| Oncologists sue HHS over Medicare Part B sequester cuts
The trade group for independent oncologists sued the federal government over the Medicare sequester cut to Part B drugs, arguing that Congress never gave HHS authority to change the reimbursement formula. READ MORE
The CMS said 91% of clinicians eligible for MIPS submitted data by the April 3 deadline. Even with that success, thousands of clinicians will still face reimbursement cuts for failing to meet MIPS requirements. READ MORE
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PAYMENT
Largest penalties to urban hospitals for risk-based payments, 2018 A list of providers given the largest hospital-based value-purchasing penalties by CMS in 2016. Source: HMP, CMS’ HBVP data. READ MORE
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POLITICS AND POLICY
NJ Gov. Murphy signs bill mandating health insurance coverage New Jersey residents face a penalty of 2.5% of income or $695 per taxpayer, whichever is greater, if they don’t carry health insurance. READ MORE
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Ambien as sleep aid and its side effects
There are many ways to sleep. I do not recommend ambien. There are sleeping tips such as cool room temp, exercise, fresh air, warm bath, magnesium with calcium and zinc, melatonin, repetitive tasks like praying or meditating, eating protein rich food like peanuts before sleeping and other ways to put you to sleep.
Ambien as sleep aid and its side effects
One of the most popular sleep aids is Ambien (zolpidem tartrate) – a sedative used to treat insomnia. An estimated 50 to 70 million American suffer from sleep disorders and, according to the Centers for Disease Control and Prevention, about 4 percent of Americans use a prescription sleep aid.
Although Ambien is often regarded as a “safer” alternative to benzodiazepines such as Valium, you should be aware that it comes with its own set of risks. While the relaxing effects of Ambien are highly desirable to millions of people, they may come at a cost.
Here’s a look at five things you’ll want to consider before popping those Ambien.

- #1: Increases the chances of driving a car (sleep-driving)
The FDA warns that after taking Ambien, you should not drive or engage in activities that require mental alertness. Many people take Ambien to help them sleep and the day after they wake up and drive to work. This is dangerous given that Ambien can impair a person’s ability to drive even after a full night’s sleep.
(The FDA produced a podcast on why it’s important to avoid driving the day after taking Ambien CR. You can listen here.)
- #2: Sleepwalking
It is not uncommon for people to do or say things that they wouldn’t normally do while on Ambien. One of the more serious side effects of taking Ambien is getting out of bed and not being fully awake. People report doing activities they weren’t aware of at the time, such as making food “sleep-eating” or talking on the phone.
- #3: Having sex
Ambien lessens inhibitions and there are numerous reports of people having “Ambien sex.” Although having sex doesn’t sound like a “scary” fact to most, there are disturbing reports of Ambien being used as a date rape drug.
- #4: Ambien carries a risk for abuse
If you have to continually increase your dosage to get the desired sedative effects of Ambien, you may have developed a tolerance to the drug. This can lead to physical dependence, which means that you need Ambien in your system in order to function.
Many people who use Ambien to treat insomnia develop an addiction to the drug. If you have a history of drug or alcohol abuse, your doctor will likely not prescribe Ambien because the potential for abuse may be too high. According to a research study, 43 percent of people who developed an Ambien addiction had a previous history of substance abuse.
- #5: Withdrawal can be unpleasant
If you have developed a dependence to Ambien, you may experience uncomfortable withdrawal symptoms. Withdrawal from Ambien can be dangerous and result in seizures and/or delirium.
Vote and be informed to protect our democracy
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Massage and caregiving services for bay area seniors
Motherhealth caregivers provide comfort and health monitoring to home bound bay area seniors. As we massage the aching bodies of seniors who are mostly bed-bound , we also give a hug and loving words. Most seniors are alone and need hugs and loving touch.
Even a trumpist who is bed ridden became soft and warm hearted upon receiving massage from Motherhealth caregivers who are from all walks of life (older, Filipina, African Americans, Ethiopians, retired, health care pros, CNAs, healers, massage therapists).
