Blue Cross Blue Shield of Michigan will drop coverage of GLP-1 obesity drugs in fully insured large group commercial plans starting in January, a spokesperson said, citing consideration of their “efficacy, safety and access, and cost.” The insurer didn’t immediately respond to questions about how many patients will be affected or what the potential safety concerns were.

GLP-1s such as Novo’s Wegovy and Lilly’s Zepbound are exploding in popularity. But with list prices of $1,000 a month or more for a single user, insurers are balking at cost and trying to limit how widely they’re used. The US Medicare health program for the elderly doesn’t cover them for obesity at all, although it covers similar drugs for diabetes.

Some states’ Medicaid plans that cover low-income residents pay for GLP-1 drugs, but even that has been contentious. North Carolina’s health plan for state employees dropped coverage of the drugs for weight loss earlier this year after projecting a $1.5 billion loss by the end of the decade. Health plans offered through the Affordable Care Act Marketplace rarely cover the treatments for obesity, according to an analysis from health researcher KFF.

Novo is “disappointed” in the decision, a spokesperson said, “as it is contrary to actions that many throughout our country are taking – which is to expand coverage for these important medicines.” About half of all commercial insurance plans cover Wegovy, the spokesperson said.

A loss of driving abilities often serves as a red flag to family members that a loved one may be struggling with Alzheimer’s Disease or other forms of dementia. But convincing loved ones to let others do the driving can present formidable challenges.

“We don’t like to think about it, but it can be a matter of life or death for the driver, and for anyone else who might be injured,” said Alice Keane, a retired educator and volunteer for the Alzheimer’s Association.

Keane helps caregivers from Chicago’s South Side and surrounding suburbs explore these and other difficult situations. A year and a half ago, the resident of Smith Village in Chicago’s Morgan Park neighborhood began facilitating an Alzheimer’s Association caregiver support group with fellow Alzheimer’s Association volunteer Bridget Murphy, who also is Smith Village’s life enrichment director.

The group meets at the senior community at 6:30 p.m. the third Tuesday of each month in a conference room just off the main lobby at 2320 W. 113th Place.

In 2020, Keane’s husband, former 28th District state Rep. Jim Keane, died of COVID-19 and complications related to advanced Alzheimer’s Disease. He’d also taught at Leo High School and founded the local 1700 chapter of the American Federation of Teachers. While helping him, Keane appreciated the support of an Alzheimer’s Association caregivers group in Arizona where the couple owned a vacation home.

“The purpose of the support group is support — allowing people to be free to express their frustrations and talk about things that are puzzling them,” Keane said. “It’s about listening, sharing advice, and supporting each other. It’s what I needed when I was going through this with Jim.”

After Jim’s death, and with time on her hands during the pandemic, Keane decided to help others by signing up with the Alzheimer’s Association as a volunteer and trained to facilitate caregiver support group discussions. A volunteer for the Illinois chapter — also a caretaker — was her mentor.

Keane said her experiences as a caregiver enable her to empathize with those seeing their ones lose their brilliance and mental capabilities.

Phyllis Tucker attends the caregiver support group. She and her husband, Roosevelt Tucker Jr., both live at Smith Village, He graduated from New York University and managed a successful career as an insurance claims adjuster.

“He would always do work around the house, all kinds of projects,” Tucker said. “He’d get up on our steep pitched roof. He couldn’t do those things anymore.”

Caregiver Fran Blake, also a Smith Village resident, describes his wife as having had amazing talents as well. The mother of six, Peggy Blake organized school carnivals, a teen social club and ski trips for students at St. Cajetan Catholic Elementary School. After her children were grown, she worked for local politicians.

For all three caretakers, the gravity of what was happening to their loved ones became apparent as their driving skills eroded.

Tucker, a retired registered nurse, noticed that her husband started getting lost while driving. “We’d have to make him stay where he was and go get him,” she said. “During a cold spell, he left the car running until it ran out of gas.”

The mental lapse resulted in severe damage to the car. Tucker told her husband the cost of the repairs and convinced him to let the car go. With one car remaining in the household, she took over the driving.

Blake and other family members noticed his wife Peggy repeating herself. Not long after, when the couple was still living in Palos Heights, he said, “She called me asking, ‘How do I get to Harlem Avenue?’ And this was something she’d done many times before.”

Blake intervened by hiding the keys. “It didn’t stop her desire to drive,” he said. “She still wanted to drive, but I would tell her the keys were lost and I could drive her.” He also reminded her of her struggles with double vision as a reason not to drive.

