150119408 ARTICLE http://www.charlestondailymail.com/article/20150116/ARTICLE/150119408 Fri, 16 Jan 2015 11:27:59 -0500 HUNTINGTON, W.Va. (AP) - A scholarship fund is being launched to honor the newly retired CEO of Cabell Huntington Hospital.

Officials announced the $1 million endowment for the Brent A. Marsteller Scholarship Fund this week to benefit students at the Marshall University's medical school.

The scholarship will be funded over five years in $100,000 yearly installments by both Cabell Huntington Hospital and Marshall Health. That's primary physician practice group affiliated with the hospital and medical school.

Marsteller retired from the hospital last month. The Huntington native took the job in October 2000 after leaderships at other hospitals in West Virginia, Ohio and Florida.

Among the hospital's accomplishments under Marsteller are the construction of the Edwards Comprehensive Cancer Center and a new wing for patients. He plans to continue with the hospital as a consultant.

US releases W.Va. sign-ups for health insurance marketplace http://www.charlestondailymail.com/article/20150115/ARTICLE/150119505 ARTICLE http://www.charlestondailymail.com/article/20150115/ARTICLE/150119505 Thu, 15 Jan 2015 10:53:12 -0500 CHARLESTON, W.Va. (AP) - Federal officials say more than 26,000 West Virginians have signed up for the health insurance marketplace under the program's second open enrollment.

The U.S. Department of Health and Human Services says 26,236 people signed up ahead of the deadline Thursday for coverage starting Feb. 1.

For those who missed the deadline, an open enrollment period will extend until Feb. 15. If that deadline is missed, the earliest coverage for those seeking coverage would be 2016.

In the first month of the second enrollment, HHS says 85 percent of Virginia consumers who signed up were eligible for financial assistance.