Text 408-854-1883 for prompt response of your caregiving needs or email motherhealth@gmail.com

Women find strength and camaraderie in rowing as they age
Women find strength and camaraderie in rowing as they age
Jayne Lytel, 61, is a member of D.C.’s Potomac Boat Club. She has been rowing since 2012. (Matt McClain/The Washington Post)
As they launched their rowing shell onto Boston’s Charles River one sunny October morning, four Alexandria women prepared to live a rower’s dream: competing in the three-mile Head of the Charles Regatta that is to rowers what the Boston Marathon is to runners.
They’d trained together for months, even hired a coach to push them harder, and here they were, fit and ready.
Average age in the boat: 63.
That was two years ago. Harriett Pallas, 67, Brenda Waltz, 67, Pamela Zitron, 69, and Eleanor Richards, 61, are still rowing and still competing along with a growing contingent of older women who discover that rowing can be a good way to get and stay fit. Many later find themselves racing on rivers from the Potomac to the Thames and beyond.
The four came to rowing by different paths. Waltz and Zitron found the sport through younger family members who rowed, and Richards claims that learning to row “was my midlife crisis.” Pallas, already a cyclist, skier and tap dancer, tried it and was hooked.
“I don’t know what I’d be without rowing!” she said.
[We all know exercise makes you live longer. But this will actually get you off the couch.]
Most aerobic sports bathe the brain with feel-good endorphins after a workout, and rowing is no exception. Studies show that rowing offers cardiovascular and respiratory advantages for those who train even semi-seriously. And sports physiologist Fritz Hagerman, who taught at Ohio University and died in 2013, found that the lungs of rowers who train seriously use oxygen far more efficiently than those of most other athletes. After all, rowing uses all the body’s oxygen-hungry major muscle groups in the legs, torso and arms.
Lytel uses a rowing before getting onto the water on Mar. 26. (Matt McClain/The Washington Post)
Weight control can be an added benefit. In the past year, Waltz has lost 60 pounds. “I realized if I was going to row the way I wanted to, I’d have to lose the weight,” she said.
Some women even swear that it staves off the post-menopausal thinning of bones that can lead to fractures.
Most older women who row admit that after they decided to give the sport a try, they got pulled in by the rhythm, the water and the way it looks easy but can be maddeningly challenging.
Just as important as the health benefits for many are psychic boosts such as companionship. A rowing shell full of friends can offset even an empty nest.
[The best team in Rio? The U.S. women’s eight]
Best of all, for women of a certain age, rowing can deliver a huge sense of accomplishment.
Jayne Lytel, 61, a member of D.C.’s Potomac Boat Club, understands. “I start my day rowing three mornings a week, and I like the way it makes me feel,” she said. “I feel proud that I can do this!”
“It’s such a challenging sport,” said Joanna Rubini, 42, a coach in Alexandria. “It’s very empowering when you can do it.”
In the past five years, rowing has grown in popularity for every age group. USRowing, the sport’s governing body, says that its membership of 23,000 grew by 22 percent between 2015 and 2016. About 14 percent of its members are 50 or older. At the 2016 Head of the Charles Regatta, almost a quarter of the competitors were older than 50. USRowing doesn’t break down those figures by gender.
Lytel and Chuck Selden prepare to row after launching their craft from the Potomac Boat Club. (Matt McClain/The Washington Post)
“The growth in the number of our older members underlines the fact that you can be 13 or 93; you’re always the right age to row,” said Susan Smith, membership director at USRowing. “Rowing is truly a lifelong sport, no matter if you’re a racer or a recreational rower.”
But first, there’s the learning process. And the fact that the stroke — like a new dance step — must be learned is another of rowing’s advantages.
“Running or walking, people can do that fine,” said Stella Volpe, 53, a sports physiologist and nutritionist who heads Drexel University’s nutrition sciences department. With “something like rowing . . . there’s the mental effort in learning something new. You need to think a lot in the boat.”
[You’re never too old to exercise. A 98-year-old shows us why.]
There’s also a good reason why rowing maintains bone density, according to Volpe, a rower herself. When the rower pushes against the boat’s footplate as she pulls her oar through the water, she’s “putting a lot of mechanical loading on the bones and the muscles,” she said. “And that’s good for the bone.”
