Thursday, June 4, 2009

News Clipping Archives

 

Maryland / Regional

State Center project in Baltimore moves to design phase (Baltimore Sun)

Delaware reports 34 new swine flu cases (USA Today)

State issues rockfish warning (Baltimore Sun)

Prince George's leaders campaign for improved state health care (Prince George’s County Gazette)

 

National / International

10 foods allergy sufferers should try (Baltimore Sun)

No scars: New obesity surgery goes through mouth (Baltimore Sun)

Black Gyrl Cancer Slayer Says 'Be Your Best Advocate' (AOL.com)

10-year-old SoCal girl copes with breast cancer (Washington Post)

A Move Toward Requiring Health Coverage (Washington Post)

Slump Pushing Cost of Drugs Out of Reach (New York Times)

F.D.A. Chief Lauds Food Safety Bill as the ‘Right Direction’ (New York Times)

 

Opinion

Transforming State Center (Baltimore Sun Editorial)

New beginning for Md. drug policy? (Baltimore Sun Commentary)

Medicare, Start the Bidding (New York Times)

Make a stink about the fish kill (Baltimore Sun Letter to the Editor)

 

 

Maryland / Regional

 

State Center project in Baltimore moves to design phase

Board of Public Works OK's plan for $1.5 billion proposal

 

By Laura Smitherman

Baltimore Sun

Thursday, June 4, 2009

 

The $1.5 billion proposal to redevelop the State Center complex in Baltimore moved into the design phase Wednesday with the Board of Public Works' approval of a master plan that will guide the project.

 

The three-member state spending board, which includes Gov. Martin O'Malley, unanimously approved the master development agreement despite concerns about the viability of the 28-acre mixed-use development in which the state would be the anchor tenant. Comptroller Peter Franchot, another board member, expressed a "nagging concern" that the state is "stepping into a fiscal hole," given the shaky real estate market.

 

But officials with the Maryland Department of General Services and developers who have been working on the project assured board members that the state would have an opportunity to back out of the deal before ground is broken in the summer of 2010. If the state pulled out then, it would only be on the hook for up to $5 million in planning costs.

 

In other action, the board:

 

• Approved $4.6 million in contracts for consultants to help the Maryland Public Service Commission in its regulatory oversight of the energy markets and Constellation Energy Group.

 

O'Malley, a Democrat, said this would enable the state to retain the necessary expertise to protect a public hit by rising electricity bills. He also vowed to renew his effort to re-regulate energy markets in the next General Assembly session after his proposal faltered this year.

 

The governor's office is negotiating with Constellation to secure ratepayer relief and other concessions as the Baltimore company seeks to sell half its nuclear power business to Electricite de France. The PSC is expected to make a crucial decision in a case related to that transaction next week.

 

The governor and Franchot, also a Democrat, took the opportunity to criticize a contract provision for Constellation Chief Executive Officer Mayo A. Shattuck III that entitles him to a potential payout of up to $87 million. Franchot called the possible payment "obscene" and pointed out that the governor only makes $150,000 a year. O'Malley said he's thankful to have a job and urged the PSC to ensure "the people don't get worked over by the energy industry."

 

The so-called golden parachute payment would be triggered by Shattuck's termination in the event of a "change in control," and not by the EDF deal. Constellation has said Shattuck does not qualify for the large payment and noted that ratepayers do not pay for his compensation.

 

• Approved a $9.8 million contract with Rite of Passage, a Nevada company, to open a juvenile detention center for boys on the former grounds of Bowling Brook Preparatory Academy. The Carroll County facility was shuttered two years ago when a boy in custody died.

 

Child advocates questioned whether the company could provide the necessary services for troubled youth, but Juvenile Services Secretary Donald W. DeVore said it would provide a "full-range" of counseling, vocational and educational programs.

 

Copyrigth 2009 Baltimore Sun.

 

Delaware reports 34 new swine flu cases

 

Associated Press

USA Today

Thursday, June 4, 2009

 

DOVER, Del. (AP) — Delaware health officials say they have confirmed 34 more cases of swine flu, bringing the state's total to 139 confirmed cases.

 

Health officials said Thursday that five of the 34 new cases reported between May 26 and Tuesday have been hospitalized and all are recovering after mild symptoms.

 

Twenty-six of the new cases were reported in New Castle County and about two-thirds are age 19 and younger.

 

Officials say all the symptoms reported continue to be mild.

 

Copyright 2009 The Associated Press. All rights reserved.

 

State issues rockfish warning

Advisory for toxic PCBs extended to Atlantic waters

 

By Meredith Cohn

Baltimore Sun

Thursday, June 4, 2009

 

State officials warned Wednesday that people should restrict consumption of Atlantic striped bass - the state fish and one of the most popular with recreational anglers on Ocean City's beaches and charter boats, as well as with area restaurant diners.

 

The Maryland Department of the Environment issued the advisory for striped bass, also known as rockfish, and bluefish caught in coastal waters because they contain high levels of a banned toxic substance. People should not eat the fish more than once a month, the state said. Pregnant women, women of childbearing age, nursing mothers and children 6 and younger should avoid the fish altogether.

 

If consumers significantly cut back on the fish, the warning - a first for coastal waters - could have an economic impact on those who make a living taking weekend fishermen out on the ocean. It could also affect commercial fishermen, though the advisory does not officially extend to commercially caught fish; that is beyond the state's jurisdiction.

 

The news concerned Gary Beach, owner of the Marlin Moon Grille in West Ocean City, because all his striped bass comes from the Atlantic. His savvy customers won't order foods that have received negative publicity, but fish may be something of an exception because there are warnings for many kinds, including tuna for its high levels of mercury. In any case, striped bass wasn't on the menu Wednesday, so he couldn't gauge an immediate response from diners.

 

"Our guests' well-being is very important to us," he said. "We switch out ingredients all the time for safer ones. ... In this case, I'd say, I'd serve rockfish if they'd eat it. But everything in moderation."

 

That's also the message from state officials, who had previously advised consumers to eat striped bass caught in the Chesapeake Bay no more than about twice a month, and only the smaller fish that have absorbed fewer toxins.

 

The state acted in accord with other Eastern states in issuing the Atlantic advisory because the fish tested higher in polychlorinated biphenyls, or PCBs, classified as a neurotoxin and a probable human carcinogen.

 

Department of the Environment Science Services Director Rich Eskin said the fish are safe for most people in moderation. "We encourage people to keep fishing. Fish to your heart's content. Eat only some of it. And eat the smaller fish."

