Month: May 2022

Student Competition Winner: Says He Has Six Months To Survive, He Opens An Art Exhibition

This part is one of our 10 winners 2022 Profile Contest. You can find more here. Nathan CoAuthor, 17 and go Lumis Chaffee School Windsor, Con.

By Nathan Co

In 2019, South Korean photographer Kim Geo-sik was recognized as the best artist of the year by the Korean company KT&G. Prior to this recognition, he humbly described his popularity as “a small group of committed fans”.

During his growing fame, doctors finally diagnosed him with gastric cancer. When they told him that he had six months to live, he claimed his life insurance policy and was ready to live the rest of his life to the fullest. He opened his art exhibition in 2021 not only to explore abstract images through photography but also to find meaning in times of trouble.

The following interview has been translated from Korean and edited for clarity.

Credit …Nathan Co

Tell me about yourself.

I am a photographer who uses gelatin silver print, basically black-and-white photography. Most contemporary artists no longer use this medium.

The complex, slow and limited process of black and white photography is inconvenient. I was curious about the contemporary changes in the photo production process. Thus, in my latest series, I have focused on each production stage, highlighting the role of black-and-white photography in the contemporary industry. My work was considered relatively obsolete, which allowed me to receive positive attention.

At the highest point of your career, you have cancer. Outbreaks appear to be exacerbated during this time. I can only imagine the range of emotions you felt.

When I was allowed to live six months, I was disappointed. I had a high fever during my battle with cancer. At the beginning of the epidemic, worrying about the symptoms of Covid-19, such as fever, meant that I desperately missed out on much-needed treatment.

I initially thought that preparing for my solo show would be more effective than continuing chemotherapy, as the treatment seemed painful and inadequate. Then, a friend of mine who is a surgeon persuaded me to have surgery that many hospitals did not approve at that time. The operation was incredible, and at the end of the seven-hour process, all the doctors in the room applauded. Thanks for the surgery, I’m still here.

What does it mean to live in the face of death, and what does life mean to you?

People often say, “What would I do if I didn’t have much time to survive?” Yet this was my reality. An artist never knows what a comfortable life means. I thought working in the last days of my life might not be a comfortable end to life, but it would be a happy, meaningful end.

In the end, I figured I’d finish the job I had originally planned to do. After my solo show, I stayed in my bed mainly because of the side effects of the treatment. Yet at the same time, I’m thinking of ideas for my next project. Our will is endless!

In addition, too small to waste lives. I spend more time with my wife now, because the only thing I can leave for my loved one is memory.

Are you surprised at your work?

That can be realized in a photo of an object or a world of your head. That process of real and accurate presentation always fascinates me and gives me a feeling of sheer excitement.

What other lessons can you pass?

During my battle with cancer, I realized that life is limited and that there are infinite ways in which we can die. The meaning of the words infinite and finite is difficult to grasp in everyday life. It is important not to be influenced by what other people say. Choose your limited way to live a good life.

Rural Health Startup Homeward Partners with Right Aid for Caring for Seniors

Rural Health Startup Homeward is partnering with Rite Aid to connect the elderly with clinical services such as wellness monitoring and screening.

This collaboration will allow Right Aid Pharmacists to send Medicare-eligible clients to HomeWord for care. In addition, HomeWord’s mobile care units will be available in some Right Aid locations in rural Michigan, with the goal of expanding to additional markets.

Homeword, which Launched earlier this year with an investment of $ 20 million from General Catalyst, the focus is on providing services to patients at home or virtually through his travel mobile unit. It said it would launch network services for patients covered by Medicare and Medicare Advantage plans, including primary care and cardiology, from the third quarter of this year.

“As we rebuild health and care for rural Americans, we must consider the specific needs of this community and the millions of people living in the so-called desert healthcare. Come on. ‘ Instead, we are creating opportunities for rural Americans to take care of their daily lives and routines, ”CEO Dr. Jennifer Snyder said in a statement.

“Rite Aid is a highly recognized and trusted pharmacy service organization where rural locations serve thousands of people every day. Through our partnerships, we will be able to connect individuals to our services because we can improve access to important, frontline services in those communities.”

Why it matters

According to the CDC, Rural Americans are more likely to die of heart disease, cancer, unintentional injury, COPD and stroke than their counterparts in rural areas. The research is published Clothes Last year the disparity in mortality between rural and large metropolitan areas increased significantly between 1999 and 2019.

Older rural residents were more likely Skip medical care because of the cost, which was more common for black and Hispanic adults.

People living in rural areas also usually have to travel more to get health care. Meanwhile, In 2020 alone 19 rural hospitals were closed, 181 since 2005.

Greater trend

Time a In a panel discussion on ViVE shortly after Homeward’s launch, Snyder, who is also a veterinarian at chronic care management company Livinggo, said the startup focused on rural health because the current healthcare system is designed for urban areas, leaving rural communities vulnerable.

The startup plans to collaborate with existing local health systems, sending patients back to outside providers if necessary.

“We see ourselves as an extension of the current ecosystem, not as a competitor,” he said.

Digital nutrition startup Kulina Health raises $ 4.75M

Digital nutrition startup Kulina Health has secured $ 4.75 million in a seed-funded round led by HealthWorks and Brooklyn Bridge Ventures.

Other investors participating in the growth include Rethink Impact, Tensility Ventures, Alpine Meridian Ventures, Knightsgate Ventures, Graham & Walker, Architect Ventures and Rido Ventures.

