Wednesday, December 06, 2017

Cutting re Laura Hillenbrand and CFS

https://well.blogs.nytimes.com/2011/02/04/an-author-escapes-from-chronic-fatigue-syndrome/

An Author Escapes From Chronic Fatigue Syndrome


Laura Hillenbrand, the best-selling author of “Seabiscuit: An American Legend,” is known for her exuberant storytelling and dynamic characters. Her newest book, “Unbroken: A World War II Story of Survival, Resilience and Redemption,” is a riveting tale of the life of an athlete and war hero, Louis Zamperini.

Ms. Hillenbrand’s ability to transport her readers to another time and place is all the more remarkable in light of the fact that she is largely homebound, debilitated by chronic fatigue syndrome, or C.F.S.
The illness, a devastating and little understood disorder, is characterized by overwhelming fatigue and various nonspecific symptoms like muscle pain, memory problems, sore throat, swollen lymph nodes, achy joints and unrefreshing sleep. I recently spoke with Ms. Hillenbrand about her latest book and why she is speaking out about the challenges of life with C.F.S. Here’s our conversation.
Q.
Why have you started talking about your illness?
A.
I had never been public about my illness at all before “Seabiscuit.” I didn’t want to talk about it very much because I had the experience of being dismissed and ridiculed. People don’t understand this illness, and the name is so misleading. I realized I had this opportunity because I was going to be getting press attention for the book. I’m going to talk about it because I can. Maybe that will save the next person from going through what I did.
Q.
Do you think it’s hard for people to understand how debilitating chronic fatigue can be?
A.
This is why I talk about it. You can’t look at me and say I’m lazy or that this is someone who wants to avoid working. The average person who has this disease, before they got it, we were not lazy people; it’s very typical that people were Type A and hard, hard workers. I was that kind of person. I was working my tail off in college and loving it. It’s exasperating because of the name, which is condescending and so grossly misleading. Fatigue is what we experience, but it is what a match is to an atomic bomb.
This disease leaves people bedridden. I’ve gone through phases where I couldn’t roll over in bed. I couldn’t speak. To have it called “fatigue” is a gross misnomer. Most people, when they hear the disease name, it’s all they know about it. It sounds so mild. When I first was sick, for the first 10 years or so, I was dismissed. I was ridiculed and told I was lazy. It was a joke.
Q.
When did you learn you had chronic fatigue syndrome?
A.
I got it when I was 19, and I was diagnosed at 20 by the head of infectious disease at Johns Hopkins. It was the most hellish year of my life. I went from doctor to doctor. I got very thin and lost 22 pounds in a month. One doctor thought I was anorexic and lectured me about it. After my appointment he followed me to the bathroom and put his ear to the door. When my doctor at Johns Hopkins finally said, “You have a real disease,” that was an important moment for me.
Q.
What were your first symptoms?
A.
As it does in most people, it had a very sudden onset. I was an athlete and had always been healthy. I was riding in a car on my way back from spring break my sophomore year of college and felt very nauseated. I guessed it was food poisoning. I woke up a few days later, and I literally could not sit up, I was so weak. It hit me that fast. I had to drop out of school because I couldn’t make the walk to the classes.
Q.
What happened once you left school?
A.
I was bedridden the first two years. I was having fever all the time and huge lymph nodes; the reddest, rawest, terrible sore throat; typical sweats and chills like the flu, but it didn’t go away, month after month. I had the most extreme exhaustion and balance problems, strange cognitive things, trouble concentrating. I couldn’t read analog clocks anymore. I’d try to say one word and a different word would come up. I had brain fog that was terrible in 1987 and 1988, and then it started to slowly get better.
I did better until 1991, when I tried to take a road trip to Saratoga. I had a catastrophic C.F.S. crash, went into shock, and went back down to the bottom to worse than ever. Then vertigo started, and ever since the room appears to be moving around me. I feel like I’m moving all the time.
Q.
How are you now?
A.
I’m housebound now. I had a relapse while I was working on the book in 2007. I got weaker than I’ve ever been. I’ve been too weak to leave the house for two years. I only leave the house about once a month. I’m just not very strong. A lot of days I don’t get down the stairs. It’s a slow process to recovery. The book publicity is quite difficult for me. I’m not able to do that much of it. It’s taking a whole lot out of me.
Q.
It’s hard for me to imagine how you could have done the research and writing for two books during this time. How did you do it?
A.
It’s a trade-off for me. While it’s really hard to do, at the same time, I’m escaping my body, which I really want to do. I’m living someone else’s life. I get very intensely into the story, into the interviews and the research. I’m experiencing things along with my subjects. I have a freedom I don’t have in my physical life.
