Happy Thanksgiving

Over the course of a year, we experience many holidays. If you work in state government you get more than I do off from work, and I do miss that part of government work. Some of them are merely days off, some are religious in nature. Thanksgiving has come to be my favorite. We take time off solely for the purpose of giving thanks. There’s no pressure in gift giving, or the other commercial trappings of Christmas. Just plain ol’ gratification of saying thanks for all the good things we have.

I enjoy watching football as much as anyone and my favorite dessert from my time with my grandmother was pumpkin pie. I truly enjoy arguing politics and religion with any family member that dares question me at the dining room table. But, I have to say I have much to be thankful for, even in 2019.

I have a lovely wife, who is healthy and two great dogs. We live comfortably in a nice home, and have transportation. Charleston is a great community and my home state, for all its misgivings, is full of wonderful citizens. I get to work for a great group of people and have some wonderful people that work for me. Though I could stand to get back to my fightin’ weight, I’m fairly healthy and have some great friends all across the country. I have many things that can never be taken from me like a great education (earned at WV Tech and WVU).

I’m going to publish this on my blog so you can read it and I hope you get inspired a bit this Thanksgiving, but I might just look back on it to remind myself just how fortunate I am.

Happy Thanksgiving.

T21

The name T21 sounds like the subtitle to an Arnold Schwarzenegger sequel. However, its a public policy sweeping across states and has even received some support from President Trump. T21 or Tobacco to 21 is an effort to raise the legal purchasing age to 21. Over 500 city/county jurisdictions and 18 states have enacted this as a law.

Public policy advisors everywhere have worked to get this into law. A recent Gallup poll found that a majority of Americans agree. Last year, in a West Virginia legislative hearing, Bureau for Public Health Commissioner Dr. Cathy Slemp was asked about an exemption for military members. Dr. Slemp showed where even the United State DOD doesn’t want their young women and men smoking. Unhealthy behaviors are bad for military readiness.

The truth is recent studies have shown that these laws reduce smoking rates in young people age 18-20. The other thing we know, is that the longer people avoid picking up this habit, the less apt they are to be a cigarette smoker in the future, which means healthier, longer lives. And if you aren’t a smoker and wonder how this affects you, less smokers will eventually help with health insurance costs.

For more information, go to tobacco21.org.

Be Patient, Be Kind and You Can Help Someone with Substance Abuse Disorder

Last week, I had the privilege of meeting some of the finest minds in the addiction treatment and recovery world at the Appalachian Addiction and Prescription Drug Abuse Conference. This is timely, as we are in the midst of an addiction crisis. Politicians are threatening to lock up offenders and want to further regulate medication assisted treatment (MAT). This is unfortunate. Perhaps some politicians should have come to hear more about how to solve the problem.

On the AHP, I had a great time interviewing Dr. Marvin Seppala, the Medical Director at the Hazelden Betty Ford Clinic. Dr. Seppala is a brilliant man with a kind heart. He cares about the patients he’s helping. We discussed issues like Mrs. Ford coming out years ago and admitting she had a problem. That opened a door for many people that is still open today. We also talked about how to address addiction with a loved one that has a problem. (To answer the question you probably just asked yourself, you research the issue and talk to them about it. Being patient, be kind, you shouldn’t expect immediate results.)

Hazelden Betty Ford pioneered a 12-step recovery. We’ve all heard of it. Work your steps and work to stay sober in a community of your peers. Now, the group that brought you abstinence based recovery brings you MAT. What works for one person, works for one person. You can’t assume everyone will respond to treatments the same way. It’s not one size fits all. You can even take MAT while working through the 12-steps if you need to.

Since doing this, Hazelden Betty Ford has changed outcomes for the better. They are more successful which means there are more people out there under the control of substance use disorder. Patients must consider this disease all their life, but they can go on living. It was a culture change for the clinic, but one for the better.

If you know someone who you believe has a substance abuse issue, remember they are ill, not a lesser person. Research the issue and talk to them about what treatments might be available. One day we might beat addiction, until then be patient, be kind, and you might just save someone’s life.

You can hear my interview with Dr. Seppala available Monday morning on the Appalachian Health Podcast. It is available on Apple Podcast, Spotify, or at dannyscalise.com.