What does this mean?

Kulina offers virtual appointments with registered dietitians who can help you create nutritional plans based on user needs, including managing diabetes and eating disorders. Patients can also access an app where they can find their goals, session notes and handouts. They can also chat with their dietitian during the appointment.

The startup plans to use Seed for expansion as well as continue to develop their product and technology platform.

“At this critical juncture, we are interested in investing in Culina Health. For those living with chronic conditions, and especially for GIs and autoimmune individuals, care can be difficult to manage. Lifestyle changes, medications – this is often a stressful and irresistible process, “said Doba Parushev, director of venture capital at Healthworks, the investment arm of CareFirst Blue Cross Blue Shield.

“Kulina’s ability to use registered dietitians for complex care support has the potential to change all that. Working with and working with existing human care providers, Kulina not only addresses nutritional needs in a personalized and measurable way, but ensures that the whole journey – From management to treatment to diagnosis – as seamless, efficient and effective as possible. “

Snapshots of the market

Another company in the personalized nutrition space is Season Health, which has announced that it has been raised এ 34 million in funding for the series in April. Season sets itself up as a “digital food pharmacy”, where patients can create meal plans based on their needs and deliver ingredients and recipes to their homes.

European nutrition and lifestyle-changing coaching app Oviva raised সি 80 million in Series C funding last year to expand its reach and place more offers in the United Kingdom, Germany, Switzerland and France.

Already affiliated health technology company Withitngs has also expanded into the fitness and nutrition space. It is Acquired Berlin-based 8fit earlier this year to provide personalized programs and advice for users.

After Feterman’s stroke, doctors see the potential for a Senate campaign

What is the real prediction for John Feterman, a Democratic Senate nominee from Pennsylvania, who had a stroke on May 13?

The 52-year-old Lieutenant governor of Pennsylvania received his party’s nomination just days later, placing one of the most fruitful Senate contests in the midterm elections. But emergency medical questions remain.

He was released from the hospital, his campaign said Sunday, and Mr Feterman said doctors had assured him he would fully recover – but the campaign did not say when he would return to the campaign.

“I’m going to take the time I need to rest now and get to 100 percent so I can go full speed soon and turn this seat blue,” Mr Feterman said in a statement on Sunday. Felt but intended to “continue to rest and recover.”

With such an important race for balance, which could determine the majority of the Senate, Mr. Feterman’s health condition is in the public interest. Yet, despite repeated requests, her campaign did not make it available to her or her doctors to discuss her stroke and her treatment.

And stroke, cardiology and electrophysiology experts say some of the campaign’s public statements do not provide adequate explanations for Mr Feterman’s described diagnosis or the treatment he received.

The stroke, he said in a statement released by his campaign, was caused by a blood clot. He said that the clot is the result of atrial fibrillation, a condition where the upper chambers of the heart vibrate erratically and are not compatible with the lower chambers of the heart. Doctors at a community hospital near Lancaster General Hospital have successfully removed the clot, the campaign said.

On May 17, the day of the primary election, a pacemaker and a defibrillator were implanted in Mr Feterman’s heart, which his press office said in a statement, “will help protect his heart and address the underlying cause of his stroke, atrial fibrillation (A-fib), Controls his heart rate and rhythm. ” Her press office said she was expected to fully recover from her stroke.

Medical experts used a defibrillator to ask questions about Mr Feterman’s treatment. They say it can only be understood when he has a different condition that puts him at risk of sudden death, such as cardiomyopathy – a weak heart muscle. This type of heart condition can cause blood clots. Or, doctors say, the propaganda about clot-causing affib may be correct.

Thrombectomy, the method most likely used to remove the clot, also indicates that Mr. Feterman experienced more than a minor stroke, although rapid treatment can prevent damage and protect his brain.

“I was in the hospital for more than a week,” Mr Feterman said in a statement. “I’m aware it’s serious, and I’m taking my recovery seriously.”

In a brief interview on May 20, Mr. Fitterman’s wife, Gisele Barreto Fitterman, told the story of her stroke from her perspective.

“We were on the street campaign,” he said. “We had breakfast, and she was feeling well.”

The couple got into a car to go to an event at Millersville University when he said, “The left side of his face was bent for just a second.”

“I had a gut instinct that something was happening,” said Mrs. Feterman. “I shouted at the soldier, ‘I think he has a stroke.’ Said, ‘I’m fine. What are you talking about? I feel good. ‘”

State troops soon took Mr. Feterman to Lancaster General Hospital, where he began treatment. Ms Feterman said it involved her going through her groin, which suggested she had a thrombectomy, a procedure where doctors slide a small plastic tube through the groin, pushing it into the brain and then using a suction or wire mesh to draw blood. Lets out the clot. .

Two days later, his campaign announced that Mr. Feterman had been hospitalized with a stroke. When asked about the delay, Ms. Feterman said, “Less than 48 hours is a very impressive time when dealing with sensitive medical issues.”

Shortly after this question, Rebecca Katz, a senior adviser to Mr. Feterman’s campaign, abruptly ended the call with Miss Feterman.

Medical experts say some aspects of the story were difficult to reconcile with their knowledge of stroke treatment.

Massachusetts General Hospital stroke specialist and professor of neurology at Harvard Medical School. Doctors treat thrombectomy only when a large artery in the brain is blocked, said Lee Shoyam.

