Nobel Prize in Medicine Awarded to Swede Svante Pääbo

Nobel Prize in Medicine Awarded to Swede Svante Pääbo
Nobel Prize in Medicine Awarded to Swede Svante Pääbo

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STOCKHOLM — Swedish scientist Svante Paabo won the Nobel Prize in medicine Monday for his discoveries on human evolution that provided key insights into our immune system and what makes us unique compared with our extinct cousins, the award’s panel said.

Paabo spearheaded the development of new techniques that allowed researchers to compare the genome of modern humans and that of other hominins — the Neanderthals and Denisovans.

While Neanderthal bones were first discovered in the mid-19th century, only by unlocking their DNA — often referred to as the code of life — have scientists been able to fully understand the links between species.

This included the time when modern humans and Neanderthals diverged as a species, determined to be around 800,000 years ago, said Anna Wedell, chair of the Nobel Committee.

“Paabo and his team also surprisingly found that gene flow had occurred from Neanderthals to Homo sapiens, demonstrating that they had children together during periods of co-existence,” she said.

This transfer of genes between hominin species affects how the immune system of modern humans reacts to infections, such as the coronavirus. People outside Africa have 1-2% of Neanderthal genes.

Read More: 6 Groups Making Mental Health Care More Accessible to People of Color

Paabo and his team also managed to extract DNA from a tiny finger bone found in a cave in Siberia, leading to the recognition of a new species of ancient humans they called Denisovans.

Wedell described this as “a sensational discovery” that subsequently showed Neanderthals and Denisovan to be sister groups which split from each other around 600,000 years ago. Denisovan genes have been found in up to 6% of modern humans in Asia and Southeast Asia, indicating that interbreeding occurred there too.

“By mixing with them after migrating out of Africa, homo sapiens picked up sequences that improved their chances to survive in their new environments,” said Wedell. For example, Tibetans share a gene with Denisovans that helps them adapt to the high altitude.

“Svante Pääbo has discovered the genetic make up of our closest relatives, the Neanderthals and the Denison hominins,” Nils-Göran Larsson, a Nobel Assembly member, told the Associated Press after the announcement.

“And the small differences between these extinct human forms and us as humans today will provide important insight into our body functions and how our brain has developed.”

Paabo said he was surprised to learn of his win on Monday.

“So I was just gulping down the last cup of tea to go and pick up my daughter at her nanny where she has had an overnight stay, and then I got this call from Sweden and I of course thought it had something to do with our little summer house in Sweden. I thought, ‘Oh the lawn mower’s broken down or something,’” he said in an interview posted on the official home page of the Nobel Prizes.

He mused about what would have happened if Neanderthals had survived another 40,000 years. “Would we see even worse racism against Neanderthals, because they were really in some sense different from us? Or would we actually see our place in the living world quite in a different way when we would have other forms of humans there that are very like us but still different,” he said.

Paabo, 67, performed his prizewinning studies in Germany at the University of Munich and at the Max Planck Institute for Evolutionary Anthropology in Leipzig. He is the son of Sune Bergstrom, who won the Nobel prize in medicine in 1982. According to the Nobel Foundation, it’s the eighth time that the son or daughter of a Nobel laureate also won a Nobel Prize.

Scientists in the field lauded the Nobel Committee’s choice this year.

Read More: Human Waste Could Help the Fight Against Future Infectious Disease Outbreaks

David Reich, a geneticist at Harvard Medical School, said he was thrilled the group honored the field of ancient DNA, which he worried might “fall between the cracks.”

By recognizing that DNA can be preserved for tens of thousands of years — and developing ways to extract it — Paabo and his team created a completely new way to answer questions about our past, Reich said. That work was the basis for an “explosive growth” of ancient DNA studies in recent decades.

“It’s totally reconfigured our understanding of human variation and human history,” Reich said.

Dr. Eric Green, director of the National Human Genome Research Institute, called it “a great day for genomics,” a relatively young field first named in 1987.

The Human Genome project, which ran from 1990-2003, “got us the first sequence of the human genome, and we’ve improved that sequence ever since,” Green said. Since then, scientists developed new cheaper, extremely sensitive methods for sequencing DNA.

When you sequence DNA from a fossil millions of years old, you only have “vanishingly small amounts” of DNA, Green said. Among Paabo’s innovations was figuring out the laboratory methods for extracting and preserving these tiny amounts of DNA. He was then able to lay pieces of the Neanderthal genome sequence against the human sequencing coming out of the Human Genome Project.

Paabo’s team published the first draft of a Neanderthal genome in 2009. The team sequenced more than 60% of the full genome from a small sample of bone, after contending with decay and contamination from bacteria.

“We should always be proud of the fact that we sequenced our genome. But the idea that we can go back in time and sequence the genome that doesn’t live anymore and something that’s a direct relative of humans is truly remarkable,” Green said.

Katerina Harvati-Papatheodorou, professor of paleoanthropology at the University of Tübingen in Germany, said the award also underscores the importance of understanding humanity’s evolutionary heritage to gain insights about human health today.

“The most recent example is the finding that genes inherited from our Neanderthal relatives … can have implications for one’s susceptibility to COVID infections,” she said in an email to the AP.

The medicine prize kicked off a week of Nobel Prize announcements. It continues Tuesday with the physics prize, with chemistry on Wednesday and literature on Thursday. The 2022 Nobel Peace Prize will be announced on Friday and the economics award on Oct. 10.

Last year’s medicine recipients were David Julius and Ardem Patapoutian for their discoveries into how the human body perceives temperature and touch.

The prizes carry a cash award of 10 million Swedish kronor (nearly $900,000) and will be handed out on Dec. 10. The money comes from a bequest left by the prize’s creator, Swedish inventor Alfred Nobel, who died in 1895.

Jordans reported from Berlin. Ungar reported from Louisville, Kentucky. Maddie Burakoff contributed from New York.

More Must-Read Stories From TIME


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Hyaluronic Acid- 6 Stunning Benefits of Hyaluronic Acid

Hyaluronic Acid- 6 Stunning Benefits of Hyaluronic Acid
Hyaluronic Acid- 6 Stunning Benefits of Hyaluronic Acid

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Contributed by: Anjali Sharma 

Introduction 

Your body naturally produces hyaluronic acid, commonly referred to as hyaluronan, which is a transparent, sticky material.

The areas of your skin, connective tissue, and eyes contain the most of it.

Retaining water is its primary purpose in order to keep your tissues lubricated and wet.

The applications of this skin friendly acid are numerous. It’s popularly consumed as a supplement, but it’s also used via injections, topical serums, and eye drops.

Is hyaluronic acid safe?

Yes. According to research, hyaluronic acid is safe to use. It rarely causes reactions or side effects and using it while pregnant or breastfeeding is safe.