Blake wanted proof to convince his wife to give up on driving, so he consulted with her doctor who agreed she posed a risk to herself and others. The physician filled out a form provided by the Illinois Secretary of State to revoke her driver’s license.

He showed her the letter from the state. “If she could pass a driving test and written exam, her license would be reinstated,” Blake said. “For a while, she still wanted to take the test, but eventually forgot about it.”

Tucker and Blake appealed to their spouses’ sense of responsibility to convince them to stop driving, which aligns with suggestions offered by the Alzheimer’s Association.

Keane often suggests consulting the Alzheimer’s Association website for tips on dealing with driving and other challenges, including caretaker self-care. She too followed the association’s suggestion to have a conversation with loved ones about giving up driving.

As she tells it, Jim Keane put up little resistance. “He was aware of his mother’s struggles with dementia later in life, so he was more resigned to it,” she said.

Regardless of what stage of disease their loved ones were contending with, caregivers said attending the caregiver support at Smith Village has helped.

“It’s a real comfort to be able to talk with people who share the same concerns,” Blake said. “When I first came here, I was concerned about seeing that my wife was properly medicated. It helped to talk about different medications.”

Tucker needed time to process the reality of her husband’s illness but eventually realized that sharing with other caretakers was beneficial. “Most of the things I understood, but I understood it more hearing how other people thought about it and how they problem solved,” she said.

Alzheimer’s Association caregiver support groups can be found across the country. They often take place in libraries and public settings.

Besides Smith Village residents who attend the meetings, about 15 other caregivers come to the sessions. The next meeting of the support group at Smith Village is 6:30 p.m. June 18.

More resources and tips for caregivers, including how to address driving issues are at https://www.alz.org/help-support/caregiving/safety/dementia-driving.

Susan DeGrane is a freelance reporter for the Daily Southtown. 

“When I got hurt a couple years ago, we had a male physical therapist, and he was really lax about it,” Comas said. “He just told me I’m ‘good to go.’ Having an environment for women would’ve been a lot more comfortable and better for healing the injury long term.”

Dr. Mary Mulcahey, director of sports medicine and an orthopedic surgeon at Loyola Medicine, said stories like Faith’s were what inspired her to help launch a new program to provide health care for female athletes. Loyola’s new Women’s Sports Medicine program aims to educate women on the risks of sports injuries while offering gender-specific care, she said.

“The main impetus or idea behind this is that there are certain injuries that are more common or unique to female athletes, so the program really focuses on having a group that has expertise in treating these conditions and is aware of some of the nuances and differences with treating female athletes,” Mulcahey said.

Mulcahey said that the program will utilize a network of physicians including primary care, sports medicine, orthopedic medicine, endocrinology, urogynecology, sports, cardiology, and obstetrics and gynecology, along with physical therapists and athletic trainers.

The program will allow female athletes to more easily access different kinds of doctors at once, she said. There can be a number of factors that play into an individual injury, according to Mulcahey, and offering a network that can easily connect athletes with several types of doctors eliminates tedious middle steps.

“If I were to see a patient who had a stress factor, for example, I would inquire about their menstrual cycle and their eating habits,” Mulcahey said. “This is a good example of where the interdisciplinary approach really works. If they’re having irregular menses, I could refer them to an OB-GYN colleague. I’d ask about their eating habits, and maybe refer them to a nutritionist or dietician or maybe even a counselor in the program.”

While Mulcahey said it has historically been possible to refer patients to other doctors, the Women’s Sports Medicine program introduces a streamlined approach for female athletes.

The doctors included in the program also all have a particular focus on female patients, she added. Having that specialized knowledge can help in approaching an injury as simple as an ACL tear.

“ACL tears are upwards of eight times more common in female athletes,” Mulcahey said. “In the knee, the ACL is smaller, the overall alignment of the lower extremity of the legs is different in female athletes, hormonal variations and fluctuation throughout the menstrual cycle have a huge impact on the risk of ACL tears. You need doctors that understand that.”

In February, Comas tore her ACL while wrestling and came to Mulcahey for surgery. She said that receiving a treatment specialized for women’s bodies made her feel a lot safer, especially as a wrestler.

Because of a lack of women in her sport, Comas said, she’s often had to wrestle men or women who were in a completely different weight class, presenting a higher risk of injury. Having a doctor who understood how women are built differently from men and could address her symptoms with that in mind made a big difference, she said.

“My freshman year I got injured, and my coach was just asking ‘When can she wrestle? Can she do this?’ Comas said. “I think with this injury things have been explained better and people have been a lot more patient. I can actually focus on healing the injury.”

