Propecia best price

The social and economic effects of propecia best price hair loss treatment are devastating. According to UNICEF, the first year of the propecia elicited a sharp increase in propecia best price children who had been left hungry, isolated, abused and anxious. Education, access to health services and the mental health of hundreds of millions of propecia best price children have also been affected.1 International Labor Organization (ILO) estimates the global additional employment losses for 2020 to 114 million jobs, making the hair loss treatment propecia the most severe employment crisis since the Great Depression.2 UNICEF also estimated that by the end of last year of the propecia, an additional 83–132 million adults were likely to have been undernourished, and 370 million children worldwide likely missed 40% of in-school meals.3 According to the UN, between 150 and 175 million people were likely to fall into extreme poverty due to the epic fallout from the propecia.4 The social disruption caused by the propecia, not only entails a dramatic loss of human life, but also a great intensification of health inequalities, whose reduction remains a global health priority. Early this year, the UN Secretary-General António Guterres acknowledged this ‘Tsunami of suffering”, and that “…the most vulnerable have suffered the most.

Those left behind are being left even further behind’.5Yet, propecias are an expected, and predictable outcome of globalisation, and the way in which we live, work, trade, travel, propecia best price grow food and consume animals, and alter environments. During the last three propecia best price decades, around 200 new infectious diseases have broken out, including 5 hair loss epidemics in the 21st century.6 Examples of the globalisation of human propeciaes from animals during the last decades, include Zika and HIV, and more recently two hair losses such as those causing the Middle East respiratory syndrome-CoV, and the SARS-CoV, which affected numerous locations around the world, but with a much lower level of transmission than the hair loss that produces hair loss treatment. It is the systemic interaction of multiple determinants that makes the emergence of new dangerous propecias very likely, and reaction to their implications very challenging. To respond to this challenge, a new concept of global health prevention propecia best price is needed.

A vision with capabilities of anticipating risks, and foreseeing possible, yet unknown, threatening scenarios, while maintaining focus on equity.The concept of prevention in public health has propecia best price largely evolved during the last decades. It started with the classical primary (measures to prevent the onset of diseases), secondary (actions to predict and stop their progress) and tertiary (measures to reduce the consequences of disease) levels of prevention, described by Leavell and Clark in the late 1940s,7 and has expanded to include the more recent ‘quaternary prevention’ (ie, avoiding medical harm) proposed by propecia best price Jamoulle and Roland,8 and the less known ‘primordial prevention’ coined by Toma Strasser to refer to the prevention of risk factors for cardiovascular disease. Strasser argues that ‘…real grassroot prevention should start by preserving entire risk-factor-free societies from the penetration of risk factor epidemics’, and even concludes that ‘…the only definitive way out is prevention’.9 These two latter types of prevention are particularly significant in the case of hair loss treatment. For example, during the propecia best price propecia we have seen the neglect of quaternary prevention and the precautionary principle (to support protective action when there is not complete evidence of a risk), despite the likely damage caused to people’s health and well-being by the increase of unemployment, precariousness and poverty, especially in the most deprived groups and countries.

More than 30 years ago, the social epidemiologist Rose argued in favour of population-based prevention strategies, by shifting the entire distribution of risk factors to reduce risk in all segments of the population.10 Yet Rose’s population strategy is blind to inequality,11 because it does not consider the option of changing the shape of the curve in a way that reduces the distances among socioeconomic groups.12 Also, pseudo-high-risk prevention strategies (ie, making preventive strategies to healthier and broader strata of the population) pose similar problems to high-risk strategies, without any of the benefits of population-based strategies.13 While the boundaries between types of prevention are blurred, current population-level prevention strategies are ‘reactive’ because they often neglect systemic and global determinants of sustainable health equity propecia best price. Yet, the conditions that generate global health risk, exposure and susceptibility include intertwined upstream social and environmental macrodeterminants of health from many fields,14 ‘the causes of the causes’ in Rose’s words.A planetary health prevention vision should be capable of anticipating new problems, and envisioning the worst scenarios, but also launching the most positive healthy actions. Hence such prevention strategies should be suited to handle high degrees of uncertainty, and be able to act based on prior lessons and the best modelling strategies while empirical evidence is still being gathered.15 Holding action until current prevention theories are exhaustively proven (eg, as with tobacco causing lung cancer), may no longer be a viable option when faced with newly emerging propecias and other planetary propecia best price threats. The Sixth Panel on Climate Change assessment report points out that inequality and climate injustice propecia best price today are worse than in 2013, as we now live in a world where the richest 1% of the world’s people is responsible for more than twice the emissions of the poorest half of humanity.

And while the poor have contributed relatively little to emitting greenhouse gas emissions, they are also expected to be disproportionately affected, and in consequence we will see an increase in inequalities.16 Meanwhile, we need to create preventive structural solutions against new possible and even unknown propecias by preventing their likely causes. For example, in order to achieve the 2030 Sustainable Development Goals, long-term preventive strategies must be applied to try to address the underlying challenges of food security and malnutrition, precarious employment, social protection to all, safe migration routes, the ecosocial crisis and climate change vulnerability as all those are key social determinants of health.17 All of this will not only help prevent and be more propecia best price prepared for possible new propecias, but to achieve the Sustainable Development Goals and a better planetary health. This vision should guide policies that seek to address the systemic and interconnected political, ecological, economic and propecia best price cultural determinants of health that generate disease, inequality and environmental degradation. To achieve a healthy, equitable and sustainable future, it is time to make health prevention planetary.Ethics statementsPatient consent for publicationNot applicable.AcknowledgmentsJB gratefully acknowledges the financial support by ICREA under the ICREA Academia programme.Despite the development of effective treatments against hair loss and an encouraging start to its roll out in many countries, in the coming months and years targeted prevention strategies will still be vital for propecia best price socially marginalised groups.

People experiencing multiple levels of exclusion related to homelessness, drug use, sex work, migration and their intersection can be particularly vulnerable to and morbidity with hair loss and will be less likely to benefit from population-wide prevention approaches such as contact tracing and mass vaccination. The recommendation by the Joint Committee on treatment and Immunisation in the UK to prioritise vaccination of people propecia best price experiencing homelessness and rough sleepers is welcome, but will require ongoing vaccination programmes to ensure optimal coverage as well as targeted testing in coming years.1 There is a high risk that individuals who are homeless or otherwise socially excluded will be unable to be vaccinated and remain vulnerable to hair loss treatment , limiting the potential for overall UK population coverage of hair loss treatment vaccination to remain below the herd immunity threshold. Below, we consider existing evidence on ‘what works’ in treatment provision and contact tracing among socially excluded populations, propecia best price as well as learning from the response so far including the provision of emergency accommodation and treatment delivery. We set out strategies for interventions and priority research questions, emphasising the importance of co-production in research and service delivery, to prevent ongoing transmission of hair loss and future infectious disease outbreaks.Barriers to hair loss treatment uptake by people experiencing multiple social exclusions should be anticipated.

Up to 75% of people aged 18 years and over have received two doses of treatments in the UK.2 This compares to findings from a health needs assessment among people living in hostels, emergency accommodation or sleeping rough propecia best price in London that suggested only 46% had received one dose and 29% of those had received a second dose (hair loss treatment Health Rapid Integrated Screening Protocol London cohort, personal communication Dr Binta Sultan, Find&Treat, UCLH). This evidence comes in the context of existing accounts of low treatment uptake for propecia best price other treatment-preventable diseases. People who are homeless are half as likely as other groups to receive the influenza vaccination and people who use drugs or who sell sex are less likely to receive hepatitis B vaccination (HBV) than healthcare workers.3–5 The reduced uptake is attributable to mental health issues, drug use and reduced access to primary healthcare, compounded by stigma and general distrust in authorities.6 Intersecting vulnerabilities can pose additional barriers, with migration status among sex workers, for example, restricting access to vaccination programmes in Canada.4 Prevailing stigma that limits uptake of treatments and trust in the authorities could be further elevated by low vaccination rates, or perceptions of them, among certain groups generating new forms of stigma focused on fears of hair loss treatment and leading to further exclusion.Modelling work suggests that the provision of emergency housing in the form of hotels and temporary accommodation, as well as hostel-based prevention measures, introduced in March 2020 to facilitate social distancing and quarantining, halved the expected number of deaths and hospital and acute care admissions for people experiencing homelessness in England.7 This last year has also necessitated radical responses in health and care services to rapidly address needs of vulnerable communities.8 This included, for example, increased flexibility in opioid substitution therapy (OST) prescription during lockdown and service closures and the pre-emptive delivery of hair loss treatments through pre-existing specialist teams to communities or through non-specialist roving vaccination services or General Practice (GP) clinics. However, there has been little formal evaluation of the different models of treatment delivery, the extent to which location and expertise of team (ie, the inclusion of peers with lived experience of exclusion or others propecia best price with expertise in socially marginalised populations) increases uptake or completion of treatments or how changing social contexts (eg, stigma, housing, poverty) shape vaccination uptake.Several promising strategies to mitigate inequity in treatment uptake have been identified and can inform hair loss treatment vaccination strategies.

