www.charlestondailymail.com Health http://www.charlestondailymail.com Daily Mail feed en-us Copyright 2014, Charleston Newspapers, Charleston, WV Newspapers Sierra Club shows support for EPA rule http://www.charlestondailymail.com/article/20141202/DM0104/141209773 DM0104 http://www.charlestondailymail.com/article/20141202/DM0104/141209773 Tue, 2 Dec 2014 21:40:05 -0500

Although state and industry officials disagree with the Environmental Protection Agency's Clean Power Plan, it has the full support of the West Virginia chapter of the Sierra Club.

The organization on Monday submitted its comments to the EPA. The plan was first proposed in June, and the public comment period ended Monday. The EPA is expected to finalize the rule next month.

Although leaders in the coal industry as well as Appalachian Power and the state Department of Environmental Protection say the proposal will have dire consequences for the coal industry and consumers, West Virginia Sierra Club president Jim Kotcon says it has "strong local support."

"Modernizing the way we get our energy will create green jobs throughout the state while reducing the air and water pollution that threatens the health of our most vulnerable citizens," Kotcon said in a statement.

The EPA's proposal aims to reduce carbon emissions by 2030. However, states must make significant headway by 2020 and industry leaders warn the rule, if implemented, could lead to the closure of coal-fired power plants in West Virginia and drive up energy costs.

But Kotcon said West Virginia is presented with an opportunity to explore other forms of energy.

"Gov. Tomblin should work with West Virginians to proactively seize the many new business opportunities a strong state Clean Power Plan will create," he said. "In a rapidly changing world that is shifting to clean energy, our success will be based on leveraging the opportunities of the future rather than clinging uncritically to the past. It is time to move beyond the reactionary doom-and-gloom naysaying of the coal industry, which profits out-of-state coal companies at the expense of our health."

The Sierra Club submitted comments from more than 450 West Virginians in support of the rule.

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The deadline for lobbyists to register with the state Ethics Commission is fast approaching.

Lobbyists who want to be included in the 2015 Directory of Lobbyists need to register with the commission by Dec. 11. All registrations expire Dec. 31, but early registration is encouraged.

To register, lobbyists must complete the West Virginia Lobbyist Payment and Registration Information Cover Sheet, Lobbyist Registration Statement and an Employer Representation/Authorization form for each employer or entity represented. The forms are available at www.ethics.wv.gov. Registration fees are $100 per lobbyist and $100 for each employer represented.

For information, contact Kimberly Pickens at 304-558-0664 or at kimberly.p.pickens@wv.gov.

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Veterans seeking to expand their education are invited to attend an education fair Thursday.

The event is sponsored by the West Virginia Council for Community and Technical College Education and Veterans Upward Bound. Representatives from participating two- and four-year institutions will be on-hand to speak with prospective students about financial aid, course offerings, admissions processes and job outlook.

The event is scheduled for 1 to 4 p.m. Thursday at the Advanced Technology Center in South Charleston. Contact Renada Snodgrass at 304-558-0087 or snodgrass@wvctcs.org for information.

Compiled by Whitney Burdette

Kanawha official has been on the move for a decade http://www.charlestondailymail.com/article/20141127/DM01/141129336 DM01 http://www.charlestondailymail.com/article/20141127/DM01/141129336 Thu, 27 Nov 2014 15:59:44 -0500 By Charlotte Ferrell Smith When Kanawha County Commissioner Dave Hardy got an unpleasant report from his doctor, he began taking steps toward better health.


On May 28, 2004, he was told he was 10 pounds overweight and had high cholesterol.

"I had never had a weight or health problem," Hardy said. "I went home and looked at American Heart Association guidelines and came up with a plan to walk 45 minutes a day."

Ten years later on May 28, 2014, he had logged 7,108 miles and lost 11 pounds. He gets good reports from his doctor these days with no signs of high cholesterol, high blood pressure or diabetes, a condition that runs in his family.

"I have great stamina and feel great," he said.

He has kept off the pounds without making any diet adjustments. He eats anything he likes while making a walking routine an essential part of life.

He doesn't use any fancy tracking equipment. He simply figures walking 45 minutes at a brisk pace equals a distance of three miles. He logs his progress in a diary.

"I average walking 22 days a month," he said. "I schedule it like a business appointment. If it is pouring rain, I don't walk. When it's cold outside, I put on gloves and toboggan and I'm warm in five minutes. I have an elliptical machine at home but I prefer walking outside."

He varies the scenery by choosing different routes. He walks in downtown Charleston or through Kanawha City. He circles tracks at area schools or hits a trail if he is feeling particularly energetic. If sidewalks are icy, he finds high school tracks less slippery.

"I never walk near traffic where I could get hit by a car," he added.

For those beginning a walking routine, he suggests starting with about 20 minutes and working up to 45 minutes. Pushing too fast or too long can lead to discouragement and scrapping the entire plan, he said.

"I walk 45 minutes, no more and no less," he said.

Good shoes are a must. "I go through about three pairs a year."

Consistency is the key to success, he added.

"The key is to do it no matter what," he said.

He makes sure his walking shoes are readily accessible. Even on business trips, he can walk hotel parking lots.

He has found walking to be a good way to maintain a healthy weight, relieve stress and have some alone time for thinking and planning.

While he generally walks alone, he isn't opposed to having someone join him.

"Often, people tell me they see me walking all over town," he said. "They say they wish they had my determination. I invite them to join me."

Aside from feeling better, he also sleeps better when he exercises.

Asked if he does any other form of exercise, he said, "I swim in the summer, which is also great for the whole body. Occasionally, I will break into a light jog but at my age it's not a good idea."

Hardy, 56, said he wishes all West Virginians would take strides toward better health by making a walking routine part of life.

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

W.Va. jackpot winner helps 2 health care groups http://www.charlestondailymail.com/article/20141126/ARTICLE/141129435 ARTICLE http://www.charlestondailymail.com/article/20141126/ARTICLE/141129435 Wed, 26 Nov 2014 10:49:58 -0500 MARTINSBURG, W.Va. (AP) - A charitable fund established by Powerball jackpot winner W. Randy Smith has donated pickup trucks to a hospice and a home health organization.

Media outlets report that The W. Randy Smith Family Fund presented one 2015 truck to Hospice of the Panhandle and a second 2015 truck to Panhandle Home Health on Tuesday.

Smith won a $79 million Powerball jackpot in 2010. He chose the $44 million cash option and pocketed $30 million after taxes.

Smith established the charitable fund at the Eastern West Virginia Community Foundation.

Google unveils spoon for tremor sufferers http://www.charlestondailymail.com/article/20141125/ARTICLE/141129493 ARTICLE http://www.charlestondailymail.com/article/20141125/ARTICLE/141129493 Tue, 25 Nov 2014 17:15:27 -0500



MOUNTAIN VIEW, Calif. - Google is throwing its money, brain power and technology at the humble spoon.

But these spoons (don't call them spoogles) are a bit more than your basic utensil: Using hundreds of algorithms, they allow people with essential tremors and Parkinson's disease to eat without spilling.

The technology senses how a hand is shaking and makes instant adjustments to stay balanced. In clinical trials, the Liftware spoons reduced shaking of the spoon bowl by an average of 76 percent.