 

Eskin said the state will continue monitoring the fish and update advisories as needed.

 

Previous advisories applied only to the Chesapeake Bay, lakes and rivers because there wasn't sufficient information about coastal areas, he said.

 

Data sharing with other states led to the Atlantic's inclusion.

 

He said officials have found less contamination in fish caught in the bay - spawning ground for at least three quarters of all East Coast striped bass - than fish caught near New York and New Jersey, for example.

 

Because striped bass are highly migratory, there are fish with higher and lower levels of PCBs in the bay, but the average is still lower than Atlantic fish. The average would be lower for fish served in restaurants, as well, because they come from farms, the bay and the ocean.

 

Upon learning of the new advisory for the Atlantic fish, one veteran Ocean City charter boat captain was dismissive.

 

"Commercial fisherman are scooping up bluefish and they're still being bought and sold in markets. So, what are you going to do?" said Steve Peterson, who fishes three miles off the coast.

 

"They can print all they want about it, and I'm still going to eat them. It's a media thing. One day it's swine flu and then the next day it's something else."

 

Staff writers Frederick N. Rasmussen and Candus Thomson contributed to this article.

 

Copyright 2009 Baltimore Sun.

 

Prince George's leaders campaign for improved state health care

Forum held in Clinton to discuss remedies for high insurance costs

 

By Megan McKeever

Prince George's County Gazette

Thursday, June 4, 2009

 

Prince George's County Councilman Tom Dernoga made a controversial statement to local residents when he said, "We already have universal healthcare," at a community healthcare forum May 27 in Clinton.

 

"Unfortunately it's not the universal healthcare you want," said Dernoga (D-Dist. 1) of Laurel, referring to the 150,000 uninsured Prince George's residents burdening the troubled county hospital system. "It's bad for you, it's bad for the uninsured and it's bad for the county."

 

Mel Franklin, president and founder of the Greater Marlboro Democratic Club, who announced he plans to run for the 2010 District 9 County Council seat, organized Monday's event in order to start a community discussion that he hopes could spur the creation of a task force to address county health issues.

 

"We need an agenda, we can't just talk about these things," Franklin said.

 

The Bowie Health Campus, Laurel Regional Hospital and Prince George's Hospital Center in Cheverly serve more than 180,000 patients a year, a high number of whom don't have health insurance. The strain has caused the hospitals to operate at a loss for more than a decade.

 

There are currently nine local and national companies vying to buy the three county hospitals.

 

Members of the Prince George's County Hospital Authority, which was created last year in an effort to sell the hospitals, said they hope to sell each of the centers by Aug. 1.

 

Donald Shell, the county's health officer, said hospital inadequacies stem from many of the roughly 600,000 Prince George's County residents who have health insurance but seek treatment in other counties or states.

 

"Prince George's residents go to other counties to spend their healthcare dollars. But other counties don't come to Prince George's," Shell said.

 

Unfortunately, "it's a Catch 22," he said, adding that for the hospitals to improve, residents need to seek local treatment, but residents avoid local treatment because of its poor reputation. If insured residents were treated locally, they would help offset the cost of the many uninsured residents treated at area hospitals.

 

Shell said residents must demand quality care at local institutions.

 

Fort Washington resident Edward Smith said the stage has been set to start a grassroots community effort that would demand better health care in the county.

 

"It's going to take action, so let's see what action we can get," he said.

 

Vincent DeMarco, president of the Maryland Citizens Health Initiative, a program founded in 1999 to educate state residents about healthcare, attended to promote a proposal by the Maryland Health Care for All! Coalition to provide affordable health insurance for the unemployed, self-employed and those employed by small businesses throughout the state.

 

DeMarco said the coalition's proposed universal health care plan, which was pitched to the Maryland General Assembly in the fall, would pool individuals and small businesses, giving them the same buying power as larger corporations and dropping the cost of health insurance.

 

Separately on May 27, the Prince George's Black Chamber of Commerce endorsed the Health Care for All! plan, as did the Greater Baltimore Black Chamber of Commerce and the Black Chamber of Commerce of Anne Arundel County Inc.

 

Hubert Green of Clinton, president of the Prince George's group, said Friday that many members of the chamber's constituency are small business owners or self-employed.

 

"It's becoming a problem for small businesses to provide health care for their employees," Green said. "The cost is prohibitive, and as a result businesses cannot expand."

 

Copyright © 2009 Post-Newsweek Media, Inc./Gazette.Net.

 

National / International

 

10 foods allergy sufferers should try

 

Health watch

 

Tribune Newspapers

By Julie Deardorff

Baltimore Sun

Thursday, June 4, 2009

 

Christine Doherty's body won't tolerate wheat gluten. She's allergic to corn and eggs. And her daughter has soy allergies.

 

They still eat. The Doherty family simply avoids processed foods -- which can be stripped of essential nutrients and contain excess sugar, salt, fat and chemical preservatives -- and seeks out gluten-free and low-allergen fare.

 

"It's not like you have to choke freaky food down," said Doherty, a naturopathic doctor in New Hampshire who specializes in food allergies and celiac disease, an autoimmune disorder.

 

More than 11 million Americans are estimated to have food allergies, which occur when the immune system reacts poorly to certain food. If you have an allergy, you know: Within minutes of eating the offending food, you may experience hives, swelling or have trouble breathing.

 

Less obvious and more common are food intolerances, which can be digestive issues that don't involve the immune system. Symptoms may include cramps, gas and bloating. Unlike with food allergies, you may be able to eat small amounts of problem foods.

 

But don't torture yourself. Instead, try some of these lower risk alternatives to the most common food allergies, including milk, eggs, peanuts and soy.

 

Apples and applesauce

In addition to vitamin C, pectin (a soluble fiber), potassium and important phytochemicals, apples contain high amounts of quercetin, which can help reduce allergy symptoms, according to a study in the Journal of Allergy and Clinical Immunology. German researchers recently showed organically produced apples have a 15 percent higher antioxidant capacity than conventionally produced apples.

 

Try this: Lightly saute slices from one apple with one diced potato and onion.

 

Cruciferous vegetables

Some people with allergies have trouble removing toxins through the liver and kidneys, said nutrition expert Bonnie Minsky. If the toxins back up into the body, it increases the chances of inflammation, which leaves an allergic person even more sensitive. Vegetables such as broccoli, cauliflower, Brussels sprouts and cabbage greatly assist the process, she said.

