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Tobacco to 21 is Progressing in the Hawaii State Legislature

Guest Blogger: Don Weisman, Hawaii Government Relations Director

As of April 1, Hawaii Senate Bill 1030, which proposes to raise the legal age to purchase tobacco products to 21, has passed through the required House and Senate committees. The next steps pending approval on the House floor, will be to move to a conference committee where House and Senate members will work out differences in their respective versions of the bill.

Tobacco to 21, as the issue is often referred, has taken on greater focus since a March 14 report issued by the Institute of Medicine (IOM) found that it could join higher tobacco taxes, comprehensive smoke-free air laws, and adequately funded community tobacco prevention, control and cessation programs as the cornerstones of effective reduction of tobacco addiction and use among minors. The IOM strongly concluded that boosting the tobacco sale age to 21 will have a substantial positive impact on public health and save lives. It found that raising the tobacco sale age will significantly reduce the number of adolescents and young adults who start smoking; reduce smoking-caused deaths; and immediately improve the health of adolescents, young adults and young mothers who would be deterred from smoking, as well as their children. Significantly, the greatest impact would be among adolescents 15-17 who would no longer be able to pass for legal age and would have a harder time obtaining cigarettes from their older friends and classmates.

Overall, the report predicts that raising the minimum age for the sale of tobacco products to 21 will, over time, reduce the smoking rate by about 12 percent and smoking-related deaths by 10 percent.

The American Heart Association is supporting the Hawaii state legislation. National data shows that 95 percent of adult smokers begin smoking before they turn 21. The ages of 18 to 21 are a critical period when many smokers move from experimental smoking to regular, daily use. While half of adult smokers become daily smokers before 18, four out of five do so before they turn 21. Increasing the tobacco sale age to 21 will help prevent these young people from ever starting to smoke. If passed, Hawaii would join at least 58 localities in 7 states – including Hawaii County and New York City – that have already raised the tobacco sale age to 21. California, Washington and New Jersey state legislatures are also currently considering similar bills.

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From the Bottom of our Hearts - Thank You!

National Volunteer Week (April 12-18) is right around the corner and we couldn’t let it pass without saying how much we appreciate all your contributions as a You’re the Cure advocate. It’s advocates like you who give their time, energy, and passion to help create healthier communities across the country.  We are deeply grateful for your commitment and talent as an advocate.

Since staff can’t always shake your hand and say thank you in person we’ve got a brief video to share. When you watch I am sure you too will be moved by all the great work happening in your states and communities and we look forward to more success in the future. Take a moment to check out the video and then encourage other to get involved and join in the fun.

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Ali and Rock Riggs

Alison “Ali” Riggs, and her husband Rock, are two of the AHA advocates helping to guide a bill through the Hawaii State Legislation this year that would require all newborns to be screened for critical congenital heart defects using pulse oximetry prior to discharge from their birthing center.

Below is their story:

 My 3-year-old daughter Grace was born with a severe heart defect. Her defect was not detected until she was six days old and was struggling to live. She spent the first eight months of her life in a children’s hospital, suffering unimaginable pain and fear.

We were extremely fortunate that she survived although her life will be a challenging one. If we would have known about her condition right away, her body, specifically her lungs, would most likely be stronger and her hospital stay and subsequent care would have been less.

A pulse-ox test is simple, painless, and inexpensive. Eight months in the neonatal intensive care unit is none of these. That’s why we’re strongly supporting the American Heart Association’s efforts to pass legislation requiring all babies to be screened prior to discharge. It will save and improve lives.

Ali and her husband have helped us educate lawmakers about this screening and its importance. Pulse oximetry is a simple, inexpensive, non-invasive screening tool used already by most hospitals that measures blood oxygen levels and pulse. When placed on a baby’s hand or foot it can indicate, if measures read low, the possibility of a congenital heart defect and the need for more extensive testing. Babies born with congenital heart defects sometimes don’t exhibit symptoms until days or weeks after being discharged and returning home. In critical cases, by the time the symptoms appear, and parents recognize them and return to the hospital, it might be too late to save the baby or long-term complications can occur. If identified early, many congenital heart defects can be corrected through advance treatments allowing the babies to go on to live relatively normal lives.

The Hawaii pulse oximetry screening bill passed out of the State Senate in March and was headed into a conference committee where final language was hoped to be agreed upon by House and Senate representatives. If approved it will move to Governor Ige’s desk for signature into law. Stay tuned for an update on the bill’s status in next month’s You’re The Cure newsletter.