"We want to help people in their daily lives today and hopefully increase understanding of disease in the long run," Google spokesperson Katelin Jabbari said.

Other adaptive devices have been developed to help people with tremors - rocker knives, weighted utensils, pen grips. But until now, experts say, technology has not been used in this way.

"It's totally novel," said UC San Francisco Medical Center neurologist Dr. Jill Ostrem, who specializes in movement disorders like Parkinson's disease and essential tremors.

She helped advise the inventors and says the device, which has a fork attachment, has been a remarkable asset for some of her patients.

"I have some patients who couldn't eat independently, they had to be fed, and now they can eat on their own," she said. "It doesn't cure the disease - they still have tremor - but it's a very positive change."

Google got into the no-shake utensil business in September, acquiring a small, National of Institutes of Health-funded startup called Lift Labs for an undisclosed sum.

More than 10 million people worldwide, including Google co-founder Sergey Brin's mother, have essential tremors or Parkinson's disease. Brin has said he also has a mutation associated with higher rates of Parkinson's and has donated more than $50 million to research for a cure. But the Lift Labs acquisition was not related, Jabbari said.

Lift Lab founder Anupam Pathak said moving from a small, four-person startup in San Francisco to the vast Google campus in Mountain View has freed him up to be more creative as he explores how to apply the technology even more broadly.

His team works at the search giant's division called Google(x) Life Sciences, which is also developing a smart contact lens that measures glucose levels in tears for diabetics and is researching how nanoparticles in blood might help detect diseases.

Joining Google has been motivating, said Pathak, but his focus remains on people who are now able to eat independently with his device.

"If you build something with your hands and it has that sort of an impact, it's the greatest feeling ever," he said. "As an engineer who likes to build things, that's the most validating thing that can happen."

Pathak said they also hope to add sensors to the spoons to help medical researchers and providers better understand, measure and alleviate tremors.

Shirin Vala, 65, of Oakland, has had an essential tremor for about a decade. She was at her monthly Essential Tremor group at a San Ramon medical clinic earlier this year when researchers developing the device introduced the idea and asked if anyone was interested in helping them.

As it was refined, she tried it out and gave them feedback. And when they hit the market at $295 apiece, she bought one.

Without the spoon, Vala said eating was really a challenge because her hands trembled so hard food fell off the utensils before she could eat it.

"I was shaking and I had a hard time to keep the food on a spoon, especially soup or something like an olive or tomatoes or something. It is very embarrassing. It's very frustrating," she said.

The spoon definitely improved her situation. "I was surprised that I held the food in there so much better. It makes eating much easier, especially if I'm out at a restaurant," she said.

New FDA rules require calories to be posted on menus http://www.charlestondailymail.com/article/20141125/ARTICLE/141129498 ARTICLE http://www.charlestondailymail.com/article/20141125/ARTICLE/141129498 Tue, 25 Nov 2014 17:04:19 -0500


The Associated Press

WASHINGTON - Whether they want to or not, consumers will soon know how many calories they are eating when ordering off the menu at chain restaurants, picking up prepared foods at supermarkets and even eating a tub of popcorn at the movie theater.

The Food and Drug Administration announced long-delayed calorie labeling rules Tuesday, requiring establishments that sell prepared foods and have 20 or more locations to post the calorie content of food "clearly and conspicuously" on their menus, menu boards and displays. Companies will have until November 2015 to comply.

The regulations will also apply to convenience stores, bakeries, coffee shops, pizza delivery, amusement parks and vending machines.

The idea is that people may pass on that bacon double cheeseburger if they know it has hundreds of calories - and, in turn, restaurants may make their foods healthier to keep calorie counts down. Beverages are included in the rules, and alcohol will be labeled if drinks are listed on the menu.

"Americans eat and drink about one-third of their calories away from home and people today expect clear information about the products they consume," FDA Commissioner Margaret Hamburg said. The effort is just one way Americans can combat obesity, she added.

The menus and menu boards will tell diners that a 2,000-calorie diet is used as the basis for daily nutrition, noting that individual calorie needs may vary. Additional nutritional information beyond calories, including sodium, fats, sugar and other items, must be available upon request.

The rules deal a blow to the grocery and convenience store industries, which have lobbied hard to be left out since the menu labels became law in 2010 as a part of the health care overhaul. Even before the new rules were announced, some Republicans in Congress had expressed concern that they would be too burdensome for businesses.

The law came together when the restaurant industry agreed to the labeling in an effort to dodge a growing patchwork of city and state rules. But supermarkets, convenience stores and many other retailers that sell prepared food said they wanted no part of it. The restaurant industry pushed to include those outlets, as they increasingly have offered restaurant-like service.

The FDA issued proposed rules in 2011 that included supermarkets and convenience stores but excluded movie theaters. The final rules being released Tuesday include all of them.

Representatives for the supermarket industry have said it could cost them up to a billion dollars to put the labels in place - costs that would be passed on to consumers. They said the rules could cover thousands of items in each store, unlike restaurants, which typically have fewer items.

To assuage some of their concerns, FDA excluded prepared foods that are typically intended for more than one person to eat and require more preparation, like deli meats, cheeses or bulk deli salads.

But a sandwich for sale at the same counter would have to have a calorie label nearby, and many prepared foods in the grocery store will have to be labeled - from the salad bar to the hot food bar to cookies and birthday cakes in the bakery. In some cases foods will have to be labeled in one area but not in another - cut fruit would be labeled on a salad bar, for example, but not in a container for sale, because that is generally meant to take home and eat over a period of time.

Leslie G. Sarasin, president and CEO of the Food Marketing Institute, said the group is extremely disappointed in the rules, which she said will affect stores' offerings of "fresh, minimally processed, locally produced items" such as cut cantaloupe, mixed salads, or steamed seafood.

Hamburg acknowledged that the regulations seem complicated but said standards are necessary as supermarkets are selling more restaurant foods. The FDA says the idea is to label calories of foods that are meant to be eaten in the store, as a customer is walking away or soon after they arrive at another location.

"The grocery store questions are some of the hardest ones, but it is very clear that the grocery store of today is different than it was 10, 20 years ago," Hamburg said.

The pizza industry, led by delivery giant Domino's, has also vigorously fought the rules, saying there are millions of ingredient combinations possible. The FDA attempted to mollify some of their concerns by allowing pizza restaurants to label pizza calories by the slice, as they had requested, but would still force the labeling on menu boards in takeout restaurants.

The delivery pizza industry had asked to post information online instead, saying only a small percentage of customers walk into their stores and about half order online.

As in the proposed rules, the final version still exempts airplanes, trains, food trucks and other food served on forms of transportation.

The point of menu labeling is to make sure that customers process the calorie information as they are figuring out what to eat. Many restaurants currently post nutritional information in a hallway, on wrappers or on their website. The new law will make calories immediately available for most items.

New York City was the first in the country to put a calorie posting law in place, and other cities and states have followed since then. Several restaurant chains such as McDonald's are already putting calorie labels on menus and menu boards nationwide.

W.Va. center offers end-of-life directive cards http://www.charlestondailymail.com/article/20141124/ARTICLE/141129603 ARTICLE http://www.charlestondailymail.com/article/20141124/ARTICLE/141129603 Mon, 24 Nov 2014 16:45:04 -0500 CHARLESTON, W.Va. - West Virginians can obtain wallet-sized cards listing their end-of-live advance directives.

