Pioneering Psychotherapist Shares Strategies for Managing
Anxiety & Maintaining Emotional Wellness

Unlike many of the most important events in one's life - graduation, marriage, having a child - almost no one anticipates a cancer diagnosis.

This year, nearly 239,000 U.S. men will be diagnosed with prostate cancer and more than 232,000 women will learn they have breast cancer, according the American Cancer Society. Over their lifetimes, nearly half of all men can expect a cancer diagnosis, and more than a third of women.*

"Thankfully, we now have many tools for detecting cancers early and treating them successfully. But learning you have cancer remains one of life's most frightening and stressful experiences," says cancer psychotherapist Dr. Niki Barr, author of "Emotional Wellness, The Other Half of Treating Cancer," (canceremotionalwellbeing.com).

"Developing ways to help patients address their emotional well-being throughout their medical journey, still lag behind medical advances, but physicians and psychologists recognize that healing improves when both the physical and emotional needs of patients are served."

In her years of clinical practice working exclusively with cancer patients and their loved ones, Barr developed an Emotional Wellness Toolbox that patients stock with what Barr has found to be the most effective tools.

Here are some of her tools for managing anxiety - a normal and emotionally healthy response to a cancer diagnosis, but one that can spiral out of control.

• Catch your anxious thoughts. Stop anxious thoughts - thoughts about fear, unease and worry -- before they lead to anxiety. Start by writing your thoughts down on individual note cards and identifying the first one that's leading to you feeling anxious.  Then the next one. When you've identified all of your anxious thoughts, go back to the first one and, on the card, write a new thought that will not make you feel anxious. It should be a thought that is confident and empowering. Continue down the list and do the same for each anxious thought.

• Erase 'what if' thinking. What if the cancer has spread? What if the treatment doesn't work? One 'what if' leads to another and often spirals into anxiety. Be aware when you start asking 'what if' and instead ask yourself, "Is this thought helping me or hurting me?" and "Is this thought moving me forward or backward?"

• Ground yourself. Interrupt a chain of anxious thoughts by focusing on details around you. Look at the color of the walls in the room you're in; take in the pictures on the walls, the books on the shelves and the titles on their spines; look at the person you're talking to, the color of their eyes, the clothes she's wearing. Being very focused on external details can derail anxious thoughts.

• Use distraction. Choose a favorite place and visit it. Absorb everything about it - the colors, smells, any people involved, the sounds, tastes, how it feels. Build it up very clearly in your mind, going over and over it, so it can become a distraction tool. When you're waiting for a medical test or procedure, undergoing a procedure, or any other time you need to "be" somewhere else, call up your distraction and visit.

Other tools for your box include meditation CDs that use guided imagery; favorite music CDs; and a journal to record your thoughts and feelings.

"Being able to manage your anxiety enables you to move forward through cancer whether patient, caregiver or family member," Barr says.  "Don't tell yourself you can't handle whatever you're going through. Yes, you can ... five minutes at a time."

*The data does not include non-melanoma skin cancers, the most common diagnosis.

About Niki Barr, Ph.D. (@NikiBarrPhD)

Niki Barr, Ph.D. founded a pioneering psychotherapy practice dedicated to working with cancer patients in all stages of the disease, along with their family members, caregivers and friends. In her book, she describes an "emotional wellness toolbox" patients can put together with effective and simple strategies, ready to use at any time, for helping them move forward through cancer. Dr. Barr is a dynamic and popular speaker, sharing her insights with cancer patients and clinicians across the nation.

Tuesday, June 18, 2013

Sen. Chuck Grassley of Iowa has been looking into how hospitals are using a discount prescription drug program, known as 340B.  Certain hospitals appear to be making sizeable profits from the program at the expense of Medicare, Medicaid and private health insurance.  An in-depth report from Kaiser Health News this month explored financial bonuses given to the leaders of several non-profit hospital systems for reasons including expansion of hospital operations.  Grassley staff research found that each system except for one discussed in the articles has at least one 340B-eligible hospital.  One of the medical systems in the Kaiser Health News coverage, Carolinas HealthCare System, was among three North Carolina hospital systems Grassley looked at as part of his interest in the 340B program.  Grassley made the following comment on 340B eligibility and hospital executive bonuses.

"Hospitals eligible for the 340B program are supposed to have a high indigent patient population.  If some 340B-eligible hospitals have significant money available for executive bonuses, that raises questions about how they allocate their resources.  Are they doing everything possible to help uninsured patients receive health care, including affordable prescription drugs?  I intend to continue looking into how hospitals are using the 340B program and how their uses affect other programs in the health care system."

