Cancer. Mental Illness. Grief. How 9/11 First Responders Face The Enormous Challenges Set in Motion 20 Years Ago – SurvivorNet

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For most Americans, every Sept. 11  brings back memories of the horrendous suffering and lives lost to the terrorist attacks in 2001.

But for many of the first responders who rushed to the World Trade Center that horrible day, the painful recollections are more than a once-a-year event. They still cope daily with cancer, mental illness and other serious ailments that resulted from their rescue and recovery efforts at the twin towers and in the aftermath of the attacks.

Now, as the nation marks the 20th anniversary of the attacks, retired New York City and Suffolk County, New York, police officer Tom Wilson is among those still suffering. He receives treatment for his tongue cancer and its complications through the main health fund for 9/11 responders who were subjected to the dust and toxins that filled the air in south Manhattan after the buildings came down.

“I remember my mouth burning, my eyes burning, my throat burning breathing in all that crap,” he tells SurvivorNet.

And it’s no wonder: For the first couple of days at the WTC site, he worked without a respirator or other breathing protection. All told, he spent about 300 hours near Ground Zero.  He later was detailed for three days to the Fresh Kills Landfill on Staten Island where concrete shards and twisted metal were inspected as they passed along a conveyor belt in case any further human remains might be discovered. At least there, he had better protection, but not perfect:  filters on face masks were packed with grime eight hours into a 12-hour shift.

‘It Was So Aggressive’

When it comes to staying alive, Wilson and others depend on the World Trade Center Health Program, created to aid first responders and others who were in lower Manhattan when it comes to their ongoing medical issues.

As of June, the program was caring for 81,460 responders and another 30,582 eligible “survivors,” those who lived or worked near the New York disaster zone on 9/11 or in the weeks following. The program also includes those who may have had exposure at the Shanksville, Pennsylvania, site where United Airlines Flight 93 crashed after passengers attempted to take it back from the terrorists.

Cancer treatment is an important part of the program. The most prevalent types have been cancers of the skin, prostate, female breast, lymph nodes and thyroid. With the rescue and response effort having become nationwide in the days after 9/11, the program now includes enrollees from every state.

In addition to treatment through the WTC health program, the September 11th Victim Compensation Fund offers payments for 9/11-related injuries and deaths. It gained even more attention in 2019 when the victims were joined by former Daily Show host Jon Stewart, who made an impassioned, scolding plea to lawmakers to reauthorize and enhance the program.

“I remember my mouth burning, my eyes burning, my throat burning breathing in all that crap,” Tom Wilson says.

The program was reauthorized through 2090, a victory for 9/11 rescuers and survivors, “but we weren’t dancing in the streets or taking a victory lap because our guys were dying,” said Rich Palmer, a retired New York prison warden who works with the FealGood Foundation, a nonprofit that supports responders and one of the groups that pushed hard for the legislation. He and other corrections employees were among those working at the World Trade Center site in the aftermath of the attacks.

The continued action that it took to reauthorize the act reflects how it has taken years for many of the responders’ and survivors’ health issues to surface.

Wilson’s cancer symptoms didn’t appear until 2008 when he saw doctors for what he thought was a sinus issue, accompanied by a chronic cough and gastrointestinal problems. At first, the symptoms were dismissed as a sinus infection, but one doctor probed deeper and found cancer.  “His big concern was that it was so aggressive,” he said. “Mine went deep into the muscle tissue.”

When Just Talking Hurts

Wilson had to have a portion of his tongue surgically removed along with 39 lymph nodes. Doctors took a section of an artery from his left arm and implanted it into his neck. And they then fashioned a new tongue muscle for him using tissue from his left wrist. It was followed by six weeks of radiation therapy during which he lost 100 pounds and three teeth.

To this day, talking for extended periods can be painful.

Then starting in 2016, new problems cropped up as a result of radiation treatment years before.  He developed thyroid irregularities and osteonecrosis, a condition that results from bone exposure and poor blood circulation in the jaw. He fears his jaw could break and that he will require further surgery.

