The Pulse - ehagedorn's Blog - Bakersfield.com

Ombudsman: Budget cuts hurt long-term care

Several state agencies are lamenting their cuts in funding.

Nona Tolentino, director of long-term care services at Greater Bakersfield Legal Assistance and program director of Kern's Long-Term Care Ombudsman Program, wrote via e-mail about the unfunded mandates she is left with in wake of the cuts.

According to the state budget, funding for the Long-Term Care Ombudsman and Supportive Services programs was reduced by $5,978,000. The program was cut by 49 percent, the California Association of Area Agencies on Aging reports.

The ombudsman program investigates and works to resolve complaints made by, or on behalf of, residents in long-term care facilities.

Here's what Tolentino wrote:

Other programs were also hit but did not get the same fiscal impact as the ombudsman program.

For those who are unfamiliar with our funding process, the ombudsman program receives its mandate from the Older Americans Act and California Older Americans Act. The Federal OAA requires our focus on the nursing homes and facilities for the elderly. The California Legislature enhanced our authority and extended the scope of our duties through subsequent legislation, including the mandate to receive and investigate abuse and report, not only in nursing homes, but in residential care facilities, adult residential facilities and day programs. This is in addition to responding to 24-hour crisis line calls, witnessing advance health care directives completed in nursing homes.

We are a volunteer-based program, but our limited staff investigates and resolves more than 50 percent of the complaints, especially those with complex allegations of abuse, inappropriate discharges, transfers or evictions and those situations that involve complex medical or legal issues.

This cut, which is retroactive to July 1, has placed Ombudsman programs in a precarious and unprecedented state ... Our state office is reviewing feverishly our unfunded mandates as we speak, and our local agency, Greater Bakersfield Legal Assistance, which houses our program, is also reviewing our contract.

Please be mindful that our office remains open albeit with limited responses at this time until the dust settles ... We remain committed to doing the best we can under the existing budget constraints, and ask for your understanding at this time.

For more information, I've also attached the press release on the cuts from the California Association of Area Agencies on Aging.

Kern's longstanding battle with the mosquito

Mosquitoes, while small, have caused big problems in Kern. Recently it was West Nile virus, and 70 years ago, it was malaria.

Local history buff George Gilbert Lynch sent me this history on malaria in the county. Interesting reading.

The last epidemic of mosquito-born malaria in Bakersfield occurred as recently as August 1939.

In Thomas Baker's writings, (Colonel Baker's son, who suffered from chronic malaria for years), he stated, "Malaria was epidemic in early Bakersfield from the 1860's through the turn of the century. 'Fever n' ague' was the local name of the debilitating disease. Chills 'n' fever were accepted as a way of life for the small community. Quinine was the generally accepted treatment, but many of the tough old pioneer men believed whiskey was the best cure and they drank their 'medicine' quite freely, but after the hangover, the fever was still present."

The early fever 'n' chills victims had no idea as to what was causing their disease. It was suspected the water was the culprit. Their suspicions were correct, we now know, but in a way they did not understand.

Sloughs ran in every direction around Bakersfield back then and were filled most of the year with stagnant water. This was thought to pollute the drinking water with malaria, which came from wells, many of which were shallow holes of from 10 to 15 feet deep. This conclusion forced many families to haul their drinking from the eastside wells in the foothills.

The "tule fog" that lay in a thin layer on the surface of the ground was also blamed by many to be the cause of the chills 'n' fever. Believers in this myth built their homes on high underpinnings or stilts in order to avoid the evil fog and this feature also helped during the occasional floods.

Of course, we now understand it was the bite of the mosquitoes that bred by the billions in the stagnant water of the sloughs that was the cause of the malaria fever. We now also know many deadly diseases besides malaria were spread by the little blood suckers back then.

"Epizootie" outbreaks were common in the 1870's. Horses and mules died by the thousands during each siege of the disease and later, in the 1930s, Dr. Karl Meyer of Berkley University, during his studies in Kern County, discovered the "Epizootie" disease was in reality, Western Equine Encephalitis. It had also been misdiagnosed for years as polio in hundreds of local patients. The mosquitoes of early Kern were spreading more than the chills 'n' fever; many must have died of this unknown disease in those early days.

The malaria epidemic of 1939 began when members of the mosquito clan of anopleles began biting farm workers north of Bakersfield. The first case of the epidemic was diagnosed at Kern General Hospital on Aug. 23, 1939. Soon 16 more were admitted, and many more were thought to have been unreported. Dr. Joe Smith, county health director, reported an Arkansas man, working in the harvesting north of town, was treated for malaria a month previous and these new cases were from the same agricultural area of Kern. This migrant worker was believed to have brought the disease to our local area from Arkansas.

Within weeks the Kern County Mosquito Abatement crews had located the breeding place of the anopheline mosquitoes, which were carrying the disease. It was a permanent three-mile long slough, along the north bank of the Calloway Canal, caused by runoff irrigation water. The mosquitoes were breeding in this stagnant water by the millions.

Immediately, county equipment and personnel were at work draining the infested slough into the Calloway Canal, where free of weeds and grass the water could be oiled in order to kill the mosquito larvae. The swift detective work by the Kern County Health Department in locating the infested slough prevented this epidemic from spreading county- or valley-wide.

Next time you see one of those mosquito abatement employees inspecting the drains, give them a courteous thank you for protecting our health by their constant daily fight against the dangerous little demons, which currently can carry West Nile Fever.

Read the complaint filed against Dr. Freesemann, others

The complaint filed against Dr. Jeff Freesemann and the others charged in the investigation of drugs at local nightclubs was sparse but offered a few clues.

