Category Archives for Healthcare

Putting the Brakes on Testosterone Prescriptions

Published in Pawtucket Times on March 30, 2015

Sophisticated mass marketing pitching testosterone to combat age-related complaints combined with lax medical guidelines for testosterone prescribing can be hazardous to your physical health, even leading to strokes and death, warns an editorial in this month’s Journal of the American Geriatrics Society.
The March 2015 editorial coauthored by Dr. Thomas Perls, MD, MPH, Geriatrics Section, Department of Medicine, Boston Medical Center in Boston, and Dr. David Handelsman, MBBS, Ph.D., ANZAC Research Institute, in New South Wales, Australia, expressed concern over commercial-driven sales of testosterone, effectively increasing from “$324 million in 2002 to a whopping $2 billion in 2012, and the number of testosterone doses prescribed climbing from “100 million in 2007 to half a billion in 2012.”

Pitting Patients Against Patients

The editorial authors see the “40 fold” increase of testosterone sales as the result of “disease mongering,” the practice of widening the diagnostic boundaries of an illness and aggressively promoting the disease and its treatment in order to expand the markets for the drug. Glitzy medical terms, like “low T” and “andropause,” showcased in direct-to-consumer product advertising pit aging baby boomers against their physicians, who demand the prescriptions, say the authors.

“Clearly, previous attempts to warn doctors and the public of this disease mongering that is potentially medically harmful and costly have not been effective, says co-author Dr. Perls.

The epidemic of testosterone prescribing over the last decade has been primarily the proposing of testosterone as a tonic for sexual dysfunction and/or reduced energy in middle-aged men, neither of which are genuine testosterone deficiency states,” observes Dr. Handelsman.

According to the National Institutes on Aging (NIA), the nation’s media has increasingly reported about “male menopause,” a condition supposedly caused by diminishing testosterone levels in aging men. “There is very little scientific evidence that this condition, also called andropause or viropause, exists. The likelihood that an aging man will experience a major shutdown of testosterone production similar to a woman’s menopause is very remote.”

The authors agree with the NIA’s assessment, but go further. They point out in their editorial that for many men, testosterone does not decline with age among men retaining excellent general health, and if it does, the decline is often due to common underlying problems such as obesity and poor fitness. Those who hawk testosterone have developed advertising that focus on common complaints among older men such as decreased energy, feeling sad, sleep problems, decreased physical performance or increased fat.

But, many times a testosterone level won’t even be obtained and the patient is told that, simply based on these common symptoms alone or with minor reductions in serum testosterone, they have “late onset hypogonadism” or that their erectile dysfunction may be improved with testosterone treatment, say the authors. But the authors also point out the true hypogonadism is the cause in fewer than 10% of men with erectile dysfunction.

FDA Enters Debate

The U.S. Food and Drug Administration’s (FDA) recent dual commission findings concluded that testosterone treatment (marketed as ‘low T’) is not indicated for age-associated decline. The benefits of this “deceptive practice” remain unproven with the risks far outweighing the perceived benefits,” says the agency. Pharmaceutical companies are now required to include warning information about the possibility of an increased risk of heart attacks and stroke on all testosterone product labels.

Health Canada, Canada’s FDA, recently echoed the FDA’s committee findings that age-related hypogonadism has not been proven to be a disease-justifying treatment with testosterone. Both agencies warn of an increased risk of blood clots in the legs and lungs and the possibility of increased risk for heart attack associated with testosterone use.

In a statement, James McDonald, the chief administration officer for the Board of Medical Licensure and Discipline, says: “There is a concern in healthcare regarding direct-to-consumer prescribing of medication. At times, the prescription is not evidence-based, and can lead to misuse. There is concern with Testosterone, a schedule 3 controlled substance,that can be used as a performance-enhancing drug. The Rhode Island Board of Medical Licensure (BMLD) investigates complaints regarding all types of misuse of prescription medications as well as complaints regarding over-prescribing.”

