[My] Life in Wisconsin

Death Panel.

Rating:★★★★★
Category:Other

This is probably the best definition of "death panel" that I have seen to date.

XOXO
Me


"A death panel is when your wife has cancer, and in the middle of chemo treatments the insurance company finds out that she had cancer years earlier, calls it a pre-existing condition and cuts off the insurance.
{Thus} leaving us with the choice of saving her life or losing everything we worked for. Or letting her die and being able to keep my kids in their home.
Yes, she lived!  We lost everything, and had to live with friends until we got back on our feet. Funny thing though, the insurance company had no problem taking our money month after month.

Maybe, just maybe, a government run option will not give me all the coverage I want but they also will not cut me off and leave me to die so they can make a buck."


end quote.



 ♫  I HEAR THAT TRAIN A COMING-
ITS COMING DOWN THE TRACKS
IT IS CARRYING TRUTH, HONESTY AND LEADERSHIP AND WE ARE NEVER GOING BACK.





Clearly...

Sounding out the words is not enough.
It is not enough to simply teach our children/adults HOW to read.
Far more reaching, we must also teach them to comprehend -and to understand, what they are reading.

XOXO
Me


American Indian reservation reaping oil benefits - Yahoo! News

http://news.yahoo.com/s/ap/20100224/ap_on_bi_ge/us_tribal_oil;_ylt=AlC8LqzL9ctRXJ7vKkhxFdF0fNdF
Good Morning All;
As I have read my news, I found this wonderful news story.
I believe this to be the very best case of Native American recovery that I have ever heard of!
DC has nothing better than this
hehehe








Hats off to the Mandan, Hidatsa and
Arikara tribes! I am thrilled for you all.
Best of luck.


XOXO
Me

__________________________________

American Indian reservation reaping oil benefits

By JAMES MacPHERSON,

NEW TOWN, N.D. – An oil boom on American Indian land has brought jobs, millions of dollars and hope to long-impoverished tribal members who have struggled for more than a century on the million-acre Fort Berthold Indian Reservation.

In little more than a year, oil companies have put dozens of money-producing rigs on remote rolling prairie and sprawling badlands that are home to small cattle ranches and scattered settlements of modular housing. Although other tribes around the nation have oil interests, industry officials said none has likely experienced a recent windfall of this scale.

The reservation is occupied by the Mandan, Hidatsa and Arikara tribes, known as the Three Affiliated Tribes, who were placed in west-central North Dakota by the federal government in the 1800s — long before anyone knew of the oil.

"If they knew there was billions of barrels of oil here, they would never have put us here," said Spencer Wilkinson Jr., general manager of the Four Bears Casino on the reservation.

"There is probably more opportunity here than people have had in their lifetimes," said Marcus Levings, chairman of the Three Affiliated Tribes. Roads are now sometimes clogged with traffic, including Hummers and expensive pickup trucks. The local casino is buzzing with free-spending locals. And tribal members who had moved away to find work are now moving back for the abundant good-paying jobs.

Tribal officials say the oil has helped right a wrong done to the tribes in the 1950s, when more than a tenth of the reservation was flooded by the federal government to create Lake Sakakawea, a 180-mile-long reservoir.

Oil companies are now drilling beneath the big lake, using an advanced horizontal drill technique. Recently completed regulatory paperwork removed the last obstacle.

Since the boom began, lease payments of more than $179 million have been paid to the tribe and its members on about half of the reservation land, tribal record show. Millions of dollars more in royalties and tax revenue are also rolling in.

Levings said the tribe will use its money to pay off debt, and bankroll such things as roads, health care and law enforcement.

The reservation contains portions of six counties, covering more than 1,500 square miles. It lies atop a portion the oil-rich Bakken shale formation, which the U.S. Geological Survey estimates holds 4.3 billion barrels of oil that can be recovered using current technology. The agency said the Bakken was the largest oil deposit it has ever assessed.

In addition to the oil money, the tribes get $60 million to $70 million in federal aid annually from the federal government.

"This is an opportunity for us to help ourselves as much as we get help," Levings said. About 4,500 of the approximately 12,000 tribal members live on the reservation, one of about 300 in the United States.

State demographer Richard Rathge said 28 percent of people on the reservation were living in poverty in 2000, the latest figures available. More than 40 percent did not have a job at that time.

The opening of the casino in the 1990s added about 200 jobs. But oil's impact has been huge. "Anybody who wants to work can work," said Levings, with jobs available on rigs and in support industries such as oil supplies and trucking.

The reservation was the last area to be targeted by companies in the state's oil patch because of onerous federal requirements. But a 2008 tax agreement standardized the rules for oil drilling.

Dozens of wells have been drilled and more than 500 could be operating within five years.

Lovina Fox hopes at least one winds up on her land near Mandaree, a town of about 500 on the reservation. Lights from nearby drill rigs and flares burning off excess gas already illuminate her home.

"Everybody knows everybody here," she said. "If people are getting rich they're not saying anything and keeping it hush-hush. But it's not hard to figure out who's getting money — it's the people who have haven't worked in years and all the sudden, they're driving new vehicles."

Tribal member Rose Marie Mandan, who admits to earning "a nice little cushion" from oil payments, said she moved away from the reservation more than 50 years ago to find a job, then returned after retiring. "In the 1950s there were no jobs here," said Mandan, 80. Now she's seeing tribal members moving to the reservation for work.

Chuck Hale worked as a roughneck in other states before returning to his home near New Town to take a good-paying oilfield job. "It's tough work and it's damn cold," Hale said. "But it's worth it."

Mandan worries about the effects of the instant wealth. "It can be good but only if people know how to use the money," she said.