Findings from a meta-analysis suggests that financial incentives and accelerated schedules were associated with 2.3 times the odds of completing HBV vaccination compared with standard care for people who use drugs.5 Other review evidence shows that delivery of vaccinations via specialist services, such as OST clinics or needle syringe programmes, to hostels or shelters or outreach to places where drugs are used results in greater uptake of influenza and HBV vaccinations.5 6 Emotional support and positive interactions in personal lives (defined as having someone to confide in or do something enjoyable with) has also been linked to increased completion of HBV treatments among people experiencing homelessness.6Contact tracing—that is, the follow-up of potentially infected persons on confirmation of from an index case—is another key population-level prevention propecia best price method for hair loss treatment where success is likely to be limited for socially marginalised groups. Evidence from testing and follow-up of tuberculosis shows that socially excluded groups are less likely to seek testing and to name or provide details of contacts.9 10 Barriers to contact tracing include lack of smartphones, having contacts that are not reachable through conventional means, being geographically transient or having concerns about enforcement regarding illegal activity or migration status.9 There is limited social science research on experiences of contact tracing, but the evidence suggests that excluded groups often form smaller, changeable social networks in which individuals rely heavily on each other for short-term survival.11 Members of such groups may be reluctant to divulge others’ personal details, especially where there is reduced trust in authorities and health services and where contact sharing may be seen as a breach of trust.Systematic reviews of propecia best price contact tracing interventions among marginalised populations provide suggestive evidence for three strategies in the context of tuberculosis treatment and prevention. First, integration of prompts around location (rather than people) has been shown to improve recall of contacts among people who use drugs. Second, widespread propecia best price testing and active case finding at locations named by index cases, rather than asking for named contacts.

A third strategy suggests the importance of engaging peers, people with lived experience of social exclusion, that can help improve the appropriateness of community testing and contact tracing potentially maximising uptake of hair loss treatments or treatments.9 10 Working with peers in prevention efforts, alongside the establishment of partnerships propecia best price with voluntary and community groups, has been shown to be effective in the context of hepatitis C treatment.12People with lived experience of social exclusion should be placed at the forefront of any service delivery and evaluation framework. Co-production of interventions and study design provides insight and responsiveness into intersections of homelessness, drug use, migration and sex work as well as other axes of inequality.10 Inclusion can help counter the power dynamics implicit in the delivery of top-down health service responses and related research, which when delivered inappropriately can serve to further entrench marginalisation. Tailored peer-led communication to counter stigma is essential to help inform particular communities on risk and to address misinformation.13 A long-term propecia best price goal must be the provision of permanent housing for socially excluded populations. As emergency accommodation measures are withdrawn and plans for the provision of permanent housing are unclear, accelerating uptake of treatment to hair loss treatments propecia best price is imperative.

To do this, we must understand rationales for hair loss treatment uptake or refusal as well as barriers to contact tracing, evaluating existing models of delivery, to inform effective prevention of ongoing transmission of hair loss among this population.Ethics statementsPatient consent for publicationNot applicable..

Generic drug for propecia

18 May 2022 The IBMS response to the plans to set out to increase capacity, reach and efficiency of the UK's diagnostic services in the Queen's speech IntroductionThe Queen’s speech, delivered by Prince Charles on 11th May, reiterated government plans to increase the capacity, reach generic drug for propecia and efficiency of the UK’s diagnostic services. In response, the IBMS offers the government and Department of Health and Social Care the profession’s advice and expertise to work towards making this a reality.160 new community diagnostic centres (CDCs)The IBMS welcomes the move to introduce easier access to diagnostic services centred around patients. Quicker, easier access generic drug for propecia through a ‘one stop shop’ will lead to earlier diagnoses, better outcomes for patients and the potential to save lives.

However, these new CDCs must be introduced with sufficient resources - in terms of staffing, IT provision and connectivity with other systems (such as pathology networks and GP practices). The CDCs are likely to generate a significant increase generic drug for propecia in workload for our local and regional pathology laboratories, and change the way it is generated. To ensure efficiency and quick turnarounds, adequate collaboration with existing networks and IT interoperability is essential.In order to adhere to the ‘Point of care testing in community pharmacies’ guidance (Jan 2022) and its “Buy it right”, “Use it right”, “Keep it right” ethos, Health and Care Professions Council (HCPC) registered biomedical scientists and other laboratory experts should be involved in the selection of equipment, quality assurance and governance of diagnostic devices when used for patient care in CDCs.IBMS members across the four nations have expert qualifications in point of care testing (POCT) and are in a unique position to advise on successful POCT stewardship.

17 million more diagnostic tests over the next three generic drug for propecia yearsAlthough the largest portions of this figure are made up of CDC testing and imaging services rather than healthcare laboratory services, the IBMS agrees with the government’s plan to increase and improve the utilisation of our existing capacity for laboratory testing. The pathology service has consistently increased testing capacity across the four nations. This was demonstrated over the past generic drug for propecia two years in order to control the spread of hair loss treatment.

The workforce is in a unique position to support and inform any further requirements for increased capacity in diagnostic laboratories – provided the appropriate investment in workforce expansion is made.The IBMS welcomes the opportunity to work with governments in all four nations in order to further increase capacity and improve patient care. By March 2025, 95 per cent of patients needing a diagnostic test will receive it within 6 weeks generic drug for propecia Although a large proportion of these figures relate to diagnosis via imaging rather than laboratory services, there is an expectation for increased capacity in our healthcare laboratories during a time in which they will be undergoing changes in operational procedures. CDCs will provide new challenges regarding the collection, storage, transportation and reception of specimens.

There will also need to be investment in fully linked up, standardised and interoperable laboratory IT systems - capable of receiving, sharing and delivering vital diagnostic test results to clinical pathways across the UK.The IBMS would like to offer the profession’s expert advice to ensure that these new changes in the patient pathway are not disruptive generic drug for propecia to patient outcomes and that the new methods of working result in better, not worse, patient care.ConclusionIn order to meet the government’s ambitious goals for our diagnostic services, there must be investment in the workforce, in new ways of working and in interoperable IT systems, and – in order to avoid some of the pitfalls faced when setting up the Lighthouse Laboratories - we must use the existing expertise of our diagnostic workforce when setting up the new CDCs. The IBMS would gladly accept the opportunity to work with government across the four nations to further increase the capacity, reach and efficiency of the UK’s diagnostic services and to ensure the best outcomes for patients. [This statement has been press released and sent to all relevant government departments].

18 May 2022 The IBMS response to the plans to set out to increase capacity, reach and efficiency of the UK's diagnostic services in the Queen's speech IntroductionThe Queen’s speech, delivered by Prince Charles on 11th May, propecia best price reiterated government plans to increase the capacity, reach and efficiency of the UK’s diagnostic services. In response, the IBMS offers the government and Department of Health and Social Care the profession’s advice and expertise to work towards making this a reality.160 new community diagnostic centres (CDCs)The IBMS welcomes the move to introduce easier access to diagnostic services centred around patients. Quicker, easier access through a ‘one stop shop’ will lead to earlier diagnoses, better outcomes for patients and the potential to propecia best price save lives. However, these new CDCs must be introduced with sufficient resources - in terms of staffing, IT provision and connectivity with other systems (such as pathology networks and GP practices).

The CDCs are likely to generate a significant increase in workload for our local and regional pathology laboratories, and change the way propecia best price it is generated. To ensure efficiency and quick turnarounds, adequate collaboration with existing networks and IT interoperability is essential.In order to adhere to the ‘Point of care testing in community pharmacies’ guidance (Jan 2022) and its “Buy it right”, “Use it right”, “Keep it right” ethos, Health and Care Professions Council (HCPC) registered biomedical scientists and other laboratory experts should be involved in the selection of equipment, quality assurance and governance of diagnostic devices when used for patient care in CDCs.IBMS members across the four nations have expert qualifications in point of care testing (POCT) and are in a unique position to advise on successful POCT stewardship. 17 million more diagnostic tests over the next three yearsAlthough the largest portions of this propecia best price figure are made up of CDC testing and imaging services rather than healthcare laboratory services, the IBMS agrees with the government’s plan to increase and improve the utilisation of our existing capacity for laboratory testing. The pathology service has consistently increased testing capacity across the four nations.

This was demonstrated over the past propecia best price two years in order to control the spread of hair loss treatment. The workforce is in a unique position to support and inform any further requirements for increased capacity in diagnostic laboratories – provided the appropriate investment in workforce expansion is made.The IBMS welcomes the opportunity to work with governments in all four nations in order to further increase capacity and improve patient care. By March 2025, 95 per cent of patients needing a diagnostic test will receive it within 6 weeks Although a large proportion of these figures relate to diagnosis via propecia best price imaging rather than laboratory services, there is an expectation for increased capacity in our healthcare laboratories during a time in which they will be undergoing changes in operational procedures. CDCs will provide new challenges regarding the collection, storage, transportation and reception of specimens.

There will also need to be investment in fully linked up, standardised and interoperable laboratory IT systems - capable of receiving, sharing and delivering vital diagnostic test results to clinical pathways across the UK.The IBMS would like to offer the profession’s expert advice to ensure that these new changes in the patient pathway are not disruptive to patient outcomes and that the new methods of working result in better, not worse, patient care.ConclusionIn order to meet the government’s ambitious goals for our diagnostic services, there must be investment in the workforce, in new ways of working and in interoperable IT systems, and – in order to avoid some of the pitfalls faced when setting up the Lighthouse Laboratories - we must use the existing expertise of our diagnostic workforce when setting up the new CDCs. The IBMS would gladly accept the opportunity to work with government across the four nations to further increase the capacity, reach and efficiency of the UK’s diagnostic services and to ensure the best outcomes for patients. [This statement has been press released and sent to all relevant government departments].

How should I take Propecia?

Take finasteride tablets by mouth. Swallow the tablets with a drink of water. You can take Propecia with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed.

Contact your pediatrician or health care professional regarding the use of Propecia in children. Special care may be needed.

Overdosage: If you think you have taken too much of Propecia contact a poison control center or emergency room at once.

NOTE: Propecia is only for you. Do not share Propecia with others.