The West Virginia Center for End-of-Life Care is providing the cards to people who have filed advance directive forms with the agency.

Advance directives allow people to list what medical decisions can be made on their behalf in the event that they aren't able to because of incapacitation or illness. They include living wills, do-not-resuscitate orders and medical power of attorney.

The center's director, Dr. Alvin Moss, told The Charleston Gazette that advance directives aren't always available at the time of treatment. The cards alert health care providers that the patient has forms that should be checked before treatment.

Worldwide obesity costs hit $2 trillion http://www.charlestondailymail.com/article/20141120/ARTICLE/141129861 ARTICLE http://www.charlestondailymail.com/article/20141120/ARTICLE/141129861 Thu, 20 Nov 2014 20:28:33 -0500


tHE Associated Press

LONDON - The global cost of obesity has risen to $2 trillion annually - nearly as much as smoking or the combined impact of armed violence, war and terrorism, according to a new report released Thursday.

The McKinsey Global Institute consulting firm's report focused on the economics of obesity, putting it among the top three social programs generated by human beings. It puts its impact at 2.8 percent of global gross domestic product.

"Obesity isn't just a health issue," one of the report's authors, Richard Dobbs, said in a podcast. "But it's a major economic and business challenge."

The company says 2.1 billion people - about 30 percent of the global population- are overweight or obese and that about 15 percent of health care costs in developed economies are driven by it.

In emerging markets, as countries get richer, the rate of obesity rises to the same level as that found in more developed countries. The report offers the stark prediction that nearly half the world's adult population will be overweight or obese by 2030 should present trends continue.

"We are on an unfortunate trajectory," Dobbs told The Associated Press. "We have to act."

The report's authors argue that efforts to deal with obesity have been piecemeal until now, and that a systemic response is needed.

McKinsey says there's no single or simple solution to the problem, but global disagreement on how to move forward is hurting progress. The analysis is meant to offer a starting point on the elements of a possible strategy.

"We see our work on a potential program to address obesity as the equivalent of the maps used by 16th-century navigators," McKinsey said in its report. "Some islands were missing and some continents misshapen in these maps, but they were still helpful to the sailors of that era."

Officials admit health care goof http://www.charlestondailymail.com/article/20141120/ARTICLE/141129865 ARTICLE http://www.charlestondailymail.com/article/20141120/ARTICLE/141129865 Thu, 20 Nov 2014 20:27:11 -0500


The Associated Press

WASHINGTON - The Obama administration Thursday acknowledged it has been over-reporting the number of people signed up under the health care law, a discrepancy that congressional Republicans seeking to repeal the program say they uncovered.

It's another credibility problem for the administration after video surfaced recently of former White House adviser Jonathan Gruber suggesting that deception was used to pass President Barack Obama's signature law.

Health and Human Services Secretary Sylvia M. Burwell called the lapse "unacceptable."

"The mistake we made is unacceptable," Burwell said on Twitter. "I will be communicating that clearly throughout the (department.)"

Administration spokesman Aaron Albright said that the overcount involved about 400,000 people.

Those consumers have separate dental coverage in addition to a medical plan, and were double-counted by mistake, said Albright. They had purchased both the medical and dental plans through HealthCare.gov and state insurance markets created under the law.

That means the correct number of people enrolled for medical coverage as of Oct. 15 is about 6.7 million, not the 7.1 million that Health and Human Services Secretary Sylvia M. Burwell has been citing.

The discrepancy was uncovered by Republican investigators for the House Oversight and Government Reform Committee, poring over sign-up spreadsheets.

Chairman Darrell Issa, R-Calif., said in a statement that he believes the administration was deliberately trying to disguise the rate at which people have been dropping out of the program, either because they don't meet eligibility requirements or weren't paying their premiums.

"Faced with large numbers of Americans running for an exit from Obamacare, instead of offering the public an accurate accounting, the administration engaged in an effort to obscure and downplay the number of dropouts," said Issa.

Responded administration spokesman Albright: "No. It was a mistake."

Back in May, the administration reported that more than 8 million people had signed up through the new insurance markets, which offer taxpayer-subsidized private plans. That was celebrated as vindication for the health care law after the botched rollout of HealthCare.gov.

The 8-million number was always expected to go down, because it included people who had not yet sealed the deal by paying their first month's premium.

The next update came in September, when Medicare Administrator Marilyn Tavenner told Issa's committee there were 7.3 million people enrolled at that point. Burwell later revised that number down.

But by then, the committee had requested the underlying files, and a spokeswoman said its investigators dug in, discovering the overcount.

The latest twist comes amid a still-simmering controversy over comments by MIT economist Gruber, an adviser during the drafting of the law. Video clips show him saying that "the stupidity of the American voter" helped Democrats pass the health care makeover.

Gruber has since disavowed the most controversial remarks, saying he "spoke inappropriately and I regret having made those comments." But the videos have fired up opponents of the law, who are calling on the new Republican-led Congress to mount an all-out effort for its repeal.

The enrollment overcount was first reported by Bloomberg.

Senate weighs generic drug costs http://www.charlestondailymail.com/article/20141120/ARTICLE/141129866 ARTICLE http://www.charlestondailymail.com/article/20141120/ARTICLE/141129866 Thu, 20 Nov 2014 20:26:53 -0500


The Associated Press

WASHINGTON - Some low-cost generic drugs that have helped restrain health care costs for decades are seeing unexpected price spikes of up to 8,000 percent, prompting a backlash from patients, pharmacists and now Washington lawmakers.

Members of the Senate Aging committee meet Thursday to scrutinize the recent, unexpected trend among generic medicines, which are copies of branded drugs that have lost patent protection. They usually cost between 30 to 80 percent less than the original medicines.

Experts point to multiple, often unrelated, forces behind the price hikes, including drug ingredient shortages, industry consolidation and production slowdowns due to manufacturing problems. But lawmakers convening Thursday's hearing, led by Vermont Senator Bernie Sanders, say the federal government needs to do more to bring down prices.

"These companies have seen the opportunity to make a whole lot of money and are seizing that opportunity," said Sanders, who chairs the Senate Subcommittee on Primary Health and Aging.

Sanders is a political independent who usually votes with the liberal wing of the Democratic party. "There is no rational economic reason for prices to go up 1000 percent," he said.

One strategy Sanders favors: requiring generic drugmakers to pay rebates to the federal Medicare and Medicaid drugs plan when the prices of their medications outpace inflation. Those payments are already mandatory for branded drugs, but have never applied to generics.

The lower prices of generic drugs make them the first choice for both patients and insurers: Generic drugs account for roughly 85 percent of all medicines dispensed in the U.S., according to IMS Health. Typically, generic drug prices fall as more companies begin offering competing versions of the same drug.

But recent examples suggest the market forces that have kept generic prices low are not working properly.

The average price of albuterol sulfate, a common asthma treatment, shot from $11 per bottle last October to $434 per bottle in April 2014, an increase of over 4,000 percent, according to data from the Healthcare Supply Chain Association cited by Sanders' committee.

The price for the antibiotic doxycycline hyclate, used to treat various infections, rose more than 8,280 percent during the same time frame from $20 per 100-pill bottle to $1,849.