Benefits of Hyaluronic Acid

Promotes healthy and smooth skin

Your skin can feel and appear supple with hyaluronic acid supplements.

Your skin contains around half of your body’s hyaluronic acid, which binds to water to help keep your skin stay moist.

However, the ageing process, exposure to pollutants, cigarette smoking, and UV rays from the sun can reduce its levels in the skin.

By providing your body with more levels of it to integrate into the skin, supplements may be able to stop this loss.

Adults’ skin moisture levels have risen considerably with doses of 120-240 mg per day for at least a month.

It supports skin to stretch and flex and lowers skin wrinkles and lines. 

Helps in relieving joint pain 

The joints contain hyaluronic acid as well, which helps to maintain the area between your bones well-lubricated.

Bones are less prone to grind against one another and create painful discomfort when the joints are lubricated.

Supplements containing this acid are highly beneficial for patients with osteoarthritis, a degenerative joint condition brought on by the wear and tear of the joints over time.

People with osteoarthritis, particularly those between the ages of 40 and 70, can dramatically lessen knee discomfort by taking 80-200 mg daily for at least two months.

For pain treatment, hyaluronic acid can also be injected right into the joints. 

Boosts wounds healing 

Hyaluronic acid is crucial for the healing of wounds.

Although it occurs naturally in the skin, its levels rise when there is damage that has to be repaired.

By controlling levels of inflammation and telling the body to develop new blood vessels in the affected area,it promotes wound healing more quickly.

It has been demonstrated that using it to treat skin wounds can reduce the size of wounds and lessen discomfort more quickly than using a placebo or no therapy at all.

When topically administered to open wounds, its antibacterial characteristics can help lower the risk of infection.

Soothes dry eyes

Due to decreased tear production or tears that evaporate too rapidly, one out of every seven elderly persons experiences dry eye symptoms.

It is frequently used to treat dry eyes because of its great moisture retention capabilities.

Eye drops with 0.2 to 0.4 percent hyaluronic acid have been found to improve eye health and lessen the symptoms of dry eyes.

Additionally, slow-release hyaluronic acid-containing contact lenses are being created as a potential dry eye therapy.

It’s eye drops are also routinely used during eye surgery to reduce swelling and hasten the healing of wounds.

Aids acid reflux 

Supplemental hyaluronic acid may lessen acid reflux symptoms.

When acid reflux happens, the stomach’s contents are regurgitated up into the throat, resulting in discomfort and harm to the oesophagal lining.

It could ease the soreness and hasten the healing of the oesophagal lining.

Prevents bladder pain

A disorder known as interstitial cystitis, or painful bladder syndrome, affects 3 to 6 percent of women.

This condition results in a strong and persistent need to urinate, as well as stomach discomfort and soreness.

It has been discovered to help reduce the discomfort and frequent urination linked to interstitial cystitis when put directly into the bladder with a catheter, despite the fact that the origins of this ailment remain unclear.

Researchers believe that hyaluronic acid helps heal damaged bladder tissue, lessening the bladder’s sensitivity to discomfort, in addition to relieving these symptoms.

Side effects and precautions with hyaluronic acid

There have been very few negative effects associated with using hyaluronic acid in general.

As it is produced by the body, allergic responses are quite uncommon.

One trial of 60 individuals with osteoarthritis using 200 mg per day for a year found no adverse side effects.

However, as its effects during pregnancy or nursing, have not been properly investigated, these populations should exercise caution and abstain from consuming it as a supplement.

Additionally, some research suggests that hyaluronic acid might stimulate the growth of cancer cells since they are sensitive to it.

Because of this, it is typically suggested that anyone with cancer or a history of cancer avoid consuming it as a supplement.

Final thoughts

Most individuals may safely use hyaluronic acid supplements, which have numerous positive health effects.

Hyaluronic acid is widely known for its positive effects on the skin, particularly in decreasing dry skin, the appearance of fine lines and wrinkles, and accelerating the healing of wounds.

Additionally, it can assist those who have osteoarthritis in reducing joint discomfort.

Hyaluronic acid eye drops for dry eyes and catheter-based insertion of hyaluronic acid directly into the bladder for pain relief are two further significant applications.

Overall, it is a helpful dietary supplement for a number of ailments, particularly those affecting the skin and joints.

Furthermore, you should also undergo preventive health checkups. These health checks give a complete report about your health, allowing you to take necessary precautionary measures to improve your well-being and keep a host of ailments at bay.

Book The Full Body Good Health Test Today!

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The Dead Dad Club | Cup of Jo

The Dead Dad Club | Cup of Jo
The Dead Dad Club | Cup of Jo

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Emma Straub Peter Straub dad

Emma Straub Peter Straub dad

Anger is a step, right, a phase? I know that the phases of grief aren’t linear, but today I find myself tapping the keys on the ol’ anger piano, kind of like Tom Hanks in Big

I’m angry at the people who haven’t written to me to say that they’re sorry for the loss of my dad, I’m angry at the people who I’ve done favors for who haven’t written to say thank you, I’m angry at the fact that both of my children and I have gotten sick this month, and that we finally have childcare again, but I’m still unable to get any work done because of aforementioned sickness. I’m angry at people who say hello and tell me how excited they are for my new bookstore — sweet, well-meaning, book-loving people! Who obviously have no idea that my father just died and that I’m incapable of being excited about anything!

Pretty much the only people I’m not angry at are my booksellers, my husband, my mom, my children, and the four people who write me every day or so. I’m even angry at my cats for not being my beloved deceased cat, Killer, who slept on my neck every night. My cats are very good cats, they’re not just the best cats. Listen, I had to skip therapy today to pick up a sick kid, so apologies, I know this is not why you’re reading, to hear me malign my felines.

Today, when I took my sick kid to the doctor, the doctor and nurse told us over and over how funny we were, and how happy they were to have us, and I just thought, that is us — that is my kid, and me, and my dad, always always being the best patient, warm and charming to everyone, even when we feel terrible.

That was a good feeling — seeing the straight line between my dad and me and my children, but then someone sent me this poem (shout out to Sarah, not sure if you want credit or not, so I will not give your last name, but she’s Fancy and Literary, people), and it made me mad, too, in the I’m-mad-my-dad-died way. I was glad she sent the poem, and I cried.

Perfection Wasted
by John Updike

And another regrettable thing about death
is the ceasing of your own brand of magic,
which took a whole life to develop and market —
the quips, the witticisms, the slant
adjusted to a few, those loved ones nearest
the lip of the stage, their soft faces blanched
in the footlight glow, their laughter close to tears,
their tears confused with their diamond earrings,
their warm pooled breath in and out with your heartbeat,
their response and your performance twinned.
The jokes over the phone. The memories packed
in the rapid-access file. The whole act.
Who will do it again? That’s it: no one;
imitators and descendants aren’t the same.

