Understanding a Treatment Option for Advanced Kidney Cancer
(Family Features) When kidney cancer spreads or becomes advanced, it can be challenging to treat. Common signs and symptoms can include blood in urine, lower back pain on one side, a mass on the side or lower back, loss of appetite or unexplained weight loss.
While a diagnosis of advanced kidney cancer can be overwhelming, there are steps patients can take to feel more empowered as they face the disease, starting with learning about the treatments that may be available for them.
Exploring Your Options
Asking questions to understand where the cancer has spread, what the expected prognosis is and the potential benefits of treatment – including the possibility to live longer – can be critical to aligning on a path forward.
Fortunately, there are several types of medicines available for advanced kidney cancer today, depending on the specifics of each patient’s disease. Chemotherapy, targeted therapy or immunotherapy are a few types of treatment that may be considered, sometimes in combination. Immunotherapy works differently than chemotherapy or targeted therapy, as it helps a person’s own immune system to fight cancer and can enable the immune system to find and attack cancer cells. For some patients, dual immunotherapy – or a combination of two immunotherapy treatments – may be recommended.
For example, Opdivo (nivolumab) + Yervoy (ipilimumab) is approved by the U.S. Food and Drug Administration (FDA) as a combination of two immunotherapies for certain newly diagnosed adults whose kidney cancer (also referred to as renal cell carcinoma) has spread. It is not known if Opdivo is safe and effective in children younger than 18 years of age. Opdivo (10 mg/mL) and Yervoy (5 mg/mL) are injections for intravenous use.
This combination of two immunotherapies has the potential to work with the immune system in different but complementary ways to help fight cancer. While Yervoy may stimulate the kind of cells that help fight cancer, Opdivo may help these cells find and fight the cancer cells again.
While doing so, this immunotherapy combination can also affect healthy cells. These problems can sometimes become serious or life threatening and can lead to death. These problems may happen anytime during treatment or even after treatment has ended. You may have more than one of these problems at the same time. Some of these problems may happen more often when Opdivo is used in combination with Yervoy.
Opdivo and Yervoy can cause problems that can sometimes become serious or life-threatening and can lead to death. Serious side effects may include lung problems; intestinal problems; liver problems; hormone gland problems; kidney problems; skin problems; eye problems; problems in other organs and tissues; severe infusion reactions; and complications of stem cell transplant, including graft-versus-host disease (GVHD), that uses donor stem cells (allogeneic). Call or see your healthcare provider right away for any new or worsening signs or symptoms. Please see additional Important Safety Information below.
Understanding Overall Survival
“After my cancer diagnosis, my wife and I prayed about our future and pursuing every avenue with that goal in mind,” said Terry Broussard, who has been living with advanced kidney cancer. “I wanted a treatment that may give me a chance to live longer in order to see my youngest child graduate high school.”
Broussard’s doctor recommended treatment with Opdivo + Yervoy, which has overall survival data at five years. The FDA approval of this dual immunotherapy in advanced renal cell carcinoma (RCC) was based on results from the CheckMate -214 clinical trial, which included 847 previously untreated patients with kidney cancer that had spread and with one or more risk factors.
In the primary analysis at two years (25.2 months), the length of time patients lived without tumors worsening was 11.6 months for this immunotherapy combination and 8.4 months for sunitinib. There was no meaningful difference between the two treatments.
Researchers also assessed the overall response rate, which is a measure of the percentage of patients whose cancer shrunk (partial response) or disappeared completely (complete response) after treatment.
At the two-year time point, 41.6% of patients treated with Opdivo + Yervoy (95% CI:36.9-46.5) responded to treatment (n=177/425) versus 26.5% (n=112/422) of those treated with sunitinib (95% CI:22.4-31.0). Partial tumor shrinkage occurred in 32.2% of the patients treated with this immunotherapy combination compared to 25.4% of those treated with sunitinib. Tumors disappeared completely in 9.4% of patients treated with this immunotherapy combination versus in 1.2% of patients treated with sunitinib. The disappearance of any measurable tumors in response to treatment does not necessarily mean the cancer has been cured. Opdivo + Yervoy will not work for everyone. Individual results may vary.
“Advanced kidney cancer is a complex disease with many treatment options, which can feel overwhelming for people facing a devastating cancer diagnosis,” said Ulka Vaishampayan, M.D., professor, Internal Medicine, Division of Hematology/Oncology, University of Michigan. “The goal of treatment is to help patients live longer, and research like these five-year data gives us insight into what treatment with Opdivo + Yervoy may look like for patients from the trial over time.”
The most common side effects of Opdivo, when used in combination with Yervoy, include: feeling tired; diarrhea; rash; itching; nausea; pain in muscles, bones, and joints; fever; cough; decreased appetite; vomiting; stomach-area (abdominal) pain; shortness of breath; upper respiratory tract infection; headache; low thyroid hormone levels (hypothyroidism); constipation; decreased weight; and dizziness.
