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Wednesday, April 29, 2020

Small Pharmacy Takes Down Big Drugmaker



I had a fairly dim view of drug quality in the United States going into this, but we’ve discovered tons of problems I never even thought of—and they’re all over the place. —Adam Clark-Joseph, one of Valisure’s founders


A tiny startup in New Haven, Connecticut has thrown a stone into the waters of drug formulation. The splash caused a global recall of heartburn pill Zantac, and the ripples continue to affect the drug-making industry. Online pharmacy Valisure bills its mission in part as bringing “transparency and increased quality to the pharmaceutical industry.” Last November, its scientists told regulators that Zantac and the generic form, ranitidine, contained a cancer-causing chemical.

The Food and Drug Administration confirmed unacceptable levels of the chemical, N-nitrosodimethylamine (NDMA) in some ranitidine products for sale in the U.S., including a syrup made for babies. The agency warned people against panicking and noted that many products made to alleviate heartburn did not contain the chemical.

“We know impurities in medicines are of great concern to patients and consumers who rely on safe and effective medicines approved by the FDA, and we are working with manufacturers and global regulators to provide clear and actionable information,” says Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research. “These investigations take time and do not provide instantaneous answers.”

Valisure’s Beginnings


The company started the way many do: one of its founders was a guy with a problem. Adam Clark-Joseph refilled a prescription for a supposedly identical drug but it didn’t work. An economist and grad-school student, he’d had some training in chemistry and was shocked when his doctor told him he’d probably just gotten a bad batch and to try another pharmacy. Was this really possible in America?

It turns out it was, and is. Together with business partner David Light, the two put their own money into a pharmacy that would verify the content of prescription drugs, many of which are made overseas. The results have been eye-opening.

Valisure makes its money by buying drugs wholesale and reselling them at a higher price, the way all pharmacies do. But what’s different is that they test every batch coming through their doors, on the assumption that there’s no other way to be sure of what clients are putting in their bathroom cabinets.

One of their first ventures was testing lamotrigine, an anticonvulsant. The lab has artificial stomach acid that can reveal how long extended release pills take to dissolve. In this case, some batches took more than 24 hours, and one took over 48 hours, in spite of labelling saying the medication would dissolve in 12 to 15 hours. Finally, they found one maker that met their standards so they could dispense the drug.

Another discovery featured rapid-release Tylenol that wasn’t so rapid. It dissolved slower than tablets with the same dose that cost a lot less. Not a health problem, perhaps, but seemingly misleading all the same. A spokesman for Tylenol maker Johnson & Johnson noted that the gelcaps were “rapid release” compared to conventional tablets, not uncoated ones. But how can consumers keep track of such minutia?

Drug Production


A lot of the hue and cry over drug production has occurred as it has moved offshore, driven by cost savings and lax environmental regulations, according to testimony submitted to Congress by Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research. Although the FDA evaluates drugs for effectiveness and safety prior to approval, a 2016 Government Accountability Office report found that nearly a third of foreign drug establishments licensed by the FDA had not undergone inspection. The FDA says it has now caught up.

However, many think these inspections are inadequate and too infrequent. David Gortler is a former FDA official who is now employed by Valisure as chief medical officer. He feels that every batch of a drug, especially those produced in foreign factories, should undergo testing.

“It’s really becoming a national health crisis,” Gortler says, “and eventually it’s going to become a national security crisis.”

If You Want Pills Tested


As of January 8, 2020 the recall on products containing ranitidine was still in effect. Check here https://www.fda.gov/drugs/drug-safety-and-availability/fda-updates-and-press-announcements-ndma-zantac-ranitidine for updates. If you’d like to use Valisure to check your own prescriptions, you can learn more about the company and contact them here https://www.valisure.com/how-it-works/ or by calling 833-825-4787. Currently, it is the only U.S. pharmacy testing every batch of medicine it dispenses. It will also test pills that you have received from other sources. However, it cannot test medications paid for by government programs including Medicare and Medicaid, nor accept controlled substances, nor analyze biological drugs such as insulin. 