Appalachian Addiction & Prescription Drug Abuse Conference

This week, a diverse group of professionals in the field of addiction gathered at the Marriott in Morgantown, WV.  I began working with Dr. Brad Hall and his team a few years ago when this conference was getting bigger, and now over 500 providers, peer coaches, and others gather in the fall.  The participants learn from the best. This issue has hit this country hard, but Appalachia and West Virginia have been hit particularly hard.  We are learning more and more about addiction, how it affects people, and how to treat it.  Over the next few weeks, people who missed the conference will be able to hear from some of these experts as I interviewed them on the Appalachian Health Podcast. 

Over 500 participants listened to experts in the field of addiction and treatment.

Addiction is a health condition with a nasty reputation.  The stigma of addiction hurts.  It hits hard. It makes life difficult for the patients suffering from this disease.  At the conference Ken Rodenbaugh, a practicing nurse, told his powerful story about the stigma of addiction.  Later in the evening, Dr. Alisa Duran talked about the vulnerability of personal stories.  Being a professional and a person in recovery can be difficult.  I interviewed them together about their stories. 

The Mountain State was  blessed to have the experts discussing treatment options.  I interviewed Dr. Marvin Seppala, Chief Medical Officer of the Hazelden Betty Ford about MAT & 12-Step Programs for treatment of addiction, and Dr. Jeannie Sperry, Co-Chair of the Division of Addictions at the Mayo Clinic, about the use of Cognitive Behavioral Therapy in the treatment of pain & addiction.  

Kelly Lemon, a nurse practitioner and nurse midwife from WVU Medicine gave a timely talk on Addiction, Pregnancy, and Neonatal Abstinence Syndrome.  Kelly and I sat down for a few minutes before her presentation to discuss these issues and how they are affecting the West Virginia.  With the WV Legislature legalizing cannabis for medical use a couple years ago, Dr. Libby Stuyt, a psychiatrist from Colorado gave some great information in her talk about Fact & Fiction in marijuana and CBD.  Dr. Stuyt and I discussed her views on cannabis as well as her expertise on auricular acupuncture.  

You can hear my interviews with all of these people in the coming weeks on the Appalachian Health Podcast.  There were many others at the conference including WVU Health Sciences Dean Dr. Clay Marsh and the President of WVU E. Gordon Gee.  Other experts in the field were there, however I didn’t have time to interview them all.  I felt honored to get a few moments to talk about one of the most important health issues with some of the worlds best.  

Addiction is a disease.  It’s difficult to understand. Stigma gets in the way of people getting the treatment they need.  The professionals at this conference provided an education on the most current treatment options as well as other topics in the field. 

Real Men Wear Pink

I began a new habit for October.  It started last year when I joined my friends at the American Cancer Society (ACS) for their Real Men Wear Pink campaign.  Every day in October, I will wear pink and post photographs of my outfit on social media.  I’m doing this to help save lives from breast cancer.  I’ll do it to show my support, raise awareness, and raise funds for this important cause.  

I’m committed to Real Men Wear Pink.  These donations support the ACS work to save lives.  They are determined to ensure that no one touched by breast cancer does it alone.  They are committed to helping those currently dealing with a breast cancer diagnosis, those who may face a future diagnosis, and those who may avoid a diagnosis altogether thanks to education and prevention.  

Every dollar raised helps through early detection and prevention, innovative breast cancer research, and patient support.  They are currently funding more than $62 million in breast cancer research grants nationwide.  They also proved free, comprehensive information and support to those touched by breast cancer when where they need it and the ACS helps people take steps to reduce their breast cancer risk or find it early, when it may be the easiest to treat.  

If you’ve been following this blog, my social media, my podcast, or my television show you know breast cancer has been the theme recently.  This has hit me personally.  Breast Cancer has struck my family, friends, and coworkers.  Almost certainly, it has affected you or someone you care about.  You can support my Real Men Wear Pink efforts by going to my Facebook Fundraiser.  Please take the time to share it on social media or donate whatever amount you can. Your donation truly will help someone in need. 

Bernie Sanders Should Meet Angie Settle

In this country, we have a debate over whether healthcare is a right or a privilege.   My guest this week on the AHP proved that health is a right, at least it is on the East End of Charleston and the surrounding areas she and her team serve. WV Health Right was founded and continues to operate on the belief that every person is entitled to quality healthcare, even if they don’t have private insurance.  In fact, 28,000 West Virginians get quality medical care, dental care, pharmaceuticals, vision care, behavioral health services, and health education because of a small clinic on Washington Street.  It is their mission.  