Establishing and Leaning on a Support System
To learn more, visit Opdivo.com.
Source: Bristol Myers Squibb
Photo caption: Terry Broussard and his wife, Tracy. Broussard is an actual patient who has been compensated by Bristol Myers Squibb for his time.
INDICATION AND IMPORTANT SAFETY INFORMATION
It is not known if OPDIVO is safe and effective in children younger than 18 years of age.
Information provided in this article is not a substitute for talking with your healthcare professional. Your healthcare professional is the best source of information about your disease.
Important Safety Information for OPDIVO® (nivolumab) + YERVOY® (ipilimumab)
What are the serious side effects of OPDIVO + YERVOY?
Problems can also happen in other organs and tissues. These are not all of the signs and symptoms of immune system problems that can happen with OPDIVO and YERVOY. Call or see your healthcare provider right away for any new or worsening signs or symptoms, which may include:
Getting medical help right away may help keep these problems from becoming more serious. Your healthcare team will check you for these problems during treatment and may treat you with corticosteroid or hormone replacement medicines. Your healthcare team may also need to delay or completely stop your treatment if you have severe side effects.
Possible side effects of OPDIVO + YERVOY
The most common side effects of OPDIVO, when used in combination with YERVOY, include: feeling tired; diarrhea; rash; itching; nausea; pain in muscles, bones, and joints; fever; cough; decreased appetite; vomiting; stomach-area (abdominal) pain; shortness of breath; upper respiratory tract infection; headache; low thyroid hormone levels (hypothyroidism); constipation; decreased weight; and dizziness.
These are not all the possible side effects. For more information, ask your healthcare provider or pharmacist. You are encouraged to report side effects of prescription drugs to the FDA. Call 1-800-FDA- 1088.
Females who are able to become pregnant:
Tell your healthcare provider about all the medicines you take, including prescription and over-the- counter medicines, vitamins, and herbal supplements.
Please see U.S. Full Prescribing Information and Medication Guide for OPDIVO and YERVOY.
© 2023 Bristol-Myers Squibb Company. All Rights Reserved.
OPDIVO® and YERVOY® are registered trademarks of Bristol-Myers Squibb Company.7356-US-2200719 2/23
Bristol Myers Squibb
Free Seminar from Curlew Hills Memory Gardens
Wed Mar 29th 6:00pm - 7:00pm
funeral cremation seminar outback-steakhouse
Palm Harbor, 31988 US Hwy 19 N, Palm Harbor map
As a service to our community, we are pleased to offer a free seminar to
those interested in learning more about making final arrangements.
Topics we’ll discuss include:
• At-need vs Pre-need Benefits
• Veterans Benefits – What the Gov’t Does & Does Not Provide You
• Social Security Benefits
• Handling a Death While Traveling
• Why Insurance Should not be Used for Purchasing Burial Needs
• How to Transfer Your Loved One Out-of-state
• How to Transfer Your Out-of-state Burial Property to Florida
• Advanced Funeral Planning – Burial & Cremation Options
RSVP is REQUIRED. Please call Curlew at 789.2000 to reserve your seat.
There will be No Selling at the seminar. Information only.
Complete meal provided FREE to all Seminar Attendants.
We kindly request “first time guests” only.
DEAR PAW'S CORNER: What is the value of training dogs using a clicker? I have tried using a clicker to train my dog Atlas, but he didn't listen very well. When should I click at him -- when he's misbehaving? Or when he's doing something right? And how can he tell? -- John H., Springfield, Massachusetts
DEAR JOHN: Clicker training, or "mark and reward" training, can seem almost magical in terms of how quickly and enthusiastically a dog learns. But that magic only happens when it's being done correctly.
Basically, you press the clicker device when your dog does precisely the thing that you are trying to train him to do. And you follow up immediately (like, within a second) with a reward -- usually a little bit of a treat. So, here's how it is done:
-- Decide on one behavior that you want your dog to learn in your training session. Start with a basic behavior, like "sit," "come here," "lie down" or "give paw."
-- Give Atlas the command. If he doesn't follow the command, don't click.
-- As soon as he follows the command, click once and give him a little treat.
-- Repeat the process again and again until he follows the command immediately.
By associating the clicker noise with a command and a reward, Atlas will quickly build a positive association with the command. This works for many types of training, from basic obedience to agility to job-specific commands. But you start with just one command at a time.
Also, consider working with a trainer, either one on one or in a group training setting. You'll pick up many training skills quickly. It's worth the investment. Send your tips, comments or questions to
firstname.lastname@example.org.(c) 2023 King Features Synd., Inc.