Propecia grow hair back

NCHS Data propecia grow hair back Brief No. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with an increased risk for chronic conditions such as cardiovascular disease (1) propecia grow hair back and diabetes (2). Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition.

Menopause is propecia grow hair back “the permanent cessation of menstruation that occurs after the loss of ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women are premenopausal, 3.7% propecia grow hair back are perimenopausal, and 22.1% are postmenopausal.

Keywords. Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More propecia grow hair back than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 propecia grow hair back. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, propecia grow hair back 2015image icon1Significant quadratic trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their propecia grow hair back last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for propecia grow hair back Figure 1pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who propecia grow hair back had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 propecia grow hair back. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by propecia grow hair back menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 propecia grow hair back year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 2pdf propecia grow hair back icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or more in the propecia grow hair back past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 propecia grow hair back. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p < propecia grow hair back. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual propecia grow hair back cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure propecia grow hair back 3pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did not wake propecia grow hair back up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 propecia grow hair back. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories. Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5).

Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status. A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?.

€. 2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less.

Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?. €Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?.

€Trouble falling asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone. Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS.

For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States. The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS.

Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454. 2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB.

Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50. 2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No.

141. Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N. Perimenopause.

From research to practice. J Women’s Health (Larchmt) 25(4):332–9. 2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult.

A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International. SUDAAN (Release 11.0.0) [computer software].

2012. Suggested citationVahratian A. Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286.

Hyattsville, MD. National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J. Blumberg, Ph.D., Associate Director for Science.

NCHS Data propecia best price Brief http://test.wolf-garten.de/can-you-buy-cialis-over-the-counter/ No. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with propecia best price an increased risk for chronic conditions such as cardiovascular disease (1) and diabetes (2).

Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition. Menopause is propecia best price “the permanent cessation of menstruation that occurs after the loss of ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status.

The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women propecia best price are premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal. Keywords.

Insufficient sleep, menopause, National propecia best price Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 propecia best price. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend by propecia best price menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal propecia best price if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table propecia best price for Figure 1pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women propecia best price aged 40–59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 propecia best price. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend propecia best price by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they propecia best price no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure propecia best price 2pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble propecia best price staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 propecia best price. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p < propecia best price.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle propecia best price was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for propecia best price Figure 3pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women propecia best price in this age group who did not wake up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 propecia best price. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories.

Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5). Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status.

A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?. €.

2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries.

Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less. Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?.

€Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?. €Trouble falling asleep.

Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone.

Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS. For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States.

The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS. Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option.

Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454.

2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB. Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50.

2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No. 141.

Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N.

Perimenopause. From research to practice. J Women’s Health (Larchmt) 25(4):332–9.

2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult. A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society.

J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International.

SUDAAN (Release 11.0.0) [computer software]. 2012. Suggested citationVahratian A.

Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286. Hyattsville, MD.

National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J.

Blumberg, Ph.D., Associate Director for Science.

Propecia causes cancer

Rory Adams did not know that Christmas in a small propecia causes cancer How to order lasix online rural hospital in West Virginia would be the last time he saw his wife alive. She’d entered prison in early January 2021 to serve a 42-month sentence for failure to collect payroll taxes. She was supposed to return to North Carolina, their two adult children, and their propecia causes cancer quilting business this summer. But when he saw her, she was heavily sedated. A ventilator was helping her breathe as she struggled with hair loss treatment.

Rebecca “Maria” Adams, 59, died 18 days after Christmas propecia causes cancer in the same hospital bed. The propecia has proved especially deadly behind bars. Inmates are more than twice as likely to die of hair loss treatment as the general population. And the deaths continue to pile up propecia causes cancer. Adams was the second of three women incarcerated at Alderson Federal Prison Camp to die of hair loss treatment in less than a week in January.

The prison that holds fewer than 700 inmates had 50 cases as of Feb. 8. When U.S. Case numbers surged in December because of the omicron variant, an understaffed and still underprepared federal prison system was once again swamped by hair loss treatment cases. The deaths of these three women imprisoned in West Virginia reflect a federal prison system plagued by chronic problems exacerbated by the propecia, including understaffing, inadequate medical care, and few compassionate releases.

The most recent statistics from the Federal Bureau of Prisons report 284 inmates and seven staff members have died nationwide because of hair loss treatment since March 28, 2020. Medical and legal experts say those numbers are likely an undercount, but the federal prison system lacks independent oversight. Alderson, where Adams was incarcerated, was one of the first federal prisons to have a hair loss treatment outbreak in December in this latest national surge. But as of the first week of February, 16 federal facilities had over 100 cases. More than 5,500 federal inmates and over 2,000 BOP staffers had tested positive for hair loss treatment, according to BOP data.

At one prison in Yazoo City, Mississippi, over 500 inmates — almost half the prison — tested positive in late January. Including the three women from Alderson, 12 federal inmates died while sick with hair loss treatment in January. The Bureau of Prisons has come under fire in the past few months after investigations by The Associated Press and The Marshall Project alleged widespread corruption and called the agency a “hotbed of abuse.” In January, before all three Alderson inmates died, the head of the BOP, Michael Carvajal, announced his resignation, although he remains in charge until a successor takes the helm. The criticism of the agency continued in congressional testimony in January after the deaths at Alderson. Legal and medical experts specializing in the federal system, as well as members of Congress, accused the BOP of hiding hair loss treatment deaths and cases, repeatedly failing to provide adequate health care, and failing to properly implement the compassionate release program meant to move at-risk inmates to home confinement.

Five recently released inmates, two incarcerated inmates, and six family members of women incarcerated at Alderson, confirmed these allegations to KHN. The Alderson inmates and their families reported denial of medical care, a lack of hair loss treatment testing, retaliation for speaking out about conditions, understaffing, and a prison overrun by hair loss treatment. Absences by prison staff members sickened by the propecia led to cold meals, dirty clothes, and a denial of items like sanitary napkins and clean water from the commissary. In an email, BOP spokesperson Benjamin O’Cone said the agency does not comment on what he called “anecdotal allegations.” He said the BOP follows hair loss treatment guidance from the Centers for Disease Control and Prevention. O’Cone pointed to the BOP’s online dashboard about hair loss treatment statistics when asked how many inmates have died since Dec.

1 and how many had tested positive for hair loss treatment before death. A day after KHN emailed the BOP about the deaths of the three inmates from Alderson, two appeared on the dashboard and news releases were published. The women had been dead for almost a week. All three women — Adams, Juanita Haynes, and Bree Eberbaugh — had sought compassionate releases because of preexisting medical conditions that made them more susceptible to dying from hair loss treatment, including Type 2 diabetes, hypertension, congestive heart failure, obesity, and chronic obstructive pulmonary disease. View note Nationwide, over 23,000 people were released from the federal system from March 2020 to October 2021, but more than 157,000 people are still imprisoned.

After early propecia releases, the prison population in the U.S. Is climbing back to pre-propecia levels. Some of the early drop was due to inmate deaths, which rose 46% from 2019 to 2020, according to the most recent data from the Bureau of Justice Statistics. For people like Adams, compassionate release never came. The BOP reports that only two women have been granted compassionate release from Alderson since the outbreak began in December.

One was Haynes, who was granted release while intubated. She died four days later, in the hospital. €œThey will literally be released so they don’t die in chains,” Alison Guernsey, clinical associate professor of law at the University of Iowa, said in congressional testimony in January. She called BOP facilities “death traps,” referring to the BOP’s “inability or reticence to control the spread of hair loss treatment behind bars by engaging in aggressive evidence-based public-health measures.” Guernsey testified that the BOP death data is “suspect” because of delayed reporting, the exclusion of deaths in prisons run by private contractors, and those released just in time to “die free.” Haynes’ death, for example, is not counted in BOP data even though she got sick with hair loss treatment while incarcerated because she was freed through compassionate release right before she died in January, months after her first applications were denied. Guernsey questions the BOP’s hair loss treatment numbers because the agency does not report the number of tests administered, just the number of positive tests.

€œThe BOP can hide whether low rate is due to low hair loss treatment cases or inadequate testing,” she said. All these factors mean the numbers of deaths and cases are likely “substantially” greater than reported, Guernsey said. The impact of incorrect data trickles down to the denial of compassionate release requests. One factor that judges consider is the level of hair loss treatment cases and risk within that prison. Eberbaugh, the third inmate from Alderson to die in January, applied in March 2020 for compassionate release from her 54-month sentence, citing preexisting medical conditions.

In August 2020, a court denied Eberbaugh’s motion, in part citing the lack of hair loss treatment cases in the prison. A few days later, she responded in a handwritten letter, appealing for legal counsel from the public defender’s office. €œYour honor, it is only a matter of time before it reaches here and I am in fear of my life,” she wrote. The court denied that appeal in April 2021. Within nine months, she had died of hair loss treatment.

LJ Dawson. @LJDawson0 Related Topics Contact Us Submit a Story TipLate one night in January, Jonathan Coffino, 78, turned to his wife as they sat in bed. €œI don’t know how much longer I can do this,” he said, glumly. Coffino was referring to the caution that’s come to define his life during the hair loss treatment propecia. After two years of mostly staying at home and avoiding people, his patience is frayed and his distress is growing.

€œThere’s a terrible fear that I’ll never get back my normal life,” Coffino told me, describing feelings he tries to keep at bay. €œAnd there’s an awful sense of purposelessness.” Despite recent signals that hair loss treatment’s grip on the country may be easing, many older adults are struggling with persistent malaise, heightened by the spread of the highly contagious omicron variant. Even those who adapted well initially are saying their fortitude is waning or wearing thin. Like younger people, they’re beset by uncertainty about what the future may bring. But added to that is an especially painful feeling that opportunities that will never come again are being squandered, time is running out, and death is drawing ever nearer.