Like, what the fuck, my brilliant, hilarious dad was irreplaceable, and I’m mad. I just cried again after pasting it in here.

I’ve been listening, slowly, to Anderson Cooper’s podcast about grief and cleaning out his mother’s apartment a few years after she died. If you’d asked me before I started listening if I had any particular thoughts about Anderson Cooper, I would have said no, but now I would say, Anderson is my brother, and I love him.

It’s so weird, grief. People keep welcoming me into the Dead Dad Club, or the dead parent club, or the worst club in the world, and I do think that in some ways, we’re all in the same club, but I also feel aware of how many different cliques there are, like Cher giving Tai a tour of the school campus in Clueless — the people who idolized their parent, the people who were still children when their parent died, the people who had unhappy, complicated relationships, the people who were estranged, the people who were surprised. I’m in so many different categories — the daughter category, the writer category, the lived-five-blocks-away-on-purpose category, the over share-r category, the optimist category, the parenting-to-small-children category.

We just hired a new babysitter, and she and the kids played a very good drawing game the other day, and when they were showing us their perfect masterpieces, many of them involved death, and she checked in, asking, Is this okay? Is this okay in this household? (Yes.) And that too made me think of my dad.

Not just because, yes, we’ve had this recent death and so it’s on our minds, but also that he wrote scary fucking books, and was always telling scary stories, and my parents’ house has always been full of monstrous-looking things, but also ALSO, and this is the most important part, the part I’m still trying to reckon with, because he always understood that the bad, scary, dark parts of life were integral. To ignore those parts, to skate over them on the smooth surface of life, meant that you weren’t actually paying attention, or that you’d been extraordinarily lucky, and that you just didn’t see the patch of rough ice ahead.

Right now, I’m trying to pay attention to these dark corners, these unfamiliar rooms. I feel a bit like I’m trying to find a light switch in a room that my father occupied for much of his life, a room I’d never been in before. How many metaphors fit in one paragraph? A lot.

I feel less mad now. Thank you for reading.


Emma Straub is a New York Times bestselling author. Her newest book, This Time Tomorrow, is an autobiographic time travel novel that follows her and her dad living in the Upper West Side in the ’90s. She’s also the co-owner of Books Are Magic bookstores. You can subscribe to her newsletter, if you’d like.

P.S. Emma’s house tour and how to write a condolence note.

(Photo courtesy of Emma Straub. This essay first appeared in her wonderful newsletter and is republished with permission.)

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 Effective Tips To Reduce Belly Fat 

 Effective Tips To Reduce Belly Fat 
 Effective Tips To Reduce Belly Fat 

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Contributed by Harleen kaur

Introduction

Did you know the most dangerous type of fat is belly fat?  

Belly fat develops in the lower abdomen, it can encircle internal organs. Poor food, insufficient exercise, stress, and other factors are a few causes of belly fat in many people.

Belly fat is the fat that has additional padding present beneath the skin (subcutaneous fat). It also includes visceral fat, which surrounds your internal organs and is deeply embedded in your abdomen.

Regardless of total weight, having a lot of belly fat promotes greater health risks like type 2 diabetes, colon cancer, cardiovascular disease, imbalance in insulin levels, and other conditions which can harm your overall well-being.

However, losing belly fat is not that easy. Commit yourself to wholesome, natural food, at least 30 minutes of daily exercise and maintain an active lifestyle. 

Here are some effective tips that can help you get rid of your belly fat:

Eat healthy food

A diet high in fruits and vegetables has been scientifically shown to have several health advantages, including lowering your chance of developing certain chronic diseases and maintaining good physical health. However, it’s also advised to concentrate on eating plant-based foods, such as whole grains, fruits, and vegetables which can limit your intake of unhealthy food and help you to shed lots of weight. 

Limit your portion size 

Calories accumulate even when you make healthy decisions. Reduce the size of your portions. 

This will help you in consuming fewer calories and you will intake less however there is a simple straight formula for this. Gaining weight occurs when you consume more calories than you burn. Additionally, you can reduce weight by eating fewer calories and indulging in more physical activity.

Indulge in workout 

A daily routine of exercises helps you get leaner and fitter in the long term. If you do not find time to visit a gym, you can even create a weight loss exercise plan at home. 

Moderate aerobic activity, such as brisk walking, and running, for at least 75 minutes a week can help you to lose a lot of weight. 

Additionally, Exercise can also be an effective lifestyle modification for weight loss and also has mental and physical benefits that can improve the overall quality of life in addition to weight loss.

Drink water 

Your body needs to consume an adequate amount of water every day. Multiple studies have shown that drinking water can help you lose weight, maintain your weight, and it may even slightly boost the number of calories you burn each day. Moreover, it is advised drinking water before meals can lessen hunger and help you to intake fewer calories.

Limit sugary products 

The next time you want to add a little sweetness to your favourite dish or beverage, carefully evaluate how many calories it will add. Heart disease, diabetes, excess weight, and many others are commonly linked to diets high in added sugar. Limiting your overall sugar consumption may help lower your risk of developing these conditions and improve other aspects of your well-being.

Final thoughts 

It will take a lot of patience and persistence to lose belly fat, but as we’ve all heard, slow and steady wins the race. You must remain motivated during the entire journey.

You are what you eat. Because your body responds to the food you eat, having a meal plan and some lifestyle modifications are necessary for reducing weight.

You can gradually lose weight by developing a daily routine of light to moderate exercise. When exercising, it’s important to start slowly and build up your intensity as you get used to a routine.  

Additionally, Knowing why the body stores belly fat is important since it may also be a sign of a health issue. Check your sugar levels, insulin resistance, thyroid levels, Polycystic Ovarian Disease (PCOD), and other hormone imbalances.

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Treating Bleeding Gums home remedies for gum bleeding

Treating Bleeding Gums home remedies for gum bleeding
Treating Bleeding Gums home remedies for gum bleeding

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Contributed by: Rachana Aarya

Although bleeding gums are very common, it is also mostly preventable if you begin treatment at an early stage. In this article, we have put together some natural home remedies you can add to your regimen to correct minor stages of bleeding gums.

Clove oil

Clinical research indicates that clove oil is one of the best home remedies, which has the natural ability to reduce the inflammation of gums and stop the gums from bleeding to a larger extent. While many different chemicals have been identified in clove oil, it is mainly the presence of the bioactive component eugenol that bestows it with strong anaesthetic and antibacterial properties. This oil has been used for centuries to treat bleeding gums, toothache, gingivitis, sore gums, etc. Additionally, its aromatic properties help to freshen your breath instantly and curb bad breath. 

To reap its benefits, just dab a small piece of moistened cotton into the clove oil and rub it all over the gums. Let it sit for one minute and then rinse your mouth with water to remove all bits of cloves and spit the water out completely. 