Writing is a godsend to me that way. Without it I wouldn’t have anything. I am completely still almost all the time. A lot of time I don’t leave the upstairs. What I have is the story I’m working on. It’s a wonderful thing for me to get out of my body for a while.
Q.
Do you think having C.F.S. influences your writing?
A.
Because my life is so silent and so still, I think I’m able to get deeper into what I’m working on. My mind is willing to get out of here and go into there. It becomes such an intense experience.
Q.
Did you always want to be a writer?
A.
At the time I got sick, I wanted to be a history professor. I was 8 years old when I went across the street from my house to a fair, and they always had a used book sale. For a quarter I bought a book called “Come On Seabiscuit.” I loved that book. It stayed with me all those years. I was sick and housebound and looking for something I could write about. I wrote an article. I was partway through it and realized there was a huge untold story.
Q.
How did you do the reporting for the book?
A.
Lots and lots of interviews, at least a hundred, and going through newspaper archives. The family of Seabiscuit’s owner sent me 30 enormous leather scrapbooks. I bought so many things on eBay — vintage things, magazines. I did many interviews with very, very old men.
Q.
Who helps you manage your life?
A.
I’m married. I have a wonderful husband. The house is all set up for me. There is a refrigerator upstairs. My desk has everything I need. Toaster, utensil and bowls, teapot — everything I need. I got married in 2006. We’ve been together since before I got sick. He’s my college sweetheart. We waited to get married until I got reasonably well. I was too sick to go to the reception. I was just at the wedding for a few minutes. He has been through this with me. Some couples it would drive apart; it has drawn us together. We have a deep understanding. He doesn’t see me as a sick person. He sees me as everything else I am. It’s a really wonderful relationship. We had to learn how to do it. It’s not easy at all to be a couple with a disease.
Q.
Why did you decide to write about Louis Zamperini?
A.
Seabiscuit led me to him. My subject was one of the greatest runners in the world in the 1930s, likely to break the four-minute mile. Seabiscuit was famous at the same time. All the newspapers that covered Seabiscuit also covered Louis. I kept reading about him. When I got done with Seabiscuit, I wrote him a letter and called him, and he told me his life story. I had to write this book.
It’s the most amazing survival story. Louis was an Olympic runner who hung up his shoes and became a bombardier. He crashed in the Pacific and floated on a raft for 47 days. Sharks jumped on board to pull him off. He was attacked by a Japanese bomber. He nearly starved to death. He went through a typhoon and was captured. His captors experimented on him, enslaved him, and he was a prisoner for two years. The things that happened to him, and his defiance — it’s an amazing story.
Q.
It sounds like on some level you could relate to him.
A.
I think because of what I’m dealing with, I’m really interested in people who become trapped in extremity and have to rely on their character to pull them out of it. I’m fascinated by the struggle, and the attributes that enable people to survive these things. I want to look to them for inspiration. I think that’s why I’m drawn to it.
Louis has told me he felt I was someone who was easy to open up to because he knows I’ve suffered. With someone else, I think he might have been a little more taciturn. But he felt, “She gets it. She’s been to this place herself.”
Having to go all the way to the bottom of yourself to find the resources to survive: this is something I understand well. I understand desperation. It’s an emotion I have dealt with a thousand times in the last 24 years. You feel like you don’t know where you’re going to get the strength to go on. We’ve been to the same place in different circumstances. I’m not comparing myself to a prisoner of war, but there are common emotions that enable me to identify with him.
Q.
Do you think your writing would be different if you didn’t have this illness?
A.
I don’t remember what it’s like to feel well. I’m 43. I was 19 when I got sick. It’s a lifetime ago. It’s hard for me to imagine what I would have been as a writer without the history I have now. We’re all sitting in our particular circumstances and writing from that place.
Q.
Your personal story is so compelling. Have you thought about writing something autobiographical?
A.
My husband wants me to. I just don’t know that I want to do that. I have to spend so much time being vigilant on my body and worrying about my body and suffering. So much of my own autobiography would be about my health, and I don’t know if I want to spend my professional life thinking about that. I write to escape my circumstances.
Body willing, and if I can find a subject that compels me, I’ll keep writing. It’s a great way to touch the world, because I’m not in this world. I went out recently to the CVS drugstore for the first time, and they had these new checkout things with no person at the checkout counter. I was baffled by this. Writing is my way of communicating with the world, and I don’t have any other way to do it, so I want to keep doing it.

