Trump faces his annual medical exam Friday

President Donald Trump boards Marine One as he leaves Walter Reed National Military Medical Center in Bethesda, Md., after his first medical check-up as president. (AP Photo/Carolyn Kaster, File)

President Donald Trump is in for some poking and prodding as doctors assess whether his “incredibly good genes” continue to serve him well.

Trump was traveling to Walter Reed National Military Medical Center outside Washington on Friday for a follow-up to his first annual medical checkup as president.

His personal physician declared him to be in “excellent health” in January 2018 after a battery of tests on his heart, lungs, gastrointestinal system and other areas. Dr. Ronny Jackson, a Navy rear admiral, then presided over an extraordinary White House news conference in which he said of Trump: “He has incredibly good genes, and it’s just the way God made him.”

Jackson, then the president’s personal physician, also predicted that Trump, who doesn’t drink alcohol or smoke, will make it through his presidency with no serious medical issues.

Some questions and answers about Trump’s physical exam:

___

WHO WILL EXAMINE THE PRESIDENT?

The exam will be overseen by Sean Conley, a Navy veteran and doctor of osteopathic medicine who is now the physician to the president. Jackson oversaw Trump’s January 2018 exam after having done the same for President Barack Obama. The personal physician coordinates a team of doctors who rigorously examine the president. Jackson said 12 “consultants” were involved last year.

___

WHAT HAPPENED TO DR. JACKSON?

Jackson was replaced last year after Trump nominated him to lead the Veterans Affairs Department. Questions immediately arose about Jackson’s qualifications to run government’s second-largest bureaucracy. He had no significant management experience. Anonymous allegations also surfaced from current and former colleagues accusing Jackson of professional misconduct, including loosely dispensing medications and on-the-job drunkenness. Jackson denied the allegations but eventually withdrew his nomination. The Pentagon continues to investigate the allegations.

Despite the ongoing investigation, Trump recently promoted Jackson to be an assistant to the president and chief medical adviser. In that role, the White House said Jackson will provide advice across the administration on topics including veterans’ issues, the opioid crisis and health issues at the U.S.-Mexico border. Jackson will also travel and work closely with White House staff. Trump also re-nominated Jackson for a second star because of inaction by the previous Congress on an earlier nomination.

___

IS AN EXAM MANDATORY?

No, but modern officeholders undergo them regularly and release a doctor’s report assuring the public that they are fit for office.

___

WHAT’S INCLUDED IN THE EXAM?

A lot. Last year, the public learned details about Trump’s height, weight, heart rate, blood pressure and cholesterol levels. Doctors checked his eyes; ears, nose and throat; heart; lungs; gastrointestinal tract; skin; and teeth. Neurological, cognitive and stress tests were also performed. Trump’s hearing was not tested; Jackson said he ran out of time. The exam stretched past four hours.

___

WILL THERE BE ANOTHER COGNITIVE TEST THIS YEAR?

That’s up to Trump. Jackson said he hadn’t planned on giving a cognitive test last year, largely because he interacted with the president several times a day and saw no reason to. But he said Trump requested the test and achieved a perfect score. At the time, speculation had been growing about the president’s mental state, based on descriptions of him in a behind-the-scenes account of the administration’s early days and a public episode in which Trump slurred his words. Trump tweeted in his own defense that he is a “very stable genius.”

Jackson said it is Trump’s call on whether another cognitive test is performed. Questions about the president’s mental state have largely subsided.

___

HOW IS THE PRESIDENT’S HEALTH?

It’s hard to know what, if anything, has changed, before the results of Friday’s exam are made public.

Jackson’s assessment last year was that Trump was in “excellent” health overall. But he added that the president, who tipped the scale at 239 pounds, would do well to drop 10 to 15 of them and shift to a low-fat, low-carb diet and take up a more defined exercise routine. Jackson said he’d work with the president (and enlist first lady Melania Trump and the president’s daughter Ivanka) and the White House kitchen staff on both areas. Trump’s primary form of exercise is golf. He has also said he gets lots of exercise just walking around the White House complex.

