Tag: death

EMBRACING CHANGE

by Herb Ryan, posted in Education, Health

 

Embracing Change. Photo: NASA

 

By Peg Ryan
Mile High Pilates and Yoga

We are all temporary residents of Planet Earth and none of us knows when our visa will expire.  Despite the fact that this is the one certain fact of our existence, we spend our lives either resisting or, mostly, ignoring it. Hoping it will just go away.  Or maybe somehow we will miraculously be exempt.  Of course, no one wants to dwell on the fact of his/her own demise even though it is inevitable.  Our society has an uncomfortable relationship with this concept.  Some of us have beliefs about what happens after death that subdue negative thinking on the subject.  But mostly what we think of when we reflect on the impermanence of life is it’s loss.  And it’s not just people but every living thing on the planet that will undergo the transformation from life to not-life, whatever that entails.  Those left behind lose someone or something, creating a void where that living being once was.  Those about to move into the transition will lose everything that is familiar, the perceptions that a lifetime of consciousness has provided.  They think of all the events they will miss.  So it’s not really death that we worry about.  Of course, we may fear the potential pain that might accompany death.  But what we really fear is loss.  And change.

No one likes change.  Yet change is as inevitable as death.  Everything is changing all the time, and despite our best efforts, there is nothing we can do to stop it.  Even when we think we’ve managed to head off certain changes, other changes will still occur that may not have been anticipated.  This is not to say that we shouldn’t work to make changes that could improve our lives.  But outcomes will most likely be different from what we expected when we began this work. Unexpected things happen all the time.  This is why many thinkers on these subjects recommend focussing on the process, rather than the outcome.  There’s an old Yiddish saying, “Man plans and God laughs”.  Life is unpredictable.  Pay attention to the journey, but let the chips fall where they may.

Loss comes in many forms, not just the ultimate.  Often we fail to acknowledge the significance of other losses in our lives.  Sometimes we know they are coming, other times we don’t.  Either way, we don’t always have a choice in how things work out.  We lose jobs, homes, money, youth, independence, etc., etc.  Even when we think we’ve chosen well, there are many factors beyond our control.  Sometimes things work out the way we want, sometimes they don’t.   It’s so easy to judge the actions of others.  Or to beat up on ourselves when we think we’ve made some huge blunder.  Hindsight is 20-20.  But most of us do the best we can with what we have to work with at the time.  And time only moves in one direction.  There is no going back.  What exists right now is what we have to work with.  We can’t change other people.  Circumstances beyond our control create situations that can’t be changed.  Sometimes we can change parts and pieces or maybe work toward a change.  But for the most part the only thing we can change is our attitude and perception.

In an article in Yoga Journal author Sally Kempton talks about navigating through change.  She cites “the Buddhist Doctrine of Impermanence, annica, [which] tells us that change is inevitable, continuous, and unavoidable.”  There is also a way of viewing this as the constantly shifting nature of energy:

“the intrinsic, dynamic power at the heart of life. . . . Every moment, every enterprise, every cell, is part of this flow of creation, sustenance, and dissolution. This flow is happening on a macrocosmic level—as the flow of seasons, tides, and cultures—and on a microcosmic level, through the various shifts in your physical states, the ups and downs of your life, and the flow of thoughts and emotions in your mind.”

When seen this way, even the most determined control freak must acknowledge that these changes are happening right before our eyes in every moment of every day.  Like it or not.

Perhaps instead of thinking of “endings” and “beginnings”, we can think of change as heralding transformation.  Part of our fear of loss is fear of the unknown.  What will be on the other side of this loss?  We know what life was like before the change.  How will we deal with what comes next? Even if the current state of affairs is not optimal, at least it’s familiar – the “devil you know “.  In the article cited above, Ms. Kempton also talks about ritual.  She writes, “In traditional societies, every phase of life was regarded as an initiation into a new way of being and was marked with a ceremony. . . Nowadays, we don’t always do a ceremony, but we still undergo initiations.”  All life changes require us to “step outside your habits, test your skills, and, for a time, inhabit the unknown. . . Each of these changes will subtly or even dramatically redefine you. You won’t be quite the same person after you step out of the old situation and into the new.”  Furthermore, “the change itself . . is the doorway into the next stage of growth—one that propels you into a deeper relationship with yourself and the world.”

