Hundreds of thousands of people in Kentucky got health insurance under the Affordable Care Act, but the state is also home to Senate Majority Leader Mitch McConnell who’s led efforts to kill the law. With the failure of the latest GOP attempt to replace the ACA, the state’s voters weigh in.
For analysis about the future of the Senate GOP health care bill, David Greene talks to Matthew Continetti, editor-in-chief of the conservative publication the Washington Free Beacon.
Senate Republicans have shelved their health care bill after two more Senate Republicans, Mike Lee and Jerry Moran, announced their opposition to the bill Monday night.
Steve Inskeep talks to Democratic Sen. Mazie Hirono of Hawaii about her party’s strategy going forward as Republicans tried to repeal and replace the Affordable Care Act, also known as Obamacare.
Sen. John McCain, R-Ariz., has been critical of how the GOP health overhaul bill would affect people in his state.
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The initial report of Sen. John McCain’s surgery sounded simple: the removal of a blood clot above his left eye. But it was actually brain surgery, and the clot was almost 2 inches long.
The surgery prompted Senate Majority Leader Mitch McConnell to delay a vote on the health care bill until the 80-year-old McCain is well enough to return to the Senate.
As NPR’s Geoff Bennett and Tamara Keith reported, “the Republican senator’s absence from the Capitol would have complicated the already tight math surrounding a planned Senate health care vote to repeal and replace the Affordable Care Act.”
But it remains unclear how long McCain’s convalescence will last.
NPR’s Robert Siegel spoke with Dr. Peter Najaki, director of the neurosurgery residency program at the Barrow Neurological Institute in Phoenix, about the kind of surgery McCain had and how long his recovery might take. He was not involved in McCain’s care. These excerpts have been edited for length and clarity.
Sen. McCain’s office describes the procedure as a minimally invasive craniotomy with an eyebrow incision. What does that mean?
So there are a lot of ways to get into the head, and some are more invasive and some are less. What that really means is that instead of making a large opening in the head and opening a large window through the skull, we make a small one right over the eye through the eyebrow and open a little window and really make a direct route to whatever we need to get to, assuming it’s right under that spot.
The blood clot was described as 5 centimeters, about 2 inches. Is that average, relatively large or small, and what danger would it have posed?
The real key is 5 centimeters in which direction? Something which is 5 centimeters around is really pretty big for the frontal lobe, whereas if it’s shaped like a pancake, it’s not very big. So if the blood is outside the brain, it may not be that impactful. If it’s inside, it may or may not be impactful.
When you use the word impactful in this case, what kind of impact are you alluding to?
The left frontal lobe in most people is considered the dominant one, meaning it’s responsible for a lot of high-level thinking. … If you’re a very high functioning person like he is, a lot of things like judgment and speech can be in that area. Happily, it sounds like he’s out quickly and doing very well.
How long might it typically take a robust 80-year-old to recover and be back on the job?
Reasonably, we would send someone home in a day or two, which nowadays for this kind of minimally invasive neurosurgery is realistic. But I wouldn’t counsel anybody to go back to normal activity for at least weeks. And many people may take even four to six weeks to feel really up to snuff.
Last month, McCain seemed confused in his questioning of former FBI Director James Comey. He later said, “I was up late watching the Diamondbacks baseball game.” Is there any link between confused speech or thinking and a blood clot of this size?
I think in this case it would be speculation, because this might well have started after that, for all we know. But if you had something in that location, I suppose it’s possible. As I say, probably speculation at this point.
The imperiled Senate health care bill hit an unexpected hurdle over the weekend with a health scare that is keeping GOP Sen. John McCain home in Arizona. Without his vote, the bill cannot pass.
NPR’s Audie Cornish talks to Texas A&M professor Kelly Wilson about the Trump administration’s moves to defund teen pregnancy research programs, including the program she leads at Texas A&M.
A vote on the Senate’s health care bill has been delayed. An American graduate student who disappeared in Iran months ago has been sentenced to 10 years in prison, according to an Iranian news agency.
Clare Kelley practices “forest bathing” along the edge of an urban forest on Washington D.C.’s Roosevelt Island, in the middle of the Potomac River. In contrast to hiking, forest bathing is less directed, melding mindfulness and nature immersion to improve health.
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When my editors asked me to report on forest bathing, I packed a swimsuit. I assumed it must involve a dip in the water.
It turns out, my interpretation was too literal.
I met certified Forest Therapy guide Melanie Choukas-Bradley and several other women who’d come along for the adventure at the footbridge to Theodore Roosevelt Island, a dense jungle of an urban forest along the Potomac River in Washington, D.C.
Here, I began to get it. Forest bathing isn’t a bath. We sat on the banks of the river, but we did not get in the water.
It’s not a hike either. We did walk the forest trails, but we meandered with no particular destination in mind.
Melanie Chouckas-Bradley leads a group of five women in a forest bathing excursion. She is certified as a forest therapy guide through the Association of Nature & Forest Therapy.
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The aim of forest bathing, Choukas-Bradley explained, is to slow down and become immersed in the natural environment. She helped us tune into the smells, textures, tastes and sights of the forest. We took in our surroundings by using all our senses.
As we passed through a stand of pawpaw trees, we touched the bark. We smelled the black walnuts, which give off a lovely citrus fragrance. We got a little shower of ripe mulberries, too.
“Close your eyes and just breathe, just breathe,” Choukas-Bradly intoned. It felt a bit like a meditation retreat.
It took me a few minutes to clear out the clutter in my brain, and tune into the natural world.
“When you open your eyes, imagine you’re seeing the world for the very first time,” Choukas- Bradley told us.
