Here is how it works. A patient with nerve damage goes into a doctor’s office and is hooked up to a machine. The doctor uses electrodes in the area where the person has the pain. “The machine develops a series of synthetic natural looking wave forms… they form a positive and negative phase, in an irregular S shape,” says Aris Despo, vice president and business developer for Competitive Technologies. “Prof. Marineo developed these wave forms. These wave forms look very similar to the waveforms produced by the body in the nervous system. The algorithm assembles these synthetic waveforms randomly and dynamically. They are inserted back into the nerve pathway like an artificial neuron. The brain is a memory device and chronic pain is part of memory function of the brain. What we’re doing is substituting these synthetic wave forms representing  new information of no pain so that the patient then feels no pain. Over time and treatment, the perception of pain is reduced and over time, you have no pain.”

The treatment takes an hour at a maximum. It requires ten applications, and people can pay for it even though it isn’t yet covered by insurance, says Despo. The cost varies depending on the doctor but he estimates $150-200 per application. As for side effects, the only side effect is some irritation where the electrode was on the body.

Despo says patients should be evaluated on a case-by-case basis and that technology is not a cure-all for the underlying cause of the pain.

“For example it does not cure the tumor causing the pain, or the damaged disc in the back,” Despo says. “(In) patients with multiple neuropathies, each individual neuropathy has to be identified, and their no-pain period will be shorter than a single neuropathy because it may be difficult to identify each neuropathy.”

The inventor of scrambler therapy, Professor Giuseppe Marineo, was kind enough to answer some questions below.

JZ: Why did you develop this therapy? How long did it take to develop?

GM: My primary research area is the regeneration of organs and tissues. When I worked on nerve injury patients, I often met sick with very strong neuropathic pain that did not benefit from any type of conventional care. For this reason I started my research on chronic pain, which led to the Scrambler Therapy. The theoretical development lasted about a year. In 1996 (I) started clinical trials on chronic and oncological pain very severe and incurable with drugs or others care, which ended successfully in 2002.

JZ: What happens if, after 10 treatments, the patient has pain? Does the therapy lose its effectiveness?

GM: With the exception of end-stage cancer pain that requires treatment at the request of the patient, 10 applications are usually sufficient. However, you can repeat the treatment if necessary. There are no known phenomena of loss of efficacy.

JZ: How can technology help assist doctors and patients in determining the best outcome?

GM: The best results depend only on good training in the use of therapy and compliance with treatment protocols. A treatment executed by staff who have good training and respect the treatment protocols, usually leaves the patient without pain at the end of the cycle, and the % of success is between 93 and 100%.  Link to published results:
www.joplink.net/prev/200301/24.html.

The  % of success in the absence of training and lack of respect for protocols can greatly diminish, together as the quality of results. A standard training course lasts only three days, this is the best help we can give doctors and patients.

James Zipadelli is a freelance writer who writes about health and aging for OurParents.com. His Web site is www.jameszipadelli.com. He can be reached at jzipadelli@gmail.com.

Sen. Rob Kane (R-Watertown) voted yes. In his remarks, Kane said, “This bill gives people the opportunity to stay in their homes.”

Sen. Edith Prague (D-Columbia), who has been the primary supporter of this bill, voted yes. Prague said, “I am happy with the support that has been verbalized in this bill. Anyone with experience with an Alzheimer’s patient knows how difficult it is to care for them. In the end, the caregiver is worn out. When the person has to be moved to a nursing facility, most facilities have units that are extremely costly.”

State Rep. DebraLee Hovey (R-Monroe) voted no. In her remarks, she said that she sympathized with people who have Alzheimer’s and dementia-related disorders. However, she added, “Each one of us would have some area of home health care as an area we were concerned about. To specifically have one deliniated is not appropriate.”

Rep. Anthony Hwang (R-Fairfield) voted yes, but he also had concerns. “I hope we don’t set a precedent to pre-empt the authority of the Governor’s budget,” Hwang said. ”However, I know there are 300 people on the waiting list. It is really important for them to be in familiar surroundings, and this population is one we definitely need to pay attention to.”

Rep. Fred Camillo (R-Greenwich)  concurred. “It’s a great program, but I do question the precedent we may be setting here, and I hope that those who vote for this remember not to make this a habit. We’re having a hard time reigning in spending… but I do support this bill.”

Information upcoming.

The Medicare Savings Programs allow seniors to get a break on their Medicare part B premiums, deductibles, and prescription drugs. The law was changed in October 2009 and according to DSS spokesman David Dearborn, the income requirement was raised, and the asset requirement was dropped.  As a result, Dearborn estimates that 23,000 more seniors have become eligible for the Medicare Savings Programs. The Medicare Savings Programs have served 82,945 in Connecticut as of February 2010. You should check the availability of similar programs in your state.   

John Erlingheuser is the advocacy director for AARP-Connecticut, but he also his mother’s primary caregiver. His mother, who is 80, began under the Medicare Savings Program in January 2010.  Erlingheuser he is happy that a program he helped spearhead is helpful in such a personal way.