Wilkinson Jr., the casino general manager, said casino revenue jumped from $4.5 million in 2008 to $7.2 million in 2009.

He said he had advised tribal elders "to have fun at the casino but don't spend it all there. I've told them to invest it in something useful, like ... their house and kids and grandkids, and send them to college."

***

say  "YAY!"


Inexplicable Shot




As I uploaded my pictures from my camera this morning, I found this one in the middle of all my other photos.

As you all know by now, I do encounter a wee bit of the paranormal in my home.
Nothing scary ever. Mostly just 'weird' (for lack of a better word).

I really don't 'see' anything out of the ordinary here.
Knowing I have not gone anywhere inbetween these pictures.
Save for the fact that this is not my house!

Please explain?

XOXO
Anne

PS: I Have a Double-Basin Sink!


These drips are the good ones!


Good Morning Everyone!
Just doing a bit more catching up...

1.   When Casey was brought in for her latest two surgeries, she didn't get the same pre~op staff she'd had for the last two.
So she had to make her mark all over again while we waited for her to be taken down to the OR.

CaseyFace
She only LOOKS innocent.
.

Silly Casey
She had to fill out her patient board.
And had a very good time doing so! hehehe
.
.

Nurse Tim, New Jewelry for Casey
Nurse Tim even gave her jewelry!
.
.
.
2.   I am happy that some of you (13 out of 27), were willing to share what you drive. 
How would you feel if you drove a Toyota right now?

3.   As a sidenote, I believe I am a dying breed. Those of us raised by parents who were proud veterans, who remembered Pearl Harbor- Who would not allow "Jap~Crap" in their driveways if they were paid to do so. (No offense meant- re: the reference above).
I have always driven American made cars. This is a carryover from my parents and the pride they had in their country. This is how I was raised.

4.  We have had some 'wunnaful' weather lately.
Punk and I have spent a great deal of time outside.
I get real Vitamin D, and she gets pooped out. hehehe


Check the temp!
.
.
.
Cnv0086
No outerwear required!
Nice!
.
.
And here, just to show you that the sun was not on the thermometer...

.
Cnv0087
And hadn't been for quite some time!

Spring is just around the corner! Say YAY!
.
.
.


Cnv0077
There is still much snow everywhere.
It doesn't even slow this puppy down...
.
.
.
Cnv0085 ..... Cnv0094
She laid down in the snow after chasing her shadow in the mud.

***  I always pick up an cheap extra blanket when I go to Goodwill.
When I get them home, and after laundering in bleach, I cut them in half and stitch the raw seams. 
These work wonders to clean the muddy dog when she comes back inside.
.
.
.
5.   Somebody killed a sparrow and left the evidence behind...
.
.
.

Cnv0090

.
I think I know who it was...
.
.

Cnv0089
hehehe



I cannot tell a lie... It really wasn't Sputnik-
But I do have an abominable lack of birds! Not sure why? 
My cardinals are here, still both of my feeders have been full for over a week!

This really concerns me too. 
I miss my chickadees very much. We "talk" to each other.

Come to think of it, I haven't seen my squirrels either.
(Though Punk sees the dang 'wabbits' all the time, and takes off like a shot).

6. 
That nice weather has now disappeared behind the clouds. We have had snow for 2 days now.

The Punk lost her toy this morning..

.


Lost Toy.  :-(
Somewhere...
.
.
I really can't complain about the snow. It has been a decent amount this year. Not like where my Aunt Marlene lives in Philadelphia- (I think I heard they will be getting even MORE in the next day or so)!


.
7. 
Garbage and Recycle Day today- 
My dumpsters were both frozen to the ground!


.
.

Dumpsters

I did manage to free them and get them down to the end of the driveway.
No I didn't kick them either. hehehe

I wasn't able to take the garbage down last week, so it was kind of full.
The recycle one hadn't been emptied for over a month! Oops.
We had left before it got emptied that one week, so it was full even though we were gone all that time.

A big thank you to my Dearest KelliBaby too! 
She did take the trash one out-
Know that our recycling bins only get picked up every other week. It was an 'off'~week when she'd brought it down.

.
.
8.  The road out front this morning was almost invisible...
.
.
.


My road?

.
.
.
9.  But the snow does not stop the buses from being on time.
.
.
.

Bus Stop
If you look closely you can see the warning red lights on that bus.
.
.
.

10. Punk was so excited that even made her very own snow angel.
.
.
Ready to Roll
Kinda? Sorta? !
Sorry- I wasn't fast enough to get her while she was upside down and rolling.


Hope you all have a "wunnaful" Wednesday!
I still have my running around to do. Maybe after I hear a snowplow...

Love to all

XOXO
Me

Kitchen Sink Mixture- (A 10 Thought Tuesday).

What to do with an errant eyelash?
Isn't there supposed to be some way to make a wish on it?
.
.
.
Good Morning Everyone!
I hate that I cannot blog every day. Gone are the days of being able to sit and write.  God definitely deals humility.


1. 
I have been online, just not on here as much as I need to be to keep up with everyone-
A gal that I "met" through one of the pancreatitis groups (Lori) will be having her TP/AIT this Thursay. She has her presurgery visit today with Dr. Sutherland. Please wish her well. I have tried to impart a few of Casey's experiences to her. We have been writing back and forth a lot. Weird that she lives only 30 miles away! hehehe
Small world indeed! I can't wait for Casey and Lori to compare notes and scars!

2.  At one of those pancreatitis groups I have been called a "cultist" for passing on Casey's experiences with Dr. Sutherland. This, by a man who is older, and chose not to have this done (11 years ago?).
Those of us that have faith in Dr. S. are also "adjudicating, petty, and "Bent Out of Shape" by this Andre person.
Hmmm...