Monday, December 04, 2017

Cutting from Huffpost re crisis in Yemen



http://www.huffingtonpost.co.uk/entry/im-an-aid-worker-in-sanaa-and-no-one-is-safe_uk_5a256717e4b0a02abe929e14?5ju&utm_hp_ref=uk-homepage


I'm An Aid Worker In Sana'a And No One Is Safe

This violence is completely paralysing humanitarian operations

 04/12/2017 15:31 GMT

Suze van MeegenProtection and advocacy adviser with the Norwegian Refugee Council

MOHAMED AL-SAYAGHI / REUTERS
No one is safe in Sana’a at the moment. I can hear heavy shelling outside now and know it is too imprecise and too pervasive to guarantee that any of us are safe. Over the past two days, the capital has endured relentless bouts of intensive gunfire and artillery shelling from all sides— bullets and shelling from Saleh loyalists and Ansar Allah fighters, airstrikes from the Saudi-led coalition. The aerial bombardment continued last night, intensifying further today with more attacks on the airport.
I spoke to a colleague who is trapped, his house between two checkpoints and surrounded by snipers. He and his family are sheltering in their basement, without any electricity, listening to tanks roll by outside. Yemenis have few protections against the sort of violence happening now – and that includes both the bombardments and the more insidious kind that is depriving them of access to food and healthcare.
As with all international aid agencies, our operations are at a standstill. Our Yemeni staff have all been accounted for, though some are in heavily impacted areas, reporting heavy artillery moving immediately outside and snipers on neighbouring rooftops. Most report sheltering in their home basements, but some are now without any electricity.
We have been facing enormous challenges reaching the overwhelming number of people who need assistance to stay alive through the collapse of Yemen’s basic civil services. We faced enormous challenges trying to prevent people from dying of cholera while authorities in Yemen made access to them difficult. The ongoing blockade of commercial imports through Hodeida Port is beyond challenging and will inevitably result in thousands of preventable deaths. But this violence is completely paralysing humanitarian operations. We cannot move from our houses. Sana’a is in hibernation and with it, so is any chance of reaching people with food, water, healthcare or education.
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KHALED ABDULLAH / REUTERS
Roads into Sana’a are blocked, checkpoints are tense and the airport is unreachable due to heavy fighting. The UN aid flights to Sana’a – the only way of getting in and out of the capital – were denied clearance by the Saudi-led coalition, but conditions are in any case currently too tense to enable movement, and airport damage now needs to be assessed.
As international humanitarian workers, we have privileges and protections that leave us as well-equipped as possible to withstand violence of this kind, but our national colleagues may not. The direct and indirect impact of this violence on civilian populations is inestimable. The current violence will bring a whole nation to its knees - on top of almost 1000 days of conflict, and an ongoing blockade that is preventing the delivery of commercial food and fuel through the county’s main port. In just a few days, the fighting has killed and injured civilians, including children. There will be hundreds of casualties – thousands if this is allowed to go on. Facilities have been closed and some medical personnel forced to flee their posts for safety, leaving the sick and injured even more vulnerable. Seven million Yemenis are currently dependent on humanitarian aid to survive and none living in areas affected by the current violence can receive it while the humanitarian response is on pause. An already catastrophic crisis is being made worse and hundreds of thousands of deaths could ensue in the short term as a result.
I don’t want to leave, knowing that our national staff can’t and nor can the people that depend on humanitarian assistance. None of the international humanitarian staff I know want to leave because we know that the impact will be felt by civilian - people who want no part in this violence and are most affected by it.
We urgently call on all parties for an immediate ceasefire to enable the delivery of aid and safe movement of Yemeni people. The sick and injured must be allowed to access medical care. People must be allowed to get food and water after days in hiding. Civilians with a safe place to go must be allowed to get there. 
Yemen’s humanitarian crisis has not happened organically. It is entirely man-made and must now been undone. We call on all governments with influence over parties to the conflict to make this stop. The blockade must be lifted and Yemen needs a political solution now.