John Field of Mt Vernon, Missouri, says he used to be able to buy a month's supply of doxycycline for $4 to treat his Lyme disease, which forced him to stop working as a pipe fitter. The medication now costs $167 per month, a 4,000 percent increase that he is unable to afford.

"Only by the grace of my family was I able survive and escape the trap of homelessness," says Field, 50. "My sister has paid for all of my medication."

Last month, Sanders and House Rep. Rep. Elijah Cummings, D-Maryland, sent letters to the makers of 10 generic drugs that have seen price increases of over 300 percent or more in recent months, including doxycycline.

The Generic Pharmaceutical Association says that the ten drugs cited by lawmakers do not reflect the broader U.S. market, which includes 12,000 generic medications that have reduced drug costs by billions. The group also points to data suggesting generic drug prices have been cut in half since 2008, according to pharmacy benefit provider Express Scripts.

The letters from Sanders and Cummings follow requests for congressional hearings by the National Community Pharmacists Association, which says independent pharmacies are being squeezed by the price hikes. In some cases, pharmacists are losing money on drugs that are purchased at new sky-high prices but are still reimbursed by pharmacy benefit plans at the older, low rates.

"Community pharmacies are put in the untenable position of having to absorb the difference between the large sums of money that they spent to acquire the drugs and the lower amounts that they are paid," states Rob Frankil, in prepared testimony obtained by the Associated Press.

Frankil is scheduled to testify on behalf of the pharmacist group, along with generic industry executives and academics, including Dr. Aaron Kesselheim of Harvard Medical School.

Kesselheim will recommend that federal officials be notified of all drug price increases greater than 100 percent, according to written testimony. In previous cases where drug shortages have led to price spikes, the Food and Drug Administration has approved emergency imports of extra supplies from foreign sources.

Kesselheim also says more funding is needed for the Federal Trade Commission, which has responsibility for policing anticompetitive tactics among companies, including generic drugmakers.

FDA says pill harder to abuse http://www.charlestondailymail.com/article/20141120/ARTICLE/141129877 ARTICLE http://www.charlestondailymail.com/article/20141120/ARTICLE/141129877 Thu, 20 Nov 2014 19:48:46 -0500



WASHINGTON - Federal health regulators on Thursday approved the first hard-to-abuse version of the painkiller hydrocodone, offering an alternative to a similar medication that has been widely criticized for lacking such safeguards.

The Food and Drug Administration approved Purdue Pharma's Hysingla ER for patients with severe, round-the-clock pain that cannot be managed with other treatments. The once-a-day tablet is designed to thwart abuse via chewing, crushing, snorting or injecting. The FDA said the medication is difficult to crush, break or dissolve.

Purdue Pharma's new drug poses a direct commercial challenge to Zogenix's much-debated drug Zohydro, a twice-a-day hydrocodone tablet approved by the FDA last year.

Doctors prescribe opioids for a range of ailments, from post-surgical pain to arthritis and migraines. Deaths linked to abuse of the medications have quadrupled since 1990 to nearly 17,000 annually, according to the Centers for Disease Control and Prevention.

Medical experts disagree over the appropriate role of opioids in treating pain, with some arguing that they should only be used for the most severe cases, such as cancer pain or end-of-life care.

The FDA has been under intense public pressure to combat the national epidemic of prescription opioid abuse.

The agency's approval of Zohydro last year prompted a wave of criticism from elected officials, law enforcement and anti-addiction groups who said that the pill should have been reformulated to discourage abuse. The extended-release painkiller was the first FDA-approved pure form of hydrocodone, the most abused prescription drug ingredient in the country. Previously hydrocodone was only available in lower-dose combination pills like Vicodin.

Initially, news of Purdue's abuse-resistant hydrocodone led to speculation that the FDA might remove Zogenix's drug from the market, since it lacked anti-abuse features.

But FDA officials said Thursday they plan to monitor rates of abuse and misuse with Zohydro and compare them to the new alternative.

"If we determine that the drug is no longer shown to be safe and effective the FDA can initiate proceedings to remove that drug from the market," said Dr. Douglas Throckmorton, a deputy director with the FDA's drug center.

While FDA officials highlighted their commitment to approving harder-to-abuse pain relievers, the agency's critics questioned why regulators didn't bring the new drug before a public advisory meeting. The FDA's approval of Zohydro was widely critized, in part, because it came despite an 11-2 vote against the drug by its outside experts.

"Precisely because the approval of opioids is so controversial the FDA is bypassing its advisory committee meetings," said Dr. Andrew Kolodny, a psychiatrist who specializes in addiction treatment and leads the group Physicians for Responsible Opioid Prescribing.

Kolodny also warned that Hysingla could potentially be more dangerous than Zohydro since the maximum dose per pill is 120 milligrams of hydrocodone, more than twice the dose contained in a 50-milligram pill of Zohydro. Drug abusers have developed various methods for unlocking the time-release formulations of prescription pain relievers and releasing the entire dose at once.

Purdue Pharma's Hysingla is only the fourth drug ever approved by the agency with claims that it discourages abuse and tampering. Purdue markets two of the other drugs, including a crush-resistant version of its oxycodone pill, OxyContin, and a combination pill, Targiniq, which includes an extra ingredient designed to block the effects of oxycodone if the tablet is crushed. These drugs, along with Hysingla, can still be abused when swallowed intact - the most common method for abusing painkillers.

San Diego-based Zogenix is working on its own harder-to-abuse version of Zohydro which, if approved, could replace the current version by next spring. The only other opioid with FDA-approved labeling indicating that it can limit painkiller abuse is Pfizer's Embeda.

Last month Purdue agreed to pay Zogenix $10 million to waive its exclusive rights to a single-ingredient hydrocodone product. Zogenix holds rights to a three-year period of competition-free marketing for its drug.

While Purdue Pharma has quickly come to dominate the market for harder-to-abuse painkillers, drug industry critics often single out the company as a key contributor to the overprescribing of opioids in the U.S. In 2007, Stamford, Connecticut-based Purdue Pharma and three of its executives paid $634 million and pleaded guilty to charges of misleading the public about the safety and addictiveness of OxyContin.

Local artists commissioned to display works in planned cancer center http://www.charlestondailymail.com/article/20141119/DM01/141119118 DM01 http://www.charlestondailymail.com/article/20141119/DM01/141119118 Wed, 19 Nov 2014 12:40:09 -0500 By Charlotte Ferrell Smith Seven artists have been commissioned to do 12 pieces of art to be displayed in the new Charleston Area Medical Center Cancer Center that is targeted to open in the spring of 2015.

The "Healing Power of Art" was presented during the regular meeting of the CAMC Board of Trustees on Wednesday morning by Gail Pitchford, president of the CAMC Foundation.

Fifty artists submitted applications to a committee to be considered. The works that were selected include paintings, photography, wood and glass.

Pitchford said works selected for the center were chosen for the expertise of the artists as well as the healing properties of the works to be displayed in various areas of the center in Kanawha City.

Artists include Stuart Kevin, glass; Jonathan Cox, wood; Linda Schweitzer, painting; Helen Chilton, painting; Steve Shaluta, photography; Steve Payne, photography; and Leslie Cerier, photography.