“You don’t usually do this for someone with a slight drop in the face,” he said. Dr Shoaib was surprised that doctors examining Mr Feterman at the hospital noticed other symptoms, such as a loss of vision on his left side or a lack of awareness on his left side, often referred to as “neglect”.

“These strokes tend to be very serious,” said Dr. Shoaib. “She is OK. She went to a hospital that could treat her.”

Overwhelmed by the signs of a stroke described by Mrs. Fitterman, a spokesman for Mr. Fitterman wrote in an email that he “told The Associated Press last week that Giselle ‘noticed that John was not himself, and that he began blurring his speech shortly afterwards.’ ”

But what caused the stroke?

Ms Feterman said her husband knew she had atrial fibrillation, which carries a high risk of stroke, and she took anticoagulants as an ideal way to reduce the risk of stroke in people with atrial fibrillation, “on and off”.

But treatment with pacemakers and defibrillators is a mystery, if all of them had atrial fibrillation, medical experts say.

“It doesn’t make perfect sense,” said Dr. Brahmaji Nallamothu, an interventional cardiologist at the University of Michigan.

Defibrillators – which always come with a pacemaker – are used to prevent sudden death, said Dr. Elaine One, an associate professor in the Department of Cardiology and Cardiac Electrophysiology at Columbia University Medical Center. They are usually implanted in people with weak heart muscle, or who have survived an episode of heart failure, or in people with a genetic predisposition to sudden cardiac death.

“We will not use it for atrial fibrillation,” said Dr. One.

Dr. Rajat Deo, an associate professor of medicine and a cardiac electrophysiologist at the Pearlman School of Medicine at the University of Pennsylvania, agreed with the use of the defibrillator and said he shared Dr. One’s suspicions that Mr. Feterman had a damaged heart.

“I think it would be fair to say that he has at least two separate issues,” said Dr. Deo about Mr. Feterman. “One is Afib, from where he probably suffered a stroke that was successfully treated.”

He added, “The second problem is that he probably has some underlying heart condition that increases his risk of ventricular arrhythmias and thus increases the risk of sudden cardiac death.”

Afib may be related to another condition, Dr. Deo said. Patients with weak heart muscle are also at risk for atrial fibrillation.

On the other hand, Dr. Dio states that Mr. Feterman’s weak heart has nothing to do with atrial fibrillation. It is impossible to know without further information from his doctors.

Dr. Dio added that if Mr. Faterman received appropriate state-of-the-art medical therapy and was protected from sudden cardiac death with defibrillators, “he should do well while continuing his campaign.”

Experts also raised concerns about the potential of former Vice President Dick Cheney, who performed a defibrillator implant in 2001. He completed two terms at the White House in 2004, including a hard-fought re-election.

And there’s a time before the general election campaign in Pennsylvania begins in earnest: it’s not clear who will be Mr. Faterman’s opponent, because the Republican race is very close to being called and could lead to a recount.

But Dr. One was less transparent about Dr. Feterman than Dr. Dior.

“She is at risk of sudden cardiac death,” he said. “For someone on the campaign trail that could raise concerns.”

Outbreaks of hepatitis in the United States and Canada are associated with strawberries

Public health officials say they are investigating outbreaks of hepatitis A in the United States and Canada, possibly linked to organic strawberries.

U.S. health officials said the outbreak probably came from fresh organic strawberries branded as FreshCampo and HEB, which were purchased between March 5 and April 25.

The Food and Drug Administration said strawberries were sold in stores including Aldi, HEB, Kroger, Safeway, Sprouts Farmers Market, Trader Jose, Walmart and Weiss Market.

Strawberries are now out of their shelf life, and those who bought them between March 5 and April 25 should discard them, even if they freeze to eat later, health officials say.

In the United States, the FDA says it has identified 17 cases of hepatitis A associated with strawberries – 15 in California and one each in Minnesota and North Dakota. According to the agency, 12 people have been admitted to the hospital.

In Canada, health officials say they have confirmed 10 cases – four in Alberta and six in Saskatchewan. He has been admitted to four hospitals in the country.

No deaths have been reported in the United States or Canada, according to officials in both countries.

Hepatitis A is a contagious virus that can cause liver disease. The FDA has stated that infections can occur when food is eaten after being handled by a person who does not follow proper hygiene.

Symptoms usually develop 15 to 20 days after eating contaminated food and may include fatigue, nausea, vomiting, abdominal pain, jaundice, thick urine, and pale stools, the FDA said.

Those who believe they may be infected or have eaten stinking strawberries in the past two weeks should talk to their healthcare provider, the FDA said.

In a statement, HEB, based in Texas, said it had not received or sold organic strawberries from the supplier under investigation since April 16.

“All strawberries sold on HEB are safe,” the company said No illnesses have been reported from HEB or Texas from strawberries related to the FDA investigation. “

Freshcampo says it is no longer shipping fresh organic strawberries associated with the outbreak. Those sold between March 5 and April 25 came in a plastic clamshell package with a label that read, “Distributed by Meridian Fruit,” the company said in a statement.

The statement said, “FreshCampo wants consumers to know that it will continue to work with health officials and supply chain partners to determine where problems may occur in the supply chain and will take the necessary steps to prevent this from happening again.”

How to train for backpacking

June is National Gate Outdoor Month. Here at MDA, we’re spending the next few weeks preparing you for your best summer outdoors with posts to inspire you to go into nature.

The couple backpacking through the mountains overlooking the sea.Today we are talking about how to train for backpacking. Let’s start with the most obvious question: what is backpacking? Backpacking is a multi-day hike where you carry all your gear on your back.