“Obviously it has its glitches, but it’s a great program once you get through all the glitches,” Erlingheuser, 40, says. “My mom is the higher end of eligibility through ConnPACE. Her Medicare premiums are no longer deducted by Social Security. Prior to being on the Medicare Savings Program, each prescription she has had a co-pay of $16.25 and she has seven prescriptions. After being on MSP, it went down to $6.20 on brand-name drugs and $2 for generics.”

Erlingheuser said the changes in the law helped his mother become eligible for the low income subsidy, even though she previously owned her own home and had some savings.  “Those on the lower income levels also get help paying for their Medicare supplement plan for health care,” Erlingheuser says.

Dearborn says that all Medicare MSP clients are eligible for LIS.

“LIS is not, however, part of the MSP,” Dearborn says. “It is a separate program; however, MSP eligibility confers eligibility for the LIS.” According to Erlingheuser, the glitch in the program can occur when a resident first gets enrolled.

“Once a person is made LIS (low income subsidy), it’s now up to the Feds to put their prescriptions in the system,” Erlingheuser says. “When you go to the pharmacy, your pharmacist can tell you that ConnPACE is rejecting drugs because the government only puts the Medicare Savings names in twice per month. DSS will reimburse you for any overpayment after you pay full-cost when you first get enrolled.”

According to Erlingheuser, his understanding was that DSS would reimburse his mother for overpayment of prescriptions and his mother was reimbursed in a month and a half. Erlingheuser also said AARP-Connecticut had also received several calls from constituents who were under the impression that DSS would reimburse them. In response to that point, Dearborn says, “DSS does not reimburse an individual for overpaid prescription drug co-pays, the Part D prescription drug plan does.”

Erlingheuser praised DSS for its work under difficult circumstances.

“DSS are strained to the gills with all the changes to requirements for ConnPACE,” Erlingheuser says. “They’re short-staffed because of layoffs and retirements. It’s been a lot of pressure to try and make this happen but in the end it’s been a good thing.”

That’s why, for the last two months, I have followed one such program, the respite care program, in Connecticut. Although the program has support in the legislature, Gov. Rell, like most states across the country, is looking at a budget shortfall and has to find ways to balance the budget. However, these programs do help people, and cuts to these programs affect the quality of caregivers’ lives and their loved ones.

It raises difficult questions: First, how do legislators and the Governor decide which programs should be funded and which should be cut? Second, what responsibility do we have as a society to ensure that our most vulnerable citizens are taken care of? How do we ensure these programs exist in the most cost-effective way possible, without sacrificing services, and ultimately, helping residents live longer and happier lives?

We need to report on these issues in as complete a manner as possible. It is going to affect our budgets, caregivers and families for years. The story that I am writing on Medicare Savings Programs is a perfect example. The MSP allows seniors to get a break on their Medicare part B premiums, deductibles, and prescription drugs. The law in Connecticut has been changed since 2009 which makes more seniors eligible for these programs. However, the program still needs tweaking, which need to be addressed.

It’s important to check in your state to see whether or not your loved ones qualify for similar programs.

Most important, I hope that you find useful information in these stories. I hope you discuss the type of care your loved one wants before a crisis occurs. Finally, I am grateful to OurParents.com for giving me an outlet to continue this work.

“Alzheimer’s is a debilitating disease that affects caregivers and families,” State Sen. Rob Kane, (R-Watertown) who spoke during the press conference, says. “I understand that from a family’s perspective. However, I’m also a fiscal conservative. This bill speaks to the disease and saves the taxpayers money. That’s why I believe in it and support it.”

Christy Kovel, the senior communications director for the Connecticut chapter of the Alzheimer’s Association, says she is hopeful the respite care program will be re-opened to new enrollees in the final budget package. Kovel says the state saves money by giving a stipend to a caregiver, instead of having someone with Alzheimer’s go into a nursing home.

“If this program remains closed and the caregivers have loved ones on a waitlist, they will have to use other alternatives for services,” Kovel says. “As people advance in the disease progress, they may need 24-hour care and would not be ultilizing the respite program. The lack of having this program will leave caregivers with fewer options to support them in caring for a loved one with Alzheimers.”

Kovel also says that seventy percent of people with Alzheimer’s disease are cared for in the home, and she worries that if people with Alzheimer’s or dementia-related disorders are placed in nursing facilities, then the program shrinks because new applicants aren’t being added.

Kane acknowledges Gov. Rell is in a difficult position with trying to bring down the deficit.

“I can understand where Gov. Rell is coming from,” Kane says. “We do have a $500 million budget deficit and we do need to look at all areas where we save money. Yes, we do have an initial cost here and we need to move forward, but there are certain programs like this one that saves the state money. I think that the money was pulled from this program too soon.”

“The number of individuals with Alzheimer’s disease continues to grow,” Kovel says. “In Connecticut, we are anticipating a twelve percent increase in the number of individuals who have Alzheimer’s disease by 2025.  Our demographics show us that our state is aging. Investing in home and community based options of care makes good fiscal sense.  It’s more cost-effective to keep someone at home than to place them in an institution which costs the state a lot more money.”