The Kaiser Health News project on hospital executive bonuses is available here.  Grassley's earlier correspondence with the federal agency in the charge of the 340B program, the Health Resources and Services Administration, is available here and here.  Grassley's letter to HRSA citing the three N.C. hospitals is available here. Grassley's letters from the three hospitals are available here, here, and here.  Proprietary drug pricing information is redacted in some instances. Grassley's follow-up letter to the Carolinas Medical Center in Charlotte is available here.

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DAVENPORT, Iowa - June 18, 2013 - Genesis will offer three CarFit events this summer for older drivers.

CarFit is a national educational program that offers older adults the opportunity to evaluate how well their personal vehicles "fit" them.  Health professionals work with older drivers and review 12 key areas to ensure
they "fit" their vehicle properly for maximum safety.  A CarFit check takes approximately 20 minutes to complete.

The three Genesis CarFit events coming up are scheduled for:

Wednesday, July 10 - Event will be held from 10 a.m.-2:30 p.m. at Genesis Medical Center, East Rusholme Street, Davenport.

Thursday, August 8 - Event will be held from 10 a.m.-2:30 p.m., at Genesis Medical Center, Illini Campus.

Saturday, September 14 - Event will be held from 10 a.m.-2:30 p.m., at Genesis Medical Center, East Rusholme Street, Davenport.

Older drivers are often the safest drivers because they're more likely to wear their seatbelts and less likely to speed or drink and drive, statistics show.  However, they are also more likely to be seriously injured in a crash because their bodies are more fragile.

"Older drivers can improve their safety by ensuring their cars are properly adjusted for them," said Gretchen Cluff, an Occupational Therapist at Genesis and a Certified Driving Rehabilitation Specialist.  "A proper fit in their car can greatly increase not only the driver's safety but also the safety of others.

"Once seniors arrive for their check, they will asked basic information and then we will evaluate how they fit in their car. For example, are they sitting too close to the airbag?  Are their mirrors adjusted appropriately to maximize their view?  Is their seat in the best position to reach the brake and gas pedals?

"We can only make recommendations and can't touch or change anything for liability reasons.  We can, however, provide the senior drivers with important information that could increase their driving safety."

Three examples underscore the importance of road safety to the CarFit program:

• Knowing how to properly adjust one's mirrors can greatly minimize blind spots for drivers when changing lanes.

• Good foot positioning on the gas and brake pedals is important. Drivers who reach with their toes to press on the pedals can cause fatigue in their legs and slow reaction time.

• Drivers run a risk of serious injury if they are sitting closer than 10 inches from the steering wheel.

Other CarFit events have shown that more than one-third of seniors had at least one critical safety issue.  One in 10 sat too close to the steering wheel, and 20 percent did not have a line of sight at least 3 inches over the steering wheel.

Genesis offers the only hospital-based driver's evaluation program in eastern Iowa with a Certified Driving Rehabilitation Specialist.

To reserve a time for an evaluation at either upcoming CarFit event, call (563) 421-1480.

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(DES MOINES) - Gov. Terry Branstad today announced he will sign Senate File 446, which contains the Iowa Health and Wellness Plan, on Thursday, June 20, 2013 at 9 a.m.at the Mason City Clinic in Mason City, Iowa.

The Iowa Health and Wellness plan will make Iowa a national leader for patient outcomes and quality of care for low-income individuals. The plan is designed to protect Iowa from federal budget cuts in the future, increases the number of Iowans on private insurance, and will provide $48 million in property tax savings in the first full year of implementation.

Thursday, June 20, 2013

9 a.m. Gov. Branstad signs Iowa Health and Wellness Plan into law

Mason City Clinic - Atrium, 250 South Crescent Drive, Mason City, IA

Note: The Mason City Clinic is on the Mercy Hospital campus with the main entrance facing east.

Senate File 446: An Act relating to appropriations for health and human services and including other related provisions and appropriations, providing penalties, and including effective, retroactive and applicability date provisions.

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MOLINE, IL - A person's smile is a special point of pride - so when dental work becomes necessary, no one likes to wait for the finished results. Now, thanks to cutting-edge advances in dental technology, realistic tooth restoration can be achieved in one day, according to the experts at Goebel Family Dentistry.

The dentists at the helm of Goebel Family Dentistry are the father-and-son team of Gary Goebel, D.D.S., and Tom Goebel, D.D.S. Their new practice, which opened on April 1, 2013, is located at 1601 River Drive, Suite 300, in downtown Moline.