3. 
Mean people suck.

4. 
Casey is doing quite well. Still healing of course, but better and better with each day too.

5.  I am being, and have been, "stalked" by a former 'friend' from 360. She follows me everywhere on here, ingratiating? her bitter self to/upon unsuspecting contacts of mine. While we do not agree on many things, I believe we should agree that this is a good thing.
Like a little lost chicken. (And I do mean "chicken"). Bawk bawk
Too funny.

6. 
SERIOUSLY! - A PHILOSOPHICAL GOLF PRO?  Good one, RT!

7.  Do you love the person? Or their gender?  Please click to answer CAB's poll.


8.  I am upset that our Presidents health words did not contain the Public Option.
The White House has written a great blog about it too. It is entitled, "

Will the Republicans Post Their Health Plan… and When?
Happy I do not have Blue Cross and Blue Shield as they are upping their premiums by 30%! Good grief! I am sure they will not be the only ones, just the 1st.


9.  I have a ton of running to do today. AND I also have to clean house.
I do not like these days especially much.


10.  Last, but in no way least, Master Gabriel's adoption will be finalized soon.
As Mama~Kristin says, 'it is a double edge sword' for me. Know that I wholly support this family and their adoption of my grandbaby. Know too, that I have hated feeling like the impotent grandmother from the get~go.
(Credit where credit is due, I do blame Roberta for that feeling).


All this, and more, on my mind today. Heck, I might even do ten more tomorrow.

Love to all.

XOXO
Me aka
adjudicating, petty, and bent~out~of~shape
(And I cringed at "mizzuss")? hehehe



Car Question for Everyone


...And not enough "givens" for a poll.

What kind of car do you drive?
Why?



I shall have a new blog shortly- but in the meanwhile I am just curious...

XOXO
Me



Voters trust Obama over GOP on wide range of issues -

http://thehill.com/blogs/blog-briefing-room/news/82445-poll-shows-voters-trust-obama-over-gop-on-wide-range-of-issues
From The Hill's Blog Briefing Room

Poll shows voters trust Obama over GOP on wide range of issues
By Michael O'Brien -
02/20/10 01:00 PM ET

Voters trust President Barack Obama more than Republicans on a host of major issues, a new poll found this weekend.

A new Newsweek poll released this weekend shows that voters trust Obama on issues ranging from the economy and budget to handling wars and national security more than they do Republicans.

Republicans did edge Obama in one area, though: the use of military courts versus civilian trials to prosecute suspects in terrorism cases.

Voters, though, expressed confidence in the president on a number of other issues.

49 percent said they prefer Obama's approach on job creation, compared to 26 percent who prefer Republicans in Congress. 46 percent said they favor Obama's approach on the economy, as well, while 30 percent backed the GOP.

And on some traditionally Republican issues, 44 percent favor Obama's approach on tax policy to 34 percent for Republicans. 42 percent also trust Obama to handle the debt and federal deficit, compared to 33 percent who trust Republicans.

Obama also maintained an edge on a number of war and national security issues.

46 percent like Obama's approach to the war in Afghanistan, while 27 percent like Republicans' ideas. 45 percent also back the president's handling of the war in Iraq, while 30 percent would prefer to see the GOP in charge. 40 percent said they prefer Obama's handling of Iran, while 30 percent prefer Republicans.

38 percent, though, like the GOP's approach to prosecuting terrorists over the 34 percent who prefer Obama's approach. Republicans have hammered away on the administration's handling of this issue over the past two months, making it a top issue in the special election of Sen. Scott Brown (R-Mass.), as well.

Obama also enjoys a wide margin over Republicans when it comes to his climate change legislation. 38 percent say they'd prefer to see Obama's approach prevail, over 26 percent who like Republicans' plans.

The Newsweek poll, conducted by Princeton Survey Research Associates International from Feb. 17-18, has a 3.6 percent margin of error.

*****

Hi All;
I know this strays away from my healthcare articles, but I did find it very interesting.
Telling too that I have found that most who will not agree will not be able to support their own conclusions. (Why is that)?

I will be blogging shortly but I just thought you may find this as interesting as I do.

So... What say you?

XOXO
Me

"Hide~Doah?"


(from the Greek: τῆλε, tēle, "far" and φωνή, phōnē, "voice")


Happy Saturday;
Once again, I have not blogged in ages.
Nor have I visited.
My bad.

More than a few times lately my phone has rung...
Here is just one of the latest examples:

Phone goes: "RING" - "RING"

Naturally I say "Hello!"

And this is what I hear.
"Hide-Doh? Deddizz?"

Huh?!?   ....  (I mean 'what')?!?

Hmmmmmmmm...  


(
Aw hell, I'll just start over)...


"Hello?"
This is what I hear.
"Hide-Doh? Deddizz?"

Wait a second... Seems as I recall there has been a "Deddizz" ...
But it ain't me.    -----   Is it?!? 
I check quick-like.    ----- Nope.  It ain't me.

I say "No Sir, no Deddizz here."

He asks "Izz dizz riyot?"

He proceeds to say something barely intelligible.

Huh?!? ..... (I mean 'what')?!?


WAIT!!!!

A "riot"?!?  

Is there a riot here????
Yikes!

Wait.. That sounded kinda familiar...
Maybe?- WAS- my phone numberEven in Swahili I guess

He persists.
"I am so and so, from MC...-"...  (some dang thing or another that I cannot understand).

"I am so and so, calling for Deddizz."
Yeah Buddy, I got that...

I say, "No Deddizz here. Sorry."

He persists even more.
Are you Mrs. Deddizz *******?"