cuttings on Laura Hillenbrand on illness experience

http://emerge.org.au/wp-content/uploads/2014/07/The-New-Yorker-Jul-07_-2003_p56-65.pdf - article in New Yorker - 'A sudden illness - how my life changed'

http://stanmed.stanford.edu/2016summer/leaving-frailty-behind.html

Leaving frailty behind

A conversation with Laura Hillenbrand

This interview was condensed and edited by Paul Costello
Illustration by Lara Tomlin
She is an author of extraordinary success. Laura Hillenbrand’s Seabiscuit and Unbroken are literary phenomenons: Together, there are more than 13 million copies in print, and both have been made into blockbuster motion pictures. Seabiscuit, published in 2001, tells the story of a racehorse that captured America’s heart during the Great Depression. Unbroken, published in 2010, is the biography of World War II hero Louis Zamperini, who survived a bomber crash into the Pacific and more than 2½ years as a prisoner of war in Japan. Hillenbrand wrote the books while besieged by chronic fatigue syndrome, or ME/CFS, which has at times ravaged her like a tidal wave. Stricken in 1987, she has endured vertigo and exhaustion so severe that for many years she was incapacitated and housebound.
Recently, Hillenbrand has made a lot of changes in her medical treatments and in her life. There’s optimism in her voice and a sense of wonderment at new beginnings. A big one is a move across the country to be with her boyfriend in Oregon, where she finds solace in afternoon car rides with views of resplendent Mount Hood.
For this special issue of Stanford Medicine on well-being, we were curious: What does the word “well” mean to someone who has been unwell for so long? Executive editor Paul Costello spoke with Hillenbrand about her illness, her newfound strengths and how she is leaving frailty behind.

Costello: Does the term “being well” register for you?
Hillenbrand: I don’t really think about that as an aspiration, exactly. I think about if I could do this thing, if I could ride a bike for miles, or if I could climb to the top of the Empire State Building. What I think about is a life in which I don’t have to monitor my body. A life in which I’m not constrained in terms of what I want to do and not paying a huge price for what I do. I’m doing much better now than I’ve done in years, and I’ve started riding horses. That’s a great joy to me because it was something I did when I was a healthy person and I was younger.

Costello: Is horseback riding therapeutic for you?
Hillenbrand: Riding is very therapeutic. It’s also therapeutic just as a physical accomplishment. It’s a sport. For decades I didn’t do sports. I maybe could walk around the block. Now I put on my helmet and my boots, and I just feel like I’m more of a normal person. I love that. It’s a marvelous feeling to wed yourself to an animal of such strength.
Costello: It sounds like your life has taken a shift.
Hillenbrand: Everything has come together to give me a little bit of push. I started to test the boundaries and found out, “Well, I could do this. I could do that.” Each one of those things that I did would make me feel like, “Maybe I can try the next thing.” It’s an extremely slow process, and sometimes I overstep and slip backwards. But I keep trying. Once I got out here to Oregon, I got on a bike, which was another thing I was really into when I was healthy, and now I’m starting to ride a bike. Not very far. Not very well. But I’m doing it.
Costello: You moved from Washington, D.C., to Oregon. Did you have to prepare yourself?
Hillenbrand: It took years to get ready to do this. To put you in the perspective of where I was, I had not left Washington, D.C., since 1990 because of vertigo, which has been a problem for me for most of the time I’ve had CFS. It’s not a common kind of vertigo: It has been absolutely constant. It feels like the floor is pitching up and down. It looks like the room is moving around me. My desk is moving. Everything looks and feels like it’s moving. It’s hell.
I began to try to inure myself by getting in a car and riding for five minutes. It would be awful and I would feel terrible. I was so dizzy for an hour afterward, but I just wanted to see: If I keep doing this, can I teach my brain how to tolerate it? I’d go a little longer and a little longer. And over two years, I went from being just miserably dizzy after five minutes to being able to go two hours.
Once I hit two hours, I started thinking maybe I could come across the country. My boyfriend was living in Oregon. I wanted to be with him. I wanted to start a new life. D.C. was not the right place to be for someone with CFS who was very intolerant of heat. I also wanted a simpler world around me because complicated things are difficult with the cognitive problems from CFS.
I was in love and I wanted to be with the man I was in love with. We got an RV and we took a monthlong trip crossing the country and it was a miracle for me. It was the most wondrous thing.

