Health

Exercising Critically Ill Patients May Help Speed Recovery

Published

11 years ago

March 31, 2015

In this photo provided by the Wake Forest Baptist Medical Center, taken March 11, 2015 in the intensive care unit at Wake Forest Baptist Medical Center, physical therapist Katie Kellner helps patient Terry Culler do some exercises and briefly stand despite being hooked to a ventilator. There’s increasing evidence that mild exercise may have its place even for the sickest ICU patients, and new animal research suggests it may target both muscles and lungs. (AP Photo/Warren Cameron Dennis III, Wake Forest Baptist Medical Center)

LAURAN NEERGAARD, AP Medical Writer

WASHINGTON (AP) — The intensive care unit is a last frontier for physical therapy: It’s hard to exercise patients hooked to ventilators.

Some hospitals do manage to help critically ill patients stand or walk even if they’re tethered to life support. Now research that put sick mice on tiny treadmills shows why even a little activity may help speed recovery.

“I think we can do a better job of implementing early mobility therapies,” said Dr. D. Clark Files of Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, who led the research and whose hospital is trying to get more critically ill patients up, ventilator and all.

Hospitals have long nudged less critical patients out of bed, to prevent their muscles from wasting away. But over the past several years, studies in ICUs have shown that some of the sickest of the sick also could benefit — getting out of intensive care sooner, with fewer complications — once it’s medically feasible for them to try.

This isn’t just passively changing a patient’s position. It could involve helping them sit on the side of the bed, do arm exercises with an elastic band or in-bed cycling, even walk a bit with nurses holding all the tubes and wires. It takes extra staff, and especially for patients breathing through tubes down their throats, it isn’t clear how often it’s attempted outside specialized centers.

At Wake Forest Baptist, a physical therapist helped Terry Culler, 54, do arm and leg exercises without dislodging his ventilator tubing, working up to the day he stood for the first time since developing respiratory failure about three weeks earlier. “I cheered, I was clapping,” his wife, Ruanne Culler of Lexington, North Carolina, said after two therapists and a nurse finally helped him to his feet.

Biologically, why could such mild activity help? Files focused on one especially deadly reason why people wind up on a ventilator: acute respiratory distress syndrome, or ARDS, the problem Terry Culler battled. It strikes about 200,000 Americans a year, usually after someone suffers serious injuries or another illness such as pneumonia; it can rapidly trigger respiratory failure. Survivors suffer profound muscle weakness.

Files’ team injured the lungs of laboratory mice in a way that triggered ARDS. The animals, sick but still breathing on their own, walked or ran on a treadmill for a few minutes at a time over two days.

That short amount of exercise did more than counter wasting of the animals’ limbs. It also slowed weakening of the diaphragm, used to breathe. And it tamped down a dangerous inflammatory process in the lungs that Files suspects fuels muscle damage on top of the wasting of enforced bed-rest.

“It’s not only putting a load on the legs,” Files explained. “It’s something systemic.”

When certain white blood cells stick inside ARDS-affected lungs too long, they slow healing. The lungs of the exercised mice contained fewer of those cells — and their blood contained less of the protein that activates them, Files reported in the journal Science Translational Medicine this month.

Examining blood frozen from ARDS patients who had participated in an earlier Wake Forest Baptist study comparing early mobility to standard ICU care, he found patients who had gotten a little exercise harbored less of that protein.

The new research adds to the biologic rationale, but there’s already enough evidence supporting early mobility that families should ask whether their loved one is a candidate, said ICU specialist Dr. Catherine Hough of the University of Washington, who wasn’t involved with Files’ study.

She’s surveying a sample of U.S. hospitals and finding variability in how often ICUs try, from those that help a majority of critically ill patients stand to others where no ventilated patients do. Obviously, key is whether the patient can tolerate movement. But so is whether hospitals keep ventilated patients sedated despite research showing many don’t need to be, Hough said.

Back at Wake Forest Baptist, Terry Culler began the exercises when he was medically stable, and he scribbled notes saying he wanted to participate.

“It’s given him something to look forward to,” his wife said a few weeks before he was released from the hospital.

“Ask about it every day,” University of Washington’s Hough advises families, given that critical illness changes frequently. “On Monday, the patient might have a good reason not to be moving forward with mobilization, but there’s a very good chance it’s different on Tuesday,” she said.