By Jean Mlincek
(Editor’s note. This is the first column in a series explaining why the author was almost void of humor this past year. You will find her restored sense of humor elsewhere in this newspaper.)
I hit my “Stop -the-world-I-want-to-get-off” moment early in 2021. Nothing seemed funny to me anymore, so I “retired” from writing humor for Senior Voice. It felt as if my soul had flat lined.
Our world is changing. People are changing. Norms are changing, and it isn’t pretty. It is hard to believe, considering how the masses function today, that man and woman are God’s highest creation. We alone are created in His likeness, His image. We often forget that wonderfully astounding fact.
You look at people today and you know something has gone sideways. Too many people are rude, violent, selfish, unkind. And so ignorant of the fact that they sabotage themselves, so needy that they compromise self-worth, so bent on power and “perfection” that they ruin the original work of God. I hate what I see.
One thing that troubles me a lot is the rampant abuse of our own bodies. It’s not just the internet ogres who are body shaming; we do it to ourselves, especially women. The death of Lisa Marie Presley is a classic and tragic example. She lost 50 lbs. in 6 weeks so she could “look good” at the Golden Globe Awards. Dear God, she looked terrible: frightfully pale. eyelids half shut, steps precarious. Was her attempt to “look good” a case of stupid vanity, or was she just another victim of our cultural demand that women must look beautiful 24/7? Either verdict still is cause for an untimely and unnecessary death
I grew up hating my nose, my thighs, my big ears, my rounded shoulders, my inability to grasp left-brain tasks. I wasn’t born with this self-hatred. It came from the outside, one blow after another. Even now, I am still beating myself up because I fall short of “beautiful” per my culture, the beauty industry, Hollywood, the Kardashians, and everyone else who dictates what beautiful looks like. I hate my body. No, in reality, I hate ME--the one graced with the image of God! My body works hard for me, but I rarely sing praise about it. . And I easily dismiss my true beauty--the twinkle in my hazel eyes, my soft hands, my creative mind, my nurturing spirit, my deep empathy. Thanks to my body, I can walk, talk, touch, laugh, hug, pray, share kindness, encourage.
I never realized how brutal, how unforgiving I was of my own body until I read Jen Hatmaker’s wonderful book titled “Fierce, Free and Full of Fire; The Guide to Being Glorious You.” Women in particular consider their bodies an “it.” And we are unmerciful towards “it.” Hatmaker says we should address our bodies as “she” or “her”--because our body is us, not something we are forced to drag around. She is so right. My body IS glorious; “she” has served me well. She deserves daily celebration. I need to cut her a break.
I hate that we have been pummeled into self-loathing. We need to find joy in being ourselves, in being accepted “as is”, in loving and being loved. Unfortunately, our world has become too dark, too demanding to allow those rights.
Next: The clowns in Congress.
Jean Mlincek is a free lance writer who resides in St. Petersburg, FL.
By Jean Mlincek
I call them “crazy ants.” I am talking about Florida’s newly arrived drivers.
“Crazy ants” is the name of a species of ant that seem frenzied over nothing and which move fast and chaotically and exhibit psychotic behavior. They dart and dash about in patterns that make no sense. They have found their match in today’s frenzied, speed happy, pyschotic, erratic Florida driver.
Driving today is a nightmare thanks to crazy ants (and thanks to our city leaders who have promoted a ridiculous influx of crazy ants from other states). With today’s roads more congested than ever, one would think the call would go out for patient, safe driving. The only call crazy ants hear is “Start your engines”, and God forbid if you are in their way. It’s bad enough that they ride your bumper, but you hear their engine revving so loudly behind you that you are certain your vehicle is about to go airborne, landing somewhere in the state of Wyoming.
I tell my Northern friends that here in St. Pete, I feel like I’m driving in New York City, even though I have never driven in New York City. I only know that no one likens drivers here to those in Frankenmuth, Michigan. So there you have it.
Crazy ant drivers are rude and reckless. They are notorious for speeding through school zones. I hate to think that they don’t see the orange cones, the flashing yellow lights, the other cars going 15 mph, but apparently they don’t. They barrel past the “End School Zone” as if the school crossing guard is there to wave a victory flag as they sail through. They apparently don’t see the children, either.
They have no respect for pedestrian crossings or bike riders or the elderly who ride with full vulnerability on electric powered mobility scooters. Crazy ants see all three as annoying speed bumps forcing them to slow down or stop. Only they often don’t stop.
They risk sideswiping other cars just to get one measly car ahead. Any stretch of highway, no matter how short, is their Indy 500. They treat parking lots at malls like racetracks, totally ignoring shoppers going to and from their cars. They think anything that moves, whether other drivers, bicyclists, or pedestrians, should relinquish a path for their maniacal driving. I hate venturing out anymore because these assholes ON our roads are more dangerous than the numerous potholes IN our roads.