Giavanna Green, a 17-year-old cheerleader who tore her meniscus and ACL in October, had surgery in May after months of confusion about her injury. Mulcahey also performed Green’s surgery, and Green said she felt supported and encouraged by the network of doctors at Loyola.

Green said that Mulcahey stressed stretching and taking care of her leg, doing proactive exercises to prevent hurting or re-tearing the ligaments. Green said she appreciated that education since things like stretching and taking care of the body can be glossed over in sports, she said

“A lot of people push themselves so hard,” Green said. “If someone came in and taught us to understand how not to overwork ourselves and cause these injuries, I feel like it would be really beneficial.”

Mulcahey said that she plans to do just that in Loyola’s new program. The program aims to partner with local teams, clubs and sports organizations to provide teach-ins and resources on injury prevention for female athletes like Comas and Green.

Getting to women before they are injured is imperative, Mulcahey said.

“We want to connect with and be available for various women’s sports teams,” she said. “We also are looking at giving talks at some of our local high schools where there are many active women and girls, where we could share information about injuries and injury prevention. We’re trying to bring that education into the community.”

Overall, Mulcahey said, the program aims to dig deeper into female injuries, separating outcomes in male and female athletes and learning more about what injuries are more common in or completely unique to female athletes.

“In having a women’s sports medicine program, there is an opportunity to do research to really investigate these injuries in female athletes,” Mulcahey said “Are there differences? Are there things we need to be keeping in mind? Should we be modifying our approach to care for our female athletes? The Women’s Sports Medicine program is an opportunity to do that.”

WASHINGTON — A closely watched Alzheimer’s drug from Eli Lilly won the backing of federal health advisers on Monday, setting the stage for the treatment’s expected approval for people with mild dementia caused by the brain-robbing disease.

Food and Drug Administration advisers voted unanimously that the drug’s ability to modestly slow the disease outweighs its risks, including side effects like brain swelling and bleeding that will have to be monitored.

“I thought the evidence was very strong in the trial showing the effectiveness of the drug,” said panel member Dean Follmann, a National Institutes of Health statistician.

The FDA will make the final decision on approval later this year. If the agency agrees with the panel’s recommendation, the drug, donanemab, would only be the second Alzheimer’s drug cleared in the U.S. shown to convincingly slow cognitive decline and memory problems due to Alzheimer’s. The FDA approved a similar infused drug, Leqembi, from Japanese drugmaker Eisai last year.

Lilly studied its drug by grouping patients based on their levels of a brain protein, called tau, that predicts severity of cognitive problems. That prompted FDA reviewers to question whether patients might need to be screened via brain scans for tau before getting the drug. But most panelists thought there was enough evidence of the drug’s benefit to prescribe it broadly, without screening for the protein.

“Imposing a requirement for tau imaging is not necessary and would raise serious practical and access concerns to the treatment,” said Dr. Thomas Montine of Stanford University, who chaired the panel and summarized its opinion.

The FDA had been widely expected to approve the drug in March. But instead the agency said it would ask its panel of neurology experts to publicly review the company’s data, an unexpected delay that surprised analysts and investors.

At a high level, Lilly’s results mirrored those of Leqembi, with both medications showing a modest slowing of cognitive problems in patients with early-stage Alzheimer’s. The Indianapolis-based company conducted a 1,700-patient study showing patients who received monthly IV infusions of its drug declined about 35% more slowly than those who got a sham treatment.

But there were differences in the way Lilly tested its drug that raised questions for FDA.

One change was measuring patients’ tau, and excluding patients with very low or no levels of the protein. But panelists said there was enough data from other measures to feel confident that nearly all patients could benefit from the drug, regardless of their levels.

In another key difference, Lilly studied taking patients off its drug when they reached very low levels of amyloid, a sticky brain plaque that’s a contributor to Alzheimer’s.

Lilly scientists suggested stopping treatment is a key advantage for its drug, which could reduce side effects and costs. But FDA staff said Lilly provided little data supporting the optimal time to stop or how quickly patients might need to restart treatment.

Despite those questions, many panelists thought the possibility of stopping doses held promise.

“It’s a huge cost savings for the society, we’re talking about expensive treatment, expensive surveillance,” said Dr. Tanya Simuni of Northwestern University. She and others experts said patients would need to be tracked and tested to see how they fare and if they need to resume treatment.

The main safety issue with donanemab was brain swelling and bleeding, a problem common to all amyloid-targeting drugs.

