Health

(NEW YORK) — One of the most important aspects of medicine is the relationship between a doctor and their patient, according to physician and Yale School of Medicine professor F. Perry Wilson.

However, Wilson said that relationship has been strained in recent years and has led to complications in treating people.

Wilson spoke with ABC News Live Tuesday about his new book, How Medicine Works and When It Doesn’t: Learning Who to Trust to Get and Stay Healthy, and gave tips on how people can improve this relationship.

ABC NEWS LIVE: So it’s January. Everybody has their ideas of getting healthy, and there are a lot of tips and tricks for that. You point actually, though, to the medical system itself is kind of being responsible for some of those gimmicks, if you will.

DR. F. PERRY WILSON: Yeah, well, part of the problem is that people are pushed away from [the] medical system and from good knowledge because a lot of times the health system itself is failing to meet their real needs. We have frustrations with insurance companies, [and] with pharmaceutical companies. You don’t have enough time to see your doctor because your doctor is working for a corporation that is telling you to see more and more patients all the time. And what this frustration leads to is people running away from good science-based, [and] evidence-based medicine and into the arms of people that might not have their best interests at heart promoting unsafe practices. And that can be really bad for your health. We’ve got to sort of change that framework.

ABC NEWS LIVE: You write, “The most powerful force in medicine is trust.” Explain what you mean by that and where you feel like the breakdown in trust comes from.

WILSON: Yeah, well, that relationship between a patient and their doctor, we call it the Therapeutic Alliance. And I actually like that term because it makes me feel like we’re in kind of a battle against disease. And what that takes is a real deep bond of trust. I have to trust that you’re telling me the truth. You’re being open with me about what’s bothering you and what you’re up to. And you have to trust me that I have your best interests at heart. And when we are trying to work within a framework that is profit-driven, that is insensitive to the real needs of patients, well, that trust doesn’t work anymore.

ABC NEWS LIVE: And when you talk about that trust between the doctor and patient relationship, how does one go about rebuilding that and even establishing it? Because I have to say, when I go into my doctor, I feel like it’s like, I’m just on a clipboard. Okay. How are you doing? What’s your weight? What’s your height? You feeling OK? All right, onto the next person. So how do I actually have that relationship?

WILSON: Yeah, well, so it comes from both sides. For patients, they need to start to realize that a lot of the things they’re seeing online on social media, what I call [an] easy fix or one simple thing, medicine. One dietary supplement to take to give you shredded abs or one exercise to alleviate depression. Those things aren’t real. Real change takes work, and so patients have to move a little bit to understand that, that we’re going to ask some tough things of you; real lifestyle change if you want to get healthy. At the same time, doctors need to start realizing that we’re on the same side as patients. It is us and patients against this system.

And once doctors start to realize that they have more in common with their patients than they do with the C-suite executives who are writing their checks, we can see some real change.

ABC NEWS LIVE: What is good medicine as you define it here in the book?

WILSON: Well, good medicine comes from a number of things. It comes when people look at data and make their conclusions based on data as opposed to deciding what they want their conclusion to be and finding the data that fits. And we live in a world for better or worse. If you want to find data to support what you believe to be true or what you want to be true, it’s out there. It may be false, but you can Google it. It’s on social media. And so people, to make the best choices for their health, can’t just decide what they want to conclude in advance. They have to actually come to it with an open mind and a good doctor. Practicing good medicine is going to help you ask those right questions.

ABC NEWS LIVE: What are those right questions, though? How would I know what I should ask?

WILSON: Well, the most important thing is to be honest about what’s bothering you. And one question that I encourage doctors to ask their patients and the trainees that I work with [is] to ask their patients… “Are you lonely?” There’s an epidemic of despair in the country right now. Death rates among people in the 35 to 55 age bracket who should be really living their best lives are increasing due to alcohol abuse, drug abuse and suicide. A lot of that is due to social isolation, loneliness, [and] despair, and doctors don’t address those issues.

ABC NEWS LIVE: You know, people often say, be your best advocate. You are your best advocate. Right. And so how would you encourage someone? I guess it’s kind of along those same lines as far as just being honest.

WILSON: [There are a] couple of things you can do. No. 1, you can ask this question: What else could it be? This is a question that reframes as a doctor. You’re my 20th patient of the day. I just need to get out, I’m hungry, etc. That question flipped a switch in my mind. That’s going to make me say, “OK, wait, OK, yeah, I think I know what’s going on here, but you just ask, what else could it be?” And it forces me to take a step back and rethink the situation that can be really valuable information.

The other thing you can do is bring someone with you. It’s the same as if you go to a mechanic or anyone else who has sort of expertise beyond what your level is. Having that other person there who’s just kind of a step outside can lead to some better questions, and I’ve had great interactions with patients where I’m talking to the patient and he’s nodding and yep, I get it. I agree. I understand. And his wife will kind of turn and say, “Do you get it? Do you know it? Did you hear what he just said?” And all of a sudden it becomes clear? No, you know, the communication wasn’t there. So, bring an advocate, bring someone with you and make sure your doctor’s OK. Having someone else in the room, they should be. If not, sometimes you’ve got to find a different doctor.