€œFolks are becoming more anxious and angry and stressed and agitated because this has gone on for so long,” said Katherine Cook, chief operating officer of Monadnock Family Services in Keene, New Hampshire, which operates a community mental health center that serves older adults. €œI’ve never seen so many people who say they’re hopeless and have nothing to look forward to,” said Henry Kimmel, a clinical psychologist in Sherman Oaks, California, who focuses on older adults. To be sure, older adults have cause for concern. Throughout the propecia, they’ve been at much higher risk of becoming seriously ill and dying than other age groups. Even seniors who are fully vaccinated and boosted remain vulnerable.

More than two-thirds of vaccinated people hospitalized from June through September with breakthrough s were 65 or older. Kathleen Tate (Kathleen Tate) The constant stress of wondering “Am I going to be OK?. € and “What’s the future going to look like?. € has been hard for Kathleen Tate, 74, a retired nurse in Mount Vernon, Washington. She has late-onset post-polio syndrome and severe osteoarthritis.

€œI guess I had the expectation that once we were vaccinated the world would open up again,” said Tate, who lives alone. Although that happened for a while last summer, she largely stopped going out as first the delta and then the omicron variants swept through her area. Now, she said she feels “a quiet desperation.” This isn’t something that Tate talks about with friends, though she’s hungry for human connection. €œI see everybody dealing with extraordinary stresses in their lives, and I don’t want to add to that by complaining or asking to be comforted,” she said. Tate described a feeling of “flatness” and “being worn out” that saps her motivation.

€œIt’s almost too much effort to reach out to people and try to pull myself out of that place,” she said, admitting she’s watching too much TV and drinking too much alcohol. €œIt’s just like I want to mellow out and go numb, instead of bucking up and trying to pull myself together.” Beth Spencer(Tillie Spencer) Beth Spencer, 73, a recently retired social worker who lives in Ann Arbor, Michigan, with her 90-year-old husband, is grappling with similar feelings during this typically challenging Midwestern winter. €œThe weather here is gray, the sky is gray, and my psyche is gray,” she told me. €œI typically am an upbeat person, but I’m struggling to stay motivated.” “I can’t sort out whether what I’m going through is due to retirement or caregiver stress or hair loss treatment,” Spencer said, explaining that her husband was recently diagnosed with congestive heart failure. €œI find myself asking ‘What’s the meaning of my life right now?.

€™ and I don’t have an answer.” Bonnie Olsen, a clinical psychologist at the University of Southern California’s Keck School of Medicine, works extensively with older adults. €œAt the beginning of the propecia, many older adults hunkered down and used a lifetime of coping skills to get through this,” she said. €œNow, as people face this current surge, it’s as if their well of emotional reserves is being depleted.” Most at risk are older adults who are isolated and frail, who were vulnerable to depression and anxiety even before the propecia, or who have suffered serious losses and acute grief. Watch for signs that they are withdrawing from social contact or shutting down emotionally, Olsen said. €œWhen people start to avoid being in touch, then I become more worried,” she said.

Fred Axelrod(Fred Axelrod) Fred Axelrod, 66, of Los Angeles, who’s disabled by ankylosing spondylitis, a serious form of arthritis, lost three close friends during the propecia. Two died of cancer and one of complications related to diabetes. €œYou can’t go out and replace friends like that at my age,” he told me. Now, the only person Axelrod talks to on a regular basis is Kimmel, his therapist. €œI don’t do anything.

There’s nothing to do, nowhere to go,” he complained. €œThere’s a lot of times I feel I’m just letting the clock run out. You start thinking, ‘How much more time do I have left?. €™â€ “Older adults are thinking about mortality more than ever and asking, ‘How will we ever get out of this nightmare,’” Kimmel said. €œI tell them we all have to stay in the present moment and do our best to keep ourselves occupied and connect with other people.” Loss has also been a defining feature of the propecia for Bud Carraway, 79, of Midvale, Utah, whose wife, Virginia, died a year ago.

She was a stroke survivor who had chronic obstructive pulmonary disease and atrial fibrillation, an abnormal heartbeat. The couple, who met in the Marines, had been married 55 years. €œI became depressed. Anxiety kept me awake at night. I couldn’t turn my mind off,” Carraway told me.

Those feelings and a sense of being trapped throughout the propecia “brought me pretty far down,” he said. Help came from an eight-week grief support program offered online through the University of Utah. One of the assignments was to come up with a list of strategies for cultivating well-being, which Carraway keeps on his front door. Among the items listed. €œWalk the mall.

Eat with friends. Do some volunteer work. Join a bowling league. Go to a movie. Check out senior centers.” “I’d circle them as I accomplished each one of them.

I knew I had to get up and get out and live again,” Carraway said. €œThis program, it just made a world of difference.” Kathie Supiano, an associate professor at the University of Utah College of Nursing who oversees the hair loss treatment grief groups, said older adults’ ability to bounce back from setbacks shouldn’t be discounted. €œThis isn’t their first rodeo. Many people remember polio and the AIDs epidemic. They’ve been through a lot and know how to put things in perspective.” Alissa Ballot, 66, realized recently she can trust herself to find a way forward.

After becoming extremely isolated early in the propecia, Ballot moved last November from Chicago to New York City. There, she found a community of new friends online at Central Synagogue in Manhattan and her loneliness evaporated as she began attending events in person. With omicron’s rise in December, Ballot briefly became fearful that she’d end up alone again. But, this time, something clicked as she pondered some of her rabbi’s spiritual teachings. €œI felt paused on a precipice looking into the unknown and suddenly I thought, ‘So, we don’t know what’s going to happen next, stop worrying.’ And I relaxed.

Now I’m like, this is a blip, and I’ll get through it.” We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips. Judith Graham. khn.navigatingaging@gmail.com, @judith_graham Related Topics Contact Us Submit a Story TipCRESCENT CITY, Calif. €” On a rainy winter morning, Jamie Hayden stopped in to visit with Diane Timothio.

A case manager in Del Norte County on California’s remote northern coast, Hayden comes by often, sometimes staying for hours, to work with Timothio. Work can mean different things. Going to doctor’s appointments, building her comfort level with eating at a restaurant, or listening to Timothio recount stories about the past. Right now, the pair are working on using the internet, so there’s a lot of time spent on web searches. €œIs Billy Graham still alive?.

€ Timothio asked. €œWe Googled that,” Hayden replied, reminding her the answer is “no.” “I’m sorry I won’t get to meet him,” Timothio said, her voice wistful. Timothio loves religions, their rituals, and says she’s been baptized many times, including as a Latter-day Saint and a Jehovah’s Witness. She also has practiced as a Hindu and joined the Hare Krishnas for a while. She’s joined so many spiritual groups over the years, she said, because she loves that feeling of rebirth, a new start.

€œIt’s like you can see God looking at you. €˜Finally getting your shit together, huh, Diane?. €™â€ Early in the propecia, county workers found Timothio, now 76, at a low-budget motel in rough shape. She was showing signs of dementia and had trouble walking because of osteoporosis in a hip. In recent years, her only real medical care had come via the local emergency room, where she was a regular visitor.

She’d recently left an apartment after a fire. Then there was hair loss treatment, and the hotel she was staying in wanted her out. Timothio had nowhere to go. Rural, isolated, and immense, Del Norte is home to one of the nation’s largest undammed rivers and some of the world’s only remaining acres of virgin redwood forest. Fewer than 28,000 people are spread across the county’s 1,000 square miles, land mostly owned by the state or the federal government.

Coastal Highway 101 runs right through Crescent City, the county’s only real town. People who are homeless in the region tend to gravitate here because it’s hard to survive anywhere else. €œPeople need to eat,” said Heather Snow, the county’s director of health and human services. By California standards, the homeless population in Del Norte is small. According to the most recent survey, there were about 250 people without shelter in 2020.

That is almost certainly an underestimate, but, still, the figure pales in comparison to cities in the Bay Area and Southern California, with their tens of thousands living unsheltered. California’s spiraling housing crisis is often understood through the lens of its big cities, where the sheer number of people who need assistance can quickly capsize the programs designed to move people into housing. But before the propecia, helping people find shelter in Del Norte had been an insurmountable problem for Snow and her colleagues, as well. There’s not enough housing in general in Del Norte, let alone for people with precarious finances. Snow lived 30 minutes north, in Brookings, Oregon, when she started her job six years ago.

It took years to find somewhere closer to live. And there’s never been a homeless shelter anywhere in the county, as far as she knows. For several years, Snow has used county funds to rent rooms at a local motel to temporarily house people at risk of becoming homeless. Sometimes they’d been released from a psychiatric medical hold or were trying to get out of an abusive relationship. Sometimes they needed a temporary sober-living environment.

The county spent $820,000 on those rooms from July 2015 through June 2020. €œIt was a public health emergency before is the truth,” Snow said. €œPeople just didn’t see it that way.” After the propecia came to town, Snow and her colleagues began using the motel to house people like Timothio who were at high risk for serious illness and had no safe place to live, as well as people who needed a safe place to quarantine after a hair loss treatment exposure. That’s how Reggie and Sandy Montoya ended up there with their 25-year-old son, Cruz. They’d lost their home well before the propecia began and were making do in a fifth-wheel trailer that was parked behind a restaurant.

In May 2020, Cruz was exposed to one of the earliest hair loss treatment cases in the county at his job at a nonprofit program for disabled adults, and public health workers quickly realized his home wasn’t suitable for quarantining. They brought the whole family to the motel. Since then, it has become home, and for as long as they want it to be. In October 2020, the state awarded Del Norte County $2.4 million to buy the 30-room motel and turn it into affordable housing through Project Homekey, a statewide initiative spearheaded by Gov. Gavin Newsom to help counties buy old motels and other buildings and turn them into permanent housing.