Say you’re going for a hike one day with water, food, and basic survival gear, but you’ll be back in your car the day you travel. Not that backpacking.

If you’re tracking across the country, but someone else is shifting your gear from one sleeping area to another, that’s not backpacking either.

In short, backpacking is basically a long journey that requires more gear and more detail because you will spend at least one night – but probably many more – camping out. I think backpacking is a kind of patient sport. Like any endurance game, you want to take training for your event. You probably won’t enter a half-marathon this coming weekend with minimal or no training. You Can, But it will hurt much less, and your chances of success will be significantly higher, if you take the time to train. The same goes for backpacking.

The good news is, if you already have a strong fitness base, you’re well on your way. Now you need to organize your training to get ready for your backpacking expedition. The details depend on how long you will be there, how much weight you will carry, your current fitness level and the type of terrain you will be facing. Nevertheless, the general principles remain the same. You need to prepare for:

  • Time on your feet
  • Carrying weight
  • Walking on uneven soil
  • Climbing (going up and down hills, stepping on logs, etc.)

Lower body strength is important, of course, but core, upper back and shoulder strength, ankle and buttocks strength and mobility, balance and of course stamina. Here’s how to get started.

Training for backpacking: Getting started

Before we move on to specific exercises, let’s start with some simple tips that you can use to prepare your body for the adventures ahead.

First and foremost, give yourself enough time to prepare. Plan a training tailored to your travel needs. Experienced, fit hikers will probably go out on a short one or two night trip with minimal training. If you sit down most of the time and plan a seven-night through-hike (point-to-point backpacking trip), you’ll need enough lead time — a few months or more.

Don’t just focus on strength or endurance. As I said before, but it repeats itself: proper training covers strength, endurance, mobility and balance. Imagine climbing a rock or a fallen tree, jumping over a rocky outcrop, crossing a river, and climbing over a loose rock. It’s about balancing on one leg and keeping yourself straight as nature and gravity conspire to pull you down. Can be invaluable training equipment for single leg exercises, BOSU balls, obel boards and the like.

Train at least some of you in the same gear you plan to use on your trip. Make sure your shoes do not cause blisters and that your sports bra does not disintegrate. Wear your backpack on short hikes.

Try to replicate the environment you are going to encounter. You probably won’t be able to do all of your outdoor training in exactly the same situations you will encounter during your adventure, especially if you are traveling to a different part of the world. That’s fine, but try your best to predict the factors that might affect your experience. If your trip takes you to the side of the hill, find the hill for training or plan to step-up a ton in the gym. Do you need training for hot or cold weather? High altitude? Humidity? The more extreme the environment, the more important it is to prepare accordingly.

Think of yourself as an athlete! Looking for the best ultralight gear, the advantages and disadvantages of different tents and sleeping pads are easy to weigh, but the most important part of your equipment is your engine — it’s you! (The second part of this series will talk more about gears and other considerations.) Be sure to check the fuel and hydration as the training progresses.

Exercise to prepare for backpacking

Below is a sample of the types of exercises you can use to get ready for backpacking, but this is by no means a complete list.

Walking, hiking, rocking

As a dedicated Mark’s Daily Apple reader, I’m sure I don’t need to tell you that walking is great, full stop. Spending a lot of time on your feet is also one of the most important things to prepare for backpacking. If you haven’t already made a concerted effort to reduce your seating and include frequent movement and walking throughout the day, now is the time to start!

You will want to take some of these walks in nature. Voila, now you are hiking! Carry a weighted pack, and you’re rucking. Wailing in the woods is great, but also throw the rucksack to walk around the block or take your kids to school. (Mark has a dedicated post that is coming soon.)

Gradually increase the time, distance and how much weight you carry. Try hitting different terrain – rocky, sandy, muddy, level, steep. These can challenge your body in a variety of ways and can be great for strengthening your legs and ankles.

Go super primal while hiking: pick up logs and rocks along the trail, take them off for a while, then lower. Check out the idea here.

The primary essential movement

It’s not just a shameless plug, I swear! Primal Essential Movements, plus variations, perfect for getting ready for your big backpacking adventure.


After walking and hiking, squats are probably going to be your biggest ally. Do as much as you can – and do many different things Mix in sets of barbell squats, resistance band squats and goblet squats, to name a few.

Split squats, where one leg is in a lunge position in front of the other, also challenges your balance, so prioritize these as well. Even better, do a Bulgarian split squat where your hind legs are elevated.

To further challenge your balance, try a one-legged pistol squat or squat with one or both feet on an unstable surface like BOSU.

Push-ups and pull-ups

Walking for hours with a heavy backpack is no joke. You need to do the work on your shoulders, chest and upper back.

Working all day on the computer results in tight pecs, round shoulders and front head posture (Aka Technical neck). Carrying a pack can exacerbate these problems. This post and this post offer some solutions.

The board

Key strength is important for balance and keeping your pelvis and spine in proper alignment. In addition to the traditional planks, do side planks and exercise in this primal at-home core workout.

Let me put a plug for Pilates here. Not only sound education but his alertness and dedication too are most required. The glute bridges, for example, are a classic pilot move that is extremely useful for backpackers.

Step up

That’s exactly what it sounds like: step on things. Get in the gym box or stamp in your backyard. Climb the stairs or hit the stairs to the gym (check your heart rate if you want to keep it airy). For some high-intensity work, try Mark’s favorite, Versclimber.