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(FORT WORTH, Texas) — Twin sisters who were conjoined at the chest and stomach have undergone successful surgery to separate.

Doctors at Cook Children’s Medical Center in Fort Worth, Texas, announced Wednesday that 16-week-old sisters JamieLynn and AmieLynn are now sleeping in separate cribs after the separation surgery, the first surgery of its kind in the hospital’s 150-year history.

The girls’ parents, Amanda Arciniega and James Finley of Saginaw, Texas, said they learned via an ultrasound during pregnancy that they were expecting conjoined twins.

“On the ride home, we were quiet and it was kind of sad. We were thinking, ‘Why us, out of everybody?'” Arciniega said in a video shared by Cook Children’s. “It’s a lot.”

Arciniega gave birth to her daughters in October at Texas Health Harris Methodist Hospital in Fort Worth. She was 34 weeks pregnant at the time and delivered her daughters via C-section, doctors said.

JamieLynn and AmieLynn were then transferred to Cook Children’s neonatal intensive care unit, where they stayed until the separation surgery.

Only a small handful of conjoined twins survive past birth, according to Dr. Jose Iglesias, medical director of pediatric surgery at Cook Children’s Medical Center and the lead surgeon for the twins’ separation surgery.

“Conjoined twins that reach and stay viable after birth, at least for the first few days, there’s really only about five or eight of those on the entire planet,” he said. “So it is a very are situation.”

Conjoined twins occur once in every 50,000 to 60,000 births, and approximately 75% of conjoined twins are female, according to the Children’s Hospital of Philadelphia, which has completed more than two dozen separation surgeries.

A large team of doctors and nurses at Cook Children’s prepared for three months for the surgery, which included surgeons, anesthesiologists, neonatal specialists and more.

“In order to prepare for this, it’s a lot of practice, practice, practice and more practice, trying really to think of every possible scenario so that we’re not surprised by anything,” said Dr. Chad Barber, a neonatologist at Cook Children’s. “There’s always going to be unexpected things, but if you’re prepared for the worst possibilities and the most unlikely outcomes, then you can at least hopefully not get caught too off guard.”

The operation on Monday, which lasted 11 hours, involved separating the girls’ liver as well as their skin, fascia and bowel, according to Dr. Ben Gbulie, a plastic surgeon at Cook Children’s.

The medical team was divided into two teams to take care of the two girls, with AmieLynn’s team wearing green hats and JamieLynn’s team wearing purple hats during the surgery.

Following the surgery, Iglesias said doctors were able to close both girls’ abdominal walls.

“They’re both doing very well,” he said. “The team performed phenomenally and we’re just incredibly happy.”

Describing the sisters’ future, Iglesias added, “They’re going to grow up like the little girls they’re meant to be, independent and feisty, like they’ve already shown us.”

Of the treatment at Cook Children’s that his daughters received, Finley said, “It feels like we’re at the best possible place we can be. I wouldn’t want to be anywhere else.”

“We’re family here,” added Arciniega.

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(NEW YORK) — Two doses of the mRNA COVID-19 vaccine among school-aged children safely and effectively reduces COVID-19 infection risk as well as associated risks for developing multisystem inflammatory syndrome and COVID-19 related hospitalizations, new data suggests.

This study adds evidence to existing studies and “supports the safety and efficacy of mRNA COVID-19 vaccine in children aged 5-11 years,” authors Dr. Jun Yasuhara of the Center for Cardiovascular Research at Nationwide Children’s Hospital and Dr. Toshiki Kuno of the Division of Cardiology at Montefiore Medical Center told ABC News.

Researchers at Nationwide Children’s Hospital and Montefiore Medical Center analyzed rates of COVID-19 infection, symptom severity and vaccine side effects among 10,935,541 vaccinated children aged 5 to 11 years compared to 2,635,251 unvaccinated children.

They found vaccinated children had lower rates of infection and less severe symptoms if they did end up infected. Severe reactions to the shot were rare and any local injection irritation went away after several days. The low rates of severe side effects should be reassuring for parents and guardians worried about adverse events following vaccination, according to the study’s authors.

The study also found only a small increase in risk for kids to develop inflammation of the heart (myocarditis) after COVID-19 vaccination. It found that there are 1.8 cases of myocarditis per million children who get two doses of the vaccine, a comparable or slightly higher rate than in children diagnosed with myocarditis before the COVID-19 pandemic.

But the risk of myocarditis after getting sick with COVID-19 is far higher than after getting the vaccine, according to Kuno and Yasuhara. Furthermore, kids are less likely to survive if they get COVID-19-related multisystem inflammatory syndrome, a rare condition associated with the virus, compared to those who developed myocarditis after mRNA vaccination.

