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Heart to heart

Lee Cowan has had a remarkable heart-to-heart talk with a woman who can tell us a LOT about hearts, all of it learned through the most trying of experiences: 

"My transplanted heart was coming to its abrupt end. It was not a case of, 'Let's try this medicine,' or 'Let's watch and wait.' No, it was over."

When Amy Silverstein sat down to write about her life, death was probably a little indignant. After all, Amy cheated death not once, but twice.

At the heart of Silverstein's story are her hearts -- yes, hearts . Silverstein has had three hearts so far, starting with the one she was born with. That one failed when she was just 24 years old, while she was out on a date.

"We were at dinner and all of a sudden, my heart started beating erratically," she recalled. 

What did it feel like?  "Just a pulsing that was very powerful -- boom boom boom , fast. I just remember saying, 'Don't let me die, don't let me die.'"

Turns out a virus had damaged her given heart beyond repair. Her only option was a transplant.

She was eventually matched with a heart from a 13-year-old donor, but living as a transplant patient wasn't the turnaround some might expect. The medication she was taking daily to keep her body from rejecting her new heart was nasty stuff -- with even nastier side effects.

Heart to heart

Amy Silverstein underwent a second heart transplant 25 years after her first donor heart began to fail.  

Family photo

Amy and Scott, the man she was out with on that fateful date, married a year to the day after she got the transplant. "I've spent most of my adult life trying to keep Amy alive," Scott said.

He had no illusions their life together would be easy, and it wasn't. 

"We've had an incredible love affair for 25 years," Scott said, "but day-to-day, it was filled with a lot of sickness, a lot of crisis, a lot of nights in the emergency room."

Her closest friends saw just how hard living really was -- not that Amy wasn't grateful. "We don't live inside of her body," said Lauren Stern. "And as close as we are, we don't know what it takes for her to get up and live every day, and be in discomfort and feel nauseous and sick."

"I fought to keep this heart going with every pill, with every heart biopsy, with every run I would take," Amy said.

"You took really good care of it," said Cowan.

"Such good care, such honoring of this gift that I had, but you know, when you're 25 years old and you feel so ill, it's just for me impossible to have gratitude just carry you along with a smile. I believe that you can be grateful and angry, grateful and sad, grateful and lonely."

Heart to heart

Grove

That sentiment made it into a book she penned back in 2007 called "Sick Girl" (Grove). In

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On her third heart

June 25, 2017, 9:44 AM

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Doctor charged in opioid deaths of patients

An Oklahoma doctor was charged Friday with second-degree murder in the overdose deaths of at least five patients from the powerful painkillers and other drugs she prescribed, often in combinations that made up an addict's "holy trinity" of pills, state investigators said. 

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How the Senate health care bill differs from the House version and Obamacare

Senate Republicans unveiled a "discussion draft" of their version of health care reform legislation to repeal and replace Obamacare Thursday morning, after setting aside the version of the bill the House passed last month. 

With only a slim Republican majority in the Senate, any dissent in the GOP could lead to the failure of the legislation, known as the Better Care Act. Five Republican senators have already said they cannot vote for the legislation as it stands. The Senate bill appeared shortly after White House press secretary Sean Spicer and President Trump himself said the administration  wants a bill with "heart. "

Mr. Trump on Thursday said the bill will need "a little negotiation, but it's going to be very good." He said he is "very supportive" of the bill.

Here is how the 2010 Affordable Care Act, also known as Obamacare, differs from the House's American Health Care Act  and how they both differ from what the Senate is offering

Penalizing people without insurance

  • Obamacare: Imposed financial penalties on people who don't have insurance.
  • House GOP bill: Removes financial penalties for those without insurance. Instead, insurers would be allowed to charge a 30 percent penalty above original premiums if an insured person's coverage is interrupted for 63 days. Eliminates individual and employer mandates.
  • Senate GOP bill: Removes financial penalties for those who don't have insurance, eliminates individual and employer mandates. On Saturday, Vox reported Senate Republicans plan to add a provision imposing a six-month waiting period for buying insurance for individuals who allow coverage to lapse.

Medicaid

  • Obamacare: Expanded the insurance program by raising income threshold; widened eligibility in states that expanded Medicaid.
  • House GOP bill: Phases out Medicaid expansion under Obamacare, freezing funding for the expansion in 2020.
  • Senate GOP bill:   Phases out additional funding  under Obamacare by 2024 in states that expanded Medicaid; allows states to choose between a block grant funding format and per-capita funding; allows states to impose a work requirement for people who aren't pregnant, disabled or elderly.

Coverage for people with pre-existing conditions 

  • Obamacare: Insurers cannot deny coverage to people with pre-existing conditions  
  • House GOP bill: Has loopholes that could mean people with pre-existing conditions are not guaranteed coverage by allowing states to apply for waivers that could eliminate "essential benefits" that insurers have to cover. Premiums for those with pre-existing conditions could increase substantially.
  • Senate GOP bill: Preserves more protections for people with pre-existing conditions than House bill, although critics say assurances are not as iron clad as those under Obamacare. States would not be allowed to obtain waivers for Obamacare rule banning insurers from charging those with pre-existing conditions higher premiums.

Essential health care benefits

  • Obamacare: Requires insurers to provide coverage for 10 essential health care needs, like ambulatory services, emergency services, mental health and substance disorder services and pregnancy care.
  • House GOP bill: Requires insurance companies to cover such essential health benefits, but allows states to apply for waivers to eliminate the requirement to cover those services.
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Doctor in rural Tennessee worries about health care bill's effects

June 23, 2017, 6:46 PM

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