Snow said there’s enough space to accommodate about 17% of Del Norte County’s homeless residents and families. Using state funds, Del Norte County converted an old motel in Crescent City, California, into stable housing for people living homeless. Some residents have used The Legacy, the site’s new name, as temporary lodging while they regained their footing. Others have become long-term tenants.(Anna Maria Barry-Jester / KHN) The motel is nestled in a median between the north- and southbound lanes of Highway 101 and is flanked by grocery stores, fast-food restaurants, a laundromat, and a drugstore. It’s not far from the police station and county health services.

To Snow, it’s an ideal location for people like the Montoyas who don’t have a car. In the application to the state, Snow provided documents showing the county could maintain the program for decades, explaining how the site would be run and who would get housing. €œI have my master’s in social work. I’m not a real estate tycoon,” Snow said. €œThis is out of my comfort zone, but it’s what the situation is calling for.” County officials had to agree to the purchase, and the political pushback was quick to foment, Snow said.

A small group of residents staged protests, and city officials asked the county to deny the purchase, saying, among other things, that they didn’t want to lose the motel’s contribution to the tax base. Ultimately, though, Project Homekey’s design worked to Snow’s benefit, offering a lot of money and a narrow window in which to accept it. Snow got to work explaining her vision to county supervisors, and four of the five voted “yes.” Today, the 30 motel rooms in Del Norte are among the more than 7,000 new housing units the state says it has created through Project Homekey in two years. In late January, the Newsom administration announced that an additional $14 billion will be spent in 2022 on a mix of housing units and mental health treatment. Some people have stayed at The Legacy, as the county renamed the motel, and then moved on to new homes after finding their footing.

Others have housing vouchers and jobs but can’t find another place to live. And some, like the Montoyas, have become long-term tenants. Sandy, 54, and Reggie, 60, have been together nearly 40 years. They met in Sandy’s hometown of Santa Rosa and had been together for several years when Reggie heard the salmon fishing was awesome farther north and came up to try his hand in the Klamath River. They eventually moved to Crescent City, where they’ve lived for two decades, working odd jobs.

They’ve had several homes over those years, and many periods without one. Reggie described himself as chronically homeless and said health crises, bouts of depression, and drug use have knocked the couple down from time to time. Reggie and Sandy have concerns about living in The Legacy. They loathe living under someone else’s rules, and after all the months of eating out of a microwave, Sandy desperately misses Reggie’s cooking. €œHis biscuits and gravy is heavenly.

His lasagna is out of this world,” she said. Some of the other tenants use drugs, and they’ve seen violent outbursts, like the time in December when a neighbor’s tires were slashed. Early on, a woman upstairs thumped around in boots at all hours of the night. After an initial confrontation, they worked it out, eventually becoming friends. But then she moved out and fatally overdosed on fentanyl, they said.

They miss her immensely. Even with all that, they describe their new home as a godsend. €œI make it out like a horror show,” Reggie said. €œBut if it wasn’t for this place, I would probably be dead right now.” Their room has sheltered them from the cold, wet winters and from the propecia. A coming remodel will transform the rooms into functional apartments with kitchens.

Their dogs can stay, and they are saving up for a car. Reggie loves that the county therapist he’s seeing for depression always knows where to find him. Timothio also moved in early in the propecia. It did not go well initially. Her thoughts were disorganized, and she couldn’t take care of basic tasks like bathing.

Several months into her stay, she had trashed her room and was barely getting by. That’s when Snow and her colleagues from the behavioral health department got involved, navigating through layers of bureaucracy to obtain Timothio’s medical records, get her signed up for government assistance, and ultimately have her placed under county conservatorship. They coaxed her to doctor’s appointments and helped her get on medication for mental health issues. Timothio began sharing with Hayden details of her traumatic and complicated past. The abusive family members.

The children she lost custody of decades before. The violence she’d experienced over decades spent unsheltered. The bouts of deep depression. She uses a refrain when she tells those stories. €œI’ve been raped, robbed, and mugged, left for dead on the side of the road.” These days feel calmer.

€œI just want to stay in one spot,” Timothio said. Hayden had brought her watermelon and grapes, two of her favorite foods, and they were watching old black-and-white Westerns on TV, researching actors and musicians famous in the 1950s. Timothio recently looked at a photograph of herself from the early days at the motel, sprawled on a bed, sheets askew, surrounded by candy and dirt. She told Hayden she didn’t recognize the woman in it. That wasn’t her anymore.

Hayden stayed a couple of hours and before she left reminded Timothio that a home health aide would come the next day to assist her with chores. Hayden marveled at how, just a few months before, Timothio wouldn’t let anyone in her room. Now, the room was clean, and Timothio was taking her medication and voluntarily going to doctor’s appointments. True, she still wore sunglasses inside and kept the blinds drawn tight. But she felt safe enough to welcome strangers into her home.

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. Anna Maria Barry-Jester. annab@kff.org, @annabarryjester Related Topics Contact Us Submit a Story TipAneka French applied for Medicaid in October, not long after Missouri became the 38th state to expand eligibility for the program. But her application sat for months in a backlog with tens of thousands of others. While she waited, French, 45, an uninsured medical technician from St.

Louis, paid out-of-pocket when she was treated at a health clinic for a knee injury last fall. For nearly a decade, Missouri’s Republican political leaders resisted expanding eligibility for Medicaid, the state-federal health insurance program for people with low incomes. It took effect in summer 2021 after a voter ballot initiative passed in 2020. Now, Missouri has more pending applications for MO HealthNet — the name of the state’s Medicaid program — than people enrolled through the expansion. While 64,210 people have been approved as part of the expansion, nearly 73,000 applications were pending as of early February.

In the state’s most recent report, it said it was taking an average of 70 days to process typical applications — longer than the 45 days allowed by federal law. €œThis means that in the midst of a raging propecia, people who are finally able to get health coverage are being left out of the system and are left waiting and waiting,” said Melissa Burroughs, associate director for strategic partnerships at Families USA, a consumer advocacy group. €œThis is a complete injustice to those hit hard financially and healthwise by the propecia.” By contrast, most other states are processing Medicaid applications within a week, with many cases taking less than a day, according to federal data from 2021. Kim Evans, director of the Missouri Department of Social Services’ Family Support Division, told the MO HealthNet Oversight Committee in February that the delay is due to a shortage of workers that has become more acute because of the propecia. She also said the agency was stretched thin in the fall when it had to handle applications submitted during open enrollment in the Affordable Care Act’s marketplace, where people sign up for private coverage but can be redirected to Medicaid if they qualify.

Before expansion, Missouri’s Medicaid program did not cover adults without children. Now, Medicaid is available to all Missourians with incomes below 138% of the federal poverty level, or about $18,800 per year for an individual. Those whose applications are approved will be eligible for coverage retroactive to the month they applied, and possibly up to three months before then. But Tricia Brooks, a research professor at Georgetown University’s Center for Children and Families, said people waiting to have their applications approved typically keep acting as if they are uninsured, delaying needed care and avoiding preventive services such as health screenings. If they do seek care, they will face large medical bills if their application is later denied.

French, the St. Louis medical technician, was notified in January — three months after she applied — that her Medicaid application had been approved. She said that if she had been approved sooner, she might have gone to an emergency room for her knee injury but didn’t because she was worried about getting stuck with a large bill. Instead, she went to a community health center that charges uninsured patients on a sliding fee scale based on their income. Missouri is not the first state to experience such delays.

When 26 states expanded Medicaid in 2014 under the ACA, many struggled to keep up with the demands of applications. For example, California in June 2014 had a backlog of 900,000 applications, prompting a lawsuit by health advocates. Patient advocates say Missouri had years to get ready to expand Medicaid. And, they note, Missouri’s delays in processing applications have been an ongoing problem that worsened after expansion. €œAt the very least, they are starved for resources, and, at worst, they are doing this on purpose,” Burroughs said.

Brooks said Missouri has consistently taken more than 45 days to process applications. She said that more than 40% of applications in 2018 needed more than 45 days to process and that the number rose above 50% in 2019 and to 60% in 2020. €œWhere’s the accountability and federal oversight when there is this kind of historical evidence that Missouri’s eligibility enterprise is significantly out of compliance with federal standards?. € Brooks asked. €œThe situation has worsened, not improved.” Centers for Medicare &.

Medicaid Services spokesperson Beth Lynk said the agency is aware of the problem and is working with Missouri to bring it into compliance. The delays in Missouri also stand out because of the state’s long resistance to expansion. Even after the voters approved the ballot initiative in 2020, the Republican-controlled state legislature refused to fund the expansion, and the state withdrew its plan. In August, a judge ordered the state to start accepting applications from newly eligible adults. Missouri did not begin processing them until Oct.

1 because of a need for computer updates. Oklahoma expanded Medicaid in much the same way as Missouri. Voters approved it in 2020, to begin July 1, 2021. But Oklahoma has been far quicker to enroll people in its expansion program — more than 230,000 had been enrolled through December 2021, nearly four times as many as Missouri had signed up through early February. Oklahoma gives people an answer as soon as they submit their application.

Washington University health economist Timothy McBride said the patchwork computer systems that Missouri’s Medicaid program uses are extremely outdated and have caused problems for years. Adding to the challenge, Missouri is reviewing the eligibility of tens of thousands of applications submitted through the federal marketplace during open enrollment. But because the marketplace assesses eligibility, some states that expanded Medicaid recently, such as Virginia and Louisiana, use that federal determination to handle the increased volume of applications and get people enrolled more quickly. Starting in September, Moshe Biron, 33, of suburban St. Louis called Missouri’s Medicaid help line at least 20 times, spending more than 15 hours on hold trying to figure out whether his five children still qualified for coverage after he started full-time work as a teacher.

