Doctors: A Harder Death for People With Intellectual Disabilities

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Supported by Well | Live A Harder Death for People With Intellectual Disabilities Photo Credit iStock Hanover, N.H. — Several weeks after my patient was admitted to the intensive care unit for pneumonia and other problems, a clear plastic tube sprouted up from the mechanical ventilator, onto his pillow and down into his trachea. He showed few signs of improvement. In fact, the weeks on his back in an I.C.U. bed were making my 59-year-old patient more and more debilitated.
Still worse, a law meant to protect him was probably making him suffer more.
When the prognosis looks this bad, clinicians typically ask the patient what kind of care they want. Should we push for a miracle or focus on comfort? When patients cannot speak for themselves, we ask the same questions of a loved one or a legal guardian. This helps us avoid giving unwanted care that isn’t likely to heal the patient.
This patient was different. Because he was born with a severe intellectual disability, the law made it mu..

A Perplexing Marijuana Side Effect Relieved by Hot Showers

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Supported by Well A Perplexing Marijuana Side Effect Relieved by Hot Showers Photo Thomas Hodorowski quit smoking marijuana after learning his years-long bouts of nausea and vomiting were caused by his habit. Credit Joshua Lott for The New York Times By the time Thomas Hodorowski made the connection between his marijuana habit and the bouts of pain and vomiting that left him incapacitated every few weeks, he had been to the emergency room dozens of times, tried anti-nausea drugs, anti-anxiety medications and antidepressants, endured an upper endoscopy procedure and two colonoscopies, seen a psychiatrist and had his appendix and gallbladder removed.
The only way to get relief for the nausea and pain was to take a hot shower.
He often stayed in the shower for hours at a time and could be in and out of the shower for days.
When the hot water ran out, “the pain was unbearable, like somebody was wringing my stomach out like a washcloth,” said the 28-year-old, who works as a production ..

Marijuana Use Tied to Fatal Car Crashes

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Supported by Well | Live Marijuana Use Tied to Fatal Car Crashes Photo April 20 has become known as a day to celebrate the pleasures of marijuana consumption with parties that traditionally begin at 4:20 p.m.
But a study in JAMA Internal Medicine has found that the high spirits may have a price: a significant increase in fatal car wrecks after the “4/20” party ends.
Researchers used 25 years of data on car crashes in the United States in which at least one person died. They compared the number of fatal accidents between 4:20 p.m. and midnight on April 20 each year with accidents during the same hours one week before and one week after that date.
Before 4:20 p.m. there was no difference between the number of fatalities on April 20 and the number on the nearby dates. But from 4:20 p.m. to midnight, there was a 12 percent increased risk of a fatal car crash on April 20 compared with the control dates. The increased risk was particularly large in drivers 20 and younger.
“These crashe..

Phys Ed: Bananas vs. Sports Drinks? Bananas Win in Study

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Supported by Well | Move Bananas vs. Sports Drinks? Bananas Win in Study Photo Credit iStock A banana might reasonably replace sports drinks for those of us who rely on carbohydrates to fuel exercise and speed recovery, according to a new study comparing the cellular effects of carbohydrates consumed during sports.
It found that a banana, with its all-natural package, provides comparable or greater anti-inflammatory and other benefits for athletes than sports drinks. But there may be a downside, and it involves bloating.
For decades, athletes and their advisers have believed, and studies have confirmed, that eating or drinking carbohydrates during prolonged exertion can enable someone to continue for longer or at higher intensities and recover more quickly afterward than if he or she does not eat during the workout.
The carbohydrates rapidly fuel muscles, lessening some of the physiological stress of working out and prompting less inflammation afterward.
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The Final Obamacare Tally Is In. About 400,000 Fewer People Signed Up This Year.

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Supported by Health The Final Obamacare Tally Is In. About 400,000 Fewer People Signed Up This Year. Photo The Centers for Medicare and Medicaid Services said on Tuesday that 11.8 million people signed up for insurance under the Affordable Care Act for 2018, a slight drop from the previous year. Credit Joe Buglewicz for The New York Times WASHINGTON — The Trump administration said on Tuesday that 11.8 million people had signed up for health insurance through the Affordable Care Act marketplaces for 2018 — roughly 400,000 fewer than last year. The drop was relatively small, given that Mr. Trump had sharply cut federal outreach efforts and the open enrollment period was half as long as in past years.
Virtually the entire decrease came in the 39 states that use the marketplace run by the federal government, HealthCare.gov. In the 11 states that sell coverage for the Affordable Care Act — popularly known as Obamacare — through their own marketplaces, enrollment remained the same as la..

ScienceTake: Hot Springs Lower Stress in Japan’s Popular Bathing Monkeys

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Hot Springs Lower Stress in Japan’s Popular Bathing Monkeys

The snow monkeys of Japan are famous, as monkeys go. This troop of Japanese macaques lives in the north, near Nagano, the mountainous, snowy site of the 1998 Winter Olympics.
Others of their species live even farther north, farther than any other nonhuman primate, so they are able to adapt to winter weather.
But the source of this troop’s fame is an adaptation that only they exhibit: soaking in hot spring bathing pools. Their habitat is full of natural hot springs that . tend to be over 140 degrees Fahrenheit, a temperature that is apparently uncomfortable for the monkeys.
It wasn’t until 1963 that a young female macaque was first observed bathing in a pool built by a hotel, with the water cooled to a temperature comfortable enough for humans and monkeys.

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At first, one or two monkeys joining human visitors were a curiosity , but eventually they bec..

Nonfiction: A Reckoning With an Imperfect Science in ‘Blue Dreams’

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Supported by Book Review | Nonfiction A Reckoning With an Imperfect Science in ‘Blue Dreams’ Photo Credit Sophy Hollington BLUE DREAMS
The Science and the Story of the Drugs That Changed Our Minds
By Lauren Slater
400 pp. Little, Brown & Company. $28.
In 1988, Lauren Slater put a single cream-and-green pill in her mouth and, with a sip of water, became one of the first patients in the United States to take Prozac. She also emerged as one of its most poetic chroniclers when she detailed her heady, complex love affair with the drug in “Prozac Diary” (1998).
Thirty years since that first dose, neither Slater nor the drug has aged particularly well. Slater, who has spent much of her life wrestling with bipolar and obsessive-compulsive disorders, jumped from an initial prescription of 10 milligrams to 20 to 30 to 60, landing at 80 mg, which is where she left off in “Prozac Diary.” A doctor eventually upped her dose to 100 mg a day — 20 beyond what’s F.D.A. approved. But the drug tha..

Older Americans Are ‘Hooked’ on Vitamins

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Supported by Well Older Americans Are ‘Hooked’ on Vitamins Photo Credit Tony Cenicola/The New York Times When she was a young physician, Dr. Martha Gulati noticed that many of her mentors were prescribing vitamin E and folic acid to patients. Preliminary studies in the early 1990s had linked both supplements to a lower risk of heart disease.
She urged her father to pop the pills as well: “Dad, you should be on these vitamins, because every cardiologist is taking them or putting their patients on [them],” recalled Dr. Gulati, now chief of cardiology for the University of Arizona College of Medicine-Phoenix.
But just a few years later, she found herself reversing course, after rigorous clinical trials found neither vitamin E nor folic acid supplements did anything to protect the heart. Even worse, studies linked high-dose vitamin E to a higher risk of heart failure, prostate cancer and death from any cause.
Dr. Gulati told her father he “might want to stop taking” the vitamins.
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