(Yeah well I was- )
--- at one short point in my life,
many,
many,
many moons ago...


(
but I don't tell him that)...

I say "He is not here"

"Oh Mizzuss ******* ..."
...
...
...
".................blah blah blah.................."


I cut him off.

"There is no Deddizz ******* here."


"Mizzuss *******. We nidz to speeeeek wit Deddizz."
Still not here. Sorry fella.

"He hasn't been here for a while."

"Mizzuss..." (repeat all sorts of  "blah, blah, blah").

I say, "Not here."

"Mizzuss *******. We nidz to speeeeek wit Deddizz."
Still not here. Sorry fella.


"Deddizz does not live here."


CLICK! goes the line. 

...In MY ear?

Aw shucks, and I was having so much fun...
Oh maybe they will call back.

Have a wunnaful weekend!

XOXO
"Mizzuss"

Huh?
  ...  (I mean 'what')?!?            


photo from Google search

"Lost" in Think...


G
ood Morning All;
I hope all is well in your little corner of reality.
I know I am way far behind- I promise to try to keep up better. I have had the need to be more involved at the pancreatitis group that I am part of. I shall post a note about that after this...


I found this within an email from About.com.


Quote of the week:

"The search for the truth is an important search, and if it isn't, we're lost in all kinds of ways.
  • We're lost in the fields of Holocaust denial.

  • We're lost in being able to compare what is good and what is bad because we can't agree what actually happened.

  • We're lost when it comes to guarding minorities against populist agitation.

Nobody's going to die from saying Shakespeare wasn't Shakespeare, but in other areas, when the truth suffers, our [own] decision making suffers.

When there is no authority to the truth, prejudices thrive.
"
D. Aaronovitch

***


I understand the quotation.
What I don't understand is why it had to be penned in the first place.


What do you think?
-Are we truly that prejudiced against our fellow human beings?
-Are we that narrow?
-Are we that stupid?
-Are we that blind?
-Are we that cold?
-What else may have suffered along the way?
-Whom has suffered?
-When will it [ever?] be enough?

I believe your answers may make my heart sad.


Have a 'wunnaful' day
Love to all.

XOXO
Me




Bliss on a Pillow



Good Morning All;
Before we left for Casey's last two surgeries, I had parked Casey's car in the garage here.

When we got back, I had changed the cars around- Mine inside, hers outside.
Yes, they would both fit if my garage wasn't so darn full of 'stuff'. But such is obviously not the case, so out hers went.

Having my own car in the garage makes it much easier for me to get in/out of the car, not having to deal with the snow and the ice under my feet; and not having to clean it off either.

On Saturday I had to go into town.  And dangitall, if my garage door hadn't frozen solid to the apron. I tried the long ice scraper...
No luck, so I tried it on the outside of the garage door too. When that didn't work, I was quite upset and kicked the garage door.
(Unfortunately I kicked that door with the same foot that has an ingrown toenail). 
Then to add a little more insult to injury I saw the dent I left in the door.
Oops...

But alas!,    I still have Casey's car here, so I cleaned that off, came back in the house for her keys, (it fired right up), and off we
(me and The Punk) went!

I stopped to fill her car up with gas, and drove on into town. Wanting to call before I got there, I realized I had left my cell phone at home. Oh well.

We returned home about 11:30, and I was very tired too. Looking forward to being able to sleep, I grabbed my purse and got out of the car.
After digging in my bottomless purse for about 5 minutes,  I realized I had no key to get in the house.  I must have set my own keys down when I had returned to the house to grab Casey's keys...
So to get back in that little car and drive right back into town- this time to Casey's.  (No phone to wake her or to warn her I was coming either). 

I could have gone to Kelli and Tim's, but Kelli had just put in an awful week- A friend of hers had lost her husband in a freak snowmobile accident. His funeral had been Friday- so Saturday had been Kelli's day of rest.
I was n
ot about to go pound on their door at 11:30 at night.

Thankfully Casey was still up- although having her buzzer go off at midnight was a bit unsettling for her...
We had a nice visit too. And I was given her key, with a bit of a giggle.
Suffice to say that Saturday/Sunday sleep was bliss on a pillow!

Life goes on. 
I'd better close. I have a dent to go hammer out, and must find my rubber hammer first.
Later, I shall go soak my foot, then add a dab of Novocaine to that toe and fix that too.

Hope all is well with everyone- or at least better than here! hehehe

XOXO
Me

H1N1 Flu- (Last Post)


http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm#UnderCounting#UnderCounting

CDC Estimates of 2009 H1N1 Influenza Cases,
Hospitalizations and Deaths in the United States,
April 2009 – January 16, 2010

February 12, 2010 1:00 PM ET

April – December 12, 2009 Estimates
April – November 14, 2009 Estimates
April – October 17, 2009 Estimates

Background

Estimating the number of individual flu cases in the United States is very challenging because many people with flu don’t seek medical care and only a small number of those that do seek care are tested. More people who are hospitalized or die of flu-related causes are tested and reported, but under-reporting of hospitalizations and deaths occurs as well. For this reason CDC monitors influenza activity levels and trends and virus characteristics through a nationwide surveillance system and uses statistical modeling to estimate the burden of flu illness (including hospitalizations and deaths) in the United States.