Once you’re ready to add weight, wear a weighted backpack during a step-up for a fantastic workout.

If your campaign involves serious altitude gains, you can use this simple stair height calculator to plan some workouts that you need to exceed approximate feet / meter.


Plyometric exercises are incredibly effective and efficient for building strength and stamina, and they are great for those legs and ankles.

These may include:

  • Box jump where you can jump on a high platform using both legs
  • Ski jump where you jump from side to side (side to side)
  • Burpees with a jump to the top
  • The squat jumps where you descend into the squat and explode upwards as you stand

Or any number of options. These videos from the Marks Daily Apple YouTube channel give a lot of ideas:

Jumping Workout (Children)

Jumping Workout (Advanced)

15 barpiece option


There is no better way to logically target hamstrings. Make sure you use the correct form to avoid straining your back. Enjoy yourself with a variety of deadlift variations to keep things appealing — Romanian, sumo, hex bars, kettlebells — and again include one-legged deadlifts to work on balance and leg and ankle strength.

Heel sprint

We are obviously huge fans of running around these parts. Sprinting climbing for backpacking training has two distinct advantages: (1) lower risk of injury than regular (flat) sprints and (2) extra mountain work.

Okay, that’s enough to get you started. You already have a good chance of incorporating a number of these steps into your regular workout, which means you have a good foundation to build on. I will finish by mentioning Location of ancestral rest. These are not exercises on their own, but they create ankle and hip mobility, stretch and strengthen the lower body, and complement your workout by getting you out of a chair that does no good to your body.

That’s it for today. Stay tuned for the second part where we talk about gear and more. Get your sign out of this post today! And let us know in the comments where you would like hiking and backpacking.

Related posts from Mark’s Daily Apple

14 basic tips for good hiking

Cato on the Trail: What to pack for primal and cato camping, hiking and backpacking

Summer Survival Tips

Winter Survival Tips


About the author

Lindsay Taylor, PhD, is a senior author and community manager on primary nutrition, a certified primary health instructor and co-author of three Kito Cookbooks.

As a writer at the Marx Daily Apple and leader of the affluent Cato Reset and the Primal Endurance community, Linds’ job is to help people learn what, why and how to lead a health-centric lifestyle. Prior to joining the primary team, he earned his Masters and PhD. In social and personality psychology from the University of California, Berkeley, where he also worked as a researcher and instructor.

Lindsay lives in Northern California with her husband and two sports-obsessed sons. In her spare time, she enjoys ultra running, triathlon, camping and play nights. Follow her on Instagram @theusefuldish as Lindsay tries to work on maintaining a healthy balance with work, family and endurance training and, above all, fun in life.

Click here if you want to add an avatar to all your comments!

Indian Derma Startup Clinically Develops AI-Powered Skin, Hair Treatment Plans

Clinically, a digital dermatology startup in India is working to use artificial intelligence to provide automated hair and skin treatment plans.

What does this mean?

Founded in 2021, the startup is connecting patients and dermatologists through its web-based platform and delivering prescription products directly to consumers.

Its system works by users first filling out a questionnaire form, which asks about their hair and skin concerns and some photos. Then, they’ll connect with a dermatologist for a video consultation via WhatsApp – they can also opt for consultation via a phone call or chat. The dermatologist will prescribe cosmeceutical products that can be purchased and ordered at the clinic’s pharmacy.

Currently, the Clinical Board consists of eight dermatologists and product researchers, and supplies about 125 partner brand prescription grade hair and skin products.

The startup is now building a database of skin and hair profiles and prescriptions to create an AI model for providing automated treatment plans.

“The feature is currently in beta,” says founder Arjun Swain MobiHealth News. “[You] Think of it as a skin / hair recommendation engine or prescription prediction that encodes the technical expertise of thousands of doctors across India, “he said.

Why it matters

According to Swain, the “severe shortage” of dermatologists in India – one dermatologist for every 130,000 population – makes proper dermatological advice often confined to large, urban areas. For this reason, Clinically builds a digital clinic to make high-quality dermatology services more accessible, providing the benefits of “quick, affordable and most professional” health counseling.

It is making its way into the Indian healthcare industry by bundling telemedicine for skin and hair care with one-day prescription products. “We are two and [soon, we will provide] Flows seamlessly with our AI-based referral engine or prescription predictions, ”Swain said.

Supported by American startup Accelerator Y Combinator, Clinicli currently serves consumers in about 500 cities across India and seeks to reach more people while seeking more partnerships with cosmeceutical brands and dermatologists.

Snapshots of the market

Beauty and personal care apps are also working in India’s emerging AI Dermatology space CureSkin, which recently won সির 5 million in a series round of funding in March. The company uses AI to provide personalized treatment plans for skin, hair, body and other personal care concerns.

Colonoscopy should be free. Here’s how to avoid being charged: Shot

Preventive care for patients should be free under the Affordable Care Act, but Elizabeth Melville of Sunapi, NH, was charged 20 2,185 in 2021 for a colonoscopy.

Philip Keith / KHN

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Philip Keith / KHN

Preventive care for patients should be free under the Affordable Care Act, but Elizabeth Melville of Sunapi, NH, was charged 20 2,185 in 2021 for a colonoscopy.

Philip Keith / KHN

Elizabeth Melville and her husband are slowly hiking all 48 mountain peaks at 4,000 feet in New Hampshire.

