HRT - Hormone Replacement Therapy in Saddle Brook, NJ

By Dave Rosen

For three years, my sister in Saddle Brook has been battling colon cancer. The state-issued insurance supplied to New Jersey employees only added to that battle. Here’s why.

Michelle, who has been stoic since her original Stage 3 diagnosis, learned this spring after being in remission for several months that her doctors saw troubling markers, which again showed signs of disease. Her physicians at Memorial Sloan Kettering strongly recommended surgery to remove any visible cancer, followed by a chemotherapy “bath” in the abdomen before the incision is closed. For decades, this has been a successful and standard treatment for abdominal cancers in the USA and around the world.

However, one week before the surgery, after all the pre-operative tests and mental preparation, her government-funded health insurance provider, through her husband’s employer, the New Jersey Veterans Home at Paramus, denied coverage for the surgery. The company determined that the procedure was “not medically necessary.” Her stunned doctors went through the appropriate rounds of appeals to no avail.

Michelle was beyond upset. “Some of the world’s top doctors, who’ve dedicated their lives to studying and treating my specific cancer were overruled by an insurance company and state bureaucrats on whether this surgery was medically necessary,” she told me.

Don’t miss an issue of our Opinion newsletter! Get it delivered each Wednesday right into your inbox by adding your email below and hitting "subscribe."

Of course, the surgery would not be scheduled without payment up-front, so with no time to waste, Michelle and her family were forced to borrow the incredibly large sum. This was life-altering debt for a working-class family. It should also be noted, Michelle’s original diagnosis came when she was 49 years old. At the time, a year too young for insurance plans to cover a colonoscopy, the test which could have detected her cancer at an earlier stage.

During this process, we also learned about “self-funded” insurance policies. About 75.5 million employees in the United States, or 63% of all workers, were insured under these kinds of plans in 2015, but few people realized this. These plans are something the public should know about and understand. With these types of policies, your employer is the ultimate decision-maker on whether a health condition can be covered.

New Jersey contracts with Horizon Blue Cross/ Blue Shield of New Jersey to administer the policy, but the full cost of the payouts comes from the employer. That means that the denial letter comes from the insurance company but the employer is in charge, says Laurie Todd, who’s also known as The Insurance Warrior. The employer can intervene and approve coverage for procedures like this, but they have no incentive to do so. It costs too much.

In Michelle’s case, the New Jersey Division of Pensions and Benefits has the power to decide what care they will pay for.

So who told this state agency to deny Michelle’s surgery? We decided to research the doctors employed by Horizon Blue Cross/Blue Shield, and at least in Michelle’s case, the doctors had limited or no expertise in the treatments her Memorial Sloan Kettering and Cancer Institute of New Jersey doctors were recommending. How can this be an acceptable way of doing business?

Now I’ll admit, I’m writing this for selfish reasons — to vent, to yell from the rooftops. You see, Michelle is my big sister. My only sibling. Witnessing what this insurance nightmare is doing to her, her family and our aging parents make me feel completely powerless… and furious. It is also devastating to know our situation is not unique.

I thought, perhaps as you make your way to the polls this November, you should know how current state insurance plans and the leaders that implement them are saddling New Jersey families with generational debt. Shame on them all.

The good news here is that Michelle’s surgery has been a success, so far. But there are follow-up procedures ahead and a rough road to managing this significant financial debt.

“All we can do now is worry about how we’ll ever be able to pay for it all,” Michelle tells me. It’s just another “perk” of living and working in New Jersey.

Dave Rosen lives in Ringwood with his wife and young children. He and his wife run an audio mastering studio and a pro audio gear company. His sister, Michelle Rosen-Levy, and her family have set up a GoFundMe to help pay for the surgery.

Here’s how to submit an op-ed or Letter to the Editor. Bookmark NJ.com/Opinion. Follow us on Twitter @NJ_Opinion and on Facebook at NJ.com Opinion. Get the latest news updates right in your inbox. Subscribe to NJ.com’s newsletters.

SADDLE RIVER, N.J. — Israel Adesanya, finally in a somewhat quiet moment after a busy afternoon, sat down at a marble countertop and opened a black plastic-foam box.

He was almost through his promotional activities for the day as the Ultimate Fighting Championship’s middleweight champion — including interviews and photo shoots while working around training — and he was hungry. He needed a quesadilla.

