House passes 'Momnibus' bill with measures for maternal health

Rep. Kim Moser speaks about her 'Momnibus' bill. (LRC photo)

By Isabella Sephaban
Kentucky Lantern

A maternal-health bill nicknamed “Momnibus’ was unanimously approved by the Kentucky House Tuesday after about 20 minutes of discussion.

The bipartisan House Bill 10 came out of a working group of Republican and Democratic women in the House and the Senate.

The Momnibus legislation would expand the Health Access Nurturing Development Services (HANDS) program and allow such home-visitation programs to be available up to three years after a child’s birth. It also would educate mothers on topics such as the benefits of breastfeeding, safe sleep for infants, and provide lactation consultation and equipment. These services would also be available via telehealth.

Supporters say Momnibus addresses Kentucky’s high rate of maternal deaths following childbirth.

Rep. Kimberly Poore Moser, the bill’s main sponsor, said “53 percent of women who die in the year following childbirth die as a result of their substance-use disorder.”

Other factors that increase maternal mortality include diabetes, heart disease and mental illness.

“These are all made more difficult during and after pregnancy, and can cause dangerous situations,” said Moser, a Republican from Taylor Mill in Northern Kentucky.

Although these situations are harmful and at times, even deadly, Moser said that “deaths due to any of these factors are usually preventable, and the ways to prevent these deaths are to identify and treat these diseases early in the pregnancy, if not before.”

“This is why prenatal care is so critical,” she said.

During their workgroup, Moser and her colleagues discovered that “there’s no structured mechanism to accessing mental health care quickly, in that Kentucky families lack support during the postpartum period to keep mothers, babies, and their families healthy.”

Momnibus aims to help decrease these high maternal mortality rates by ensuring access to insurance coverage for pregnant women.

Although there are special enrollment periods to buy insurance coverage for marriage, divorce, and fostering children, there are no special enrollment periods available for pregnancy, said Moser.

“A special enrollment period will allow pregnant women to purchase insurance coverage for pregnancy to get the care that she and her baby need during the prenatal period, for a healthy delivery, and during postpartum,” she said.

Momnibus also aims to address the lack of mental health care available to pregnant women by implementing a new psychiatric access program called Lifeline for Moms.

Moser said this program will establish “a hotline for providers to get an immediate consultation for a mother in need of mental health services.”

The lawmakers working on Momnibus have already applied and received a $750,000 grant to start implementing the program. This grant would be used to “specify the needed stakeholders to study birth and pregnancy outcomes, make recommendations to improve outcomes, provide oversight for the Lifeline for Moms program, and provide an annual report of their research and observations,” according to Moser.

The bill is in the Senate awaiting a committee assignment. Moser told Kentucky Health News that it will be handled by Sen. Julie Raque Adams, R-Louisville.

On 4th anniversary of Ky.'s first Covid-19 case, Beshear says it's a time 'to say that we're going to try to do better and better . . . '

Gov. Andy Beshear spoke at the observance of the fourth anniversary of Kentucky's first case of Covid-19. Next to him are Health Commissioner Steven Stack, in the front row, and Kandie Adkinson, in the back row. At the end of the front row are Rowena Holloway, widow of Virginia Moore, who was Beshear's main sign-language interpreter during the pandemic, and LeRoy Mitchell, who talked about his near-death from the disease and his sister's death from it. (Lantern photo by McKenna Horsley)

By Sarah Ladd
Kentucky Lantern

Four years after the day that Kentucky confirmed its first official case of Covid-19, Kandie Adkinson rang a singular bell in the state Capitol rotunda, its chime echoing through the marbled halls.

She did this to honor those lost to Covid-19, just as she did during much of the pandemic.

Adkinson was joined Wednesday by Gov. Andy Beshear and others who gathered in the rotunda to mark the day with grief for those lost to the virus and hope for the future.

In the last four years, nearly 20,000 Kentuckians have died with Covid-19. Many more contracted the illness and survived, like LeRoy Mitchell.

“Most of us know somebody that died because of Covid,” said Mitchell, who drives a bus for the Clark County school system.

His sister died with the virus on Sep. 5, 2020.

“If losing my sister was not devastating enough for me and my family,” he said, “four months later, Covid came for me in the worst kind of way.”

His wife discovered him on Jan. 8, 2021, he said. He was unresponsive and sent to the Clark County Regional Medical Center via ambulance then by helicopter to the University of Kentucky hospital’s intensive care unit in Lexington.

When he got there, he said, he “had no time to spare.” His doctors later told him Covid-19 had caused his diabetic coma and the blood clot in his lung, and was “trying to shut down my kidneys.”

He went on oxygen and spent three weeks in the hospital, followed by rehabilitation for two weeks. He grew weak in the hospital, losing 50 pounds during his ordeal.

“I … basically went back to being like an infant, baby stage. I could not do anything for myself,” he said. His road to recovery — complete with a wheelchair, walker, oxygen tank and supportive wife — took eight months, he said.

Ultimately, Mitchell told those gathered Wednesday, “Covid lost. And I won with life.”