Too often, a line of 50 or more cars wait impatiently to get on the entrance ramp to our interstates,
blasting horns, thrusting the middle finger out their window, and engaging in hot-under-the-collar behavior. For what? The highways are at a crawl, so why the pressure to “move us along’’? If they are in such a hurry to “get out of Dodge” every evening, why did they move to “Dodge” in the first place. We were doing fine without them.
I have never liked round abouts, but even in that small circle, crazy ants rule with their infantile aggression. They won’t let you merge and if you happen to accomplish that feat, they won’t let you exit. I always feel like a hamster on a wheel, going round and round until I somehow escape the “dreadmill’’. The Kia Soul hamsters make driving look so leisurely, God bless their “Souls.”
Crazy ants are a prime pest in South America, but trust me, we aren’t crazy about crazy ants here in Florida.
Jean Mlincek is a freelance writer who resides in St. Petersburg, FL.
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THE INDEPENDENT ORDER OF ODD FELLOWS TARPON SPRINGS LODGE NO. 34 CELEBRATES 130 YEARS OF SERVICE
By Harry Fuller <email@example.com>
The Independent Order of Odd Fellows Tarpon Springs Lodge celebrated its 130th anniversary at a celebratory picnic held at the Lodge on Saturday, March 19, 2022. On March 18, 1892, twelve members of the Independent Order of Odd Fellows convened in Tarpon Springs to form Tarpon Springs Lodge No. 34. The Lodge is one of the oldest fraternal and service organizations in the Tampa Bay area and has approximately forty members today. Over one hundred people attended the picnic, including many Brothers and Sisters from other Florida Lodges and even one Brother as far away as New Hampshire. Then Mayor of Tarpon Springs Chris Alahouzos presented to Noble Grand Alan Causey a City of Tarpon Springs Proclamation that recognized March 19, 2022 as Odd Fellows Day. The Grand Master of the Grand Lodge of the State of Florida, Nicholas Farradaz, also presented a Proclamation to the Lodge. A Proclamation from the Pinellas County Board of County Commissioners was also received. A portion of the Pinellas County Commission proclamation stated, "The Independent Order of Odd Fellows is an international fraternal order composed of thousands of members operating in approximately 10,000 lodges, located in 29 countries and ...seeks to improve and elevate the character of mankind by promoting the principles of friendship, love, truth, faith, hope, charity and universal justice".
The Lodge continues to be active in the community by contributing funds to Tarpon Springs Elementary School so school supplies may be purchased for needy children and sponsoring a team with Tarpon Springs Little League. Other activities include a bi-monthly cleanup through an adoption of a section of the Pinellas Trail in Tarpon Springs with Keep Pinellas Beautiful, volunteering with Pinellas County .
Emergency Management to distribute emergency radios to local residents, refurbishing the garden at the Boys and Girls Club of Tarpon Springs, providing scholarships to local high school students, working
with other organizations such as The Florida Dream Center to assist local residents, and helped to create the Greater Tarpon Springs Community Council with other local groups to address various issues facing Tarpon Springs
The Independent Order of Odd Fellows is one of the Most Justified and Ancient fraternal orders. While the true origins of the Odd Fellows are lost to the mists of time, historical records indicate that the Order evolved from medieval trade guilds into a fraternal organization during the 1700s in the period of the Enlightenment in England and Scotland. One of the theories why the name Odd Fellows is used comes from the guilds in which workers did not fit in the major trade guilds and were composed from the "odd trades", such as porters or teamsters. After an apprenticeship was completed, a member became a "fellow" in the guild. The name "Odd Fellows" remained when the guilds transformed into a fraternal order. The purely American wing of the Independent Order of Odd Fellows (I.O.O.F.) was formed in 1819 in Baltimore, Maryland.
The Lodge hosts an open house and potluck on the second Thursday of every month at 7:00pm and the public is invited to attend. Odd Fellows member only meetings are on the fourth Thursday of every month at 7:00pm. The Lodge is located at 438 East Lemon Street, Tarpon Springs, FL 34689. For more information about Tarpon Springs Lodge No. 34, visit www.IOOFTarponSpringsLodge34.org or
www.facebook.com/IOOF34. To contact the Lodge directly, email TarponIOOF34@gmail.com. The Sovereign Grand Lodge website is www.odd-fellows.org.
By Harry Fuller <firstname.lastname@example.org>
https://www.seniorvoiceamerica.org/ October 2022
Ask a smoking male about his greatest risk due to smoking, and you’re likely to hear things like lung cancer, heart attack and stroke. But it’s rare that anyone would mention an abdominal aortic aneurysm.