Click below for the other articles in the April 2020 Senior Spirit




Sources:


Blog posting provided by Society of Certified Senior Advisors




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Tuesday, April 28, 2020

The Eight Forgotten Expenses of Retirement Planning



These surprise costs during retirement can mean canceling that dream vacation, or much worse.


You’ve reviewed your budget for retirement and you’re all set … or are you? Usually expenses go down slightly after your working days are over. There’s no longer a use for that professional wardrobe, you don’t need the gas to drive into work and you may eat more lunches at home. Your house may be paid off, or nearly so, and that’s a load off your plate as well. You’ve budgeted for taxes and insurance, groceries, some entertainment and the car … and you have a little account set aside for travel. What could go wrong?

Welcome to the world of “stealth” expenses, the ones most of us never plan for. If you think they can’t happen to you, take a look at the statistics: nearly 1 in 5 retirees, and 1 in 4 retired widows, experiences at least four or more of these events during their retirement years. If you haven’t planned for them to happen, the numbers show you should.

Tips for Managing Unexpected Retirement Expenses


Planning for these expenses is your best defense against them. Take a look at your budget and figure out what you’d do if they happened to you. Everyone should have an emergency fund, preferably assets, but it could be a line of home equity credit or reverse mortgage. Consider purchasing dental insurance to defray costs, and shop around among dentists for a good price. Long-term care insurance can help with this expense, although it’s important to compare policies. Learn how to say “no” to your adult children, at least for expenditures, if not for housing. Above all, avoid the use of high-cost debt such as credit cards and payday loans.

Let’s take a look at some of the most common financial shocks during retirement.

  • Home repairs. Many retirees forget to set aside money for a new furnace or roof, two common items that need replacing over the three decades or so of retirement. You can’t put off getting a new furnace when your old one quits in the middle of winter and delaying a new roof when the old one is leaking can risk damaging your home’s interior. Both of these are expensive and necessary, and more than a quarter of retirees report needing at least one.

  • Dental care. Have you priced a root canal lately? A crown? No, we’re not talking about a diamond tiara but you might think you deserve one for the price! Dental work is expensive, and you’re likely to need more of it as you age. It’s also one of the big three (dental, hearing, vision) not covered under Medicare. 

  • Long-term care. Many retirees think Medicare will cover them in the event they need long-term care. Nope. In fact, average medical expenses for a couple in retirement run about $285,000 before adding in long-term care. With rooms going for up to $8,500 a month, it can quickly exhaust assets and in turn force retirees to turn to Medicaid for help.

  • Divorce. Never think you are immune; good financial planners will make sure you’re set as a couple but will also make sure that each of you separately will thrive in retirement. “Gray divorce” is a catchphrase for a phenomenon that is increasing in prevalence, and the nest egg that covered two people just fine may not work so well when you need separate housing, or when one person is gravely ill. 

  • Adult children. Just when you think all you have to worry about is yourself, your daughter gets divorced or your son is overwhelmed by student loan debt and those little birds that flew the nest years ago come back. 

  • Widowhood. The sadness over the loss of a spouse can trigger depression, but what about the financial effects? If you’ve lost a pension or the one who handled your finances, it could be enough to throw your budget into jeopardy. 

  • Required distributions. Sure, you have to make traditional IRA withdrawals after age 72, but that’s more money for you, right? Not necessarily. They can bump you up into a higher tax bracket, taking a percentage of the money you were counting on to continue growing. This extra income can also qualify you for higher Medicare Part B payments, which are tied to annual income.

  • Replacement costs. The lawnmower quits, the refrigerator gives up, the deck begins to rot: all these replacement costs can ding your budget, especially if they happen at once. But when it’s your car, the amount needed can be as much as some couples spend in a year. 

Click below for the other articles in the April 2020 Senior Spirit



Sources:

Blog posting provided by Society of Certified Senior Advisors



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Looking Our Best as We Age



Fillers, smoothers and lifts: Older adults may not be the selfie generation, but they aren’t shy about using products to look their best.


You’ve put on a few years, sure, but you still want to present your best face to the world. More than 4 million cosmetic procedures were performed on Americans age 55 and older last year, a 28% jump from 2010. But you’ve got questions. Are fillers really going to make a difference? Is plastic surgery worth the cost when you’re 60 or older? What’s the best moisturizer for older skin? More than ever, older adults feel like they deserve to look good, and there are more products than ever to choose from.