 

Try this: Eat broccoli steamed and mixed with fresh garlic and olive oil.

 

Quinoa

Probably the least allergenic of the grains, quinoa's high protein content (12 percent to 18 percent) and balanced set of essential amino acids make it a complete source of protein, according to chef Lisa Williams (lisacooksallergenfree.com), who has allergies to wheat and dairy and sensitivities to sugar and gluten. Quinoa is a good source of dietary fiber, phosphorus, magnesium and iron.

 

Try this: Since breakfast is often problematic for people with allergies, try quinoa in the morning; add nuts and fruit if you can.

 

Lentils

Food can be expensive when you're on a specialized diet, which makes relatively cheap lentils a superfood on all fronts. Lentils are loaded with iron, protein and folic acid. One cup has 16 grams of fiber -- six times more than a serving of Metamucil, Doherty said. They're also versatile and easy to store. If you're allergic to peanuts, you have a 5 percent chance of having an allergic reaction to other legumes such as lentils, according to allergy expert Dr. Lee Freund, author of "The Complete Idiot's Guide to Food Allergies."

 

Try this: Combine two cups of cooked lentils with two oranges cut into cubes and two chopped sweet peppers, suggests naturopathic doctor Michael Murray in "The Condensed Encyclopedia of Healing Food." Season with salt and your favorite herbs and spices.

 

Sweet potato

Nutritious and rich in complex carbohydrates and fiber, sweet potatoes are a member of the morning glory family. They are brimming with carotenoids, vitamin C, potassium, fiber and vitamin B-6, which all contribute to reduced inflammation, Minsky said.

 

Try this: Make sweet potato fries by slicing and lightly coating with olive oil and your favorite spices. Bake until crispy (about 20 minutes) at 300 degrees.

 

Avocado

Avocados can be an ideal source for healthful fat. It's also a natural anti-inflammatory because it has a high amount of vitamin B-6 and magnesium, Minsky said. "Avocado is also a blood sugar stabilizer and liver cleanser which further lowers the risk of allergic inflammation," she said. If you have a latex sensitivity or are allergic to melons, you may have a reaction to avocados.

 

Try this: Mix a cup of corn, a cup of tomatillo salsa and one diced avocado. Top with cilantro.

 

Dulse

A red seaweed that is salty when it's dry and slippery when you start to chew. It's high in iodine, which is good for the thyroid, said Doherty. It also has calcium, potassium, magnesium, iron and other vitamins and minerals.

 

Try this: Use it like a condiment; sprinkle the powder on broccoli or potatoes or add to salad dressings. Add big leaves to soup.

 

Rice milk

Rice is a standard hypoallergenic food. Though rice milk is low in protein, it's a popular alternative for those who avoid cow's milk because they are lactose intolerant.

 

Try this: Make a smoothie with two cups of plain rice milk, a cup of juice, a few chucks of frozen fruit and a shot of omega 3 fish oil (unless you have seafood allergies), as suggested by Robyn O'Brien, founder of AllergyKids and author of the book "The Unhealthy Truth."

 

Salba seeds

A light-colored version of chia seeds, salba seeds can be found as a whole grain, in ground powder or in some snack products. Unlike flax seeds, they are digestible in whole seed form, Doherty said. They're rich in omega 3 fatty acids, dietary fiber, antioxidants, magnesium, folate, calcium and iron, as well as vitamins A and C.

 

Try this: Sprinkle the seeds in smoothies, cereal, yogurt or casseroles. Doherty mixes equal parts of rice bran, salba and flax meal and puts it on oatmeal or gluten-free macaroni and cheese.

 

Figs

Packed with potassium and containing more calcium than orange juice, sweet figs beat candy for an instant sugar fix, said Doherty, who compiles the Top 10 Superfood List for Living Without magazine. Figs are high in soluble fiber, which can relieve constipation. Dark figs have a stronger taste. Eat them fresh, if you can.

 

Try this: "Use a fig puree as a sweetener," said nutrition expert Jonny Bowden. Combine 8 ounces of figs with a quarter-cup to a third of a cup of water in a blender. Pureed figs also can be used as a sandwich filler.

 

Copyright © 2009, Chicago Tribune

 

Copyright 2009 Baltimore Sun.

 

No scars: New obesity surgery goes through mouth

 

Associated Press

By Lindsey Tanner

Baltimore Sun

Thursday, June 4, 2009

 

CHICAGO - Doctors are testing a new kind of obesity surgery without any cuts through the abdomen, snaking a tube as thick as a garden hose down the throat to snap staples into the stomach.

 

The experimental, scar-free procedure creates a narrow passage that slows the food as it moves from the upper stomach into the lower stomach, helping patients feel full more quickly and eat less.

 

Doctors say preliminary results from about 200 U.S. patients and 100 in Europe look promising.

 

After about 18 months, obese European patients have lost an average of about 45 percent of their body weight, said Dr. Gregg Nishi, a surgeon at Cedars-Sinai Medical Center in Los Angeles. He discussed the European and U.S. studies during a Chicago conference this week for digestive disease specialists.

 

The procedure is only being done in the studies, which recently ended enrollment. Makers of the device used in the operation plan to seek federal approval if the research continues to go as planned.

 

While the two studies are still under way and only brief details are being released, Nishi said results so far are slightly better than typical results from with conventional stomach stapling.

 

Risks include perforating the esophagus, as Nishi said happened to a patient at another center, but otherwise, he said, there have been no major complications.

 

Some study patients have lost weight after unknowingly undergoing fake procedures -- sedation and the tube, but no stapling. Results comparing them with the real thing aren't yet available.

 

Liliana Gomez, an administrative coordinator at Cedars-Sinai, was among the first Americans to have the scarless obesity surgery last year, as a test case for the U.S. study. She had planned on more invasive conventional surgery until learning that doctors at her hospital were studying the scarless stapling technique.

 

"When I found out it was going to be oral, through your mouth, I was like, 'Wow, that's kind of different,'" she said.

 

Since her operation in August, Gomez has lost about 40 pounds (18 kilograms) and dropped from size 22 to size 16.

 

The 35-year-old mother of three has a long way to go -- she's still obese according to body mass index standards. But Gomez says she has cut her meal portions by more than half and still feels full, and is optimistic she'll continue to lose weight.