Three deaths in the donanemab study were linked to the drug, according to the FDA, all involving brain swelling or bleeding. One of the deaths was caused by a stroke, a life-threatening complication that occurs more frequently among Alzheimer’s patients.

FDA’s panel agreed that those the risks could be addressed by warning labels and education for doctors as well as medical scans to identify patients at greater risk of stroke.

What’s the FDA warning?

The warning says to avoid oysters and bay clams harvested from Netarts and Tillamook bays in northern Oregon since May 28, as well as shellfish harvested from areas around Willapa Bay in southern Washington since May 26. They may be contaminated with high levels of paralytic shellfish poisoning, or PSP, a naturally occurring toxin produced by algae.

Shellfish harvested from those areas during that period were distributed beyond Oregon and Washington to Arizona, California, Colorado, Hawaii, Nevada, New York. The FDA has warned restaurants and retailers in those states not to serve it.

What do we know so far?

Elevated levels of toxins were first detected in shellfish on the Oregon coast on May 17, state fish and wildlife officials said.

Since then, a paralytic shellfish poisoning outbreak has sickened at least 31 people in Oregon, according to the Oregon Health Authority. The agency has asked people who have harvested or eaten Oregon shellfish since May 13 to fill out a survey intended to help investigators identify the cause of the outbreak and the number of people sickened.

Oregon authorities have closed the state’s entire coastline to the harvesting of mussels, razor clams and bay clams. Agriculture officials have also closed three bays, including those named in the FDA advisory, to commercial oyster harvesting.

Officials in neighboring Washington have also closed the state’s Pacific coastline to the harvesting of shellfish, including mussels, clams, scallops and oysters, a a shellfish safety map produced by the Washington State Department of Health shows.

What is paralytic shellfish poisoning?

Paralytic shellfish poisoning, or PSP, is caused by saxitoxin, a naturally occurring toxin that’s produced by algae. Saxitoxin is a neurotoxin, meaning it can damage nerve tissue.

People who eat shellfish contaminated with high levels of saxitoxins usually start feeling ill within 30 to 60 minutes, according to Oregon health officials. Symptoms include numbness of the mouth and lips, vomiting, diarrhea, shortness of breath and irregular heartbeat in severe cases.

There is no antidote to PSP, according to the health agency. Treatment for severe cases may require mechanical ventilators to help with breathing.

Authorities warn that cooking or freezing contaminated shellfish doesn’t kill the toxins or make it safe to eat.

What is causing this?

A “very large” algal bloom has resulted in “unprecedented levels” of PSP toxins along Oregon’s coast, Matthew Hunter, shellfish program manager for the Oregon Department of Fish and Wildlife, said during a briefing.

The toxins have accumulated in the shellfish, sickening some people who have eaten them.

While the factors that create harmful algal blooms are not well understood, certain factors — resulting from both natural processes and human activities — are believed to play a role, according to the National Oceanic and Atmospheric Administration.

“Studies show that many algal species flourish when wind and water currents are favorable,” the agency says on a webpage dedicated to explaining harmful algal blooms. Some blooms, it says, stem from “sluggish water circulation, unusually high water temperatures, and extreme weather events like hurricanes, floods, and drought.”

Algae growth can also increase when nutrients used in fertilizers, mainly phosphorus and nitrogen, flow into bodies of water, according to the agency.

How long will this last?

Oregon officials said it may take weeks, months or even up to a year for toxin levels to subside, depending on the type of shellfish.

Mussels can accumulate paralytic shellfish poison rapidly, but also rid themselves of it quickly, according to Hunter, the Oregon fish and wildlife official. Because of this, it may take anywhere from two weeks to a month for mussels to eliminate the toxin.

Razor clams, however, are slower to do so. It may take them several months to a year to cleanse themselves due to the current high levels of toxin, Hunter said.

How common is this?

Such high levels of paralytic shellfish poison haven’t been detected in Oregon in decades, according to Hunter, who cited a previous shellfish harvesting closure in the state in 1992.

However, PSP has been prevalent in the regional waters for centuries, he said.

What’s the economic impact?

The harvesting closures may deal a blow to Pacific Northwest fisheries.

The shellfish industry generates $270 million each year for the region’s economy, according to the National Oceanic and Atmospheric Administration, and employs some 3,200 people.

Even with the sometimes grueling recovery period, which included being on a ventilator right after surgery, intense rehabilitation and taking 25 pills daily to ward off rejection and infection, Knight, 64, is upbeat about the entire experience.