Beshear signed a proclamation Tuesday making March 6 a “Day of Compassion.”

In the future, he said, “we want to, as much as we can every year, not just talk about the loss — and loss is important — but also talk about what good can come out of it?”

“While we don’t face a pandemic, we still face challenges right now. And if we could just approach them with a little bit of the same, at least, attempt to understand each other and love each other, then this world could be a much better place.”

March 6 should be a time to reflect, he said, “where we always say that we’re going to try to do better and better and better as the years go by.”

March is Colorectal Cancer Awareness Month; Kentucky has the nation's fourth highest rate of death from colon cancer

Photo illustration by OnTheRunPhoto, iStock/Getty Images Plus

By Natalie Pitman
University of Kentucky

In March, we wear blue to recognize Colorectal Cancer Awareness Month, first observed in March 2000. Since then, it has become an opportunity to spread awareness about the importance of screening and honor those diagnosed with colorectal cancer.

Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women. It’s estimated that 106,590 new cases of colon cancer and 46,220 new cases of rectal cancer will be diagnosed in 2024. Kentucky has the fourth highest rate of death from colon cancer in the nation.

“The good news is colorectal cancer is easier to prevent than most other cancers and is highly treatable. It is often curable when caught early, and we could dramatically reduce complications from this disease by getting more people screened,” says Darwin Conwell, M.D., UK HealthCare medical pancreatologist and Jack M. Gill Endowed Chair in Internal Medicine at the UK College of Medicine.

Let's talk about the importance of colorectal cancer screenings and why they should be a priority for everyone.

What is colon cancer? The colon and rectum are parts of the digestive system. Colorectal cancer begins when cells that are not normal grow inside the colon or rectum. Early symptoms may be subtle, making regular screenings crucial for early detection.

Who should get screened? Most people should begin getting screened at age 45. You may need to begin screening earlier. Talk with your provider if you or a close relative has had colon polyps or colon cancer, or if you have an inflammatory bowel disease.

What are the different screenings? Screenings play a pivotal role in catching abnormalities before they turn cancerous. Detecting and removing polyps during screenings significantly reduces the risk of colorectal cancer.

There are different tests to detect colorectal cancer. For most people, the best test is the one they can complete. Talk with your primary-care provider about which test is right for you. More information is provided below or click on this link for a flyer.

UK HealthCare offers three types of colorectal cancer screening tests:

• Colonoscopy: The provider performing the screening can see and remove growths (polyps) in the colon and rectum during this test to prevent or detect colorectal cancer. You will need to take off work the day of the procedure. Some patients who take off the day before the procedure as well to complete bowel preparation. If a polyp is detected, it can be removed during the procedure. Screening is conducted every 10 years if results are normal.
• Cologuard: Your healthcare provider will order the Cologuard test to screen for colorectal cancer. Cologuard can be completed at home and is designed to detect abnormal cells in your stool. After you collect the sample, follow the Cologuard instructions to mail the sample to a lab. Results are sent to you and your provider. Screening is conducted every three years if results are normal.
• FIT Tests: The provider will test your stool sample for blood, by ordering a FIT test. You can complete the FIT test at home. Screening should be completed every year if results are normal.

A positive Cologuard or FIT test result is not the same as a cancer diagnosis, so please talk to your health care or telehealth provider for next steps.

“Colonoscopies are considered the gold standard for colorectal cancer screening, but stool-based tests like Cologuard or FIT tests can be a more accessible option if work, transportation, or family obligations are preventing you from getting a colonoscopy,” said Dr. Avinash Bhakta, a UK Markey Cancer Center colorectal surgeon. “Regardless of the test you choose, the most important thing you can do is get screened regularly.”

If you have a primary-care provider, or if you are in for a checkup or treatment, ask them if you’re due for your routine colorectal cancer screening. Based on your health history, they will be able to tell you which screening option is best for you.

Screening can help detect early signs and help monitor situations that can increase your risk of developing colorectal cancer. Getting screened for colorectal cancer is one of the most important ways you can take charge of your health.

Top UK surgeon discusses diseases of the thyroid gland, which are common, more so in Kentucky than in the rest of the nation

A thyroid exam (Photo by Antonio Diaz, iStock/Getty Images Plus)

By Dr. William Inabnet III

University of Kentucky

Twenty million people in the United States suffer from thyroid disease, and Kentucky has a higher rate of thyroid cancer than the rest of the country, according to the National Cancer Institute.

The thyroid gland is an organ that sits in the neck and controls the body's metabolism. The metabolism processes the food you consume and turns it into energy. Around 50% of the population develops thyroid nodules, yet only 5% of these nodules are malignant.

There are two types of thyroid disease: overactive and underactive. With overactive thyroid disease (hyperthyroidism), there is an excess of the thyroid hormone in the body which leads to the metabolic rate rising. This can lead to panic attacks, anxiety, heat intolerance, hair loss and palpitations of the heart.

The metabolic rate lowers when there is too little thyroid hormone being released (hypothyroidism). Depression, weight gain and thinning of the hair are all symptoms of an underactive thyroid.

