Obamacare: More Success Than Failure So Far

peter-butlerBy Peter W. Butler, MHSA

More than six years after it was signed into law, the Affordable Care Act continues to arouse strong opinions and strong objections. Consider, for instance, the viewpoint made clear by the title of a Sept.11 Chicago Tribune editorial, “Why Obamacare Failed.”

Simply dismissing the ACA as a “failure,” however, is not supported by the facts when considered in the context of what Obamacare, as the ACA is more widely known, set out to accomplish. According to the obamacarefacts.com website, the goal of the Affordable Care Act is to “give more Americans access to affordable, quality health insurance and to reduce the growth in U.S. health care spending.”

Although some of the editorial made valid points about problems with state health insurance exchanges (marketplaces), especially in Illinois, the exchanges are a small part of Obamacare. The Tribune editorial board appears to have reached its conclusions based on premium increases and the limited number of choices available on the state exchanges.

How the ACA has helped

This view ignores a wide array of peer-reviewed data that examines the full impact of the ACA. These data and evaluations present a health care system that is performing much better than it was prior to the enactment of the ACA.

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Alzheimer’s Risks, and How You Can Protect Yourself

alzheimersBy Neelum T. Aggarwal, MD

The passing of the actor Gene Wilder — remembered by many for his lovable portrayal of Willy Wonka — further reinforced that fact that Alzheimer’s disease does not spare anyone. Many people were no doubt surprised to hear about his diagnosis and that he died from complications of Alzheimer’s disease. After all, Gene Wilder was wildly talented, engaged in creative activities all of his life, appeared physically spry and had a wonderful imagination. How could this happen to him?

Indeed, Alzheimer’s disease dementia can happen to anyone, and crosses race/ethnicity and social economic status. More than 5.5 million people in the United States officially have Alzheimer’s disease dementia, which is an underestimation, as many people live with the disease never receive a diagnosis.

Minorities, African-Americans and Latinos are appearing to be hit harder with Alzheimer’s disease and dementia. African-Americans are at least 1.5 times more likely to develop the disease, and the data suggests the same for Latinos. Recent data is also confirming that sex and gender differences are present in Alzheimer’s disease — women are developing  the disease more than men.

Lifestyle factors that may increase Alzheimer’s risk

Comorbid medical conditions such as heart disease, diabetes, nutritional deficiencies and depression all can lead to poor cognitive function and can be risk factors of Alzheimer’s disease. People with a history of hypertension also may have a greater risk for Alzheimer’s disease dementia and other dementias. In addition, people who have decreased heart function are two to three times more likely to develop significant memory loss compared to those with better heart function. Lastly, those with multiple cardiovascular risk factors were more likely to have impairment in learning, memory and verbal fluency tests and worsened over time.

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‘Smart Screening’ for Prostate Cancer

leslie-deaneBy Leslie Deane, MD

As a young boy growing up, I saw two of my grandfather’s brothers be diagnosed with prostate cancer and develop metastases from it, and ultimately succumb to this disease. This was in the pre-prostate specific antigen (PSA) era. This was at a time when men were still treated with diethylstilbestrol, and treatments for advanced prostate cancer were not available. Had screening been an option at that time, they may have been diagnosed earlier and possibly not suffer the way they did.

PSA is an enzyme that is present in prostatic tissue, and its level in the blood can be measured by simple blood test. It is used to estimate a man’s chances of having prostate cancer based on its level.

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Tyler’s Story: Treating Crohn’s Disease

kesavan-blogBy Anil Kesavan, MD

I first met Tyler Jankiewicz and his mother, Ann, in August 2013, when he was 15 years old. Tyler had been referred to Rush’s pediatric gastroenterology program seven months earlier and was diagnosed with Crohn’s disease, a chronic autoimmune disease that causes inflammation throughout the intestinal tract. People with Crohn’s experience a variety of symptoms (abdominal pain, diarrhea, vomiting, blood in the stool), as well as weight loss, inflammation in the eyes and skin, fevers and joint pain.

Tyler first started having symptoms in December 2012, and his condition had progressed dramatically. He couldn’t eat and rapidly lost 40 pounds. By the spring of 2013, his weight was down to 115, and he didn’t have the strength or stamina to play volleyball on his high school team. He was anemic, and his condition was worsening.