“Better to do this now than next week,” Adesanya, 33, said last Thursday as he wiped crumbs from his lips. He dipped his takeout food into more cheese and pico de gallo salsa as he sat in the kitchen of a sprawling three-story, $12.8-million estate in a wooded, wealthy New York City suburb, a mansion that his team has rented in the run-up to his next title defense on Saturday night.

Promotional obligations for fighters always intensify as bouts get closer, and the demands are especially immense for Adesanya (23-1-0). He is the biggest active star for the world’s largest mixed martial arts organization, and he is set to headline U.F.C. 281 against Alex Pereira (6-1-0) on Saturday at Madison Square Garden.

When Adesanya squares up against Pereira, he will be facing two foes.

The first is Pereira himself, who bested Adesanya twice in the earlier stages of their careers on the kickboxing circuit. The other is a mounting criticism that Adesanya, whose marketable theatrical personality helped propel him to mainstream recognition, fights with an unappealing style for average fans.

Adesanya is confident that he can overcome both. But if you still think he is boring, he said he wouldn’t care. To him, that’s your fault.

“They’re blessed to watch me fight — I’m just being honest,” Adesanya said. “When I’m gone, they’re going to realize it, but they can’t appreciate it right now because I’m still here.”

Adesanya, who was born in Nigeria and grew up in New Zealand, won the U.F.C. middleweight 185-pound championship in April 2019, just over a year after he joined the promotion. He is undefeated in the division and suffered his only loss in mixed martial arts in 2021 when he challenged Jan Blachowicz for the 205-pound light heavyweight belt. Saturday will be his seventh middleweight title defense.

Adesanya’s charisma outside the octagon complemented his feats inside of it, which expedited his track to stardom. Adesanya is nicknamed “The Last Stylebender” a nod to the mid-2000s Nickelodeon cartoon “Avatar: The Last Airbender,” and he incorporates numerous anime references into his persona. He is creative with his walkout entrances, and in his most recent fight at U.F.C. 276 in July, he honored the Undertaker, an iconic figure in World Wrestling Entertainment, by slowly marching to the octagon in a brimmed top hat and holding an urn for the symbolic ashes of his opponent, Jared Cannonier.

Adesanya, who regularly documents his life on YouTube, said he tried to be himself, which he thinks has separated him from other champions.

“I’ve just been the coolest at it,” Adesanya said. “The way I’ve handled it, the way I’ve done it, the way I’ve carried myself — I feel like no one has done it like me.”

Since then, the U.F.C. has sought more mainstream stars to succeed those from previous years, including the retired Ronda Rousey and the active but not very active star Conor McGregor, who is rehabilitating from a broken leg in 2021 yet is still perhaps the sport’s biggest draw despite losing three of his past four fights and experiencing some legal troubles.

Adesanya has fought at least twice a year since joining the U.F.C., and he quickly became a dependable linchpin for the company’s fight calendar. He said he accepted his level of fame last year after initially shying away from it. Dana White, the U.F.C. president, said Adesanya capitalized on the opportunity.

“He’s always on people’s minds,” White said last week in a telephone interview. “The world is so crazy right now, and people can forget about you quick with their own problems, but he doesn’t let you. He’s in your face all the time.”

Adesanya has enjoyed the benefits. He signed a new contract with the U.F.C. in February, and celebrities like Drake have publicly supported him before his fights.

But the good will from fans has perhaps reached a crossroads. Adesanya has not knocked out an opponent since 2020, and his last three fights were unanimous decisions against Marvin Vettori, Robert Whittaker and Cannonier. In those three contests, he lost only three of 15 total rounds, using his 80-inch reach and precise striking skills to tactically attack his opponents. Adesanya said he thought those fights were not as competitive because those opponents struggled to gauge his range and movement, making them timid.

“I put on fantastic shows with a small margin for error,” Adesanya said. “People don’t understand, man, that I do this to these guys, and I make them look silly. These guys are not average, but they can’t do anything with me.”

Some fans, who crave knockouts and bloody showstoppers, have labeled his risk-averse style boring, unlike that of McGregor, who routinely knocked foes out with a powerful left hand, and of Rousey, who rose to fame with a string of quick arm-bar submissions.

In the closing seconds of Adesanya’s bout against Cannonier, boos rained inside T-Mobile Arena in Las Vegas for the perceived lack of action. Adesanya said he heard the discussion but said he would not change his approach.