Aging affects your face in several ways. The skin and fatty layer underneath thin out, muscle support goes lax and some subtle bone loss may also occur. Decades of sun exposure may have left skin very wrinkled. But you can do something about it.

Botox


Botox injections, done with a thin needle, paralyze muscle activity temporarily. We’re talking frown lines between your brows, and the muscles that turn your smile upside down. It’s not terribly expensive, and it lasts for months. But wait, it’s only intended for use by those 65 and younger, according to the FDA. What gives?

No worries, boomer. Doctors say it is perfectly safe as long as you realize that results may not be quite as dramatic as they are for the younger population. We’ve already earned some wrinkles, and Botox is not going to affect your skin, only the muscles that lie beneath. For that reason, dermatologists recommend pairing it with fillers.

Fillers


Best Moisturizers


As we get older, our skin becomes thinner and dryer. Even people who have never needed to moisturize their skin may find their arms and legs looking a little like shedding snakes.

But most of us don’t have the wallet for fancy preparations, and who knows if they actually work any better than the stuff at Target? Some beauty editors who specialize in products for people over 60 give us their tips on the best low-cost options to try:


  • True Skin Daily Facial Moisturizer
  • Ponds Rejuveness Anti-Wrinkle Cream
  • Aveeno Positively Radiant Moisturizer
  • L’Oreal Age Perfect Skin Renewal with Rosy Tone Moisturizer
  • Cera Ve Face and Body Moisturizer


If you’re willing to pay whatever it takes, some beauty experts swear that hyaluronic acid, which can hold 1,000 times its weight in water, is the way to go. Here are some products they recommend:


  • Revision Skincare Nectifirm
  • Drunk Elephant Protini Polypeptide Cream
  • Murad Hydro-Dynamic Ultimate Moisture
  • Revision Skincare Intellishade Original Tinted Moisturizer



Fillers are liquid injectables that plump up the skin where lines and wrinkles form. Everyone is different, but you may have deep lines from the outside of your nostrils down past your lips (naso-labial depressions) or lines around your eyes (crow’s-feet). Maybe you have those little lines around your mouth that suck up lipstick. Lung ads in the 60s told you only lifelong smokers would get those little lines. They lied. You have them.

But help is on the way! Trot down and get yourself some Juvederm or Restylane (which move into the layer just under the skin) in your lips. Injections last up to a year and will plump your smackers back up to their former selves. Those nose lines will lessen considerably when pumped up with Radiesse, which can last up to 18 months. Some docs like to start with a little Radiesse in the cheeks to lift up the folds so they can inject less filler in the lines you’re trying to diminish.

Fat Grafting


When fillers are unlikely to be effective because skin is loose, an alternative technique is still possible. Fat grafting harvests fat from another part of the body such as the belly or hip (yes!) and transfers it where needed. Compared to fillers, fat is softer, blends well into the body and potentially contains stem cells to repair aged and damaged areas.

Facelifts


Your work years are winding down or finished. Is it worth it to get a facelift? Gretta sure looks good out on the pickle ball court, and you suspect she’s had a little work done. Doctors say it’s not so much how old you are, but how healthy you are that matters. (Thumbs up to pickle ball). Get your regular doctor’s clearance, then make sure to get advice from a qualified, board-certified plastic surgeon.

You may be a candidate for a mini face lift, also called a Y lift. It is minimally invasive, doesn’t require anesthesia and can be performed during a 30-minute office visit. It consists of either fillers of hyaluronic acid or permanent filler injections just below the top level of the cheekbones. About a teaspoon of the substance goes into each cheek, deep into the soft tissue layer to lift the skin below. Effects last one to five years. Cost is about $1,500 to $5,000.

You may decide a mini-lift is not enough, and you want the longer-lasting results, usually three to ten years, of the real thing. Your muscles will be tightened up and excess skin cut off. The best surgeons are a little bit artist, a little bit doctor for minimal scarring and great results. Variations on the procedure can address different areas, such as lifting eyebrows or removing excess skin on eyelids.