Turmeric

This wonder yellow powder is a popular home treatment for bleeding gums. This spice is readily available at home and has powerful anti-inflammatory and anti-bacterial properties. Its bioactive ingredient curcumin is works like a miracle in treating bleeding gums. As an antimicrobial and antifungal solution, it facilitates wound healing and keeps gum disease under control.

Topically apply a pinch of turmeric, twice a day, directly onto the gums and massage the area for about a minute to heal gum bleeding. 

Guava Leaf

Guava leaves are a powerhouse in dental hygiene. They help in curing bleeding from gums and keep the teeth healthy. There’s some research that suggests that the flavonoid in guava leaf can drastically reduce inflammation and bleeding. 

The tender leaves of the guava plant are imbued with potent anti-inflammatory and anti-bacterial properties, that offer a quick and easy remedy to treat bleeding gums right at home. Be it swollen gums, or gingivitis, these leaves play a crucial role in dealing with all kinds of dental issues.

You may chew guava leaves or make a paste of the leaves and apply it on the bleeding gums. Alternatively, boil a few guava leaves in water and rinse your mouth with it to get quick relief.

Green tea

Multiple research shows that there is a relation between intake of green tea and bleeding gums. Studies show that sipping green tea daily can give you healthier teeth and provide relief from bleeding gums. Green tea has a high concentration of catechin, a natural antioxidant that decreases the body’s inflammatory reaction to bacteria in the mouth.

Drink green tea twice or thrice a day for relief from gum bleeding. 

Salt Water

This process is an old folk remedy for curing bleeding gums. The most common cause of gum bleeding is bacterial growth and inflammation in the mouth. rinsing the mouth with warm salt water can soothe inflamed gums, restrict bacteria, relieve bad breath, and help ease pain 

Simply mix one teaspoon of salt to lukewarm water and swish it around in your mouth for a few seconds throughout the day at regular intervals to get respite from bleeding gums. 

Gum bleeding is common. Applying simple home care remedies can help in preventing gum bleeding and maintaining healthy gums, so that you may flash your pearly whites uninhibitedly.  

Having said that it is important to remember that these home care tips should not be considered as a replacement for your routine dental visit check-ups. These can in no way be regarded as a substitute for the medical treatment or cure of periodontal disease. Instead, they should complement them.

While the problem of bleeding gums is a very common dental and oral health condition, you can manage it by following proper oral hygiene. To know the exact reason that causes your gums to bleed, you should schedule an appointment with your doctor or go for a dental checkup.

Also,  it is advised to have frequent preventive health check-ups to keep an eye on overall health.

Book The Full Body Good Health Test Today!

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Severe Sleep Apnea Diagnosis Panics Reporter Until He Finds a Simple, No-Cost Solution

Severe Sleep Apnea Diagnosis Panics Reporter Until He Finds a Simple, No-Cost Solution
Severe Sleep Apnea Diagnosis Panics Reporter Until He Finds a Simple, No-Cost Solution

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I woke up in a strange bedroom with 24 electrodes glued all over my body and a plastic mask attached to a hose covering my face.

The lab technician who watched me all night via video feed told me that I had “wicked sleep apnea” and that it was “central sleep apnea” — a type that originates in the brain and fails to tell the muscles to inhale.

As a journalist — and one terrified by the diagnosis — I set out to do my own research. After a few weeks of sleuthing and interviewing experts, I reached two important conclusions.

First, I had moderate apnea, if that, and it could be treated without the elaborate machines, mouthpieces, or other devices that specialists who had consulted on my care were talking about.

Second, the American health care system has joined with commercial partners to define a medical condition — in this case, sleep apnea — in a way that allows both parties to generate revenue from a multitude of pricey diagnostic studies, equipment sales, and questionable treatments. I was on a conveyor belt.

It all began with a desire for answers: I had been feeling drowsy during the day, and my wife told me I snored. Both can mean obstructive sleep apnea. With obstructive sleep apnea, the mouth and throat relax when a person is unconscious, sometimes blocking or narrowing the airway. That interrupts breathing, as well as sleep. Without treatment, the resulting disruption in oxygen flow might increase the risk of developing certain cardiovascular diseases.

So I contacted a sleep-treatment center, and doctors gave me an at-home test ($365). Two weeks later, they told me I had “high-moderate” sleep apnea and needed to acquire a continuous positive airway pressure, or CPAP, machine, at a cost of about $600.

Though I had hoped to get the equipment and adjust the settings to see what worked best, my doctors said I had to come to the sleep lab for an overnight test ($1,900) to have them “titrate” the optimal CPAP air pressure.

“How do you treat central sleep apnea?” I worriedly asked the technician after that first overnight stay. She said something about an ASV (adaptive servo-ventilation) machine ($4,000). And one pricey lab sleepover wasn’t enough, she said. I needed to come back for another.

(Most procedures and devices mentioned in this article were covered or would have been covered by insurance — in my case, Medicare, plus a supplemental plan. Unnecessary care is a big reason Americans’ insurance costs — premiums, copays, and deductibles — tend to rise year after year.)

As a journalist who spent years covering the business of health care, I found there was more motivating my expensive testing cascade than concerns about my health.

The American Academy of Sleep Medicine, or AASM, a nonprofit based near Chicago, decides what is sleep apnea and how to treat it. Working with sleep societies around the world, it publishes the International Classification of Sleep Disorders, relied on by doctors everywhere to diagnose and categorize disease.

But behind that effort lie considerable conflicts of interest. Like so much of U.S. health care, sleep medicine turns out to be a thriving industry. AASM finances its operations in part with payments from CPAP machine manufacturers and other companies that stand to profit from expensive treatments and expansive definitions of apnea and other sleep disorders.

Zoll Itamar, which makes the at-home testing device I used, as well as implantable nerve-stimulation hardware for central sleep apnea, is a $60,000, “platinum” partner in AASM’s Industry Engagement Program. So is Avadel Pharmaceuticals, which is testing a drug to treat narcolepsy, characterized by intense daytime sleepiness.

Other sponsors include the maker of an anti-insomnia drug; another company with a narcolepsy drug; Fisher & Paykel Healthcare, which makes CPAP machines and masks; and Inspire Medical Systems, maker of a heavily advertised surgical implant, costing tens of thousands of dollars, to treat apnea.

Corporate sponsors for Sleep 2022, a convention AASM put on in Charlotte, North Carolina, with other professional societies, included many of those companies, plus Philips Respironics and ResMed, two of the biggest CPAP machine makers.

In a statement, AASM spokesperson Jennifer Gibson said a conflict-of-interest policy and a non-interference pledge from industry funders protect the integrity of the academy’s work. Industry donations account for about $170,000 of AASM’s annual revenue of about $15 million, she said. Other revenue comes from educational materials and membership and accreditation fees.