Costello: What did you discover on the trip?
Hillenbrand: Every single thing was beautiful. Every drop of rain, every stretch of highway, every blade of grass was beautiful because I was not in a bed, I was not in a house. People kept saying, “Well, you’re going to have to be bored in the Midwest because it’s not pretty.” I thought it was gorgeous. I was gasping at the grasslands of Kansas. And I thought Illinois was resplendent. And then we went to the Badlands and I’d never seen a canyon before. I just shrieked when I saw it. It was a surprise. My boyfriend didn’t tell me we were going. He said, “Don’t look at the map. I don’t want you to know where we are.” We just pulled up and the land drops away and there are canyons everywhere. I can’t describe how overwhelmed I was by the beauty.
We went to the Black Hills and we went to Spearfish Canyon. We went out to the West Coast. I put my hand in the Pacific Ocean. [laughs] We started at the Atlantic Ocean in Delaware. I got in the water in the Pacific. What I experienced was an overwhelming sense of gratitude because I had been set free. I was not well. I am not well. I am always dealing with symptoms, but I was free enough to have that experience, to see America.

Costello: Love has really changed your life.
Hillenbrand: It’s the biggest thing that got me to take this leap. It was very, very, very risky for me to do this. I could have died on this trip. When I push too far ... at one point, when I tried to take a trip in 1991, I went into shock and very nearly died.
I could have landed in bed for another 10 years. It was so risky, but I just believed that I could do it. I believed in the person I was with. I thought, I have to try. I cannot live my whole life in a room. I can’t do it. I won’t do it. I’m willing to risk everything to escape.

Costello: Can you describe how you experience the illness?
Hillenbrand: The typical experience of it is akin to being bound in plastic so that you can’t move your arms and legs, you can’t speak and be heard. You are suffocating. It closes off the world to you in a most profound way so that all that is left of you is the thoughts in your mind, because you just aren’t capable of doing anything, of interacting with the world at all. There was a period of time where I didn’t leave the house for two years. I was too weak to do it. That is the physical experience of it. You become a purely intellectual thing because you are no longer a physical creature at all.
The parameters of my strength are nothing like that of a normal person. There’s a red line I cannot cross, because to cross it means to plunge into a “crash,” a devastating state of exhaustion in which I can’t stand, sit up, or sometimes even speak.
In terms of what that has given me, I feel like independent of what the cause of suffering is, there is this place that suffering takes you that is common to people suffering from all different kinds of things, serious diseases or terrible grief or all of the things that fell us in our lives.
In writing Unbroken, which is about servicemen at war and prisoners of war and people in horrific states of suffering, I felt like I was able to climb into their bodies and minds maybe better than I would have been if I had just been a regular healthy person.
I felt like I knew what Louis Zamperini felt when he was being held prisoner on Kwajalein Island and having medical experiments done on him by the Japanese. Not that I am comparing my disease to the experience of a prisoner of war. That’s a different and horrible thing that’s inflicted upon you by others. But the quality of the suffering … when he and I would discuss it, he knew I knew something of what he felt. He told me that enabled him to delve more deeply into it with me than he had with other people. He felt like if he told me this story, I would write it down right.
At the end he told me that what I wrote was so true to his experience that he kept having to put the book down and look out the window and tell himself, “I’m here. I’m here. I’m here. I’m not there anymore.”
Costello: Are there any scenes from either of your books that you return to when you are facing a challenge that seems insurmountable?
Hillenbrand: Stanley Pillsbury was the top turret gunner on Louis’ B-24 bomber. There is a very harrowing experience that these men went through when fighting off Zeros [Japanese fighter planes] after bombing Nauru Island.
A Zero was coming at Stanley Pillsbury and he had been shot in the leg with a cannon. His leg was horribly mangled. He was terrified. He was a very quiet and recessive kind of man. He did not have a swaggering kind of personality that you think of in a war hero, but he had this moment where he’s in agony with his leg dangling down and the plane has been hit 600 times by cannon fire and bullet fire. It’s likely to crash.
Somewhere inside himself Stanley found this wondrous strength and he pivoted in his motorized chair and he took aim. He could see the Japanese pilot flying toward him, and he thought, “I have to kill this man.” But he had to do it to save all the men aboard his plane. He fired and he shot down the Zero and he saved everybody on the plane.
That is something I go back to a lot because Stanley had no idea that he had that kind of strength in him, that he could do that. None of us knows what we would really be in these circumstances of extremity. Stanley found out that day. I like to remember that when I feel frightened. When I feel too small for my circumstances, I remember Stanley.