Despite the vaccine’s safety, too few children are getting vaccinated. A report from the Centers for Disease Control and Prevention released in January found overall low rates of vaccination coverage among children and adolescents between 5 and 17 years old. The report also revealed racial disparities in COVID-19 vaccination status for adolescents and children. Vaccination coverage among Black children aged 5-11 years was lower than that among Hispanic, Asian and other minority children.

In another study, only one in five parents of school-aged children said their child either received the updated COVID-19 booster or will definitely be doing so, while 9% reported their child will probably receive a booster. This is in contrast to the 61% of parents who stated their child remained unvaccinated and thus ineligible for the booster.

There are many reasons why parents are reluctant to get their kids vaccinated against COVID-19, according to Dr. Angela Myers of the Infectious Diseases Division Director at Children’s Mercy Kansas City in Kansas City, Missouri.

That includes a misconception that the vaccine is not effective because it doesn’t block all infections, Myers said.

“Instead [it] protects against severe infection, hospitalization and death,” she said.

Myers said parents should talk to their child’s pediatrician if they have questions about the vaccine.

“Despite vaccine hesitancy and sometimes refusal, the child’s primary care clinician is still the best place to get the best, most up-to-date, information,” she said. “Pediatric clinicians want what’s best for all children and data has shown that they remain the most the most trusted source of information for parents making vaccine decisions.”

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(NEW YORK) — Nearly one year after two congressional reports found heavy metals such as arsenic, lead, cadmium and mercury in popular baby foods, the federal agency that oversees food safety has proposed a change.

The U.S. Food and Drug Administration on Tuesday released draft guidance proposing new limits for the amount of lead allowed in processed foods, such as those packaged in jars, pouches and boxes, for kids under the age of 2.

The new limits would help reduce exposure to lead in those foods by as much as 27%, the agency said.

“For more than 30 years, the FDA has been working to reduce exposure to lead, and other environmental contaminants, from foods. This work has resulted in a dramatic decline in lead exposure from foods since the mid-1980s,” FDA commissioner Dr. Robert M. Califf said in a statement. “The proposed action levels announced today, along with our continued work with our state and federal partners, and with industry and growers to identify mitigation strategies, will result in long-term, meaningful and sustainable reductions in the exposure to this contaminant from foods.”

The FDA’s guidance is not yet final and will go through a review process before being formally adopted, but it is a strong signal to baby food manufacturers that they will likely need to comply with these new levels soon.

The new limits on lead mark the next step in the FDA’s continuing effort called “Closer to Zero,” which aims to reduce levels of exposure of lead and other metals to the lowest level possible for babies and young children.

Toxicologists say that at very low levels, heavy metals are unlikely to pose a serious health threat, but there are no known safe level of heavy metals in foods for children.

In order to suffer detrimental effects, a person would have to be exposed to toxic heavy metals for a prolonged period of time. Periodic ingestion of the levels found in baby food products would generally not be considered dangerous.

The FDA stressed in its announcement that the new draft guidance is “not intended to direct consumers in making food choices.”

“To support child growth and development, we recommend parents and caregivers feed children a varied and nutrient-dense diet across and within the main food groups of vegetables, fruits, grains, dairy and protein foods,” Susan Mayne, Ph.D., director of the FDA’s Center for Food Safety and Applied Nutrition, said in a statement. “This approach helps your children get important nutrients and may reduce potential harmful effects from exposure to contaminants from foods that take up contaminants from the environment.”

What to know about heavy metals in baby foods

Exposure to toxic heavy metals poses a specific risk to toddlers and infants because they absorb more than adults and their brains are still developing, according to the National Institutes of Health.

Even low levels of lead in blood may go on to affect IQ, a child’s ability to pay attention and academic achievement, according to the American Academy of Pediatrics.

“The concern is not that the amount that’s in baby foods or the amount that babies are consuming is going to make them acutely sick,” Dr. Stephanie Widmer, an ABC News medical contributor, board-certified emergency medicine physician and medical toxicologist, told ABC News last year. “The concern is long-term effects on neurodevelopment, brain function, possibly the long-term risk of cancer down the road, and it’s really difficult to establish what levels are increasing your risk for danger.”

Experts point out that heavy metals are naturally occurring and are found in all of our foods, which makes it hard to tell parents a specific type or brand of baby food to avoid.

“Rattling off a list of which ones are safe, which ones are not would be probably impossible,” Widmer said. “Because everything really out there has some level of heavy metals in it. It’s in the soil and things that grow in the soil.”

Diagnosing heavy metal poisoning can also be difficult and symptoms may be easy to miss. Those symptoms include things ranging from changes in behavior and learning, vomiting and abdominal pain to joint pain, anemia, numbness and weakness, according to the NIH.

The American Academy of Pediatrics recommends screening for elevated lead levels in children 9 to 12 months old, and again around age 2.

Therapies to help children who have been overexposed to heavy metals are available.

What parents can do

Here are four things Widmer said she did when her two children were in their baby food stages.

1. I varied my kids’ diets.

“I made sure there was variability in their diet,” Widmer said. “Heavy metals are in everything, so if you’re not eating the same thing, the same food group every day, you are decreasing your risk.”