When the 2009 H1N1 flu outbreak began in April 2009, CDC began tracking and reporting the number of laboratory-confirmed 2009 H1N1 cases, hospitalizations and deaths as reported by states to CDC. These initial case counts (which were discontinued on July 24, 2009), and subsequent ongoing laboratory-confirmed reports of hospitalizations and deaths, are thought to represent a significant undercount of the actual number of 2009 H1N1 flu cases in the United States. A paper in Emerging Infectious Diseases authored by CDC staff entitled “Estimates of the Prevalence of Pandemic (H1N1) 2009, United States, April–July 2009” reported on a study to estimate the prevalence of 2009 H1N1 based on the number of laboratory-confirmed cases reported to CDC. Correcting for under-ascertainment, the study found that every case of 2009 H1N1 reported from April – July represented an estimated 79 total cases, and every hospitalized case reported may have represented an average of 2.7 total hospitalized people. CDC then began working on a way to estimate, in an ongoing way, the impact of the 2009 H1N1 pandemic on the U.S. in terms of 2009 H1N1 cases, hospitalizations and deaths. CDC developed a method to provide an estimated range of the total number of 2009 H1N1 cases, hospitalizations and deaths in the United States by age group using data on flu associated hospitalizations collected through CDC’s Emerging Infections Program.[e1]

The Numbers

(Print table Adobe PDF file)

On November 12, 2009 CDC provided the first set of estimates on the numbers of 2009 H1N1 cases and related hospitalizations and deaths in the United States between April and October 17, 2009.

Estimates from April – October 17, 2009:

  • CDC estimated that between 14 million and 34 million cases of 2009 H1N1 occurred between April and October 17, 2009. The mid-level in this range was about 22 million people infected with 2009 H1N1.
  • CDC estimated that between about 63,000 and 153,000 2009 H1N1-related hospitalizations occurred between April and October 17, 2009. The mid-level in this range was about 98,000 H1N1-related hospitalizations.
  • CDC estimated that between about 2,500 and 6,000 2009 H1N1-related deaths occurred between April and October 17, 2009. The mid-level in this range was about 3,900 2009 H1N1-related deaths.

Updated Estimates from April – November 14, 2009

Using the same methodology CDC updated the estimates to include the time period from April through November 14, 2009 on December 10, 2009.

  • CDC estimated that between 34 million and 67 million cases of 2009 H1N1 occurred between April and November 14, 2009. The mid-level in this range was about 47 million people infected with 2009 H1N1.
  • CDC estimated that between about 154,000 and 303,000 2009 H1N1-related hospitalizations occurred between April and November 14, 2009. The mid-level in this range was about 213,000 H1N1-related hospitalizations.
  • CDC estimated that between about 7,070 and 13,930 2009 H1N1-related deaths occurred between April and November 14, 2009. The mid-level in this range was about 9,820 2009 H1N1-related deaths.

Updated Estimates from April – December 12, 2009

Using the same methodology CDC has updated the estimates to include the time period from April through December 12, 2009.

  • CDC estimates that between 39 million and 80 million cases of 2009 H1N1 occurred between April and December 12, 2009. The mid-level in this range is about 55 million people infected with 2009 H1N1.
  • CDC estimates that between about 173,000 and 362,000 2009 H1N1-related hospitalizations occurred between April and December 12, 2009. The mid-level in this range is about 246,000 H1N1-related hospitalizations.
  • CDC estimates that between about 7,880 and 16,460 2009 H1N1-related deaths occurred between April and December 12, 2009. The mid-level in this range is about 11,160 2009 H1N1-related deaths.

Updated Estimates from April 2009 – January 16, 2010

Using the same methodology CDC has again updated the estimates to include the time period from April 2009 through January 16, 2010 on February 12, 2010.

  • CDC estimates that between 41 million and 84 million cases of 2009 H1N1 occurred between April 2009 and January 16, 2010. The mid-level in this range is about 57 million people infected with 2009 H1N1.
  • CDC estimates that between about 183,000 and 378,000 H1N1-related hospitalizations occurred between April 2009 and January 16, 2010. The mid-level in this range is about 257,000 2009 H1N1-related hospitalizations.
  • CDC estimates that between about 8,330 and 17,160 2009 H1N1-related deaths occurred between April 2009 and January 16, 2010. The mid-level in this range is about 11,690 2009 H1N1-related deaths.

 

Note: Less than 5% of increases in the estimates from one reporting date to the next are the result of delayed reporting in cases, hospitalizations and deaths.

top of page

CDC Estimates of 2009 H1N1 Cases and Related Hospitalizations and Deaths from April 2009 - January 16, 2010, By Age Group

2009 H1N1 Mid-Level Range* Estimated Range *
Cases    
0-17 years ~19 million ~13 million to ~27 million
18-64 years ~33 million ~24 million to ~49 million
65 years and older ~5 million ~4 million to ~8 million
Cases Total ~57 million ~41 million to ~84 million
Hospitalizations    
0-17 years ~82,000 ~58,000 to ~120,000
18-64 years ~150,000 ~107,000 to ~221,000
65 years and older ~25,000 ~18,000 to ~37,000
Hospitalizations Total ~257,000 ~183,000 to ~378,000
Deaths    
0-17 years ~1,230 ~880 to ~1,810
18-64 years ~8,980 ~6,390 to ~13, 170
65 years and older ~1,480 ~1,060 to ~2,180
Deaths Total ~11,690 ~8,330 to ~17,160

* Deaths have been rounded to the nearest ten. Hospitalizations have been rounded to the nearest thousand and cases have been rounded to the nearest million. Exact numbers also are available.

The latest estimates released on February 12, 2010 incorporate an additional 5 weeks of flu data (from December 13, 2009 through January 16, 2010) from the previous estimates released on January 15, 2010.

The latest estimates through January 16, 2010 show a relatively small increase in the total number of 2009 H1N1 cases, hospitalizations and deaths since the previous estimates posted on January 15, 2010. The additional five weeks of flu activity data added to the get these updated estimates correlate with a five week period of generally low flu activity in the United States.