From Aug. 24 through Aug. 26, Tessa Galvan, Stephen Galvan, Phil Nunez, Dr. Freesemann and Shelly Freesemann conspired together to transport/sell controlled substances and possess a controlled substance for sale, according to the complaint.

On Aug. 24, Mr. Galvan tells his sister, Ms. Galvan, he needs to buy meth.

On Aug. 25, Mrs. Freesemann arranges to meet Mr. Galvan the following day.

Aug. 26 was a busy day, the filing said:

Mr. Galvan meets Dr. Freesemann at the Valley Gun Shop.
Mr. Galvan and Ms. Galvan arrange to obtain meth.
Mr. Galvan and Nunez arrange to meet for Mr. Galvan to obtain meth.
Mr. Galvan and Nunez meet at The Roadhouse parking lot.
Mr. Galvan meets the Freesemanns at their home on Montmedy Court.
The Freesemanns and Michelle Hori transport Ecstasy. The Freesemanns also transport or sell cocaine, meth and psilocybin (hallucinogenic mushrooms).
Ms. Galvan possesses cocaine.
The Freesemanns and Hori possess less than 28.5 grams of marijuana.

The Freesemanns and Hori were also armed with firearms when they committed the crimes, the filing says.

The complaint also points out that Mr. Galvan was convicted of possessing/purchasing for sale a narcotic/controlled substance Feb. 26, 2002 in the Superior Court of Kern.

The Freesemanns filed a motion to advance today in court and, along with Hori, are due back in court for a pre-preliminary hearing Nov. 5, according to the Superior Court of Kern's Web site.

Ms. Galvan and Nunez have no court dates scheduled. Mr. Galvan's pre-preliminary hearing is Thursday.

TUESDAY NIGHT UPDATE: The Californian obtained arrest records for the suspects in this case. Read "Police left doctor free for three weeks after seizing drug stash," which was just posted on Bakersfield.com.

Previous stories and blog posts:
Blog post: BPD wrap up nearly year-long drug investigation (9/18/08)
Blog post: Prominent doctor arrested in drug investigation (9/18/08)
Story: Prominent doctor, six others arrested after long drug investigation (9/18/08)
Story: Men arrested in 11-month drug investigation appear in court (9/19/08)
Blog post: BPD: Drug cache found in Dr. Freesemann's home, motor home (9/25/08)
Story: Doctor and wife to be charged Friday in drug case (9/25/08)
Story: Charges filed against doctor, others in drug case (9/26/08)

Tips to avoid hospital, school infections

In a tearful press conference last week, a few people affected by hospital infections thanked the governor for signing bills that will, hopefully, limit the infections' spread.

(Read "Widow thanks governor for bill to curb health care infections" on Bakersfield.com)

Senate Bill 158, which was sponsored by Sen. Dean Florez, requires health facilities to develop a patient safety plan and train staff on infection control measures. The bill requires the state Department of Public Health to report hospitals’ infection control procedures and incidences of infections annually.

Also signed was Senate Bill 1058, sponsored by Sen. Elaine Alquist, which requires hospitals to screen patients and meet sanitation requirements.

Carole Moss, who lost her 15-year-old son to a hospital-acquired drug-resistant staph infection, spoke at the press conference.

Her and her husband started Nile's Project to educate families on these infections.

Here are some tips she offered to reduce the risk of hospital infection:

Ask that hospital staff clean their hands before treating you and ask visitors to clean their hands. If you’re worried about being too aggressive, just remember your life could be at stake. Don’t be falsely assured by gloves. If caregivers have pulled on gloves without cleaning their hands first, the gloves are already contaminated before they touch you.
Before your doctor uses a stethoscope ask that the diaphragm (the flat surface) be wiped with alcohol. Stethoscopes and other equipment are often contaminated with dangerous bacteria.
If you need a “central line” catheter, ask your doctor about the benefits of one that is antibiotic-impregnated or antiseptic-coated to reduce infections.
If you need surgery, choose a surgeon with a low infection rate. Surgeons know their rate of infection for various procedures. Don’t be afraid to ask.
Beginning three to five days before surgery, shower or bathe daily with chlorhexidine soap. It can be bought without a prescription and will help remove dangerous bacteria you may be carrying on your own skin.
Ask your surgeon to have you tested for methicillin-resistant Staphylococcus aureus (MRSA) at least one week before coming to the hospital. The test is simple, usually just a nasal swab. If you have it, extra precautions can be taken to protect you from infection.
Stop smoking well in advance of your surgery. Patients who smoke are three times as likely to develop a surgical site infection as nonsmokers.
On the day of your operation, remind your doctor that you may need an antibiotic one hour before the first incision. For many types of surgery, a pre-surgery antibiotic is the standard of care but is often overlooked by busy hospital staff.
Ask your doctor about keeping you warm during surgery. For many types of surgery, patients who are kept warm resist infection better. This can be done with special blankets, warmed IV liquids, hats and booties. After surgery, when it’s time to try walking, request clean booties before getting back into bed. Do not track bacteria from the floor into your sheets.
Do not shave the surgical site. Razors can create small nicks in the skin, through which bacteria can enter. If necessary, ask that clippers be used.
Wash your hands frequently. Avoid touching your hands to your mouth, and do not set food or utensils on furniture or bed sheets. Germs such as “C.Diff” can live for many days on surfaces and can cause infections if they get into your mouth.
Ask your doctor about monitoring your glucose (sugar) levels continuously during and after surgery, especially if you are having cardiac surgery.
Avoid a urinary tract catheter if possible. This is a common cause of infection. If you have a catheter, ask your caregiver to remove it as soon as possible.
If you must have an IV, make sure it’s inserted and removed under clean conditions and changed every three to four days. Alert hospital staff immediately if any redness appears.
If you are planning to have a baby by Cesarean, take the steps listed above.