Trump’s love of fast food remains, however. Last month, he invited the college football champion Clemson Tigers to the White House during the partial government shutdown. With the White House kitchen too understaffed to cater a meal for the strapping athletes, Trump stepped in: He ordered burgers, french fries and pizza.

___

HOW WILL THE PUBLIC LEARN THE RESULTS?

Conley is expected to release a paper statement sometime after the exam with his initial assessment of Trump’s health.

Jackson released a statement some hours after last year’s exam that declared Trump to be in “excellent health.” Jackson then delivered — in what he said was at Trump’s request — a detailed, in-person readout the following week in which he spent about an hour answering questions from reporters in the White House briefing room.

___

Follow Darlene Superville on Twitter: http://www.twitter.com/dsupervilleap

_______________________________________________________

Copyright © 2019 Capitol Hill Blue

Copyright © 2019 The Associated Press. All Rights Reserved

Soldiers sue over health damage from waste disposal

Toxic waste in Afghanistan.
Toxic waste in Afghanistan.

A federal appeals court on Thursday revived dozens of lawsuits by soldiers and others who claim they were harmed by improper waste disposal while serving in Iraq and Afghanistan.

The lawsuits claim Houston-based contractors KBR and Halliburton Co. exposed soldiers to toxic emissions and contaminated water when they burned waste in open pits without proper safety controls. U.S. District Judge Roger W. Titus in Maryland dismissed the lawsuits last year, ruling that the contractors could not be sued because they were essentially an extension of the military.

But a three-judge panel of the Richmond-based 4th U.S. Circuit Court of Appeals said in its unanimous decision that the contractors are protected only if they were following explicit instructions from the military. The court said Titus improperly tossed the case without sufficient evidence on that issue.

“In short, although the evidence shows that the military exercised some level of oversight over KBR’s burn pit and water treatment activities, we simply need more evidence to determine whether KBR or the military chose how to carry out these tasks,” Judge Henry F. Floyd wrote for the appeals court.

The consolidated cases now go back to Titus for further proceedings.

“We are pleased with the decision and look forward to our day in court,” said Susan L. Burke, attorney for the soldiers. “The 4th Circuit clarified the law in a way that’s quite helpful. The decision makes it clear nobody can stand in the shoes of the sovereign and get immunity if they’re doing things contrary to what the sovereign directed them to do.”

The two sides disagree on whether the contractors were following military instructions.

KBR spokesman Richard B. Goins said company officials were disappointed with the court’s ruling.

“The court basically asks the trial court for more facts and we believe this is, at heart, a mistaken reading of the extensive existing record,” Goins said in an email.

He said company officials are evaluation options for further appeals, which include asking the full appeals court or the U.S. Supreme Court to review the case.

The lawsuits claim that the open burning of waste by the contractors caused serious physical injuries, including cancer and permanent respiratory damage.
_______________________________________________________

Copyright  © 2014 Capitol Hill Blue

Copyright  © 2014 The Associated Press  All Rights Reserved.

Fat women are often poor women

Women who are poor are much more likely to be obese but men are not, U.S. government researchers said on Tuesday in a report that contradicts some common perceptions.

They found income does not greatly affect whether a man is obese but that education seems to affect both sexes.

“Among men, obesity prevalence is generally similar at all income levels, with a tendency to be slightly higher at higher income levels,” the team at the National Center for Health Statistics wrote.

Obesity is a growing problem for U.S. policymakers. Two thirds of Americans are overweight or obese, with 72 million U.S. adults, or 26.7 percent, being obese, with a body mass index or BMI, of 30 or more.

Several studies have linked obesity with both income and education.

The NCHS researchers used data from a national study of 5,000 people that is done every year.

Of the obese adults, 41 percent live in prosperous homes, bringing in at least $77,000 a year for a family of four, or 350 percent of poverty-level income.

They found 39 percent live in homes making between 130 percent and 350 percent of the poverty level, and 20 percent lived in poorer homes with incomes below 130 percent of the poverty level or $29,000 for a family of four.