Melanie Choukas-Bradley reads some nature-inspired poetry and quotes from renowned naturalist John Muir, as part of the walk. “The air is as delicious to the lungs as nectar to the tongue,” Muir wrote. “That could describe our day here now,” Choukas-Bradley says.
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After I opened my eyes, the green looked a lot greener. And I began to see things I hadn’t noticed before: the flutter of birds, the ripple of the water, the swaying of trees.
A forest guide “helps you be here, not there,” says Amos Clifford, a former wildnerness guide with a Masters degree in counseling, and the founder of the Association of Nature & Forest Therapy, the organization that certifies the guides.
Clifford’s goal is to encourage health care providers to incorporate forest therapy as a stress-reduction strategy. There’s no question that stress takes a terrible toll in the United States; a 2015 study found work-related stress accounts for up to $190 billion in health care costs each.
“It’s my hope that the health care system will include [forest therapy] into the range of services they reimburse for,” Clifford says.
The practice began in Japan. Back in the early 1990s the Japanese Ministry of Agriculture, Forestry and Fisheries coined the term Shinrin-yoku — which translates roughly as forest bathing.
An invasive non-native plant called Wineberry (left) produces delicious red fruit related to raspberries. Choukas-Bradley and the forest bathers (right) open a bladdernut capsule and see the shiny seeds — like popcorn kernels inside. This forest bathing excursion was sponsored by the Audubon Naturalist Society.
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Now, forest bathing is starting to take off in the U.S. The Associations of Nature & Forest Therapy plans to train and certify about 250 new guides next year. “We’re aiming to have 1,000 trained guides within three years,” Clifford says.
There’s a growing body of evidence that the practice can help boost immunity and mood and help reduce stress. “Medical researchers in Japan have studied forest bathing and have demonstrated several benefits to our health,” says Philip Barr, a physician who specializes in integrative medicine at Duke University.
One study published in 2011 compared the effects of walking in the city to taking a forest walk. Both activities required the same amount of physical activity, but researchers found that the forest environment led to more significant reductions in blood pressure and certain stress hormones.
On average, the forest walkers — who ranged in age from 36 to 77 — saw a reduction in their systolic blood pressure from 141 mmHg down to 134 mmHg after four hours in the forest.
This might not sound like a big difference, but it can be clinically significant. Most doctors these days agree that people younger than 60 should aim to keep their blood pressure under 140.
“I’m very impressed with the primary research done in Japan,” Barr says. He thinks many patients could benefit from forest bathing, especially those who are under stress.
“Forest bathing could be considered a form of medicine,” Barr says. “And the benefits of nature can be accessed so simply.”
It’s not a big surprise that researchers were able to document a decrease in blood pressure among forest bathers. As people begin to relax, parasympathetic nerve activity increases — which can lead to a drop in blood pressure.
There’s another factor that might help explain the decline in blood pressure: Trees release compounds into the forest air that some researchers think could be beneficial for people. Some of the compounds are very distinctive, such as the scent of cedar. Back in 2009, Japanese scientists published a small study that found inhaling these tree-derived compounds — known as phytoncides — reduced concentrations of stress hormones in men and women and enhanced the activity of white-blood cells known as natural killer cells .
Another study found inhalation of cedar wood oils led to a small reduction in blood pressure. These are preliminary studies, but scientists speculate that the exposure to these tree compounds might enhance the other benefits of the forest.
The idea that spending time in nature is good for our health is not new. Most of human evolutionary history was spent in environments that lack buildings and walls. Our bodies have adapted to living in the natural world.
But today most of us spend much of our life indoors, or at least tethered to devices. Perhaps the new forest bathing trend is a recognition that many of us need a little nudge to get back out there.
The practice of retreating to nature to find stillness and calm is age-old. In his essay Walking, Henry David Thoreau wrote, “I think that I cannot preserve my health and spirits, unless I spend four hours a day at least — and it is commonly more than that — sauntering through the woods and over the hills and fields, absolutely free from all worldly engagements. ”
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In this file photo, a woman puts in her contact lens.
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It wasn’t old age, or disease: A “bluish foreign body” that was found in an English woman’s eye turned out to be a mass of contact lenses, surprising medical staff who were preparing the woman, 65, for routine cataract surgery. They report pulling 27 lenses from the woman’s eye.
“She was quite shocked,” specialist trainee ophthalmologist Rupal Morjaria tells Britain’s Optometry Today.
Morjaria says she and her colleagues were startled to find 17 contact lenses clumped together as they were injecting anesthesia into the woman’s eye at Solihull Hospital, southeast of Birmingham. They then recovered another 10 lenses. Part of their surprise, she said, was because the patient hadn’t complained of any irritation.
“When she was seen two weeks after I removed the lenses she said her eyes felt a lot more comfortable,” Morjaria tells Optometry Today. “She thought her previous discomfort was just part of old age and dry eye.”
The woman had not complained about problems other than cataracts, according to the report Morjaria and others published in the British Medical Journal. The patient had been wearing monthly disposable contact lenses for some 35 years, she said.
Morjaria said she hopes the episode, which occurred last winter, raises awareness for patients who wear contacts but might go long periods without getting an eye exam — perhaps because they order them online rather than in person. The incident should also raise issues for optometrists, she said, noting that the mass of contact lenses hadn’t triggered an obvious infection.
Their BMJ article prompted one physician to remark in the comment section, “It does make one wonder about the appropriateness and completeness of the examination of the referring clinician!”
As for the surgery that had been planned — it was postponed, in part to allow bacteria that had accumulated to clear from the area of the eye.