“People just expect, when you’re as great as I am, they just expect you to always show out and show off, which I do, but sometimes it’s just not the way it plays out,” Adesanya said. “I think that’s just what society does — they build you up so they can tear you down.”

He added: “It’s a high-level game we play, but not everyone who watches is high-level.”

Adesanya is not the first combat sports star to face such criticism. The boxer Floyd Mayweather and the former U.F.C. champions Georges St. Pierre, Khabib Nurmagomedov and Tyron Woodley have all at points been branded as dull. White, who in the past has publicly admonished fighters after bouts he felt were too docile, said he had no issue with Adesanya’s recent performances. He compared it to football, saying each pass was not a Hail Mary and each Super Bowl was not a high-scoring affair.

Eugene Bareman, Adesanya’s longtime coach at City Kickboxing, the powerhouse gym in Auckland, New Zealand, said that he had emphasized being calculated rather than flashy during fights.

“Make no mistake, my job is to get him a win in the most pleasing fashion to the crowd, to the U.F.C. and to his management,” Bareman said in an interview. “But the line we won’t cross is where we’re willing to go out there with our chin out and just risk too much for that result. We won’t cross that line and just go out there recklessly and risk everything that he and everyone around him for years have worked so hard for.”

Adesanya said he is confident his fight with Pereira would be different because he expects Pereira to press forward and be aggressive in stand-up exchanges. Pereira beat Adesanya via decision in a kickboxing bout in 2016, then knocked him out a year later in a rematch.

Bareman said he had been more demanding on Adesanya this training camp, and they arrived to the United States from New Zealand earlier than usual with more than 25 people, a group that includes training partners, coaches and dietitians.

Should Adesanya defeat Pereira, the U.F.C.’s options for his next opponent are limited. Other than Pereira, Adesanya has defeated the top six ranked middleweight contenders, including Vettori and Whittaker twice. The logical next step seems to be another challenge for the light heavyweight belt, but Adesanya said he did not want to look too far ahead.

“I’m just focused on this guy because if I don’t get through this guy, all of my plans are failed,” Adesanya said.

After the interview concluded and Adesanya finished his quesadilla, he went to one of the home’s nine bathrooms to prepare for another photo shoot while his teammates swam in the indoor pool. As he walked toward the camera set in the mansion’s garage, a U.F.C. public-relations manager, with a laptop in hand, informed Adesanya that he had another set of videoconference calls afterward.

Adesanya, clearly losing energy, put his hand calmly on the manger’s shoulder and politely asked, “Is it OK if we do those tomorrow?”

Adesanya soon agreed to do them anyway, after learning the day ahead was already spoken for.

Biotin is a leading skin health and beauty ingredient. Data from market researcher SPINS (Chicago) for the 52 weeks ending October 31, 2021, showed biotin as the top-selling hair, skin, and nail ingredient in the U.S. mainstream supplements market, clocking in at $147 million in channel sales and growing 4.6% that year. But while more companies are formulating with biotin, and more consumers are buying it, not everyone knows that biotin ingredients are not all built alike. This past October, Nutrition21 (Saddle Brook, NJ) announced that its recently launched Lustriva beauty-from-within ingredient gained Generally Recognized as Safe (GRAS) status, authorizing its use in food and drink. The ingredient combines bonded arginine silicate and magnesium biotinate, and according to the company, studies show that it is 40 times more bioavailable than D-biotin, which is the more common form of biotin currently on the beauty market.

Katie Emerson, MS, RD, LDL, manager of scientific affairs for Nutrition21, said that D-biotin “just doesn’t really compare” with the bioavailability that Lustriva offers. Part of what makes Lustriva more bioavailable is the combination of magnesium biotinate and bonded arginine silicate, which together “help stimulate blood flow and help with nutrient absorption,” added Matthew Ruggiero, assistant marketing manager, Nutrition21, at SupplySide West.

But educating the market so steeped in D-biotin will take some time, the company admits. “It takes a little more education just because I feel like everyone knows biotin is phenomenal for hair and skin,” said Emerson. “It’s in all the products. But what people don’t realize is that you’re not getting the benefits you want because you’re not absorbing it as well as you think you are. So, when you tell people, ‘Oh, I have something that’s a more superior form of biotin,’ they’re like, ‘Wait, what’s wrong with biotin?’”