In addition to pieces by these individuals, 200 more works of art will be displayed throughout the new 100,000-square-foot, $50 million facility that will house the David Lee Cancer Center, CAMC Breast Center and Charleston Radiation Therapy Consultants.

In other business, Brenda Grant, CAMC chief strategy officer, presented highlights of reports for Kanawha County hospitals including General, Memorial and Women and Children's. These included a 2013 Community Benefit Report and a 2014 to 2016 Community Health Needs Assessment and Implementation Plan. For the Putnam County facility, CAMC Teays Valley Hospital, she presented highlights of the 2013 Community Benefit Report and Report on Implementation Strategies. She said the website camc.org would provide information for the public.

University of Charleston President Ed Welch, who heads the quality committee, said the amount of time a patient spends in the emergency room before being evaluated for treatment has improved but still is not as successful as the committee had hoped. Another challenge is reducing the amount of time a patient to be admitted must wait before getting a bed, he said.

He reported a reduction from 5 percent to 3 percent in the number of people leaving without being seen.

At the beginning of the meeting, "Heart and Soul" awards were presented by David Ramsey, CAMC president and chief executive officer. The recognition goes to employees who go above the call of duty to offer excellent care. Two employees were recognized on Wednesday.

Jonathan Wood, a nurse at Memorial Hospital, stayed with a patient shortly before she died and passed along her last words to her thankful family.

Josh McClannahan, a nursing assistant at Memorial, cared for a patient whose elderly mother was also in the hospital. He took the daughter to see her mother who was near the end of life.

"To the patient, it was a huge gesture," Ramsey said.

Following the meeting, Dr. Jamie Jeffrey, a pediatrician for 23 years, expressed excitement about a new program in area schools geared to promote health among the children.

"It's a school-led initiative with kids teaching adults about big, fat industries and couch potato companies," she said. "Hearing it from me is nothing. Hearing it from kids is everything."

"Kidz Bite Back" is a youth-led health and wellness campaign with youth striving to improve the health of their peers, families and communities. Fourth- and fifth-grade students are trained to be "Kidz Advocates" and then tell fellow students and adults about the program. Peers and adults are taught how companies target children with billions of dollars in advertising, marketing and free toys to get them to consume excessive amounts of junk food, soft drinks and fast foods instead of having these in moderation.

The wellness initiative was presented as a pilot program at Grandview Elementary last school year and is being brought this year to Anne Bailey Elementary and Ruffner Elementary. Two advocates are trained for each fourth- and fifth-grade class and then teach peers.

Jeffrey believes a program geared to youth led by peers will have a great impact and she hopes to see the program become so successful that it spreads throughout the state.

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

WV rural health center marking 20th anniversary http://www.charlestondailymail.com/article/20141119/DM01/141119124 DM01 http://www.charlestondailymail.com/article/20141119/DM01/141119124 Wed, 19 Nov 2014 09:31:59 -0500


HURRICANE - The Center for Rural Health Development in Hurricane is celebrating a milestone.

The center is marking 20 years of work on rural health issues. The private, not-for-profit organization started its work in 1994.

Officials held an open house on Tuesday afternoon to mark the occasion and announced the creation of the Institute for Rural Health Improvement. The new initiative is aimed at improving health outcomes in communities across West Virginia.

According to its website, the center has developed and implemented programs to help improve health and strengthen health care delivery in West Virginia.

In 2003, it began providing management and technical assistance as the lead agency for the West Virginia Immunization Network.

Dairy farmer defends ban of raw milk sales http://www.charlestondailymail.com/article/20141118/DM01/141119164 DM01 http://www.charlestondailymail.com/article/20141118/DM01/141119164 Tue, 18 Nov 2014 19:24:42 -0500 By Joel Ebert A Greenbrier County dairy farmer who gives raw cow's milk to his own children asked lawmakers not to legalize the sale of raw milk in West Virginia.

Rem Perkins, owner of Perk Farms, cited concerns over safety for the general public, farmers and cooperatives. He said it would be best to continue the state's ban.

"Kids today don't have the immunity - they didn't grow up on farms, they play video games, play basketball and soccer but they don't go out and get on farms and get dirty," he said.

Perkins said although his five children consume raw milk, they are immune to the dangers that may be associated with it because they grew up on a farm.

"We live, work and eat on the farm, which makes our immunity similar to what the cows are, so it doesn't affect us the same as everybody else," he said.

Pasteurization, which is the process of heating milk to a specific temperature for a set period of time, kills harmful microorganisms that can be present in raw milk.

According to the Centers for Disease Control and Prevention, raw milk can contain pathogens like Salmonella, E. coli and Listeria.

Perkins said insurance companies would not cover any claims brought against farmers who sell raw milk.

He also said whenever reports come out that someone may have gotten sick from consuming raw milk, the entire milk industry is adversely affected.

"It's bad for all the farmers and the co-ops that are selling milk. It will decrease milk consumption," he said.

Producing 1,100 gallons of milk each day, Perkins' farm would suffer if someone in West Virginia consumed raw milk and got sick as a result. Instead of legalizing the sale of raw milk, Perkins said there are other ways for people to meet their needs.

"They can buy a cow and milk their own cow," he said.

Delegate Mike Manypenny, D-Taylor, asked Perkins whether he was qualified in the field of human immunities.

"I have no expertise, as far as, other than what I've seen, what neighbors have told me and what I've read in articles about raw milk and the bugs that cause problems," Perkins said.

Manypenny said the federal government's recommendations, which suggest children and pregnant women avoid consuming raw milk, were a better option than Perkins' idea.

"If we were to follow the federal guidelines, I would think that it would be more acceptable to sell raw milk to allow the public the ability to buy it," Manypenny said.

Perkins faced questions about his dairy farm and whether he was aware that raw milk is often consumed by people who can't digest homogenized milk. He was also asked whether he would support the sale of raw milk if it had a warning label on it.

"It's like selling cigarettes with a cancer warning on the side of it. I still don't think you should be buying cigarettes," he said. "You're taking a risk that you shouldn't be taking when you're not from a farm."

The 2014 legislative session featured unsuccessful attempts to change the state's strict laws regarding the sale of raw milk. Twenty-nine states allow some form of raw milk sales, though very few permit it to be sold in grocery stores.

Contact reporter Joel Ebert at 304-348-4843 or joel.ebert@dailymailwv.com. Follow him at twitter.com/joelebert29.

Ebola puts Mali on high surveillance http://www.charlestondailymail.com/article/20141116/ARTICLE/141119373 ARTICLE http://www.charlestondailymail.com/article/20141116/ARTICLE/141119373 Sun, 16 Nov 2014 20:10:25 -0500



BAMAKO, Mali - It all started with a sick nurse, whose positive test for Ebola came only after her death. In a busy clinic that treats Mali's elite as well as wounded U.N. peacekeepers, what patient transmitted the virus?

Soon hospital officials were taking a second look at the case of a 70-year-old man who died after being brought to the capital late at night from Guinea suffering from kidney failure. A friend who visited him later died under suspicious circumstances, too.

It wasn't renal disease, they then realized. The 70-year-old man had Ebola and all three of the relatives who brought him to the clinic that night had all since been admitted to an Ebola treatment center back home in Guinea, too.

On Friday, Malian health authorities went to disinfect the mosque where the 70-year-old's body was prepared for burial - nearly three weeks ago. Already some are criticizing the Malian government for being too slow to react when health authorities had announced his death as a suspected Ebola case earlier in the week.