9/11 Cancers — New Warning Says 300,000 People at Risk Are Not Getting Help They Need

Wilson also has been diagnosed with radiation fibrosis syndrome on his neck, a complication for cancer survivors caused by scar tissue and radiation treatment. In his case, it is compressing his carotid artery causing severe headaches and dizziness.

Yet Wilson didn’t let his 9/11-related health issues stop his career. He spent eight years on the NYPD followed by 18 years in Suffolk County earning recognition along the way. He kept working even after being sidelined for three months while he dealt with his injuries.

He lauds the WTC health program, but noted some of the issues he developed had not yet been covered when they cropped up, such as an implant needed to replace one of his three lost teeth. There was no billing code for the $8,000 procedure at the WTC program at the time, he said, but he was able to turn to another nonprofit dedicated to assisting 9/11 front-line workers, the Ray Pfeiffer Foundation. The charity, named for a New York firefighter who died from a 9/11 related cancer, helps first responders pay for treatment that isn’t covered by insurance or other programs.

Wilson, 52, said he has been able to seek out the very best treatment. But just as he had to look for another way to pay for his dental implant. Even though more conditions have been added over time — the FealGood Foundation puts the list of cancers covered now at 68 — not all ailments make the list.

AJ Tarquinio with his dad, Glenn.

‘An Absolute Godsend’

Glenn Tarquinio, 58, was lucky when it came to his coverage. The retired NYPD and Suffolk County officer’s prostate cancer was diagnosed in 2020, seven years after it was added to the list of covered cancers. As a result,  he calls the WTC program “an absolute godsend.”

As for himself, the retired NYPD officer has no doubt that his cancer is connected to the endless days he spent sifting through the rubble of the World Trade Center. All told, it amounted to 185 hours over more than four months.

“I was on the bucket brigade, rescue and recovery. You were shoulder-to-shoulder, 30 to 40 people deep, (digging with) shovels and hands,” he recalled. Dirt and debris were hoisted in buckets to be inspected for human remains. “You would see a hand in there, a foot, a shoe.” Even the small body parts would be treated as a whole, placed in a body bag and draped with an American flag.

Yet though the twin towers had been crammed with office equipment, everything was pulverized.  No desks, computer parts, telephones — “not even a pencil,” Tarquinio said. Nothing was recognizable.

Before cancer surfaced, he had to deal with another health crisis: post-traumatic stress syndrome. It started about six years after 9/11 when Tarquinio took off his usual week to indulge in home gardening and reseeding his lawn. An old shopping mall was being torn down a few blocks away and he could hear the construction equipment at work. The beeping as machinery and tractors as they backed up. Billowing clouds of dust and smoke from the site. The crash of bricks tumbling into truck beds.

“That was the trigger. I started to get chills. I would get flashbacks,” he said. He found himself leaving the house to get away from the clamor, only returning to gardening after 4 p.m. when demolition was done for the day. One day at a hospital, he pulled aside a doctor in the psych ward he knew and told him about the problem. “Congratulations,” the doctor said facetiously, “You have PTSD.”

Tarquinio said he underwent extensive counseling. While the condition is “always there,” he’s come far enough that he became part of a peer counseling group to help other first responders cope with their PTSD.

“The amount of hurt, the amount of pain they were in,” he said of those seeking help. “You were taking on their burden.”

PTSD is an insidious disorder that plays out in different ways, such as drinking bouts or overspending. “It comes out as everything but what it is,” Tarquinio said. “Before you know it, you are buried in your own indulgences and you can’t get out from under them.”

The WTC program covers the treatment of PTSD, along with other mental illnesses arising from 9/11, including panic disorder, substance abuse and depression.

And then there are the 9/11-related ailments that aren’t cancer or PTSD, but every bit as dangerous.

‘I Couldn’t Get Out of Bed’

Michael O’Connell (right) with Jon Stewart (left)

Michael O’Connell received specialized care after contracting sarcoidosis, an autoimmune disease that can involve inflammation in the lungs. After having joined the NYPD in 1998, O’Connell had transferred to the fire department and was a probationary firefighter on 9/11. He was in the first wave of rescuers at the scene after the WTC collapse and continued to return to the site every other day for a month.