Here’s what else I found. Almost everybody breathes irregularly sometime at night, especially during REM sleep, characterized by rapid eye movement and dreams. Blood oxygen levels also fluctuate slightly.

But recent European studies have shown that standards under the International Classification of Sleep Disorders would doom huge portions of the general population to a sleep apnea diagnosis — whether or not people had complaints of daytime tiredness or other sleep problems.

A study in the Swiss city of Lausanne showed that 50% of local men and 23% of the women 40 or older were positive for sleep apnea under such criteria.

Such rates of disease are “extraordinarily high,” “astronomical,” and “implausible,” Dr. Dirk Pevernagie, a scientist at Belgium’s Ghent University Hospital, wrote with colleagues two years ago in a comprehensive study in the Journal of Sleep Research.

“Right now, there is no real evidence for the criteria that have been put forward to diagnose obstructive sleep apnea and rate its severity,” he said in an interview.

Likewise, 19% of middle-aged subjects in a 2016 Icelandic study appeared to have moderate to severe “apnea” under one definition in the International Classification of Sleep Disorders even though many reported no drowsiness.

“Most of them were really surprised,” said Erna Sif Arnardóttir, who led the study and is running a large European program to refine detection and treatment of apnea.

Nevertheless, the official AASM journal recommends extremely broad screening for sleep apnea, looking for patients who have what it defines as illness. Everybody 18 and older should be screened every year for apnea if they have diabetes, obesity, untreated high blood pressure, or heart disease — even if they have never complained about sleep problems, the group says.

AASM “continually evaluates the definitions, criteria and recommendations used in the identification of sleep apnea and other sleep disorders,” Gibson said in the statement. Meanwhile, routine screening by primary care doctors “is a simple way” of gauging whether a high-risk patient may have obstructive sleep apnea, the statement said.

The U.S. Preventive Services Task Force, an authoritative body that reviews the effectiveness of preventive care, takes a conservative view, more like that of the European researchers, concluding there is “insufficient” evidence to support widespread screening among patients with no symptoms.

Many insurers refuse to pay for CPAP machines and other treatments prescribed for people at the outer edges of the AASM’s apnea definition. But AASM is pressuring them to come around.

After all my reporting, I concluded that my apnea is real, though moderate. My alarming reading in the overnight lab — diagnosed quickly as central sleep apnea — was a byproduct of the testing machinery itself. That’s a well-described phenomenon that occurs in 5% to 15% of patients.

And when I looked closely at the results of my at-home diagnostic test, I had an epiphany: My overall score was 26 breathing interruptions and blood-oxygen level declines, on average, per hour — enough to put me in the “high-moderate” category for apnea. But when I looked at the data sorted according to sleeping positions, I saw that I scored much better when I slept on my side: only 10 interruptions in an hour.

So I did a little experiment: I bought a $25 pulse oximeter with a smartphone app that records oxygen dips and breathing interruptions. When I slept on my side, there were hardly any.

Now I sleep on my side. I snore less. I wake up refreshed. I’m not daytime drowsy.

None of my specialists mentioned turning on to my side — known in medical parlance as “positional therapy” — though the intervention is recognized as effective by many researchers. Sleeping on one’s back contributes to snoring and blockages, especially as people age and the muscles in the throat become looser.

“Positional patients … can sleep in the lateral position and sleep quite well,” said Arie Oksenberg, a sleep researcher formerly at Loewenstein Hospital in Israel.

But it’s not easy to find this in the official AASM treatment guidelines, which instead go right to the money-making options like CPAP machines, surgery, central apnea, and mouth appliances.

Dealing with apnea by shifting slightly in bed gets little more than a couple of paragraphs in AASM’s guideline on “other” treatments and a little box on a long and complex decision chart.

A third or more of patients wear CPAPs only a few hours a night or stop using them. It turns out people don’t like machines in their beds.

“Positional therapy is an effective treatment option for some patients,” said the AASM’s Gibson. But she said there are concerns about whether patients will sleep on their sides long term and whether trying to stay in one position might cause sleep interruptions itself.

It’s true that side-sleeping doesn’t help everybody. And it often takes practice. (Some people tape a tennis ball to their pajamas to keep them off their backs.) Even conservative sleep doctors say CPAP machines are the best solution for many patients.

But there is a largely overlooked alternative.

“Are we missing a simple treatment for most adult sleep apnea patients?” was the name of a 2013 paper that Oksenberg and a colleague wrote about positional therapy.

In my case, the answer was “yes.”

Jay Hancock is a former KHN senior correspondent.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Mental Health Crisis Teams Aren’t Just for Cities Anymore

Mental Health Crisis Teams Aren’t Just for Cities Anymore
Mental Health Crisis Teams Aren’t Just for Cities Anymore

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NEWTON, Iowa — Jeff White knows what can happen when 911 dispatchers receive a call about someone who feels despondent or agitated.

He experienced it repeatedly: The 911 operators dispatched police, who often took him to a hospital or jail. “They don’t know how to handle people like me,” said White, who struggles with depression and schizophrenia. “They just don’t. They’re just guessing.”

In most of those instances, he said, what he really needed was someone to help him calm down and find follow-up care.

That’s now an option, thanks to a crisis response team serving his area. Instead of calling 911, he can contact a state-run hotline and request a visit from mental health professionals.

The teams are dispatched by a program that serves 18 mostly rural counties in central and northern Iowa. White, 55, has received assistance from the crisis team several times in recent years, even after heart problems forced him to move into a nursing home. The service costs him nothing. The team’s goal is to stabilize people at home, instead of admitting them to a crowded psychiatric unit or jailing them for behaviors stemming from mental illness.

For years, many cities have sent social workers, medics, trained outreach workers, or mental health professionals to calls that previously were handled by police officers. And the approach gained traction amid concerns about police brutality cases. Proponents say such programs save money and lives.

But crisis response teams have been slower to catch on in rural areas even though mental illness is just as prevalent there. That’s partly because those areas are bigger and have fewer mental health professionals than cities do, said Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness.

“It certainly has been a harder hill to climb,” she said.

Melissa Reuland, a University of Chicago Health Lab researcher who studies the intersection of law enforcement and mental health, said that solid statistics are not available but that small police departments and sheriffs’ offices seem increasingly open to finding alternatives to a standard law enforcement response. Those can include training officers to handle crises better or seeking assistance from mental health professionals, she said.

The shortage of mental health services will continue to be a hurdle in rural areas, she said: “If it was easy, people would have fixed it.”

Still, the crisis response approach is making inroads, program by program.

White has lived most of his life in small Iowa cities surrounded by rural areas. He’s glad to see mental health care efforts strengthened beyond urban areas. “We out here get forgotten — and out here is where we need help the most,” he said.