"It's been 18 days since the Guinean man sick with Ebola died here. It's just too late," said Koumou Keita, his face full of worry.

For nearly a year, Mali had been spared the virus now blamed for killing more than 5,000 people across West Africa despite the fact the country shared a porous land border with Guinea, the country where the epidemic first erupted.

Now there are least three confirmed Ebola deaths, and two others suspected deaths in Mali's capital, Bamako. Residents here who have seen the carnage from Ebola in neighboring Guinea now fear the worst.

"I feel uneasy because I have the impression that our authorities are not giving us the whole truth," said Ibrahim Traore, who works at a supermarket in the capital. "There are a lot of things not being said about how the Ebola virus came to Bamako."

Health officials now must try to track down not only family and friends who visited the 70-year-old man at his hospital bed, but also the scores of people who prepared his body for burial and attended his funeral. Teams of investigators are also headed to the border community where authorities believe the Patient Zero in the Bamako cluster - the 70-year-old man - first fell ill.

"The future of Ebola in Mali will depend on the quality of the surveillance of these contacts. If they are rigorously followed, and any subsequent cases are quickly identified and isolated, the battle will be won. But if there are failures in the process, it will lead to further contamination and further problems," said Ibrahima-Soce Fall, Mali's WHO representative.

Among those placed under quarantine are about 20 members of the U.N. peacekeeping force who had had been treated for battlefield wounds at the Bamako hospital where the dead nurse had worked. The peacekeepers had been based in the north of the country, where they have been trying to stabilize a vast region where jihadists ruled until a French-led war in 2013.

In rencet years Mali already has suffered a separatist rebel insurgency, a coup that overthrew its longtime leader and a war against jihadists. No Ebola threatens to be another source of misery if it is not contained.

"Ebola could case many deaths here in Mali, said Aminata Samake, who works at a bank in the capital. "We have a tradition of living closely together that could contribute to a huge contamination. Take the example of public transport - you find people crammed into a bus, one on top of the other. Large families share the same plates, even the same glasses for tea."

Government says health care site working well http://www.charlestondailymail.com/article/20141116/ARTICLE/141119394 ARTICLE http://www.charlestondailymail.com/article/20141116/ARTICLE/141119394 Sun, 16 Nov 2014 15:58:56 -0500


The Associated Press

WASHINGTON - As a crucial second sign-up season gears up, the Obama administration said Sunday that HealthCare.gov is stable and working well, a far cry from last year's frozen computer screens and frustrated customers.

Health and Human Services Secretary Sylvia M. Burwell said she expects "strong and healthy growth" for 2015. About 7 million people are signed up, and Burwell expects to grow that by 2 million more or so.

The Congressional Budget Office has projected a total of 13 million enrolled for 2015, and some see the administration as trying to lower expectations.

Burwell told NBC's "Meet the Press" that 100,000 people had submitted new applications this weekend via the federal website serving 37 states. That's a big difference from last year, when only a handful of customers managed to enroll on the first day.

Burwell also said that a half-million people who already have coverage through the program were able to log into their accounts this time.

There were reports Saturday that returning customers had problems, and it appeared some of that may have been confusion trying to remember user names and passwords. Administration spokesman Aaron Albright said Sunday he had not seen any indication that the website was the cause.

Many returning customers had not reset their passwords, as they were asked to earlier this year. Some could not recall their accurate user names. A common mistake involved consumers who entered their email addresses as user names, when they had actually created a user name earlier on. That meant they couldn't get a password reset email from HealthCare.gov, because they did not use the correct user name.

Call centers have been helping resolve cases where consumers had trouble resetting their passwords, and the Health and Human Service Department said accounts were being unlocked on a timely basis. All told, the call centers had taken about 100,000 calls by Sunday morning, on a range of situations.

President Barack Obama noted the improvements. "HealthCare.gov works really well now," he said.

HealthCare.gov is an online marketplace that offers subsidized private coverage to people who don't have health insurance on the job. Because of political opposition and technical issues, the federal government is running the health insurance exchange in most states.

Thirteen states and Washington, D.C., are running their own markets. Washington state had problems Saturday with its exchange, which was generating inaccurate subsidy calculations.

Premiums, on average, appear to be stable this year. But experts say overall national numbers can mask big changes from state to state, and sometimes even within parts of a state. In particular, customers who already got covered this year are being advised to shop around to avoid significant cost increases.

With Congress fully under Republican control, the administration cannot afford another website meltdown.

Website helps patients compare health insurance expenses http://www.charlestondailymail.com/article/20141113/DM01/141119620 DM01 http://www.charlestondailymail.com/article/20141113/DM01/141119620 Thu, 13 Nov 2014 16:40:17 -0500 By Whitney Burdette A unique service can help patients see how different health insurance plans available through the Affordable Care Act will affect their pocketbooks.

The National Health Council launched puttingpatientsfirst.net to allow consumers to compare health insurance plans and their costs.

Eric Gascho, assistant vice president of government affairs for the council, was in Charleston Thursday to show patient care advocates how to navigate the site.

Patients with chronic diseases or disabilities can benefit most from seeing the comparison, Gascho said, though anyone can use the site. Open enrollment in the federal exchange opens Saturday.

"There was nothing out there telling people what plan they should be buying," Gascho said.

Premiums, deductibles and out-of-pocket costs vary by plan, so consumers need to be careful about what plans they select if they want to keep costs down. Gascho said research has shown plan selection can cause expenses to vary by as much as 400 percent. In West Virginia, Highmark Blue Cross/Blue Shield is the only insurer offering plans through the exchange. Nevertheless, Gascho said it is important for consumers to understand how different plans through that insurer can affect them financially.

"That makes this website even more powerful," he said.

The site is easy to navigate. Patients are asked to input their age and location. They then are asked to estimate how many times they'll visit a primary care provider, specialist, mental health specialist and emergency room and how many times they'll need in-patient or out-patient surgery. They also have the option to input any medications they take and their dosage. Gascho said the medication database also includes generic drugs.

From there, the patient can see which plan offers the lowest cost, including a breakdown of medical and medication out-of-pocket costs and annual premium. An updated version of the site, scheduled to launch in mid-December, will allow patients to input their incomes to help them determine if they qualify for tax credits or other subsidies.

"Here's a tool that will help your members decide what plan is best for them," George Manahan, spokesman for the West Virginia Parkinson's Support Network, told the advocates gathered Thursday.

Manahan said patients with chronic illnesses, such as Parkinson's disease, Alzheimer's and multiple sclerosis are worried about changes in health insurance plans. They may not know if their medication is listed on the plan's formulary or what their out-of-pocket costs will be.

"The first year, there was some question about whether your doctor was in-network because it was the first year," Manahan said. "Open enrollment starts Saturday, so we're interested to see what will happen with open enrollment."

Manahan said only two movement disorder physicians specializing in Parkinson's practice in West Virginia - one at West Virginia University and another in Charleston. But the doctor in Charleston is leaving.

"So if the doctor at WVU isn't in-network, that's a problem for us," he said. "It's doctors, its medications. Those are two really key areas we focus on. I'm sure it's the same with MS and Alzheimer's. They have specialists they have to go to. You want to make sure they're in network and also the drugs are also within the formulary so you can afford them."