While the focus of the press conference and legislation was on hospital-acquired infections, Moss had some tips for preventing MRSA in schools:

Encourage students to clean their hands frequently.
Parents, tuck a small container of hand sanitizer in your child's book bag, if your child is mature enough to use it properly.
Educators, ensure that all shared equipment (wrestling mats, baseball gloves, gymnastics equipment, etc.) and locker room facilities, such as benches, are cleaned with detergents, which must remain on the surfaces for at least three minutes. Quickly spraying and wiping is not effective.
School authorities should periodically have surfaces in the gym and classrooms cultured, to know the extent of MRSA contamination.
Warn students not to share gym clothes, towels and other personal items. MRSA bacteria can live on fabrics and hard surfaces for up to 90 days.
Educators, install dispensers inside each classroom. Students should not have to get a hall pass to leave the classroom to clean their hands.
Warn students against sharing bars of soap. Use pump dispensers only.
Educators, make sure that when a student gets a cut or abrasion on the playground or in class, it is cleaned immediately by someone whose hands are also clean. Classrooms should have a first aid kit or ready access to the help of a school nurse.
School authorities should investigate the anti-microbial coatings available for use on sports equipment and other high-touch surfaces and washable keyboards for computers.
Athletes, gym teachers and coaches are at higher risk of exposure to MRSA. In high contact sports MRSA screening may be advisable.

BPD: Drug cache found in Dr. Freesemann's home, motor home

The district attorney's office expects files to be charged Friday against Dr. Jeff Freesemann and his wife Shelly.

The couple, along with five other people, were arrested Sept. 17 after a nearly yearlong investigation by the police into the sale of Ecstasy, meth and cocaine at local nightclubs.

(Read "Doctor and wife to be charged Friday in drug case" on Bakersfield.com and in tomorrow's Californian.)

Documents related to the case are attached to this post.

The warrant filings show that an astounding amount of drugs were found at the Freesemanns' home and in their motor home.

Found at their Montmedy Court home were:

One 5-by 6-inch piece of paper with the writing: "Sent 8/18/08 Fed-Ex, Doctor Wendel Smith, 3015 North 33rd Street, Tacoma, WA 98407." The back of the paper had a list of things to do, numbered one through seven.
One black Pelican case
Several sample packets of Viagra and Cialis
One blue pill cutter
One Ruger Red Hawk 44-caliber pistol, loaded with extra ammunition
Five Remington brand 44-caliber live ammunition rounds
Several Levitra, Viagra and Cialis pill samples
One Compaq laptop computer
45 gelatin capsules containing an off-white powder (suspected Ecstasy), weighing 26.7 grams
One white container with 3.2 grams of suspected powder cocaine
Clear liquid (suspected Ecstasy)
One empty Tylenol bottle
One white container with 0.08 grams of suspected powder cocaine
One Aciphex 20-milligram pill bottle containing eight oblong pills weighing 1.8 grams
One Aciphex 20-milligram pill bottle containing 12 pills weighing 1.4 grams
One glass vial containing 1.3 grams of suspected powder cocaine and gray marijuana smoking pipe
208 suspected Ecstasy pills (pink), each stamped with a crown, weighing 76.7 grams
Five and a half green suspected Ecstasy pills weighing 1.6 grams and 19 blue suspected Ecstasy pills, each stamped with a female sitting with her right leg over her left leg (similar in appearance to the woman displayed on the back of big rig mud flaps), weighing 4.9 grams
One metal container
Several empty pill bottles

The Freesemanns transported drugs out of Bakersfield in their motor home, according to the probable cause statement by Detective Mike Hale.

And found in their white 2005 Ford E-450 Classic motor home parked in the 29000 block of Stockdale Highway were:

One Smith & Wesson 9mm, semiautomatic black and stainless steel firearm
Eight unspent FC brand Luger 9mm live ammunition rounds, which were loaded into the magazine of the Smith & Wesson firearm
One blue nylon Eagle Creek brand zippered bag containing the gun and ammunition
One yellow Pelican case
One brass Pelican combination padlock
One Dermalogica brand 2.7-ounce white plastic bottle with "Daily Microfoliant" written on the side
One small glass vial with a black screw-on cap
Three clear plastic bindles containing 1.3 grams of suspected marijuana
One small brown wooden marijuana pipe
One small clear glass vial containing 1 gram of white powder (suspected cocaine hydrochloride)
One blue metal vial with a screw-on cap and a key ring through the cap loop
Three Adipex-P white pills with blue specks (pills used in the treatment for obesity), having "A-159" stamped on the side
One small white plastic vial with a screw top containing 2.6 grams of white powder (suspected cocaine hydrochloride)
Several small square black pieces of foam used as stuffing to protect items in the yellow Pelican case
Several small square black eye droppers with black screw tops
Four 30-milliliter brown glass bottles having a "GNC Herbal Supplements" label and "Bchinaca" on the side of them
One white plastic bottle with a "Rite Aid Children's Vitamins" label on the side of it
101 red circular pills with a crown imprint on one side, total weight 29.5 grams
Two white plastic vials, one containing 0.1 grams of white residue suspected to be meth and the other containing 1 gram of rocky white substance, also suspected to be meth
One white plastic Metamucil bottle containing 54 Metamucil capsules
One silver metal vial with a screw top containing 4.4 grams of white powder (suspected cocaine hydrochloride)
One silver metal vial with screw top containing 2.7 grams of white powder (suspected cocaine hydrochloride)
One white plastic vial with a screw top containing 0.8 grams of a brown leafy substance (suspected psilocybin mushrooms)
One orange plastic vial
Two Cialis yellow circular pills with "C10" stamped on the side
11 suspected Ecstasy pills (blue and cylindrical) with "A" and a squiggly minus sign, total weight 3 grams
One Viagra-50 pill (blue and odd shaped) with numbers printed on the side of it
39 Lunestra (small and blue) prescription sleep aid pills with imprints on the side of them
One white plastic vial containing 1.3 grams of a white rock substance (suspected meth)
One small white Tylenol medicine vial with a screw top containing three Tylenol pills
Two small white plastic vials, each containing 1.5 grams of a white rocky substance (suspected meth)
One small white Tylenol vial with a screw top containing five Tylenol pills
Two white plastic vials, each containing 1.2 grams of a white rocky substance (suspected meth)
One white plastic Excedrin medicine vial with a screw top containing two Excedrin pills
Two white plastic vials, one containing 1.7 grams of a white rocky substance (suspected meth) and the other containing 1.4 grams of a white rocky substance (suspected meth)
One blue nylon zippered bag
One white and green metal tin with a Starbucks label on the side of it
85 suspected Ecstasy (blue and cylindrical) pills with a lady stamped on the side of them, total weight 20.9 grams
One silver metal mint tin
15 suspected Ecstasy (red and cylindrical) pills with a crown stamped on one side of them, total weight 10.1 grams
One white plastic Advil medicine vial with a screw top containing four Advil pills
Three suspected Ecstasy pills (red and cylindrical) with a crown stamped on one side, total weight 1 gram
One white plastic vial containing 1.3 grams of a white powder (suspected cocaine hydrochloride)
One white plastic Advil medicine vial with screw top containing four Advil pills
Three suspected Ecstasy pills (red and cylindrical) with a crown stamp on one side of them, total weight 1 gram
One white plastic vial containing 1.5 grams of a white powder (suspected cocaine hydrochloride)
One white plastic Advil medicine vial with a screw top containing six Advil pills
Two suspected Ecstasy pills (red and cylindrical) with a crown stamped on one side of them, total weight 0.6 grams
One white plastic vial containing 1.1 grams of a white powder (suspected cocaine hydrochloride)
One UK brand yellow ultra box (a Pelican case)
One electronic key card for a room at the Mandalay Bay Hotel/Resort in Las Vegas
One 2-fluid-ounce brown glass bottle having a label identifying the contents as an "Insure Dietary Supplement" with a black eye dropper cap that contained an odorless clear liquid (possibly GHB)
One white plastic Advil medicine vial with a screw top containing three Advil pills
One white plastic vial containing one blue cylindrical pill with a lady stamped on the side of it, total weight 0.3 grams
One white plastic vial containing 0.3 grams of a white powder (suspected cocaine hydrochloride)
One white Tylenol medicine vial with a screw top containing four Tylenol pills
One white plastic vial containing three suspected Ecstasy (red and cylindrical) pills with a crown stamped on the side of them, total weight 1.1 grams
One white plastic vial containing 0.5 grams of a rocky white substance (suspected meth)
One pink Coach zippered pouch
One white plastic Tylenol medicine vial with a screw top containing two Tylenol pills
One plastic vial containing three suspected Ecstasy (red and cylindrical) pills with a crown stamped on one side of them, total weight 1 gram
One white plastic vial containing 0.1 grams of a white rocky substance (suspected cocaine hydrochloride)
One orange medicine vial containing 13 1/2 Xanax pills, having a prescription label addressed to Jeff Freesemann
One red nylon zippered wallet containing credit cards and identification for Shelly Freesemann
One Cruise America rental agreement for the motor home
One electronic key card for the Roosevelt Hotel in Los Angeles
One brass metal marijuana smoking pipe
One purple cloth coin purse
One red plastic vial containing marijuana, having a label reading, "Train Wreck Medical Marijuana"
1.1 grams of suspected marijuana, which was in the labeled vial
One clear Rubbermaid container with a green lid
One white Centrum plastic medicine bottle containing 16 Centrum pills
One clear plastic bag containing 3.2 grams of a crystallized white substance (suspected meth)
One orange pill vial containing 13 Famciclovir pills (white), having a label addressed to Shelly Freesemann
One orange metal vial with a screw top
Two gelatin capsules containing 0.1 gram of white powder (suspected Ecstasy)
One clear zip-lock baggie containing six gelatin capsules containing white powder (suspected Ecstasy), total weight 1.2 grams

So between the home and the motor home, police found:

0.8 grams of mushrooms
18.58 grams of cocaine
14.6 grams of meth
410.5 Ecstasy pills (149.8 grams)
102 unidentified pills
2.4 grams of marijuana

The budget dust settles: How did health programs fare?

Gov. Arnold Schwarzenegger signed the tardiest state budget ever today.

The $144.5 billion spending plan did see some line-item vetoes from the governor, including cuts to a program that lowered prescription drug prices for low-income residents.

(Read "Schwarzenegger signs Calif. budget 85 days late" on Bakersfield.com.)

The Department of Health and Human Services was hit hard by the governor's vetoes, reducing the department's budget by $153 million. It was the third hardest hit, after the Business, Transportation and Housing Agency and tax relief/local government programs.