The article goes on to provide some ideas for moving through change gracefully.  These, of course, require practice. Practice implies that success is not guaranteed, but there will always be another opportunity to try.  There are many articles and numerous suggestions from all kinds of authors on what to include in such a practice.  Everyone needs to find what works for them.  Still when change is sudden and catastrophic, it can be difficult to remember how to practice, let alone recognize that you are embarking on a new way of life.  Mourning is also a ritual.  Recognizing loss and the need to mourn is just as important as accepting change.  But all suggestions seem to boil down to the same concept:  leave the past behind, let the future take care of itself and simply be here now.  In this moment.  Hear your breath.  Count your blessings.  If you’re still a resident on the planet with an unexpired visa there will always be something to be grateful for.  Loss hurts.  It’s OK to hurt.  It’s part of being human.  Allow it.  Be kind to yourself.

In Washington, There’s a Tax for Every Occasion

by Herb Ryan, posted in South Dakota Politics

By Sen. John Thune
October 20, 2017

Death should not be a taxable event. Surprisingly, though, the idea that it would be such an occasion has become a political issue that can pit family-run farms and ranches against Washington’s political elite who think certain Americans, including some farm and ranch owners, should be taxed two or three times on their wealth. I simply disagree.

I don’t need to tell the hard-working farm and ranch families across South Dakota that they’re in a land-rich and cash-poor business. They know the assets on the business’ balance sheet far exceed the earnings that end up in the family checkbook. But for too many lawmakers in Washington, they just don’t seem to care.

The case against the death tax, which can hit families at the worst possible moment, is pretty straightforward. As everyone knows, an individual’s wages are taxed when they are earned. Interest, dividends, and capital gains from wages that are saved are then taxed again. When the owner of those assets passes away, the death tax can hit his or her earnings yet again – for a second or third time. It’s this extra assessment on previously taxed assets that folks, myself included, find so objectionable.

Wealth isn’t only measured by the amount of money a person has in his or her bank account. It’s also measured by non-liquid assets, like land or other property. That can spell trouble for a land-rich South Dakota family-run farm or ranch if the death-tax collector shows up at the door, particularly now, after the U.S. Department of Agriculture says cropland values have increased by 400 percent over the last 15 years. Remember, growth in land value doesn’t always translate into growth in cash from those assets.

For supporters of the death tax, their favorite talking point is that it hits a small number of family-owned businesses, farms, and ranches each year, as if that somehow justifies a confiscatory tax on a larger swath of Americans. What they conveniently fail to mention is the large expense – both in time and money – that farmers and ranchers invest during their lives to avoid being a death tax statistic. Too often, these folks have to hire costly lawyers, accountants, and estate planners, all of which can cost well over one hundred thousand dollars, to develop an effective estate plan. They can also spend tens of thousands of dollars each year in life insurance premiums – again, all just to avoid being a victim of the death tax.

Don’t take my word for it, though. A South Dakota rancher and estate planner recently wrote, “My brothers and I own an 8,000-head cattle feeding and finishing operation that will be threatened by the death tax if nothing changes … Repeal of the death tax means farmers, ranchers, and small business owners like me can stop wasting money on a tax that threatens our family’s future. That extra money can be spent more wisely in our local economy, which helps our community grow through increased jobs, wages, and purchasing.”

I get it. Many of my Democrat colleagues who support the death tax see it as an opportunity to raise revenue and spend it on other federal programs. They don’t think many farmers and ranchers pay the death tax, and for those who are fortunate enough avoid it, the tens of thousands of dollars they shell out to do so are just a mere inconvenience. In effect, they are punishing success by demanding another big tax at death. To those lawmakers, I’d say you need to meet more farmers and ranchers.

In my opinion, one family-run operation that’s forced to sell because of the death tax is one too many. Now is the time to bury the death tax once and for all, and I’ll continue my years-long fight to do so in the tax reform bill I’m working on in the Senate.

State Fire Marshal’s Office Hosts Line-of-Duty Death Training March 10-11

by Herb Ryan, posted in Emergency Services, South Dakota

 

Image: National Fallen Firefighters Foundation

 

 March 7, 2017

PIERRE, S.D. – What needs to be done following the death of a public safety officer is the focus of a special training being held this weekend in Pierre.

The South Dakota Fire Marshal’s Office is hosting the Line-of-Duty Death Local Assistance State Team (LAST) Training Friday and Saturday at the George S. Mickelson Criminal Justice Center in Pierre. The program is put on by the National Fallen Firefighters Foundation.

The two-day event involves training and a table top exercise on Saturday. Anybody involved in the management of and recovery efforts following a line-of-duty death of a public safety officer is invited to attend.