Types of thyroid disease have names: Hashimoto's is the most common thyroid disease, leading to hypothyroidism. Graves’ disease is more dangerous than Hashimoto’s because the excess amount of thyroid hormone being pumped into the body can lead to hyperthyroidism.

What to look for: To monitor your thyroid health at home, there is a self-examination you can perform called “check the neck.” In this process, you are feeling for a lump, or nodule, on the thyroid gland.

Touch the thyroid gland where it sits over your airway on the neck. If you feel a lump — don’t panic. You can check in with your primary care provider for further care. Typically, an ultrasound is the best way to diagnose thyroid disease or cancer, followed by a biopsy on the nodule.

One of the first ways to check for a problem with your thyroid is to go to your primary-care provider and get a blood test. This cannot diagnose thyroid cancer but can check your levels of thyroid-stimulating hormone. This blood test can rule out conditions like hypothyroidism or hyperthyroidism.

The prognosis of thyroid cancer is very favorable. There is a combination of surgical therapy and other therapies indicated for this cancer. If you have any questions or concerns, talk to your primary-care provider.

William B. Inabnet III, M.D., is UK HealthCare surgeon-in-chief and chair of the Department of Surgery in the UK College of Medicine.

Don't forget to turn your clocks ahead March 10; sleep experts say sticking with standard time would be best for health, safety

CDC illustration

By Melissa Patrick
Kentucky Health News

It's almost time to "spring forward" one hour into daylight saving time, which sleep experts don't support because they say it doesn't align with humans' internal circadian rhythms. Daylight saving time begins Sunday, March 10 at 2 a.m. local time. 

The American Academy of Sleep Medicine says "The United States should eliminate seasonal time changes in favor of permanent ST [standard time], which aligns best with human circadian biology. Evidence supports the distinct benefits of ST for health and safety, while also underscoring the potential harms that result from seasonal time changes to and from DST." The AASM published its position statement in the Journal of Clinical Sleep Medicine. 

The authors explain that human activities are affected by three clocks: the internal biological rhythm, also known as the circadian clock; the solar clock; and the social clock. When these three clocks align, the authors write that this allows for optimal health and performance. 

But when the solar clock is misaligned with the other two, they write, that causes a desynchronization between the internal circadian rhythm and the social clock -- and that happens with the change to daylight saving time. 

"The yearly change between ST and DST introduces this misalignment, which has been associated with risks to physical and mental health and safety, as well as risks to public health," says the statement. 

The AASM statement has links to several studies that show the adverse physical and mental health outcomes that come from moving clocks forward in the spring, including a surge of heart attacks, strokes and car crashes, to name a few.

A new study of the heart-health effects by the Mayo Clinic "suggests that the impact is likely minimal," says a release from the clinic.

Federal law allows individual states to exempt themselves from observing daylight time, and Kentucky has a bill to do that. However, House Bill 674, sponsored by Rep. Steven Doan, R-Erlanger, has not even been assigned to a committee.

Flu shots limit infection rates, which are still elevated in Kentucky

State health department graphs, adapted by Kentucky Health News

By Melissa Patrick
Kentucky Health News

The Kentucky Department for Public Health still considers hospitalizations for respiratory illnesses high and says flu activity remains elevated. 

Health officials say the best way to protect yourself from these viruses is to stay up to date with your vaccines. 

The Centers for Disease Control and Prevention recommends that everyone 6 months old and older get the annual flu vaccine and updated Covid-19 vaccines, especially children younger than 5 or anyone at high risk for complications.

Vaccines for respiratory syncitial virus are recommended for some infants and young children, pregnant women and adults 60 and older. At some places and times, there has been a shortage of these vaccines. 

This year's "flu vaccines have worked, substantially reducing the risk of flu-related medical visits and hospitalizations across all age groups, with some estimates higher than have been previously observed, even during well-matched seasons," said a CDC report released on Feb. 29.

"Specifically, flu vaccination has reduced the risk of flu medical visits by about two-thirds and flu-related hospitalization by about half for vaccinated children and flu medical visits by half and hospitalization by about 40% for vaccinated adults."

Even though flu season usually peaks around January, it lasts until May. Health experts say that if there is any flu activity occurring, it's not too late to get vaccinated.

What the numbers say

Emergency-department visits for respiratory illness in Kentucky have stayed about the same for the last two weeks, with 3,607 visits reported in the week ended Feb. 24.

Hospitalizations for respiratory disease in that week stayed about the same as the week prior, with 491 530 hospitalizations reported in the week ended Feb. 24. 

Kentucky had 20 counties with Covid-19 hospitalizations between 10 and 19.9 hospitalizations per 100,000 people, a rate that the  CDC considers "medium." 

Those counties are Adair, Green, Russell, Taylor, Clinton, Cumberland, Lewis, Elliott, Menifee, Morgan, Rowan, Barren, Hart, Metcalfe, Monroe, Bath, Montgomery, Floyd, Johnson and Magoffin. 

Overall, there was little change in the three respiratory viruses tracked by the state health department: Covid-19, influenza and RSV, with flu continuing to drive ED visits and hospital admissions. 

