The Pulse

The Pulse is written by Kristin Gourlay, an award winning health care reporter for Rhode Island Public Radio.

Full archive of The Pulse can be found here.

Gov. Gina Raimondo has appointed a working group to "reinvent Medicaid." The group must present the Governor with ideas for trimming costs and improving quality by the end of April. Sounds wonky, perhaps,  but this is a big and important job. The results could affect all of us. How?

Rhode Island Department of Health

Nurses and social workers will visit more homes across Rhode Island thanks to a two-year, $10 million dollar federal grant aimed at helping pregnant women and young children. The program could soon be serving more than a thousand Rhode Island families.

Congress established this home visiting program a few years ago to help families reduce the risks of pre-term births, low birth weights, and infant mortality. This round of funding marks a big expansion of the program in Rhode Island, said State Health Department Director Doctor Michael Fine.

James Volk / CDC

Three strains of meningococcal bacteria - the critters that can cause meningitis - circulate and cause disease in the U.S. Until recently, we only had vaccines to protect against two of them. But in October 2014, the FDA approved a new vaccine for the strain known as serogroup B; on January 23rd, the agency approved a second vaccine for serogroup B, this one requiring just two doses, rather than three.

An oblique fracture, more specifically. That's what doctors saw on the X-ray of my son's femur.

My son is a walking, talking, energetic boy of 18 months. But a strange string of events at day care last Friday - a twist, the catching of a foot on a table leg, a toppling over -  has immobilized him. Doctors put him under, and set him in a spica cast. It's a nearly full-body mummification of both legs, down to the toes, and up the torso, to just under his little arm pits. His legs are splayed open, so he looks a bit like a cowboy who's just gotten off a very fat horse.

Aaron Read / RIPR

Our months-long series about hepatitis C, "At the Crossroads: The Rise of Hepatitis C and the Fight to Stop It," has officially come to an end. We had a great public forum ("Hepatitis C: Cost, Cure, and Challenge") last night at Brown University, the audio from which is posted here, and some key takeaways from which I'll share, below.

    

Researchers with the Hasbro Children’s Hospital Pediatric Refugee Health Program in Providence have found that the longer child refugees stay in the U.S., the greater the chance they'll become overweight or obese.

It's sinister, this virus: hepatitis C can live in the body for decades before causing any noticeable symptoms. By then, the symptoms could be serious: at the worst, cirrhosis or liver cancer. Most people who have hepatitis C don't know it. In this case, what you don't know can hurt you, or even kill you.

HealthSource RI is out with its most recent enrollment data.

It looks like the state's online health insurance marketplace kept two-thirds (71%) of enrollees from last year and gained a quarter more (about 5,000 new enrollees). So with total enrollments for 2015 at 22,910, HealthSource RI didn't lose a bunch of customers but didn't gain a whole lot either.

Here's my holiday wish list for all Rhode Islanders:

May you get the health care you need and deserve, at a price you can afford.

May you find the path to a healthier life well-lit and accessible, and begin to or keep trudging it.

And may you (miraculously) not gain any weight while indulging in treats this season.

Happy holidays, and see you next year!

Rhode Island Public Health Association / Rhode Island Department of Health

A couple of years ago, I read an issue brief written by Brad Brockmann with the Rhode Island Center for Prisoner Health and Human Rights. The brief, called "Hepatitis C: Threat and Opportunity," depicted the number of HIV cases against the number of Hepatitis C cases in Rhode Island in 2007 - 2008 in a bar graph. The bar for the number of hep C cases was much, much higher.

At a public hearing yesterday at the Dept. of Health, doctors, dentists, physician assistants, and advanced practice nurses voiced their opposition to the department's proposed regulations governing the prescribing of opioids. The new rules would require prescribers to sign a fairly lengthy agreement with patients, alerting them to the risks of taking prescription painkillers like OxyContin and Vicodin, and agreeing to certain kinds of monitoring. Many health care providers feel these agreements aren't necessary and that, in fact, they're patronizing.

What do you think?

No surprise here: the Philadelphia Transportation Authority is suing Gilead, maker of the expensive new hepatitis C drugs Sovaldi and Harvoni, over the cost of those drugs. A course of Sovaldi, not including drugs you might have to take in combination with it, as some patients do, costs $84,000. Harvoni, which won FDA approval more recently, costs $94,000.

According to the Philadelphia Star Tribune:

Timothy Flanigan

A Rhode Island doctor has just returned from Liberia where for three months he trained health care workers fighting the deadly Ebola virus. Dr. Timothy Flanigan is one of several Rhode Islanders who have traveled to the West African nation to fight the disease that the World Health Organization estimates to have killed some 6500 people.

Shortly after arriving back home, he sat down with me to talk about what he saw and where he sees hope.

You can listen to our conversation here.

Kristin Gourlay / RIPR

Pun intended.

It's National Influenza Vaccination Week (according to the CDC), which I read as yet one more way to snap us out of complacency and into a clinic for a flu shot.

But it seems no amount of exhortation will move some people closer to the needle (or nasal spray).

Sen. Sheldon Whitehouse says he hopes legislation to boost funding to treat addiction will move forward this week. Whitehouse and colleagues from both sides of the aisle hosted addiction experts on Capitol Hill this morning to learn more about the challenges that remain for addicts even in recovery.

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