Widmer said varying her kids’ diets included switching back and forth between feeding them homemade baby food and store-bought baby food, as well as frequently rotating the types of foods they were eating.

“Bananas one day, baby spinach another day and just making sure that variability is there,” she said. “Not getting the same repeat exposure to the same food and whatever compounds are in that food is the best thing that parents can do.”

2. I didn’t lose sleep over it.

“Parents of little ones have plenty on their plate already, they have plenty of things on their minds and plenty of things to worry about, and I would not put this at the top of the list,” said Widmer, who noted that babies only eat baby food for a short period of time. “I would not lose sleep over this.”

She added, “It’s something that is being paid closer attention to and will be regulated more and more and more, and parents shouldn’t feel pressure. The thing you can do is pay more attention to the variability in the diet.”

3. I tried to avoid a few key foods.

“Rice tends to have a lot of high levels of heavy metals,” Widmer said. “So avoiding foods and cereals that are rice-based is probably best practice.”

In addition to rice, Widmer said she also recommends trying to limit foods that grow in the ground, like carrots, potatoes and sweet potatoes, as they can be exposed to heavy metals in the soil.

Widmer said parents shouldn’t skip those foods entirely, but rather ensure they are not a daily staple in a baby’s diet.

4. I washed foods when I made homemade baby food.

“If you are making baby food at home, really washing the foods beforehand helps,” she said. “If you are going to use a rice-based cereal or rice-based food, really soaking the rice and washing it with boiling water after would help.”

Widmer also recommends that parents wash their baby’s hands before they eat, too.

The AAP notes that heavy metals can get into tap water, so if that is a concern, the recommendation is to contact your local health department to have your water tested.

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(NEW YORK) — The new service, called RxPass, gives users access to 60 generic medications treating more than 80 of the most common health conditions, including high blood pressure, anxiety and acid reflux, according to Amazon.

While other online pharmacies offer perks like free delivery and discounts on prescription medications, Amazon’s RxPass differs by offering a flat rate for an unlimited number of prescriptions monthly, as long as the medication is one of the 60 types the service carries.

Users also do not need to use health insurance to access medications, meaning they pay the $5 monthly fee only, without any deductibles or copays.

“With RxPass, Prime members can get as many eligible medications as they need for one flat, low fee of $5 and have them conveniently delivered free to their door,” the company said in a statement.

Amazon currently has over 200 million members using its Prime membership, which costs $14.99 per month. The optional add-on of the RxPass membership would push the cost of a Prime membership closer to $20 per month.

“According to the FDA, there are thousands of online pharmacies and this space is only growing,” said Dr. Alok Patel, a physician at Stanford Children’s Health and an ABC News medical contributor. “So it’s good to see companies like Amazon put forward projects like RxPass to further add competition in this space and make getting generic medications more convenient, affordable and with price transparency.”

There are limits though to who can participate in Amazon’s RxPass service.

People who are enrolled in Medicare, Medicaid or any other government health care program are not eligible, though Amazon says those customers can still use their government insurance to fill prescriptions at Amazon Pharmacy.

RxPass is also only available to people in 42 states. It is not currently available in California, Louisiana, Maryland, Minnesota, New Hampshire, Pennsylvania, Texas and Washington, according to Amazon.

Users also have to sign up for an Amazon Prime membership first in order to be able to access the RxPass service.

Amazon says people can cancel their RxPass membership on a monthly basis, or once their supply of medication expires. As an example, Amazon says on its website that if you purchase a 90-day supply of a medication, you have to pay for three months of an RxPass subscription.

Prime members can sign up for RxPass starting today on Amazon’s website or app under the Amazon Pharmacy section.

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(NEW YORK) — Potentially more lives were saved Sunday when a man disarmed the alleged Monterey Park, California shooter after he had allegedly killed 11 people and wounded nine others at a nearby location.

Brandon Tsay told ABC News’ Good Morning America Monday that “something came over me” when he managed to wrestle the gun away from the alleged assailant in Alhambra, California, and forced him to leave.

It was reminiscent of the deadly Club Q shooting in Colorado Springs, Colorado, in November, during which two patrons tackled the shooter to the ground after killing five people and wounding 17 others, disarming him and holding him down until police arrived.

But what possesses some people to charge in the face of danger?

Psychiatrists told ABC News part of this is due to the fight-or-flight response, which is a psychological reaction that occurs in response to an event that is stressful, frightening or life-threatening.

“Seeing somebody with a weapon and being certain that there is an immediate threat to one’s life, we all have pretty much the same response,” Dr. Emmanuel Maidenberg, a clinical professor of psychiatry at the University of California, Los Angeles, told ABC News. “It’s an activation of the physiological system and it’s one of the mechanisms that we all have built in that helps us to fight or escape from a danger. So, that’s universal for all of us.”

In response to this danger, the sympathetic nervous system — which regulates unconscious actions in the body — is activated, leading to a release of hormones, and preparing the body to either fight or flee.