Their four assumptions:

  1. Each person has inherent uniqueness, value, and worth and is therefore worthy of respect of others
  2. Basic healthcare is a fundamental right
  3. With that, there are corresponding responsibilities, including to participate in their care
  4. Members of a society have the responsibility to care for the most weak and vulnerable  

These assumptions sum up the philosophy.  In my time working with WV Health Right CEO, Angie Settle, I believe the staff lives the mission.  I learned a lot from interviewing Angie.  I also garnered a great deal of respect for the paid staff who work for less than they’d be paid at comparable facilities and the army of volunteer physicians and dentists who give freely of their time to treat patients for which they don’t receive anything other than a thank you.  

The debate about healthcare as a right has been going on for decades.  Presidents going back to FDR & Harry Truman worked to have reform in the system including everything from a single payer to our current implementation of the Patient Protection and Affordable Care Act.  With election season just getting its stride for the 2020 contests, we hear a lot of Democratic Presidential candidates talking about “Medicare for All” and Republicans asking how we’re going to pay for it.  Maybe Senator Sanders, Senator Warren, and their Republican counterparts should spend a few hours with Angie Settle and crew. They provide healthcare for all and they pay for it.

Vaccines on Offense and Defense. A guest post from my friend, Dr. Lisa Costello.

For many, including me, football, fight songs, and colorful foliage are symbols of fall. As a pediatric hospitalist in Morgantown, the fall, however, serves as a sign of something else, something that’s not fun at all, the flu.

Flu can be a tough opponent for patients and health care providers. Fortunately, we have a game plan to help us fight it! The best way to prevent you or someone you love from catching the flu is by receiving the seasonal influenza vaccine this year and every year. Yes, the key to victory when it comes to fighting flu is getting a flu shot. In fact, the key to fighting many diseases is vaccination.

The best teams have a great offense and great defense, right? Vaccines are safe, effective, and the best way our bodies are able to score immunity (offense) to prevent illness from happening (defense.)

Vaccines have been part of the fabric of our society for decades and are the most significant medical innovation of our time. Vaccines prevent life-threatening diseases, like the flu, measles, diphtheria, polio, and hepatitis to name a few, and even prevent forms of cancer, notably cancer caused by the human papilloma virus (HPV). Vaccines keep communities healthy, and protect us all, including some of the most vulnerable in our society, including the elderly, children who are too young to be vaccinated or have compromised immune systems.

Routine childhood immunization is one of the crowning achievements in public health over the past century. Studies have estimated that childhood vaccination programs have prevented hundreds of millions of cases of diphtheria, hepatitis A, measles, mumps, pertussis, polio and rubella since 1924. Robust medical evidence continues to show that vaccines are safe. Vaccines are effective. Vaccines save lives.

However, challenges remain. Outbreaks of measles, pertussis, Hib, and other vaccine preventable diseases are returning. Numerous factors–including the cost of acquiring and administering vaccines, an increasingly complex delivery system, as well as a small but growing number of parents who are forgoing vaccination for their children–put success in jeopardy.

West Virginia, however, is leading the nation in an important public health measure: school-age vaccination rates. We do so because we have the nation’s strongest vaccination requirements for children in school. This is something to be proud of because we are all better off for it. Be part of a winning team, make sure your and your family’s vaccines are up to date.

This post was written by Lisa M. Costello, MD, MPH, FAAP. You can hear a conversation with her about vaccines on the Appalachian Health Podcast. Dr. Costello is an Assistant Professor in the Department of Pediatrics at West Virginia University, Vice-President of the WV Chapter – American Academy of Pediatrics and Treasurer of the WVSMA. You can follow West Virginian’s premier #tweetiatrician on Twitter at @LisaCostelloWV.

Vaping: What we don’t know can kill us?

As of this week, the CDC has informed us that over 450 people have pulmonary illnesses that are linked to e-cigarette use including some in West Virginia.  They are also asking practitioners to help them find out if there are other illnesses yet to be identified that are linked to vaping.  Five people have been confirmed dead.  