Drs. Handelsman and Perls also warn about another drug commonly hawked for anti-aging, growth hormone. The FDA requires that doctors perform a test to demonstrate that the body does not produce enough growth hormone. “Those who market and sell HGH for these common symptoms nearly never perform the test because if they did a properly performed test, it would almost never be positive because the diseases that cause growth hormone deficiency in adults, such as pituitary gland tumors, are very rare,” said Perls. Growth hormone is well known for its side effects, including joint swelling and pain and diabetes. Ironically, opposite of anti-aging claims, growth hormone accelerates aging, increases cancer risk and shortens life span in animal studies.

In the editorial, Perls and Handelsman call upon professional medical societies and governmental agencies to take definitive steps to stop disease mongering of growth hormone and testosterone for conjured-up deficiencies.
“These steps include the banning of ‘educational’ and product advertising of testosterone for these contrived indications,” said Perls. “Furthermore, the FDA and Health Canada should require a physician’s demonstration of a disease process proven to benefit from testosterone administration in order to fill a lawful prescription for testosterone.”

Tightening Up Prescription Guidelines

The issue of prescribing testosterone is firmly on the medical profession’s radar screen with the FDA’s recent committee’s findings and Perls and Handelsman’s pointed editorial calling for the medical profession to seriously tighten up the lax consensus guidelines in order to stop the medically inappropriate prescribing of testosterone.
Rather than pushing testosterone, wouldn’t it be a “mitzvah – a good deed- if the nation’s pharmaceutical companies ran public service commercials stressing the importance of losing weight, exercising and eating nutritious meals as a way to effectively combat age-related problems, like low libido. But, this won’t happen because it is not a revenue generator or good for the company’s bottom line.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Rhode Island Can Hold Its Own When It Comes to Music

Published in Woonsocket Call, on March 15, 2015

New York, L.A. and Nashville have long been considered the music capitals of the United States. Now, with the Rhode Island Music Hall of Fame gearing up for its fourth annual induction season, Little Rhody is poised to prove it has the right combination of musical talent to hold its own against these highly regarded music communities.

Next month, trombonist/composer George Masso and 12 others join an elite group of Rhode Island musicians: those who have been recognized not only for their major impact on Rhode Island’s music scene but also on the national stage. Cranston native Masso, along with the other new inductees, will be enshrined by the Rhode Island Music Hall of Fame (RIMHOF) at this year’s induction ceremonies and concert events. Every year the Pawtucket-based nonprofit, formed in 2011, celebrates, honors, and preserves the legacy of Ocean State musicians, educators, and industry professionals.

Rick Bellaire, RIMHOF Vice Chair and Archive director, says it was an easy choice to recognize the 88-year-old musician. “During his illustrious career, George has excelled in just about every area of the music business – trombonist, composer, pianist, recording artist, arranger and educator,” adding that the George played with many of the national big bands in the 1940s and ‘50s and has toured and recorded as a sideman with some of our greatest jazz legends including Benny Goodman, Bobby Hackett and The World’s Greatest Jazz Band.

According to Bellaire, Masso has also released more than a dozen albums as a leader which feature many of his own compositions. “He also taught music in the Cranston public schools for eleven years and another eight years at the University of Connecticut mentoring some of our finest musicians including RIMHOF inductees,” says Bellaire.

George Masso will be inducted into RIMHOF along with Mark Cutler and his bands, The Schemers and Raindogs; Brenda Bennett, Nelson Eddy, George Wein, Duke Belaire, Paco Zimmer; Georgie Porgie & The Cry Babies, The Others and The Ascots (recognizing the great Rhode Island garage bands of the ‘60s); and Bob Petteruti, Marty Ballou and Marty Richards (in the new “MVP sideman award” category).

“This year, we will be honored to have some of the most senior inductees with us,” he continued, “all of whom are still active participants on the music scene, including Mr. Masso, drummer/band leader Duke Belaire (83) and bassist/educator Bob Petteruti (85).”

The Music Hall of Fame initiative,” says Bellaire, “provides a great opportunity to not only acknowledge Rhode Island’s musical greats and celebrate their achievements, but to finally have an organization whose primary goal is to promote and preserve Rhode Island’s rich musical heritage in all its forms. With actual exhibit space, coupled with our online archive, we have in place the tools to curate and showcase the best of Rhode Island’s musical artistry.”