The Appropriations Committee voted on Governor Rell’s version of the budget last Thursday (HB 5018), which takes $1 million out of the respite program. However in the Appropriations Committee version of the budget, it appears the money to fund the respite program was preserved. (It’s on page 173).

Kane is a member of the Appropriations Committee and says he is aware of the emotional cost these programs have on people, not just the financial cost to the state.

“It’s always a difficult question to grapple with as far as grading the importance of different programs, but I’m sure there are other areas that may not pay the kind of dividends that this one does,” Kane says. “It’s not an easy thing, but we have to continue those discussions.”

There has not yet been a date set to vote on the budget as a whole.

James Zipadelli is a Connecticut-based freelance journalist. For more stories in this series, please go to www.jameszipadelli.com.

While politicians are making difficult decisions with Connecticut’s budget, it’s worth noting that the statewide respite program is helping, and has helped families, like Danbury resident John Whitcomb.

Whitcomb wears many hats. He’s the Chief Examiner for the City of Danbury. He sits on several boards and is a part of the Governor’s State Contractor Standards Board. But he says his most important task was caring for his wife, Farida, (Pita), who developed early-onset Alzheimer’s in her late 40s and passed away last June at age 55.

This is what Whitcomb had to say about the statewide respite program and how he was treated by the Department of Social Services.

“Nursing home care costs will absolutely bankrupt anyone, unless you’re a Rockefeller. The cost is going to wind up on the state (at 10,000 per month). Just by delaying the necessity of moving into a nursing home, the state saves very large costs,” Whitcomb says.

“She was able to make some use of the program,” Whitcomb says. “In her case, her death in June 2009 came more suddenly than I had anticipated. She did not need to be admitted to a nursing home, partly because we were able to use respite care. She would have certainly been eligible for a nursing home. So I think it’s clear in this case she did save the state money.”

“The paperwork for the program was reasonable. I know I found it more streamlined then most bureaucracy is,” Whitcomb says. “DSS treated me and my wife very well. And I’m not afraid to criticize government agencies.”

“Most folks think of Alzheimer’s as something your 70 year old Grandma gets,” Whitcomb says. “Most people think you can’t decide between the peas or the beans at the grocery store. All of a sudden, she would scoot down an aisle and my fear was that she would go out of the building before I found her. Wandering is a big thing with Alzheimer’s.”

“On one occasion when my wife was coming home from work, it’s a 30 minute drive home, and I hadn’t heard from her in 3 hours,” Whitcomb says. “She called me on the cell phone and said, “I don’t know where I am.” I had her read signs to me over the cell phone to determine where she was. She had driven out of state and I had to talk her home on the cell phone the whole way.”

“I think anyone who is needing to deal with a disease like this… it’s very important to have a strong network of friends and professionals in services that can be helpful and who know what to anticipate and what resources are available. That’s really critical. You’re not going to change the progress of Alzheimer’s… it’s inevitable that it leads to death, and progresses and gets worse. The rate is impossible to predict. But staying connected is extremely important.”

“It is also important for anyone with first hand experience to make sure folks in decision making positions realize the impact of these programs. The respite program saves money. It does not take a great deal of thinking to realize the alternative costs are far higher.”

For Connecticut residents who have questions about the program, here’s the Q&A with DSS’s David Dearborn.

James Zipadelli is a Connecticut-based freelance journalist. For more stories in the series, please go to OurParents.com or his Web site, www.jameszipadelli.com.

Volunteer service, such as tutoring children, can help older adults delay or reverse declining brain function, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health. Using functional magnetic resonance imaging (fMRI), the researchers found that seniors participating in a youth mentoring program made gains in key brain regions that support cognitive abilities important to planning and organizing one’s daily life. The study is the first of its kind to demonstrate that valuable social service programs, such as Experience Corps a program designed to both benefit children and older adults’ health can have the added benefits of improving the cognitive abilities of older adults, enhancing their quality of life. The study is published in the December issue of the Journals of Gerontology: Medical Sciences.

About 78 million Americans were born from 1946 to 1964. Individuals of retirement age are the fastest-growing sector of the U.S. population, so there is great interest in preserving their cognitive and physical abilities, especially given the societal cost of the alternative.

“We found that participating in Experience Corps resulted in improvements in cognitive functioning and this was associated with significant changes in brain activation patterns,” said lead investigator Michelle C. Carlson, PhD, associate professor in the Bloomberg School’s Department of Mental Health and Center on Aging and Health. “Essentially the intervention improved brain and cognitive function in these older adults.”

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Researchers at the University of Colorado Hospital Acute Care for the Elderly Service surveyed adult patients aged 21 to 89. They discovered that a total of 88% of hospitalized seniors could not recall any medications they had been prescribed. Among the total group, 96% of patients could not remember any medications they had been prescribed. Patients were given a list of medications and asked to check which ones had been prescribed. That list was then compared to actual prescription records. Antibiotics, cardiovascular medications and antithrombotics were the most commonly omitted medications on the checklist, according to the report.

In Illinois and other states, nursing home administrators may be disciplined by state and federal authorities for a variety of legal infractions such as professional incompetence and violating Illinois’ Nursing Home Care Act, which protect patients from emotional and physical harm.

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