Dana Perrone, 70, a member of the Potomac Boat Club, reports that since she began rowing 16 years ago, scans show she has maintained her bone density without the medication she once took.
“My doctor says, ‘Don’t quit!’ ” she said.
To learn the basics, newbies often try a “learn to row” event. USRowing sponsors a National Learn to Row Day, this year on June 3, when some rowing clubs in the D.C. area open their boat bays to the public for demonstrations of the stroke and even short paddles in one of those sleek narrow boats called shells.
More women are turning to rowing as a form of exercise. It’s good for the bones and the brain. (Matt McClain/The Washington Post)
But rowing demands more than an hour or two of instruction. And for those who want more, the Washington Rowing School in Bladensburg, several local clubs and Thompson’s Boat Center, near the Kennedy Center, offer learn-to-row courses. RowVigor, a new “rowing gym” in Arlington, provides rowing machine instruction for those who want to learn the basics on dry land.
Writer and photographer Mary Berry, 79, of Alexandria first picked up an oar when she was 52. Today, she drives to Philadelphia almost every weekend to row with a team out of Vesper Boat Club. A look at her family tree with its long-lived females convinced her she needed serious exercise if she was going to face the coming decades with a strong body.
“Getting old is rough,” she said. “And you need to hang on to your mobility. . . . The harder you exercise the more you gain in mobility.” But not if it meant destroying her knees, Berry concluded. Low-impact rowing was the answer.
For many women born before the mid-1950s, rowing may be their first experience of team competition.
“All of us were pre-Title IX,” Richards said, referring to the 1972 federal law demanding equal sports opportunities for men and women on most college campuses. “I never had the chance to be on a team, to compete.”
Berry found that racing satisfied her competitive streak while making her a better rower. As she began to work harder, to actually train with a coach, she began to experience the exhilaration of rowing in total synch with crewmates whose oars hit the water together and finish the stroke at exactly the same moment.
“I didn’t think I was particularly competitive, but racing was a way of getting better at rowing,” Perrone said. “You have to work harder than just paddling.”
Gabriele Cipollone, 60, a former Olympian, coaches Berry along with 11 other women who range in age from 60 to 80. In 2015 and 2016, her boats won gold, silver and bronze medals at the Masters National Regatta sponsored by USRowing. Berry and three other rowers won a gold in Belgium at an international competition.
“You have to have some kind of self-discipline to row,” Cipollone said. “A lot of women never did athletics. They aren’t familiar with the idea of pushing yourself for an hour. Or a half-hour, with a break, and then another half-hour. . . . Not everybody is willing to do this. If they decide, ‘It’s not for me,’ that’s fine.”
Research shows that rowing burns calories at the same or even higher rates than running. (Matt McClain/The Washington Post)
Michael Porterfield, 50, who coaches in Alexandria and at Capital Rowing Club, said coaching older rowers is gratifying but not always simple.
“You have to understand the athletes — their baselines and level of fitness,” said Porterfield, a coach for the women’s Olympic team in 2000. “You have to know how to work around limitations.” And sometimes, he said, it’s knowing when to tell a rower she is pushing too hard and needs a day off.
Older rowers “are all different. Some want to look at the birds. Some are super-competitive and don’t care they’re a shade slower than younger rowers,” Rubini said. “They still have an edge.”
But those who put in the work necessary to row well often gain benefits that go beyond stronger bones and competition medals. Cipollone said one of her older rowers “came to me and thanked me for saving her life”: Rowing had lowered her blood pressure and left her happier as well.
School counselor Dee Marrara, 53, started rowing a year ago in D.C. after she’d finished treatment for breast cancer. She spotted a flyer on a learn-to-row program at her oncologist’s office and decided to try it.
“I’m an athlete again,” said Marrara, a former collegiate basketball and soccer player. “Cancer took this away from me for a while. I can use my body again. I’ve regained my sense of identity.”