The state reported 3,857 laboratory confirmed cases of the flu in the week ended Feb. 24 and 2,246 laboratory confirmed cases of Covid-19. This reflected a slight drop in flu cases and a nearly 9% drop in Covid cases.

Among children, ED visits for respiratory disease increased 12% in children four and younger, to 671, compared to the prior week, and hospitalizations for children 5 to 17 increased 50%, to 18. The increase in ED visits for younger children was driven by the flu, and hospitalizations for the older children were driven by an increase in  both flu and Covid-19.

Since the respiratory-illness season began the first week in October, 384 Kentuckians have died from Covid-19, and 51 from flu, according to the health department. One Covid-19 victim and one flu victim have been children. 

Bowling Green hospital uses new technology to find lung cancer

Jennifer Finch, director of clinical intergration at Med Center
Health in Bowling Green, directs discussion of cases in the
hospital's new lung-cancer screening program. (Photo provided)

Kentucky Health News

The Medical Center at Bowling Green has established "a fast-track clinic that will help in the fight against lung cancer and give patients a better chance of surviving it," Ann Marie Dotson reports for the Bowling Green Daily News.

"The goal of the program is to detect lung nodules at the earliest stages to either prevent serious issues before they occur or to treat concerns quickly by offering a variety of options tailored to a specific diagnosis," Dotson writes, noting the it uses "a new technology that allows pulmonologists to biopsy smaller nodules."

Jennifer Finch, director of clinical integration at Med Center Health, said the program can detect cancer at stage 1, where there is a survival rate of 70 to 80%. “Historically, on small lesions, we had to wait and watch to see if they grew, but this computer-assisted robotic guided program guides the doctors to the small nodule, allowing them to get it,” she told Dotson.

The hospital said it started the program because Kentucky has the highest rate of new lung-cancer cases across the country, Dotson reports. It's a collaboration between its cardiothoracic surgeons, oncologists and Western Kentucky Heart and Lung board-certified pulmonologists.

"The team meets each Friday to view and discuss patients who may need further examination and review reports of patients who have incidental lung nodules and those detected through low-dose CT scans, working directly with the patient’s primary care providers," Dotson reports. "Eligible patients are then scheduled for consultations with the program’s team of physicians."

Finch told Dotson, “As a team, we review the patient’s history, whether the patient is a smoker, family history and cancer risk to see if the nodule could be benign or cancerous.”

Then the team devises a treatment plan "based on the patient’s needs, including further testing, surgery, diagnostic imaging, chemotherapy, radiation therapy or a biopsy." Finch said since the program opened Dec. 8, “we have had fantastic outcomes already.”

She added, “This program is really personal for me, and I have such a passion for it because my father died of lung cancer.” Kentucky leads the nation in lung cancer and deaths from it.

State's health chief urges parents to get kids vaccinated against measles, the most contagious disease, which can do great harm

By Melissa Patrick
Kentucky Health News

A highly contagious childhood disease that was declared eliminated in the United States in the year 2000 is making a comeback, largely driven by a declining vaccination rate in the country.  

"Unfortunately, as the measles vaccination rate has decreased, it's just one of those things where folks are opting out of vaccination more often, we're starting to see the increase of measles in the United States," Dr. Steven Stack, commissioner of the Kentucky Department for Public Health, said at a Feb. 29 press conference. 

In Kentucky, about 90% of the state's kindergarteners are vaccinated for measles, mumps, and rubella "and that has to be 95% or higher to stop transmission," said Stack. 

Stack spent the bulk of his time talking about a disease that he said most people in our country, including health-care providers, have never seen. Further, he said, it is a disease that is "virtually, entirely vaccine-preventable." 

"If you are vaccinated, you almost certainly will get no symptoms from measles," he said. "In fact, the vaccine is so effective, you won't get sick at all and you don't transmit the virus." 

Stack said symptoms of measles include a cough, congestion, fever that may go up to 104 degrees, and a full-body rash. The Centers for Disease Control and Prevention also mentions sore, red eyes that may be sensitive to light; watery or swollen eyes; small greyish-white spots in the mouth, and a loss of appetite. 

"You feel miserable," said Stack, adding, "In the unlucky ones, the complications are pneumonia, diarrhea, ear infections, and even sometimes brain swelling that can lead to things like seizures, developmental disabilities and other permanent brain damage."

Among the unvaccinated population, Stack said more than one in five measles victims are hospitalized and one in 20 get pneumonia, which is the most common cause of death. 

"The most common age of death is under 5,  those are the individuals hurt the most by this disease if you're unvaccinated," he said. "And for the really unlucky, one in one thousand can get a permanent brain injury from the brain swelling that I talked about." 

Dr. Steven Stack with Gov. Andy Beshear (File photo)

Because measles is a highly contagious virus that is spread through the air, with an incubation period of 10 to 12 days, it is easy to spread it unknowingly. Stack said a person is contagious for four days before the rash and four days after the rash, which is why it is recommended for anyone who has been exposed to measles or who has it to stay at home for 21 days to avoid spreading the disease. 