Costello: Your books are beloved. You’ve reached epic fame. How has that outside success impacted you?
Hillenbrand: Having been able to write the books was lifesaving for me. It gave me an ability to connect with the world. It gave me an escape from my body. It enabled me to create things that had importance.
These are not books that the world will turn upon forever. These are stories from history, but they are very inspiring stories, and they do bring joy and relief and peace to people when they read them. That means a great deal to me.
I had lost the ability to connect with the world in any way at all. Even just talking on the phone I couldn’t do much of the time. I was able, though, to write these books and tell these stories, and reach out to people I would never meet all over the world and create something. It validated my life.
It changed the way I thought of myself, also. Most patients will tell you that it’s terribly humiliating to have this particular disease, because it isn’t taken seriously. You are treated with terrible contempt, sometimes by your own family. You lose that respect that you normally receive in conversing with the world because people are really spilling contempt on you all the time.
It gets to you after a while. You start to feel like nothing because you’re told that all the time. That you’re lazy, and that you’re useless. These are words that I heard a lot. When I wrote those books, I proved I wasn’t lazy and I wasn’t useless.

Costello: Were you proving something to yourself?    
Hillenbrand: I was proving what I was. It was really, really hard to write a book with this disease. It’s never easy to write a book, but to do it with vertigo and to do it with exhaustion it took every bit of me. I would do it again because of the self-respect I got out of it.

Costello: Are you angry at the medical community over the disease being so misunderstood?
Hillenbrand: I felt very, very angry for a long time about it, angry with specific doctors who were particularly appalling in their behavior toward me. I was angry over the damage that caused, physically and emotionally.
I don’t feel contempt for the medical community. Different doctors are different people. I got my diagnosis from a wonderful guy, the head of infectious diseases at Johns Hopkins, who was the first person who was willing to say, “You have a serious disease, and the other people who have dismissed you are simply wrong. I don’t know what’s wrong with you, but I believe that you’re very ill.” That took humility for him to say. I am so grateful for it. I walked out of there happy even though he said, “I can’t treat you. I don’t know what to do for you.” But simply telling me, “I respect you, and I have a limit to my understanding of disease,” was a beautiful thing.
My physician in Washington, D.C., would exhaust himself trying to help me, and he would stay with me for hours. He would make house calls because I couldn’t come to him. He was wonderful to me.
I don’t blanket the whole medical community for what some people did back then, and I am treated with much more respect now.

Costello: What gives your life meaning?
Hillenbrand: I want my life to touch the lives of others in a positive way if I can possibly do that. I want to give as much of myself and whatever gifts I have to other people to make the world better if I can. I write with the goal of serving my subjects in terms of telling their stories and trying to illuminate the world a little bit with what those stories have to offer about living and about history. Those are the things that motivate me every day. A weirdly beautiful gift the disease has given me is to appreciate everything in this world, even the things that you simply take for granted if you’re well.

Saturday, December 02, 2017

instagramming knitters

https://www.instagram.com/woolapyk/

https://www.instagram.com/verapaelman/

https://www.instagram.com/sidselsangild/

https://www.instagram.com/satoko.tricot_the/

http://filcolana.dk/en

https://www.ravelry.com/designers/sidsel-sangild


Cutting from the nation re insulin price hikes in US - a medication discovered almost a century earlier


https://www.thenation.com/article/alex-azar-trumps-hhs-pick-has-already-been-a-disaster-for-people-with-diabetes/


'Alex Azar, Trump’s HHS Pick, Has Already Been a Disaster for People With Diabetes

While he was at Eli Lilly, the company more than tripled the price of its best-selling insulin.