 

The new method is part of a medical movement to perform surgery through body openings such as the nose, mouth and vagina instead of making cuts. The idea is to reduce chances of infection and pain, and speed recovery. With no scars, there are cosmetic advantages, too.

 

Gomez had considered a gastric bypass operation, a more complex kind of stomach stapling, but worried about risks from that surgery. It reduces the stomach to the size of a golf ball and reroutes the digestive tract.

 

Whether done through one large abdominal incision or several tiny ones, gastric bypass is far more invasive and increases chances for malnutrition because it repositions how the stomach attaches to the intestines to restrict calorie absorption.

 

Another popular weight-loss surgery option involves putting an adjustable band around the top part of the stomach to create a small pouch.

 

The experimental method Gomez had is the oral version of a different kind of stomach surgery, which reduces the size of the stomach with staples but doesn't reroute the digestive system.

 

Surgery is generally considered a last-resort treatment for obesity, which affects more than 15 million Americans. Still, demand is high. More than 200,000 Americans are expected to have conventional forms of obesity surgery this year, according to the American Society for Metabolic & Bariatric Surgery.

 

Dr. Scott Shikora, the society's president, called the oral procedure exciting and innovative, but said, "It is too early for us to say this is going to be a breakthrough."

 

Shikora said many U.S. obesity surgeons prefer the rerouting surgery or flexible bands, and that it remains to be seen whether the oral method has the same drawbacks as more outmoded stapling procedures.

 

The U.S. study is taking place at 10 centers. Patients will be followed for at least one year, with final results expected in 2010. They are randomly selected to undergo either the operation or a sham procedure.

 

Nishi said of 25 patients enrolled at his hospital, 17 got the real treatment, with no complications.

 

"I'm very impressed with it," Nishi said. So far, it looks like "a viable alternative," he said.

 

Satiety Inc., a California company that created the medical devices used in the technique, is paying for the research. Nishi said he has no financial ties to the company.

 

At Washington University School of Medicine in St. Louis, where the first U.S. procedure was done last summer, about 30 patients have undergone the treatment. Side effects have been minimal, including sore throats, nausea and some abdominal pain lasting less than a week, said Dr. J. Christopher Eagon. He said weight loss results from his center aren't yet available.

__

On the Net:

 

American Society for Metabolic & Bariatric Surgery: http://www.asbs.org

 

Satiety, Inc.: http://www.satietyinc.com

 

Copyright 2009 Associated Press. All rights reserved.

 

Black Gyrl Cancer Slayer Says 'Be Your Best Advocate'

 

By Chana Garcia

AOL.com

Friday, May 29, 2009

 

Filed under: Cancer

 

I knew something was wrong.

 

It all started in February of 2008 with some weird gurgling in my belly, followed by a bit of weight gain and bloating. I had just spent Christmas and New Year's in Mexico and thought maybe I had eaten something bad or accidentally drank the water. I was kicking myself for asking for a glass of ice one morning.

 

Thinking I was suffering digestion issues from a week of partying hard, I made an appointment to see a gastroenterologist. That one appointment turned into many. The bloating continued to worsen and, at one point, I looked several months pregnant. My co-workers and neighbors, excited about my impending motherhood, asked about my due date and guessed at the sex of my baby. Looking back, I wish that had been the case.

 

Over the following months, I underwent a series of tests before an ultrasound finally revealed what was happening inside my body.

 

"You have two large tumors on your ovaries," my gastro doc said. "One is the size of a softball."

 

Now, I had been diligent about making my yearly doctor's visits and had seen my gyn several months before.

 

When she saw the results of my ultrasound, she thought a cyst she'd found on my right ovary a few years prior had simply grown into a mass that needed to be removed. The process would involve a minimally invasive surgery, she told me, which we could schedule when she returned from vacation in a week. "Your chances of having ovarian cancer are low," she told me reassuringly.

 

If you go by the statistics, she was right.

 

Listening to a Nagging Feeling

Ovarian cancer is a rare disease, accounting for about 3 percent of all cancers. It primarily affects Caucasian women over the age of 50 and is prevalent among the orthodox Jewish community. As a 32-year-old black woman, I didn't fit the bill.

 

But I hadn't been feeling like myself, and I had a nagging feeling that I was suffering from something a bit more serious than enlarged cysts. So while my gyn was on vacation, I called her office relentlessly. I harassed her staff until her nurse practitioner finally agreed to administer a CA-125 test, which is used to determine the presence of cancer in the blood. Normal results are between 20 and 30. Mine was in the thousands.

 

In May, three months after that initial doctor's visit, I was diagnosed with ovarian cancer, stage III C. What followed was a whirlwind of appointments and discussions with specialists in New York City, where I live.

 

I had very little time to grasp the enormity of the situation, which probably kept me from spiraling into depression. I reached out to friends who are doctors and each of them advised me to act quickly to find the best surgeons and oncologists to remove the cancer. "This is serious," one doctor friend told me with worry in her voice.

 

A particularly hard disease to detect and treat, ovarian cancer can easily spread to other organs. More than 70 percent of cases are found in later stages, resulting in a five-year survival rate of about 46 percent. It's often referred to as a silent killer because, until fairly recently, it was widely believed to be asymptomatic. It turns out, however, that most ovarian cancer patients experience weight gain or loss and digestion problems.

 

That gurgling I had noticed months earlier was fluid, called ascites (a-site-ease), building up around my tumors - another classic symptom. Close to nine liters had been drained from my abdomen during my surgery.

 

And because it rarely affects younger women or women of color, it can easily slip under a doctor's radar.

 

I am a classic example of what happens when medical professionals engage in age- and race-based bias. It never occurred to my gyn, also a young black woman, that I had ovarian cancer. She had almost completely ruled it out.

 

Proud to Be a Survivor

Shortly after my surgery, which left me unable to have children of my own, I made a promise to myself that I would triumph over this disease and do whatever I could to promote awareness.

 

If nothing else, my story illustrates why it's crucial to listen to your body. Ask questions, keep records and be persistent if you suspect something is wrong - in short, become your own advocate. If I hadn't, my story could've been tragic.

 

Today, a year after one of the most difficult times in my life, I'm proud to call myself a survivor. Not long after my surgery, I was diagnosed with a low-malignant tumor that, nevertheless, had to be treated aggressively. I still have to undergo chemotherapy twice a month to attack some residual cancer hanging around in my abdomen and to stay ahead of this often-recurring disease. For many ovarian cancer patients, the road to recovery is a lifelong fight, but there are survivors who have been in remission for 20-plus years. I plan to be among them.

