Cameron Crazies Could Soon Travel 'Coach K Highway'

(From The News & Observer, Mary Helen Moore, 12/08/22)

The route to Duke basketball games could soon take Cameron Crazies along “Coach K Highway.” Duke University has asked that a portion of N.C. Highway 751 be renamed in honor of longtime men’s basketball coach Mike Krzyzewski. Krzyzewski spent 42 seasons at Duke and won five national titles before retiring last year.

The three-mile section of N.C. 751 under consideration is between Duke University Road and Kerley Road. Also named Cameron Boulevard, it passes near Cameron Indoor Stadium and through Duke Forest. The Durham City Council will vote on a resolution in support of the renaming at its Dec. 19 meeting. The resolution, if unanimous, will kickstart an application to the state Department of Transportation. The NCDOT board gets the final say.

Duke agreed to pay the $2,000 that new signs are expected to cost. Duke’s rival UNC succeeded last year in getting two stretches of Interstate 40 renamed for legendary basketball coaches Roy Williams and Dean Smith. [Source]

Stiff-Person Syndrome and What You Need to Know

(photo: Pascal Le Segretain/Getty Images)

Multiple award-winning singer Celine Dion shocked the world Thursday, announcing she has a rare neurological disorder called Stiff-Person Syndrome (SPS).

In Dion's Instagram video she says:  “Recently I have been diagnosed with a very rare neurological disorder called Stiff-Person Syndrome, which affects something like one in a million people. While we’re still learning about this rare condition, we now know this is what’s been causing all of the spasms that I’ve been having."

According to the National Institute of Neurological Disorders and Stroke, SPS has features of an autoimmune disease and is characterized by fluctuating muscle rigidity in the trunk and limbs, as well as a heightened sensitivity to stimuli such as noise, touch, and emotional distress, which can trigger muscle spasms. It’s often misdiagnosed as Parkinson’s diseasemultiple sclerosis, or fibromyalgia. Researchers are still trying to understand the disorder, and currently there is no cure.

According to Yale Magazine, the cause of this extremely rare disease is still unknown. But researchers suspect that it may be the result of an autoimmune reaction where the body attacks nerve cells in the central nervous system that control muscle movement.

Symptoms can lead to difficulty walking and, over time, even greater disability. People with Stiff Person Syndrome are also more likely to have symptoms of depression and anxiety.  In part, this is because of the unpredictability of the disease, but patients also have lower levels of the neurotransmitter GABA, which regulates anxiety.

Most people start experiencing symptoms between the ages of 30 and 60.

Reaching a diagnosis for Stiff Person Syndrome can be difficult. Generally, SPS is suspected based on characteristic symptoms. A comprehensive medical history and examination, along with additional investigations, including blood tests and spinal fluid analysis, can confirm the diagnosis. When conducting those tests, your doctor is looking for elevated levels of GAD antibodies.

Electromyography or EMG is also sometimes recommended to study the electrical activity of skeletal muscles. Your doctor will be looking for typical motor unit activity findings that are common in people with SPS.

Doctors will also rule out other possible causes of symptoms, including Parkinson’s disease, multiple sclerosis, fibromyalgia, psychosomatic illness, or anxiety and phobia.

There is no cure for Stiff Person Syndrome. When doctors treat patients with this condition, they focus on relieving symptoms with medications such as sedatives, muscle relaxants, and steroids. Intravenous Immunoglobulin and plasmapheresis, among other immunotherapies, may also be prescribed. Physical, occupational, and aqua therapy are also important for patients with SPS.

For more from Yale click HERE.

Potentially Landmark Class-Action Lawsuit Filed Against NC

(Photo: Gannett)

(This story first appeared in Wilmington Star-News, 12/07/02 by Matthew Prensky)

Crystal Klunk’s daughter suffers inside one of North Carolina’s psychiatric residential treatment facilities — a place that resembles solitary prison confinement more than a care facility meant to help kids with mental health issues, the mom says. Spotty supervision, sporadic treatment and only occasional schooling have been part of the girl’s experience, Klunk said. They have not seen their daughter, who first tried to kill herself at age 10, in months. The staff at their daughter Alexis’ center reportedly has not updated Klunk on the teen’s status.

A six-month investigation in 2021 by North Carolina and Virginia journalists in the USA TODAY Network featured Klunk and other families, plus shocking details of neglect and abuse inside these locked centers. Now, citing the “Locked Away” reporting series, a potentially landmark class-action lawsuit has been filed in federal court against the state of North Carolina.

The lawsuit aims to reduce North Carolina’s focus on these institutions and to shift many children to more appropriate support services based in their home communities. The Middle District Court filing by Disability Rights North Carolina, the state NAACP and the children themselves cite gruesome allegations of kids subjected to physical, psychological and sexual abuse at these psychiatric centers — reports that were brought to light in the multi-part Locked Away investigation.