“I’m grateful, I’m blessed, ” Knight said as she sat in a clinic room at Northwestern Medicine Palos Hospital waiting to see her lung transplant pulmonologist. “I don’t think it was a problem at all, I feel good.”

Part of that outlook comes from having a firm grasp of the big picture.

“I was able to get two new lungs,” Knight said.

Dr. Mrinalini Venkata Subramani, her pulmonologist, said she was doing great. She had end-stage COPD and was on oxygen, plus during her transplant three months ago, lung cancer was found. She also had major abdominal surgery last year, followed by weeks of rehabilitation.

“I knew Michelle prior to the transplant,” Subramani said. “I’ve seen the change she’s undergone from being very, very sick … to now being independent.

“Her breath is completely normal and she’s able to do everything she wants to do.”

The Lung Transplant Clinic at Palos, which opened in January, has been a big help. She and her family and caregivers had been going downtown to Northwestern for appointments and testing. The trips to and from Chicago just added to the exhaustion she felt in an already weakened state.

Subramani said when Francesca Agostinelli, Knight’s 25-year-old daughter and primary caregiver, was told about the clinic opening, she was almost in tears, “she was so relieved she didn’t have to drive (her mother) downtown to appointments.”

“For patients who live in this area, that can be hours,” said Anne O’Boye, manager of the Northwestern Medicine Canning Thoracic Institute Lung Transplant Program. “It’s making a big impact on patients.”

Subramani said it typically took patients four to 12 weeks after surgery to fully recover, depending on their strength going into the transplant and recovery immediately after.

Northwestern Medicine performed the first double-lung transplant for a COVID-19 patient in 2020, but the lung transplant program has been around for nearly 10 years, transplanting more than 400 patients, hospital officials said. The DREAM program, which was formally launched in 2023 to provide lung transplants for certain lung cancer patients, has performed lung transplants on more than 40 patients.

“Our double lung transplant program is a life-saving program for end-stage lung disease and the lung disease could be from various causes,” Subramani explained.

Knight’s family has helped her through the many visits, pain and recovery, which was evident to the health care staff who helped her.

“The family was an enormous support,” Subramani said.

Knight’s daughter said she and her sisters had rallied around their mom to help. But Agostinelli has been on-call for her mom the most because they live together, while her three sisters reside out of state.

Though Knight needs to be seen only once a month at this point, after the transplant it was three to four times weekly for testing and appointments.

“It is a lot of work,” said Agostinelli. “They trained us on how to give medications, what to look for (in terms of infection or rejection).

“They’re like a family. The Northwestern team has been so incredibly helpful about explaining everything.”

Knight, too, praised the doctors, nurses and other health care workers, who continue to help her.

“The staff has all been very kind,” she said.

Janice Neumann is a freelance reporter for the Daily Southtown. 

Kennedy and Steinem would lecture together on college campuses in the 1970s, and the crowds would inevitably include a heckler.

“Just pause,” Kennedy advised, “let the audience absorb the hostility. Then say, ‘I didn’t pay him to say that.’”

Because ultimately, Steinem wrote, hostility educates an audience — about what stands in the way of progress and why it’s important to keep pushing.

So when Jessica Calarco’s phenomenal new book, “Holding It Together: How Women Became America’s Safety Net,” came out less than a month after NFL kicker Harrison Butker used a college commencement address to tell “the ladies present today” that “homemaker” would be their most important title, I thought, “She didn’t pay him to say that. … But, man, it would have been money well-spent.”

Calarco is a sociologist and author whose latest work interrogates the ways in which unpaid or underpaid women keep society afloat by bearing the brunt of the labor of child rearing, early education, health care, elder care and more — and why this system is broken, unsustainable and beneficial to almost no one except the wealthiest of the wealthy.

“The U.S. avoids catastrophe and keeps our society and our economy from crumbling by relying on women as the invisible glue,” Calarco writes.

“Holding It Together” is based on research Calarco and her team conducted from 2018 to 2022, 400 hours of interviews and two national surveys. She weaves in contemporary history, long-held economic principles and hundreds of families’ personal experiences to show the toll on women — and society — when we spin this set-up as a value system rather than calling it what it really is: exploitation.

“In essence, the U.S. has decided that we can get by without a social safety net because women will protect us instead,” Calarco writes. “That choice is drowning women and leaving our society sicker, sadder and more stressed. Yet the engineers and profiteers of our DIY society refuse to see women struggling, because acknowledging those struggles would shatter the illusion. Ignoring women leaves us exactly where they want us — keeping society afloat without any buoy to hold us, and so out of breath that no one can hear us if we cry.”