Known as AAA, abdominal aortic aneurysms are weak spots in the aortic artery, and they can be silent, deadly killers. Consider these statistics:
* Over 15,000 people in the U.S. died last year from ruptured abdominal aortic aneurysms.
* AAAs are the tenth leading cause of death in men over 60.
* An estimated 1 million men and women worldwide are living with undiagnosed AAAs.
For a little background, most people know the aorta as the main artery that starts in the heart, but as it travels through the chest it’s called the thoracic aorta, and when it reaches the abdomen, it’s called the abdominal aorta. As a main part of the body’s vascular system, it carries oxygenated blood away from the heart, and then splits into the two iliac arteries that supply the legs with blood.
What are the symptoms?
According to the Society for Vascular Surgery, many people do not feel symptoms at all. However, the following are warning signs that might prompt a screening for AAA:
* A pulsing feeling in your abdomen, similar to a heartbeat.
* Severe, sudden pain in your abdomen or lower back. If this is the case, your aneurysm may be about to burst.
* On rare occasions, your feet may develop pain, discoloration, or sores on the toes or feet.
AAA can be life-threatening if the aneurysm bursts, so if you experience any symptoms you
should consult with a vascular specialist right away. Typically, the aneurysm can be identified through an abdominal ultrasound, computed tomography (CT) scan or magnetic resonance imaging (MRI).
What is the treatment?
If an aneurysm is confirmed, there are two pri-mary types of recommended treatment, since no change in lifestyle will make the aneurysm go away.
Endovascular Surgery: Some patients can undergo a catheter/stenting surgery, which is less invasive, involves a shorter hospital stay and a quicker recovery overall. However, not all patients qualify for this type of surgery based on the location and shape of their aneurysm, and this option does involve more follow up, future scans and possible maintenance to ensure the stent inside the artery is still working.
Open Surgery: As the name implies, open surgery requires an incision in the abdomen. Then, instead of placing a stent inside the artery, the surgery actually removes the damaged part of the artery and replaces it with a graph, which is a plastic tube the same size as a normal artery that allows the blood to flow through.
While there are some occasions where the aneurysm is small enough to merit a “wait and see” approach, whereby it is monitored every 6-12 months, a neglected or undiagnosed aneurysm can be dead-ly. If the aneurysm bursts, patients may suddenly feel intense weakness, dizziness, or pain, and may eventually lose consciousness. This is a life-threatening situation that requires immediate medical attention.
Senior Voice America Publications
DEAR DR. ROACH: I am 78; I had a hysterectomy in 1976 due to excessive vaginal bleeding, but I still have my ovaries. I have had hot flashes since undergoing menopause — they usually last three to five minutes, and I have them about every two hours around the clock (which obviously interferes with my sleep).
Over the last 28 years, I have tried Premarin (which gave me bad head-aches), gabapentin, venlafaxine, Bellergal, melatonin, black cohosh, clonidine, DHEA, Pro-Gest cream (chamomile, hops and valerian root), progesterone and estrogen (together), avoiding caffeine, and eliminating dairy products. None of these has helped.
I would appreciate it if you could offer any suggestions. — L.E.
ANSWER: I’m sorry to hear of your difficulties. You have certainly tried about all the available therapies.
There are two additional ones you might want to consider: Megesterol is a hormonal therapy that is helpful for some women, but the fact that you haven’t responded to estrogens and progestins is not promising. The other is called a stellate ganglion block. You can ask your physician about it.
DEAR DR. ROACH: After a patient has had megadoses of IV and oral antibiotics, is there any-thing they should do to restore the balance in their body, such as eating probiotics or yogurt? Or is that all nonsense? — N.W.
ANSWER: The idea makes perfect sense: Antibiotics not only kill the bad bacteria that is infecting us, they also kill many of the healthy bacteria that help us with digestion and other functions. (The whole suite of healthy bacteria living in our gut is termed the “microbiome.”) Why not help the gut return to normal by giving it some healthy bacteria, such those found in yogurt with live cultures, or specific probiotics, which are just the healthy bacteria?
The answer is that it has been very hard to prove that there is any benefit in doing so. In people with no symptoms after finishing an antibiotic course, there probably aren’t any benefits.
At least one study showed what researchers called a “very severe disturbance” in the person’s microbiome and actually slowed the return to a per-son’s normal microbiome, which they had prior to antibiotics. Worse still, very rarely, infections have been transmitted through probiotics.
Symptoms after antibiotic therapy, especially diarrhea and fever, could indicate a very severe infection called Clostridioides difficile (“C. diff”), which does not respond to probiotics and usually needs powerful antibiotics to treat. Pro-biotics have not been found to prevent C. diff.
DEAR DR. ROACH: Why are older patients always asked, “Have you ever fallen?” It is annoying, and I wish you would stop asking. — L.M.B.