 

Easy To Slip Through The Cracks

With more than 1 million Americans diagnosed with cancer every year, it's clear that we have a lot of work ahead of us. But there's some encouraging news coming out of Washington for all cancer patients.

 

Under President Barack Obama's proposed health care reform, more than $600 billion in reserve funds would be used to transition our current health care system into something more like universal coverage, and funding for cancer research would double over the next five years. The president has even dedicated certain dollars to fighting diseases that are particularly hard to cure, like ovarian and pancreatic cancer.

 

Back in March, Senators Edward Kennedy and Kay Bailey Hutchinson introduced critical legislation that would require private insurers to cover routine care for all cancer patients, as well as those participating in clinical trials. It's the most comprehensive plan Congress has seen since the National Cancer Act was passed in the '70s.

 

The most important step to conquering cancer, however, is becoming vigilant about your own health. Getting regular checkups is vital to preventive care, especially for those who have a family history of cancer. And if you suspect something's wrong, be proactive about it. Don't let yourself slip through the cracks.

 

No one is going to care more about your well being than you. Take it from me.

 

Chana Garcia is a freelance copy editor for Black Voices who has been writing about cancer awareness and women's-health issues. To learn more, visit her blog at blackgyrlcancerslayer@wordpress.com.

 

For more information about ovarian cancer, check out the following resources:

 

Ovarian Cancer National Alliance www.ovariancancer.org

Ovarian Cancer Research Fund www.ocrf.org

SHARE www.sharecancersupport.org

 

© Copyright 2009 AOL, LLC All Rights Reserved.

 

10-year-old SoCal girl copes with breast cancer

 

Associated Press

Washington Post

Wednesday, June 3, 2009

 

LA MIRADA, Calif. -- Ten-year-old Hannah Powell-Auslam is trying to remain brave as she copes with a rare form of breast cancer.

 

"I feel like a kid inside but sometimes I feel like an adult, when I'm always at the hospital," Hannah told ABC's "Good Morning America" in an interview that aired Wednesday.

 

The fifth-grader at Escalona Elementary School in this Los Angeles bedroom community complained of itching in her side in April. Her mother discovered a lump, and that led to a diagnosis of breast cancer.

 

Her family said she was diagnosed with invasive secretory carcinoma, a type discovered in children in the 1960s.

 

"Hannah's prognosis is very good and the type of cancer is very slow growing," her father, Jeremy, said in an e-mail Wednesday.

 

Children still represent only a fraction of a percent of all breast cancer cases.

 

Hannah had surgery and has begun chemotherapy.

 

"You feel like you're sick all the time. You just want to go lay in bed," she said.

 

The show filmed Hannah at home getting her head shaved rather than waiting for chemotherapy to take its toll. Other family members got buzz cuts, too, in solidarity.

 

"I might be just a little bit afraid. I love my hair. I worked so hard to grow it," Hannah said before the event.

 

© 2009 The Associated Press.

 

A Move Toward Requiring Health Coverage

In Letter to Senate Democrats, Obama Suggests Hardship Waiver for the Poor

 

By Ceci Connolly

Washington Post

Thursday, June 4, 2009

 

One day after signaling a fresh willingness to consider taxing employer-sponsored health insurance, President Obama indicated yesterday a new openness toward a nationwide requirement that every American have health coverage.

 

In his push to enact sweeping health-care reform legislation this summer, Obama previewed what could be the outlines of a compromise on two of the thorniest issues confronting Congress. He said he could support mandates on both individuals and employers to contribute to the cost of health insurance if the bill provides protections to certain small businesses and poor people.

 

"If we do end up with a system where people are responsible for their own insurance, we need to provide a hardship waiver to exempt Americans who cannot afford it," he wrote in a letter to top Senate Democrats.

 

During the presidential primaries last year, Obama attacked then-Sen. Hillary Rodham Clinton's proposed individual mandate as a scheme to "go after people's wages."

 

In the letter, however, he said he understands that key committees are "moving towards a principle of shared responsibility -- making every American responsible for having health insurance coverage, and asking that employers share in the costs."

 

The approach tracks closely with a universal health program enacted in Massachusetts three years ago in which individuals must have coverage and businesses must either offer insurance to employees or pay into a state fund that provides coverage. In Massachusetts, individuals can receive free or subsidized care based on income.

 

Broadly speaking, the business community has opposed requirements to "pay or play," as the employer mandate is often known. But a survey conducted by the Main Street Alliance, a small-business coalition advocating reform, found that 77 percent of 1,200 small firms interviewed are willing to pay a portion of workers' health-care costs.

 

"Do we feel a responsibility to help our employees afford health care? Yes, we do," Freddy Castiblanco, owner of La Terraza Cafe in Queens, N.Y., said in congressional testimony yesterday. "Are we willing to contribute? Yes."

 

Castiblanco, who employs 11 people, said any health-care overhaul should include the option of a government-sponsored insurance policy for people having trouble buying coverage on the private market.

 

That idea got a boost from Obama, who said in the letter that he "strongly" believes in giving Americans the choice of a public option.

 

"This will give them a better range of choices, make the health-care market more competitive, and keep insurance industries honest," he wrote.

 

Obama also pledged -- without providing details -- to trim an additional $200 billion to $300 billion out of Medicare and Medicaid spending over the next decade. That would be on top of the $309 billion in Medicare reductions in his budget, though Congress has not embraced the specifics.

 

For the first time, the president also said he is considering proposals that would empower the Medicare Payment Advisory Commission to implement cost controls on the health program for seniors and the disabled. The idea is similar to legislation sponsored by Sen. John D. Rockefeller IV (D-W.Va.), who wants to make the commission an independent agency in the executive branch functioning along the lines of the Federal Reserve Board. Obama, however, suggests following the model of the military base closing commission, with Congress still involved in Medicare's coverage and price decisions.

 

Senate Finance Committee members were told privately yesterday that the panel will probably see draft legislation on June 17 and begin marking up the bill the following week.

 

Copyright 2009 Washington Post.

 

Slump Pushing Cost of Drugs Out of Reach

 

By Kevin Sack

New York Times

Thursday, June 4, 2009

 

ROCKY MOUNT, N.C. — A year or so ago, when customers buttonholed the pharmacists at Almand’s Drug Store here the questions were invariably about dosing or side effects. These days, they are almost always about cost.