“Once it’s triggered, you get characteristic physical and emotional responses,” Dr. Richard Friedman, a professor of clinical psychiatry and director of the Psychopharmacology Clinic at Weill Cornell Medicine in New York City, told ABC News.

“Your heart rate goes up, your blood pressure goes up, you pump out cortisol, the stress hormone, and epinephrine and norepinephrine — which is adrenaline and noradrenaline — rise and you’re supercharged, and you are ready to either flee, to defend yourself, or fight if you’re trapped, and you can’t flee,” he continued.

Friedman said a person can’t know how they’re going to respond in that situation, because it’s a primal instinct.

However, if a person is confronted by a threat and does not have the capacity to run away — such as what appears to have happened with Tsay and the shooter — they are more likely to fight, experts said.

“If you’re literally cornered, you’re much more likely to defend yourself by attack than you are by fleeing and, under the influence of stress hormones, you’re capable of tremendous acts of aggression and self-defense,” he said. “People are capable of doing things that they’re not aware of, in normal circumstances, when they’re activated by the fight or flight response.”

Sometimes the occupation of the person that disarms a gunman can play role in their choice to do so. For example, in the Club Q shooting, it was a current U.S. Navy petty officer and a US. Army veteran who subdued the gunman.

“It’s reasonable to assume because it’s not a theoretical thing; it’s practice,” Friedman said. “So, if, let’s say you have extensive experience in law enforcement or military service, in which you actually were in situations of danger, and responded, and so you had practiced it, you might be much more effective and much more likely to act in an effective way when confronted and surprised by a shooter.”

“It’s a learned response,” Maidenberg said. “They’ve gone through a process of adding through a learning process, that behavioral response as available to them.”

Although, this is not always the case. Friedman brought up the elementary school shooting in Uvalde, Texas, in May 2022, where students who survived waited for more than an hour before officers entered classrooms.

“The police did not go into the school, and were roundly criticized for not doing it,” he said. “You wonder, were these police with less experience? Did they have very little actual real-life experience with disarming aggressive people?”

Being involved in a mass shooting — and especially being a person who disarmed the perpetrator — can be traumatic, but not everyone needs counseling, the experts said.

Even though about 60% of men and 50% of women will experience at least one trauma in their lifetime, not everyone develops post-traumatic stress disorder after.

In fact, only about 6% of the U.S. population will have PTSD at some point in their lives, according to the U.S. Department of Veteran Affairs.

Friedman said it’s much more beneficial to tell a survivor some things they will experience over the next few days and to leave the option open to talk or seek counseling if they need, but not to push it.

“Forcing people to talk about it, what we’ve learned is, you can actually make traumatic events more upsetting and burn them in, by making people talk about it when they either don’t want to or not ready to,” he said. “The notion of universal debriefing, where people are aggressively encouraged to relive something, can actually be harmful and, although it’s well intended, it’s the wrong way to do it.”

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(WASHINGTON) — The U.S. Food and Drug Administration is considering a new COVID-19 vaccine strategy that would see Americans getting a single annual shot, similar to the flu vaccine.

Up until now, Americans who’ve gotten a primary series have received boosters that have targeted specific variants, with the most recent booster targeting the original variant and the Omicron subvariants BA.4 and BA.5.

However, the Vaccines and Related Biological Products Advisory Committee, the FDA’s advisory panel, is holding a meeting Thursday to discuss a new schedule: one shot every year for all Americans, regardless of vaccination status.

According to briefing documents published Monday, the new approach would simplify public health messaging on when to get COVID vaccines, with the hope that making the guidance easier for people to understand could potentially increase vaccination rates in the U.S.

There might be an exception, however, for people at higher risk of severe disease, including senior citizens and immunocompromised people. The FDA proposal suggests these groups continue receiving two shots per year.
Younger children who have never been vaccinated or infected with the virus would also continue with two shots a year.

“In age and risk groups presumed to have ‘insufficient preexisting immunity,’ two doses of an approved or authorized COVID-19 vaccine may be needed to induce the expected protective immunity for the desired duration,” the proposal reads.

The FDA’s independent advisors are likely to weigh in during Thursday’s meeting with potential changes to the guidelines, though, and advisors from the Centers for Disease Control and Prevention will also consider the new vaccine schedule in February.

For the flu vaccine, researchers and modelers often look to the southern hemisphere, which experiences its flu season first — typically from May to October — to predict how the season will look in the U.S. and model the flu vaccine accordingly.

Similar, it is assumed the FDA and other public health organizations will try to determine in the late spring or early summer which variant will be circulating in the fall and have a vaccine ready to go.

“FDA anticipates conducting an assessment of SARS-CoV-2 strains at least annually and to engage VRBPAC in about early June of each year regarding strain selection for the fall season,” the FDA said.
It is not expected that the discussion on Thursday will lead to an immediate decision or policy change, with discussions to likely to continue over the next few weeks and months.