ANSWER: Falls in older adults are a major cause of disability. Falls can lead to fractures, and fractures lead to poor movement, sometimes to a progressive decline.
A history of a fall is a major risk for future falls, so any person with a history of indoor falls should undergo a comprehensive evaluation as to why they fell and see what can be done to prevent future falls. This includes, of course, managing any chronic illness, but also correcting vision as much as possible; evaluating the home for risks such as poor lighting and area rugs; and evaluating gait and balance, with a referral a physical therapist for exercises to improve these, and for assistive devices if necessary.
Falls may also be the first indication of a significant medical or neurological condition that may benefit from treatment. I’m sorry you find it annoying, but it’s an important question.
Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@ med.cornell.edu.
© 2023 North America Synd., Inc.
All Rights Reserved
By Mary Gynn, RN, BSN, MSN, MS, MPH Diabetes Educator
“The National Action Plan to Improve Health Literacy”
Healthcare is changing dramatically for those who seek care and those who deliver it. The Patient Protection and Affordable Care Act has brought healthcare coverage to millions of consumers who previously could not afford or did not want health insurance. Now the health benefit experience will present them and others with a variety of choices and complexities to consider. Those choices will be difficult if they don’t have an understanding of what’s being said or written and they’re making those choices for the first time.
Presently, consumers are overwhelmed by the flood of information and decisions that need to be made. Health Literacy can play a huge role in providing understandable communications between the consumer and their healthcare provider.
The growing pressure on health systems is to reduce, ration and delay health services to contain health costs. But people are living longer creating more time for minor dysfunctions to develop into disabling chronic diseases. Health literacy or people’s ability to obtain, process, communicate and understand basic health information and services is essential to those actions. Yet, few American are proficient in understanding available health information.
The Health Literate Care Model article cited: Health Education Behavior, December 2013, 40:6635-639. “The Public Health Journey: The Meaning and the Moment” by Howard Koh, Cindy Brach, Linda Harris, Michael Pearlman, calls for health professionals to approach all patients with the assumption that they are at risk of not understanding their health conditions or how to deal with them. Health Literacy would then become a value that is used in all aspects of planning and clinical information systems.
Howard Koh, MD, MPH, wrote when he was Assistant Secretary for Health , “As a result, I’ve observed the difficulties many people face as they attempt to use our health care systems. When people receive accurate, easy to use information about a health issue, they are better able to take action to protect and promote their health and wellness.
Improving health literacy, that is, the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions is critical to achieving the objectives set forth in Healthy People 2020, 2021, and 2022.
The National Action Plan to Improve Health Literacy envisions a restructuring of the ways we create and disseminate all types of health information in this country. The Plan also calls us to ensure that all children graduate with health literacy skills that will help them live healthier throughout their lifespan. It seeks to engage organizations, professionals, policymakers, communities, individuals and families in a linked effort to improve health literacy. Its plan is to provide everyone with access to accurate and actionable health information and supports lifelong learning and skills to promote good health.
It has been my experience as a RN Community Health Educator that Prediabetics and Diabetics who were diagnosed in the past still have basic questions that should have been dealt with for the successful at home self-management of their disease. It was my good luck and search to find the Florida Literacy Coalition to join those who have wisdom, insight, research, technicians and practices within the world of family and adult health literacy.
The Florida Literacy Coalition has knowledge of the problem as the health delivery system continues to drastically change, the education of health professionals continues to change, as new medications are discovered and the cost of care continues to soar. Tomorrow’s health care systems are destined to change.
Mary Gynn, RN
Aging Well and Reaching Beyond
The Real State of Real Estate
Did you know about Senate Bill 4-D and how it can affect your home and your retirement?
By Audra Christian
In response to the tragedy of the Champlain Towers South collapsing that caused the death of 98 people the Florida Senate and legislators had an emergency session in May of 2022 and passed Senate bill 4-D, we refer to it as SB 4D for short. This senate bill has caused quite the stir in the free state of Florida because it inadvertently created a few unintended consequences.
I have attached what the stellar management company for On Top of The World has posted on their website, which is definitely the easiest explanation of the bill.
“Florida’s Senate Bill 4D, which was passed in May 2022, made it mandatory for all Florida condominium and cooperative buildings, three stories or higher, to undergo milestone inspections, structural inspections, and submit specific information to the DBPR.
In addition, regarding the funding of reserves for the continued maintenance and repair of condominium and cooperative buildings, among other things, the bill prohibits waiver of reserves by associations for certain structural components.
Your Association needs your support in making legislators aware of what impact this law would have on residents of On Top of the World Condominium Community here in Clearwater.”