Plaintiffs claim there is a systemic effort by North Carolina health and human services officials to warehouse foster children with mental health disabilities in these locked wards. The state’s decisions have failed vulnerable children and wasted taxpayer money on what is a punishing and expensive system of centers, the filing says. The plaintiffs, which include four children and their guardians, want North Carolina to provide adequate and appropriate services in the community for foster kids who need mental health care. It will take an investment in a web of services at multiple stages of a kid’s mental health journey — and could be financed in part with ample dollars the state is currently sending to PRTFs.

Tuesday afternoon’s lawsuit alleges children inside PRTFs are confined to prison-like settings “under the care of a poorly trained and understaffed workforce, where they are subject to broken bones, sprains, bruises, and dangerous physical and chemical restraints; withstand sexual and physical abuse, bullying, and hate speech by both youth and staff; and face mental health deterioration and cocktails of strong psychotropic medications.”

“DHHS is failing hundreds of children with disabilities in foster care, warehousing them in dangerous, expensive, damaging institutions,” said Virginia Knowlton Marcus, chief executive officer of Disability Rights North Carolina. “These children deserve and have the right to a family and place in our communities where they can meet their full potential. Instead, they receive institutionalization and irreparable harm to their childhood and wellbeing.”

USA TODAY Network-North Carolina has reached out to the state Department of Health and Human Services for comment on the filing. The head of DHHS is the named defendant in the lawsuit, representing the state. [Source

NCMS Goes 'Over the Edge' for Special Olympics!

RALEIGH -- Members of the North Carolina Medical Society went Over The Edge Saturday to support Special Olympics North Carolina!

They each rappelled 30 stories off the 150 Fayetteville Street building in downtown Raleigh (that is 30 stories)! It was to raise awareness for nearly 40,000 North Carolina athletes across the state.

Rappelling is used to demonstrate the courage people with intellectual disabilities face every day. You must have courage to try something that doesn’t come easily to you. Special Olympic athletes bravely face challenges on the field, in the pool and on the court. They are the inspiration for this event.

Over the Edge 2022 for Special Olympics North Carolina is part of the NCMS strategic planning initiative to create community involvement with new partners across the state. This was our 3rd year taking part to honor the medical providers that care for the athletes in this program.

(L-R) Eileen Raynor, MD (NCMS Board of Directors, President Elect), Evan Simmons, NCMS Director of Board and Executive Services, and Cynthia Gary, MPH, PA-C (NCMS Foundation Board of Trustees Member)

Donations are still being accepted.  If you would like to support Special Olympics North Carolina, click HERE. 

Are You Ready for Interoperability?


Interoperability could make treating patients and disease tracking much easier.
(From Healthcare Tech by Maia Anderson) 
The word “interoperability” may sound complicated, but the concept behind it is actually pretty simple. Say you wake up in the middle of the night with shooting pains in your abdomen and go to the ER. Your ER doctor may want to do some blood work, but that was done at a primary care visit last week. Your ER doc pulls up those bloodwork results on their computer, so you don’t need to get bloodwork done again, as Advanced Data Systems explains.

That’s interoperability in a nutshell—being able to share patient information easily between different doctors and computer systems to make patient care easier (and save costs, like unnecessary blood tests). Full interoperability would also mean this imagined ER doc would have been alerted upfront that the bloodwork was done, so the onus isn’t on the patient.

That’s not possible today, given that many systems in healthcare are unable to communicate with each other, according to Amit Trivedi, senior director of informatics and health IT standards at the nonprofit Healthcare Information and Management Systems Society. Getting to that point will take significant change and investment in new technology.

But when it comes to adopting new technology, the healthcare industry “tends to be conservative and risk averse, because at the end of the day, any change has to be looked at through the lens of patient safety,” Trivedi said.

Despite that, change is coming. In a big step toward increasing interoperability, an Oct. 6 federal rule now requires that healthcare facilities give patients access to their complete digital health records.

The healthcare industry is working to advance interoperability because it would make patient care a lot easier if providers were able to access a fuller understanding of a patient’s health history. It would also have big implications on population health, as it would give regulators, like the CDC, a much fuller picture of who’s contracting diseases and where, Trivedi said.