They found that 33 percent of men living in well-to-do households with income at 350 percent of the poverty level were obese, compared to 29 percent of men who lived below 130 percent of the poverty level.

But income seems to affect a woman’s weight. The researchers found 29 percent of women in well-to-do homes were obese, but 42 percent of women living below poverty level were.

Education plays an important role. Just over 27 percent of men with a college degree were obese compared with 32 percent of those with less than a high school education, while 23 percent of women with a college degree were obese, compared to 42 percent of women with less than a high school education.

A second study found children and teens living in homes with college-educated adults were less likely to be obese, and found stronger associations between obesity and income.

Just under 12 percent of boys and girls living in prosperous homes were obese, compared to 21 percent of boys and 19 percent of girls in the poorest homes.

Body-mass index is the weight in kilograms divided by the square of the height in meters. A BMI of between 25 and 30 is overweight and a BMI of 30 or over is obese.

A person 5 feet 5 inches tall is classified as overweight at 150 pounds (68 kg) and obese at 180 pounds (82 kg). A 5-foot-10 inch (1.8 meter) tall person who weighs 209 pounds (95 kg) has a BMI of 30 and is obese.

Being overweight or obese raises the risk of heart disease, diabetes, some cancers and arthritis and a study published this month in the New England Journal of Medicine confirmed that adults with a BMI of 25 or more are likely to die than someone the same age who is slimmer.

Copyright © 2010 Reuters

Enhanced by Zemanta

Well doh! Oil spill leaves people depressed

Margaret Carruth: In the depths of an oil spill depression (AP)

Margaret Carruth: In the depths of an oil spill depression (AP)Before the BP oil spill, the Gulf Coast was a place of abundant shrimping, tourist-filled beaches and a happy if humble lifestyle. Now, it’s home to depression, worry and sadness for many.

A Gallup survey released Tuesday of almost 2,600 coastal residents showed that depression cases are up more than 25 percent since an explosion killed 11 people and unleashed a gusher of crude into the Gulf in April that ruined many livelihoods. The conclusions were consistent with trends seen in smaller studies and witnessed by mental health workers.

People just aren’t as happy as they used to be despite palm trees and warm weather. A “well-being index” included in the Gallup study said many coastal residents are stressed out, worried and sad more often than people living inland, an indication that the spill’s emotional toll lingers even if most of the oil has vanished from view.

Margaret Carruth is among those fighting to hang on.

Her hairstyling business dried up after tourists stopped coming to the beach and locals cut back on nonessentials like haircuts. All but broke and unable to afford rent, Carruth packed her belongings into her truck and a storage shed and now depends on friends for shelter.

“I’m a strong person and always have been, but I’m almost to the breaking point,” says Carruth.

The Gallup survey was conducted in 25 Gulf-front counties from Texas east to Florida over eight months before and after the spill, ending Aug. 6. People reported 25.6 percent more depression diagnoses after then spill than before it, although the study didn’t conclude the additional cases were tied directly to the oil.

The survey said people along the Gulf reported feeling sad, worried and stressed after the spill, while people living inland reported less over the same period. More than 40 percent of people in coastal areas reported feeling stress after the BP geyser blew, a 15 percent increase from before.

The oil spill followed waves of hard luck for the Gulf region, including hurricanes and recession. Experts say it’s impossible to determine how much of the current mental health downturn could have roots in problems other than crude washing into marshes and beaches, damaging the seafood and tourist industries.

But an earlier study conducted in 13 counties and parishes with a total population of 1.9 million showed that 13 percent of coastal adults from Louisiana to Florida suffered probable serious mental illnesses after the spill.

The level of mental illness was similar to that seen six months after Hurricane Katrina decimated the coast five years ago, and experts aren’t yet seeing any improvement in mental health five months after the oil crisis began. Before Katrina, a study by the National Institute of Mental Health said only 6 percent of area residents had likely mental illnesses.