"Using the E4D Dentist™ system, we can now offer same-day crowns, inlays, onlays, and veneers to qualifying patients," said Dr. Gary Goebel. "We are excited to bring this technology to our patients."

According to Dr. Gary Goebel, the E4D system replaces conventional methods, which include the use of an unpleasant impression material and the uncomfortable waiting period as it solidifies. "Images from a clean, fast digital scan are obtained in just a few minutes," he said.

The scanned information is then transferred to the design center, where a 3D model of the tooth needing restoration is created through the system's state-of-the-art DentaLogic™ software. "We can customize the restoration to fit the patient's specific characteristics," said Dr. Tom Goebel, "after which, it is created in a milling unit, right in our office."

The final result is a natural-looking restoration that fits with the surrounding teeth, making the crown, inlay, onlay, or veneer virtually undetectable. "The elimination of impressions, temporaries, second appointments, and needless waiting elevates the entire dental experience for the patient," said Dr. Gary Goebel.

For more information on Goebel Family Dentistry, call 309-277-3480 or visit www.goebelfamilydentistry.com.

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Washington, D.C. - The Susan B. Anthony List (SBA List) today announced the creation of a National Pro-Life Women's Caucus to recruit and organize pro-life women in state legislatures and statewide offices nationwide. The initial Leadership Team includes: Gov. Jan Brewer (AZ), Gov. Mary Fallin (OK), Lt. Gov. Sue Ellspermann (IN), Lt. Gov. Rebecca Kleefisch (WI), Lt. Gov. Kay Ivey (AL), Lt. Gov. Kim Reynolds (IA), and Atty. Gen. Pam Bondi (FL), as well as more than twenty state legislators from across the country.

Directed by SBA List Vice President for Government Affairs and former Congresswoman Marilyn Musgrave, the National Pro-life Women's Caucus will foster community between pro-life women lawmakers across the country, and connect them with the resources they need to pass pro-life laws. The Caucus will also actively encourage and recruit pro-life women to run for higher office.

Marilyn Musgrave served three terms representing Colorado's 4th District in the U.S. House of Representatives prior to joining the Susan B. Anthony List in 2009. She served in the Colorado House and Senate before running for the United States House in 2002.

"Women are the best messengers when it comes to defending the lives of the unborn and the integrity of motherhood," said Governor Jan Brewer (R-AZ). "I am proud to be a part of this national effort to highlight the leadership of lawmakers who are leading the charge to protect innocent unborn human life and women from the violence of abortion."

This effort will complement the existing Congressional Pro-life Women's Caucus. Congressional pro-life women leaders endorsed the effort, saying:

"We need strong, articulate women in Washington and in state legislatures who will boldly support policies that respect and promote life," said Senator Deb Fischer (R-NE).  "I'm excited to support the National Pro-life Women's Caucus as it builds up the next generation of pro-life women leaders."

"I am passionate about the need for women's leadership in politics, especially here in Washington," said Congresswoman Cathy McMorris Rodgers (R-WA). "The Pro-Life Women's Caucus will advance strong pro-life women in state legislatures and give them the tools and resources needed to run for higher office. I hope to see many of its members joining me here in Congress soon."

The Susan B. Anthony List, and its affiliated Political Action Committees, the SBA List Candidate Fund and Women Speak Out PAC, are dedicated to pursuing policies and electing candidates who will reduce and ultimately end abortion. To that end, the SBA List emphasizes the education, promotion, mobilization, and election of pro-life women.  The SBA List is a network of more than 365,000 pro-life Americans nationwide.

For more information, please contact Jameson Cunningham with Shirley & Banister Public Affairs at jcunningham@sbpublicaffairs.com or (703) 739-5920.

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Rock Island, IL -Nelson Chiropractic, located in Bettendorf, will be hosting a Patient Appreciation Week June 10 through June 14. During this special week, Dr. Nelson, Dr. Friemel and Dr. Gall will be donating their time and services?consultation, state-ofthe-art computerized spinal exam and x-rays if they are needed?to new patients in exchange for a $20 donation to Christian Care's Domestic Violence Shelter. This is a value of over $200! Nelson Chiropractic will also be taking donations from anyone who wants to drop off supplies or money for the organization.

Christian Care, a local nonprofit, provides safe shelter, nutritious meals, and a wide variety of resources to needy men, women and children throughout the Quad Cities. Our vision is to transform the lives of those we serve, offering the homeless and survivors of domestic violence an opportunity to start a new, more productive life.

