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WoodysPhotos/iStockBY DR. NITHIN PAUL

(NEW YORK) -- Surgeons in Michigan are prescribing fewer opioid medications after operations, but here's the kicker: Their patients are not complaining.

A new study further explores whether too many opioids were being given to patients and how new guidelines can help surgeons curb usage without affecting pain relief.

In the study, opioid dosages often were decreased to 18 pills from 26 pills, with "no clinically important changes in pain scores."

"The results here are promising," said Dr. Joshua Sharfstein, co-author of "The Opioid Epidemic: What Everyone Needs To Know" and professor of practice at the Johns Hopkins Bloomberg School of Public Health. "Most [physicians] prescribe by routine, and changing those routines is hard. This shows that some changes are possible."

Cop In the seven months after the guidelines were released, the number of prescriptions for fewer pills almost tripled, to 59% from 20%, according to the study. Many physicians prescribed about eight fewer pills, and patients consumed about three fewer.

The Michigan Surgical Quality Collaborative and the Michigan Opioid Prescribing Engagement Network reviewed data on how 50,000 patients took opioids for pain management. New guidelines were developed for surgeons on how to prescribe opioids for nine common surgeries including hernia repair and gallbladder removal.

About 12,000 patients were tracked across 43 hospitals. When more than half of those patients were interviewed about their pain levels, most didn't report feeling an increase in them and were satisfied with their care.

This study comes at an important time.

Opioid medications, which are highly addictive, are causing an epidemic in this country. The Centers for Disease Control and Prevention has determined that about 130 Americans die every day from overdosing on opioids.

Dr. Joceline Vu, one of the study's authors and a surgical resident at University of Michigan, thinks that these new guidelines can be a part of the solution.

"For healthy people, surgery may be the first time they are exposed to opioids," she told ABC News. So if people unfamiliar with taking opioids are given more than required, that person could become dependent on them, she added. Or the pills could find their way into the community.

Sharfstein agreed with Vu, adding that this is one part of a large and complex problem.

Before these guidelines, Vu said there wasn't a systematic way for surgeons to determine how many pills to give to patients when they're released from the hospital. Many physicians, Vu added, worried that prescribing too few pills could mean their patients feel more pain and consequently report lower satisfaction scores, which are used to judge a hospital's success.

Vu went on to say that not only have the guidelines been useful in preventing prescriptions of too many pills but that patients never felt their pain or concerns were ignored.

"It is important that this study be read, and people realize that changes are possible," said Sharfstein, adding that in fighting the opioid epidemic on several fronts, evidence-based recommendations could prove crucial.

Nithin Paul, M.D., M.P.H., is a family medicine and preventive medicine resident physician at Medstar and Johns Hopkins University writing for ABC News' Medical Unit.

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Doug Nash(NEW YORK) -- Reports of health problems from a dangerous so-called “miracle cure” marketed widely online in recent years as a mineral solution known as “MMS” -- whose promoters tout it as a treatment or cure everything from HIV/AIDS and cancer to autism and fibromyalgia –- are back on the rise, according to a new warning issued by the U.S. Food & Drug Administration (FDA).

In a statement released earlier this month, FDA officials warn that ingesting MMS is “the same as drinking bleach” – a warning that was echoed by medical experts, toxicologists and chemists contacted by ABC News in a new probe of the mixture and its promoters.

"Product directions instruct consumers to mix the sodium chlorite solution with citric acid -- such as lemon or lime juice .... before drinking," the warning FDA notes. "When the acid is added, the mixture becomes chlorine dioxide, a powerful bleaching agent."

Meanwhile this month, the founder of a fringe healing "church" known for marketing the mixture -- who changed course and declared in a church newsletter that "MMS cures nothing!" after being featured in an earlier 2016 ABC News investigative report -- is back to hawking MMS as the solution to "whatever ails you."

FDA spokesman Jeremy Kahn said the statement was issued in part to combat the product’s increasing web presence.

“We’ve seen an uptick in social media traffic and searches all over the web,” Kahn told ABC News. “We’re hoping to remind folks that this product is still out there, it’s dangerous, and to beware.”

The FDA has documented at least 20 reports of MMS poisonings, Khan said, including the hospitalization of a child. FDA records on the agency's website document the April, 2015 hospitalization of a 10-year-old girl with autism after ingesting MMS.

But the FDA is only relying on self-reported incidents, according to Kahn, and does not as a practice follow up with people after they report symptoms of MMS poisoning.

“I can guess there are cases from 2019 that are still processing in our system,” he said. “There are probably many cases that we just don’t receive notice of.”

'The vision of her face'

Marketed under names like “Miracle Mineral Solution,” “Master Mineral Solution,” “MMS” or “CD protocol,” the potentially toxic mixture was ingested by Sylvia Nash, 56, shortly before her death in 2009, according to her husband, Doug Nash, a planetary geologist and former investigator for the National Aeronautics and Space Administration's (NASA's) Apollo Lunar Sample Analysis Program.