She writes about the way our culture raises girls to be “mothers-in-waiting,” the way our schools limit access to evidence-based education about avoiding pregnancy, the way our policies curtail birth control access and abortion rights, and then the way we write off unplanned pregnancies (which make up roughly half of all U.S. pregnancies) as the result of poor choices.

She points out that 90% of workers hired to care for the resulting children are women, and they’re among the lowest-paid in the U.S. economy — often lacking access to health insurance or paid sick leave.

She writes about the American obsession with rags-to-riches stories, callousness toward poor people and widespread beliefs that prosperity and health are simply the result of good choices. All of which serve to “divide and delude us into accepting the DIY society and women’s role as a substitute safety net.”

She notes that simply telling men to take on more of the domestic burden isn’t a solution.

“Telling men ‘Do more!’ doesn’t change the incentives that men have to dump the risk they face onto the women in their families — the same set of incentives that leads privileged women to dump the risk they’ve been handed onto others more vulnerable than them,” Calarco writes. “Telling men ‘Do more!’ also doesn’t change the gendered structure of our economy, the gendered pressures that men face to prioritize paid work over caregiving or the gendered differences in socialization that leave men less prepared to do the work of care.”

It also, Calarco writes, hands women yet more thankless roles: gender police and cleanup crew.

The answer, Calarco makes painstakingly clear, is an actual social safety net, made up of well-funded public programs that protect people from exploitation, provide essential protections like health insurance, paid sick leave and paid family leave. Such a safety net would allow families real choices and grant people dignity throughout their life spans.

She makes the case for a union of care, similar to other labor unions, that bridges the gap between disparate care industries as well as the gap between paid and unpaid care workers and the gap between people who give and receive care. A unifier, where so much division exists.

Which brings us, believe it or not, back to Butker’s commencement address.

“I have seen it firsthand how much happier someone can be when they disregard the outside noise and move closer and closer to God’s will in their life,” he told the graduates, invoking his wife as an example. “Isabelle’s dream of having a career might not have come true, but if you asked her today if she has any regrets on her decision, she would laugh out loud, without hesitation, and say, ‘Heck, no.’”

I’m sure that’s true. If you asked me today if I regret any of the time or energy I’ve devoted to my children I would also say, “Heck, no.”

But that’s not for everyone. And it’s also not a system — certainly not an equitable or sustainable one. (A spouse with an NFL salary, for example, makes forgoing a career that provides a paycheck, insurance and retirement benefits possible in a way that few women will experience.)

And that, believe it or not, brings us back to Steinem’s memoir.

Kennedy, Steinem wrote, was used to skeptics — including women — who didn’t see the point of all her women’s lib talk. Women have it fine, they’d tell her. I have it fine, they’d tell her. And Kennedy would tell them this, Steinem wrote.

“Just because you’re not feeling sick doesn’t mean you should close the hospitals.”

Join the Heidi Stevens Balancing Act Facebook group, where she continues the conversation around her columns and hosts occasional live chats.

Twitter @heidistevens13

“(Lurie Children’s) needed some additional space and this will help them meet their strategic goal,” said ADA Executive Director Dr. Raymond Cohlmia.

The tower was home to the ADA for nearly 60 years, but with staff now going to the office just two or three days each week, the organization no longer needs the same amount of office space, he added. The group will instead move its office headquarters into the top four floors of 401 N. Michigan Ave. on the Magnificent Mile. The ADA also plans to consolidate its research laboratories from both 211 E. Chicago Ave. and other facilities in Maryland into a new facility in the Boston metro area.

The price paid for the ADA property was not disclosed.

The organization is financially healthy, Cohlmia said, so selling the building wasn’t done to generate a windfall.

“That really wasn’t a factor in our decision,” he said. “Ultimately, we wanted to stay in Chicago and this allows us to reconfigure our space while meeting the needs of today’s work environment. And we also thought, ‘why don’t we help Lurie at the same time?’”

The nonprofit Lurie Children’s completed the 1.4-million-square-foot, 24-story hospital at 225 E. Chicago Ave. in 2012, and soon expanded into the ADA building, becoming its largest tenant. Although it has not finalized an expansion plan, hospital officials said buying the tower will allow Lurie to serve more patients.

“As we continue to experience strong demand for our services, we plan to expand clinical capacity by moving more administrative offices out of the main hospital to our new building next door,” Kary McIlwain, senior vice president at Lurie Children’s, said in a statement. “This is an exciting milestone that coincides with the June anniversary of the hospital’s move 12 years ago to the state-of-the art facility we built in Streeterville. Acquiring this adjacent building will help ensure a sustainable and impactful future for our organization and the communities we serve.”