Gascho said the Council is working toward making the process more transparent. Much of the time, the costs of premiums, deductibles and out-of-pocket expenses is what drives a consumer to choose a particular plan.

"We really want to make sure people know what is on the formulary and we want them to know what the cost sharing requirements are," he said. "So we're really looking to push for more transparency from the plans so when they go on the website to purchase their plan, they know exactly what they're getting. I think in some cases that information isn't as clear as it should be and we'd like to see a better job being done."

Although the Affordable Care Act is controversial, many West Virginians have benefited from various provisions of the law. As of Nov. 8, 146,342 West Virginians have enrolled under Medicaid expansion. Ellen Potter with the Office of the Insurance Commissioner said 19,000 West Virginians enrolled on the marketplace last year and officials expect to see that number increase in 2015.

Several local health care groups are partnering in the coming week to offer free education services to potential exchange enrollees. The sessions will take place from 11 a.m. to 7 p.m. Saturday at the Charleston Civic Center and 11 a.m. to 7 p.m. Wednesday at Process Strategies-Highland, 1418 MacCorkle Ave. in Charleston.

Information about open enrollment can be found at http://bewv.wvinsurance.gov/.

Contact writer Whitney Burdette at 304-348-7939 or whitney.burdette@dailymailwv.com. Follow her at www.Twitter.com/wburdette_DM.

W.Va. introduces behavioral health call center http://www.charlestondailymail.com/article/20141111/ARTICLE/141119882 ARTICLE http://www.charlestondailymail.com/article/20141111/ARTICLE/141119882 Tue, 11 Nov 2014 11:36:55 -0500 CHARLESTON, W.Va. (AP) - Gov. Earl Ray Tomblin is introducing a 24-hour call center for behavioral health services related to substance abuse.

On Monday, Tomblin announced West Virginia's first Behavioral Health Referral & Outreach Call Center. The statewide service will offer educational materials, info on available local behavioral services and referrals based on individual care needs.

The center will have a live database updated daily with facilities' bed capacity and other treatment information.

The initiative will coordinate with current on-call or crisis support systems. The center will track and follow up on all calls.

The governor's regional substance abuse task forces and Advisory Council on Substance Abuse suggested implementing the program.

Massachusetts town weighs nation's first tobacco ban http://www.charlestondailymail.com/article/20141110/ARTICLE/141119950 ARTICLE http://www.charlestondailymail.com/article/20141110/ARTICLE/141119950 Mon, 10 Nov 2014 16:14:45 -0500


The Associated Press

WESTMINSTER, Mass. - The cartons of Marlboros, cans of Skoal and packs of Swisher Sweets are hard to miss stacked near the entrance of Vincent's Country Store, but maybe not for much longer: All tobacco products could become contraband if local health officials get their way.

This sleepy central Massachusetts town of 7,700 has become an improbable battleground in America's tobacco wars. On Wednesday, the Board of Health will hear public comment on a proposed regulation that could make Westminster the first municipality in the United States to ban sales of all tobacco products within town lines.

"To my knowledge, it would be the first in the nation to enact a total ban," said Thomas Carr, director of national policy at the American Lung Association. "We commend the town for doing it."

Town health agent Elizabeth Swedberg said a ban seemed like a sensible solution to a vexing problem.

"The tobacco companies are really promoting products to hook young people," she said, pointing to 69-cent bubblegum-flavored cigars, electronic cigarettes and a new form of dissolvable smokeless tobacco that resembles Tic Tac candies. "The board was getting frustrated trying to keep up with this."

Citing a report from the U.S. surgeon general, Swedberg said that if tobacco use continues unabated, 5.6 million American children who are younger than 18 today will die prematurely because of smoking. Change, she said, "has to start somewhere."

Brian Vincent would rather it not start with his family-owned grocery on Main Street. Tobacco products, he said, make up more than 5 percent of sales.

A quarter of his customers purchase tobacco, Vincent said, and while they're there, they often pick up a gallon of milk or one of the fresh-baked maple-candied bacon chocolate chip cookies that are displayed by the check-out aisle.

"It's going to send business five minutes this way or five minutes that way - no one's going to quit," said Vincent, who admits to enjoying a cigar himself now and then.

Encouraged by the New England Convenience Store Association, Vincent has been asking customers to sign a petition against the proposal. He has gathered more than 800 signatures so far, and other merchants are on track to deliver hundreds more to town officials this week.

David Sutton, a spokesman for Richmond, Virginia-based Altria Group Inc., owner of the nation's biggest cigarette maker, Philip Morris USA, called the proposal a "bad policy" that will harm local employers.

"We believe businesses should be able to choose which products they carry," Sutton said. "If the ban were to be implemented, adult tobacco and e-vapor consumers could shift their purchases to neighboring stores. The proposed regulations, if enacted, would fundamentally alter these businesses and would likely cost Westminster jobs."

So many people have called Town Hall about the proposal, the Board of Health - whose meetings about septic system updates and mosquito control rarely attract an audience - will hold Wednesday's public hearing in an elementary school cafeteria rather than in its usual second-floor conference room.

Colleen Conner, who pops into Vincent's nearly every day to pick up a pack of American Spirits, is among those who signed the petition. Should the measure pass, she said, she'll drive 25 miles north to New Hampshire and buy her cigarettes there in bulk.

"When you're a smoker, you'll quit when you're ready, not because someone told you to," she said. "I think it's going to hurt the store - and I love the store."

Swedberg, the town health agent, said the Board of Health hopes that if it enacts the regulation, loyal customers will support local businesses by buying more nontobacco products. And she thinks stores could see another benefit: "For people who are trying to quit, it could be a better place for them to shop, because they wouldn't be confronted with tobacco."

Board members are keeping an open mind and will take public comment into account, Swedberg said. But she remains supportive of the ban and hopes more communities across the country will follow Westminster's example.

It's an admirable goal, said Westminster resident Claudia Kulik, who turned to a hypnotist to quit cigarettes 10 years ago.

Yet even she doubts that making it impossible to buy tobacco products in town would make a difference to a smoker seeking a fix. She once went out in an ice storm for cigarettes.

"I would have gone through hell or high water," she said.

Research says ice like 'coffee' for people with iron deficiency http://www.charlestondailymail.com/article/20141109/ARTICLE/141109248 ARTICLE http://www.charlestondailymail.com/article/20141109/ARTICLE/141109248 Sun, 9 Nov 2014 18:19:04 -0500


Special to The Washington Post

Patients suffering from pagophagia compulsively crave and chomp on ice, even scraping buildup off freezer walls for a fix. The disorder appears to be caused by an iron deficiency, and supplements of the mineral tend to ease the cravings. But what is it about ice that makes it so irresistible?

A new study proposes that, like a strong cup of coffee, ice may give those with insufficient iron a much-needed mental boost. Fatigue is the most common symptom of iron-deficiency anemia, which occurs when the body can't produce enough oxygen-carrying hemoglobin because of low iron.

"I had a friend who was suffering from iron-deficiency anemia who was just crunching through massive amounts of ice a day," said study author Melissa Hunt, a clinical psychologist at the University of Pennsylvania. "She said: 'It's like a cup of coffee. I don't feel awake until I have a cup of ice in my hand.'"