Last year The New York Times published an op-edurging the break up of the “insulin racket.” But rather than break it up, Trump has nominated one of its architects, Alex Azar, for secretary of Health and Human Services.
From 2007 to 2017, Azar worked for pharmaceutical giant Eli Lilly. While he was a senior VP, Lilly paid a record $1.415 billion to settle a case on its off-label promotion of the antipsychotic Zyprexa. Rising up the ranks, Azar became president of Lilly USA, the largest division of Eli Lilly, in 2012, a position he held until resigning in January of this year.
During Azar’s tenure, Eli Lilly raised the prices on its insulins in the United States by 20.8 percent in 2014, 16.9 percent in 2015, and 7.5 percent in 2016. Eli Lilly’s biggest seller, Humalog insulin, is now off-patent. But rather than becoming cheaper, Humalog costs more now than when it first came to market in 1996. When Azar started working at Eli Lilly in June 2007, the list price for a vial of Humalog was $74. When he quit in January 2017, it was $269.
At T1International we asked people with type 1 diabetes around the world how much they paid each month to stay alive. The United States topped every country, spending on average $571.69 per month on diabetes costs. Even with insurance, some Americans are spending around half their income on insulin and other supplies.
In fact, price gouging from Eli Lilly and other insulin manufacturers has already had deadly consequences. Shane Patrick Boyle, a founder of Zine Fest Houston, died on March 18 after his GoFundMe campaign to pay for insulin came up $50 short. Alec Raeshawn Smith, age 26, was found dead in his apartment on June 27. He was rationing his insulin after he aged out of his parent’s insurance coverage. The sad fact is more people would be alive today if insulin was affordable for all Americans.
Contrary to pharma propaganda, insulin is neither “new” nor “innovative.” It was developed in Toronto in 1921. The discoverers turned down the chance to create for-profit clinics. Instead, they licensed their creation for $1 (Canadian) a piece. Their recorded reason for doing this was to make sure insulin would be available for all who needed it. Eli Lilly’s was tasked with manufacturing insulin for North America. There was an understanding insulin would be sold at a reasonable price until there was a cure for diabetes.
What difference a century makes! Eli Lilly is currently under investigation by multiple state attorneys general for price fixing. It is also named in a class-action lawsuit that alleges that it colluded with Novo Nordisk and Sanofi to keep the prices in the US insulin market rising. These “Big 3” insulin makers control over 90 percent of the global market and maintain their lock on it in many ways. One is “pay-for-delay schemes,” like when Sanofi paid Eli Lilly to delay the launch of an insulin similar to its Lantus brand. Another is to sue potential competitors for intellectual property infringement, such as when Merck attempted to enter the insulin market in 2016. The companies also funnel money into patient-advocacy groups, both big and small. This might explain the inaction or even outright opposition of these groups on measures that may rein in prices.
At first glance Trump’s decision to appoint Azar is surprising. Public support for lower drug prices is at an all-time high. Why hire a man directly responsible for raising the price of a drug that millions depend on? The reason becomes clear once you review the campaign contributions. Azar’s Lilly spent millions lobbying Congress, the Department of Health and Human Services, spending $5.7 million in 2016 alone. The company has deep ties to the Trump administration. Lilly’s current CEO, David Ricks, was one of the first business leaders to meet with Trump after his inauguration. Ricks has publicly and repeatedly backed Trump’s tax-reform plans. Vice President Mike Pence also knows Azar well from his time as governor of Indiana, where Eli Lilly is headquartered. Clearly the Trump administration and Alex Azar feel they have a friend in each other.
Alex Azar was part of pharma-lobby group Biotechnology Innovation Organization (BIO) until this year. When you ask pharma-lobby groups like BIO to explain why drugs cost so much, they’ll tell you “it’s complicated.”
In fact, it is simple. Drugs cost far too much. There are all sorts of ideas on how to bring prices down. Allow Medicare to negotiate drug prices. Let private citizens buy their drugs abroad. Mandate transparency on the dealings between drug companies, pharmacies, and middlemen called pharmacy benefit managers, as the State of Nevada did this year with SB539, a bill with bipartisan support.
We can expect Alex Azar to pursue none of these options. Looking at his track record, you can bet he will continue to back pharma-friendly approaches. Expect the Orwellian phrase “value-based pricing” to be commonplace. Since insulin literally keeps people alive, the Big 3 insulin producers have already tried to argue that value is a good reason to keep the prices high. The fact that insulin is almost 100 years old and costing pennies on the dollar to be produced means little when next quarter’s revenue is at stake.
Trump has repeatedly called for drug-price reform. Last year he called out big pharma for “getting away with murder.” Yet by nominating Azar he just sent a clear message to industry. It’s open season.
Oppose this nomination.'
James ElliottJames Elliott is a trustee of T1International, a registered UK Charity dedicated to #insulin4all that does not accept pharmaceutical funding