To that end, Nutrition21 is showing its customers and potential new beauty clients the data backing the enhanced-bioavailability claims it has on Lustriva. “We show them the studies and the graphs, and they start to understand,” Emerson said. “It really speaks volumes to how the hair and skin improve so quickly over time, in as early as two to three works. It keeps working for up to 12 weeks, and I think that’s because the biotin’s actually working because it’s in the bloodstream. It’s doing its job, whereas D-biotin just doesn’t.”

The Powerball jackpot for Saturday’s record lottery drawing — the largest in U.S lottery history — has soared to an estimated $1.6 billion with a cash option of $782.4 million.

The winning numbers drawn were: 28, 45, 53, 56 and 69. The Powerball was 20 and the PowerPlay was 3x.

There have been 39 drawings held since the jackpot was last won. A $206.9 million Powerball ticket was purchased in Westmoreland County, Pennsylvania, for the Aug. 3 drawing.

The biggest jackpots in lottery history that have been won are a Powerball win worth $1.586 billion on Jan. 13, 2016, followed by a $1.537 billion Mega Millions jackpot won on Oct. 23, 2018.

The longest jackpot run in Powerball history without a top prize winner ended on Oct. 4, 2021, when a ticket in California won a $699.8 million jackpot on the 41st drawing.

In all, five Powerball jackpots have been won in 2022. The largest was a $632.6 million jackpot hit on Jan. 5 and split by winners in California and Wisconsin.

Three second-prize tickets worth at least $1 million were sold in New Jersey for Wednesday’s drawing.

A $2 million Powerball ticket — sold with the Power Play for an extra $1 — was bought at Raceway gas station store at the intersection of Route 516 and Higgins Road in Old Bridge.

Two other second-prize Powerball tickets worth $1 million each were purchased at The Market at Saddle Brook on Fairlawn Parkway in Saddle Brook and the Wawa on Route 1 in Edison, the New Jersey Lottery said Thursday.

The second-prize tickets matched five numbers but not the Powerball. The New Jersey $1 million and $2 million tickets bought for Wednesday’s drawing were among 19 second-prize tickets sold across the country as players hoped to win the $1.247 billion jackpot.

Wednesday’s winning numbers were: 2, 11, 22, 35 and 60. The Powerball drawn was 23 with a Power Play of 2X.

In addition, a $100,000 ticket was bought by someone in New Jersey using the Jackpocket app. Fifteen other tickets worth $50,000 were sold around the state.

Meanwhile, no one won the secondary, $10 million Double Play drawing held after the main drawing Wednesday. The Double Play numbers drawn were 20, 34, 37, 57 and 67. The Double Play number drawn was 26.

The odds of hitting the Powerball jackpot are 292,201,388 to 1. A player who buys a $2 ticket has about a 1 in 11,688,053 chance to match five numbers and win at least $1 million, while the odds are 913,129 to 1 of winning the third prize of at least $50,000.

Powerball is played on Monday, Wednesday and Saturday in 45 states, as well as Washington, D.C., the U.S. Virgin Islands and Puerto Rico.

NJ Advance Media staff writer Len Melisurgo contributed to this report.

Multisite EMAGINE Stroke Recovery Trial tests breakthrough technology for stimulating the brain and spinal cord to enhance recovery of lost function

Grant and Award Announcement

East Hanover, NJ. November 18, 2022. Researchers from Kessler Foundation and Kessler Institute for Rehabilitation (collectively “Kessler”) are enrolling participants in a national trial of a breakthrough device for improving recovery after stroke. Kessler locations in West Orange and Saddle Brook, NJ, are among the 20 sites across the U.S. participating in the EMAGINE Stroke Recovery Trial, which pairs therapeutic exercise with stimulation of the brain through an investigational wearable device. Steven Kirshblum, MD, is principal investigator and Ghaith Androwis, PhD is co-primary investigator for the Kessler study.

Every year, stroke affects nearly 800,000 people in the US, according to the Centers for Disease Control and Prevention. “Given the broad impact that stroke has on individuals, families, and caregivers, as well as health care services and our economy, the benefits of improving the outcomes for stroke rehabilitation are substantial,” noted Steven Kirshblum, MD, chief medical officer for Kessler Foundation and Kessler Institute for Rehabilitation. Dr. Kirshblum also serves as chair of the Department of Physical Medicine and Rehabilitation at Rutgers New Jersey Medical School.