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Advice

Support Your Child’s Mental Health: Medi-Cal Covers Therapy, Medication, and More

Published

2 days ago

December 14, 2025

Oakland Post

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When children struggle emotionally, it can affect every part of their lives — at home, in school, with friends, and even their physical health. In many Black families, we’re taught to be strong and push through. But our kids don’t have to struggle alone. Medi-Cal provides mental health care for children and youth, with no referral or diagnosis required.

Through California Advancing and Innovating Medi-Cal (CalAIM), the state is transforming how care is delivered. Services are now easier to access and better connected across mental health, physical health, and family support systems. CalAIM brings care into schools, homes, and communities, removing barriers and helping children get support early, before challenges escalate.

Help is Available, and it’s Covered

Under Medi-Cal, every child and teen under age 19 has the right to mental health care. This includes screenings, therapy, medication support, crisis stabilization, and help coordinating services. Parents, caregivers, and children age 12 or older can request a screening at any time, with no diagnosis or referral required.

Medi-Cal’s Mental Health and Substance Use Disorder Program

For children and youth with more serious mental health needs, including those in foster care or involved in the justice system, Medi-Cal offers expanded support, including:

Family-centered and community-based therapy to address trauma, behavior challenges, or system involvement.
Wraparound care teams that help keep children safely at home or with relatives.
Activity funds that support healing through sports, art, music, and therapeutic camps.
Initial joint behavioral health visits, where a mental health provider and child welfare worker meet with the family early in a case.
Child welfare liaisons in Medi-Cal health plans who help caregivers and social workers get services for children faster

Keeping Kids Safe from Opioids and Harmful Drugs

DHCS is also working to keep young people safe as California faces rising risks from opioids and counterfeit pills. Programs like Elevate Youth California and Friday Night Live give teens mentorship, leadership opportunities, and positive outlets that strengthen mental well-being.

Through the California Youth Opioid Response, families can learn how to avoid dangerous substances and get treatment when needed. Song for Charlie provides parents and teens with facts and tools to talk honestly about mental health and counterfeit pills.

DHCS also supports groups like Young People in Recovery, which helps youth build skills for long-term healing, and the Youth Peer Mentor Program, which trains teens with lived experience to support others. These efforts are part of California’s strategy to protect young people, prevent overdoses, and help them make healthier choices.

Support for Parents and Caregivers

Children thrive when their caregivers are supported. Through CalAIM’s vision of whole-person care, Medi-Cal now covers dyadic services, visits where a child and caregiver meet together with a provider to strengthen bonding, manage stress, and address behavior challenges.

These visits may include screening the caregiver for depression or anxiety and connecting them to food, housing, or other health-related social needs, aligning with CalAIM’s Community Supports framework. Notably, only the child must be enrolled in Medi-Cal to receive dyadic care.

Family therapy is also covered and can take place in clinics, schools, homes, or via telehealth, reflecting CalAIM’s commitment to flexible, community-based care delivery.

Additionally, BrightLife Kids offers free tools, resources, and virtual coaching for caregivers and children ages 0–12. Families can sign up online or through the BrightLife Kids app. No insurance, diagnosis, or referral is required.

For teens and young adults ages 13–25, California offers Soluna, a free mental health app where young people can chat with coaches, learn coping skills, journal, or join supportive community circles. Soluna is free, confidential, available in app stores, and does not require insurance.

CalHOPE also provides free emotional support to all Californians through a 24/7 support line at (833) 317-HOPE (4673), online chat, and culturally responsive resources.

Support at School — Where Kids Already Are

Schools are often the first place where emotional stress is noticed. Through the Children and Youth Behavioral Health Initiative (CYBHI), public schools, community colleges, and universities can offer therapy, counseling, crisis support, and referrals at no cost to families.

Services are available during school breaks and delivered on campus, by phone or video, or at community sites. There are no copayments, deductibles, or bills.

Medi-Cal Still Covers Everyday Care

Medi-Cal continues to cover everyday mental health care, including therapy for stress, anxiety, depression, or trauma; medication support; crisis stabilization; hospital care when needed; and referrals to community programs through county mental health plans and Medi-Cal health plans.

How to Get Help

Talk to your child’s teacher, school counselor, or doctor.
In Alameda County call 510-272-3663 or the toll-free number 1-800-698-1118 and in San Francisco call 855-355-5757 to contact your county mental health plan to request an assessment or services.
If your child is not enrolled in Medi-Cal, you can apply at com or my.medi-cal.ca.gov.
In a mental health emergency, call or text 988, the Suicide and Crisis Lifeline.