NC Case on Congressional Districts Going Before US Supreme Court Wednesday

 The Supreme Court to weigh in on a challenge that could significantly increase the power of state lawmakers over elections for Congress and the presidency


(This article is from Mark Sherman , The Associated Press, 12/4/22)

The Supreme Court is about to confront a new elections case, a challenge asking the justices for a novel ruling that could significantly increase the power of state lawmakers over elections for Congress and the presidency. The court is set to hear arguments Wednesday in a case from North Carolina, where Republican efforts to draw congressional districts heavily in their favor were blocked by a Democratic majority on the state Supreme Court because the GOP map violated the state constitution. A court-drawn map produced seven seats for each party in last month’s midterm elections in highly competitive North Carolina.

The question for the justices is whether the U.S. Constitution’s provision giving state legislatures the power to make the rules about the “times, places and manner” of congressional elections cuts state courts out of the process. “This is the single most important case on American democracy -- and for American democracy -- in the nation’s history,” said former federal judge Michael Luttig, a prominent conservative who has joined the legal team defending the North Carolina court decision.

The Republican leaders of North Carolina’s legislature told the Supreme Court that the Constitution’s “carefully drawn lines place the regulation of federal elections in the hands of state legislatures, Congress and no one else.”

Three conservative justices already have voiced some support for the idea that the state court had improperly taken powers given by the Constitution when it comes to federal elections. A fourth has written approvingly about limiting the power of state courts in this area. But the Supreme Court has never invoked what is known as the independent state legislature theory. It was, though, mentioned in a separate opinion by three conservatives in the Bush v. Gore case that settled the 2000 presidential election.

If the court were to recognize it now, opponents of the concept argue, the effects could be much broader than just redistricting. The most robust ruling for North Carolina Republicans could undermine more than 170 state constitutional provisions, over 650 state laws delegating authority to make election policies to state and local officials, and thousands of regulations down to the location of polling places, according to the Brennan Center for Justice at the New York University School of Law.

Luttig, who advised former Vice President Mike Pence that he had no authority to reject electoral votes following the 2020 election, is among several prominent conservatives and Republicans who have lined up against the broad assertion that legislatures can’t be challenged in state courts when they make decisions about federal elections, including congressional redistricting. That group includes former California Gov. Arnold Schwarzenegger, law professor Steven Calabresi, a founder of the conservative Federalist Society and Benjamin Ginsberg, a longtime lawyer for Republican candidates and the party.

“Unfortunately, because of ongoing and widespread efforts to sow distrust and spread disinformation, confidence in our elections is at a low ebb,” Ginsberg wrote in a Supreme Court filing. “The version of the independent state legislature theory advanced by Petitioners in this case threatens to make a bad situation much worse, exacerbating the current moment of political polarization and further undermining confidence in our elections.”

The arguments are taking place a day after the final contest of the 2022 midterms, the Georgia Senate runoff between Democratic Sen. Raphael Warnock and Republican Herschel Walker. In that contest, state courts ruled in favor of Democrats to allow for voting on the Saturday before the election, over the objections of Republicans.

Jason Snead, of the conservative Honest Elections Project, said the case is an opportunity for the high court to rein in out-of-control state courts which are being pushed by Democratic attorneys to effectively create new rules governing voting, including the Georgia example. “We’ve seen a fairly pervasive attempt to use courts to rewrite election laws if those laws don’t suit partisan agendas,” Snead said in a call with reporters. “That’s not something we want to see when it flies in the face of the Constitution.”

He is among proponents of the high court’s intervention who argue the case doesn’t represent “a threat to democracy.” The justices can instead write a narrow opinion that places limits on state courts without upsetting the choices New York and other states have made to restrict partisan redistricting, a group of New York voters wrote in a court filing. The New Yorkers implicitly recognize that if the court gives more power to state legislatures over drawing congressional lines, Republicans may not necessarily benefit.

During the last redistricting cycle, states that used independent redistricting commissions rather than legislatures were largely Democratic-dominated ones. Commissions drew 95 House seats in states with Democratic legislatures and governors, as opposed to only 12 in states with GOP control. A ruling that grants legislatures ultimate power over redistricting could eradicate those commissions and let Democrats redraw a major chunk of the House map.

“The bottom line is the impact of this fringe theory would be terrible,” said former Attorney General Eric Holder, chairman of the National Democratic Redistricting Committee. “It could unleash a wave of gerrymandering from both parties.” Even less dramatic changes may not necessarily tilt the GOP’s way on a national redistricting map that was essentially fought to a draw, and where state court rulings cost Democrats about as many House seats as Republicans.

The Supreme Court refused to step into the North Carolina case in March, allowing the court-drawn districts to be used this year. Justices Samuel Alito, Neil Gorsuch and Clarence Thomas dissented. Writing for the three, Alito said “there must be some limit on the authority of state courts to countermand actions taken by state legislatures when they are prescribing rules for the conduct of federal elections. I think it is likely that the applicants would succeed in showing that the North Carolina Supreme Court exceeded those limits.”