Hunt and her colleagues had both anemic and healthy subjects complete a standardized, 22-minute attention test commonly used to diagnose attention deficit hyperactivity disorder. Just before the test, participants were given either a cup of ice or lukewarm water to consume.

Iron-deficient subjects who had sipped on water performed far more slugglishly on the test than controls, as expected. But those who ate ice beforehand did just as well as their healthy counterparts. For healthy subjects, having a cup of ice instead of water appeared to make no difference in test performance.

"It's not like craving a dessert. It's more like needing a cup of coffee or that cigarette," Hunt said.

The study was published in the October issue of the journal Medical Hypotheses.

Pagophagia is one of many types of pica, a disorder that encompasses daily craving and eating of unusual nonfoods such as clay, chalk, paste, cigarette butts or laundry starch. Patients with pica may also ingest atypical foods compulsively, such as lemons, tofu or dried pasta. About 20 percent of cases are pregnant women, since their iron stores can easily get depleted while serving both them and their growing fetuses.

For centuries, doctors have taken note of pica in many forms. The first might have been the ancient Greek physician Hippocrates of Kos, who in the 5th century B.C. wrote about pregnant women's "desire to eat earth or charcoal." A Byzantine obstetric textbook from the 6th century A.D. describes patients craving spicy or salty dishes, but also dirt, eggshells and ashes.

But pica largely remains a medical mystery. Certainly its association with low iron is real, although oddly, pica appears in only about half of iron-deficient patients.

"A general hypothesis of pica is that oftentimes, it is an attempt to supplement the diet with basic minerals - think iron or copper," Hunt said. "That might explain things like dirt consumption, but it absolutely does not explain pagophagia."

Hunt points to a phenomenon called the mammalian diving reflex as a possible reason the ice-chewing caused better test performance. When submerged in water, most air-breathing vertebrates slow down their heart rate and constrict blood vessels in their arms and legs. This decreases the oxygen supply to the body's periphery, saving it for vital organs.

"If you think about whales and dolphins diving, the water gets colder and their peripheral blood vessels constrict and shunt all the blood to the internal organs and the brain," she said. "It is sort of vestigial, but humans do show the dive reflex."

Crucially, the reflex is triggered by the face having contact with cold water, but not warm water. So perhaps the chill of chewing on ice cubes may lead to an increase of oxygenated blood to the brain, providing the cognitive boost that anemic patients need. For those with enough iron, Hunt speculates, there would be no additional benefit to more blood flow.

Catherine Broome, a hematologist with the Georgetown University School of Medicine, said she often sees pagophagia in her iron-deficient patients. She even uses the intensity of the disorder to help track whether treatment is working.

"As we replace a patient's iron, the desire to chew ice will lessen, so it's an easy symptom to follow in patients," said Broome, who found the study fascinating and the conclusion quite feasible.

Although patients will admit to having pica if asked, typically they don't volunteer the information readily.

"Patients tend to be somewhat secretive about these kinds of behaviors. You have to tease it out," said Michael Bromberg, a Temple University hematologist. "I had one patient tell me: 'I love ice. It's better than sex.'"

Bromberg remarked on some issues with the study's details, such as omitting hemoglobin data for the anemic patients and equating iron deficiency with anemia. Having an iron deficiency can progress to anemia, but the two terms aren't synonymous.

Both hematologists had never heard any of their patients say that ice makes them feel more alert. Instead, eating ice has been described more as an uncontrollable craving than a jolt of energy.

"Patients try not to eat ice," Broome said. "But like being addicted to a drug, even if you don't want to do it, you have to."

Runner recovers to go the distance http://www.charlestondailymail.com/article/20141106/DM01/141109421 DM01 http://www.charlestondailymail.com/article/20141106/DM01/141109421 Thu, 6 Nov 2014 21:34:23 -0500 By Marcus Constantino Running a marathon is a feat of athleticism and endurance.

That's why some people thought W.K. Munsey was crazy when he ran all 26.1 miles of the Marshall University Marathon on Nov. 1, less than three months after a biking accident left him with broken ribs, a collapsed lung and a shattered collar bone.

"I don't think anyone had a doubt I'd be back," Munsey smiled. "It was just a question of how long."

Munsey, 59, has been a member of the Charleston-based Tallman Track Club since 1986. He celebrated his 31st "runniversary" - the anniversary of the time he started running regularly - on Tuesday, and as of Aug. 5, Munsey said he has run every day for five years, eight months and five days straight.

But the streak came to an abrupt end as he was riding his bike down Donnally Street on the afternoon of Aug. 5 and one of his bike's wheels got caught in an expansion joint in the middle of the road. Munsey was sent flying off the bike at about 30 mph and hit the pavement hard. His bike helmet shattered from the impact.

"My helmet saved my life," he said.

Munsey remained in the hospital for five days. When he was released on Aug. 10, Munsey's wife, Sherrie, took him for a 400-meter walk.

On Aug. 13, just eight days after the accident, Munsey walked a mile. Two days later, he took a half-day off work to walk three miles with his fellow club members.

Munsey said his doctor ordered him not to run for nine weeks. As soon as he was given the green-light on Oct. 6, Munsey ran with his fellow Tallman Track Club members at the University of Charleston.

"I went out with my group and we ran a very slow three miles," Munsey laughed. "Not because of them, but because of me. It was a great return to running."

The Tallman Track Club was founded in 1976 by Kenny Tallman. Munsey said he joined the group in 1986 because he loved running, and he said he's made some of his best friends through being an active member of the group. Munsey said the Tallman Track Club is unique because it does not charge membership dues or pressure members to run.

"We're not a typical running club," Munsey said. "There's no dues or membership applications or fees. You just run with us and if you keep showing up, you're one of us."

Members of the group get together every weekday at 5 p.m. at UC to run together and socialize afterward. Munsey said anyone is welcome.

Tallman, 76, said Munsey keeps the club going by being its public face and organizing many of its events, including the club's annual winter series of races.

Though Munsey's injuries were serious, Tallman had no doubt Munsey would spring right back.

"I knew he had a real bad accident, but I knew he would be back out there," Tallman said. "I know people thought he wouldn't run again for a few months, but I wasn't worried about him.

"He's hard-headed and a real hard runner. I wasn't surprised," Tallman said.

Munsey completed the Marshall University Marathon with a time of 4:58:52. The marathon was Munsey's first major run since his accident, but he said he had no doubt he could get through it and cross the finish line. Munsey said received an overwhelming amount of cheering and support on race day.

"It wasn't fast, but there was never any doubt that I was going to make it," Munsey said. "I enjoyed the day and we just had a great time."

Running has been a big part of Munsey's life; he has five Boston Marathons under his belt and has run more than 20 marathons in his lifetime, and he hopes to qualify for the 2015 Boston Marathon at the Chevron Houston Marathon on Jan. 18. 2015 in Houston.

He said he hopes to be able to continue to run marathons into his 70s.

"I'm just blessed for the shape I was in at the time of the accident and the shape I'm in now," Munsey said. "That's what allowed me to recover as fast as I did

"I wouldn't be where I am today without all the support from my family, friends and running community. They keep me motivated," Munsey said.

Munsey said he is now 100 percent recovered from his accident and back in good health. He and his wife will celebrate their 25th wedding anniversary in June.

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