Adds Robert Billington, Chair of RIMHOF noted, “This year’s class of inductees is especially amazing due to the variety of music styles and musical periods that we are recognizing. The thousand Saturday nights that these musicians spent on the road throughout their careers will be recognized this April as their colleagues throughout Rhode Island stand to applaud their successes.”

“Our Induction ceremony in April has become the place for a ‘who’s who’ in Rhode Island music. The Rhode Island Music Hall of Fame Induction Ceremony and Concert is the place to be and be seen at as we continue to showcase the history of Rhode Island’s musical heroes,” says Billington.

This year, Bellaire said, there will be two induction events, and 11 more displays will be unveiled to celebrate inductees. Eventually, the museum will have more than 100 displays as well as memorabilia and interactive components.

The 2015 induction ceremonies will take place on two days, April 20 and April 26, at two separate locations.

The jazz inductions will take place on Monday, April 20, 7:00 p.m. at Bovi’s Tavern, 287 Taunton Avenue, East Providence, before the weekly performance by the Bovi’s big band, the John Allmark Orchestra. Being honored on that day will be George Masso, Bob Petteruti and Duke Belaire, the founder of the Bovi’s band.

The Induction Ceremony and Concert is set for Sunday, April 26, 2:00 p.m. at The Met and Hall of Fame itself, both located within the Hope Artiste Village complex, 999 Main St., Pawtucket, RI. Sunday’s afternoon event will include the unveiling of nine new exhibits as well as performances by The Schemers and Raindogs, Brenda Bennett, The Ascots, The Others, and an all-star jam session led by two of this year’s MVP sideman award winners, Marty Ballou and Marty Richards. Sunday’s concert will be preceded by the unveiling of eleven new 2015 inductee exhibits.

Tickets for the April 26 event at The Met are $20.00 in advance and $25.00 at the door. The 2 p.m. unveiling of the inductee exhibits is free and open to the public; a ticket will be required for entrance to the 3 p.m. concert in The Met. Information regarding the April 20 event and tickets for April 26 can be found at www.rhodeislandmusichalloffame.com.

All proceeds from RIMHOF’s annual induction events go toward creating the museum displays, acquiring recordings and memorabilia, and digitizing that collection for permanent online access for future generations. All organizational work has been donated by members of the Board Of Directors and a staff of volunteers.

For general information regarding the Rhode Island Music Hall of Fame, contact Dr. Robert Billington at 401-724-2200 or at bvri@aol.com.

Herb Weiss LRI ’12 is a Pawtucket-based writer who covers aging, health care and medical issues.  He can be reached at hweissri@aol.com.

President’s Budget Addresses Issues of Interest to Seniors

Published in Pawtucket Times on February 27, 2015
President Obama released his 141 page ‘policy and wish list” when he unveiled his politically ambitious FY 2016 budget on Feb 2, not having to worry about running for president in the upcoming 2016 presidential election cycle.

Yes, even inside the Washington Beltway a picture is truly worth a thousand words. Gone is the budget’s plain blue cover replaced by a black and white photo of the Tappan Zee Bridge in New York, an image that projects one of the President’s spending priorities of rebuilding the nation’s infrastructure to create jobs and improve the transportation system.

The $4 trillion presidential budget, a political campaign document outlaying his policies and priorities, would cancel automatic sequestration cuts to domestic and military programs over a 10 year period. According to the New York Times, Obama’s budget proposal would add $6 trillion to the national debt, and the single-year deficit would rise to $687 billion by 2025.

Obama’s FY 2016 budget puts more funding into education, rebuilding the nation’s infrastructure, increased defense spending, along with providing tax relief for America’s middle class while increasing the taxes for corporate America and the wealthy. Political insiders say that Obama’s budget, one that gives to the middle class and assesses higher taxes from corporate America and the wealthy, sets the issues to be surely debated in the upcoming presidential election. .