Through his state senator’s office, he learned in December that his children remained eligible but that he and his wife did not. Department of Social Services spokesperson Heather Dolce said the Family Support Division was “aggressively tackling” the backlog by offering staffers overtime and prioritizing the oldest applications. But health advocates criticized the agency for hiring third-party vendors to check the income and address information, which sometimes results in bad data that department staffers must fix. For example, some Medicaid recipients were erroneously flagged as living out of state, triggering a removal and appeals process. The state has paused residency checks at least through February.

Brooks said Missouri’s application processing time could get even worse when thehair loss treatment public health emergency ends — now slated for mid-April. Federal rules in place during the propecia have prohibited states from removing Medicaid recipients who are no longer eligible due to income status since March 2020. But the state will soon have to review every enrollee’s eligibility status, adding thousands of cases to the workload. In December, Missouri had nearly 1.2 million Medicaid enrollees, up from about 861,000 in March 2020. Bram Sable-Smith.

brams@kff.org, @besables Phil Galewitz. pgalewitz@kff.org, @philgalewitz Related Topics Contact Us Submit a Story Tip.

Rory Adams did not know that Christmas in a small rural hospital in West Virginia would be the last time propecia best price he How to order lasix online saw his wife alive. She’d entered prison in early January 2021 to serve a 42-month sentence for failure to collect payroll taxes. She was supposed to return to North Carolina, propecia best price their two adult children, and their quilting business this summer. But when he saw her, she was heavily sedated.

A ventilator was helping her breathe as she struggled with hair loss treatment. Rebecca “Maria” propecia best price Adams, 59, died 18 days after Christmas in the same hospital bed. The propecia has proved especially deadly behind bars. Inmates are more than twice as likely to die of hair loss treatment as the general population.

And the deaths propecia best price continue to pile up. Adams was the second of three women incarcerated at Alderson Federal Prison Camp to die of hair loss treatment in less than a week in January. The prison that holds fewer than 700 inmates had 50 cases as of Feb. 8.

When U.S. Case numbers surged in December because of the omicron variant, an understaffed and still underprepared federal prison system was once again swamped by hair loss treatment cases. The deaths of these three women imprisoned in West Virginia reflect a federal prison system plagued by chronic problems exacerbated by the propecia, including understaffing, inadequate medical care, and few compassionate releases. The most recent statistics from the Federal Bureau of Prisons report 284 inmates and seven staff members have died nationwide because of hair loss treatment since March 28, 2020.

Medical and legal experts say those numbers are likely an undercount, but the federal prison system lacks independent oversight. Alderson, where Adams was incarcerated, was one of the first federal prisons to have a hair loss treatment outbreak in December in this latest national surge. But as of the first week of February, 16 federal facilities had over 100 cases. More than 5,500 federal inmates and over 2,000 BOP staffers had tested positive for hair loss treatment, according to BOP data.

At one prison in Yazoo City, Mississippi, over 500 inmates — almost half the prison — tested positive in late January. Including the three women from Alderson, 12 federal inmates died while sick with hair loss treatment in January. The Bureau of Prisons has come under fire in the past few months after investigations by The Associated Press and The Marshall Project alleged widespread corruption and called the agency a “hotbed of abuse.” In January, before all three Alderson inmates died, the head of the BOP, Michael Carvajal, announced his resignation, although he remains in charge until a successor takes the helm. The criticism of the agency continued in congressional testimony in January after the deaths at Alderson.

Legal and medical experts specializing in the federal system, as well as members of Congress, accused the BOP of hiding hair loss treatment deaths and cases, repeatedly failing to provide adequate health care, and failing to properly implement the compassionate release program meant to move at-risk inmates to home confinement. Five recently released inmates, two incarcerated inmates, and six family members of women incarcerated at Alderson, confirmed these allegations to KHN. The Alderson inmates and their families reported denial of medical care, a lack of hair loss treatment testing, retaliation for speaking out about conditions, understaffing, and a prison overrun by hair loss treatment. Absences by prison staff members sickened by the propecia led to cold meals, dirty clothes, and a denial of items like sanitary napkins and clean water from the commissary.

In an email, BOP spokesperson Benjamin O’Cone said the agency does not comment on what he called “anecdotal allegations.” He said the BOP follows hair loss treatment guidance from the Centers for Disease Control and Prevention. O’Cone pointed to the BOP’s online dashboard about hair loss treatment statistics when asked how many inmates have died since Dec. 1 and how many had tested positive for hair loss treatment before death. A day after KHN emailed the BOP about the deaths of the three inmates from Alderson, two appeared on the dashboard and news releases were published.

The women had been dead for almost a week. All three women — Adams, Juanita Haynes, and Bree Eberbaugh — had sought compassionate releases because of preexisting medical conditions that made them more susceptible to dying from hair loss treatment, including Type 2 diabetes, hypertension, congestive heart failure, obesity, and chronic obstructive pulmonary disease. View note Nationwide, over 23,000 people were released from the federal system from March 2020 to October 2021, but more than 157,000 people are still imprisoned. After early propecia releases, the prison population in the U.S.

Is climbing back to pre-propecia levels. Some of the early drop was due to inmate deaths, which rose 46% from 2019 to 2020, according to the most recent data from the Bureau of Justice Statistics. For people like Adams, compassionate release never came. The BOP reports that only two women have been granted compassionate release from Alderson since the outbreak began in December.

One was Haynes, who was granted release while intubated. She died four days later, in the hospital. €œThey will literally be released so they don’t die in chains,” Alison Guernsey, clinical associate professor of law at the University of Iowa, said in congressional testimony in January. She called BOP facilities “death traps,” referring to the BOP’s “inability or reticence to control the spread of hair loss treatment behind bars by engaging in aggressive evidence-based public-health measures.” Guernsey testified that the BOP death data is “suspect” because of delayed reporting, the exclusion of deaths in prisons run by private contractors, and those released just in time to “die free.” Haynes’ death, for example, is not counted in BOP data even though she got sick with hair loss treatment while incarcerated because she was freed through compassionate release right before she died in January, months after her first applications were denied.

Guernsey questions the BOP’s hair loss treatment numbers because the agency does not report the number of tests administered, just the number of positive tests. €œThe BOP can hide whether low rate is due to low hair loss treatment cases or inadequate testing,” she said. All these factors mean the numbers of deaths and cases are likely “substantially” greater than reported, Guernsey said. The impact of incorrect data trickles down to the denial of compassionate release requests.

One factor that judges consider is the level of hair loss treatment cases and risk within that prison. Eberbaugh, the third inmate from Alderson to die in January, applied in March 2020 for compassionate release from her 54-month sentence, citing preexisting medical conditions. In August 2020, a court denied Eberbaugh’s motion, in part citing the lack of hair loss treatment cases in the prison. A few days later, she responded in a handwritten letter, appealing for legal counsel from the public defender’s office.

€œYour honor, it is only a matter of time before it reaches here and I am in fear of my life,” she wrote. The court denied that appeal in April 2021. Within nine months, she had died of hair loss treatment. LJ Dawson.

@LJDawson0 Related Topics Contact Us Submit a Story TipLate one night in January, Jonathan Coffino, 78, turned to his wife as they sat in bed. €œI don’t know how much longer I can do this,” he said, glumly. Coffino was referring to the caution that’s come to define his life during the hair loss treatment propecia. After two years of mostly staying at home and avoiding people, his patience is frayed and his distress is growing.

€œThere’s a terrible fear that I’ll never get back my normal life,” Coffino told me, describing feelings he tries to keep at bay. €œAnd there’s an awful sense of purposelessness.” Despite recent signals that hair loss treatment’s grip on the country may be easing, many older adults are struggling with persistent malaise, heightened by the spread of the highly contagious omicron variant. Even those who adapted well initially are saying their fortitude is waning or wearing thin. Like younger people, they’re beset by uncertainty about what the future may bring.

But added to that is an especially painful feeling that opportunities that will never come again are being squandered, time is running out, and death is drawing ever nearer. €œFolks are becoming more anxious and angry and stressed and agitated because this has gone on for so long,” said Katherine Cook, chief operating officer of Monadnock Family Services in Keene, New Hampshire, which operates a community mental health center that serves older adults. €œI’ve never seen so many people who say they’re hopeless and have nothing to look forward to,” said Henry Kimmel, a clinical psychologist in Sherman Oaks, California, who focuses on older adults. To be sure, older adults have cause for concern.

Throughout the propecia, they’ve been at much higher risk of becoming seriously ill and dying than other age groups. Even seniors who are fully vaccinated and boosted remain vulnerable. More than two-thirds of vaccinated people hospitalized from June through September with breakthrough s were 65 or older. Kathleen Tate (Kathleen Tate) The constant stress of wondering “Am I going to be OK?.

€ and “What’s the future going to look like?. € has been hard for Kathleen Tate, 74, a retired nurse in Mount Vernon, Washington. She has late-onset post-polio syndrome and severe osteoarthritis. €œI guess I had the expectation that once we were vaccinated the world would open up again,” said Tate, who lives alone.

Although that happened for a while last summer, she largely stopped going out as first the delta and then the omicron variants swept through her area. Now, she said she feels “a quiet desperation.” This isn’t something that Tate talks about with friends, though she’s hungry for human connection. €œI see everybody dealing with extraordinary stresses in their lives, and I don’t want to add to that by complaining or asking to be comforted,” she said. Tate described a feeling of “flatness” and “being worn out” that saps her motivation.