-On Top Of The World HOA management company
This emergency “fix” has many residents and potential buyers worried about possible looming assessments creating an unlivable and unsustainable reality for retirees in Florida. With many retirees on a very fixed income any sort of normal assessment can create a problem let alone a massive assessment to obtain the sort of reserves this bill can allow. Many people think this bill was a knee-jerk protection for insurance companies not homeowners. Some people believe this bill to be a land grab by developers since land is at a premium in Florida. Some people believe that the assessments being required should be covered by insurance companies that the condo owners have been paying insurance payments to for so many years. I guess we will see how this issue resolves.
This brings up one major question for Florida residents. “Do you know who your legislators, senators, county commissioners and school board members are for your area?” You should. These are the people who are making these decision. Whether their decisions are good or bad you still need to know who they are. They need to know who you are. The new normal since the covid lockdowns is to know these people…because that is what they are, people. Not only am I a very successful real estate professional I am a person who thoroughly enjoys helping homeowners meet and work with their local office holders. They need our direction to make the best decisions they can as they work for us. We must be actively involved not just for our sakes but the next generation of Americans. Set the standard now of being involved. If you would like to have more information feel free to reach out to me.
For Real estate help email@example.com
For getting involved TownHallAmerica@gmail.com
By PatZi (with a Z!)
The other day I was interviewing a writer about her book. It’s about gratitude, and I told her a story about that happened to me when I was a child. Since she liked the story I thought I would share it with you.
Recently for some reason I had a craving for an orange. I don’t actually eat oranges very often and I don’t think I had eaten one for several years. Definitely it was before the pandemic when I would go to Yellow Bank Groves a seasonal store open from October to May. I don’t know if they were open during the pandemic, but then I didn’t get out during those bleak and blurry years.
Anyway, I decided I wanted an orange. You can imagine my surprise when I discovered that my local supermarket wanted $1.69 for one orange. It was outrageous! As much as I wanted an orange, I just couldn’t spend that kind of money. It’s as bad as spending $5.50 for a dozen eggs.
At the time here in Clearwater, Florida we were going through a bitter cold spell. There was even sleeting rain and wind that I felt certain my brother was sending down from Michigan’s Upper Peninsula just to tease me. He thinks it’s funny that for a Yooper, I don’t like the cold. He loves it and every year he hopes that they will break the snow record of 342 inches.
The next day I decided to brave the bad weather. I was determined to have an orange. So I bundled up and realized that I didn’t have a pair of gloves. I don’t think I’ve had a pair in thirty years. With my hands stuffed in my pockets I headed for the vegetable market.
Surely the price for oranges would be more reasonable, I assured myself as the wind ripped through my thin jacket. Not by much I discovered. Two for $3.00. Saved myself a whole 18 cents. When I got home with my two precious Navel oranges, I sat down at the kitchen table and admired them. They really were beautiful. When I was a kid, we didn’t shop in supermarkets.
Mostly everything came from my grandfather’s farm. In the summer my aunts bottled fruits in Mason jars. So, all winter long we ate apples, peaches, pears, and plum but no oranges. Except in December when my Uncle Waino, who was a wrestler and lived in Port Richey, sent us a wooden crate of them. They would arrive on a train from Chicago and the station master would
call us to pick them up.
We were so proud; No one else in our little town got a crate of oranges. And I did love those wooden crates. For years they were my only bookcases.
As I sat admiring the sheer beauty of a perfect orange, I remembered how my sister, Natalie, and I would sit by the window to peel them in the sunshine. Outside the snow would be up the edge of the window sill, but inside we were snug and warm. We liked to pretend we were in Florida. As we slowly peel the orange, because we had to save the rind for my mother to candy, we would marvel at the mist that would escape when we opened a section. We could see it in the rays of the sun. It was almost like magic as we breathed in the scent that was so exotic to us.
We would talk about a trip we hoped our parents would one day to Florida where we could see Uncle Waino wrestle and alligator. He had sent us a photo one year of him doing it. He was called the Fighting Finn. Or sometimes the Mad Viking. Florida sounded so heavenly. You never had to wear a snowsuit or galoshes and you could pick an orange off a tree whenever you felt like it.
I am grateful for that memory. I am grateful to my Uncle Waino. He was a big tough guy, a wrestler with a heart of gold. And I am grateful for so much, especially for my sister Natalie and my baby brother, Thom. I am grateful to my mother who would make orange cake in the middle of winter. And for all the neighbors who just happened to drop by because the knew she would have cupcakes that she would give them to take home.
I shared this story with Kristine Newell, the author of a wonderful book called: The Habit of Grateful: A Handbook for Gratitude. She tells the amazing story of her own life and about the lessons she learned along the way about the importance of gratitude. A great read and wonderful book to get you thinking about how you can express your gratitude for the blessings in your life. Her book is available online or go to her website: www.guidetogratitude.com
And I am grateful to all of you.