The United States experienced its first wave of 2009 H1N1 pandemic activity in the spring of 2009, followed by a second wave of 2009 H1N1 activity in the fall. Activity peaked during the second week in October and then declined quickly to below baseline levels in January. The early rise in flu activity in October is in contrast to non-pandemic influenza seasons. Influenza activity usually peaks in January, February or March. (See graph of peak influenza activity by month in the United States from 1976-2009.) Because 2009 H1N1 activity peaked in late October, the greatest increase in the number of estimated 2009 H1N1 cases, hospitalizations and deaths occurred during the period of April through November 14, 2009. The estimates provided for the subsequent 4 weeks (through December 12, 2009) showed a modest increase in the total number of 2009 H1N1 cases, hospitalizations and deaths and correlated with decreasing but still elevated flu activity nationwide. The most recent estimates updated with data from December 13, 2009 through January 16, 2010, correlate with a five week period of generally low flu activity.

Visits to doctors for influenza-like illness (ILI) in general were low between December 13, 2009 and January 16, 2010 and were either at or near the national baseline during all five weeks. During the week of December 13-19, 2009 (week 50), ILI was at the national baseline of 2.4%. It rose slightly during the week of December 20-26, 2009 (week 51) to 3.2%, decreased slightly, but stayed just above the national baseline at 2.4% during the week of December 27, 2009-January 2, 2010 (week 52), but then fell the next two weeks to below the national baseline at 1.9% during the week of January 3-9, 2010 (week 1) and 1.8% during January 10-16, 2010 (week 2). Similarly, the number of states reporting widespread flu activity declined throughout this time from a high of 7 states reporting widespread activity during the week of December 13-19, 2009 (week 50) to 4 states reporting widespread activity from December 20-26 (week 51), to one state reporting widespread activity the week of December 27, 2009-January 2, 2010 (week 52). For the weeks of January 3-9 and January 10-16, 2010 (week 1 and 2 respectively), no states reported widespread flu activity.

While activity so far this season peaked in October and then declined quickly to below baseline levels in January, there are still uncertainties surrounding the rest of this flu season, including the possibility of increases in circulation of seasonal influenza viruses and increases in circulation of 2009 H1N1 viruses.  In past pandemics, flu activity has occurred in waves and it’s possible that the United States could experience another wave of flu activity. In addition, sporadic cases of influenza may also be detected in the summer.

The data by age provided in the updated estimates continues to confirm that people younger than 65 years of age are more severely affected by this disease relative to people 65 and older compared with seasonal flu. With seasonal influenza, about 60 percent of seasonal flu-related hospitalizations and 90 percent of flu-related deaths occur in people 65 years and older. With 2009 H1N1, approximately 90% of estimated hospitalizations and 87% of estimated deaths from April through January 16, 2009 occurred in people younger than 65 years old. CDC is continuing to recommend vaccination against 2009 H1N1 at this time for all people 6 months and older, including those people 65 years of age and older because severe illness and deaths have occurred in this age group.

This methodology and the resulting estimates continue to underscore the substantial under-reporting that occurs when laboratory-confirmed outcomes are the sole method used to capture hospitalizations and deaths. CDC has maintained since the beginning of this outbreak that laboratory-confirmed data on hospitalizations and deaths reported to CDC is an underestimation of the true number that have occurred because of incomplete testing, inaccurate test results, or diagnosis that attribute hospitalizations and deaths to other causes, for example, secondary complications to influenza. (Information about surveillance and reporting for 2009 H1N1 is available at Questions and Answers: Monitoring Influenza Activity, Including 2009 H1N1.)

The estimates derived from this methodology provide the public, public health officials and policy makers a sense of the health impact of the 2009 H1N1 pandemic. While these numbers are an estimate, CDC feels that they present a fuller picture of the burden of 2009 H1N1 disease on the United States.

CDC will continue to use weekly data from systems that comprise the National Influenza Surveillance System to monitor geographic, temporal and virologic trends in influenza in the nation.

Method to Estimate 2009 H1N1 Cases, Hospitalizations and Deaths

CDC has developed a method to provide an estimated range of the total number of 2009 H1N1 cases, hospitalizations and deaths in the United States since April, 2009, as well as a breakdown of these estimates by age groups. This method uses data on influenza-associated hospitalizations collected through CDC’s Emerging Infections Program (EIP), which conducts surveillance for laboratory-confirmed influenza-related hospitalizations in children and adults in 62 counties covering 13 metropolitan areas of 10 states. To determine an estimated number of 2009 H1N1 hospitalizations nationwide, the EIP hospitalization data are extrapolated to the entire U.S. population and then corrected for factors that may result in under-reporting using a multiplier from “Estimates of the Prevalence of Pandemic (H1N1) 2009, United States, April–July 2009.”.  Adobe PDF file The lower and upper hospitalization estimates also are calculated using the EIP hospitalization data. The national hospitalization estimates are then used to calculate deaths and cases. Deaths are calculated by using the proportion of laboratory-confirmed deaths to hospitalizations reported through CDC’s web-based Aggregate Hospitalization and Death Reporting Activity (AHDRA).
Cases are estimated using multipliers derived from “Estimates of the Prevalence of Pandemic (H1N1) 2009, United States, April–July 2009.” Adobe PDF file
The lower and upper end of the ranges for deaths and cases are derived from the lower and upper hospitalization estimates. The methods used to estimate impact may be modified as more information becomes available. More information about this methodology is available.