ABC News’ Cheyenne Haslett contributed to this report.

 

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(NEW YORK) — Eggs prices are on the rise due to an ongoing avian flu outbreak limiting supply, and while they are still safe to eat, many people are seeking alternatives to keep costs down, as experts say it may take months for prices to fully normalize.

Customers aren’t just looking for swaps for their morning omelets, they’re also seeking out alternatives to include in cake batters and other baked goods, as well as egg substitutes like ground flax seeds and water, tofu, or plant-based liquid egg replacers.

But while they can simulate the texture and feel of an egg, these substitutes are not a one-for-one nutritional swap, nutritionists say.

“For years there have been staple foods that we dietitians and health care professionals recommended to people, like eggs,” Maya Feller, a Brooklyn-based registered dietitian nutritionist, told ABC News. “All of a sudden we’re talking about a luxury food.”

While Feller says she believes that egg substitutes are a great option for people who don’t want to or can’t eat eggs, because eggs are such a nutrient “powerhouse,” their replacements may not be a nutritional match.

Eggs offer a complete protein with all the essential amino acids, the building blocks for our body’s proteins that we cannot produce on our own and must get from food, Feller said. Eggs are also rich with key micronutrients like vitamin A and various vitamin B’s, including riboflavin, she said.

Eggs also contain choline, which is important for various vital bodily functions, like liver function and metabolism. Other antioxidants in eggs are linked to decreased inflammation and lower risk of health conditions, including some eye diseases.

Many of the nutrients in eggs are concentrated in the yolk. The yolk also has cholesterol, but the idea that cholesterol in eggs is harmful is somewhat outdated — though it’s important to think about this in the context of your larger diet and lifestyle, Feller explained. The American Heart Association recommends one egg a day.

Nevertheless, some egg alternatives can provide nutritional benefits.

Some substitutes are more useful swaps for baking. Alternatives suggested by cooks include flax seeds and water, chickpea flour, mashed bananas and tofu. Each of these comes from different food groups and offers distinct nutritional benefits.

Flax seeds, according to the U.S. Department of Agriculture, are a rich source of omega-3 fat, an unsaturated “good fat” that has protective effects against heart disease and stroke, among other health conditions. It is also a good source of fiber. The amount of protein per recommended serving a day of one to two tablespoons of flax seeds is smaller in comparison to one egg.

Tofu, on the other hand, which is made from soybeans, is a great source of complete protein. Similar to eggs, the protein that makes up tofu contains all the essential amino acids the body can’t make on its own. It is also a great source of calcium, vitamin B, and iron, according to the USDA.

Some companies, like Just Egg, also make plant-based egg replacers that can look and feel like omelets or scrambles. These plant-based alternatives are typically made from protein isolates of various legumes and have about the same amount of protein per serving as that of a standard sized egg.

But many of the nutrients found in eggs, like vitamin A, calcium, and iron, are not in these products.

“It’s not one to one,” Feller said, adding that they can be a good substitute “so long as you get those minerals from another source.”

For plant-based eaters who are swapping out eggs as part of a vegetarian or vegan diet, getting those micronutrients can sometimes be hard. Feller said a multivitamin supplement is a good solution.

Despite high prices, eating eggs is also still an option. The risk of getting avian flu from purchased poultry or eggs is very low, given the measures in place to cull birds when the virus is suspected and the national regulatory processes in place to make sure the products arriving at your grocery stores are safe.

The Centers for Disease Control and Prevention and USDA recommend proper handling and processing of uncooked poultry and eggs when cooking to protect against not only avian flu but also against all possible viruses and bacteria. That includes washing hands before and after handling raw ingredients, sanitizing countertops and cutlery and cooking raw food fully (which means reaching 165 F for poultry).

To better incorporate eggs into your diet amid rising prices, think of creative ways to get the most out of them, Feller recommended.

Try to stretch your egg by incorporating it into a dish, or add other healthy ingredients like veggies, potatoes, or a sprinkle of low-fat cheese. The fat in eggs can help your body absorb some vitamins found in vegetables, which makes them a great pairing, Feller said.

These additions are ways to get more “bang for your nutritious buck,” she added.

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(SALT LAKE CITY) — A plastic surgeon and three others in Utah were charged with allegedly selling people seeking fraudulent COVID-19 immunization records an estimated $97,000 worth of fake CDC cards without administering vaccines, the Department of Justice said in a Friday release.

Dr. Michael Kirk Moore Jr., 58, of the Midvale practice Plastic Surgery Institute of Utah, was charged along with his neighbor Kristin Jackson Andersen, 59; surgical coordinator Kari Dee Burgoyne, 52; and receptionist Sandra Flores, 31.

Salt Lake County, Utah, resident Moore and his co-defendants allegedly ran a scheme to defraud the Centers for Disease Control and Prevention and the United States, court documents said. Moore and Andersen were members of a group trying to “liberate the medical profession from government and industry conflicts of interest,” the documents said.