“I want to do everything I can to stay healthy so I can do skiing and hiking in my 80’s – hopefully even in my 90’s!” Melville, a 59-year-old part-time ski instructor who lives in the holiday town of Sunapi.

So when her primary care doctor advised her to be screened for colorectal cancer in September, Melville prepares for her colonoscopy on duty and visits the outpatient department at New London Hospital, which was considered a zero-cost procedure.

Typically, colonoscopy screening is performed every 10 years, starting at age 45. However, for people with a history of polyps, more frequent screening is often recommended, as polyps may be a precursor to malignancy. A benign polyp of Melville was removed during a colonoscopy about six years ago.

Melville’s second test was the same as his first: with the exception of a small polyp, which the gastroenterologist excluded while he was asleep. It was also majestic. So he thought he had worked for several years with the least favorite treatment obligation of many patients.

Then came Bill.

Patient: Elizabeth Melville, 59, has a signature health plan that her husband receives through his employer. It includes a $ 2,500 separate deductible and 30% currency insurance.

Medical Services: A screening colonoscopy, including the removal of a benign polyp.

Service Provider: A 25-bed facility at New London Hospital, New London, New Hampshire. It is part of the Dartmouth Health System, a non-profit academic medical center and a regional network of five hospitals and more than 24 clinics with annual revenues of approximately 3 billion.

Total bills: Method, স্থ 10,329 for anesthesiologist and gastroenterologist. Signer’s negotiation rate was $ 4,144, and Melville’s shares under his insurance were 2,185.

Last hour: The Affordable Care Act provides free preventive health care for patients, including free mammograms and colonoscopy. But for the purpose of screening, there is a wave playing field for charging once a procedure for diagnosis has been completed. Doctors and hospitals often decide when these departments will be relocated and a patient may be charged – but these decisions are often controversial.

Regular screening for colorectal cancer is one of the most effective tools for prevention. Screening colonoscopies reduces the relative risk of colorectal cancer by 52% and the risk of death by 62%, according to a recent study.

The U.S. Preventive Services Task Force, an interdisciplinary group of medical experts, recommends regular colorectal cancer screening for the average at-risk people between the ages of 45 and 75.

Colonoscopies can be classified for screening or diagnosis. How they are classified makes all the difference for patients to spend out of pocket. The former usually bears no cost to patients under the ACA; The latter can make the bill.

Centers for Medicare and Medicaid services have repeatedly stated over the years that under the ACA’s preventive services provision, screening is considered an integral part of a polyp removal procedure during colonoscopy and should not change patients’ cost-sharing obligations.

After all, that’s the whole point of screening – to see if polyps have cancer, they must be removed and examined by a pathologist.

Many may face this situation. According to the American Society for Gastrointestinal Endoscopy, more than 40% of people over the age of 50 have prenatal polyps in the colon.

Anna Howard, head of policy at the American Cancer Society’s Cancer Action Network, said those with higher-than-average cancer risks may face higher bills and are not protected by law.

Anyone with a family history of colon cancer or a personal history of polyps increases the risk profile and insurers and providers may charge based on that. “From the very beginning, [the colonoscopy] Can be considered diagnostic, “Howard said.

In addition, performing a screening colonoscopy sooner than the proposed 10-year interval, as Melville did, could expose someone to a cost-sharing charge, Howard said.

Coincidentally, Melville’s 61-year-old husband performed a screening colonoscopy at the same facility with the same doctor a week after his procedure. Despite having a previous colonoscopy just five years ago due to her family history of colon cancer and her high risk, her husband was not charged for the test.

The main difference between the two experiences: Melville’s husband’s polyp was not removed.

Resolution: When Melville received notice of the 2,185 debt, he initially thought it was a mistake. After her first colonoscopy she had nothing to borrow. But when he called, a signer’s representative informed him that the hospital had changed the billing code for his procedure, from screening to diagnostics. A call to the Dartmouth Health Billing Department confirmed this explanation: He was told he was billed because a polyp had been removed – the procedure is no longer preventative.

During a subsequent three-way call to Melville with representatives from both the health system and Signna, Dartmouth health workers reiterated that position, Melville said. “[She] It was very firm with this decision that once the polyp was found, the whole procedure changed from screening to diagnostic, ”he said.

Dartmouth Health has refused to discuss Melville’s case with KHN, although it has allowed him to do so.

Following KHN’s investigation, Melville was contacted by Joshua Compton of Conifer Health Solutions on behalf of Dartmouth Health. Compton said diagnostic codes were inadvertently removed from the system and Melville’s claim was being recycled, Melville said.

Elizabeth Melville of NS “I want to do what I can to stay healthy so I can go skiing and hiking in my 80’s – hopefully even in my 90’s!” He says.

Philip Keith / KHN

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Elizabeth Melville of NS “I want to do what I can to stay healthy so I can go skiing and hiking in my 80’s – hopefully even in my 90’s!” He says.

Philip Keith / KHN

After contacting KHN, Cigna investigated the claim. Justin Sessions, a spokesman for Signer, said in a statement: “This issue was quickly resolved when we learned that the provider had submitted the claim incorrectly.

Takeway: Melville did not expect to be billed for this procedure. It looked like his first colonoscopy, about six years ago, when he was not charged for polyp removal.

But before getting a selective approach, such as cancer screening, Howard says it’s always a good idea to try to figure out any coverage minefields. Remind your provider that the ACA government needs to explain that even if the polyp is removed, colonoscopies will be considered screening.