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Update on the 2015 Legislative Session

Guest Blogger: Don Weisman, Hawaii Government Relations Director

AHA Priority Bills Still On Track As State Legislative Session Nears Half-Way Mark

Two of the American Heart Association’s priority bills were on track toward final passage into law as the Hawaii State Legislature neared the half-way point in its 2015 session: newborn heart screening and stroke data registry. 

(HB 467/SB 337) Newborn Heart Screening

HB 467/SSB 337 would require all newborns to be screened for critical congenital heart defects (CCHD) prior to discharge from their birthing center. One of the best ways to detect CCHD is through a simple, noninvasive, inexpensive test, called pulse oximetry, or pulse ox. The pulse ox test consists of sensors placed on a baby's hand and/or foot to check blood oxygen levels. It is a simple bedside test to determine the amount of oxygen in a baby's blood and the baby's pulse rate. Low levels of oxygen in the blood can be a sign of a CCHD. The test is painless and takes only a few minutes. If the baby’s levels are too low, additional tests may be conducted and advanced treatments pursued.

Congenital heart defects are the most common birth defect in the U.S. and the leading killer of infants with birth defects. Babies discharged from a birthing center without having a congenital heart defect diagnosed are at risk for having serious problems, or even death, within the first few days or weeks of life.

(HB 589) Stroke Data Registry

(HB 589) would establish a state stroke data registry. The bill passed its hearings in the House and was expected to pass a House floor vote before moving to the Senate for consideration. Establishment of a stroke registry in Hawaii could help illuminate weaknesses that exist in the state’s stroke system of care.

For example, data collected in a stroke registry may show poor patient education about stroke symptoms, geographical differences in the quality of stroke care received, problems with adherence to stroke treatment guidelines, or the need to improve pre-hospital stroke response or treatment by our county EMS agencies. The data could then catalyze Hawaii’s stroke stakeholders to find solutions to the challenges encountered.

Under the bill, all hospitals treating stroke patients would be required to use the AHA’s Get With The Guidelines-Stroke quality improvement tool to collect and share patient stroke data with the State Department of Health which would then work with the State Stroke Task Force, a coalition of representatives from stroke hospitals, EMS agencies, the Department of Health and the American Heart Association/American Stroke Association to assess the de-identified data and make recommendations to improve the state’s stroke system of care. Stroke is Hawaii’s third leading cause of death and a leading cause of disability.

Stay tuned for further action alerts to support these bills as they continue through the legislative process.

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The Csigi Family

For a parent, there may be no greater fear than losing a child.

Wojo and Cari Ann Csigi, of Waihee, experienced that loss in 2011 when their infant son Shayden died from complications related to congenital heart defects. Now they are finding solace through their support of the American Heart Association whose work includes efforts to improve outcomes for babies born with heart defects.

Shayden was born on July 19, 2011 six weeks pre-mature. After experiencing early signs of labor, Cari Ann called Kaiser Permanente, her medical provider and explained her symptoms. She was told to go immediately to her doctor who then had her transferred to Maui Memorial Medical Center. After an hour there, she was told that she would be transferred by air ambulance to Kaiser’s Medical Center on Oahu.

“My doctor explained to me that if I gave birth on Maui, my baby would be flown out to Oahu immediately after birth to receive the advanced care needed because he was pre-mature,” said Cari Ann. “I cried the whole plane ride over. Wojo met me and we were taken to Kaiser Moanalua Medical Center.”

“As I was wheeled into the operating room for a C-section I was super nervous, anxious and scared, but those feelings disappeared when I heard my baby boy cry for the first time,” Cari Ann continued. “Because he was six week premature, they had to take him immediately to the neonatal intensive care unit. When I finally got to hold him two days later he instantly stole my heart.”

“We were told that he may need to stay in the hospital until his original birth date. As the days went by, the hospital staff told us that Shayden was doing well and that he might be able to come home sooner. Then within three days of what we thought would be his release date, were told that they had discovered that Shayden had a heart defect and that he would have to be flown to San Diego for surgery as soon as possible. Everything happened so quickly.

Shayden had been diagnosed with a potentially life-threatening defect called aortic stenosis, a narrowing of the main artery carrying blood flow out of the heart to other organs in the body. In San Diego, he would undergo five different procedures, including two open heart surgeries. Following those procedures, doctors there were concerned that Shayden’s heart function wasn’t improving and suggested a transfer to Lucille Packard Children’s Hospital at Stanford. Wojo and Cari Ann, nervous and afraid, made the drive to the Bay area.

Shayden spent the next three and a half months at the Stanford Medical Center. In the first week he underwent a third open heart surgery. Two weeks later he went into cardiac arrest.