€œIt’s almost too much effort to reach out to people and try to pull myself out of that place,” she said, admitting she’s watching too much TV and drinking too much alcohol. €œIt’s just like I want to mellow out and go numb, instead of bucking up and trying to pull myself together.” Beth Spencer(Tillie Spencer) Beth Spencer, 73, a recently retired social worker who lives in Ann Arbor, Michigan, with her 90-year-old husband, is grappling with similar feelings during this typically challenging Midwestern winter. €œThe weather here is gray, the sky is gray, and my psyche is gray,” she told me. €œI typically am an upbeat person, but I’m struggling to stay motivated.” “I can’t sort out whether what I’m going through is due to retirement or caregiver stress or hair loss treatment,” Spencer said, explaining that her husband was recently diagnosed with congestive heart failure.

€œI find myself asking ‘What’s the meaning of my life right now?. €™ and I don’t have an answer.” Bonnie Olsen, a clinical psychologist at the University of Southern California’s Keck School of Medicine, works extensively with older adults. €œAt the beginning of the propecia, many older adults hunkered down and used a lifetime of coping skills to get through this,” she said. €œNow, as people face this current surge, it’s as if their well of emotional reserves is being depleted.” Most at risk are older adults who are isolated and frail, who were vulnerable to depression and anxiety even before the propecia, or who have suffered serious losses and acute grief.

Watch for signs that they are withdrawing from social contact or shutting down emotionally, Olsen said. €œWhen people start to avoid being in touch, then I become more worried,” she said. Fred Axelrod(Fred Axelrod) Fred Axelrod, 66, of Los Angeles, who’s disabled by ankylosing spondylitis, a serious form of arthritis, lost three close friends during the propecia. Two died of cancer and one of complications related to diabetes.

€œYou can’t go out and replace friends like that at my age,” he told me. Now, the only person Axelrod talks to on a regular basis is Kimmel, his therapist. €œI don’t do anything. There’s nothing to do, nowhere to go,” he complained.

€œThere’s a lot of times I feel I’m just letting the clock run out. You start thinking, ‘How much more time do I have left?. €™â€ “Older adults are thinking about mortality more than ever and asking, ‘How will we ever get out of this nightmare,’” Kimmel said. €œI tell them we all have to stay in the present moment and do our best to keep ourselves occupied and connect with other people.” Loss has also been a defining feature of the propecia for Bud Carraway, 79, of Midvale, Utah, whose wife, Virginia, died a year ago.

She was a stroke survivor who had chronic obstructive pulmonary disease and atrial fibrillation, an abnormal heartbeat. The couple, who met in the Marines, had been married 55 years. €œI became depressed. Anxiety kept me awake at night.

I couldn’t turn my mind off,” Carraway told me. Those feelings and a sense of being trapped throughout the propecia “brought me pretty far down,” he said. Help came from an eight-week grief support program offered online through the University of Utah. One of the assignments was to come up with a list of strategies for cultivating well-being, which Carraway keeps on his front door.

Among the items listed. €œWalk the mall. Eat with friends. Do some volunteer work.

Join a bowling league. Go to a movie. Check out senior centers.” “I’d circle them as I accomplished each one of them. I knew I had to get up and get out and live again,” Carraway said.

€œThis program, it just made a world of difference.” Kathie Supiano, an associate professor at the University of Utah College of Nursing who oversees the hair loss treatment grief groups, said older adults’ ability to bounce back from setbacks shouldn’t be discounted. €œThis isn’t their first rodeo. Many people remember polio and the AIDs epidemic. They’ve been through a lot and know how to put things in perspective.” Alissa Ballot, 66, realized recently she can trust herself to find a way forward.

After becoming extremely isolated early in the propecia, Ballot moved last November from Chicago to New York City. There, she found a community of new friends online at Central Synagogue in Manhattan and her loneliness evaporated as she began attending events in person. With omicron’s rise in December, Ballot briefly became fearful that she’d end up alone again. But, this time, something clicked as she pondered some of her rabbi’s spiritual teachings.

€œI felt paused on a precipice looking into the unknown and suddenly I thought, ‘So, we don’t know what’s going to happen next, stop worrying.’ And I relaxed. Now I’m like, this is a blip, and I’ll get through it.” We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips. Judith Graham.

khn.navigatingaging@gmail.com, @judith_graham Related Topics Contact Us Submit a Story TipCRESCENT CITY, Calif. €” On a rainy winter morning, Jamie Hayden stopped in to visit with Diane Timothio. A case manager in Del Norte County on California’s remote northern coast, Hayden comes by often, sometimes staying for hours, to work with Timothio. Work can mean different things.

Going to doctor’s appointments, building her comfort level with eating at a restaurant, or listening to Timothio recount stories about the past. Right now, the pair are working on using the internet, so there’s a lot of time spent on web searches. €œIs Billy Graham still alive?. € Timothio asked.

€œWe Googled that,” Hayden replied, reminding her the answer is “no.” “I’m sorry I won’t get to meet him,” Timothio said, her voice wistful. Timothio loves religions, their rituals, and says she’s been baptized many times, including as a Latter-day Saint and a Jehovah’s Witness. She also has practiced as a Hindu and joined the Hare Krishnas for a while. She’s joined so many spiritual groups over the years, she said, because she loves that feeling of rebirth, a new start.

€œIt’s like you can see God looking at you. €˜Finally getting your shit together, huh, Diane?. €™â€ Early in the propecia, county workers found Timothio, now 76, at a low-budget motel in rough shape. She was showing signs of dementia and had trouble walking because of osteoporosis in a hip.

In recent years, her only real medical care had come via the local emergency room, where she was a regular visitor. She’d recently left an apartment after a fire. Then there was hair loss treatment, and the hotel she was staying in wanted her out. Timothio had nowhere to go.

Rural, isolated, and immense, Del Norte is home to one of the nation’s largest undammed rivers and some of the world’s only remaining acres of virgin redwood forest. Fewer than 28,000 people are spread across the county’s 1,000 square miles, land mostly owned by the state or the federal government. Coastal Highway 101 runs right through Crescent City, the county’s only real town. People who are homeless in the region tend to gravitate here because it’s hard to survive anywhere else.

€œPeople need to eat,” said Heather Snow, the county’s director of health and human services. By California standards, the homeless population in Del Norte is small. According to the most recent survey, there were about 250 people without shelter in 2020. That is almost certainly an underestimate, but, still, the figure pales in comparison to cities in the Bay Area and Southern California, with their tens of thousands living unsheltered.

California’s spiraling housing crisis is often understood through the lens of its big cities, where the sheer number of people who need assistance can quickly capsize the programs designed to move people into housing. But before the propecia, helping people find shelter in Del Norte had been an insurmountable problem for Snow and her colleagues, as well. There’s not enough housing in general in Del Norte, let alone for people with precarious finances. Snow lived 30 minutes north, in Brookings, Oregon, when she started her job six years ago.

It took years to find somewhere closer to live. And there’s never been a homeless shelter anywhere in the county, as far as she knows. For several years, Snow has used county funds to rent rooms at a local motel to temporarily house people at risk of becoming homeless. Sometimes they’d been released from a psychiatric medical hold or were trying to get out of an abusive relationship.

Sometimes they needed a temporary sober-living environment. The county spent $820,000 on those rooms from July 2015 through June 2020. €œIt was a public health emergency before is the truth,” Snow said. €œPeople just didn’t see it that way.” After the propecia came to town, Snow and her colleagues began using the motel to house people like Timothio who were at high risk for serious illness and had no safe place to live, as well as people who needed a safe place to quarantine after a hair loss treatment exposure.

That’s how Reggie and Sandy Montoya ended up there with their 25-year-old son, Cruz. They’d lost their home well before the propecia began and were making do in a fifth-wheel trailer that was parked behind a restaurant. In May 2020, Cruz was exposed to one of the earliest hair loss treatment cases in the county at his job at a nonprofit program for disabled adults, and public health workers quickly realized his home wasn’t suitable for quarantining. They brought the whole family to the motel.

Since then, it has become home, and for as long as they want it to be. In October 2020, the state awarded Del Norte County $2.4 million to buy the 30-room motel and turn it into affordable housing through Project Homekey, a statewide initiative spearheaded by Gov. Gavin Newsom to help counties buy old motels and other buildings and turn them into permanent housing. Snow said there’s enough space to accommodate about 17% of Del Norte County’s homeless residents and families.

Using state funds, Del Norte County converted an old motel in Crescent City, California, into stable housing for people living homeless. Some residents have used The Legacy, the site’s new name, as temporary lodging while they regained their footing. Others have become long-term tenants.(Anna Maria Barry-Jester / KHN) The motel is nestled in a median between the north- and southbound lanes of Highway 101 and is flanked by grocery stores, fast-food restaurants, a laundromat, and a drugstore. It’s not far from the police station and county health services.

To Snow, it’s an ideal location for people like the Montoyas who don’t have a car. In the application to the state, Snow provided documents showing the county could maintain the program for decades, explaining how the site would be run and who would get housing. €œI have my master’s in social work. I’m not a real estate tycoon,” Snow said.

€œThis is out of my comfort zone, but it’s what the situation is calling for.” County officials had to agree to the purchase, and the political pushback was quick to foment, Snow said. A small group of residents staged protests, and city officials asked the county to deny the purchase, saying, among other things, that they didn’t want to lose the motel’s contribution to the tax base. Ultimately, though, Project Homekey’s design worked to Snow’s benefit, offering a lot of money and a narrow window in which to accept it. Snow got to work explaining her vision to county supervisors, and four of the five voted “yes.” Today, the 30 motel rooms in Del Norte are among the more than 7,000 new housing units the state says it has created through Project Homekey in two years.