Here's how some health programs fared, according to the state's budget site:

Medi-Cal: $14.2 billion in 2007-2008 to $14.5 billion in 2008-2009
Supplemental Security Income/State Supplementary Payment: $3.6 billion in 07-08 to $3.8 billion in 08-09
Regional centers: $2.1 billion in 07-08 to $2.4 billion 08-09
Developmental centers: $409.6 million in 07-08 to $361.5 million in 08-09
Community mental health services: $769.5 million in 07-08 to $835.4 million 08-09
CalWORKS: $1.5 billion in 07-08 to $2 billion in 08-09
In-home supportive services: $1.7 billion in 07-08 to $1.8 billion in 08-09
Children's services: $1.6 billion in 07-08 to $1.7 billion in 08-09
Healthy Families: $395.8 million in 07-08 to $397.5 million in 08-09
Department of Public Health: $394.9 million in 07-08 to $349 million in 08-09
Alcohol and drug programs: $268.6 million in 07-08 to $290 million in 08-09

In the Department of Public Health's budget, the governor reduced the funds for:

Infectious Disease from $365 million in the proposed budget to $358.8 million in the final budget
Family Health from $1.5 billion to $1.498 billion
County Health Services from $40.7 million to $39.8 million
Environmental Health from $132.5 million to $131.6 million

He deleted $5.5 million of the $6.8 million General Fund legislative augmentation to local health jurisdictions for AIDS/HIV education and prevention programs.

The governor eliminated the California Discount Prescription Drug Program Fund, a savings of $2 million. Eliminating this program also meant reducing other costs associated with the program in other departments.

He offered this explanation for many of his vetoes:

While this budget bill provides for a modest reserve in 2008-09, it fails to make the necessary statutory spending reductions and revenue increases needed to eliminate the state's structural budget deficit going forward. At the same time, constitutional requirements, federal law and court required payments drive the majority of the spending in any budget, and limit my ability to reduce spending. As a result, I have an obligation to reduce spending when my veto power is adequate to do so. Consequently -- and in order to further ensure that this budget remains in balance -- I am taking the difficult but necessary action reflected in this veto to further control state spending.

I'll be attaching statements I receive from organizations and unions about this budget in the comments section of this post.

I'd love to hear your thoughts as well.

Prominent doctor arrested in drug investigation

Prominent physician Dr. Jeff Freesemann and his wife were among several people arrested after a nearly year-long drug investigation by Bakersfield Police.

He was arrested on suspicion of conspiracy, possession of drugs for sale and transportation of drugs.

(Read "Prominent doctor, six other arrested after long drug investigation" on Bakersfield.com and in tomorrow's Californian.)

Freesemann, an internal medicine physician, is chief of staff at San Joaquin Community Hospital, co-owner of the Highgrove Medical Clinic and former president of the Kern County Medical Society.

I've talked to him for several stories and am shocked about this news.

He has a clean record with the state medical board.

Have you ever been treated by him? Do you know him?

British campaign IDs nine types of heavy drinkers

To curb heavy drinking, the Department of Health in England has identified nine types of heavy drinkers.

The hope is that by helping people understand their urges, they can learn to control them, according to the BBC.

"Heavy drinking" is defined as consuming 35 units a week for women, 50 for men. Alcoholism can cause brain degeneration, cancer, liver disease, heart damage, depression and memory loss, just to name a few.

The nine groups are below. Does this cover it?

Are these just stereotypes, or do you think identifying these groups will help?

Depressed drinker
Characteristics: Life in a state of crisis, possibly from being recently bereaved, divorced or in financial crisis.
Motivations: Alcohol is a comforter and a form of self-medication used to help them cope.
De-stress drinker
Characteristics: High-pressure job or stressful home life leads to feelings of being out of control and burdened with responsibility.
Motivations: Alcohol is used to relax, unwind and calm down and to gain a sense of control when switching between work and personal life. Partners often support or reinforce behavior by preparing drinks for them.
Re-bonding drinker
Characteristics: Relevant to those with a very busy social calendar.
Motivations: Alcohol is the "shared connector" that unifies and gets them on the same level. They often forget the time and the amount they are consuming.
Conformist drinker
Characteristics: Traditional guys who believe that going to the pub every night is "what men do."
Motivations: Justify it as "me time." The pub is their second home and they feel a strong sense of belonging and acceptance within this environment.
Community drinker
Characteristics: Drink in fairly large social friendship groups.
Motivations: The sense of community forged through the pub-group. Drinking provides a sense of safety and security and gives their lives meaning. It also acts a social network.
Boredom drinker
Characteristics: Typically single moms or recent divorcees with restricted social life.
Motivations: Drinking is company, making up for an absence of people. Drinking marks the end of the day, perhaps following the completion of chores.
Macho drinker
Characteristics: Often feeling under-valued, disempowered and frustrated in important areas of their life.
Motivations: Have actively cultivated a strong "alpha male" that revolves around their drinking "prowess." Drinking is driven by a constant need to assert their masculinity and status to themselves and others.
Hedonistic drinker
Characteristics: Single, divorced and/or with grown up children.
Motivations: Drinking excessively is a way of visibly expressing their independence, freedom and "youthfulness" to themselves. Alcohol used to release inhibitions.
Border dependents
Characteristics: Men who effectively live in the pub which, for them, is very much a home from home.
Motivations: A combination of motives, including boredom, the need to conform, and a general sense of malaise in their lives.

The latest budget compromise and health care

Could the longest budget stalemate in California history almost be over?

Here are the key health components of the latest budget compromise.

The 10 percent cuts to Medi-Cal provider rates would remain until March 2009.
Healthy Families premiums would increase.
Supplemental Security Income cost-of-living increases to the elderly, blind and disabled would be eliminated.
Funding for construction of seven new prison medical facilities and renovations at existing facilities would be denied.

On the bright side, this budget does not cut adult Medi-Cal dental benefits and scales back some health cuts found in previous revisions.

If you would like to dig through the proposed budget yourself, you'll find most of the compromises in Assembly Bill 88 and Assembly Bill 1781.