"Measles is probably the most contagious viral disease on planet Earth at present. The only thing that could maybe compete with it is Covid," he said. "In this room, all of us in this press conference for a period of 40 to 60 minutes, if one person had measles in this room and we were unvaccinated, nine out of 10 of us would become infected with measles in about 10 to 12 days." 

As of Feb. 29, the CDC reported there had been 41 measles cases reported in 16 states, none in Kentucky.  

"This is becoming more common and because people travel a lot and are portable in ways that weren't possible . . . in the prior century, it spreads too easily and can cause too many problems," said Stack. "Everybody please go get yourselves and your children vaccinated if you are not already vaccinated."

Florida, with its many airports and a regular vacation spot for many Kentuckians, is one of the states with a recent outbreak. Of concern to public health officials is a letter issued by the Florida State Health Department that does not urge parents of unvaccinated children at that school to get vaccinated or to quarantine. Instead, it leaves these decisions up to parents.

These recommendations go against well-established public health guidelines that call for unvaccinated people or those with no prior immunity to isolate for 21 days after exposure and for unvaccinated children to get vaccinated within 72 hours of exposure, which allows them to return to school as long as they don't develop symptoms,  Katelyn Jetelina and Dr. Kristen Panthagani, write in their Your Local Epidemiologist newsletter.

Asked about what precautions Kentuckians should take if they are traveling through the Florida airports or spending time in the state, Brice Mitchell, spokesperson for DPH said a person's level of concern should be determined by whether they are vaccinated or not.  

"If you are vaccinated for measles, there are no special precautions necessary. If you are unvaccinated for measles, the Kentucky Department for Public Health urges that you get vaccinated," he said in an email. "For further information, please review the Centers for Disease Control and Prevention guidance." 

Dr. Sean McTigue, interim chief of infectious disease at Kentucky Children's Hospital agreed.

"Anyone who is up to date with this vaccine is protected against measles infection and would not need to take any additional precautions when traveling to Florida or through Florida airports," McTigue said in an email. "If planning a trip to Florida and one or more travelers are not already up to date with MMR vaccine, then now would be an excellent time to be vaccinated." 

Two doses of measles, mumps and rubella (MMR) vaccine are recommended to children starting at 12 months. Adults can also be vaccinated. 

McTigue called this measles outbreak and others a "wake-up call" for those who are not protected and provides an opportunity for parents to protect their children against measles. 

"Because the MMR also protects against mumps and rubella, it is also an excellent way to protect against mumps which can cause testicular infection and sterility in males and against rubella which can cause severe birth defects if a pregnant woman is infected during her pregnancy," he said. 

Stack also pointed to the protections provided by the vaccine, saying in a news release, "Two doses of MMR vaccine are 97% effective at preventing measles and provides lifelong protection if exposed to the virus. Even if exposed to measles, vaccinated persons may continue routine activities.”

The CDC says that while detectable antibodies generally appear within just a few days after getting the measles vaccination, it takes about two or three weeks to be fully protected. Ideally, the CDC says a person should be fully vaccinated at least two weeks before they travel.

More information can be found in a Los Angeles Cedars-Sinai Hospital blog post, "Measles Makes a Comeback: What Parents Need to Know." It says measles cases worldwide increased 79% in 2023, according to the World Health Organization. In 2022, the WHO estimated that measles killed more than 130,000—most of them children.

“Measles is a huge concern and directly related to declining measles vaccination rates,” said Dr. Priya Soni, a pediatric infectious-disease specialist with Cedars-Sinai Guerin Children’s Hospital. “Vaccine hesitancy, fueled during the pandemic by the anti-vaccine movement, has affected vaccination rates nationwide. In addition, because children were quarantined during the pandemic, many missed out on well-child visits and didn’t catch up on their vaccines. That has meant 61 million fewer doses distributed nationwide between 2020 and 2022.”

Although the first dose of the MMR vaccine is traditionally given to infants 12-15 months of age, and the second around a child’s fifth or sixth birthday, Soni said infants as young as 6 months can receive the first vaccine if they are traveling to areas where the measles infection rate is high.

UK doctor points to treatment for 'hidden disability' of hearing loss

Hearing loss is so often an invisible disability

with treatment options that should be more well

known, said Dr. Beth McNulty, UK HealthCare

neurotologist. (Photo provided by McNulty)

By Rick Childress

University of Kentucky

Forty years ago, there was no effective treatment for deafness.

Now, a nine-month-old infant can get a cochlear implant — a procedure that first got Food and Drug Administration approval in 1984.

“In my opinion, it is one of the greatest achievements of modern medicine,” said Dr. Beth McNulty, a UK HealthCare neurotologist — a doctor who specializes in the ears, nose and throat, commonly known as an ENT.

In the inner ear, a cochlear implant converts acoustic energy into electric energy, stimulating the auditory nerve electrically. It may restore hearing in those born with congenital deafness, as well as patients with slowly progressive hearing loss for whom hearing aids no longer work.