Justice Brett Kavanaugh has separately written about the need for federal courts to police the actions of state courts when it comes to federal elections.

Chief Justice John Roberts’ record on this question gives both sides some hope. In 2015, he wrote a strong dissent from the court’s decision upholding an independent redistricting commission in Arizona. Roberts wrote that the Constitution does not permit “a state to wholly exclude ‘the Legislature’ from redistricting. ” But in 2019, Roberts wrote the court’s majority opinion that closed federal courts to claims of partisan gerrymandering but noted state courts remained open. “Provisions in state statutes and state constitutions can provide standards and guidance for state courts to apply,” he wrote, in an opinion joined by Alito, Gorsuch, Kavanaugh and Thomas. The court’s other conservative justice, Amy Coney Barrett, has no track record in this area.

In North Carolina, a new round of redistricting is expected to go forward next year and produce a map with more Republican districts, whatever the outcome of the high-court case. In last month’s elections, voters flipped the majority on the state Supreme Court, electing two new Republican justices that give the GOP a 5-2 edge and make it probable, though not certain, that the court would uphold a map with more Republican districts. [Source]

Work in Moore County? Need NCMS Help?

Photo courtesy: Duke Power

As widespread power outages caused by vandalism continue in Moore County, the North Carolina Medical Society is looking to help our affected members.

With power out to businesses possibly stretching into Thursday, NCMS wants to remind you that we are a resource for our members.

Duke reported about 38,000 residences and businesses remained without power Sunday. It provides power to nearly the entire county. The outage hit Moore Regional Hospital, which switched to generator power. A hospital spokeswoman in a message to staff said the outage did not affect patients. “The Moore campus is safely operating on backup generator power and we have not experienced any issues or concerns,” Gretchen Kelly said. Kelly told The N&O on Sunday that the hospital has enough fuel on hand for several days for generator power and plans in place to obtain more fuel as needed.

If you have questions or concerns about your practice or patients, or help finding resources, please reach out to your NCMS Team.

NCMS Gets Into Holiday Spirit Early!

Happy Holidays from the staff of the North Carolina Medical Society!

On December 2, CEO Chip Baggett hosted the NCMS final staff meeting of 2022.  It was a chance to celebrate the successes of the year, including the return of the LEAD Conference and the first Golden Stethoscope Awards Gala.  Chip lauded the staff, Board of Directors, and NCMS members for working through the pandemic and building on our long history of supporting quality healthcare in North Carolina.

He also took time to look forward at a bright 2023 on the horizon for NCMS!

It was no prob-llama in his amazing holiday sweater!

NCMS CEO Chip Baggett getting into the holiday spirit!  

The team had a raucous White Elephant Gift Exchange, where the gifts ranged from used Christmas lights, to books, to a some prized holiday decor!

We also prepared to say goodbye to Gail Stephenson, Director of Event Services, who is retiring this month.  She is going off with some bling!  This her response to her gift from Reeds Jewelers.

As always, everyone at NCMS is looking forward to meeting with our members and working hard!

Here's to 2023!

Is Long Covid the Next Public Health Disaster?

Long Covid economic impact estimated at $3.7 trillion, rivaling Great Recession

As the United States prepares to enter its fourth calendar year of the coronavirus outbreak, it could also be facing a tough winter.  Some new studies suggest that most Americans have had COVID-19 already and the DCD says 2,000 more are still dying each week.  Now, long Covid is becoming a concern.

The number of people who are suffering from long Covid are rising and the impact is far reaching.  In addition to the toll on health, long Covid also creates issues with disability benefits, life insurance, household debt, retirement and financial ruin.

David Cutler of Harvard University says, all told, long Covid is a $3.7 trillion drag on the U.S. economy — about 17% of our nation’s pre-pandemic economic output. The aggregate cost rivals that of the Great Recession, Cutler wrote in a July report.

With that, a debate still seems to rage about what long Covid actually is.  Some studies say women and people of color are higher risk and could also be more likely in bisexual and trans people.

Treatments vary and have different degrees of success.  Greg Iacurci wrote an in-depth piece for CNBC about the physical and economic toll of long Covid.  Read his insights by clicking here.

Wanted: Surgical Service Teams for AHRQ Safety Program

 Act now to join AHRQ Safety Program for MRSA Prevention

The Agency for Healthcare Research and Quality is recruiting teams to participate in the AHRQ Safety Program for MRSA Prevention.

It is a FREE 18-moonth program that seeks to reduce surgical site infections with a focus on those caused by methicillin-resistant Staphylococcus aureus (MRSA).

The program begins next month and participants will receive technical assistance, coaching, webinars, and tools to support your infection prevention program.

Continuing education credits will be offered at no charge.

For full information and how to participate click here.