Skin elasticity and overall health will determine if you’re a good candidate. If you opt for plastic surgery, go in with realistic expectations. You won’t look 20 years younger. You won’t suddenly be mistaken for Jane Fonda on the street. But you will look more youthful. Cost: $7,000 to $20,000.

Laser Resurfacing


If it is more the quality of your skin you want to change, look no farther than laser skin resurfacing. Safe, effective treatments can reduce the effects of sun, aging and some facial skin disorders. The laser peel removes outer layers of skin to reveal healthier dermis underneath and stimulate the production of collagen and new skin cells.

The best patients for this procedure want to remove lines, wrinkles, uneven pigmentation or superficial facial scars and have skin that is elastic, non-oily and not prone to scarring from minor injury.

What About Cost?


It can be harder to find out the cost of fillers and procedures than to find hen’s teeth in a haystack, but one Denver area clinic tells it like it is. Although the Happy Clinic does not perform cosmetic surgery, it is a destination clinic for fillers, Botox and laser work. Check out prices, and even specials, online.

As always, a healthy lifestyle is your best defense against aging prematurely. But there are times when we just want to feel a little more confident, a little more special, and there’s no reason not to investigate clinical help. Whether you’re headed off to a reunion, a wedding, or you just want to see a change in the mirror, it doesn’t hurt to check out your options.

Sources:


Blog posting provided by Society of Certified Senior Advisors



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Monday, April 27, 2020

When Are the Self-Driving Cars Coming?



Robocars were supposed to be ready by now. Why can’t we use them yet and when can we expect them on the streets?


Car companies have been testing and perfecting for years now. We kept getting promises of self-driving vehicles chauffeuring us around by 2019, then 2020. Grandma and Grandpa have failing eyesight, and their kids are fed up with negotiating through traffic as cities and towns become more congested. Driving at night is getting harder for many older adults. Baby boomers are ready to sleep while the car does the work. But where are the cars?


Timelines Pushed Back


Tesla, Waymo and Cruise all had us champing at the bit, but they have pushed back their timelines. Leaders in the industry have revised their expectations after realizing how many details have to move into place before driverless cars are a reality.

In early 2019, Ford CEO Jim Hackett admitted: “We overestimated the arrival of autonomous vehicles."

Avideh Zakhor, a University of California at Berkeley professor in the electrical engineering and computer sciences department, explains what happened:

“There was a sense maybe a year or two ago, that ‘Oh, our algorithms are so good! We’re ready to launch. We’re gonna launch driverless cars any minute.’ And then obviously there’s been the setbacks of people getting killed or accidents happening, and now we’re a lot more cautious.”

The Five Levels of Automation



  • Level 1 automation means that some small steering or acceleration tasks are performed by the car without human intervention, but everything else is fully under human control.

  • Level 2 automation is like advance cruise control or original autopilot system on some Tesla vehicles. The car can automatically take safety actions, but the driver needs to stay alert at the wheel.

  • Level 3 automation still requires a human driver, but the human is able to outsource some “safety-critical functions” to the vehicle, under certain traffic or environmental conditions. This poses some potential dangers as humans pass the major tasks of driving to or from the car itself, which is why some car companies are interested in jumping directly to Level 4.

  • Level 4 automation is a car that can drive itself almost all the time without any human input but might be programmed not to drive in unmapped areas or during severe weather. This is a car you could sleep in.

  • Level 5 automation means full automation in all road and weather conditions.



Flying Cars Are Coming


That’s right. Flying cars are no longer merely the product of sci-fi movies as partners Hyundai and Uber showed off a model of their concept vehicle to take ride sharing to the next level—literally—at the latest Consumer Electronics Show. The Hyundai S-A1 would carry passengers at 180 miles per hour. Looking like a cross between a jet and a giant drone, the SA-1 got a lot of attention.

“We’re looking at the dawn of a completely new era that opens the skies above our cities,” Jaiwon Shin, the head of Hyundai’s Urban Air Mobility division, said at the announcement. “We will be able to fly on demand—just imagine that.”