Some crisis teams, like the one that helps White, can respond on their own, while others are paired with police officers or sheriffs’ deputies. For example, a South Dakota program, Virtual Crisis Care, equips law enforcement officers with iPads. The officers can use the tablets to set up video chats between people in crisis and counselors from a telehealth company. That isn’t ideal, Wesolowski said, but it’s better than having police officers or sheriffs’ deputies try to handle such situations on their own.

The counselors help people in mental health crises calm down and then discuss what they need. If it’s safe for them to remain at home, the counselor calls a mental health center, which later contacts the people to see whether they’re interested in treatment.

But sometimes the counselors determine people are a danger to themselves or others. If so, the counselors recommend that officers take them to an emergency room or jail for evaluation.

In the past, sheriffs’ deputies had to make that decision on their own. They tended to be cautious, temporarily removing people from their homes to ensure they were safe, said Zach Angerhofer, a deputy in South Dakota’s Roberts County, which has about 10,000 residents.

Detaining people can be traumatic for them and expensive for authorities.

Deputies often must spend hours filling out paperwork and shuttling people between the ER, jail, and psychiatric hospitals. That can be particularly burdensome during hours when a rural county has few deputies on duty.

The Virtual Crisis Care program helps avoid that situation. Nearly 80% of people who complete its video assessment wind up staying at home, according to a recent state study.

Angerhofer said no one has declined to use the telehealth program when he has offered it. Unless he sees an immediate safety concern, he offers people privacy by leaving them alone in their home or letting them sit by themselves in his squad car while they speak to a counselor. “From what I’ve seen, they are a totally different person after the tablet has been deployed,” he said, noting that participants appear relieved afterward.

A photo shows Jeff White looking out a window inside of the nursing home where he lives.
Jeff White is glad to see mental health care efforts strengthened beyond urban areas. “We out here get forgotten — and out here is where we need help the most,” he says.(KC McGinnis for KHN)

The South Dakota Department of Social Services funds the Virtual Crisis Care program, which received startup money and design help from the Leona M. and Harry B. Helmsley Charitable Trust. (The Helmsley Charitable Trust also contributes to KHN.)

In Iowa, the program that helps White always has six pairs of mental health workers on call, said Monica Van Horn, who helps run the state-funded program through the Eyerly Ball mental health nonprofit. They are dispatched via the statewide crisis line or the new national 988 mental health crisis line.

In most cases, the Eyerly Ball crisis teams respond in their own cars, without police. The low-key approach can benefit clients, especially if they live in small towns where everyone seems to know each other, Van Horn said. “You don’t necessarily want everyone knowing your business — and if a police car shows up in front of your house, everybody and their dog is going to know about it within an hour,” she said.

Van Horn said the program averages between 90 and 100 calls per month. The callers’ problems often include anxiety or depression, and they are sometimes suicidal. Other people call because children or family members need help.

Alex Leffler is a mobile crisis responder in the Eyerly Ball program. She previously worked as a “behavior interventionist” in schools, went back to college, and is close to earning a master’s degree in mental health counseling. She said that as a crisis responder, she has met people in homes, workplaces, and even at a grocery store. “We respond to just about any place,” she said. “You just can make a better connection in person.”

Thomas Dee, a Stanford University economist and education professor, said such programs can garner support from across the political spectrum. “Whether someone is ‘defund the police’ or ‘back the blue,’ they can find something to like in these types of first-responder reforms,” he said.

Critics of police have called for more use of unarmed mental health experts to defuse tense situations before they turn deadly, while law enforcement leaders who support such programs say they can give officers more time to respond to serious crimes. And government officials say the programs can reduce costly hospitalizations and jail stays.

Dee studied the Denver Support Team Assisted Response program, which lets 911 dispatchers send medics and behavioral health experts instead of police to certain calls. He found the program saved money, reduced low-level crime, and did not lead to more serious crimes.

Dr. Margie Balfour is an associate professor of psychiatry at the University of Arizona and an administrator for Connections Health Solutions, an Arizona agency that provides crisis services. She said now is a good time for rural areas to start or improve such services. The federal government has been offering more money for the efforts, including through pandemic response funding, she said. It also recently launched the 988 crisis line, whose operators can help coordinate such services, she noted.

Balfour said the current national focus on the criminal justice system has brought more attention to how it responds to people with mental health needs. “There’s a lot of things to disagree on still with police reform,” she said. “But one thing that everybody agrees on is that law enforcement doesn’t need to be the default first responder for mental health.”

Arizona has crisis response teams available throughout the state, including in very rural regions, because settlement of a 1980s class-action lawsuit required better options for people with mental illnesses, Balfour said.

Such programs can be done outside cities with creativity and flexibility, she said. Crisis response teams should be considered just as vital as ambulance services, Balfour said, noting that no one expects police to respond in other medical emergencies, such as when someone has a heart attack or stroke.

“People with mental health concerns deserve a health response,” she said. “It’s worth it to try to figure out how to get that to the population.”

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‘I can get my life back’ | Health Beat

‘I can get my life back’ | Health Beat
‘I can get my life back’ | Health Beat

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More than 500 black Sharpie markers. Fifty-foot swaths of white fabric. Forty hours a week for over a year.

That’s just some of what it took for Laura Clayton to create her two artistic renderings of Noah’s Ark, displayed in the Grand Rapids international artist competition, ArtPrize, in 2014 and 2017.

But there was one other critical element to her art that she took for granted.

A healthy right shoulder.

When she fell and injured her shoulder in 2020, it forced her to put her art on hold. Now, following surgery to repair a torn rotator cuff, she’s back at it—with her eyes on ArtPrize 2024.

“Now that the pain is gone, I feel like a free bird,” Clayton said. “I’m just so glad I can move it and use it.”

And that’s just what Kendall Hamilton, MD, an orthopedic surgeon with Spectrum Health Medical Group Orthopedics & Sports Medicine, likes to hear.

“She’s doing outstanding,” Dr. Hamilton said. “I think she’s one of the success stories. I’m happy that we’re able to intervene at a time when someone is experiencing so much pain, to step in and alleviate the pain so she can get back to doing the things she enjoys.”

Minimally invasive

Clayton’s health journey started in spring 2020, when she fell at her home in Comstock Park.

She had landed on her right shoulder. Having broken around a dozen bones throughout her life, she felt pretty sure she hadn’t broken anything.

“I thought, ‘Well, I didn’t break a bone, so I’m just a little bruised up,’” Clayton said.

So she lived with it. For a while.

“It just never got better,” she said.

She struggled with pain for close to two years, until in February 2021 she finally visited a doctor.

Conservative treatment with injections, anti-inflammatory medications and physical therapy didn’t work, so the doctor referred her to Dr. Hamilton.