“Contact the insurer before the colonoscopy and say, ‘Hey, I just want to understand what the coverage limitations are and what the costs might be out of my pocket,'” Howard said. Billing from an anesthesiologist – who prescribes a single dose of sedative – can also be a problem with colonoscopy screening. Ask if the anesthesiologist is in-network.

Be aware that physicians and hospitals must provide a reasonable estimate of patients’ expected costs prior to the planned procedure under the No Surprise Act, which will take effect this year.

Take the time to read any paperwork you need to sign and build your antenna for the problem. And, importantly, ask to see the documents ahead of time.

Melville said a health care billing representative told him that one of the papers he signed at the hospital on the day of his procedure was that if a polyp was discovered, the procedure would become diagnostic.

Melville no longer has the paperwork, but if Dartmouth Health had its signature on such a document, it would probably be a violation of the ACA. However, there is little “direct federal oversight or enforcement” of the law’s preventive service requirements, said Karen Politz, a senior fellow at KFF.

In a statement describing the general practice at New London Hospital, spokesman Timothy Lund said: “Our physicians discuss the possibility of progressing the process from screening colonoscopy to diagnostic colonoscopy as part of the informed consent process. All their questions are answered by the attending physician. “

To patients like Melville, though, that doesn’t seem fair. “I still think that if someone had prepared for a colonoscopy to process these choices, it wouldn’t make sense to ask questions and possibly say ‘no thanks’,” he said.

Stephanie O’Neill contributed to the audio portrait with this story.

Bill of the Month by a Crowdsource Inquiry KHN And NPR Which dissects and interprets medical bills. Do you have an attractive medical bill you would like to share with us? Tell us about it!

Medical vacation provides shelter for the homeless to recover from illness:

Henry Jones, who became seriously ill after being homeless for 11 years, was admitted to Christ House in 1991, one of the first medical vacation programs in the country.

Ryan Levy / Tradeoffs

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Henry Jones, who became seriously ill after being homeless for 11 years, was admitted to Christ House in 1991, one of the first medical vacation programs in the country.

Ryan Levy / Tradeoffs

In the summer of 1991, Henry Jones felt he was at the end of the line.

“There was no way,” he thought. “I prayed and was tired, but I couldn’t see any way.”

Jones was homeless in Washington, D.C. for 11 years and took their toll for years. “I’m getting sicker and sicker,” he said. “I can feel my health failing.”

On a hot June morning, Jones was in a particularly rough shape – his legs ached, his stomach ached, and his arms trembled. A security guard had to give him a ride from the hospital parking lot to the ER because he could barely stand.

The hospital would not admit him, but a social worker referred him to a place called Christ House, a facility for homeless men who were too ill to be on the streets or in shelters, but not sick enough in need of hospital level care. .

Today, there are a growing number of programs such as Christ House that provide short-term medical care for the homeless, known as medical vacation or rehabilitation care. This growth is partly fueled by a push by state Medicaid programs to help patients prevent preventable healthcare use, such as emergency room visits.

“We’ve seen sick homeless people who were on the streets getting worse,” said Dr. Janelle Goechias, who started the 34-bed facility in 1985. For. “

By the time Henry Jones arrived in 1991, Christ House had admitted more than 300 people a year.

“I couldn’t believe what I was seeing,” Jones said, recalling his first day. “I was sleeping in a nice, clean bed. I was getting some good food to eat. The nurses and doctors, they were very worried. They just wanted me to get well, and I could see that.”

Medical leave is increasing

Christ House was one of the first medical rest centers, and is now one of 133 programs spread across 37 states and Washington DC, all offering a safe place for homeless people to recover from surgery or other serious illness, to manage a chronic condition. Help learn and find permanent housing.

But the programs are unregulated and unlicensed, and they often look incredibly different from each other, according to Julia Dobbins, director of the National Health Care Medical Vacation for the Homeless Council.

The most common setting is a homeless shelter – a few beds or a separate room where a nurse comes to check in once a day. Others, such as Christ House, have their own building and include a full-service kitchen, social space, examination room and round-the-clock medical services.

In the last seven years, driven by multiple factors, the number of medical retirement homes has more than doubled.

First, the number of homeless people increased every year from 2016 to 2020, reaching about 600,000. The homeless population is also getting old and sick. Research shows that homeless people in their 50s are in worse health than people in their 70s who have a place to live, and half of homeless adults are over 50 years old.

At the same time, doctors, healthcare executives, and state and federal policymakers are beginning to recognize that non-medical factors, such as housing, affect human well-being and that the healthcare industry should do something about it – such as medical vacations.

Private Medicaid plans to increase fuel consumption

Perhaps the most surprising driver of medical vacancy growth is the interest of managed care companies – a private insurance company that covers 7 out of 10 people on Medicaid.

Most medical vacation programs have multiple funding sources. Hospitals, philanthropists, and state and local governments are historically the most common, but about 1 in 3 programs now receives some funding from Medicaid plans.

Dobbins said it began when the Affordable Care Act allowed 38 states and Washington, D.C., to expand Medicaid to any childless low-income adult, bringing thousands of previously ineligible homeless people to Medicaid.

A resident watches cooking in the living room at Hope Has a Home Medical Resort in Washington, DC

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A resident watches cooking in the living room at Hope Has a Home Medical Resort in Washington, DC

Ryan Levy / Tradeoffs

Many state Medicaid programs are simultaneously pressuring caregivers to reduce costly avoidable care, forcing more insurers to consider medical leave.