Testing


Although accidents have been few and far between, driverless vehicles are held to high standards. As of the end of 2019, 41 states had enacted legislation or signed executive orders curbing the testing and use of autonomous vehicles. Some automakers are going beyond miles on the road for testing vehicles, and have added simulated situations that are rarely found in real life to prepare cars for the limits of what they may encounter.

Aurora CEO and co-founder Chris Urmson talked about how valuable this testing is:

“We can create situations that we’re basically never going to see or very rarely see. So, for example, we might want to simulate what happens as a bicycle comes through an intersection, runs a red light and crashes into the side of our car. Turns out that doesn’t happen very often in the real world, but we want to know that if that happens, our vehicles are going to do something safe ... we’re basically allowing the car to practice up in the cloud instead of on the road. And at the end of the day the training that happens online turns into better and better performance offline.”

Currently about 40,000 people per year are killed on the roads in the U.S., with human error responsible for 90% of those crashes. Some say that when autonomous vehicles are able to cause fewer accidents than the 50th percentile driver on the road, it’s time to bring them on. Tesla founder Elon Musk has said that it is irresponsible not to have these vehicles traveling when they are safer than human drivers.

Expected Arrival


“We expect Level 4 vehicles to be feasible in small quantities within the next five years,” Urmson said. “What that means is you’ll probably see hundreds or maybe thousands of vehicles out either delivering packages or moving people through neighborhoods, or maybe hauling goods on our freeways.”

Most experts think that ride services and package delivery by autonomous car will be here years ahead of personal vehicles.

“It’s going to be around that decade-plus before that is going to be an option for consumers to purchase a self-driving vehicle,” said Kristin Kolodge, executive director, driver interaction and human machine interface research at J.D. Power.

In fact, a recent survey found that auto and tech industry experts set the timeline for having one of these in your garage at around 12 years, when less than 10% of all vehicles will drive themselves. Robotaxis, however, should be common by 2025.

Sounds like baby boomers will get to benefit from robotic cars, just not quite as soon as we thought. For the time being, look for more delivery vehicles to be operated without humans at the wheel. In short order, ride-sharing vehicles with no driver will whisk you to your destination—and you won’t even have to tip!




Click below for the other articles in the April 2020 Senior Spirit






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Sunday, April 26, 2020

Pickleball Is All the Rage Among Older Adults



Forget tennis and golf. The “in” crowd is playing pickleball, and they’re having a blast.


Recent retiree Ted Crawford moved to Grand Junction, Colorado from Denver just over a year ago “without knowing a soul.” He likes to keep fit, and looked to the local college for activities. He discovered a thriving pickleball community and immediately joined in. The sport has become not only his preferred physical activity, but his main source of socializing as well. This winter, he went to Mexico with some of his new friends. When searching for a place to stay, a primary focus was on how close the group would be to pickleball courts.


Crawford is part of a growing segment of older adults embracing the game. Any age can play, but the light paddle and ball (no more tennis elbow!), smaller court and social aspect (most play is doubles) make it particularly attractive to the older crowd. It’s not uncommon to see players well into their 80s, or even 90s, on the court.

History


The game got invented, so the story goes, back in 1965 by a U.S. Congressman, Joel Pritchard, who later became the lieutenant governor of Washington state. When he and a friend were looking for entertainment one weekend, they thought of the badminton court on his property but couldn’t find the right equipment. Undeterred, they grabbed ping-pong paddles and a wiffle ball, making up the rules on the spot. It was so much fun they taught their friends to play, but the sport remained obscure for decades. Where did the odd moniker for the game come from? The name of the family dog was, you guessed it, Pickles.

According to the U.S.A. Pickleball Association, there are more than 15,000 indoor and outdoor courts across the country, with more going in all the time. Conveniently, any tennis court can serve double duty for pickleball just by painting in lines for the smaller court. More and more retirement communities are including pickleball courts in their plans as the number of players in this country has bounded well past the 3 million mark. Pickleball first became popular in the sun belt states, but it has since spread across the U.S. and internationally, as Crawford will attest.

Benefits


A small study recently found that middle-aged and older adults who played pickleball three times a week for one hour per session for six weeks improved both their blood pressure and cardiovascular fitness. Researchers said they credit the game’s “fun factor” combined with its “moderate exercise activity” as making it “an ideal alternative form of physical activity” for the group. It is well known that people stick with exercise they look forward to.