We rely on the generosity, kindness and enthusiasm of donors to help us serve the hundreds of men, women and children who turn to Christian Care for assistance each year.  

Dr. Nelson encourages people to take advantage of this opportunity to help the local shelter and invites them to call Nelson Chiropractic at (563) 359-9541 to make an appointment today. Due to legal restrictions, this offer is not available to patients with state or federally funded healthcare plans, such as Medicaid and Medicare.

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The American Lung Association released this report  today in its Disparities in Lung Health Series ? "Taking Her Breath Away: The Rise of COPD in Women." This report examines the burden of chronic obstructive pulmonary disease (COPD), also known as emphysema and chronic bronchitis, among women.

COPD has long been considered a disease of white men, as they have historically smoked at higher rates than other groups. That profile is changing, and the rate of COPD among women has climbed steadily in recent years. Closer examination reveals a number of disparities in burden of disease, risk factors, and healthcare practices that must be addressed.

This report is an important tool to raise awareness of this health disparity, generate constructive discussions and build partnerships within the healthcare industry, as well as governments, community leaders and individuals to seek solutions.

key findings include :

  • Since COPD has historically been thought of as a "man's disease," women are underdiagnosed and undertreated for COPD.
  • Women are more vulnerable than men to lung damage from cigarette smoke and other pollutants.
  • Women are especially more vulnerable to COPD before the age of 65.
  • Women with COPD have more frequent disease flare-ups?a sudden worsening of COPD symptoms that is often caused by a cold or other lung infection.
  • Effective treatment of COPD is complicated, and women don't always get the kind of care that meets their needs.

The quality of life for women with COPD is impaired at an earlier age, and is worse overall than that of men with similar severity of disease.


Iowa Supreme Court Decision Protects Nursing Practice, Ensures Patient Access to Care

PARK RIDGE, Illinois?Iowa patients were the big winners when the Iowa Supreme Court affirmed on Friday that the supervision of fluoroscopy, a type of x-ray imaging used in healthcare procedures such as pain management, is within the scope of practice for the state's advanced registered nurse practitioners (ARNPs), including nurse anesthetists.

"The Iowa Association of Nurse Anesthetists (IANA) joins the Iowa Board of Nursing and the Iowa Nurses Association in applauding this momentous decision that enables thousands of Iowans to continue receiving care from highly qualified ARNPs such as Certified Registered Nurse Anesthetists, or CRNAs," said IANA spokesperson Mindy Miller, CRNA.  "We couldn't be more pleased that our state's Supreme Court recognized, in its own words, that 'allowing ARNP supervision of fluoroscopy improves access to health care for rural Iowans and helps lower costs,' especially at a time when healthcare access and cost-containment are foremost on the minds of all Americans."

In reversing a lower court's October 31, 2011 ruling against ARNP supervision of fluoroscopy, the Supreme Court stated that "the district court erred" in invalidating the Department of Public Health and Board of Nursing rules that allow qualified ARNPs to supervise fluoroscopy. The original lawsuit, brought by the Iowa Medical Society and the Iowa Society of Anesthesiologists in June 2010, alleged that the Department of Public Health and Board of Nursing had exceeded their rulemaking authority, and that the fluoroscopy rules illegally expanded ARNP scope of practice and authorized ARNPs to practice medicine.

ARNPs use fluoroscopy in numerous procedures they perform within their scope of their practice,   such as interventional pain management, catheter insertion, and foreign body location.  Use of fluoroscopy in these and other procedures allows ARNPs to see the precise spot to inject medicine or insert a device. If ARNPs were not permitted to supervise fluoroscopy, patients in rural and other medically underserved areas would have to travel?sometimes great distances?to receive their care from physicians instead of from qualified healthcare professionals closer to home.

"The Supreme Court acknowledged that CRNAs and other advanced registered nurse practitioners have been safely providing these services for years," said Miller. "The court's decision validates the fact that the Board of Nursing does indeed have authority to regulate its practitioners, and it puts patients' interests ahead of the unsupported claims of organized medicine."

About the American Association of Nurse Anesthetists (AANA)
Founded in 1931 and located in Park Ridge, Ill., the AANA is the professional organization representing more than 45,000 Certified Registered Nurse Anesthetists (CRNAs) and student registered nurse anesthetists.  As advanced practice registered nurses, CRNAs administer approximately 33 million anesthetics to patients in the United States each year and are the primary providers of anesthesia care in rural America. In some states, CRNAs are the sole anesthesia professionals in nearly 100 percent of rural hospitals. For more information visit www.aana.com.-----------------
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