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Tyler’s Story: Coping With Crohn’s Disease

tyler-blog
Tyler Jankiewicz and his mother, Ann, describe the toll of Crohn’s disease, and how doctors at Rush helped him get better.

Tyler

At first, I was just having stomachaches — maybe one or two a day. They weren’t too bad, and if I went to the bathroom, they went away. This was in the fall of 2012, during basketball season my freshman year of high school. When the symptoms first started, I still felt mostly fine; I was still able to get through practices and games.

But toward the end of the season, around December, the symptoms really started affecting my physical abilities. My coach was very understanding. He said if I needed anything, like in the middle of a game if I needed to use the bathroom, to just give him a signal and he’d take me out. I couldn’t play in the last few games, though, because I would get winded quickly and felt weaker.

I had planned to play volleyball in the spring, but by then I was really sick and had lost so much weight, about 40 pounds. I’d lost all the muscle I had, so I wasn’t in good enough shape to even try out. The coach said, “If you get better, you’ll be able to play.” I sat in the bleachers and watched practice for a few weeks, but after a while I didn’t want to be there because it was too hard to not be on the court.

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Eman’s Story: ‘I Have Myself Back’

eman-hammadBy Eman Hammad

I started to lose the hearing in my left ear when I was 16. I began wearing a hearing aid when I was in my last year of high school, around 17. Every year my hearing was getting worse. I kept changing my hearing aid, but eventually, I couldn’t hear anything in that ear. The hearing aid didn’t even help. And after a couple more years, I started to lose hearing in my right ear, too.

I kept to myself because I felt like I couldn’t connect with people anymore. I couldn’t hear people very well. I could tell they were laughing and talking, but I didn’t know what they were talking or laughing about. I’m a very social person. I love to go out. But I even quit my studies at the university in Saudi Arabia because I couldn’t hear well. It was ruining my life.

I went to so many doctors — in Saudi Arabia where I was living and then in Turkey. I couldn’t find out the reason for losing my hearing. And every year it kept getting worse. The doctors didn’t know why it was happening.

‘We’re going to Rush’

I came to the United States about five years ago on a scholarship to study advertising at the Illinois Institute of Art. While I was here, my brother researched the best doctors for me. He found an ear, nose and throat doctor who specializes in hearing loss, Dr. Mark Wiet. My brother said, “We’re going to Rush.”

When I met with Dr. Wiet, he just looked at my eyes, and he said, “I’m going to order a genetic test for you.” And then after we did the testing, he found out that I have advanced osteogenesis imperfecta. It causes hearing loss, among other issues. He just looked at my eyes, and he figured that out.

Because of the osteogenesis imperfecta, the color of my eyes is different. Instead of being white, the area around my pupil is blue-gray. That’s one of the signs of osteogenesis imperfecta. I went to so many doctors and nobody had known.

Help with hearing loss

Osteogenesis imperfecta causes problems with my bones, so I also see Dr. Sonali Khandelwal in rheumatology on a regular basis. Whenever she asks if she can bring in residents to check out my eyes, I always let her know that as long as they’re good looking, it’s fine with me. ☺

Even though the condition is something I’ll live with the rest of my life, just finding out what was going on with me was such a relief. And after Dr. Wiet put in a cochlear implant to help my hearing loss, I really got back my confidence. I started to go out by myself and go clubbing. I love, love dancing so much. I feel now like finally, I have myself back.

Promoting Suicide Awareness

depressed-woman

By Chris Spaletto, MAAT, ATR, and Kevin Pittman, RN, BSN 

If you are on the Rush campus this week, you may see us giving purple-and-teal-colored ribbons to passersby. As clinicians at the Rush Day Hospital — the outpatient adult program in the Department of Psychiatry — we and other psychiatry units at Rush are doing our part to promote awareness of National Suicide Prevention Week.

The Rush Day Hospital treats people 18 years and older diagnosed with affective disorders and other conditions that interfere with relationships and daily functioning. We work collaboratively as a team, which includes nursing, social work, art therapy and a psychiatrist who serves as our medical director.

Here are some important facts about suicide:

  • In the United States, 50 percent more people die by suicide each year than from homicide.
  • Experts believe that most suicidal individuals do not want to die. They just want to end the pain.
  • When suicide risk or intent is detected early, lives can be saved.

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