“It just got to the point where she was unable to function and enjoy her hobbies,” Dr. Hamilton said.

An MRI revealed a torn rotator cuff, with both labral and bicep tearing.

On June 6, 2022, she underwent surgery to repair the damage. The doctor performed the outpatient procedure at the Spectrum Health South Pavilion Surgical Center, using a minimally invasive arthroscopic technique.

That meant quicker recovery with less swelling, less blood loss and less pain, Dr. Hamilton said.

Two days after surgery, she started physical therapy twice per week at the Spectrum Health facility in Rockford, at MVP Athletic Club. She then transitioned to therapy once a week and, in September, her therapist allowed her to do exercises at home.

Dr. Hamilton said he tells patients to plan on six months to recover after rotator cuff surgery, but Clayton is ahead of schedule.

“I’m really glad I have it back, so I can get back to my other project,” she said.

Creative spark

Clayton has already envisioned her new project clearly in her mind. It’ll be the final piece of the trilogy she started with the pieces displayed in ArtPrize 2014 and 2017.

The first, created with black Sharpie markers on a 65-by-10-foot piece of white fabric, depicts various animals gathering at Noah’s Ark. Called “Noah’s Ark: The Promise,” it was on display for ArtPrize outside Bridgewater Place.

In the second installment, “Noah’s Ark: The Gathering,” she used black Sharpies and a 50-by-14-foot fabric, but this one featured Noah bringing in a variety of dinosaurs. It was on display at Z’s Bar & Restaurant.

The third will be her most ambitious yet—a 3D piece called “Noah’s Ark: The Flood.”

This time, she’ll be using colored Sharpies. She also hopes to include sound and lighting effects.

Her friend, Donna Jager-Brower, plans to sew on animal figures that will protrude from the piece.

Clayton works on the artwork in her living room, on a 4-by-8-foot piece of steel on the floor. Sometimes, she makes mistakes in permanent ink. She lets those serve as a creative spark.

“I didn’t fret,” she said. “If something happened, I just say, ‘I wonder what that’s going to turn out to be.’”

Self-trained, she has always loved art.

“My mother noticed I was good at art when I was young,” Clayton said.

She has already purchased the white cotton material for the final art piece.

“Now I have the rest of my life to have a strong arm,” she said. “I can get my life back.”

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‘We can all play a role’ | Health Beat

‘We can all play a role’ | Health Beat
‘We can all play a role’ | Health Beat

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Asking someone how they’re doing is a better approach than not asking anything. Meaningful connection is a critical component in suicide prevention. (For Spectrum Health Beat)

While suicide continues to be a persistent and serious public health concern, there has been cause for hope in recent years: Suicide rates declined slightly in 2019 and 2020.

New treatments and interventions are showing promise, too, creating optimism in a field that once seemed bleak.

As researchers continue to look for innovations, they’re studying new opportunities, including better screening methods, faster response tactics and novel data collection methods through wearable technology.

When people can access the mental health resources they need, it can ultimately help them heal and find new hope.

But it all hinges on getting people the help they need, said Adelle Cadieux, PsyD, a pediatric psychologist at Spectrum Health Helen DeVos Children’s Hospital.

“We can all play a bigger part, being attentive to changes in our children, the adolescents in our lives, family members and coworkers,” she said. “Simply asking people if they’re OK is a great place to start.”

It’s essential to know the warning signs.

Not everyone will directly express that they are having thoughts of suicide, she said.

“They may just talk about death and dying or have a greater sense of hopelessness,” Dr. Cadieux said. “Sometimes they mention being a burden.”

Examples of other possible signs include arranging to have a pet cared for, or making arrangements to get rid of certain belongings.

One of the significant hurdles: overcoming shame or stigmas that may sometimes be associated with seeking mental health treatment. It’s critical for people to feel they can connect with a primary care or behavioral health provider for help.

“There are supports, including primary care and behavioral health providers,” Dr. Cadieux said. “If someone is having even passing thoughts, we want to stop them from becoming more frequent and intense thoughts.”

New tools

For decades, suicide rates had been getting worse. The rate increased 30% from 2000 to 2018, but then declined slightly in 2019 and 2020, according to the Centers for Disease Control and Prevention. Data from 2021 has yet to be published.

As one of the leading causes of death in the U.S., suicide remains an urgent concern. Nearly 46,000 people died from suicide in 2020. That translates to one death every 11 minutes.

Researchers, health care providers and schools continue to advance new tools to promote treatment and awareness.

Spectrum Health, for example, has developed the innovative Blue Envelope program, training thousands of team members to rapidly respond to a patient who may be having thoughts of suicide.

The program has been so effective, it was widely adapted as a separate program for schools, now in use throughout Western Michigan.

The training instructs people to keep the patient or student SAFE by:

  • Staying with the individual
  • Accessing help
  • Validating their feelings
  • Eliminating lethal risks

Help is available

Researchers are exploring other approaches, too. While some of these ideas are being studied for impact on specific risk groups, many show promise for larger populations.

New national helpline

Earlier this year, the U.S. government introduced 988, a three-digit crisis line. Whereas 911 connects callers to emergency services, 988 quickly puts people in distress in touch with local mental health support.

Sharper screenings

Another valuable tool is screening, often performed by providers in various clinical settings.

“These help, whether you came in because you are having headaches or you’re feeling depressed,” Dr. Cadieux said. “Depression, anxiety and suicidal thoughts can happen to anyone at any point. We want to connect patients (to) support as soon as possible.”

Tapping into tech

Smartphones and wearable devices may help, too. In one study, researchers monitored wearable use among adolescents, tracking heart rate, step count and other metrics three times a day, according to the American Psychological Association.

This kind of information may help monitor a patient’s mood by tracking any deviations from their baseline measurements, indicating a possible increased level of risk for suicide.

Evolving treatment

Therapy continues to be a critical tool to help patients who may struggle with mental health. And identifying the best therapy for the patient is essential.

An American Journal of Psychiatry study found that brief treatment—12 sessions of cognitive behavioral therapy—helped reduce suicidal risk in veterans by 60%.

Making connections

After early signs of promise, the U.S. Department of Veterans Affairs is engaged in a large-scale test of Caring Letters to better treat veterans.

After a veteran is released from the hospital, their providers send a number of personal notes of support, showing an interest in their well-being. These notes also include a reminder that help is available if they need it, and it provides information about nearby resources.

The ability to connect with others is important for everyone. “Having a connection with someone who will listen and be there is so important in supporting someone who is having suicidal thoughts,” Dr. Cadieux said.

Expanding support options

Beyond connecting with care providers for help, it’s also important for people to tap into growing support networks, Dr. Cadieux said.

There are groups designed to help those who are struggling with depression, such as the National Alliance on Mental Illness. There are also groups that can provide support to concerned family members.