Thousands of residents and fellows in the Chicago area have voted to unionize in the last year — at University of Chicago Medicine in May, Northwestern Medicine in January and West Suburban Medical Center in Oak Park in November. University of Illinois at Chicago residents and fellows unionized in 2021.

Residents have long had to work many hours for relatively low pay, as they train to become specific types of physicians after medical school. Traditionally, residents have been expected to put their heads down and grind, for years, as they gain on-the-job experience and progress toward more lucrative, prominent careers.

But residents say that attitude is shifting, amid changes in the business of health care, frustrations that arose out of the pandemic, and growing unionization across many industries.

“Hospitals rely on us, but we have not been able to rely on them to guarantee fair working conditions,” said Dr. Anis Adnani, chief resident for the University of Illinois at Chicago emergency medicine residency program. “At some point we decided to become self-reliant and demand fair working conditions not only for ourselves, but for what we see every day in terms of taking care of patients.”

Before the union at the University of Illinois at Chicago reached its first contract last year, first-year residents were making a little less than $60,000 a year for up to an average of 80 hours a week of work — an income that’s about minimum wage, if broken down hourly, Adnani said. Under the contract, residents were able to secure an 18.5% raise over four years and establish a committee focused on resident well-being, among other gains, he said.

“Any entity that relies so much on a pool of labor to operate should ensure their labor force is well taken care of,” Adnani said.

Residents at Northwestern, UCMedicine and West Suburban have not yet reached contracts with their respective hospitals, having unionized more recently.

They say they were inspired to unionize partly by the success at UIC and other institutions across the country.

In general, unionization has been growing across industries in recent years, and enjoying strong support. About 67% of Americans surveyed in 2023 said they approved of labor unions, up from a long-term average of 62%, according to Gallup — an environment that has helped residents’ unions flourish.

The Committee of Interns and Residents — which represents doctors at Northwestern, UIC and UCMedicine — has seen its membership nearly double to more than 33,000 doctors nationwide since 2020. The committee is part of the Service Employees International Union and also represents doctors in California, Massachusetts, New Jersey and New York, among other places.

“There’s been a huge upswing,” said Dr. Philip Sossenheimer, a palliative medicine fellow at Stanford Health Care who was on the organizing committee for the unionization campaign at Stanford.

In the past, doctors at hospitals on the East Coast were more likely to be unionized than those in other areas of the country, and it was more common at public sector hospitals, he said. For example, residents at Stroger Hospital in Chicago, which is a public hospital, unionized in affiliation with a different group, the National Union of Hospital & Health Care Employees, in 1974. The union at West Suburban is now part of that same group.

Now, residents at an increasing number of large, academic medical centers across the country are getting in on the action, including in Illinois, which has more union-friendly laws.

“There has been an appetite for this for a long time,” Sossenheimer said. “(Older doctors) all talked about similar dissatisfaction they had back in their day, but I think there are a few things that have changed.”

For one, residents are no longer mostly white men with stay-at-home wives. About 48% of active, U.S. citizen residents with MDs in 2022 were white, and about 48% of residents and fellows were women in 2022, according to the Association of American Medical Colleges.

Residents are concerned about benefits such as parental leave, or freezing their eggs if they want to have children after their residencies, which can sometimes last as long as seven years, he said.

There’s also been upheaval when it comes to the business of health care. In the past, doctors often practiced independently. In recent decades, that has shifted. In 2022, about 47% of doctors worked in private practice, compared with about 60% a decade earlier, according to the American Medical Association — a change that stems from the economic, administrative and regulatory burdens that can face doctors in private practice, according to the association.

“The generation that preceded us as physicians did not conceive of unionization as a thing because they weren’t employees,” Sossenheimer said. “They owned their own practices. That’s changed drastically in the last 15 years.”

That new reality means doctors must now contend with employers that are watching their bottom lines and often involved in mergers and acquisitions. They feel more uncertainty about their futures.

“What changed is these interns really began to think about themselves as employees … and maybe that long-term medical professional career might take longer to get,” said Robert Bruno, a professor of labor and employment relations at the University of Illinois at Urbana-Champaign. “The industry is changing, they might find themselves in a different labor market situation.”

Residents also say that COVID-19 was a catalyst for organizing. It was a stressful period for everyone in health care, and, for many residents, highlighted their lack of power and standing at their institutions, residents say.