You may order your first Bike Rower from Motherhealth, email motherhealth@gmail.com
Michael Cohen Wiretap Cold Open – SNL
Last Week Tonight with John Oliver 5/6/18
Bernie: Support progressives who have the guts to defend working-class families
Hi,
If we are going to defeat right-wing Republicans in 2018 and 2020, we need to win in states that Trump won, like Pennsylvania. And, in my view, the only way we win in those states is by supporting progressive candidates who have the guts to defend working-class families – white, black, Latino, Asian American, Native American – and take on the power and greed of the billionaire class.
Here’s some very good news. In Pennsylvania there are three strong progressive candidates who can win their primary fights and win the general election. But they need your help.
As you know, Donald Trump represents something we have never seen before in the history of the United States. It is not just that he represents the interests of the wealthy and powerful. It’s that we have never had a president with more authoritarian tendencies than him.
The 2018 midterm elections will be long remembered as a pivotal moment in American history because, if we are successful, we can put an end to the disastrous Trump agenda. If we are not, we will have at least two more years of a rapid shift toward authoritarianism, the further normalization of corruption and the continued rise of oligarchy.
But we cannot defeat Trump and the Republican Party with the same playbook, or by supporting the same kind of candidates long favored by the political establishment and financial elite. That is how we got to where we are today.
That is why I am traveling to Pennsylvania later this week to support three strong progressive candidates: John Fetterman for Lieutenant Governor, Greg Edwards for Congress, and Jess King for Congress. Their primaries are on May 15, and they need your help now. So here is the part where I ask:
Our job in 2018 is to take on and defeat Trump’s authoritarianism, xenophobia, racism, sexism, homophobia and religious bigotry. But we can only do that if we run candidates who can rally the American people around an agenda that works for them, not the billionaire class.
For more than a decade now, John Fetterman has been an outstanding progressive leader in Pennsylvania. From early in his career he has stood with the working families of the state as he advocated for a $15 per hour minimum wage, Medicare for all, marriage equality and ending the failed war on drugs. He has been an outspoken defender of women’s health, immigrant rights, racial justice and LGBTQ equality.
For the past 25 years, Greg Edwards has worked tirelessly to organize for justice in health care, education and economic dignity. The powerful grassroots movement behind Greg Edwards is championing Medicare for all, universal pre-k, debt-free college and raising the minimum wage, and he is living his values of unwavering inclusion by building the diverse coalition Democrats need to win in his district.
Jess King has seen firsthand how the biggest corporations have hurt workers and squashed competition. In Congress, she will work to pass Medicare for all, rein in Wall Street, break up corporate monopolies, and support the real job creators: small businesses in our local economies.
These are three great candidates you can be proud to support. Please make a donation today. Please help create a progressive Pennsylvania and a progressive America.
Split a donation between John Fetterman, Greg Edwards and Jess King today:
https://go.berniesanders.com/
Candidates like John, Greg and Jess will help us stop Trump while ushering in an era of strong progressive change in this country. Thank you for supporting them. They need our help.
In Solidarity,
Bernie Sanders
Cooper: Does anyone care when Trump lies?
Baking soda kills cancer – fungus and molds
Ways to prevent chronic disease
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Trump attacks Mueller as leaked questions center on obstruction
- America’s first lynching memorial results in some local residents filled with ire, resentment
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- Trump attacks Mueller investigation, as leaked question list centers on conspiracy and obstruction
- Cartoon: ‘Dragon energy’ explained
- GOP congressional candidate claims he didn’t read hate-filled book he wrote glowing foreword for
- It’s not #metoo: Bill Cosby sealed his own fate with his quaaludes talk
- Mike Pence won’t have to worry about firearms at NRA convention because NRA is banning them
- No one should have to choose between crippling debt or necessary health care. Sign the petition to tell Congress we need Medicare for All.
- Stormy Daniels sues Trump for defamation of character
- Sessions politicizes the U.S. Attorneys’ Manual to erode freedom of the press and civil rights
- Maine’s Gov. LePage sued over his refusal to implement Medicaid expansion
- Mueller’s questions, the Republican tax scam and more
- City of Seattle moves to vacate more than 20 years worth of marijuana-related convictions
- Puerto Ricans call for a National Strike against the ‘Junta’ Control Board for May Day
- Red states have the blues in special elections