A Look at Aging Priorities

On her Feb. 3 blog post, Nora Super, executive director of the upcoming White House Conference on Aging, details how the recently released budget proposal will “ensure that older Americans enjoy not only longer but healthier lives.”

As to retirement security, Super notes that the Obama Administration strongly opposes any legislative measures that would privatize the nation’s Social Security program, or slash benefits for future generations or reduce basic benefits to current beneficiaries. Super says that half the nation’s workforce, that’s about 78 million, does not have a retirement savings plan at work. “Fewer than 10 percent of those without plans at work contribute to a plan of their own. The President’s FY 2016 Budget expands retirement opportunities for all Americans to help families save and give them better choices to reach a secure retirement,” she says.

According to Super, Obama’s Budget proposal supports healthy aging by strengthening the Medicare program by “aligning payments with the costs of providing care, along with encouraging health care providers to deliver better care and better outcomes for their patients, and improving access to care for beneficiaries.”

To put the brakes to rising prescription drug costs, Super notes that the President’s Budget proposes to close the Medicare Part D donut hole for brand drugs by 2017, rather than 2020, by increasing discounts from the pharmaceutical industry. The Budget proposal also gives the Secretary of Health and Human Services new authority to negotiate with drug manufacturers on prices for high cost drugs and biologics covered under the Part D program.

Linking nutrition to healthy aging, Super says that Obama’s Budget provides “over $874 million for Nutrition Services programs, a $60 million increase over the 2015 enacted level, allowing States to provide 208 million meals to over 2 million older Americans nation-wide, helping to halt the decline in service levels for the first time since 2010.” Also, Obama’s budget ratchets up funding for supportive housing for very low-income elderly households, including frail elderly, to give these individuals access to human services, she adds. .

Protecting older persons from elder abuse, neglect and financial exploitation, Super blogs that the President’s budget proposal includes $25 million in discretionary resources for Elder Justice Act programs authorized under the Affordable Care Act. “Funding will “improve detection and reporting of elder abuse; grants to States to pilot a new reporting system; and funding to support a coordinated Federal research portfolio to better understand and prevent the abuse and exploitation of vulnerable adults,” she says.

Here’s Super’s take on the Obama budgetary blueprint: “Taken together, these and other initiatives in the Budget will help to change the aging landscape in America to reflect new realities and new opportunities for older Americans, and they will support the dignity, independence, and quality of life of older Americans at a time when we’re seeing a huge surge in the number of older adults.”

In a released statement, AARP Executive Vice President Nancy LeaMond gives thumbs to the president’s efforts to “lower the cost of prescription drugs, promote better care, reward improved outcomes and make health care programs more efficient and less wasteful.” She also expresses her nonprofit group’s support for the President’s budgetary priorities to “create opportunities for the middle class” and his goal “to make saving for retirement easier.”

But, LeaMond expresses concerns that higher premiums, deductibles and copays might shift costs to older Americans. “As the federal deficit continues shrinking, we must find responsible solutions for strengthening critical programs and improving the retirement and overall economic security of current and future generations. We must also look for savings throughout the entire health care system, as the rising cost of health care threatens people of all ages,” she says.

In his statement, President/CEO Max Richtman, of the Washington, DC-based National Committee to Preserve Social Security and Medicare, agrees with LeaMond’s concerns of higher premiums, deductible’s and co pays, too. “While some tout increasing means testing in Medicare as a way to insure ‘rich’ seniors pay their share, the truth is, the middle-class will take this hit as well,” he predicts.

Political pundits say that Obama’s 2016 budget was dead-on arrival at Capitol Hill the day it was released at the beginning of February. In the shadow of the upcoming 50th Anniversary of Medicare, Medicaid, and the Older Americans Act, as well as the 80th Anniversary of Social Security, GOP leadership in both chambers of Congress must work with the Democratic President to hammer out a bipartisan compromise. Putting budgetary proposals that strengthens the nation’s programs and services for older Americans on the chopping block for purely political reasons is not acceptable, especially to a nation that opposes political gridlock.

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.