Next stop: Schwarzenegger's desk.

For more information about the cuts, read the posts:
Health leaders worry about fate of Medi-Cal (8/18/08)
Bakersfield nurse practitioner on TV (7/31/08)
Medi-Cal cuts impact people with private insurance too (7/28/08)
Tax hikes vs. funds for health care, education (7/9/08)
'Access to vital health care is at stake for all Californians' (6/20/08)
Mercy president: Budget cuts put lives at risk (6/3/08)
Calif. sued over Medi-Cal rate cuts (5/5/08)
Is health reform dead? (1/11/08)

Bako AIDS Project: $37,000 can go a long way

Hoping to encourage residents to take part in the Bakersfield AIDS Project's AIDS Walk in October, the nonprofit released some of its costs to demonstrate the help that is needed.

If 30 to 60 people pledge $500 to $1,000, the services will be paid for, said director Audrey Chavez, via e-mail.

Housing up to six people at one time at Ricky's Retreat, which is also the organization's headquarters, annually costs:

RENT: $800 per month = $9,600
UTILITIES: $100 per resident per month = $7,200
FOOD: $100 per resident per month = $7,200
HOUSEHOLD ITEMS/HYGIENE: $50 per resident per month = $3,600
TRANSPORTATION: Six bus passes at $30 per month = $2,160
TELEPHONE/INTERNET: $60 per month = $720

Other Bakersfield AIDS Project programs:

BUS PASSES: $30 per month for 14 clients = $5,040
DROP-IN/SUPPORT GROUP: $50 per week at four weeks per month = $2,400

This puts the total amount needed at $37,920.

The walk starts at 9:30 a.m. Oct. 12 at Ricky's Retreat, 910 Grace St. Registration is at 9:30 a.m.

For pledge forms or information about business sponsorships, call 742-3611 or e-mail audrey1bap@yahoo.com.

Do parents have a right to know about abortion?

I spent an hour yesterday watching two groups debate Proposition 4, a measure on November’s ballot requiring parental notification for pregnant minors seeking abortions.

On one side: Camilla Chavez, executive director of the Dolores Huerta Foundation; Patsy Montgomery, public affairs director of Planned Parenthood Mar Monte, and Brenda DeMonge, a mental health therapist. They represented the Campaign for Teen Safety: Vote No on 4.

And on the other: Catherine Short, co-author of the measure; Steven Francis, co-chairman of the Yes on 4 campaign, and Charles Gallagher, campaign consultant.

The two groups came together to field questions from The Californian's editorial board. I was there to write about what was said.

(Read "Parental notification measure taps passions on both sides of abortion debate" on Bakersfield.com.)

The initiative, if passed, would:

require physicians to wait at least 48 hours since the parent was informed to perform the abortion
allow parents to waive the minor’s notice of intent
allow physicians to notify another adult family member of the minor’s choosing if child abuse is feared
require physicians to alert law enforcement or a child protective agency of suspected child abuse
allow physicians to immediately perform the abortion if it is due to a medical emergency
allow minors to file a petition with juvenile court and appeal, if needed, if they do not want to alert a parent
allow judges to waive parental notification if the judge feels the minor is “sufficiently mature and well-informed”
require physicians to report abortions performed on minors to the Department of Health Services
allow minors, legal representatives and parents to sue physicians who perform abortions on minors and fail to comply with this law.

Read this PDF for more info on the proposition.

So how do you feel about this measure? Will you be voting for it?

P.S. I realize abortion is the epitome of divisive issues, but please refrain from attacking people for their views on this post. Let's keep it adult and civil, and stick to debating the issues. Play nice!

By breast or by bottle?

Breasts can be very polarizing — even when it has to do with breastfeeding, a natural practice.

Remember the dust-up over the 2006 Babytalk magazine cover that showed a baby nursing?

"In this country, breasts are highly sexualized, and people sort of forget they’re there to feed our species," said Karen Farley, program manager of the Californian WIC Association.

A new study by Farley's organization and the University of California-Davis Human Lactation Center ranked Kern County 46th of 50 counties with 24.4 percent of new mothers breast-feeding their children without using formula. (Read "Breast is best, but report says Kern just can't kick the bottle" in today's Californian.)

The researchers are pushing for more breast milk and less formula, arguing that breast milk has myriad health benefits. (The National Women's Health Information Center has a lot information on breast-feeding.)

On the other hand, breast-feeding can be painful at first and difficult for moms who go back to work.

What did you do? The breast or the bottle? And why?

Thieves reach new moral low with Red Cross theft

First, a trailer was stolen from Houchin Blood Bank in May.

And now, the local chapter of the Red Cross is suffering after thieves took $1,300 worth of diapers, toiletry kits, flashlights, water, chairs and cots from two trailers Friday night. (Read "Low blow: Supplies stolen from Red Cross" in today's Californian.)

What's next? Swiping an elderly person's cane? Pilfering toys from Toys for Tots?

"Who knows why they took it?" Kern Red Cross CEO Lorraine Castro asked hypothetically, standing in the northeast Bakersfield facility's warehouse Tuesday.

Many people assume the national organization supplements the local chapters, but it's the other way around, Castro said.

Local chapters, like Kern, pay the national branch along with raising money for local families, which is why this thievery hurts so much.

Roughly 30 families burned out of their homes were helped in June and July by the Red Cross, she said. And it usually costs about $1,000 to help each family.

"Kern County has to have the Red Cross," Castro said. "If we didn't show up, no one would."

Merced and Mariposa counties' chapter just closed after nearly 100 years in operation, she added. Keeping the organization's doors open continues to be precarious.

Castro is hoping residents donate money to replace what was stolen.

