This Is What Happens To Your Lungs If You Do The Forbidden Fruit Challenge

JR showed up to the emergency room unconscious and struggling to breathe. He’d been in this state for at least 30 minutes when his mom finally got him to the hospital.
His mom had found him lying on the floor, his lips blue. It didn’t take her long to establish what had happened. He had done the Forbidden Fruit Challenge. The 17-year-old boy, renamed to protect his identity, took part in the social media game that stemmed from the Tide Pod Challenge.
As YouTube channel Chubbyemu reports, it did not end well for him, and he was hospitalized for the effect it had on his lungs.

In an excellent explainer video, Dr Bernard explains the case of “JR”, a boy who ate three laundry pods on a dare.
The new trend, called the Forbidden Fruit Challenge, sees a group of people all agreeing to record themselves eating detergent pods and then uploading the footage to social media. Whoever gets the most likes on their video wins.
Dr Bernard explains that JR wanted to, in his own words, “experience the greatness of laundry pod flavor and become Internet famous” when he took the challenge. In front of a sink, he took three laundry pods and put them into his mouth and chewed.
“Immediately he felt a burning sensation waft up into his nose”. Next came a numbing sensation on his tongue, followed by a lot of retching. As he coughed, some of the detergent went down his throat and some of it went into his airway.
He began frothing at the mouth and felt a burning sensation down his esophagus as the liquid trickled into his stomach.

His mom found him when his lips had turned blue and he had fallen unconscious. She rang emergency services, who told her to head to the ER.
He was suffering from a caustic esophageal injury (burning of the esophagus) caused by the detergent. As Dr Bernard explains, the liquid within detergent pods can be “at least a 100,000 times more basic than human blood”. So it’s not something you want entering your system.
“Contact with mucosal surfaces like the esophagus produces liquefactive necrosis”. This means that the tissue is dying and turning to a liquid puss, which runs further into the body. Essentially, the lining of the esophagus gets disintegrated.
“All of this happens within one second of contact”.
Damage to his windpipe also made breathing difficult, and without immediate treatment, the 17-year-old would have died.
Dr Bernard explains that as the boy coughed, the detergent got into his lungs. The more he coughed, the more it lodged deeply into his airways, and the cell lining of his lungs began to strip away.

Amazon, Berkshire Hathaway And JPMorgan Chase Launch New Health Care Company

Berkshire Hathaway Chairman and CEO Warren Buffett (left) in 2017; Jeff Bezos, CEO of Amazon, in 2013; and JP Morgan Chase Chairman and CEO Jamie Dimon in 2013. Berkshire Hathaway, Amazon and JPMorgan Chase are teaming up to create a health care company announced Tuesday that is “free from profit-making incentives and constraints.”


Updated at 11:17 a.m. ET
Health care costs are “a hungry tapeworm on the American economy,” Berkshire Hathaway Chairman and CEO Warren Buffett says, and now his firm is teaming up with Amazon and JPMorgan Chase to create a new company with the goal of providing high-quality health care for their U.S. employees at a lower cost.
The new company will be “free from profit-making incentives and constraints” as it tries to find ways to cut costs and boost satisfaction with the health care plan for employees of Amazon, Berkshire Hathaway and JPMorgan Chase. The trio unveiled their new venture in a news release.
“The initial focus of the new company will be on technology solutions that will provide U.S. employees and their families with simplified, high-quality and transparent healthcare at a reasonable cost,” the companies said.
The enterprise unites three of the largest and most envied companies in their respective sectors — from retail to banking, and including Berkshire’s wide portfolio of companies such as Geico and Fruit of the Loom. And in Buffett, Amazon’s Jeff Bezos and JPMorgan’s Jamie Dimon, the companies also have veteran leaders who have shown an ability to solve vexing business problems.

According to recent annual reports, taken together the three companies employ more than 950,000 people worldwide.
The three CEOs say they’re aware of the enormous challenges they face.
“The health care system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” said Jeff Bezos, Amazon founder and CEO. “Hard as it might be, reducing health care’s burden on the economy while improving outcomes for employees and their families would be worth the effort.”
Responding to the announcement Tuesday morning, White House economic adviser Gary Cohn told CNBC “we agree in that philosophy. We think that individual workers should have to pay less for health care.”
Still, the Trump administration already “created association health-care plans, which is the exact same thing that those companies did,” Cohn said, referring to an executive order last October that sought to make it easier for employers to combine efforts in offering insurance. That order also opened the possibility some groups could get coverage across state lines — “a move that Republicans have long advocated as a way to lower costs,” NPR’s Scott Horsley explained at the time.