“In COVID, when residents were certainly on the front lines in many places, they realized how little protection they had as residents,” said Dr. Mugdha Mokashi, who is finishing her second year of residency at Northwestern Memorial Hospital.

A big reason that Mokashi, who is on the bargaining committee for her union, wanted to unionize was to give residents more power when it comes to how the hospital functions. As a resident at Northwestern, Mokashi spends half her time at Northwestern Memorial and the other half at Stroger.

“We are caring for patients with the least amount of support, the least amount of resources, and despite that, we also have the smallest voice in how the health care system works,” Mokashi said. “We don’t have any say in how finances are allocated to the department. I think the people on the front lines should have an active voice in how funds are allocated and why.”

Vanessa VanDruff, a third-year resident at UChicago Medicine, said she wanted to unionize not because she dislikes her workplace, but because she cares so much about it. Residents want the power to help improve their hospitals, she said.

University of Chicago Medical Center said in a statement it “remains committed to continuing to foster an exceptional learning and care environment for our 1,040 residents and fellows.”

VanDruff believes the unionizations at UChicago Medicine, Northwestern, UIC and West Suburban are just the beginning.

“I think unionization of residents is going to spread to almost every institution,” VanDruff said. “I think it’s that important.”

Like so many others, she woke up on that July 4 morning anticipating a fun-filled day of watching the parade with her family. However, a gunman opened fire on the festivities killing seven and injuring dozens more, including Turnipseed.

She was transported to Northwestern Medicine Lake Forest Hospital with pelvis and leg wounds. Her organs and bones were not directly hit, but there was nerve and tissue damage. In addition, she had a 14-centimeter wound on the back of her leg, leading to severe pain. Doctors did not remove the shrapnel believing that would be too risky.

As the months after the shooting passed, there were multiple stays in the hospital for Turnipseed, but she said her physical pain and mental anguish continued.

“When you are in chronic pain, it wears you down,” she said. “I tried to remain hopeful and focused, as I had a full-time job, so I am trying to manage through all of that. But, there were absolutely days I was frustrated, and there was always anger because something happened to me that never should have happened to me.”

The constant burning and shooting pain in her pelvis made simple walks outside or playing with her daughter challenging, if not impossible. Turnipseed’s doctors eventually suggested she visit Dr. Jason Ross, an anesthesiologist and pain-management specialist at Northwestern Memorial Hospital in Chicago.

Ross used injections and medications that provided short-term relief, but long-term problems remained. He then recommended a dorsal root ganglion stimulator, or DRG.

“We were getting to the point that some of the more conservative options were exhausted, and I thought the DRG option was a reasonable option for her,” he said.

The DRG procedure — which has been around for about 10 years — comes in two parts, where doctors insert a stimulator focusing on the dorsal root ganglion nerves that serve the pelvis region, Ross said. After surgery, patients can use a held-hand held iPod, or an iPhone app, to change the stimulation settings within prescribed limits.

Turnipseed did some online research and opted to have the surgery in November. Her situation improved immediately, and said she continues to make progress in the months since.

“If I am having a day where I have increased pain or something going on, I can go into the app, and pick the part of my body where I am having issues and turn up the intensity of the device,” she said.

DRG represents an evolution in spinal cord stimulation that, in general, has been around for about six decades, but was not always effective for certain types of pain, including in the pelvis.

“It is very effective in the correct type of person,” Ross said.

While it is unclear how often DRG is used, Ross said about 50,000 spinal cord stimulators are implanted each year.

Ross stressed that DRG is not for everyone, and it isn’t the first option he would recommend for someone with a painful condition.

“A lot of times, you should exhaust more conservative management before you consider a surgical intervention,” he said.

He said DRG is covered under certain health insurance plans, but it depends on a patient’s diagnosis.

“Sometimes that is the most complicated part,” Ross said. “I wish these were available for everyone, but unfortunately that is the world we live in and it can be a challenging environment to navigate.”

As for Turnipseed, she is still taking a high dose of a nerve-pain medication with serious side effects. If the pain continues to ease, she hopes to lower the dosage.

She can walk more now, including taking out the family dogs or getting to an airport gate within a reasonable distance of the entrance. However, there is still a ways to go.

“I’ve made a ton of progress,” Turnipseed said. “I’m infinitely better than where I was, but I still have pain. I can wake up the next day and feel pretty good, but before DRG, that wasn’t the case.”

She is grateful for that initial suggestion to meet Ross.

“I’m glad I have a doctor who is innovative, and willing to work with me and helping me get better,” she said.

Ross said, “Being able to restore some normalcy to her life is honestly one of the best successes of my career.”