Unable to obtain morphine, Heather Weise, 50, lay balled up in pain at her home in Milford earlier this year. It took nine days to refill her narcotic painkiller and she blamed the clampdown on opioid prescriptions for her woes. “My pain’s up there with cancer,” said Weise, an administrative assistant at the sandwich-chain Subway. “I almost ended up at the ER.”
Weise suffers from adhesive arachnoiditis, an inflammation of membranes surrounding the brain and the spinal cord, for which she was prescribed a daily dose of 120 milligrams of the opioid painkiller morphine. When her prescription ran out in the stipulated 30 days for refills, she had nowhere to turn to for relief.
The death rate from heart disease plummeted nationally over several decades for all racial and ethnic groups, but the rate of decline has slowed slightly and African Americans and low-income individuals are still at a higher risk of developing the disease and dying from it, according to a report from the National Center for Health Statistics. The report isn’t surprising to Dr. Edward Schuster, medical director, Stamford Health Cardiac Rehabilitation Program. “In the United States, there’s a lot of talk about income disparity, which is a political hotcake,” Schuster said. “But what we are seeing is a life expectancy disparity. According to a recent Journal of American Medical Association, if you’re a man in the top 1 percent of income, you can expect to live 13 years longer than someone in the 1 percent at the bottom.”
Heart disease is largely preventable by maintaining a balanced diet, a healthy weight and moderate exercise, with only 20 percent of cases involving genetics, said Dr. David L. Katz, who heads the Yale-Griffin Prevention Research Center, which works with communities to develop programs to control chronic diseases. But significant groups in lower income and urban areas don’t—or can’t—act on the message, Katz said.
Every day an estimated 6,000 women in the U.S. reach menopause, a natural part of aging. But for countless women, it feels like anything but. The symptoms, which range from merely bothersome to debilitating, are triggered by the body’s loss of estrogen, which occurs at a median age of 50 to 52 among women in industrialized countries. Vasomotor symptoms alone (hot flashes, night sweats), which disrupt sleep and count as the most commonly reported complaint, last an average of 10 years and affect nearly 90 percent of menopausal women. A recent study published in the journal Menopause found that 250,000 women who suffered from hot flashes lost a cumulative $300 million per year in wages due to lost productivity and doctor visits, compared to asymptomatic women.
With physicians’ compensation from pharmaceutical and medical device companies under increasing scrutiny, payments to doctors in Connecticut for consultant work rose to $8.5 million in 2017, up from $8 million in 2016. Payments for meals, travel and gifts also increased from $3.2 million in 2016 to $3.5 million in 2017, data from the Centers for Medicare & Medicaid Services show. Of the total $27.2 million in payments, $4.37 million – or 16 percent – went to 10 doctors holding licenses in Connecticut. The highest paid doctor was Dr. Paul Sethi, an orthopedic surgeon in Greenwich, who accepted slightly more than $1 million in 2017 in royalty fees, consulting work, and other services from several companies, including Arthrex Inc., and Pacira Pharmaceuticals Inc., maker of Exparel. The drug, Exparel, is marketed as an alternative to opioid painkillers post-surgery.
The state Medical Examining Board today recommended reinstating the medical license of a former Yale School of Medicine department head who served nine months in prison for lying about his travel expenses while at Johns Hopkins University. In 2017, Dr. Jean-Francois Geschwind of Westport pleaded guilty to four counts of mail fraud arising from his scheme to unlawfully obtain travel expenses from Johns Hopkins, where he was a radiologist, according to the U.S. attorney in Maryland. Geschwind fraudulently received reimbursement for trips to the United Kingdom, France and Japan when some of the expenses were for family vacations and meals, the U.S. attorney said. He was ordered to pay fine of $75,000 and an assessment of $400 and restitution of $583,484, Connecticut and Maryland records show. A liver cancer researcher, Geschwind wrote to the Connecticut board that in 2015, he was recruited by Yale to become its new chair of the radiology department.