The group allegedly destroyed about $28,000 or more in government-provided COVID-19 doses, usually by squirting syringes containing doses down sink drains, court documents said. They exchanged at least 1,900 doses’ worth of falsified record cards for either $50 cash payments or “donations to a specified charitable organization,” the Justice Department said. The recipient organization was linked to the group Moore and Andersen were involved with, court documents show.

Card recipients did not get COVID-19 vaccines, though some parents requested that their children receive saline shots instead so they would believe they did, court documents said.

Department of Health and Human Services Office of Inspector General Special Agent in Charge Curt L. Muller vowed law enforcement would hold people who try to illegally profit from the pandemic accountable in a statement included in the DOJ release.

“By allegedly falsifying vaccine cards and administering saline shots to children instead of COVID-19 vaccines, not only did this provider endanger the health and well-being of a vulnerable population, but also undermined public trust and the integrity of federal health care programs,” Muller said.

Moore’s biography on the Plastic Surgery Institute of Utah website said he is a graduate of the School of Medicine at the University of Miami and completed a plastic surgery residency at the University of Colorado Health Sciences Center. His Utah physician and surgeon license was still listed as active on the state’s division of occupational and professional licensing website early Monday.

The complete list of charges the defendants are facing includes conspiracy to defraud the United States; conspiracy to convert, sell, convey, and dispose of government property; and conversion, sale, conveyance, and disposal of government property and aiding and abetting, with a first court appearance scheduled for Thursday afternoon.

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(IDAHO) — An Idaho woman who documented her 19-day miscarriage on social media said it was days before she could receive care due to the state’s strict abortion laws.

Carmen Broesder, 35, from Nampa — 20 miles west of Boise — a mother-of-one was just six weeks pregnant when she began miscarrying on Dec. 8. However, she said it took eight days before she was given any medicine to manage her pain and to expel embryonic tissue, and several more days for the miscarriage to end.

In a series of TikTok videos — along with medical records, photos and videos shared with ABC News — she said that despite bleeding heavily and suffering intense cramps, she was denied a dilation and curettage, or D&C, which removes tissue from inside the uterus, multiple times.

Because a D&C can also be used when providing abortion care, she told ABC News she believes it’s directly tied to Idaho’s abortion ban.

“Why should I get to death’s door to get help?” Broesder said. “I am prepared to be a mother. I am a mother and I wanted to have another baby. That is my story and it almost killed me.”

Different than other miscarriages

After Roe v. Wade was overturned by the Supreme Court last summer, Idaho passed a strict near-total abortion ban in August 2022 with only exceptions for rape, incest or if a pregnant person’s life is in danger.

Broesder said she wasn’t seeking an abortion when she went to the hospital the first time. She said she and her boyfriend had been trying to have a second child after the birth of her 16-month-old daughter, Lucy.

While trying to conceive, Broesder said she suffered other miscarriages, but she never experienced as much bleeding or as much pain as she did when she woke up on Thursday, Dec. 8.

“That was the most horrifying moment; I woke up and I had intense stomach pain,” she said. “I couldn’t stand up too much, and I go to the bathroom, and I was just bleeding. It was a horrific amount of blood loss where I instantly know this is not okay.”

After the bleeding wouldn’t stop with a 12-hour menstrual disc or with a super plus tampon, Broesder went to a local hospital. Broesder said she told staff she thought she was experiencing a miscarriage and after they checked her in, she said she waited for hours for someone to examine her.

She said staff eventually performed an ultrasound and confirmed there was no detectable heartbeat but, because she had an OBGYN appointment on Monday, Dec. 12, they advised her to attend as scheduled.

During the OBGYN appointment, Broesder said an ultrasound technician also confirmed the lack of a heartbeat and told her to come back for a follow-up in two days. ABC News reached out to the doctor’s office for a comment on their care for Broesder but did hear back.

‘I’m going to die before someone helps me’

Broesder said she felt like something still wasn’t right with this miscarriage. She was still bleeding heavily and in pain but did not receive any medication.

“I’m feeling like no one’s listening at this point,” she said. “These people are supposed to help. So, I went home and kind of just suffered through.”

Broesder said she felt like something still wasn’t right with this miscarriage. She was still bleeding heavily and in pain but did not receive any medication either from the ER or her OBGYN.

“I’m feeling like no one’s listening at this point,” she said. “These people are supposed to help. So, I went home and kind of just suffered through.”

However, the pain and the bleeding became so bad that Broesder went to the ER the next day, where she said she again waited for hours for someone to see her — and where she made her first TikTok video about her miscarriage, which went viral.

“I’ve been actively miscarrying since the 8th,” she said in the video, posted on Dec. 13. “I have gone to a doctor, and this is my second visit to the ER if you’re wondering why women’s rights matter. I’m just going to [expletive] bleed out on this table before somebody comes and actually helps me.”

She said that she asked twice for a D&C, including from her own OBGYN.