“Smaller businesses could pool their employees together to get more purchasing power,” Cohn added Tuesday, “so they could save money on health care.”
NPR’s Scott Hensley tells Morning Edition there is precedent for the case of a non-health care company wading into the health care business — “in fact, it has happened repeatedly.”
“One of the most prominent examples is what is now Kaiser Permanente, a big provider of health care in this country. It started with the Kaiser shipyards and providing, first, workers comp kind of care and, later, more integrated health care for employees,” Scott explains. “So it is possible.”
The particulars remain scarce at the moment, though. Details such as the company’s name, base of operations and long-term leadership weren’t included in a joint news release about the new company that was sent out Tuesday morning.
At the start, the new company will be led by executives from each of the troika of giant firms: Marvelle Sullivan Berchtold, a managing director of JPMorgan Chase; Todd Combs, an investment officer of Berkshire Hathaway; and Beth Galetti, a senior vice president at Amazon.
JPMorgan’s Dimon said, “The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans.”


Amazon, Berkshire Hathaway and JPMorgan Team Up to Disrupt Health Care

Employees at an Amazon warehouse in Florence, N.J. The company will join forces with Berkshire Hathaway and JPMorgan Chase to try to improve health care. Credit Bryan Anselm for The New York Times 
SEATTLE — Amazon, Berkshire Hathaway and JPMorgan Chase announced on Tuesday that they would form an independent health care company for their employees in the United States.
In a statement, chief executives at the three corporate behemoths expressed their frustration with the nation’s expensive, often confusing health care system. The news added further uncertainty to an industry already reeling from attempts by new players to attack a notoriously inefficient, intractable sector. The lines between traditionally distinct areas, such as pharmacies, insurers and providers, are increasingly blurring.
CVS Health’s deal last month to buy the health insurer Aetna for about $69 billion is just one example of the shifts underway. Amazon’s potential entry into the pharmacy business is also reverberating.
The three companies provided few details about the new entity, other than saying it would initially focus on technology to provide simplified, high-quality health care for their employees and their families, and at a reasonable cost.
They said the initiative, which is in the early planning stages, would be “free from profit-making incentives and constraints.” Jamie Dimon, the chief executive of JPMorgan Chase, said in a statement that the effort could eventually be expanded to benefit all Americans.
“The health care system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” Jeff Bezos, Amazon’s founder and chief executive, said in a statement. “Hard as it might be, reducing health care’s burden on the economy while improving outcomes for employees and their families would be worth the effort.” 
News of the announcement sent the stocks of established health care providers plunging, and touched off a wave of speculation about what the new company might do. It was unclear whether the new venture would make it easier for consumers to understand their health care costs and access medical records, or take on more ambitious changes like the wider use of telemedicine and virtual doctor visits.
One thing is clear: these are not companies known for narrow ambitions. The partnership brings together three of the country’s most influential companies to try to improve a system that other companies have tried and failed to change: Amazon, the online retail giant; Berkshire Hathaway, the holding company led by the billionaire investor Warren E. Buffett; and JPMorgan Chase, the largest bank in the United States by assets.
“It could be big,” Ed Kaplan, who negotiates health coverage on behalf of large employers as the national health practice leader for the Segal Group, said of the announcement. “Those are three big players, and I think if they get into health care insurance or the health care coverage space they are going to make a big impact.”
Even the three companies don’t seem to be certain how they intend to shake up the health care system. People briefed on the plan, who asked for anonymity because the discussions are private, said the leaders of the three companies decided to announce the initiative while it was still a concept in part so they can begin hiring staff for the new company.
“The ballooning costs of health care act as a hungry tapeworm on the American economy,” Mr. Buffett said in the statement on Tuesday. “Our group does not come to this problem with answers. But we also do not accept it as inevitable.”
One of these people said the new company wouldn’t replace existing health insurers or hospitals, though it’s too soon to say exactly what form it would ultimately take. One idea is an online health care dashboard that connects employees with the closest and best doctor specializing in whatever ailment they select from a drop-down menu, one of the people said.
The three backers of the new company foresee striking deals for employee discounts with service providers like medical testing facilities, the person added.
“Each of those companies has extensive experience using transformative technology in their own businesses,” said John Sculley, the former chief executive of Apple who is now chairman of a health care start-up, RxAdvance. “I think it’s a great counterweight to what government leadership hasn’t done, which is to focus on how do we make this health care system sustainable.”
Planning for the new company is being led by Marvelle Sullivan Berchtold, a JPMorgan managing director who was previously head of the Swiss drugmaker Novartis’s mergers and acquisitions strategy; Todd Combs, an investment officer at Berkshire Hathaway; and Beth Galetti, a senior vice president at Amazon.
One of the people familiar with the partnership between the companies said it took form as Mr. Bezos, Mr. Buffett, and Mr. Dimon, who are friends, discussed the complications of the country’s health care system and the challenges of providing insurance to their employees. They decided their combined access to data about how consumers make choices, along with an understanding of the intricacies of health insurance, would inevitably lead to some kind of new efficiency — whatever it might turn out to be.