His disease struck suddenly. Always someone who kept himself in good shape — never smoked, remained active, played lacrosse in college — it appeared one morning in 2007.  O’Connell said he went to sleep “and six hours later I couldn’t get out of bed.” At first, doctors thought he had cancer, but then came the diagnosis of sarcoidosis. He said patients can never pinpoint how they got It, only that it came from environmental exposure.

O’Connell, 45, didn’t give up. “I had to battle back to get myself into the best shape I could health-wise,” he said. He didn’t retire until 2010.

Since then, he’s joined others in the crusade to care for 9/11 first responders. While he said he’s pleased with the care he receives, he said he hopes that more research will go into making sure that sometimes rare cancers arising from the attacks will be covered. The list of covered cancers continues to evolve. It wasn’t until 2014, for instance, that malignant neoplasms of the brain, the cervix uteri, the pancreas, and the testis were added.

“I believe we did the best job we could in making sure people were covered,” O’Connell said. “More needs to be done to make sure.”

He Was a 9/11 Rescue Worker, He Got Cancer, And He Wouldn’t Change a Thing

Learn more about SurvivorNet’s rigorous medical review process.


Chris Woodyard is a freelance writer based in Los Angeles. Read More

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Reset Your Sleep Schedule With These Simple Yet Effective Ways!

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how-to-fix-your-sleep-schedule

Have you ever wondered why you feel sleepy at the same time every night? Or why do you wake up around the same time every morning? This 24-hour sleep-wake cycle is known as the circadian rhythm. This circadian rhythm can be thrown off if you pull an all-nighter, deal with jet lag, etc.

Our sleep schedules can vary from person to person depending on our environmental factors. Our sleep schedule depends on the signals we give our bodies. Having a misaligned internal clock or a sleep cycle can result in poor sleep.

And not getting enough sleep can be harmful to our mental and emotional health. Poor sleep health can be linked to chronic problems such as sleep disorders, weight problems, depression, bipolar disorder, seasonal affective disorder, etc.

Below are some ways you can fix your sleep schedule and get back to your normal circadian rhythm.

How To Fix Your Sleep Schedule?

Here are some ways you can fix your sleep schedule:

1. Get The Light Right

One of the best ways to fix your sleep schedule is to get the light right. Too much exposure to light before bed can mess with your melatonin production. The lack of melatonin means too much alertness. During the night, make sure the lighting is soft and dim in your room. In the morning, make sure you go into the morning light, take a walk, etc to feel alert and awake.

2. Try Relaxation Techniques

Practicing relaxation exercises or meditation before bedtime can also help you fix your sleep schedule. If you’re stressed, your body will produce cortisol, the hormone that increases your stress. High levels of cortisol mean heightened awareness.

Having a relaxing bedtime ritual can promote better sleep. You can try yoga, sleep meditation, listening to sleep stories, deep breathing, etc.

3. Avoid Naps

To fix your sleep schedule, it is recommended that you avoid naps during the day as much as possible. Naps can mess up your sleep cycle. Long naps can make you feel groggy and disoriented and can mess with your sleep cycle. If you do need to nap, make it a 30-minute nap and not more than that. Also, make sure you don’t take naps after 3 pm.

4. Exercise Regularly

Another way to help fix your sleep schedule is to exercise regularly just not before bedtime. Exercise also helps in producing melatonin which regulates sleep. Aerobic exercises help the best if you want to improve your sleep. Avoid exercising too much in the evening and if you want to exercise make sure you do so at least two hours before bedtime.

5. Avoid Noise

To get a good night’s rest, make sure you stay away from a noisy environment. Loud noises can disrupt your sleep, thus messing up your sleep schedule. It is better to not have a TV in the bedroom and to keep your phone on silent mode when sleeping. If you’d like, you can try using soothing background sounds or white noise to help aid sleep.

5. Try To Stay Comfortable

Sleeping on a couch all night is not comfortable nor is sleeping on mattresses that are old and lumpy. To fix your sleep schedule, one of the things you can try is to make sure you’re comfortable when you’re sleeping. Get a comfortable mattress and a pillow. It also doesn’t hurt to have cooler temperatures when you sleep.