 

Can I get this as a generic? Is the co-pay really that high? Will you match Wal-Mart’s $4 price? “I’m out of Lexapro,” a woman pleaded one recent Tuesday, speaking of her antidepressant. “Can I just have four pills until payday on Friday?”

 

Some customers request prices for a fistful of prescriptions, and then say they can fill only the cheapest two. Others ask which are most important.

 

“It can be a hard question to answer,” said Traci W. Suber, the head pharmacist. “The only thing I can do is let them know what they’re for, get them the cheapest available and encourage them to come back for the others when they can.”

 

Even with the Medicare drug benefit, even with the prevalence of low-cost generics, even with loss-leader discounting by big chains, many Americans still find themselves unable to afford the prescription medications that manage their life-threatening conditions.

 

In downtrodden communities like Rocky Mount, where unemployment has doubled to 14 percent in a year, the recession has heightened the struggle. National surveys consistently find that as many as a third of respondents say they are not complying with prescriptions because of cost, up from about a fourth three years ago.

 

Many customers at Almand’s Oakwood neighborhood store, particularly those too well off for Medicaid but unable to afford insurance, simply pick and choose among risks. They weigh not taking maintenance medications against more immediate needs like shelter and food.

 

The pharmacists see it every day. About eight months ago, they stopped automatically preparing refills for regular customers because they found that more than half were not being collected and had to be restocked.

 

One recent Wednesday, James S. Crawford, newly discharged from the hospital after his third heart attack, fanned six green slips across the counter as if showing a hand of cards. There were a pair for high blood pressure, one each for angina, cholesterol, and acid reflux, and a renal vitamin for his kidney disease. “I need to know the prices,” he said.

 

Ms. Suber, the pharmacist, explained what each drug was for and listed the co-payments under Mr. Crawford’s Medicare plan, ranging from $8.25 to $18.49 for a one-month supply. The renal vitamin, at $21.89, was not covered.

 

Mr. Crawford, 61, who makes do on $1,800 a month in Social Security and veterans’ benefits, decided he could afford only the heart, blood pressure and acid reflux pills. “If I can rob a bank,” he said, chuckling, “I’ll be back for the others.”

 

Before leaving, he handed over yet another prescription, just for safekeeping. It was for Plavix, an anticlotting drug that helps coronary patients avoid new blockages, and it had been written in early February after Mr. Crawford’s second heart attack. At $160, the co-payment was so high he had never considered filling it.

 

Some customers get by through a patchwork of assistance programs offered by governments, charities and drug makers. The only hospital in Rocky Mount, Nash General, donated about $60,000 in medications last year, and a newly established free clinic is spending up to $600 a month on discounted prescriptions at Almand’s.

 

But the need is much greater, and the impact is already felt downstream in clinics and emergency rooms where the ailing seek treatment when their diabetes or blood pressure spikes out of control.

 

Dr. John T. Avent, a physician at a low-income clinic near Almand’s, estimated that at least 80 percent of his patients were not taking prescribed medicines.

 

“They’ll say, ‘Well, Doc, I just couldn’t afford it; I’ve been out of it for a month now,’ ” Dr. Avent said. “By that time, of course, their blood pressure is highly elevated and their hemoglobin A1C is two to three times what it should be.”

 

Dr. Daniel C. Minior, who directs the emergency department at Nash General, said he was increasingly hearing from patients that they had lost jobs and could not afford medications. “The worrisome aspect is that it’s even occurring among younger and working-age people,” Dr. Minior said. “That’s not something we saw before.”

 

Rocky Mount, planted amid tobacco fields in eastern North Carolina, has seen the closings of mills and an exodus of jobs, compounding the devastation caused by flooding from Hurricane Floyd in 1999. The Almand family once owned a dozen pharmacies in the area, but only two survive.

 

The Oakwood store, in the heart of the African-American community, faces growing competition from mail orders. But business remains steady thanks to discount programs, partnerships with neighborhood clinics, while-you-wait service, $1 delivery and a friendly, familiar staff. Each morning, the pharmacy fills with the aroma of popcorn from the machine on the counter and Gloria Mabry, who runs the cash register, greets customers by calling them Baby or Sugar, whether she knows them or not.

 

More than 70 percent of the store’s patrons are covered by Medicare or Medicaid, and the pharmacy offers $4 generics to the uninsured. But customers taking a dozen or more medications may still struggle to afford even the modest co-payments under government plans (as low as $3 in the case of Medicaid).

 

Lisa A. Hylton, 29, from nearby Sharpsburg, said she had skipped twice-monthly refills three times this year on an albuterol inhaler for her asthmatic son, Hunter. Her husband, a pipefitter, had been working only intermittently and could not afford insurance during the idle stretches, Ms. Hylton said. “It makes me feel like I can’t supply for my young-uns.”

 

Jimmie L. Bryant, 56, had been laid off for a month when he walked into Almand’s with swollen glands and a one-time voucher from the Edgecombe County Department of Social Services. For the first time since he lost his job, the voucher enabled him to fill prescriptions for Synthroid, to control his hypothyroidism, and Xanax, for depression.

 

Mr. Bryant said he had tried to get refills from his physician, but was told he would have to schedule an office visit for $120, which he could not afford. Even when he was working and had insurance, Mr. Bryant said, he would alternate between the two prescriptions, week to week.

 

“At the end of the month, I’d have a little bit of what I need in my system,” he explained.

 

Similarly, Robert E. Brown, 60, who has heart disease and emphysema, said he regularly told the pharmacists at Almand’s to reshelve his prescriptions after being quoted prices of $100 or more. “I just hand them back,” he said. “I take the ones I can afford, and then trust in the Lord.”

 

Copyright 2009 The New York Times Company.

 

F.D.A. Chief Lauds Food Safety Bill as the ‘Right Direction’

 

By Gardiner Harris

New York Times

Thursday, June 4, 2009

 

WASHINGTON — Margaret A. Hamburg, the new commissioner of the Food and Drug Administration, plunged on Wednesday into the contentious debate over how to fix the nation’s food safety system.

 

In her first appearance before Congress as commissioner, Dr. Hamburg told the House Energy and Commerce Subcommittee on Health that a safety overhaul sponsored by several leading Democrats was “a major step in the right direction,” but that her agency would need more money to carry it out.

 

The hearing demonstrated that a bipartisan consensus that had been apparent in nearly two dozen previous hearings had since been lost. Again and again, Republicans complained about specific aspects of a measure the committee is expected to vote on as soon as next week.