"She had decided to try MMS because she succumbed to the arguments of its proponents that MMS could aid in protecting the two of us against malaria in our [then] current travels on our sailboat in the western Pacific Islands," he told the FDA in a report he submitted to the agency about his wife's death. While doctors who performed the autopsy did not conclude a cause of death, Nash is convinced it was MMS.

Nash said that she initially suffered diarrhea, nausea and vomiting -- but those were all symptoms that proponents of MMS say are not uncommon and can be an indication that the treatment is working, Nash said at the time.

"But it didn't get better," he said. "It got worse and worse."

The couple had planned to sail around the world, beginning in late 2004 and take their time heading south from California and then west. Sylvia had been a crewmate at the start, but Nash said that just six months into the trip, they were "connected."

"And eventually, we married," he said.

After sailing off South America, followed by a two-year spell in New Zealand, they made their fateful stop in the Vanuatu islands in August 2009.

Nash said his wife wanted to take measures against malaria, but hadn't liked the medicine she had taken once before. Instead, she met fellow travelers on one of the islands selling something else.

Nash told ABC News in 2016 that his late wife died in his arms, slumped over with her eyes rolled back in her head, just hours after ingesting MMS.

"The vision of her face, just inches away from mine, and those eyes suddenly de-focusing on mine,” said Nash. “That’ll haunt me for the rest of my life.”

In 2016, ABC News took a closer look at religious leader Jim Humble, founder of the Genesis II Church of Health and Healing, which at one point was based in Angleton, Texas. Humble pedaled the elixir, claiming that he had treated more than 5,000 cases of malaria using only MMS. He claimed to have discovered the solution while mining gold in South America.

Nash had told ABC News that his wife was in excellent health prior to ingesting two drops of MMS mixed in lime juice, the initial dose recommended in Humble's protocol -- and that 12 hours later she was dead, according to the 2011 report he submitted to the FDA.

'They might as well be selling Clorox'

U.S. officials and medical experts have told ABC News that MMS is just a kind of industrial bleach.

"They might as well be selling Clorox,” said Ben Mizer, who as a federal prosecutor with the U.S. Department of Justice’s Consumer Protection Branch unit prosecuted four people for MMS sales in 2013. "You wouldn't drink Clorox, so there is no reason to drink MMS,” Mizer told ABC News in 2016.

That same year, ABC News tracked Humble down in a small village outside Guadalajara, Mexico, where in an interview he defended his claims that MMS is a universally effective cure-all.

“Many women with breast cancer have been cured,” Humble told ABC News. Asked whether he believes himself to be a con man, Humble replied, “Well, I don’t think so.”

Yet after he was featured on ABC News’ 20/20, Humble changed his tune about MMS -- recanting his praise for the mixture and telling his followers that he no longer believed in the healing powers of MMS.

“For lack of a better way to express things at the time – or because others put words in my mouth, in the past I have stated that MMS cures most of all diseases. Today, I say that MMS cures nothing!” Humble wrote in a 2016 Genesis II newsletter.

'For whatever ails you'

But now Humble is back to marketing MMS.

“Whatever the problem, there is a great chance that if MMS is used properly it will help one recover their health,” Humble wrote in a blog post earlier this month. In the post, he touts a self-published 2016 “MMS Recovery Guidebook” as containing a plan to cure a raft of serious illnesses with MMS.

“This plan IS for whatever ails you,” he writes in the post. "In other words, it is the protocol for Lyme, or Parkinson’s, or cancer, or fibromyalgia, herpes, Alzheimer’s, hepatitis A, B and C, liver disease etc. etc. etc. you name it, the list goes on.”

ABC News reached Humble this week via email, and in a written response to questions about his marketing of MMS, the preacher once again defended the mixture.

MMS "cannot harm the human body in any way unless one takes way, way too much which is exactly the same as any other substance including simple things like salt and sugar, even drinking too much water can cause harm," Humble wrote in an email to ABC News. "When MMS is taken according to instructions, one is 99.99% safe."

Humble also included a long list of U.S. patents for medical treatments containing chlorine dioxide -- the powerful bleaching agent produced when MMS is combined with citric acid.

Yet a close review of those patents indicates that in many of them, the chlorine dioxide concentration ranges between 0.1 and 2% of the total solution. Websites that tout MMS describe it as containing a 28% concentration of sodium chlorite, according to the FDA's most recent warning.

Dr. David Constable, science director of the non-profit American Chemical Society’s Green Chemistry Institute said that adding citric acid to a mixture that is 28% sodium chlorite and 62% water could dilute the concentration of the subsequent compound, chlorine dioxide, depending on the amount of citric acid added.