7. Eat Dinner Early

Most of the time, our sleeping habits are also affected by our eating habits. Having a late dinner or eating a heavy meal before bed can mess up your sleep schedule. Make sure you eat your meal at least three hours before bedtime. It will give your stomach enough time to digest. Also, avoid caffeinated beverages such as coffee, tea, or alcoholic beverages before bed.

8. Maintain A Routine

If you need to fix your sleep schedule, make sure you have one. Pick a bedtime and wake-up time and stick to it. Even on weekends and days off. Also, try avoiding staying up late or getting up too early before your sleep is complete. Follow and maintain a sleep routine.

9. Take Supplements, If Needed

Melatonin helps regulate our sleep cycle. If you’re having trouble maintaining your sleep schedule then it is suggested that you talk to your doctor about certain supplements (including melatonin) to help you sleep better. You can try drinking these herbal teas before bed too.

Please make sure you take the dose as recommended by the doctor as taking supplements might have some side effects. If you’re already on medications, please consult with your doctor before taking any supplements.

10. Talk To A Professional

It’s okay if you’re having trouble sleeping or you have a messy sleep schedule now and then but if your sleep troubles are continuing, it is recommended that you seek professional help immediately. Having sleep troubles can also be a sign of sleep disorders. The right professional can help diagnose a problem if there is any.

Final Thoughts

Sleep and mental health are linked to each other. Many factors can mess with your sleep schedule and can affect your mental and emotional health. Fortunately, there are ways you can fix your sleep schedule and adapt to healthier sleep habits. By maintaining good sleep hygiene and a regular sleep schedule, you can get the sleep you need to reboot your mind and body.

Like this article? Tried one or more methods mentioned? Make sure to comment below and let us know your thoughts!

Sleep Well & Take Care!

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Deployment Stress: Managing The Stress of Military Deployment

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How to cope with deployment stress

Deployments are tough! Leaving your family behind or having your family member leave, are equally stressful. No matter how much you prepare, when the time comes you go numb.

Not everyone can see through the smile on your face. There are various stressors that affect you differently at different stages of deployment.

Practicing stress management techniques is very important so that you can strike a balance. Without stress management, things get way tougher. I’ve tried to put together a list of ways you can cope with deployment stress.

But before we get to that, let’s understand what deployment stress actually is…

What is deployment stress?

For army personnel and their family deployment is not anything new. We are all aware of how deployment works. You can experience stress at different levels of deployment. The stress one experiences before, during, and after deployment is called deployment stress.

There are so many things that come to your mind when you start to near deployment. And sometimes you can be so overwhelmed by your emotions that it might result in stress and anxiety.

Stress in such situations is usually due to concerns about your loved one’s safety, taking care of your family single-handedly, finance, being away from family, etc.

Nobody likes to be the missing parent. An army spouse has a high chance of experiencing extreme stress caused due to deployment. Lack of communication, difficulty in matching time zones, managing home, job and children all alone can be challenging.

Being able to manage your stress can be very helpful in such times. The uncertainty of things can take a toll on your mental health. Being a service member or the family, stress is something that is coming your way.

Let’s quickly look at the symptoms of deployment stress first:

  • Emotional symptoms- there’s a lot of sadness, fear, worry, frustration & anticipation
  • Behavioral symptoms- anger, irritation, can’t keep calm
  • Cognitive symptoms- poor focus/thoughts/memory, negative mindset
  • Social symptoms- peer distancing, avoiding social contact

Also read: Try This Exercise To Stop Negative Thinking

Ways to Cope with Deployment Stress

Let’s begin with the pre-deployment phase.

1. Communicate well. Express your feelings and concerns with each other. Share your expectations, fears, ‘what ifs’, everything! There is so much emotion involved in this situation that only communication can soothe things down. Don’t be afraid of opening your heart.

2. Create memories. Be there for each other. Create as many memories as possible so that both of you can hold on to them during the deployment period. Spending time together is only going to strengthen your relations and will create a relaxed atmosphere, eliminating stress.

3. Look for people in similar situations. Knowing that you are not alone itself is a relief. Get to know other spouses, they can be your support group. You can learn from their experience.

During deployment

4. Enroll yourself. Do something that interests you. Take up a job, join classes, take classes, social work, etc. indulge in something that you can look forward to. Empty mind shelters the devil, keep yourself occupied doing something productive.