Throughout the remainder of the 2009 H1N1 pandemic CDC will update the range of estimated 2009 H1N1 cases, hospitalizations and deaths every three or four weeks. While EIP data is reported weekly during influenza season, because the system is based on reviews of patients medical charts there are sometimes delays in reporting and it can take some time for all the data to fill in. CDC will continue to provide weekly reports of influenza activity each Friday in FluView and will update the 2009 H1N1 Situation Update each Friday as well.

The estimated ranges of cases, hospitalizations and deaths generated by this method provide a sense of scale in terms of the burden of disease caused by 2009 H1N1. It may never be possible to validate the accuracy of these figures. The true number of cases, hospitalizations and deaths may lie within the range provided or it’s also possible that it may lie outside the range. The underlying assumption in this method is that the level of influenza activity (based on hospitalization rates) in EIP sites matches the level of influenza like illness (ILI) activity across the states.

This methodology is not a predictive tool and cannot be used to forecast the number of cases, hospitalizations and deaths that will occur going forward over the course of the pandemic because they are based on actual surveillance data.

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Background Emerging Infections Program

The Emerging Infections Program (EIP) Influenza Project conducts surveillance for laboratory-confirmed influenza-related hospitalizations in children and adults in 62 counties covering 13 metropolitan areas of 10 states. (This includes San Francisco, CA; Denver, CO; New Haven, CT; Atlanta, GA; Baltimore, MD; Minneapolis/St. Paul, MN; Albuquerque, NM; Santa Fe, NM, Las Cruces, NM; Albany, NY; Rochester, NY; Portland, OR; and Nashville, TN.) Cases are identified by reviewing hospital laboratory and admission databases and infection control logs for children and adults with a documented positive influenza test conducted as a part of routine patient care. EIP estimated hospitalization rates are reported every week during the flu season. More information about the Emerging Infections Program is available.

Seasonal Influenza-Associated Hospitalizations in the United States

An average estimated 200,000 flu-related hospitalizations occur in the United States each year, with about 60 percent of these hospitalizations occurring in people 65 years and older.

Background: A study conducted by CDC and published in the Journal of American Medical Association (JAMA) in September 2004External Web Site Icon provided information on the number of people in the United States that are hospitalized from seasonal influenza-related complications each year. The study concluded that, on average, more than 200,000 people in the United States are hospitalized each year for respiratory and heart conditions illnesses associated with seasonal influenza virus infections. The study looked at hospital records from 1979 to 2001. In 1979, there were 120,929 flu-related hospitalizations. The number was lower in some years after that, but there was an overall upward trend. During the 1990s, the average number of people hospitalized was more than 200,000 but individual seasons ranged from a low of 157,911 in 1990-91 to a high of 430,960 in 1997-98. 

More information about seasonal flu-related hospitalizations is available.

Seasonal Influenza-Associated Deaths

Flu-associated mortality varies by season because flu seasons often fluctuate in length and severity. CDC estimates that about 36,000 people died of flu-related causes each year, on average, during the 1990s in the United States with 90 percent of these deaths occurring in people 65 years and older. This includes people dying from secondary complications of the flu.

Background: This estimate came from a 2003 Journal of the American Medical Association (JAMA) studyExternal Web Site Icon, which looked at the 1990-91 through the 1998-99 flu seasons and is based on the number of people whose underlying cause of death on their death certificate was listed as a respiratory or circulatory disease. During these years, the number of estimated deaths ranged from 17,000 to 52,000. This number was corroborated in 2009, when a CDC-authored study was published in the journal Influenza and Other Respiratory VirusesExternal Web Site Icon. This study estimated seasonal flu-related deaths comparing different methods, including the methods used in the 2003 JAMA study but using more recent data. Results from this study showed that during this time period, 36,171 flu-related deaths occurred per year, on average.
More information about how CDC estimates seasonal flu-related deaths is available.

Under-Counting of Flu-Related Deaths

CDC does not know exactly how many people die from seasonal flu each year. There are several reasons for this:

    • First, states are not required to report individual seasonal flu cases or deaths of people older than 18 years of age to CDC.
    • Second, seasonal influenza is infrequently listed on death certificates of people who die from flu-related complications.
    • Third, many seasonal flu-related deaths occur one or two weeks after a person’s initial infection, either because the person may develop a secondary bacterial co-infection (such as a staph infection) or because seasonal influenza can aggravate an existing chronic illness (such as congestive heart failure or chronic obstructive pulmonary disease).
    • Also, most people who die from seasonal flu-related complications are not tested for flu, or they seek medical care later in their illness when seasonal influenza can no longer be detected from respiratory samples. Influenza tests are most likely to detect influenza if performed soon after onset of illness. In addition, some patients may be tested for influenza using rapid tests that are only moderately sensitive and result in some false-negative results.
    • For these reasons, many flu-related deaths may not be recorded on death certificates.

These are some of the reasons that CDC and other public health agencies in the United States and other countries use statistical models to estimate the annual number of seasonal flu-related deaths. (Flu deaths in children were made a nationally notifiable condition in 2004, and since then, states have reported flu-related child deaths in the United States through the Influenza Associated Pediatric Mortality Surveillance System).

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Photo from CDC on Flickr. © All rights reserved.
Caption reads: This negative stained transmission electron micrograph (TEM) shows recreated 1918 influenza virions that were collected from supernatants of 1918-infected Madin-Darby Canine Kidney (MDCK) cells cultures 18 hours after infection."

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Unless something very odd happens, I believe this will be my last post on this terrible flu.
It has been so very interesting to watch this all unfold.
Have you known anyone? Lost anyone? Were you vaccinated?
I know a few people that did get this flu- And fortunately did live through it.
My heart goes out to those of you that have lost someone, or are still suffering.

God Bless.

XOXO
Anne


Thinking Cap$ on Please. (I Need Your Help).