These devices are relatively new to the market.  Though there have been patents going back to the 1930s for vaporizers for this purpose, the appearance of people sucking on a device that looks like a USB drive and blowing small puffs of the almost odorless vapor is relatively new. Since former United States Surgeon General C. Everett Koop warned the United States of the dangers of smoking cigarettes they’ve become less cool.  Still, close to one in four West Virginians is a daily tobacco user.  Companies like Altria are shifting their supply by buying the technology to create e-cigarettes and are advertising them as the new cool and less harmless that the cigarettes they have sold for years.  The CDCs release tells us otherwise. 

In my AHP interview with Dr. Sherri Young, a public health physician and author, we discussed the dangers of vaping and how we truly do not know what happens to those who do.  States are now outlawing the flavors like cotton candy and bubble gum that most in public health believe to be marketed to minors.  Right now, we don’t know what happens if you’re a life long vaper.  Dr. Young says parents should be talking with their children.

You can see the CDC’s information here: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Look for my interview, available on September 9th, with Dr. Young on the Appalachian Health Podcast available wherever you get great content or at dannyscalise.com

WVSMA Annual Meeting in the Books

WVSMA Annual Meeting August 25, 2019
The Greenbrier Resort
White Sulphur Springs, WV

The West Virginia State Medical Association finished its Annual Meeting last week.  As the largest gathering of physicians in the State, it left participants energized and ready to work.  The conference goers were more amazed by the star studded lineup than the spectacular Greenbrier Resort or majestic Greenbrier Valley.  This year’s theme was “The Year of Giving Back”.

The Friday morning sessions began with a welcome video from U.S. Senator Joe Manchin who thanked the WVSMA for working with him on the recent Jesse’s Law followed by Dr. Lorenzo Pence and Dr. Bob Foster who gave informative talks on Osteopathic Medicine in the 21st century.  Followed by the wildly popular “Lunch with the Deans” who gave updates on what West Virignia’s medical schools are working on right now and how they work together.  On top of other Friday topics, West Virginia’s Legislative Leadership addressed the crowd and took even the toughest of questions from the WVSMA membership.

Congresswoman Carol Miller opened the Saturday session that had a panel discussion on public health issues in West Virginia.  Dr. Rahul Gupta of the March of Dimes updated the membership on maternal & child health.  The afternoon’s festivities were punctuated by Dr. Sherri Young.  Dr. Young gave a riveting speech after being introduced by this video: https://wi.st/2ztX079.  She brought tears and a standing ovation.  There were other presentations in the afternoon, including Dr. Brooke Buckley’s discussion on emotional intelligence.  The education sessions ended on a true high note with a keynote address by Dr. Peter Salk on public health issues.  

The culmination of the event was the Mako Medical Gala that had Dr. Patrice Harris address the crowd. Dr. Harris is a Mercer County native, WVU Graduate, and current President of the American Medical Association. Justice Evan Jenkins administered the oath of office to WVSMA’s 2019-2020 leadership including Dr. Young who took the reigns as President.

WVSMA Annual Meeting

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In just a few short days, the West Virginia State Medical Association will gavel in its Annual Meeting at the Greenbrier Resort in White Sulphur Springs, WV.  This is the premier event for medicine and public health in West Virginia each year.  It brings together physicians from all specialities to learn and debate the health policy topics of the day.

The two day event begins on Friday, with Dr. Lorenzo Pence giving an lecture on the historic issue of Single GME Accreditation.  Later in the day the Deans of all three medical schools in West Virginia will present and answer questions from the audience on issues from medical education to social determinants of health.  Leadership from the West Virignia legislature will be on hand to discuss current topics in health policy.  Other topics for Friday sessions include osteopathic manipulation and health homes.

The event continues Saturday with nationally known speakers like Dr. Brooke Buckley of Meritus Health, Dr. Rahul Gupta from the March of Dimes, and vaccine expert Dr. Peter Salk.  Topics on Saturday include vaccines, maternal mortality, tobacco policy, emotional intelligence, and heart health.  The day will culminate in a gala sponsored by Mako Medical where AMA President and West Virginia native Dr. Patrice Harris will speak and Dr. Sherri Young being inaugurated as President of the Association.

This event is the premier gathering of the house of medicine in West Virginia. Registration is still available by going to wvsma.org.