“Cochlear implants are performed on infants up to 103-year-olds,” McNulty said. "I always counsel patients that there's no age limit. We treat each patient individually as far as candidacy for surgery.”

The sense of sound can help a deaf mother hear her crying infant, or help a baby born deaf learn to speak. In honor of World Hearing Day Sunday, March 3, McNulty wanted to highlight how the gift of hearing can connect people and change lives.

“As the hearing loss progresses to the point of cochlear implantation, a lot of patients feel isolated, they feel like they have no hope,” McNulty said. “Communication is what ties you to the world.”

World Hearing Day brings awareness for hearing loss — so often an invisible disability. That became particularly apparent during the Covid-19 pandemic and patients who were hard of hearing couldn’t read the lips of masked people.

“It caused frustration for them, for those trying to communicate with them, like, ‘Why can't you get this?’” McNulty said. “Because they don't have a sign on their forehead that says, ‘I have hearing loss’ or ‘I have deafness.’”

Many of McNulty’s patients are in their mid-life and have had hearing loss that has progressed to where their hearing aids are no longer effective. Sadly, in some places in Kentucky, those individuals aren’t referred for cochlear implantation because of a lack of awareness of the treatment options.

“Through World Hearing Day we want to bring awareness to hearing loss as a disability, an often hidden disability, and bring awareness to the fact that nowadays we have options for treatment,” McNulty said.

Starting in 2019, the surgery can also be performed on those who are deaf in one ear.

Candidates for the surgery often score less than 50% of word understanding during audiology testing. After the surgery, average word recognition increases to 70-80%.

Before surgery, McNulty speaks directly and slowly or uses dictation software when talking with a patient. On activation day, she loves to “test the water” and speaks normally to see if the patient responds. While speech clarity may take time, often, they do respond and describe hearing sounds they haven’t heard in years.

“It’s opening closed doors for patients, bringing back the connection to their loved ones, their friends and family,” McNulty said. “It is such a rewarding part of my job.”

An infant who is born deaf would start with hearing aids by the time they’re six months old, then get a cochlear implant before their first birthday.

“If we do all those things, they will have speech,” McNulty said. “They will be in a regular classroom and may progress like nothing ever happened.”

Few in Kentucky perform the surgery; the state has only six neurotologists. Four work at UK, which also has pediatric otolaryngologists who perform cochlear implants on children, as well as audiologists who are specially trained for cochlear implantation. The audiologists are key members of the team.

“This is their passion,” McNulty said. “They work with these individuals about once a month for a whole year, programming and reprogramming to try to get this to sound just right.”

The team also consists of two cochlear-implant coordinators who help schedule appointments, answer questions and are adept at working with deaf individuals and their families.

McNulty recommends considering getting your hearing checked starting at age 50 — based off data that shows getting hearing loss treated at that age can help slow the onset or progression of dementia.

Other reasons to get your hearing checked:

• Family history of hearing loss
• History of noise exposure like in construction or the military
• Asking people to repeat themselves
• Struggling with background noise
• Tinnitus (Hearing ringing, buzzing, crickets in your ears)

Cochlear implants are a treatment option for nerve hearing loss, but hearing loss may also be conductive, or due to a mechanical problem such as a hole in the eardrum, or a bad infection. Sometimes this can also be treated surgically and reversed.

CDC shortens Covid-19 isolation advice to match other viruses

Centers for Disease Control and Prevention photo

By Melissa Patrick
Kentucky Health News

The Centers for Disease Control and Prevention has updated guidance for how long people need to isolate when they get Covid-19, to match the guidance for dealing with other viruses. 

"While every respiratory virus does not act the same, adopting a unified approach to limiting disease spread makes recommendations easier to follow and thus more likely to be adopted and does not rely on individuals to test for illness, a practice that data indicates is uneven," the CDC said in a news release.

As of March 1, people who test positive for Covid-19 no longer need to stay isolated for five days, but instead can return to their regular activities if their symptoms are mild and improving and they have been fever-free for 24 hours without the use of a fever-reducing medication. 

"This advice is similar to what has been recommended for flu for decades and will help reduce the spread of Covid-19 and other respiratory viruses during the most contagious period after infection," says a separate advisory. 

Once people get back to their normal activities, the CDC acknowledges that some people may still be contagious. Because of this, it calls on people to take additional precautions for the next five days, such as gathering outdoors when possible, practicing good hygiene, keeping a distance from others and wearing a well-fitting mask. 

The CDC says it is making updates to the recommendations now because the U.S. is seeing far fewer hospitalizations and deaths associated with Covid-19 and because there are more tools than ever to combat flu, Covid and respiratory syncitial virus (RSV). 

“Today’s announcement reflects the progress we have made in protecting against severe illness from Covid-19,” Dr. Mandy Cohen, the CDC director, said in the release. “However, we still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses—this includes vaccination, treatment, and staying home when we get sick.”

This updated guidance is intended for community settings only. There are no changes to guidelines for nursing homes and health-care facilities.