Every child deserves to grow up healthy and supported. Medi-Cal is working to transform care so it’s accessible, equitable, and responsive to the needs of every family.

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Activism

Essay: Intentional Self Care and Community Connections Can Improve Our Wellbeing

At the deepest and also most expansive level of reality, we are all part of the same being, our bodies made from the minerals of the earth, our spirits infused by the spiritual breath that animates the universe. Willingness to move more deeply into fear and pain is the first step toward moving into a larger consciousness. Willingness to move beyond the delusion of our separateness can show us new ways of working and living together.

Published

2 months ago

October 27, 2025

Oakland Post

Lorraine Bonner is a retired physician. She is also a sculptor who works in clay, exploring issues of trust, trustworthiness and exploitation, as well as visions of a better world.

By Dr. Lorraine Bonner, Special to California Black Media Partners

I went to a medical school that was steeped in the principles of classical Western medicine. However, I also learned mindfulness meditation during that time, which opened me to the multifaceted relationship between illnesses and the interconnecting environmental, mental and emotional realities that can impact an individual’s health.

Therefore, when I began to practice medicine, I also pursued training in hypnosis, relaxation techniques, meditation, and guided imagery, to bring a mind-body focus to my work in medical care and prevention.

The people I saw in my practice had a mix of problems, including high blood pressure, diabetes, and a variety of pain issues. I taught almost everyone relaxation breathing and made some general relaxation tapes. To anyone willing, I offered guided imagery.

“My work embraced an approach to wellness I call “Liberatory Health” — one that not only addresses the treatment and management of disease symptoms but also seeks to dismantle the conditions that make people sick in the first place.”

From my perspective, illness is only the outermost manifestation of our efforts to cope, often fueled by addictions such as sugar, tobacco, or alcohol, shackled by an individualistic cult belief that we have only ourselves to blame for our suffering.

To put these ideas into practical form, I would quote the immortal Mr. Rogers: “Find the helpers.” There are already people in every community working for liberation. Some of them are running for office, others are giving food to those who need it. Some are volunteering in schools, libraries or hospitals. Some are studying liberation movements, or are working in urban or community gardens, or learning to practice restorative and transformative justice, or creating liberation art, music, dance, theater or writing. Some are mentoring high schoolers or apprenticing young people in a trade. There are many places where compassionate humans are finding other humans and working together for a better world.

A more compassionate world is possible, one in which we will all enjoy better health. Creating it will make us healthier, too.

In community, we are strong. Recognizing denial and overcoming the fragmenting effects of spiritual disorder offer us a path to liberation and true health.

Good health and well-being are the collective rights of all people!

About the Author

Dr. Lorraine Bonner is a retired physician. She is also a sculptor who works in clay, exploring issues of trust, trustworthiness and exploitation, as well as visions of a better world.

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Activism

Prescribing Prevention: Doctors Turn to Lifestyle, Herbs and Veggies to Protect Against Chronic Illness in Black Californians

Published

2 months ago

October 27, 2025

Oakland Post

Dr. Bill Releford owns Bloom Ranch in Acton, a 250-acre farm in Acton. Releford, a podiatrist based in Los Angeles started the 250-acre Bloom Ranch — he largest Black-owned ranch in Los Angeles County — in 2023. The ranch provides access to nutritional fruits and vegetables, a part of Releford’s strategy for focusing on wellness and preventive care.

By Charlene Muhammad, California Black Media

Leibo Glover received his diabetes diagnosis at the same time he found out he needed a below-the-knee amputation.

“Minor,” thought the 63-year-old.

Glover had been self-medicating a toe injury before seeing the doctor.

But while driving from South Los Angeles to Miami on a family trip, an infection set in.

“I had it but didn’t know,” said Glover. “I was just going to come back to California, but they told me if I had left, I would have come home as a corpse,” Glover told California Black Media (CBM).

A majority of the nearly 3.5 million Californians diagnosed with diabetes have preventable Type 2 diabetes, according to researchers at the UCLA Center for Health Policy Research.

In 2023, diabetes was diagnosed in 1 in 6 adults with the lowest incomes (16.7% at 0–99% of the federal poverty line), compared to 1 in 11 adults with the highest incomes (8.9% at 300% or more of the federal poverty line). Age is a factor, too: more than 1 in 5 older adults age 65 and over (22.3%) had diabetes, about twice the rate of adults age 18–64 (8.6%).