5. Create/join a support group. Meet with people in similar situations. You can plan lunch dates, events, get-togethers, etc. to keep a check on how you and others are coping. You can always benefit from one another.

6. Don’t mask your emotions. Suppressing your emotions can only cause trouble. If you have something in your mind, speak up! Let it out of your system. Being able to express your feelings and emotions will only make you stronger.

7. Learn stress management techniques. Look for stress management techniques that work for you. Get to know them and practice them regularly. You can try exercises, journaling, meditation, etc.

Also read: Effective Stress Management Techniques | Vanish Your Stress at a Snap

8. Don’t try to control things. Trying to control what’s not in your reach is just a waste of time and energy. To keep mental peace try to concentrate on things that you can control. Focus on your family, friends, work, hobbies, and whatever that’s close to you.

9. Self-care. Self-care is important at all times. Do regular exercise, take healthy meals, and sleep well. Take time off for yourself, enjoy, don’t drown yourself in work and responsibility.

Post-deployment

10. Avoid assumption/judgment about the other. There has been struggle and difficulties at both ends. So try to understand the other’s point of view as well. Having a positive attitude and empathy for each other will result in reduced stress and frustration.

11. Be honest and open. You’ve been apart for a long time. You’ve been overwhelmed by emotions and struggles all this while. Being open about your feelings is very, very important at this point. Both of you must have changed a bit during the course of the deployment. Only being openly honest about yourself can help in understanding the change.

12. Be patient. Be patient with each other. Both of you were functioning at a pace that has now changed. There are a lot of emotions and expectations involved. Being patient can help you get through this initial phase smoothly.

13. Vacationing together. Make plans to go out on a holiday. It can be as small as an evening together or as big as going on a vacation elsewhere. This helps rekindle the joy, admiration, and love for each other.

There are a few ways you can eliminate deployment stress from your life. I know this doesn’t look like a huge strategic plan but trust me this works. Because small things make a huge difference.

Endnote

If life throws lemons at you, don’t just make lemonade, plant a damn lemon tree! All I’m trying to say is make the best out of your situation. Don’t focus on what is in the past or what is about to happen. Focus on the present, on things that are in your control.

Worrying about something that’s inevitable is doing you no good. So kick that stress out of your life and just focus on doing good and being good. Because what you put there comes back to you.

I hope this article helps you in eliminating deployment stress from your life. If you know someone in this situation do share the article with them so that they can benefit as well.

Do tell me about your special tricks to manage deployment stress in the comment section below!

Remember, you’re not alone!

Take care! Stay safe!

Continue ReadingDeployment Stress: Managing The Stress of Military Deployment

Speaking of self-love…

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Happiful and The Body Shop hosted an evening dedicated to conversations around self-love, with words of wisdom from Shareefa J, Cathy Reay, Rebecca Kimberley and Kat Nicholls

One of the reasons we love partnering with The Body Shop is their commitment to keeping self-love on our collective agenda. From their global self-love index research to the recent Self Love Street campaign, they’re continually reaching out to people with the message that who we are is always good enough.

This is why we were delighted to join in the self-love conversation earlier this summer, along with model, presenter and activist Shareefa J, writer, editor and skincare influencer Cathy Reay and psychotherapist and life coach Rebecca Kimberley.

Our very own Kat Nicholls, also a self-worth educator, led the conversation and now you can listen and watch below.

Find out more about The Body Shop’s Self Love Uprising movement.

 

 

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Essential Reads: Medications for Smoking Cessation in Breastfeeding Women

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Smoking is relatively common during pregnancy, with about 10% of all women smoking at some point during their pregnancy. The rates are even higher among women with psychiatric illnesses.  While many women may be able to stop smoking or reduce their intake during pregnancy, most women resume smoking during the postpartum period.  And women who suffer from postpartum depression are at even higher risk for smoking relapse.

Nicotine and other chemicals from cigarettes are transferred into breast milk at relatively high levels.  The amount of nicotine to which the infant is exposed depends on the number of cigarettes consumed by the mother per day and also on the time interval between the last cigarette and the timing of breastfeeding. Nicotine also accumulates in breast milk (milk/plasma ratio 2.9), and some might be surprised to learn that the amount of nicotine transferred into breast milk is more than double the quantity transferred through the placenta during pregnancy.