An example is one of the three managed care plans in 2016 at AmeriHealth Caritas DC, Washington DC, Washington’s Medicaid program began to dock the pay of insurers if they failed to reduce hospital admissions and unnecessary emergency room visits.

AmeriHealth estimates that it has provided Medicaid facilities to about 3,500 homeless people, and some of them have used hospital and ER. The company ran the numbers and was convinced that medical leave could improve people’s health, help businesses avoid financial penalties and save up to $ 200,000 a year.

From there, they partner with other local agencies to launch Hope has a home, two new eight-bed medical vacation facilities that opened in 2019 and still serve 62 homeless people.

“I thank God for this place,” said Wayne Gaddis, 58, who came home to Hope Hedge after spinal surgery. “If I hadn’t been here, I’d have been on the streets, probably coming back with drugs, slowly killing myself, not taking my drugs, not caring because I think no one else cared. But this place, it gives me new hope. New life. “

More proof is needed

There are about 20 peer-reviewed articles on medical leave, recently reviewed by Dobbins and his team at National Health Care for the Homeless Council. This study strongly suggests that those who use medical leave spend less time in hospital, are less likely to be hospitalized, and are more likely to use primary care.

But much of the evidence that exists has been self-disclosed by medical vacation programs, and no one has conducted strictly randomized controlled trials in the United States.

“Unfortunately, there is not as much literature in this field as we would like,” Dobbins said.

And there is even less evidence that medical leave can save insurers money.

Paying someone hundreds of dollars a day for medical leave is definitely cheaper than paying thousands of dollars a night for their hospital stay. But it can extend one’s life and reveal chronic conditions that require years of management.

“We cannot underestimate how sick we are [homeless] People are, “Dobbins said.

In the case, AmeriHealth Caritas DC says the first 11 people they sent to Hope Has A Home were less likely to go to ER. But their initial care inspection is skyrocketing, helping to increase the total cost of care by 75%.

This is just a small sample, and AmeriHealth is committed to medical leave with plans to launch two facilities for homeless women next year.

“Everything we do may not be cost-effective,” said Dr. Karin Wills, chief medical officer of CareFirst, another Washington-based care company that began paying for medical leave in 2021. “It’s important, but it’s not our primary driver.”

Principle speed and constraint

Policymakers in the states of Washington, Minnesota, Colorado and New York are exploring how they can expand access to medical vacation through Medicaid. But a big hurdle remains.

Federal Centers for Medicare and Medicaid Services are prohibited from paying for “rooms and boards”, which prevents medical leave from being provided by Medicaid, like other services such as a doctor’s visit or a nursing home stay.

Managed care agencies must establish separate agreements with each medical leave provider, and the money they spend on leave is not included in their annual contract negotiations with state Medicaid programs to determine how much state and federal money they receive.

In 2022, California became the first state to receive a waiver from CMS that allowed medical leave to be a covered benefit. Utah is in the process of getting its own waiver, further proof that CMS is open to this test.

A bedroom at Christ House, a medical vacation facility in Washington, DC

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A bedroom at Christ House, a medical vacation facility in Washington, DC

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Vacation providers, insurance companies, lawyers and policymakers have agreed that a major change in CMS policy could open the floodgates for more medical vacations. Even if that happened, it would still touch a fraction of the country’s nearly 600,000 homeless people.

“We are not going to end this crisis with medical leave alone,” said Julia Dobbins. “Medical vacation care is not accommodation.”

Forty percent of Christ House residents have been left in shelters or on the streets in the last three years. Hope Hedge has left without finding a stable place to have a share similar to Home.

Lack of affordable housing allows homes to choose between leaving someone homeless or putting someone else to bed.

“We always have to talk about access to affordable housing for people who are homeless,” Dobbins said. “Otherwise, we’re just going to talk about developing more and more leisure programs. And while I’m here to support them, that’s not my long-term goal.”

Produced this story TradeoffA podcast explores our confusing, expensive, and often anti-healthcare system.

If I’m still testing positive for the virus, can I stop isolating?

Tests differ in their sensitivity, and also in how people perform them. “Some people examine a swab and think they’ve just touched their nose,” said Dr. Gordon. “Although with other people – in fact, recently with a family member, I had to say, ‘Don’t hurt yourself,’ because they really got in there.”

One lesson is that long-term positive results are common enough that those who leave the isolation before 10 days should be careful, such as wearing a suitable mask, experts say.

Beyond that, scientists have disagreed. Some have suggested that unless they have an antigen-negative test, even if it takes more than 10 days.

“We can now make recommendations for personal experience using quick test results to guide us,” said Dr. Grad. “And since we know that some people may have an extended course, it seems reasonable to me that you should do it if you are able to continue the isolation if it is positive.”

However, many more say that as a matter of public health policy, there is no point in asking most healthy people to be isolated for more than 10 days or even to continue testing.

“No one is saying that there are some people, maybe statistically at the end of the tail, who can be infected after 10 days,” said Dr. Chin-Hong. However, people at that stage of the infection may not play a major role in spreading the virus, and constant testing may keep many people out of work or out of school without public health benefits, he said. “And you also raise an equity issue,” he adds, “like, ‘Who on earth can test enough?'”

Even then, experts say, there are some situations where people should continue testing and potentially disconnect after the 10th day. This includes people whose symptoms are not improving and who are immunocompromised because they can spread the infectious virus for a long time. (The CDC recommends that people with weakened immune systems be isolated for up to 20 days.)