Donation checks should be made out to American Red Cross Kern Chapter and mailed to P.O. Box 1226, Bakersfield, CA, 93302.

Anyone with information about the incident was asked to contact the Kern County Sheriff's Department .

Web site wants stories of health care woe

A new Web site aims to collect tales of health care troubles due to the Medi-Cal cuts and the budget impasse.

MyCAStory.org features videos, photos and stories from California residents.

According to the site, "Our purpose is to share the stories behind the numbers of everyday Californians struggling to raise families, survive, and succeed despite the looming threat of budget cuts to the state programs and services on which they rely. These are the stories behind those numbers."

This is the product of California Association of Food Banks, San Francisco's IHSS Public Authority and Health Access California.

Health Access has been busy trying to get the word out about these cuts. The group has put on a local press conference with hospital leaders and has commissioned two studies showing the unintended effects of these cuts. (Read "Health leaders worry about fate of Medi-Cal" for more information.)

No Kern County residents have contributed to MyCAStory.org yet. If you do, let me know.

BCHS coach talks about practice preceding player's death

For the first time, Bakersfield Christian football coach Doug Barnett is speaking about the practice Patrick Allen participated in two days before he died.

The school and Patrick's parents believe he died from a heat-related illness. The coroner's report is pending toxicology tests.

The following is from reporter Maggie Creamer, who met with the school's officials today.

Since Bakersfield Christian High School varsity football player Patrick Allen died on Aug. 14, the school has been reviewing its policies, President Daniel Cole told The Californian Tuesday.

Cole and athletic director/football coach Doug Barnett said in future seasons, they will pass out a handout with specific instructions for parents to keep kids healthy. They also will devote more time in the spring and early summer to talk about hydration.

Barnett said on the day Patrick died, the team started a light practice at 4:30 p.m. wearing full pads. That morning, they had practiced in shells.

Barnett said when Allen was at practice, he did not complain or exhibit signs of heat stroke.

He said he is constantly checking the air quality and alerts from the California Interscholastic Federation.

Also, Barnett meets with coaches three times a year to review policies and refresh coaches on strategies to keep athletes healthy.

The players are advised to drink water whenever they need it.

"They are constantly getting water," he said. "They have to drink at least every 10 minutes."

Also, a certified trainer is on campus whenever there athletes practice, Barnett said.

At the beginning of last week, the coaches shortened practice to allow players time to grieve, he said.

Now, the team is back to its normal routine and getting ready for the season.

Cole said they met with a grief trauma team after Patrick's death to find out the best way to let students grieve.

"We want to get the kids close to normalcy as quickly as possible," Barnett said.

(For more information, read "Death of young football player 'is going to open everyone's eyes'" from Monday's Californian. Scroll down the page for links to other related stories.)

BCHS football player's cause of death

A heat-related illness seems to be the most likely cause of Patrick Allen's death.

Allen, who played on Bakersfield Christian High School's football team, died Aug. 16, two days after suffering leg cramps, vomiting and loss of consciousness following practice in 104-degree heat.

(Read "Death of young football player 'is going to open everyone's eyes'" in today's Californian. Scroll down the page for links to other related stories.)

While the coroner's report is pending toxicology tests, his parents and school officials have blamed the heat.

Brendon McDermott, a certified athletic trainer with the University of Connecticut's Department of Kinesiology, agreed, saying "it sounds like it would be heat releated."

He did offer two other, albeit less likely, causes of death, though.

Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents into the bloodstream, which can be harmful to the kidneys and frequently results in kidney damage. This can be caused by the heat, among other things and can result in weakness, muscle ache and fatigue.
Hyponatremia is a metabolic condition in which there is not enough sodium in the fluids outside the cells. When sodium levels drop in the fluids outside the cells, water will seep into the cells to balance the salt levels. The cells will swell as a result of the excess water, and brain swelling causes most of the symptoms of hyponatremia. You might have heard about this condition when a woman died after participating in "Hold Your Wee for a Wii," a Sacramento radio promotion that involved drinking copious amounts of water to win a Nintendo Wii.

McDermott, a member of the National Athletic Trainers' Association, is chair of the writing group that is revising NATA's position statement on fluid replacement.

I'm also posting some letters I've received following today's story. If I receive more and get the author's OK to post them, I will.

Feel free to share your thoughts regarding this post and the issue of heat illness in high school sports.

Local doc, patient in The New York Times

Dr. Darshan Shah, one of the most well known plastic surgeons in Bakersfield, was quoted in a recent New York Times story on smoking and plastic surgery.

The story, "Want a Face-Lift? First, Better Stop Smoking," ran Thursday in the newspaper.

“Nicotine causes the tiny blood vessels in the skin to clamp down or constrict, which reduces blood supply to the skin,” Shah said in the story.

It goes on to say:

Margaret Pyles, 42, a human resources director for youth homes in Bakersfield, first went to Dr. Shah in 2004, looking to have a breast reduction. He told her that she needed to quit a minimum of 30 days before the surgery. A pack-a-day smoker since 16, she couldn’t face battling her addiction yet again.

But once her back pain grew constant, and her abdominal muscles too flabby for her taste, Ms. Pyles went back to Dr. Shah last month for a breast reduction and lift as well as a tummy tuck and liposuction. But not before she quit smoking with the help of Chantix and a hypnotist Dr. Shah recommended.

Both helped her overcome nicotine, she said, but fear really kept her on track. “I was afraid the anesthesia would go wrong, or I’d wake up coughing my head off and split my guts open,” she said. “And I was able to stop.”

Ms. Pyles, who has not lit up again, is thrilled that her desire to turn back the clock may help prolong her life. “I was so focused on wanting the breast reduction more than I wanted the cigarette,” she said.