“Having a colleague die in the line of duty is not something that fire departments, law enforcement agencies or EMS units want to think about,” says State Fire Marshal Paul Merriman. “How an agency handles a line-of-duty death can impact the family, the agency and the community. If not handled correctly, there can be additional pain and heartache.”

The course, done through a collaborative effort with the U.S. Department of Justice, provides the training needed to help establish state and regional (LAST) teams. Merriman says the LAST Teams would be available to help an agency or department handle the death of an officer in the line of duty.

“The primary objective of the LAST team is to provide assistance and comfort to the family and department impacted by such a tragic event,” he says. “There are a lot of details that need to be completed, such as the filing for federal, state and local benefits. The LAST teams can help with those arrangements.”

Course instructor is Ian Bennett, fire chief of the Harrisonburg Fire Department in Harrisonburg, VA.

There is no cost to attend the course.

Participants can register online at: https://reg.abcsignup.com/view/view_month.aspx?as=14&wp=27&aid=SDFA.

For more information, contact Deputy Fire Marshal Mike Erickson at mike.erickson@state.sd.us.

The State Fire Marshal’s Office is part of the South Dakota Department of Public Safety.

FDA Approves First Drug For Spinal Muscular Atrophy

by Herb Ryan, posted in Health, National

December 23, 2016

SILVER SPRINGS, MD – The U.S. Food and Drug Administration today approved Spinraza (nusinersen), the first drug approved to treat children and adults with spinal muscular atrophy (SMA), a rare and often fatal genetic disease affecting muscle strength and movement. Spinraza is an injection administered into the fluid surrounding the spinal cord.

“There has been a long-standing need for a treatment for spinal muscular atrophy, the most common genetic cause of death in infants, and a disease that can affect people at any stage of life,” said Billy Dunn, M.D., director of the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research. “As shown by our suggestion to the sponsor to analyze the results of the study earlier than planned, the FDA is committed to assisting with the development and approval of safe and effective drugs for rare diseases and we worked hard to review this application quickly; we could not be more pleased to have the first approved treatment for this debilitating disease.”

SMA is a that causes weakness and muscle wasting because of the loss of lower motor neurons controlling movement. There is wide variability in age of onset, symptoms and rate of progression. Spinraza is approved for use across the range of spinal muscular atrophy patients.

The FDA worked closely with the sponsor during development to help design and implement the analysis upon which this approval was based. The efficacy of Spinraza was demonstrated in a clinical trial in 121 patients with infantile-onset SMA who were diagnosed before 6 months of age and who were less than 7 months old at the time of their first dose. Patients were randomized to receive an injection of Spinraza, into the fluid surrounding the spinal cord, or undergo a mock procedure without drug injection (a skin prick). Twice the number of patients received Spinraza compared to those who underwent the mock procedure. The trial assessed the percentage of patients with improvement in motor milestones, such as head control, sitting, ability to kick in supine position, rolling, crawling, standing and walking.

The FDA asked the sponsor to conduct an interim analysis as a way to evaluate the study results as early as possible; 82 of 121 patients were eligible for this analysis. Forty percent of patients treated with Spinraza achieved improvement in motor milestones as defined in the study, whereas none of the control patients did.

Additional open-label uncontrolled clinical studies were conducted in symptomatic patients who ranged in age from 30 days to 15 years at the time of the first dose, and in presymptomatic patients who ranged in age from 8 days to 42 days at the time of first dose. These studies lacked control groups and therefore were more difficult to interpret than the controlled study, but the findings appeared generally supportive of the clinical efficacy demonstrated in the controlled clinical trial in infantile-onset patients.

The most common side effects found in participants in the clinical trials on Spinraza were upper respiratory infection, lower respiratory infection and constipation. Warnings and precautions include low blood platelet count and toxicity to the kidneys (renal toxicity). Toxicity in the nervous system (neurotoxicity) was observed in animal studies.

The FDA granted this application fast track designation and priority review. The drug also received orphan drug designation, which provides incentives to assist and encourage the development of drugs for rare diseases.

The sponsor is receiving a rare pediatric disease priority review voucher under a program intended to encourage development of new drugs and biologics for the prevention and treatment of rare pediatric diseases. A voucher can be redeemed by a sponsor at a later date to receive priority review of a subsequent marketing application for a different product. This is the eighth rare pediatric disease priority review voucher issued by the FDA since the program began.

Spinraza is marketed by Biogen of Cambridge, Massachusetts and was developed by Ionis Pharmaceuticals of Carlsbad, California.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Saving Lives – One Tweet at a Time

by Herb Ryan, posted in Health, National

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