As doctors plead for end to state abortion ban, legislators file bills to protect in vitro fertilization from court rulings like Alabama's

Dr. Virginia Stokes, an obstetrician-gynecologist, said she’s treated many conditions that required abortion to prevent sepsis and preserve patients’ fertility. (Kentucky Lantern photo by Sarah Ladd)

By Sarah Ladd

Kentucky Lantern

In response to a ruling from the Alabama Supreme Court stating that frozen embryos are children, Kentucky state senators from both parties have filed bills aimed at protecting access to in vitro fertilization in Kentucky.

Meanwhile, nearly 300 Kentucky health-care providers and medical students signed a letter asking legislators to restore access to abortion in the state, saying its ban on abortion handicaps their ability to provide comprehensive care.

Republican Sen. Whitney Westerfield of Christian County, a staunch opponent of abortion, filed a bill Wednesday saying that any facility or “procedure related to in vitro fertilization shall not be liable” for damages “to a patient or patient’s surviving spouse or partner resulting from the loss of a human embryo, except in cases of negligence or wanton, willful, malicious or intentional misconduct.”

It also protects health care providers “performing any procedure” related to IVF from criminal charges. The day before, Sen. Cassie Chambers Armstrong, a Louisville Democrat, filed a similar bill. The Alabama Legislature passed similar legislation Thursday.

Alabama, Kentucky and at least eight other states have laws saying human life begins at conception, with the fertilization of an egg by a sperm cell; Kentucky's law speaks of the "unborn human being."

IVF is used to treat infertility, and can help other people trying to get pregnant to do so, according to the Mayo Clinic. About 2 percent of U.S. births are results of the procedure. It sometimes involves freezing embryos for future attempts at insemination; damage to frozen embryos at a fertility clinic prompted the lawsuit that led to the Alabana ruling.

Westerfield’s filing comes as he and his wife are expecting triplets, which he announced in January. He said at that time in a Senate floor speech that they adopted and transferred embryos for the pregnancy. His 6-year-old son is an “embryo adoption” baby, he said.

At a Thursday news conference, Democratic Gov. Andy Beshear said the Alabama ruling “is what happens . . . when you embrace extremism.”

He cited Kentucky’s near-total abortion ban as another example: “Women that have non-viable pregnancies still have to oftentimes carry that pregnancy to term knowing they’re going to hear their child die moments afterwards if it hasn’t already happened.”  

Kentucky bans abortion except in cases of threat to the woman's life or of serious, permanent damage to a life-sustaining organ, under a law triggered by the U.S. Supreme Court's 2022 overturn of Roe v. Wade, the 1973 decision that created a constitutional right to abortion. 

The ban causes “devastating consequences” for patients, Louisville’s Dr. Marjorie Fitzgerald said at the health-care providers' event. “We are losing obstetricians who will not practice in our state,” a nd because of the restrictions, “Doctors are violating their Hippocratic oath to do no harm.”

Fitzgerald was joined in the Capitol Annex by Democratic lawmakers, other medical providers and a second-year medical student in Frankfort to discuss the letter written by the Kentucky Physicians for Reproductive Freedom and signed by 280 providers.

They detailed the complex nature of medical decisions that lead to abortions and slammed lawmakers for restricting their ability to provide that care.

Dr. Nancy Newman, a board-certified obstetrician, said she would not now come to the state because of a “culture of fear that our legislature has created” in which providers have to decide between jail time and what their patients need. “How do you practice medicine in a culture of fear? I don’t think you can.”

Dr. Michelle Elisburg, a Louisville pediatrician, told the story of a 14-year-old patient who was raped by a 60-year-old landlord and got pregnant.

“She had the baby and then dropped out of high school to get a job” to support herself and her child, Elisburg said. “Now both mother and child have multiple risk factors for poor health, educational and vocational outcomes, requiring more financial assistance from the state.”

Elisburg said that as a Jewish physician, she’s governed not only by the Hippocratic oath to do no harm, but also a faith-based oath to act in the best interest of her patients: “As a physician in Kentucky, I am now being forced to make impossible choices that put my professional ethics and my faith in direct conflict with the law.”

Urooj Nasim, who attends the University of Louisville medical school and said she spoke only for herself, said abortion bans may keep her and her classmates from getting the hands-on training they need to become obstetrician-gyneciogists and tackle Kentucky’s high rates of maternal mortality.

“In order to make the best calls for the patients of my future, I need to receive high quality training and all of the tools and procedures available,” Nasim said. “And in a state where physicians live in fear of being prosecuted for delivering standard care, that is just not possible.”

The American College of Obstetricians and Gynecologists says “In states with abortion bans, medical students and residents are not able to receive the hands-on training they need in order to provide patients with comprehensive care.”

Nasim, who was born in St. Louis and lived in Somerset until she was 8, told the Lantern she is “undecided” on her specialty path but was “moved by that patient population” when she worked with an obstetrician previously.

“I’m a very … mission-driven medical student,” she said. “I really want to help patients with a lot of the social factors that affect their health. And OB is a really great specialty to do that in.”

Latest in a line of protests

The Thursday letter is the latest in a long line of efforts to protest Kentucky’s tight abortion bans.