“Too often stroke results in long-term disability that adversely affects quality of life,” Dr. Kirshblum continued. “Now we know that with early and intensive intervention, stroke survivors have the capability to regain function. The EMAGINE trial capitalizes on this neuroplasticity of the brain and spinal cord by augmenting standard rehabilitation with electromagnetic stimulation and making therapy available in different settings, including the home,” he explained.

Each site plans to enroll individuals within four to 21 days of moderate-to-severe ischemic stroke. At Kessler, three participants to date have been enrolled in the study, which is randomized, sham-controlled, and double-blinded, according to Dr. Androwis, senior research scientist in the Center for Mobility and Rehabilitation Engineering Research at Kessler Foundation and director of the Center’s Rehabilitation Robotics and Research Laboratory.

The first participant has completed the nine-week protocol, which comprises 45 one-hour sessions administered five times a week. During each session, the participant performs therapeutic exercises while wearing the device, which fits over their head and torso without interrupting the participant’s ability to perform functional tasks with their upper extremities.

“Given the promising results of our already completed BrainQ trial in persons with chronic spinal cord injury, we are excited to study the potential benefits of this non-invasive brain and spine stimulation intervention in persons disabled by stroke,” said Dr. Androwis.

Using machine learning, the BQ device targets affected areas of the brain with electromagnetic field therapy. The therapy, which is low intensity and frequency tuned, is administered along with the current standard for physical and occupational therapy, toward the goal of facilitating neurorecovery. Preliminary findings were promising, which prompted the FDA to award Breakthrough Device Designation to BrainQ’s device in 2021.

BrainQ’ s developers see the device’s potential for a flexible continuum of therapy, from acute care, through rehabilitation and after discharge for at-home use. “Being able to stay engaged in therapy throughout the recovery process is a unique aspect of the EMAGINE study,”

Dr. Androwis emphasized. “Participants can access this investigational therapy from home, with oversight by a trained caregiver and remote monitoring by a member of the study team.”

“We are pleased that true leaders in rehabilitative research and clinical care, including Kessler Foundation and Kessler Institute, are our partners in the EMAGINE trial,” said Yotam Drechsler, CEO of BrainQ. “Together, we are striving toward our common goal – to transform the future of stroke rehabilitation by restoring lost mobility through innovative technology applied to home-based solutions.”

Eligible participants are recruited from Kessler Institute for Rehabilitation, a Select Medical inpatient rehabilitation hospital that provides rehabilitative care for stroke and other disabling conditions. In-patients undergoing stroke rehabilitation are evaluated for their eligibility by the Kessler study team.

The study is funded by BrainQ, developer of the investigational device.

For more information, visit the EMAGINE website.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility, and long-term outcomes – including employment – for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org.

About Select Medical

Select Medical is one of the largest operators of critical illness recovery hospitals, rehabilitation hospitals, outpatient rehabilitation clinics, and occupational health centers in the United States based on number of facilities. As of September 30, 2022, Select Medical operated 105 critical illness recovery hospitals in 28 states, 31 rehabilitation hospitals in 12 states, and 1,933 outpatient rehabilitation clinics in 39 states and the District of Columbia. Concentra operated 519 occupational health centers in 41 states. At September 30, 2022, Select Medical had operations in 46 states and the District of Columbia. Information about Select Medical is available at www.selectmedical.com.

About BrainQ

BrainQ, the EMAGINE Stroke Recovery Trial sponsor, is a US and Israel-based company pioneering a novel therapy for reducing disability and maximizing the recovery potential for stroke and other disabling neurological conditions. Their investigational device received FDA Breakthrough Device Designation. Their mission is to restore independence for the millions of people with disability worldwide through home-based accessible solutions.

Worldwide, the BrainQ technology is limited to investigational use only and is not approved or available for sale. BrainQ makes no guarantees regarding clinical trial outcomes or regulatory approval for its technology.

Media Contacts

BrainQ: Madeleine Truitt, BrainQ

[email protected]

Graphics:

Title: Demonstration of use of BrainQ’ s BQ device

Caption: A treatment session showing a research participant wearing the BQ device while a caregiver assists with therapeutic exercises for his right arm.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.