Michigan also offers resources county by county, and it operates OK2SAY, a service that focuses on student safety.

Spectrum Health offers in-person and virtual appointments for mental and behavioral health treatment.

‘Being there for each other’

Every year, millions of people struggle with suicidal thoughts. Certain groups are at much higher risk, including Native Americans, Alaska Natives and non-Hispanic white populations.

Veterans and people who live in rural areas are also at higher risk, as are elderly people, as well as young people who identify as LGBTQ.

Certain professions, including first responders and those in the mining and construction industries, are also at higher risk.

Many health problems can elevate risk, too, including chronic illness, alcoholism and addiction.

And each pocket of risk reveals just how complex and widespread the problem is.

“Any person in any walk of life—any job, any age, any socioeconomic status—may have suicidal thoughts at some point,” Dr. Cadieux said. “This isn’t a veterans’ problem or a problem for adolescents.

“It’s an everybody problem. And we can all play a role in helping and being there for each other.”

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‘I changed everything, cold turkey’ | Health Beat

‘I changed everything, cold turkey’ | Health Beat
‘I changed everything, cold turkey’ | Health Beat

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When Alan Barchett showed up for his doctor’s appointment one day in March 2019, he suspected he had a urinary tract infection.

He’d been waking each night to use the bathroom.

“And then I’d realize I was really thirsty and pour myself a big glass of juice,” he said.

He anticipated that Alexander Hinckley, DO, his doctor at Spectrum Health Lakeland Medical Center, would agree. And he figured he’d leave the office with a prescription for antibiotics and be on his way home in no time.

That’s not what happened.

“I told him that he had horribly uncontrolled diabetes,” Dr. Hinckley said.

Barchett’s A1C levels registered in the 400s. Healthy levels are below 99.

The news stunned Barchett.

“In hindsight, it’s funny that I could have been so oblivious to what I now know are classic diabetes symptoms,” he said.

Barchett would need to inject daily insulin, likely for the rest of his life, Dr. Hinckley said. And he’d need to change his diet drastically.

“You mean, like starting today?” Barchett remembers asking.

“Yes, starting today,” Dr. Hinckley advised.

An abrupt change

Dr. Hinckley had no idea how seriously Barchett would take him.

Barchett met with Spectrum Health patient educators, who explained how to administer insulin injections on his own. They also suggested he change his diet.

“I asked if there was anything I could do to change this, to not need the insulin anymore,” he recalled.

“They told me that some people—although by no means all—can reverse symptoms by lifestyle changes alone,” he said. “And if I would radically change the way I eat, I might be able to use less of the medication. Or maybe even none at all.”

That’s all Barchett, now 68, needed to hear.

“I changed everything, cold turkey,” he said.

Although they told him he could maintain a healthy diet by carefully monitoring the carbs he consumed, Barchett wanted a stricter approach.

“I cut out all the carbohydrates,” he said. “No potatoes, rice, pasta, bread. I eliminated all that.”

Several months later, he returned for a checkup. By then, he’d lost weight and dramatically lowered his A1C level.

“Dr. Hinckley cut my insulin dosage by half,” Barchett said.

Then, at his next visit several months later, those numbers were even lower. Again, Dr. Hinckley decreased the insulin.

“And at the visit after that, he told me my sugar levels had improved so much that I didn’t need insulin,” Barchett said.

Dr. Hinckley switched Barchett to metformin, an oral medication used to help manage blood sugar. After several months, his A1C had improved so much that Dr. Hinckley took him off that, too.

“He told me I didn’t need to take anything,” Barchett said.

“Within one year, Alan went from having blood sugar readings in the 400s to not being a diabetic at all,” Dr. Hinckley said.

That kind of remission is possible, but not easy, the doctor said.

It typically requires weight loss and careful eating—the kind of lifestyle changes many people find difficult to maintain.

Dr. Hinckley estimates that, among his many patients with diabetes, only about half a dozen have achieved healthy blood-sugar levels with no medication.

But most can significantly improve their condition with less extreme effort.

Ongoing research from the Diabetes Prevention Program shows that losing 5% to 7% of body weight and logging an average of 150 minutes of physical activity each week can reduce the risk of developing diabetes by 58%.

And it can help reduce the need for medication for those who have already been diagnosed.

Dr. Hinckley said Barchett also has a secret weapon in his efforts: a supportive family. Marilyn, Barchett’s wife, has been on board from the beginning.

Often, Dr. Hinckley said, “patients find the diabetes diagnosis very discouraging. So when we have a spouse who is willing to help, it’s like finding the golden ticket.”

A new way of eating

It can often take people some time to truly enjoy a new eating style, as Barchett has, Dr. Hinckley said.

He often counsels patients to explore a Mediterranean diet with plenty of vegetables, fruits and healthy oils.

And he urges them to explore online resources.

Spectrum Health Lifestyle Medicine provides a wealth of healthy recipe ideas.

The American Diabetes Association offers helpful information, along with plenty of recipes. MyPlate has quizzes, recipes and more to help people identify healthier and easy-to-follow eating plans.

Dr. Hinckley also likes the resources at the Culinary Medicine Program, a collaboration of health care providers, nutritionists and researchers.

The point is to find an approach to carb-counting that can help get glucose readings back in range and sustainable over time.

For many people, that might be a less draconian approach than Barchett’s.

“It’s got to be about meeting the patient where they are and assessing what they’re willing to do,” Dr. Hinckley said. “Patient engagement plays the biggest role here. If they’re willing to make drastic changes, I’ll meet them there.”

Barchett has found it easy to stick with his new way of eating. He weighs 34 pounds less than on the day of his diagnosis.

“I keep away from all candies, ice cream, pies and cakes,” he said. “I haven’t had a doughnut in three years. Not even a fast-food hamburger.”

A rare cheat meal might entail sharing a few of his wife’s french fries when they go out to eat. His only sweets are fresh fruits.

“My idea of a splurge is a banana or some grapes,” Barchett said.

At restaurants, he chooses broiled fish or a salad.

“I’ve even gotten used to them without Thousand Island dressing, my old favorite.”

And he still monitors his A1C levels periodically with finger pricks to ensure he’s on the right path.

Exercise is part of his routine, too. He walks the country roads near his farm in Watervliet, Michigan, and often picks up trash along the way to keep things interesting.

“The other day, I picked up $5 in cans.”

Staying active is critical, Dr. Hinckley said.

“It helps mobilize your insulin, which allows glucose to be taken up by your body better,” he said.

Exercise also helps control blood sugar levels and reduces the risk of heart disease and nerve damage.

Barchett has turned his life around, Dr. Hinckley said.

“I’ve never had anybody who’s been quite so proactive about managing their health,” he said. “And I’m so glad. I use him as a benchmark for proving that dietary changes really can help.”

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