Drug firms shipped 20.8M pain pills to WV town with 2,900 people

Over the past decade, out-of-state drug companies shipped 20.8 million prescription painkillers to two pharmacies four blocks apart in a Southern West Virginia town with 2,900 people, according to a congressional committee investigating the opioid crisis.
The House Energy and Commerce Committee cited the massive shipments of hydrocodone and oxycodone — two powerful painkillers — to the town of Williamson, in Mingo County, amid the panel’s inquiry into the role of drug distributors in the opioid epidemic.
“These numbers are outrageous, and we will get to the bottom of how this destruction was able to be unleashed across West Virginia,” said committee Chairman Greg Walden, R-Ore., and ranking member Frank Pallone Jr., D-N.J., in a joint statement.
The panel recently sent letters to regional drug wholesalers Miami-Luken and H.D. Smith, asking why the companies increased painkiller shipments and didn’t flag suspicious drug orders from pharmacies while overdose deaths were surging across West Virginia.
The letters outline high-volume shipments to pharmacies over consecutive days and huge spikes in pain pill numbers from year to year.
Between 2006 and 2016, drug wholesalers shipped 10.2 million hydrocodone pills and 10.6 million oxycodone pills to Tug Valley Pharmacy and Hurley Drug in Williamson, according to Drug Enforcement Administration data obtained by the House Committee.
Springboro, Ohio-based Miami-Luken sold 6.4 million hydrocodone and oxycodone pills to Tug Valley Pharmacy from 2008 to 2015, the company disclosed to the panel. That’s more than half of all painkillers shipped to the pharmacy those years. In a single year (2008 to 2009), Miami-Luken’s shipments increased three-fold to the Mingo County town.
Miami-Luken also was a major supplier to the now-closed Save-Rite Pharmacy in the Mingo County town of Kermit, population 400.
The drug wholesaler shipped 5.7 million hydrocodone and oxycodone pills to Save-Rite and a branch pharmacy called Sav-Rite #2 between 2005 and 2011, according records Miami-Luken gave the committee. In 2008, the company provided 5,624 prescription pain pills for every man, woman and child in Kermit.
In its letters, the panel also raised questions about Miami-Luken’s shipments to Westside Pharmacy in Oceana, Wyoming County. The committee cited documents that show a Miami-Luken employee reported a Virginia doctor, who operated a pain clinic located two hours from Oceana, was sending his patients to Westside Pharmacy, which filled the prescriptions.
In 2015, more than 40 percent of the oxycodone prescriptions filled by Westside Pharmacy in Oceana were coming from the Virginia doctor, according to the committee’s letter. The following year, the Virginia Board of Medicine suspended the doctor’s license, finding his practice posed a “substantial danger to public health and safety.”
The panel’s letter also mentions Miami-Luken’s suspicious shipments to Colony Drug in Beckley. In a five-day span in 2015, the drug wholesaler shipped 16,800 oxycodone pills to the pharmacy.
“In several instances, Colony Drug placed multiple orders for what appears to be excessive amounts of pills on consecutive days,” the committee wrote.
The House committee questioned H.D. Smith’s painkiller shipments to Family Discount Pharmacy in Logan County. The drug shipper distributed 3,000 hydrocodone tablets a day to the pharmacy in 2008, a 10-fold increase in sales from the previous year, according to the committee’s letter. The pharmacy, located in a town of 1,800 people, was shipped 1.1 million hydrocodone pills in 2008.
The House panel also cited Springfield, Illinois-based H.D. Smith for spikes in painkiller shipments to Sav-Rite, Westside Pharmacy, Tug Valley Pharmacy and Hurley Drug.
Oxycodone is sold under brand names like OxyContin, while hydrocodone brands include Vicodin and Lortab.