For more info on the dangerous mix of smoking and surgery, read this article on the American Society of Plastic Surgeons' Web site.

Also, Shah has an article on his site about this hazard.

Health leaders worry about fate of Medi-Cal

The failed vote in the Assembly last night to pass a budget has some health leaders worried that the cuts to Medi-Cal won't be restored.

Here's an excerpt from an L.A. Times story about the vote:

Assembly Republicans on Sunday blocked a proposed spending plan that would have closed the state's $15.2-billion shortfall with the help of tax hikes on the wealthy and corporations.

The failure of the Democratic plan means the state will continue to operate with no budget more than a month and a half into the fiscal year, heightening uncertainty for schools, health care providers and other services.

The move by GOP lawmakers came as little surprise on the Assembly floor since Republicans have long said they would vote against the tax proposal. But as public pressure mounted on lawmakers to take action on the budget, and back-room negotiations continued to falter, Democrats decided to bring the measure to the floor Sunday night.

The Assembly heard nearly four hours of debate during which 49 members spoke. In the end, the plan garnered a 45 to 30 plurality, but fell short of the 54 votes, or two-thirds majority, it needed. No Republican voted for it.

Several statements have graced my inbox about the vote.

From Jeanette Pruett, systems change advocate from the Kern Independent Living Center, in a statement sent out by Health Access California:

I’m very disappointed that the Assembly’s budget compromise was not passed. Without a balanced and fair budget like the one proposed, our community will suffer. We’ll lose health coverage for kids, see big cuts in health care for everyone and watch other vital social services get slashed.

From Anthony Wright, executive director of Health Access:

We appreciate the Assembly leadership's attempt to raise the revenues needed to prevent the worst of the proposed cuts to health care and other vital services — cuts that not only will make millions of Californians pay more and get less care, but also harm the health system we all rely on. The cuts would also hurt our economy, resulting in lost federal matching funds, wages, and jobs into the billions. The budget considered tonight already had tough cuts — including denying a quarter-million children health care — and yet it is being held up by those who want more cuts now and a deceptive limit to make ongoing cuts into the future. That's the wrong direction.

From a joint statement from the California Medical Association, Catholic Healthcare West, Health Access, Service Employees International Union and AARP:

The Assembly voted on a budget today that would have restored many of the deepest cuts to our health care system, sought prudent sources of new revenue and rejects a risky spending limitation which would automatically force future cuts in health care. It is far from ideal, but it was a step in the right direction. We all want a balanced budget, but thankfully those who supported this version of the budget understand that doing so by crippling the health care safety net upon which we all rely doesn’t make sense. California’s health care system has already been cut to the bone. Additional cuts now to our health care system would cause a ripple effect across California communities putting lives on the line in fewer, overcrowded ERs, crippling local economies with billions of lost federal funds and economic activity, adding to the millions already uninsured and leaving hundreds of thousands of seniors and children without access to care. We encourage all Californians who continue to struggle with this tough economy to join us in urging our leaders in Sacramento to pass a balanced budget that protects California families, patients, employers and local governments.

If I receive any more statements, I will be sure to post them.

Health Access has been busy trying to get the word out about these cuts. Read "Medi-Cal cuts hurt everyone, not just the poor, study says," which ran over the weekend and describes two studies the group commissioned.

For more information about the cuts, read the posts:
Bakersfield nurse practitioner on TV
Medi-Cal cuts impact people with private insurance too
Tax hikes vs. funds for health care, education
'Access to vital health care is at stake for all Californians'
Mercy president: Budget cuts put lives at risk
Calif. sued over Medi-Cal rate cuts
Is health reform dead?

A trip to the food bank

A lot has changed since manager Gary Romriell started working at the Community Action Partnership of Kern Food Bank over 10 years ago.

I toured the facility with Romriell this morning at the Public Health Services Department event to promote healthy food.

(Read "Food bank offers healthy alternatives for low-income families" on Bakersfield.com.)

He pointed out that a truckload of canned chicken cost $32,000 in 1995 but totals $88,000 today.

Tuna has gone from $24,000 to $44,000. Ground hamburger has risen from $42,000 to $65,000.

The rising costs have made it more difficult for the food bank to bring in ample food, he said.

Here are some other facts from Romriell:

The food bank serves 69 pantries and 25 senior centers, among several other partners.
It delivers food to 350 people who are homebound.
In 1996, 1,600 households were served through people walking into the food bank. Now it serves more than 2,600 households.
The average size of the families served has gone from 4.5 people to 5.5 people.
The food bank receives over four million pounds of food per year.

The food bank prefers monetary donations over food donations due to the discounts it gets, he said. With $1, the food bank can buy 10 pounds of food.

To donate or to find out how to organize a food drive, call the food bank at 398-4520 or send donations to Community Action Partnership of Kern Food Bank, P.O. Box 134, Bakersfield, CA 93302.

The Pulse is on Twitter!

Always the giddy follower of the latest and greatest of the Web, The Pulse now has a Twitter page!

To read it go to http://twitter.com/The_Pulse.

For those unfamiliar with Twitter, it is like a mini-blog. Users post short bursts of info that are 140 characters or less. These are called "tweets."

If you're familiar with Facebook's "update status" tool or even Bakersfield.com's "friend updates" tool, it's sort of like that.

The Pulse will use Twitter to post breaking news, interesting quotes, links to interesting health stories, links to local health stories, tidbits of info and all sorts of other stuff I haven't even thought of yet. If you have any suggestions, I'd love to hear them.

If you're on Twitter, send me a message and I'll follow you, which means I will get updates when you post something new.

And feel free to follow me. I like followers.