“That was the scariest day,” Cari Ann explained. “His blood pressure dropped, his heart rate dropped, his color changed; I thought that I was going to lose my baby that day. After 12 minutes of CPR they were able to revive him, but he was never the same after that.”

Cari Ann and Wojo said that many up and down days followed.  Shayden went through additional procedures to try and improve his condition. He contracted an infection in October and Cari Ann and Wojo were told that he might not recover, but the infection cleared. Kyra and Cari Ann’s mom were then able to visit for two weeks, the first time that Kyra and her parents had been together since their being in California.

“That was the best two weeks,” said Cari Ann. “I was so happy to finally spend time with my baby girl and my mom. Kyra got to spend time with her little brother. It was super hard to see them leave.”

One week later, Shayden contracted another infection. This time doctors sat Cari Ann and Wojo down and told them that they needed to prepare themselves and their family for the worst.

“Thanksgiving week was a really rough week for Shayden,” remembered Cari Ann. “As the days went by he began retaining fluid and got weaker. On Thanksgiving night, Wojo and I decided that it was time. While we still wanted to give Shayden every chance we could, we knew that he was telling us that he was ready to go.”

“The next day, our nurse called early and said that he was more swollen than he had ever been and that they had to increase his sedatives and turn up the rate of his ventilator to help him breathe. We got ready and went straight to the hospital.”

“When we walked into his room, I could see how swollen he was. Tears rolled down my face. We talked with our nurse and had the doctor, social worker and chaplain come in. Slowly they turned off the pumps for his medications and feeding. I got to hold him for a little while.”

“Throughout the day and night we watched as Shayden’s blood pressure and heart rate elevated then dropped, but he hung on. The hospital staff came in and talked and listened to music with us. It helped us to not feel so sad. At 1:23 a.m. on Saturday, Shayden passed. I think he was comfortable in leaving us. He could hear us with the others and knew that we would be OK. The staff let us give him a bath and put clothes on him. We got to hold him for a couple of hours, then it was time to say goodbye.”

“Losing Shayden was hard on our entire family and his memory is something we’ll carry with us the rest of our lives,” explained Wojo. “After his death, getting involved in supporting the American Heart Association has helped us to heal a little bit.”

Cari Ann’s and Wojo’s support for the American Heart Association has included organizing a team to participate in the Heart Walk event. They have also become members of the organization’s grassroots advocacy network called You’re The Cure, helping to support state legislation to improve methods used by Hawaii hospitals to screen all newborns for congenital birth defects using a technique called pulse oximetry screening.

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Poll Results are in on Sugar Sweetened Beverages and You Might Be Surprised

The American Heart Association and its coalition partners are working hard to reverse the obesity epidemic in Hawaii. While there is no one thing that will fix the problem we have seen that educating people on the amount of sugar in some of the most commonly consumed beverages helps to reduce the consumption of these beverages. Reduced consumption of these drinks can lead to better health.

We believe that another way consumption of sugar sweetened beverages can be reduced is through a small 1 cent per ounce fee added to the price of the drink.

The Hawaii Public Health Institute recently released polling data on SSB fees and found that the public is more supportive of this fee if the money generated from it goes to combating obesity in our state than state lawmakers believe.

The poll showed that 81% of those polled thought that consumption of SSB played either a significant or very significant role in the states obesity epidemic. And of those polled two-thirds supported the implementation of a 1 cent per ounce fee if all revenue generated from it went to programs designed to combat obesity, diabetes and heart disease in Hawaii. 

These polls show us that voter support is strong and that Hawaii residents know the obesity epidemic is a problem.

With help from advocates like you we hope that our work on this issue will be heard by lawmakers and they will ultimately support this 1 cent per ounce fee in order to help fight obesity in our state. Please keep your eyes open for our emails on this issue and take action when you are able.

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The American Heart Association's Go Red For Women Red Dress Collection 2015 Livestream

Join us for this exclusive virtual event where top designers and celebrities demonstrate their support for women's heart health during Mercedes-Benz Fashion Week. Heart disease is not just a man's disease. Each year, 1 in 3 women die of heart disease and stroke. We can change that--80 percent of cardiac events can be prevented with education and lifestyle changes. Help break barriers against heart disease and stroke by joining us for the Go Red For Women Red Dress Collection 2015 live online at GoRedForWomen.org/RedDressCollection on Thursday, February 12 at 8 p.m. Eastern. See you there!

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Hawaii's 2015 Legislative Session is Just Around the Corner

The 2015 legislative session kicks off in just a few days and with your help we plan to make it a big year for Heart and Stroke legislation!