Friday, November 24, 2017

Cutting from Yahoo re Egypt mosque attack.

https://uk.yahoo.com/news/least-54-killed-bomb-gun-attack-egypt-mosque-122300284.html

Egypt mosque attack: Hundreds killed in bomb and gun assault

 Tom Acres, News Reporter,Sky News

At least 235 people have been killed and dozens more injured after a suspected Islamic State bomb and gun attack on a mosque in Egypt.
The country's government has declared three days of mourning following the assault on al-Rawdah mosque on Friday afternoon - one of the deadliest attacks in Egypt's modern history - which has also wounded more than 100 people.
The mosque is in Bir al-Abed in the volatile northern Sinai Peninsula, around 25 miles from the provincial capital of el-Arish, which has been regularly targeted by IS militants in recent years.
Officials said around 40 militants armed with guns arrived at the mosque - largely attended by Sufi Muslims, seen as non-believers by IS - in four off-road vehicles before detonating a bomb and opening fire from different directions, blowing up cars to block routes as people tried to escape.
No group has yet claimed responsibility for the attack - which came as worshippers took part in weekly Friday prayers - but state news agency MENA reports that it "appeared" to have been carried out by IS.
The Egyptian military began carrying out airstrikes in the area on Friday evening.
It came an hour after President Abdel Fattah al Sisi gave a televised address in which he vowed a "brutal" response to the "criminal" and "cowardly" attack following an emergency security meeting, insisting that it "will not go unpunished".
He added: "The army and police will avenge our martyrs and return security and stability with force in the coming short period."
A local resident, whose relatives were at the scene of the bomb and gun attack, said: "They were shooting at people as they left the mosque.
"They were shooting at the ambulances too."
Another local resident, Ashraf el-Hefny, said many of the victims were workers at a nearby salt firm.
He added: "Local people brought the wounded to hospital on their own cars and trucks."
Police officers said the militants had tried to stop people from escaping from the area by blowing up cars and then using the burning wrecks to block roads.
Cairo's international airport has boosted security following the attack, with troops seen patrolling passenger halls, conducting searches and manning checkpoints.
Prime Minister Theresa May tweeted to say she was "appalled" by the "sickening attack", with US President Donald Trump condemning it as "horrible and cowardly".
"The world cannot tolerate terrorism, we must defeat them militarily and discredit the extremist ideology that forms the basis of their existence," Mr Trump added.
IS militants have killed hundreds of police and soldiers in the region since fighting intensified over the last three years , although they have mostly targeted Egypt's security forces .
Earlier this year IS posted a video of the beheading of two Sufis in northern Sinai, accusing them of practising "sorcery", and in July the group claimed responsibility for suicide car bomb attacks on two military checkpoints in the region, which killed 23 soldiers.
They have also targeted Christian churches and pilgrims in the country. A bombing in October 2014 led to the Government declaring a three-month state of emergency , but Friday's attack is region's the deadliest to date.
Middle East analyst Timothy Kaldas told Sky News that the military's "scorched Earth" approach towards eliminating IS did not appear to be working and described the scale of the attacks in the region as "unprecedented".
"The number of attacks has gone down slightly but the casualty figures have actually risen," he said.
He added: "Not enough has been done to win over the local population to deny Isis safe haven recruits.
"There's been reports of abuse where captured militants have been executed by the military, so there's a lot of concerns that the way the government is approaching things is actually increasing militancy rather than decreasing it."
The attack comes days after a deadly bombing on a mosque in Nigeria , which killed at least 50 people.