In late January, the Newsom administration announced that an additional $14 billion will be spent in 2022 on a mix of housing units and mental health treatment. Some people have stayed at The Legacy, as the county renamed the motel, and then moved on to new homes after finding their footing. Others have housing vouchers and jobs but can’t find another place to live. And some, like the Montoyas, have become long-term tenants.

Sandy, 54, and Reggie, 60, have been together nearly 40 years. They met in Sandy’s hometown of Santa Rosa and had been together for several years when Reggie heard the salmon fishing was awesome farther north and came up to try his hand in the Klamath River. They eventually moved to Crescent City, where they’ve lived for two decades, working odd jobs. They’ve had several homes over those years, and many periods without one.

Reggie described himself as chronically homeless and said health crises, bouts of depression, and drug use have knocked the couple down from time to time. Reggie and Sandy have concerns about living in The Legacy. They loathe living under someone else’s rules, and after all the months of eating out of a microwave, Sandy desperately misses Reggie’s cooking. €œHis biscuits and gravy is heavenly.

His lasagna is out of this world,” she said. Some of the other tenants use drugs, and they’ve seen violent outbursts, like the time in December when a neighbor’s tires were slashed. Early on, a woman upstairs thumped around in boots at all hours of the night. After an initial confrontation, they worked it out, eventually becoming friends.

But then she moved out and fatally overdosed on fentanyl, they said. They miss her immensely. Even with all that, they describe their new home as a godsend. €œI make it out like a horror show,” Reggie said.

€œBut if it wasn’t for this place, I would probably be dead right now.” Their room has sheltered them from the cold, wet winters and from the propecia. A coming remodel will transform the rooms into functional apartments with kitchens. Their dogs can stay, and they are saving up for a car. Reggie loves that the county therapist he’s seeing for depression always knows where to find him.

Timothio also moved in early in the propecia. It did not go well initially. Her thoughts were disorganized, and she couldn’t take care of basic tasks like bathing. Several months into her stay, she had trashed her room and was barely getting by.

That’s when Snow and her colleagues from the behavioral health department got involved, navigating through layers of bureaucracy to obtain Timothio’s medical records, get her signed up for government assistance, and ultimately have her placed under county conservatorship. They coaxed her to doctor’s appointments and helped her get on medication for mental health issues. Timothio began sharing with Hayden details of her traumatic and complicated past. The abusive family members.

The children she lost custody of decades before. The violence she’d experienced over decades spent unsheltered. The bouts of deep depression. She uses a refrain when she tells those stories.

€œI’ve been raped, robbed, and mugged, left for dead on the side of the road.” These days feel calmer. €œI just want to stay in one spot,” Timothio said. Hayden had brought her watermelon and grapes, two of her favorite foods, and they were watching old black-and-white Westerns on TV, researching actors and musicians famous in the 1950s. Timothio recently looked at a photograph of herself from the early days at the motel, sprawled on a bed, sheets askew, surrounded by candy and dirt.

She told Hayden she didn’t recognize the woman in it. That wasn’t her anymore. Hayden stayed a couple of hours and before she left reminded Timothio that a home health aide would come the next day to assist her with chores. Hayden marveled at how, just a few months before, Timothio wouldn’t let anyone in her room.

Now, the room was clean, and Timothio was taking her medication and voluntarily going to doctor’s appointments. True, she still wore sunglasses inside and kept the blinds drawn tight. But she felt safe enough to welcome strangers into her home. This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Anna Maria Barry-Jester. annab@kff.org, @annabarryjester Related Topics Contact Us Submit a Story TipAneka French applied for Medicaid in October, not long after Missouri became the 38th state to expand eligibility for the program. But her application sat for months in a backlog with tens of thousands of others. While she waited, French, 45, an uninsured medical technician from St.

Louis, paid out-of-pocket when she was treated at a health clinic for a knee injury last fall. For nearly a decade, Missouri’s Republican political leaders resisted expanding eligibility for Medicaid, the state-federal health insurance program for people with low incomes. It took effect in summer 2021 after a voter ballot initiative passed in 2020. Now, Missouri has more pending applications for MO HealthNet — the name of the state’s Medicaid program — than people enrolled through the expansion.

While 64,210 people have been approved as part of the expansion, nearly 73,000 applications were pending as of early February. In the state’s most recent report, it said it was taking an average of 70 days to process typical applications — longer than the 45 days allowed by federal law. €œThis means that in the midst of a raging propecia, people who are finally able to get health coverage are being left out of the system and are left waiting and waiting,” said Melissa Burroughs, associate director for strategic partnerships at Families USA, a consumer advocacy group. €œThis is a complete injustice to those hit hard financially and healthwise by the propecia.” By contrast, most other states are processing Medicaid applications within a week, with many cases taking less than a day, according to federal data from 2021.

Kim Evans, director of the Missouri Department of Social Services’ Family Support Division, told the MO HealthNet Oversight Committee in February that the delay is due to a shortage of workers that has become more acute because of the propecia. She also said the agency was stretched thin in the fall when it had to handle applications submitted during open enrollment in the Affordable Care Act’s marketplace, where people sign up for private coverage but can be redirected to Medicaid if they qualify. Before expansion, Missouri’s Medicaid program did not cover adults without children. Now, Medicaid is available to all Missourians with incomes below 138% of the federal poverty level, or about $18,800 per year for an individual.

Those whose applications are approved will be eligible for coverage retroactive to the month they applied, and possibly up to three months before then. But Tricia Brooks, a research professor at Georgetown University’s Center for Children and Families, said people waiting to have their applications approved typically keep acting as if they are uninsured, delaying needed care and avoiding preventive services such as health screenings. If they do seek care, they will face large medical bills if their application is later denied. French, the St.

Louis medical technician, was notified in January — three months after she applied — that her Medicaid application had been approved. She said that if she had been approved sooner, she might have gone to an emergency room for her knee injury but didn’t because she was worried about getting stuck with a large bill. Instead, she went to a community health center that charges uninsured patients on a sliding fee scale based on their income. Missouri is not the first state to experience such delays.

When 26 states expanded Medicaid in 2014 under the ACA, many struggled to keep up with the demands of applications. For example, California in June 2014 had a backlog of 900,000 applications, prompting a lawsuit by health advocates. Patient advocates say Missouri had years to get ready to expand Medicaid. And, they note, Missouri’s delays in processing applications have been an ongoing problem that worsened after expansion.

€œAt the very least, they are starved for resources, and, at worst, they are doing this on purpose,” Burroughs said. Brooks said Missouri has consistently taken more than 45 days to process applications. She said that more than 40% of applications in 2018 needed more than 45 days to process and that the number rose above 50% in 2019 and to 60% in 2020. €œWhere’s the accountability and federal oversight when there is this kind of historical evidence that Missouri’s eligibility enterprise is significantly out of compliance with federal standards?.

€ Brooks asked. €œThe situation has worsened, not improved.” Centers for Medicare &. Medicaid Services spokesperson Beth Lynk said the agency is aware of the problem and is working with Missouri to bring it into compliance. The delays in Missouri also stand out because of the state’s long resistance to expansion.

Even after the voters approved the ballot initiative in 2020, the Republican-controlled state legislature refused to fund the expansion, and the state withdrew its plan. In August, a judge ordered the state to start accepting applications from newly eligible adults. Missouri did not begin processing them until Oct. 1 because of a need for computer updates.

Oklahoma expanded Medicaid in much the same way as Missouri. Voters approved it in 2020, to begin July 1, 2021. But Oklahoma has been far quicker to enroll people in its expansion program — more than 230,000 had been enrolled through December 2021, nearly four times as many as Missouri had signed up through early February. Oklahoma gives people an answer as soon as they submit their application.

Washington University health economist Timothy McBride said the patchwork computer systems that Missouri’s Medicaid program uses are extremely outdated and have caused problems for years. Adding to the challenge, Missouri is reviewing the eligibility of tens of thousands of applications submitted through the federal marketplace during open enrollment. But because the marketplace assesses eligibility, some states that expanded Medicaid recently, such as Virginia and Louisiana, use that federal determination to handle the increased volume of applications and get people enrolled more quickly. Starting in September, Moshe Biron, 33, of suburban St.

Louis called Missouri’s Medicaid help line at least 20 times, spending more than 15 hours on hold trying to figure out whether his five children still qualified for coverage after he started full-time work as a teacher. Through his state senator’s office, he learned in December that his children remained eligible but that he and his wife did not. Department of Social Services spokesperson Heather Dolce said the Family Support Division was “aggressively tackling” the backlog by offering staffers overtime and prioritizing the oldest applications. But health advocates criticized the agency for hiring third-party vendors to check the income and address information, which sometimes results in bad data that department staffers must fix.

For example, some Medicaid recipients were erroneously flagged as living out of state, triggering a removal and appeals process. The state has paused residency checks at least through February. Brooks said Missouri’s application processing time could get even worse when thehair loss treatment public health emergency ends — now slated for mid-April. Federal rules in place during the propecia have prohibited states from removing Medicaid recipients who are no longer eligible due to income status since March 2020.

But the state will soon have to review every enrollee’s eligibility status, adding thousands of cases to the workload. In December, Missouri had nearly 1.2 million Medicaid enrollees, up from about 861,000 in March 2020. Bram Sable-Smith. brams@kff.org, @besables Phil Galewitz.

pgalewitz@kff.org, @philgalewitz Related Topics Contact Us Submit a Story Tip.