ABOUT: PatZi Gil hosts “Joy on Paper” (radio-joyonpaper.com) a nationally syndicated program for writers and those who dream of writing. The program can be heard in the Bay area
By Olga R. Rodriguez
The population of western monarch butterflies wintering along the California coast has rebounded for a second year in a row after a precipitous drop in 2020, but the population of orange-and-black insects is still well below what it used to be, researchers announced Tuesday.
Volunteers who visited sites in California and Arizona around Thanksgiving tallied more than 330,000 butterflies, the highest number of these insects counted in the last six years. It was a promising rebound after the annual winter count in 2020 recorded fewer than 2,000 butterflies. In 2021, the number recorded was 247,000.
“I think we can all celebrate and this is really exciting,” said Emma Pelton, a conservation biologist at the Xerces Society, a nonprofit environmental organization that focuses on the conservation of invertebrates. “We were all so relieved last year when we had about 250,000 butterflies, and to see that number tick up even modestly this year it's really a good sign that we've got a second chance.”
Pelton said it’s not clear why the population has rebounded but one explanation could be that eastern monarch butterflies, which tend to spend the winter in Mexico, could be mixing with their western counterparts.
“Some of that kind of leakage could be occurring and I don’t think we fully understand the system enough to say what it is," she said. “But I think one thing it’s not is that all is well or that we all made human actions that magically made it all better.”
The population is still far below what it was in the 1980s, when monarchs numbered in the millions.
Scientists say the butterflies are at critically low levels in western states because of destruction to their milkweed habitat along their migratory route as housing expands into their territory and use of pesticides and herbicides increases.
Along with farming, climate change is one of the main drivers of the monarch’s threatened extinction, disrupting an annual 3,000-mile (4,828-kilometer) migration synched to springtime and the blossoming of wildflowers.
Western monarch butterflies head south from the Pacific Northwest to California each winter, returning to the same places and even the same trees, where they cluster to keep warm. The monarchs breed multiple generations along the way for thousands of miles before reaching California where they generally arrive at the beginning of November. Once warmer weather arrives in March, they spread east of California.
On the eastern side of the Rocky Mountains, another monarch population travels from southern Canada and the northeastern United States across thousands of miles to spend the winter in central Mexico. Scientists estimate the monarch population in the eastern U.S. has fallen about 80% since the mid-1990s, but the drop-off in the western U.S. has been even steeper.
The western monarch count is conducted by trained volunteers over several weeks around the Thanksgiving holiday. It dates back to 1997 and has observed a loss of more than 95% of a population that according to earlier studies once numbered in the low millions.
This year the insects' wintering habitat along California's central coast was also battered by heavy rains and volunteers reported more monarchs blown from their clusters and vulnerable to the cold, wet conditions and predation, the Xerces Society said in a statement.
The group normally also conducts a second count after the New Year. This year's results will be announced in February and shed light on how much winter storms impacted the butterflies, said Isis Howard, an endangered species conservation biologist with the Xerces Society.
Howard said the follow-up New Year’s counts usually show a 30% to 50% decline in butterflies from the Thanksgiving count.
“Because the storms were so intense and so back-to-back this year, it seems reasonable to assume that there might be increased mortality this winter, leading to a smaller population that’ll kick off the breeding season this next spring and summer," she said.
Lending a Helping Hand
By Matilda Charles
Lending a Helping Hand
I've been looking at 2022, hoping to find some value in my time and money in this chaotic world we find ourselves in, a chaos that doesn't show any sign of ending soon. Two new activities have found their way to my to-do list. For several months I've been buying a food donation card each time I shop at a certain grocery store. It's not much, but I believe I can continue to do this. My goal is to make it through the year without missing one time. These cards are given to the local food bank, which can then use that money to buy food at a discounted rate. This has more financial benefit than if I purchased food at the regular store rate and delivered it to them. I know the food banks around here have been scrambling to keep supplies available, especially since they're serving more families than ever before. Maybe my humble donation will help just a little bit.
The other item on my new to-do list is probably the more valuable. I'll be collecting groceries weekly for three very elderly people in the neighborhood. I learned that two of them had been ordering groceries for curbside pickup -- and taking taxis to go get them because they don't drive. The third ordered her groceries for curbside, but has had them delivered.
So, instead of the extra expense of taxi or delivery, I'll pick up their orders myself. I did a test run with one to be certain there was no problem with me using someone else's credit card to pay for the curbside pickup. The bonus is that these three neighbors, who had never met, now know each other and talk frequently. I understand that there has already been a bit of coupon swapping and recipe sharing.
The International Chorale presents: "A Patriotic & Americana Concert" @ The Hale Senior Center