“From the types of patients we are seeing in our emergency departments, clinics and hospitals, the problems are persisting,” said William Pinsky of the New Orleans-based Ochsner Health System, which conducted the random telephone survey of 406 people in four states during the summer.

Sleeplessness, anxiety, depression, anger, substance abuse and domestic violence are among the most common problems reported by mental health agencies.

BP has provided $52 million for mental health care in the Gulf region, with $15 million going to the Louisiana Department of Health and Hospitals; $12 million each to the states of Alabama and Mississippi; $3 million to Florida; and $10 million to the federal Substance Abuse and Mental Health Services Administration.

Even though the oil stopped flowing in July and the BP well was finally killed this month, some officials say the toll on mental health may get worse as the financial strains of summer persist into the fall.

“It’s like a virus that’s spreading,” said Tonya Fistein, one of four counselors hired by AltaPointe Health Systems specifically to help people deal emotionally with the spill in Bayou La Batre, a tiny Alabama fishing community hard hit by the disaster.

AltaPointe’s clinic is seeing twice as many new patients as in 2009, an increase it blames on the spill. In Gulfport, Miss., 42 percent of the patients surveyed at the Gulf Coast Mental Health Center said they were sad or depressed because of the spill.

Steve Barrileaux, a psychologist at the Gulfport center, said some of the problems leading to mental health issues are obvious, like the loss of work by a person who rented chairs on the beach. Others are more subtle.

Many people are deeply worried about the environment, for instance, or lament the lost moments they would have spent fishing recreationally with loved ones. Others are still afraid to eat seafood, even on the coast where livelihoods depend on it.

“What’s scary is the long-term damage that can be done, and we just don’t know about that,” Barrileaux said.

Chanthy Prak frets constantly about how to make ends meet in the post-spill world.

Prak worked in crab houses around Bayou La Batre before the oil hit. She and her husband, another seafood worker displaced by the spill, have received only $5,000 in claims payments since May to support them and their seven children.

“I worry. There’s money going out but no money coming in,” said the Cambodia native.

In some areas, higher rates of mental problems appear to have little to do with the oil.

At Lakeview Center, which provides mental health services in Pensacola, Fla., calls have increased to a crisis intervention line compared to 2009, but relatively few people have mentioned the oil spill as the reason they need help, said spokeswoman Karen Smith. Psychologists believe the uptick is most likely linked to the recession, she said.

More oil came ashore just to the west of Pensacola in Baldwin County, Ala., however, and a survey conducted for the state by the Centers for Disease Control and Prevention found significant mental health problems that people blamed on the spill.

Twenty-three percent of households in the area reported having at least one person who blamed sleep troubles on the spill, and 11 percent had at least one person with appetite loss. Perhaps most tellingly, 32 percent reported a decrease in income linked to the oil spill, which could lead to additional strain, said Dr. Charles Woernle, the state epidemiologist with the Alabama Department of Public Health.

Officials along the Gulf Coast worry that many of the hardest-hit groups — shrimpers, Asian seafood workers and low-wage tourism employees — won’t seek help for mental problems because of cultural taboos.

At AltaPointe, officials hope to use a share of the BP money to pay for additional oil-spill counselors.

Tejuania Nelson, who runs a day-care center in fishing-dependent Grand Bay, Ala., said preschoolers whose parents were left jobless because of the spill are lashing out in unsettling ways.

“They’re throwing desks, kicking chairs,” she said. “It’s sad. With this, people do not have hope. They cannot see a better time.”

Copyright © 2010 The Associated Press

Enhanced by Zemanta

When children become their parent’s parent

Mom in 1946 after a ride from Meadows of Dan, Virginia to Gibsonton, Florida.

Three years ago, my then 83-year-old mother fell at home and fractured a vertebrae in her back.

She didn’t tell anyone about the fall and told us she strained her back.

Over the next several weeks, her “strained back” got worse. Six months after the fall, she couldn’t get out of bed. Over her protests, I called an ambulance for a trip to the emergency room where doctors discovered the broken vertebrae had fused itself to another, aggravating her advanced osteoporosis.