“The committee’s bipartisan investigation continues to identify systemic issues with the inordinate number of opioids distributed to small town pharmacies,” Walden and Pallone said in the statement. “The volume appears to be far in excess of the number of opioids that a pharmacy in that local area would be expected to receive.”
In a statement, H.D. Smith said it was reviewing the committee’s letter Monday.
“H.D. Smith works with its upstream manufacturing and downstream pharmacy partners to guard the integrity of the supply chain, and to improve patient outcomes,” the company said.
Miami-Luken did not immediately respond to a request for comment.
In February 2016, West Virginia Attorney General Patrick Morrisey ended a state lawsuit against Miami-Luken after the company agreed to pay $2.5 million to settle allegations that it flooded the state with painkillers. Morrisey, a former lobbyist for a trade group that represents Miami-Luken and other drug distributors, inherited the lawsuit in 2013 after ousting longtime Attorney General Darrell McGraw.
H.D. Smith paid the state $3.5 million to settle the same pill-dumping allegations in January 2017.
The committee gave H.D. Smith and Miami-Luken until Feb. 9 to turn over documents and answer dozens of questions about what steps, if any, the companies took to stop the flood of pain pills into Southern West Virginia.
“We will continue to investigate these distributors’ shipments of large quantities of powerful opioids across West Virginia, including what seems to be a shocking lack of oversight over their distribution practices,” Walden and Pallone said.
The state has the highest drug overdose death rate in the nation. More than 880 people fatally overdosed in West Virginia in 2016.

Couple finds worms in their feet after a beach vacation

Dozens of parasitic worms were found burrowing in the feet of a young Canadian couple after a recent trip to the Dominican Republic.

“We were scratching our toes for almost the duration of the trip,” Eddie Zytner said.
Zytner, 25, and his girlfriend, Katie Stephens, 22, of Windsor, Ontario, returned home January 18 with itchy feet. Four days later, that itch turned into painful swelling and blisters, he said.
The pain became so intense that they could not tolerate shoes or socks and had to rely on crutches to walk.
Zytner shared a photo on his Facebook account that shows tortuous red tracks on his left foot.
After multiple visits to the hospital, the couple was diagnosed with cutaneous larva migrans, caused by hookworm larvae that probably entered their skin while they were barefoot on the beaches of Punta Cana.
The parasites typically live in the intestines of dogs, cats and other wild animals, according to the US Centers for Disease Control and Prevention. The larvae burrow through human skin that comes into contact with sand or soil that has been contaminated with animal feces.
“To anybody traveling somewhere tropical, please be careful when in the sand and wear shoes!” Stephens pleaded on Facebook last week after receiving the diagnosis.
The condition typically goes away without treatment, but antiparasitic medications such as albendazole or ivermectin can help, according to the CDC. The hookworm larvae generally don’t survive more than six weeks in humans.
Both drugs are included on the World Health Organization’s list of essential medications identified for basic health-care systems. However, they are not available in Canada and can be accessed only through the federal government’s Special Access Programme on a case-by-case basis. In contrast, the drugs are available in the US with a prescription.
“The drug companies don’t think they’re going to sell enough to make it worth their while,” said Dr. Stan Houston, a professor of infectious disease and public health at the University of Alberta, who was not involved in the couple’s treatment. “So that is the reason they’re not licensed in Canada.”
According to Zytner, the couple’s request for the drugs was initially denied, but they eventually got them from a local physician who was dual certified in Canada and the US.
Zytner said their symptoms have improved significantly since they began treatment last week.
“We’ve been off crutches for a couple of days now. We can finally put some pressure on our feet,” he said. “The worms are pretty much faded away.”
Zytner also has advice for anyone planning a trip to the Caribbean: “Call the resort they’re staying at and see if they clean up all the beaches.
“Wear shoes,” he added.