Good Evening...
I am (almost) lost for words.
(I owe you BIGTIME if you can even get through the whole sordid mess)!

I know a lady that goes to the same pain center that Casey and I do.
She is a very nice lady. Well, unless you cross her. hehehe
(I really HAD to include that- As a show of deep respect and admiration).

She went in yesterday to get her prescriptions renewed for another month.

* Note:
If you have never gone to a pain management specialist doctor, you must go in every 30 days to have your pain meds refilled.
Upon your arrival to the clinic, they have a questionnaire for you to fill out, about 5 pages of different stuff.
You MUST fill every page completely.
I respect that they have you do this- Not for their own culpability, but to refresh the patients mind also.

One of the pages states something to the effect of, "I know it is harmful & dangerous to abruptly discontinue the use of these medications without doctor recommendation, supervision and guidance." 

You must check each box that you have read it each time. 
You must sign every page etc etc etc.

Thus begins her visit... Normal so far. hehehe

* Another Note:
She does not see her regular NP, rather an extra they have. New perhaps?

She indicates how much pain she has still been having- She is on extended~release morphine, in addition to something else for her breakthrough pain. I believe it is either oxycodone or vicoden.

This NP "ups" the morphine claiming that it "is less addictive" than her other pill that she takes for breakthrough pain; that when she hurts more, she should take an extra morphine pill instead of the other.

I really am at a loss to explain that to her. Hearing this makes no sense to me... But surely they know better than I do?
SO I remain mute. hehehe Really I do.
(Know that I will look it up for her- there has to be something online).
 
Since she had enough medications to last for exactly 30 days, she has none left. Keep in mind that going off either of these narcotics "cold turkey" as they say, will be dangerous to do.

She takes her 30 day refills prescriptions with her, and off to her pharmacy.
She has gotten these same meds refilled for a long time already, and at the same pharmacy.
They know her on sight, by name, and tell her the meds will be ready for pickup in about 20 minutes.

When she returns, she is told that her insurance will not pay for these medications. 
One is
$319.+. Another is $250.+, the third is $112.+

She asks, "Why not"
Stating, "They have always done so in the past?"

The pharmacy explains she must contact her doctor and her insurance company, and straighten this out. That they have no idea.

She contacts both places; leaving a message at the doctors office, and being put on hold at the insurance company 3 times for an extended period of time. So the insurance company is basically unreachable. (She was on hold 20 minutes at one point).
The doctors office calls her back. They agree to do any/all interceding on her behalf.

Later, the doctors office calls again, saying that it is all handled and that she will have her meds by that night.

She calls the pharmacy.
Nothing was ready. Nor had it even been approved with the insurance! 
She tells them to "please run it again" because she already knows it is approved.

Thinking that she will be fine until morning, she calls back the next day.
Her prescriptions have not been processed, approved, or filled.

Many "pass-the-buck" phone calls later, this is what she knows"
  1. The doctor tells her that it is in the pharmacy's hands.
  2. The pharmacy tells her it is in the insurance company's hands.
  3. The insurance company now tells her it is not a covered drug. (She will not be put through to a supervisor either).
    • She has received these same meds many times and they were ALWAYS covered.

    wtf!, Right?
Wow.
Again, I am at a loss for words.

She has been going to this pharmacy for her entire life. The pharmacy knows her. They have always gotten their money from her and/or her insurance.
This is a medicare advantage policy by the way.
Medicare Advantage policies are NOT Medicare. They are only a supplemental policy TO Medicare, and have nothing to do with the government.

This insurance company is on the east coast. With another phone call she learns that they apparently have not processed anything for 3 days, and are trying to catch up- The snowstorm put everything back, and they had been closed for those 3 days.

She cannot wait 3 days for her medications! To do so would jeopardize not only her pain, and her well being, but would add some very physical and nasty withdrawals to it.

She asks the pharmacy to please give her enough meds to cover those 3 business days, that she would pay for them herself.
No can do. It's all or nothing.
WHAT?!?

So... Who the hell is lying, and why?

Please know this is not Casey; although she has had her own problems with this clinic- Not ever with the doctor himself, but more specifically with the NP's (Nurse Practitioners). Lord knows the damned doctor doesn't have any time to spend with his patients to be able to piss them off in the 1st place.

Is your mind boggled yet?

This lady is also Native American- Choosing to use CVS instead of the clinic pharmacy because it is much closer to her home.

She calls the tribal pharmacy- Do they have these meds in stock?
Yes.
She calls CVS and asks for her written and signed scripts back, telling them when she would be there to pick them up.

She picks them up- One is written on, (the one she is already sick from withdrawing from), but they have attached a note for the Native Pharmacy to call them.

All is well.
She has her medications. (With a big smile from the pharmacist too)!

  • CVS has lost a very loyal customer. Her monthly medications are over $8800.00 annually. Now add in a sickness, or stitches, or a broken bone to that.
    • In addition to herself, lose her parents, her children, and grandchildren to add that lo$$ for CVS.

  • My guess is that the pain clinic will lose her also.
    • They lied to each other, one telling the other that it was all taken care of and covered.

  • She will also change her secondary insurance at the end of the year.

Do these insurance companys actually make people withdraw from their meds? Is that even legal?
Or like the one gal said to her, "well lady, we are not doctors!"

Somethings not right!

What's YOUR take?
Whose mess is this?
Is that NP correct about morphine being less addictive than the others?

Know that you are not permitted to be at a loss for words since I already am.
~<;-)

XOXO
Me


Life goes on...
I should not have said "all is well." But she DOES at least have her prescriptions, and that is a relief to her.
It will take some time for these drugs to actually help her again.