After six weeks in a rehab center, she returned home but her condition continued to worsen. She withdrew from friends and family, hiding behind locked doors, asking for food and supplies to be delivered and left on the porch.

Three months ago, I couldn’t get her on the phone. She had changed the locks on the house so I broke in and found her half-on, half-off the couch, unable to get up. She was emaciated and the house reeked of feces from her three dogs which could not go out.

I cleaned her and the house up and tried to talk her into going to the hospital. She talked me into letting her “sleep on it” and I left. The next day we found her on the floor where she had fallen shortly after I left. EMTs from our local rescue squad found her breathing and heartbeat erratic and her blood pressure dangerously low. They worried she might code before getting her to the nearest hospital 41 miles away.

We made it and the hospital spent several days pumping her full of nutrients, treating bed sores and other conditions. They recommended, once again, rehab.

After five weeks in a rehab center, where she fell three times while trying to get out of bed without calling for a nurse — fracturing her pelvis in one fall — the doctors ruled out her returning to home. Around-the-clock medical care is not readily available in the rural area where she lives so I exercised the medical and durable power of attorney that she had granted 20 years ago “just in case” and placed her in an assisted living facility. She fought it at first but seemed to accept it over the next month.

On August 1 — exactly one month after moving into the assisted living facility — she woke up in the middle of the night, failed to call for a nurse and tried to get up. She fell — hard — and fractured her left hip. Later that day, surgeons put her broken femur back together with a titanium rod and two screws.  After 10 days in the hospital, she returned to her third rehab center in three years.

I visit my mother every day — driving the 37 miles to the rehab center before heading for her home another 25 miles away to take care of her dogs and make sure the house is secure.  When she fell three months ago I found more than six months of unopened mail in her home and scores of unpaid bills. I assumed control of her life, paid off her bills and — with the help of my brother — set up a program to assure she is taken care of for the remainder of her life.

At 86, my mother — for the most part — is a shell of her former self. At times I see remnants of the woman who — in 1946 — climbed aboard her Harley-Davidson Knucklehead and rode 800 miles — by herself — from Meadows of Dan Virginia to Gibsonton, Florida, to meet her future in-laws. She continued to ride that bike for several years after my father died in an industrial accident three years later.

All but gone is the woman who — after my stepfather died in 1985 — decided to see the world and spent the next several years traveling that world on her own.

The frail woman I visit each day now weighs 95 pounds. Her skin tears easily from the protruding bones from advanced osteoporosis and she screams in pain from the slightest movement. Yet — when she is at her best — she still fights to regain her strength and struggles through the exercises in rehab with the hope that she can — one day — regain mobility.

As I watch her moods switch back and forth from determined fighter to dejected, declining senior, I try to keep up a strong, supportive front when with her and then turn into a sobbing mass of jelly after I leave the facility.  The past three years have taken their toll on me and those around me.

When the phone rings, I answer with a dread that it is more bad news from the rehab center. I don’t dare venture too far from the area where we live. Something could happen that requires my presence.

Friends tell me I need to let go, to reduce my daily visits to two or three times a week at most but her face usually brightens when I walk in the door of her room.  I don’t always know which person she will be when I visit. On some days I just sit and let her blast away with tirades about what a traitorous son I have become for putting her in her current “hell hole.”  On other days she thanks me for taking care of her.

She’s my mother. She took care of me for the first 17 years of my life. Now its time to do the same for her.

(NOTE TO READERS: What does this column have to do with politics? Absolutely nothing. What does it have to do with this web site? Absolutely everything. A number of readers have noticed my increasing distraction in recent months. My wife, who serves as my barometer to reality, says the distraction began three years ago when my mother fell for the first time and hit its peak in the last three months. She’s right, of course, as she always is. My focus is elsewhere and my attention span, as well as my patience, is short. My temper is short and recent events have taken its toll. I wrote this column so readers can — hopefully — understand because whatever happens in my life affects Capitol Hill Blue.)

Enhanced by Zemanta