We want to make Hawaii a healthier place for everyone and have some important issues on the table:

Improved Stroke Care - We are asking the state to require all acute stroke care hospitals to participate in a stroke registry, operated by the State Department of Health to gather data to be used to optimize Hawaii’s stroke system of care.
 

Tobacco Control – Hawaii was one of the first states to pass a clean indoor air law. We want to expand the current law to include e-cigarettes so that the indoor air we breathe is not polluted by these new tobacco products. The AHA will support state efforts to raise the age for legal purchase of tobacco products to 21. We will also defend against efforts to divert money from the State Tobacco Prevention and Control Fund (the fund established from the State’s legal settlement with the tobacco industry from damages caused by its products) from their intended use—community tobacco prevention, control and cessation services. 

Obesity Prevention – We will continue laying the groundwork for establishing a 1-cent per ounce fee on sugar-sweetened beverages. Revenue derived from the fee would be designated to fund obesity prevention and control in our state.

CPR in Schools – We are continuing our efforts with the State Department of Education to implement policy that would require all high school students receive CPR training as part of their health class (which is already a required class for students).

Newborn Heart Screening (Pulse Oximetry) – We made progress on this issue last year and hope to achieve final passage into law this year. Pulse Oximetry screening is a non-invasive screening that can detect congenital heart defects. We want all newborns to receive this screening before they are discharged from their birthing center.

We hope we can count on you for your continued support in the upcoming legislative session. We could not do the work we do without your help. Keep an eye open for our emails, follow our policy updates by “liking” the American Heart Association Facebook site, and take action when you are able.

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Meet the New Surgeon General

Dr. Vivek Murthy was confirmed by the U.S. Senate in December to serve as the next surgeon general of the United States. The surgeon general is America’s top public health official, and his responsibilities range from managing disease to promoting prevention and a healthy start for our kids.

At 37, Vivek Murthy is the youngest person and the first Indian-American to hold the post of Surgeon General.

Since this position was created in 1871, just 18 people have held the job. Dr. Murthy, the 19th, replaces an Acting Surgeon General who has filled the role since 2013. Dr. Murthy’s confirmation was delayed for nearly a year due to political issues, but in that time he received the endorsement of more than 100 public health groups, including the American Heart Association.

Dr. Murthy has both business and medical degrees from his studies at Harvard and Yale. He completed his residency at Boston’s Brigham and Women’s Hospital, where he most recently served as an attending physician. He has created and led organizations to support comprehensive healthcare reform, to improve clinical trials so new drugs can be made available more quickly and safely, and to combat HIV/AIDS.

His resume is remarkable, and we look forward to working closely with Dr. Murthy to improve the health of all Americans.

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Advocate Spotlight: Kami Sutton

As a survivor, volunteer, advocate and staff member – I wanted to share my story. 

I was recently featured on a Children’s Health Link special on our local NBC affiliate, KING5, with a story that highlights me as an 11 year old volunteer and fast forwards to where I am today. Please take a look and how far I have come and what the future holds!

Twenty-six years ago, I was born with a severe congenital heart defect (CHD). My parents were told that I might not survive the 30 minute ambulance ride from Everett to Seattle Children’s Hospital. As would become my goal in life, I did my best to prove the doctors wrong and to this day I still try to prove them wrong in the way I accomplish things they never believed possible. And always by my side, helping me achieve this was medical research and technology.

It seems that over the years, technology has always been one step behind me, as soon as I would need a new repair, it was found to be possible for pediatric use right in the nick of time. I have always been in the right place and the right time of technology and my next procedure is no different.

As I transition from pediatric to adult care at the University of Washington Medical Center, we are looking at my condition with fresh sets of eyes and new technology possibilities in hopes of avoiding a heart transplant which I have been awaiting for the past five years. A new pacemaker to improve my heart function could be the answer, but with my complex anatomy, my doctor thought it might be more difficult to place a new wire to the opposite side of my heart.

I had recently heard about research using patient-specific 3D heart models to practice cardiac ablations, so I asked the doctor if it might be helpful in my case. He was quite excited that I had suggested this and about a month ago, I underwent a cardiac CAT scan to start the process. I should be receiving my new pacemaker sometime early next year once he masters the procedure.

This technology and the possibility of me having better heart function and quality of life has been eye-opening and I again realize just how important the work we do at the AHA is. I have always had a passion for our cause but knowing that advances in medicine every day could lead to a better outcome for patients like me is what drives me.

Thank you to each and every one of you for supporting our mission, it means the world to me and every other CHD, heart and stroke patient out there!

For the full story, please click here.

Sincerely,

Kami Sutton

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