In 2022, Kentucky voters defeated a constitutional amendment that would have keptt courts from finding a right to an abortion in the state constitution.

In late 2023, a Kentucky woman sued for the right to access abortion and end an unwanted pregnancy, but dropped the lawsuit when the fetus lost cardiac activity.

Republicans and Democrats have filed bills seeking to loosen or undo Kentucky’s abortion bans, to no avail.

Several anti-abortion lawmakers have focused their efforts during the 2024 session on making Kentucky a safer place to give birth and codifying support for expectant parents.

This week state Rep. Ken Fleming, R-Louisville, filed a bill seeking rape and incest exceptions to Kentucky’s abortion bans — but only in the fist six weeks of pregnancy

Newman, an obstetrician, said “Most women don’t even know that they’re pregnant by six weeks,”  an in case of assault, “The victim likely may not even tell anyone before six weeks.”

Dr. Virginia Stokes, a board-certified obstetrician-gynecologist, said she’s treated many conditions in her tenure as a physician that required abortion — placenta previa, first and second trimester ectopic pregnancies, preterm rupture of membranes, cancer, sepsis and more.

A lack of early interventions, she said, can cause “total body sepsis and death due to the sepsis. And if death is avoided, there is a frequent loss of fertility due to disruption of the uterus.”

“The fetus will not survive if the mother doesn’t survive,” Stokes said.

In such cases she’s treated, she said, these are “gut wrenching decisions with no choice to be made” involving “very much wanted and cherished pregnancies.”

“There are lots of really bad things that can happen between six and 12 weeks,” Stokes added. “and we need to have permission to take care of those patients.”

“I am pro-life,” Stokes said. “I am for saving the life of these women who have these early pregnancy complications that require, unfortunately, a cessation of the pregnancy …. As an OB-GYN, my first priority is the life of my female patient. Please don’t tie my hands.”

UK researcher says chemicals in plastics can speed Alzheimer's

Researchers at the University of Kentucky are studying chemical compounds used in the production of water bottles and their link to Alzheimer's disease. (Photo by monticelllo, iStock/Getty Images Plus)

By Lindsay Travis
University of Kentucky

Researchers at the University of Kentucky are studying how elements of our natural surroundings can be potential risk factors for Alzheimer’s disease — including chemicals widely used in plastics.

“Bisphenols can accelerate Alzheimer’s disease and lead to cognitive deficits. Simply: Be smart and stay smart by avoiding plastics,” says Anika Hartz, the UK professor leading the study.

Anika Hartz, Ph.D., is the lead resarcher. (Pete Comparoni, UK) 

“Identifying environmental risk factors for Alzheimer’s is critical to mitigate cognitive decline in humans,” said Hartz, who holds positions in the College of Medicine and the College of Pharmacy. She is also affiliated with UK's Sanders-Brown Center on Aging, one of the nation’s leading centers on aging, Alzheimer’s disease and related neurodegenerative disorders. It is one of 33 National Institute on Aging-funded Alzheimer’s research centers in the U.S.

The study is funded by a grant from the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health.

Alzheimer’s is a progressive and irreversible neurological disorder. It’s estimated that 6.2 million Americans aged 65 and older are living with the disease that affects cognitive function, memory and behavior.

Hartz and her colleagues are examining three types of bisphenols, chemical compounds used in the production of polycarbonate plastics and epoxy resins. Theys are commonly found in food containers, water bottles and the lining of cans.

“Human exposure to bisphenols is inevitable due to their widespread presence in the environment,” said Hartz. “Our data show that bisphenols trigger blood-brain barrier dysfunction and memory problems, both hallmarks of Alzheimer’s, indicating that environmental bisphenols are a critical yet underrecognized risk factor for the disease.”

Hartz’s research team provided some of the first evidence that the chemicals are a clinically relevant environmental risk factor for Alzheimer’s. Bisphenols are a concern because previous research has shown they can affect the endocrine system, which regulates hormones. The brain plays a complex role in that system.

UK researchers want to better understand how the chemicals’ disruption of the endocrine system impacts the blood-brain barrier function, potentially driving cognitive decline and accelerating Alzheimer’s disease.

“The goal of this project is to develop fundamental knowledge of environmental impacts on human health that will help promote healthier lives and reduce the burden of diseases and conditions related to aging,” said Hartz. “New insights are expected from our study that will open the door for future evidence-based health management aimed at preserving cognition in health and disease.”

The work builds on preliminary data funded by a pilot grant from the UK Center for Appalachian Research in Environmental Sciences. Hartz said, “Without the pilot funding, the strong support of the UK-CARES leadership Drs. Ellen Hahn and Erin Haynes, the entire UK-CARES team, my colleagues Drs. Bjoern Bauer, Kevin Pearson, Richard Kryscio, Bernhard Hennig, Peter Nelson, Scott Stanley and the continuous support from Dr. Linda Van Eldik and the team at the Sanders-Brown Center on Aging, this would have not been possible.”

This study brings together a multidisciplinary group of researchers spanning the colleges of Medicine, Pharmacy, Public Health and Martin-Gatton College of Agriculture, Food and Environment.