 

That legislation, still in draft, blends provisions from bills offered by several top Democrats and includes requirements that all food manufacturers write and carry out safety plans, pay an annual registration fee of $1,000 to the F.D.A. and keep track of the distribution of all food products.

 

The agency would be required to inspect every food facility in the country at least once every four years, with high-risk ones being inspected every 18 months.

 

Despite her support for the legislation, Dr. Hamburg said the registration fees “will, sadly, not be enough to implement those targets.”

 

“They are wonderful goals,” Dr. Hamburg told reporters after the hearing, “but we have to be realistic about what resources are needed.”

 

In March, Representative Joe L. Barton of Texas, the senior Republican on the full committee, said that on the subject of food safety “there is no daylight” between himself and Representative Henry A. Waxman, Democrat of California and chairman of the committee.

 

But on Wednesday, Mr. Barton said that the registration fees were too high and that a provision requiring that foods be labeled with their country of origin was burdensome. He complained about provisions that would expand the food agency’s powers, giving it the right to force manufacturers to recall their products and to subpoena manufacturing records.

 

Mr. Waxman defended the fees as necessary to support functions that would save the food industry from expensive recalls. “The bill simply asks industry to chip in its fair share,” he said.

 

Pamela G. Bailey, president of the Grocery Manufacturers Association, told the committee that the industry was concerned about the size of the proposed fees and their possible effect on the credibility of the F.D.A.

 

“Our industry is ultimately responsible for the safety of its products,” Ms. Bailey said in a written statement, “but securing the safety of the food supply is a government function which should be largely financed with government resources.”

 

Dr. Hamburg also spoke on two other disputed issues. She told the panel that the drug agency had begun a new safety review of bisphenol-A, or BPA, a chemical used to harden some plastics. Some studies have suggested that the chemical may accelerate puberty, but the agency concluded during the Bush administration that it was safe at levels found in the American market.

 

The agency’s own science advisory panel rejected that conclusion in October. Dr. Hamburg said the agency’s new review should be completed by the end of summer.

 

Before the hearing, advocates passed out fliers nearby, protesting the routine use of antibiotics in livestock, which has led to the proliferation of antibiotic-resistant bacteria. Dr. Hamburg said she shared those concerns.

 

“It’s a huge concern of mine in terms of the growing problem of antibiotic resistance in this country and around the world,” she testified.

 

Dr. Hamburg sat quietly for the first 90 minutes of the hearing as legislators made opening statements. Asked afterward what she learned in her first appearance before Congress as commissioner, she answered, “That I have a lot to learn.”

 

Copyright 2009 The New York Times Company.

 

Opinion

 

Transforming State Center

Our view: Md. should go ahead with transit-oriented revitalization project

 

Baltimore Sun Editorial

Thursday, June 4, 2009

 

Maryland took an important step Wednesday to encourage transit-oriented development - the idea that homes, offices and shopping should be concentrated together with easy access to public transportation. The Board of Public Works approved a master developer agreement for the rejuvenation of the State Center office complex in Baltimore in a project that could transform a lifeless corner of Madison Park and connect the Mount Vernon cultural district with Bolton Hill and other neighborhoods across Martin Luther King Boulevard.

 

It was the right decision, despite legitimate concerns about the project's viability.

 

Treasurer Nancy K. Kopp and the nonpartisan Department of Legislative Services have questioned the financing and timing of the project, which is expected to cost $1.4 billion to complete. It's unclear how the project would count against Maryland's self-imposed debt ceiling; it could put the state over the limit, or at the very least reduce the capacity to borrow for other priorities, such as school construction. The developers are expected to borrow nearly $900 million for the project and the state to borrow more than $300 million, with the rest of the cost coming from direct investment and tax credits. Whether the developers can muster that kind of cash in the current economic climate remains to be seen.

 

There's also some reason to worry, given relatively high vacancy rates in downtown Baltimore, whether building 2 million square feet of office space; 250,000 square feet of commercial space, including a grocery store; and as many as 2,000 residential units would be economically viable.

 

The O'Malley administration, which has continued the Ehrlich administration's plans for the site, agreed to extra oversight of the project by the legislature. And Wednesday's agreement only puts the state on the hook for the cost of developing the plans for the site, estimated at $3 million to $5 million. The board will get another chance to decide whether to go forward with the full project in about a year, when it's likely the economy will be more settled and questions about financing and the real estate market will be clearer.

 

Maryland has a lower-risk, lower-cost alternative. It could borrow a smaller amount of money, fix up the existing buildings and continue as it is now. But the state is contemplating a long-term lease of the site to the developer - 50 years - and it's important to consider the plan in those terms. It's a safe bet that in that time, aligning development with the metro and light rail lines, connecting neighborhoods and bringing life to a forgotten pocket of the city will pay off. The project comes with risks, but they are risks worth taking.

 

Copyright 2009 Baltimore Sun.

 

New beginning for Md. drug policy?

 

By Devon Hutchins

Baltimore Sun Commentary

Thursday, June 4, 2009

 

The week before the legislative session ended, Maryland's General Assembly hosted Michael Phelps to recognize his achievements at the Beijing Olympics. Just two months after critics claimed his career and reputation would never recover from the infamous photo of him apparently smoking marijuana that circulated the Internet, state senators and delegates honored him with a standing ovation.

 

The incident underscores what some recognize as a shift away from the disproportionately "tough on crime" attitude for which Maryland legislators have been known. The General Assembly this year also moved closer to making some much needed criminal justice reform, including offering drug treatment for people who violate probation and allowing the act of calling 911 during an alcohol or drug overdose to be used as a mitigating factor in future criminal proceedings.

 

Another indication that state lawmakers might be ready to address our antiquated perspectives on criminal justice and drug policy came with the rejection of a bill aimed at criminalizing Salvia Divinorum and Salvinorin A (salvia).

 

Salvia, a psychoactive plant native to Mexico that has a generally short-acting effect on mood and consciousness, was relatively unknown until the production of a handful of online videos attracted media attention. This unleashed something of a panic among lawmakers.

 

Since 2005, several states have criminalized Salvia Divinorum, and a growing number of state legislatures are considering similar legislation. But this wave of prohibition misinforms public understanding of the substance and is ultimately both harmful and futile. Salvia use remains very low (fewer than 1 million users in 2006, according to federal estimates). Comparatively, around half of high school seniors have tried marijuana before they graduate, and teens continue to report that it is easier to obtain than alcohol or cigarettes.