OBGYNs told ABC News the “save the mother’s life” exception of abortions bans — which Broesder may have qualified for in Idaho — is often vague and the language is unclear about what qualifies as a mother’s life being in danger, what the risk of death is, and how imminent death must be before a provider can act.

Providers also may be worried about providing miscarriage care because it could be misconstrued as providing abortion care, and they could face legal repercussions.

“That’s the optimal scenario, that doctors are able to provide the care that’s necessary and evidence-based,” Dr. Beverly Gray, an obstetrician and gynecologist at Duke Health in Durham, North Carolina, who was not involved in Broesder’s care, told ABC News. “I worry about other systems that are worried about how they could come under attack for taking care of a patient or could a doctor that’s caring for the patient be prosecuted in some way. I think these are real fears that people are facing.”

Broesder was told by the second hospital that she had a complete miscarriage and was given tranexamic acid, medicine that controls bleeding and helps prevent excessive blood loss, according to medical records reviewed by ABC News, and sent home.

The hospital network, answering on behalf of both hospitals Broesder visited, said that “due to federal and state privacy laws, we cannot confirm nor deny that this patient was seen at our facilities” but that it “provides such medical care as required under the Emergency Medical Treatment and Labor Act” when a pregnant woman suffers a medical emergency that requires the pregnancy to be terminated.

During this time, Broesder said she thought she was going to die.

“I was in so much pain I didn’t know how much more my body could take,” she said. “I had gone to the ER twice and I got turned away. I go to the OB, and I got turned away. I knew I couldn’t afford much more visits for longevity afterwards to keep my family afloat. So, I was just like, well, it is what it is.”

Finally receiving care
By this time, her very first TikTok video had gone viral – the app shows it currently has more than 620,000 views – and she had been making more videos to keep those following her story updated.

She said many of her new followers told her to go to the ER again and, on Dec. 16, she decided to drive to St. Luke’s Boise Medical Center, where she was given a room and seen by a nurse.

Broesder said she requested a D&C and was denied again.

Dr. Frank Johnson, chief medical officer at St. Luke’s Health System covering Boise, Elmore and McCall, who did not treat Broesder but spoke about her case with ABC News, said “looking over this particular situation, there was no additional need for an interventional procedure by the time that she arrived here at St. Luke’s.”

So, I think in this particular case, medically appropriate care was provided to the patient,” he added.

While D&Cs are generally performed to terminate a pregnancy in the later stages, Dr. Saida Hader, an OBGYN at Rush University Medical Center in Chicago, told ABC News it can be provided if a patient is bleeding heavily in early pregnancy and miscarrying.

“D&Cs can be performed at any point in pregnancy, including early pregnancy and in the case of a miscarriage if someone is bleeding heavily,” she said, commenting in a general sense and not on Broesder’s care specifically. “What I will say, as a clinician, miscarriage is a very common occurrence in pregnancy and for patients that are clinically ‘less stable,’ which is what we call them when they’re bleeding a lot, the best course of action is a D&C and that is what you use to treat an early pregnancy in this situation.”

In an audio recording of the conversation Broesder had with the physician about why she couldn’t get a D&C, he said “there is some trepidation” about performing one in the wake of Idaho’s new abortion law.

“I felt like 50 pounds of bricks got lifted off my shoulders and got replaced with like 50 pounds of raging fire,” she said. “But I couldn’t do anything because this guy’s helping me so I’m not mad at him and it’s not his fault. I’m obviously mad at the law.”

Johnson did say, at St. Luke’s, doctors do sometimes have to consult with the legal team on cases to make sure they’re staying within the bounds of the law, although it’s not clear if this occurred in Broesder’s case.

“That’s been a new situation, really a necessity based on the ways that the laws are currently devised and written,” he said. “Traditionally, I think it is best when those conversations can occur between a physician, a woman and her family, and having to add the complexity of needing to figure out how to navigate a new law is an added challenge.”

Haider, who was not involved in Broesder’s care said the fear of criminalization and inability to provide care, even in situations where abortion providers might deem it necessary, might prevent them from acting.

“They might have initially acted sooner, they might have acted more aggressively to provide, taken more actions to intervene if they could have and by delaying that care, you’re putting the patients in a worse situation clinically and more at risk of bad outcome,” she told ABC News, speaking in a general sense.

Broesder said the doctor at St. Luke’s did discover part of the embryo was stuck in her cervix, so she received a procedure to remove part of the remaining tissue and was prescribed misoprostol, which treats postpartum bleeding, induces labor and causes an abortion.

From the day Broesder’s miscarriage started to when it ended, she said it was a total of 19 days of bleeding.

She said while she has been encouraged by the supportive comments and messages she has received on social media since her first video, she does not intend to try for another baby. She said the Idaho law worries her that if something similar happens, she could die due to fear from medical professionals about administering care.

“After this, even without the possibility or desire to have a baby, like, why would I want to go through that pain again?” Broesder said. “And why would I want to go through my daughter almost losing her mom again to have another child? That seems selfish and wrong.”

She added, “I did not deserve to have to beg for my life for eight days and nobody else does either.”

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