Robert Carmon had a rough start to life. Shortly after birth he developed asthma, a chronic disease that causes inflammation in the lungs and difficulty breathing. His attacks were so severe as an infant that his parents rushed him to the emergency room practically every week. They were terrified he might die. Today, at age 7, Robert’s asthma has stabilized.
The state Medical Examining Board Tuesday placed a Yale Cancer Center doctor’s license on probation for five years, saying his excessive abuse of alcohol affects his ability to practice as a physician. The board accepted a consent order that said Dr. Harris E. Foster Jr. abused alcohol to excess at various times between 2012 and May of this year. Last week, the cancer center’s website listed Foster as a professor of urology at the Yale School of Medicine and as the director of female urology and neuro-urology at the center in New Haven. After a reporter inquired about his status, the cancer center’s website on Tuesday only listed him as a urology professor. Mark D’Antonio, a spokesman for Yale New Haven Hospital, said Tuesday that Foster is still affiliated with the cancer center, but he cannot comment further because Yale does not comment on personnel matters.
Cancers linked to the human papillomavirus (HPV) rose dramatically in a 15-year period, even as the rates of young people being vaccinated climbed, the Centers for Disease Control and Prevention (CDC) reported. The 43,371 new cases of HPV-associated cancers reported nationwide in 2015 marked a 44 percent jump from the 30,115 cases reported in 1999, according to a CDC analysis. HPV vaccination rates have improved over the years, but not fast enough to stem the rise in cancers, the CDC said. Oropharyngeal (throat) cancer was the most common HPV-associated cancer in 2015; accounting for 15,479 cases among males and 3,438 among females, the CDC data show. HPV infects about 14 million people each year and between 1999 and 2015 rates of oropharyngeal (throat) and vulvar cancer increased, vaginal and cervical cancer rates declined, and penile cancer rates were stable, according to the CDC.
Among women, those who are low-income or minority are less likely to get treatment for depression, according to multiple studies. A report by the Connecticut Behavioral Health Partnership found that women were underrepresented in Medicaid-funded behavioral health services in the state even though research shows that women suffer from the most commonly diagnosed mental health disorders more frequently than men. Racial and ethnic disparities, while still considerable, are decreasing in some physical illnesses. “But in mental health care, in the last 10 years, we see those disparities widening,” said Megan Smith, associate professor in the Departments of Psychiatry and in the Child Study Center in the Yale School of Medicine, who runs the Mental health Outreach for MotherS (MOMS) Partnership®, a program that offers mental health services to “overburdened and under-resourced mothers.”
In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses the hurdles to mental health care and the programs breaking barriers to care with Yale’s Megan Smith and UConn Health’s Dr. Sarah Nguyen. Lack of insurance coverage, the cost of treatment, a shortage of qualified clinicians, stigma and even fear of losing custody of their children can keep women from seeking help, Smith said.
As fertility rates fall nationwide, Connecticut continues to rank among the lowest in the country—a trend doctors attribute to women here delaying childbearing. In 2016, the most recent year for which state-level data is available, Connecticut had 53.4 births per 1,000 women ages 15 to 44, compared with a national average of 62 per 1,000 women, according to data from the Centers for Disease Control and Prevention (CDC). Just four states had lower rates than Connecticut in 2016, and all are in New England: Vermont at 50.3 births per 1,000 women, New Hampshire at 50.9, Rhode Island at 51.8 and Massachusetts at 51.9. The states with the highest fertility rates in 2016 were South Dakota at 77.7, North Dakota at 77.3, Utah at 76.2 and Alaska at 76.1, the CDC reports. Unlike birth rates, which take an entire population into account, fertility rates reflect the share of babies born to women of childbearing age. Connecticut typically ranks low on the list, along with other “high achievement, high education states,” said Dr. Harold J. Sauer, chairman of obstetrics and gynecology at Yale New Haven Health’s Bridgeport Hospital.