 

Banning salvia outright would replace a regulated trade with an underground economy that emboldens criminals to market the drug and allows unrestricted access by young people.

 

If an early draft of HB 1261 had moved forward in Maryland's House of Delegates, salvia would have been labeled a Schedule I substance, equating it with drugs like heroin and LSD. However, after informed debate with the Drug Policy Alliance, which works to reduce the harms of drug prohibition, delegates rejected a ban, instead opting for age restrictions for distribution and possession of salvia by minors. The House Judiciary Committee should be admired for taking a stand against prohibitionist policies that have proven ineffective time and time again.

 

Age restrictions that prevent the sale of salvia to individuals under 21 are certainly appropriate. This would allow the state to tax and regulate the herb for adults, creating a legal economy that could bring in needed revenue, maximize police resources and allow further investigation into potential medical benefits associated with salvia. Already studies have shown that Salvinorin A could be a candidate for treatment of pain, addiction, depression, eating disorders, central nervous system illnesses, gastrointestinal disorders and HIV infection.

 

While this draft of the bill was delayed in the Senate and did not make it to a vote before the end of the legislative session, the renewed focus on health and human rights lends promise for passage of a bill next year. A rational approach to salvia bodes well for the possibility of a new era of drug policy in Maryland - one that could eventually entail substantive reform on a range of matters, from drug mandatory minimums to parole system improvements to increased access to treatment instead of incarceration.

 

Here's hoping this is indeed an indication of an institutional shift in how we think about these issues.

 

Devon Hutchins is a Policy Associate for the Drug Policy Alliance- DC Metro. Her e-mail is dhutchins@drugpolicy.org.

 

Copyright 2009 Baltimore Sun.

 

Medicare, Start the Bidding

 

By Peter B. Bach

New York Times Commentary

Wednesday, June 3, 2009

 

EVERY year, like half a million other doctors, I sign on to the government’s largest no-bid, no-compete contract. We agree to treat Medicare patients for a set rate, and Medicare agrees to take all of us on board, whether or not our services are needed in the city or town where we practice. As a result, doctors — in particular, specialists — flock to some parts of the country and shun others.

 

The trouble with this is that when there are too many doctors in one area, too much money gets spent on health care. But the system could take advantage of this fact to save money.

 

Researchers have observed that having one additional specialist (per 100,000 people) in a region leads to about $13 more in health care spending per Medicare patient. New York City, for instance, has 186 specialists for every 100,000 residents, which is twice as many as Albany’s 93. Accordingly, Medicare spends $12,114 a year treating each patient in New York City, but only $5,950 in Albany.

 

Patients in high spending areas are no sicker than patients anywhere else, their care is of no higher quality, and their health outcomes are no better, research has shown. Having more doctors doesn’t even offer more convenience. Patient satisfaction is no higher, and just as many patients complain about having trouble getting to see a doctor.

 

The White House budget director, Peter Orszag, has highlighted regional variations as a key source of overspending on health care. Such wasteful spending by Medicare and by private insurance could add up to as much as $700 billion a year — enough to provide insurance for everyone who doesn’t have it now.

 

To realize some of these savings, Medicare could use an approach called a reverse Dutch auction to set up competition for doctors in oversupplied regions.

 

Here is how it would work. Later this year, the agency would set a 2010 target number for each type of specialist in an oversupplied region. Then it would offer to sign up those doctors at a certain payment rate. The starting rate would be, say, $30 per doctor work unit. (Work units are a measurement that Medicare uses to set its rates; each procedure is assigned a specific number of work units.) This is lower than the $36 per work unit that Medicare pays all doctors today. If too few specialists signed up, the rate would go up, and it would keep rising until there were enough doctors for the area.

 

In areas where there are too few doctors, Medicare could pay more than $36 per work unit, attracting not only specialists but also the primary-care doctors who are so needed in these places.

 

I anticipate a few objections to this plan. People might worry, for instance, that some Medicare patients might no longer be able to consult their favorite doctors. But any doctors who did not sign up during the auction could still sign up as “nonparticipating providers.” Medicare already reimburses such doctors at a rate that is only 5 percent lower than the standard rate.

 

Then there is the question of whether both Medicare and participating doctors would be prepared to engage in bidding. The answer is yes. Medicare has already procured other goods and services — everything from wheelchairs to claims processing — through competitive bidding. And doctors have long had to haggle with commercial insurers over their rates.

 

To ensure that everyone has time to adjust, the bidding system could be phased in, starting with a few of the most overpopulated specialist groups in the most oversupplied regions.

 

Finally, there is the fact that some specialists would lose their Medicare business. But those doctors who are left out might move to places that really need them. Or they might stay where they are and compete with other doctors for privately insured patients, lowering fees for people who are not on Medicare.

 

Ideally, some of them would become primary-care doctors; many have already completed the training for that. Having more primary-care doctors in an area lowers health care spending and increases quality.

 

Of course, it would be nice if our Medicare system did not need to treat the important work doctors do as a commodity. But Medicare already regards all doctors as suppliers of equivalent services by paying them all the same fees for the same services. A competitive bidding system could hold down spending without reducing access to doctors or hurting the quality of care.

 

Peter B. Bach, a pulmonary specialist at Memorial Sloan-Kettering Cancer Center, was a senior adviser to the administrator of the Centers for Medicare and Medicaid Services from 2005 to 2006.

 

Copyright 2009 New York Times.

 

Make a stink about the fish kill

 

Baltimore Sun Letter to the Editor

Thursday, June 4, 2009

 

Isn't it ironic that River Network held its annual River Rally - the nation's largest conference of river advocates - here in Baltimore this past weekend, literally on top of the Harbor's largest fish kill in two years?

 

Unfortunately, only folks from other parts of the country appeared to show any outrage at the dead fish! This is not surprising given our Department of the Environment asserts that fish kills are "totally normal."

 

Fish kills are a direct result of too much pollution in our water. In this case, nitrogen and phosphorus (nutrients) were to blame. Lawn fertilizers, car exhaust and sewage overflows are some of the large urban sources of nutrients.

 

Cleaning up the water will require both lifestyle adjustments and tighter regulations on these pollutants that are plaguing Baltimore Harbor.

 

Eliza Smith Steinmeier

 

Copyright 2009 Baltimore Sun.

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