Another study by Health Economics and Evaluation Research (HEER) mapped patients with diabetes in California who had amputations. Researchers found that patients living in low-income ZIP codes were far more likely to have had lower-limb amputations than those in higher-income ZIP codes, essentially identifying amputation “hot spots.”

At the time of Glover’s 2018 diagnosis, he was experiencing housing instability and going through financial hardships. Now, he has more stable housing and he has improved his health through lifestyle changes like eating healthier and getting more sleep.

“If the equipment is right, I can stand on my leg for hours. I can actually run, jump, dance and all of that,” said Glover, who got his diabetes under control, in part, by avoiding carbohydrates and sugars.

As chronic illnesses continue to disproportionately impact Black Californians — often leading to preventable amputations and premature deaths — a growing number of doctors and advocates are expanding their care from just treatment to including prevention. From promoting diet and lifestyle changes to cultivating community farms focused on prevention and wellness like Dr. Bill Releford’s Bloom Ranch in Acton.

Releford, a podiatrist based in Los Angeles started the 250-acre Bloom Ranch in 2023 as part of his strategy for preventive care.

“This is my assignment,” said Releford.

“Bloom Ranch has been a perfect backdrop for me to be creative and to find avant-garde ways to make fresh fruits and vegetables more accessible to food deserts in Los Angeles County,” he stated.

California produces nearly half of the nation’s fruits and vegetables, yet more than 1 in 5 Californians — about 8.8 million people — currently struggle with food insecurity, according to the California Association of Food Banks.

“Studies have shown that 75% of amputations are preventable. And African Americans have the highest amputation rate in the nation,” Releford said.

As such, Releford continued, the mortality rate associated with high-level amputation is 50%, which means “if we had 10 people that all had high level amputations, five of those would be deceased in three years.”

Monday, June 28, 2025. Leibo Glover at his home in Los Angeles, California. The security professional’s leg was amputated below the knee.

Releford’s ranch is the largest Black-owned farm in L.A. County. He plans to partner with UCLA and the Charles R. Drew University of Medicine and Science to develop prescriptive vegetable boxes.

“Certain vegetables and herbs can lower blood pressure naturally, like beets, turnips, dill, basil, garlic and others,” said Releford.

“Hopefully, this will inspire other farmers to take this model and replicate it across other urban areas,” Releford added.

“A lot of studies have shown that gardening has so many health benefits – being in the sun, Vitamin D,” said Releford. “The dirt has a lot of microbes that are good for your immune system. Studies have shown that people who work in the dirt have strong immune systems.”

Gardening can potentially decrease the risk of dementia, enhance cognition, reduce stress, and boost immunity, indicates research by Genoa Barrow of the University of Southern California Center for Health Journalism as part of the 2024 Ethnic Media Collaborative, Healing California.

During a recent picturesque day at Bloom Ranch, families, school children, farmers and members of The Ultimate Book Club 1998, founded by Alina Anderson, sampled and purchased fresh produce while taking photographs.

“This is huge. “All of us have families that could use this information,” said Anderson.

Doctors like Releford, who are committed to tackling the most chronic diseases impacting all their patients utilize peer-to-peer support programs with self-management training led by individuals living with chronic conditions to provide role models and support for patients, according to a recent study by the California Health Care Foundation.

“The unifying feature of these programs is that they seek to build on the strengths, knowledge, and experience that peers can offer,” the report states.

Liz Helms, CEO of the California Chronic Care Coalition, addressed state-backed prevention policy and initiatives.

“It’s in horrible shape. It needs to get so much better, especially in underserved areas, where the Black population has a whole set of different needs,” she said.

Helms, who started advocacy after being denied access to care in the early 1990s, applauded new developments in telehealth. The opportunity to choose between visiting a doctor’s office or placing a phone call makes a difference, especially if there are transportation or distance issues, or if one is too sick, she said.

Fear is one thing people, especially in the Black community, must overcome, emphasized Helms.

“I had to get over my fear of going to the doctor, of not speaking up,” continued Helms, urging patients to “understand the baseline” of their health.

“Don’t let anyone stigmatize you or tell you that you’re not good enough to get care or look down on you. Everyone has a right to good, quality, affordable, timely health care,” said Helms.

To engage Bloom Ranch for preventive care focused on wellbeing and healthy living, call (323) 388-4828 or sign up at Bloomranchofacton.com