Many people are returning to recreational activities they suspended during the pandemic, and hearing experts warn cranking up music using earbuds can lead to hearing loss.

Dr. James Lewis, associate professor of audiology and speech pathology at the University of Tennessee Health Science Center, said many people listen to music while they are running a lawn mower or exercising in a loud gym. He explained listening to music over loud background noise can set the stage for ear damage.

"That's pretty hazardous," Lewis stressed. "Because what you tend to do when you're in a noisy environment, and you're trying to listen to your music through headphones, you tend to really increase the volume of your headphones, putting yourself at greater risk."

One in eight people in the United States 12 years or older has experienced hearing loss in both ears, according to Data from the National Institutes of Health.

He pointed out while many people are aware high-pitched tinging or buzzing is a warning sign of potential hearing loss, it is lesser known constant fatigue can also foreshadow a hearing problem.

"Especially if you know during the day you're in these environments where you really have to focus on listening," Lewis noted. "When you have hearing loss, that can cause you to exert greater effort in trying to understand what's going on. And that can have this kind of tiring effect as you go throughout the day."

Claire Johnson, manager of clinical services for UnitedHealthcare and an audiologist, said there are reminders to ensure you are not causing damage.

"One good recommendation or quick, easy rule that we recommend at UnitedHealthcare hearing is a 60/60 rule," Johnson outlined. "Limiting music to 60 minutes at a time at 60% of the player's maximum volume."

The Centers for Disease Control said the use of hearing aids is on the rise among people age 45-64, as well as among those 65 and over.

Some anesthesiologists hope this is the year Tennessee passes legislation to allow Certified Anesthesiologist Assistants to practice in the state.

Assistants are authorized to work in 20 states but not in Tennessee.

Sasi Duggirala, certified anesthesiologist assistant and managing partner at Harmony Anesthesia in Atlanta, a former Tennessean, said the state's shortage of anesthesiologists as well as Certified Registered Nurse Anesthetists delays surgeries. He is advocating for licensure of certified assistants to increase the number of anesthesia providers, saying it would ultimately improve patient care.

"After coming out of COVID, there's been just a huge backlog on necessary procedures and surgeries that need to be done," Duggirala pointed out. "The mid-level anesthetist coming only from CRNA pool is just not enough to fill that gap."

Last year, Senate Bill 453 would have allowed certified assistants to practice in Tennessee but the bill stalled in the House. Some Tennessee Certified Registered Nurse Anesthetists opposed it, claiming the assistants lack the comprehensive training of nurse anesthetists. Backers want to see the bill reintroduced.

David Ryan Diehl, certified anesthesiologist assistant at Diehl Anesthesia in Atlanta, explained his son was born with a congenital disorder requiring prosthetics. The family receives support from the Jordan Thomas Foundation in Nashville. Diehl said new legislation would allow him to practice anesthesiology in Tennessee.

"Legislation needs to be passed that allows us to practice there, to bill insurance, Medicare, Medicaid, all those types of things, and for the groups to be reimbursed," Diehl outlined. "Also for us to be insured there as well, to practice."

Dr. Richard Duncan, orthopedic surgeon and medical director of the Center for Advanced Bone and Joint Surgery at Watauga Orthopedics in Johnson City, Tennessee, pointed out both Certified Registered Nurse Anesthetists and Certified Anesthesiologist Assistants can administer anesthesia during surgeries. He highlighted their extensive training, and suggested Tennessee institutions could offer such training as an additional educational benefit.

"A Certified Anesthesia Assistant is a person that has a bachelor's degree with some prerequisites that they have to have, and testing that they do," Duncan explained. "Once they're admitted into their training, it's 24 to 28 months of didactic training, and then clinical training."

Duncan added the critical shortage of anesthesia providers affects hospitals, surgery centers and patient care across the board.


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Oregonians who are ready to leave the hospital but still require care do not have enough places to go, affecting providers and patients at all levels.

The average hospital stay has increased to nearly five days, according to the Hospital Association of Oregon. With nowhere to send discharged patients, hospitals can end up boarding them, which hurts hospitals financially and means fewer beds are available for people who need them.

Sen. Deb Patterson, D-Salem, was part of a task force which released 10 recommendations to address the problem. She said a top priority is presumptive eligibility for Medicaid, so people who likely qualify do not have to wait for their applications to be processed in order to receive care, which would also benefit providers.

"Long-term care facilities need to be assured that the patients they're accepting, they already have their insurance in place," Patterson explained.

Increased reimbursement rates for adult foster homes are high on the list for the task force, as well as continued funding for guardians. Guardians are court-appointed positions who make decisions for adults found incapable of caring for themselves because of dementia or other health problems.

The task force, which included representatives from hospitals, nursing homes and union leaders, said expanding medical respite is also critical. The programs provide short-term residential care for people experiencing homelessness who do not need a hospital to recover from an illness or injury.

Patterson stressed not having access to places to heal can be deadly.

"I would really advocate for funding for medical respite because we do not want to see people dying on the streets," Patterson emphasized.

Another issue contributing to the backlog of patients is staffing shortages in Oregon's skilled nursing and long-term care facilities. Patterson noted the state is collaborating with Future Ready Oregon to grow the health care workforce, including certified nursing assistants. She added another bill is in the works for spring, focusing on entry-level positions in long-term care.


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January's cold temperatures in Missouri and across the nation can pose risks for those with heart conditions.

The American Heart Association has tips on staying heart-healthy in winter - including dressing warmly to reduce strain on your heart, and avoiding overexertion during activities like shoveling snow.

St. Louis Physician, Dr. Ravi Johar, is a board member of the American Heart Association. He said snow shoveling is a leading cause of winter heart problems, especially for men in their 50s and 60s.

He stressed that cold weather constricts blood vessels, increasing the heart's demand for more blood during exertion.

"So you have a combination of the body needing more blood to the heart and getting less flow through it because of the cold weather," said Johar, "and that unfortunately can lead to a heart attack - and it's one of the most common times that you do see a heart attacks occurring, is at that time of the year."

Other winter tips from the American Heart Association include eating balanced meals with fruits, vegetables, lean proteins, and whole grains - and limiting alcohol because it can make you feel warmer than you are, raising the risk of hypothermia.

While it may be very comforting to enjoy a hot cup of cocoa or apple cider in the winter, heart health experts warn these drinks are often loaded with sugar - which can be dangerous for the heart if you drink too much.

Dr. Johar added that exercising in winter can be very beneficial.

"Exercise at any time of the year will increase your immunity," said Johar. "So during cold and flu season, having a little bit better immunity is always beneficial. You do need to make sure you have enough fluids, you need to stay hydrated even though you don't feel quite as thirsty cause you're not sweating as much, it's real important to make sure you stay hydrated."

The American Heart Association emphasizes that people should pay attention to symptoms like chest discomfort, dizziness, or unusual fatigue, and seek medical help if needed.