But the benefits are not limited to physical well-being, according to a larger Japanese study. It connected the “serious leisure” activity with lower levels of depression and came to the conclusion that social connections made during the game were at least partly responsible for the drop.

The game does encourage interaction. Not only are most competitions played as doubles, with two players to each side of the net, but waiting players mingle around the small (20’ x 44’) court. A game usually takes just 15 minutes to play, and there is no serious running, so knees are spared.

Former gym teacher Sandy Fruean, 67, got her Cape Cod community to paint pickleball lines on eight tennis courts at the local high school. A year ago, 30 players ranging in age from 16 to 85 took to the courts. Now, the league has 280 “picklers” as devotees of the sport are called. “One of the best things about it is the social connections people make,” Fruean notes, “with seniors in particular. And for people caring for a loved one, it is like respite care. They can stop in for an hour or two to get a little break, socialize with people and get a little exercise.”


Click below for the other articles in the April 2020 Senior Spirit



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Friday, April 24, 2020

Famous and 65

Look who's turning 65 this month

Find out which celebrities are turning 65 this month!


Image Source: 4WaySite

April 7 - Greg Reeves, American bass guitarist


A talented musician who peaked early, Greg Reeves is an enigmatic figure in rock history. Even his birthday is contested; rumor has it that he had a fake drivers license when he was perhaps 15 in order to appear to be 19. At the time, he was playing with Crosby, Stills, Nash and Young — a gig that lasted less than a year (August 1969 to January 1970) before he was fired.

Stephen Stills told Reeves to hit the road because “he suddenly decided he was an Apache witch doctor.” While Reeves dabbled in native American shamanism, the real reason may be closer to another Stills opinion: “He freaked out too much on the bass and no one could keep up because he did not play one rhythm the same. He could play bass imaginatively, but he has to be predictable as well.”

There are reports that Reeves worked with Motown Records as a session player when he was 12 years old, but they are disputed by his mother. What is known is that he was mentored by several Motown stars, including Rick James.

Reeves was a good friend of Young while he was with CSNY, and they recorded together afterward, including on After the Gold Rush. Young and others laud his ability to go from simple to complex bass lines, and the versatility of his playing.






Image Source: Evan Kafka

April 8 - Barbara Kingsolver, American novelist


Novelist, essayist and poet Barbara Kingsolver is an epic figure in American literature. She has earned a bucket of awards, including the National Humanities Medal, and has been nominated for the Pulitzer Prize. Every one of her books that has been published since 1983 has made The New York Times Best Seller list.

Raised in rural Kentucky with a childhood stint in the African Congo, Kingsolver writes about ordinary people who sometimes have extraordinary talents. Her seminal work is arguably The Poisonwood Bible, the story of a deteriorating missionary family set in the Congo.

Kingsolver’s work revolves around themes including social justice, human interaction with the natural world, and biodiversity. She established the Bellwether Prize for Fiction, in support of authors whose work hasn’t been published but advocates for positive social change.






Image Source: Fandango

April 24 - Michael O'Keefe, American actor


A film and television actor, O’Keefe is best known for his role as Fred on TV sitcom Roseanne, but he got an Academy Award nomination for Best Supporting Actor as Ben Meechum in The Great Santini. You may also remember him in his role as Danny Noonan in Caddyshack.
O’Keefe was married to famed singer Bonnie Raitt from April 1997 to November 1999. He married the actress Emily Donahoe in 2011; the couple have one child. O’Keefe was raised in a large Catholic family but has practiced Zen Buddhism since 1981.







Image Source: Wikipedia

April 24 - John Epperson [Lypsinka], American drag artist


The art of drag has become more mainstream, due in part to many talented performers such as Epperson. The actor, pianist, vocalist and writer has become known for his shows where he portrays “Lypsinka,” where she lip-syncs, in drag, to a host of well-known female roles in movie and song.

Born in Mississippi, Epperson is a gifted pianist and was full-time rehearsal pianist for the American Ballet Theatre in New York in 1980.

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