Women are strongly encouraged to breastfeed, but women who smoke are more likely to have a lower milk supply, and those who do breastfeed tend to wean their babies earlier than women who don’t smoke. Studies indicate that smoking more than 10 cigarettes per day decreases milk production and alters milk composition. Furthermore, breastfed babies whose mothers smoke more than 5 cigarettes daily exhibit behaviors (e.g. colic and crying) that may promote early weaning.

Most studies have focused only on the effects of nicotine on the nursing infant; thus, we have little information on how the breastfeeding infant may be affected by the other toxic chemicals, including arsenic, cyanide, formaldehyde, and lead, which are found in the breast milk of women who smoke.

In addition to exposure to nicotine and tobacco byproducts in the breast milk, there is well-defined literature regarding the risks children incur as a result of passive, or secondhand, exposure to smoke, including increased susceptibility to Sudden Infant Death Syndrome (SIDS), development and/or exacerbation of allergic diseases, such as asthma, and more recurrent and chronic respiratory illnesses.  Less understood are the risks of thirdhand smoke, the residual nicotine, and potentially toxic tobacco-derived chemicals left behind by tobacco smoke on surfaces including hair, skin, clothes, furniture, carpets, and walls.

Are E-Cigarettes a Safer Option?

The data regarding the use of electronic or e-cigarettes in breastfeeding women is limited.  The recent reports of EVALI or e-cigarette or vaping-associated lung injury also raise concerns about the safety of using e-cigarettes.

Many people often assume that e-cigarettes are safer than smoking regular cigarettes.  While there might be certain health advantages to e-cigarettes, they deliver the same or higher levels of nicotine to the smoker.  Thus, we must conclude that e-cigarettes carry many of the same risks associated with nicotine exposure as regular cigarettes and are not a better option for nursing mothers.

What About Nicotine Replacement Products?

According to the data provided by LactMed, a 21 mg transdermal nicotine patch delivers an amount of nicotine to the nursing baby via breast milk which is equivalent to smoking 17 cigarettes per day.  Using lower patch strengths (7 or 14 mg) results in proportionately lower amounts of nicotine delivered to the breastfed infant. We have no studies investigating the use of nicotine spray or gum in nursing mothers.

Based on these findings, we would conclude that babies exposed to the nicotine delivered through a transdermal patch may face some of the same risks as babies exposed to nicotine through maternal smoking.  

Varenicline or Chantix

Varenicline is a partial nicotine agonist used for smoking cessation.   Because there is no information regarding the use of varenicline in breastfeeding women and its impact on the nursing infant, we would typically avoid the use of this medication in this setting, if possible.

Bupropion (Wellbutrin)

There is limited information regarding the use of bupropion in breastfeeding women; however, there are data to indicate that the levels of bupropion in breast milk and in the nursing infant are low.  While the risk of adverse events appears to be below, there was one report of a possible seizure in a nursing infant whose mother was taking bupropion. No infant serum levels were obtained. If bupropion is required by a nursing mother for either smoking cessation or the treatment of depression, there is no significant evidence to recommend avoiding or discontinuing breastfeeding. 

Some Final Thoughts

Our information on the use of medications for smoking cessation in nursing mothers is limited, and there may be factors at play that may make smoking cessation more difficult, or at least different, in postpartum women (e.g., breastfeeding, sleep deprivation, postpartum depression).  Based on the information we do have, it looks as if bupropion (Wellbutrin) is the option that has the most data to support its safety in breastfeeding women and their infants.  

That said, smoking cessation strategies have limited efficacy, and recent data indicated that multiple medications and interventions may be required for success.  If these interventions do not work or are not safe to use in breastfeeding women, one may consider the cessation of breastfeeding instead. While breastfeeding has may benefit, exposure to nicotine and tobacco byproducts in breast milk may pose some degree of risk to the nursing infant.

Ruta Nonacs, MD PhD

References:

Nicotine (LactMed)

Continue ReadingEssential Reads: Medications for Smoking Cessation in Breastfeeding Women