“But just converting it to chlorine dioxide is not a good thing,” Constable said. “The key message here should be that no one should ingest chlorine dioxide under any circumstances. This is not a cure. No responsible chemist would ever recommend this.”

As of this week, MMS remains available for purchase directly from the church's website, which is run through Swiss and Icelandic proxy servers.

Kahn said this week that the FDA has learned of several groups meeting recently to strategize a push to market MMS online.

“We try to track any online sellers and bring companies and individuals to [the attention of] appropriate law enforcement agencies.”

Still, Kahn said, the most recent criminal case brought against an MMS seller was in 2015, when Louis Daniel Smith was convicted of conspiracy, smuggling, selling misbranded drugs, and defrauding the United States.

Years earlier, Nash had launched his own personal investigation into his wife's death, and said that he traced the bottle of MMS she had ingested the drops from to a Carson City, Nevada company called Project Greenlife, which was operated by Smith, according to federal prosecutors. In 2011, Nash filed a detailed report about his wife's death with the FDA, only to learn that federal authorities was already on the trail of some MMS proponents. In 2013, prosecutors indicted and eventually convicted Smith.

He was sentenced to a 51-month prison sentence and fined $13,000, court records show. Federal Bureau of Prison records indicate that he remains under supervised release after being released from prison in January.

While Smith was not charged with Sylvia's death, during court proceedings, the government alleged that "Mr. Smith's actions have posed a risk of danger to others, including contributing to the death of at least one individual." Nash said in 2016 that he believes they were referring to Sylvia.

'Flat out dangerous'

Attempts to reach Smith this week were not immediately successful, but in a blog post critical of ABC News' 2016 reporting on MMS, Smith questions whether MMS caused Nash's death, whom Smith refers to in his blog post by her maiden name, Sylvia Fink.

He calls ABC News' reporting a "hit piece" and claims without citation or evidence that "MMS has been used in over 160 countries by hundreds of thousands of people." He goes on to contend that "Doug Nash has not been truthful with the world, and it's time for the world to know. I would be remiss to allow Mr. Nash to continue this charade that has served only to insulate himself from further investigation, while leaving a scarlet letter on the MMS movement that I know from personal, first-hand knowledge has saved countless lives."

In 2016, the year after his conviction, Smith was warned in a letter from the FDA not to market sodium chlorite for human consumption, citing his 2015 conviction.

"You were managing member of PGL International, LLC (PGL) a Nevada corporation which marketed and sold various health-related products, including Miracle Mineral Solution (MMS) a mixture of sodium chlorite and water, through the website projectgreenlife.com," the letter warns Smith. "Sodium chlorite cannot be sold for human consumption and suppliers of the chemical include a warning sheet stating that it can cause potentially fatal side effects if swallowed.

Each of a half dozen independent toxicologists contacted this week by ABC News about sodium chlorite and chlorine dioxide all offered the same conclusion.

"Sodium chlorite and chlorine dioxide in very low concentrations can be used safely to disinfect drinking water," said one of them, Dr. Stephen M. Roberts, director of the Center for Environmental & Human Toxicology at the University of Florida. "Like most other things, the concentration matters. There is no credible evidence that sodium chlorite can be used for medicinal purposes to treat disease."

Another, Dr. William Sawyer, a toxicologist with the non-profit American Board of Forensic Medicine, said that "from a medical standpoint, there's no advantage to using [sodium chlorite], only toxicity."

"There's no therapeutic possibilities with drinking diluted sodium chlorite with citric acid," he said. "This is flat out dangerous."

Nash did not immediately respond this week to ABC News requests for comment on Humble's blog post or the new FDA warning.

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Moussa81/iStock(NEW YORK) -- Surgeons in Michigan are prescribing fewer opioid medications after operations, but here's the kicker: Their patients are not complaining.

A new study further explores whether too many opioids were being given to patients and how new guidelines can help surgeons curb usage without affecting pain relief.

In the study, opioid dosages often were decreased to 18 pills from 26 pills, with "no clinically important changes in pain scores."

"The results here are promising," said Dr. Joshua Sharfstein, co-author of "The Opioid Epidemic: What Everyone Needs To Know" and professor of practice at the Johns Hopkins Bloomberg School of Public Health. "Most [physicians] prescribe by routine, and changing those routines is hard. This shows that some changes are possible."

In the seven months after the guidelines were released, the number of prescriptions for fewer pills almost tripled, to 59% from 20%, according to the study. Many physicians prescribed about eight fewer pills, and patients consumed about three fewer.

The Michigan Surgical Quality Collaborative and the Michigan Opioid Prescribing Engagement Network reviewed data on how 50,000 patients took opioids for pain management. New guidelines were developed for surgeons on how to prescribe opioids for nine common surgeries including hernia repair and gallbladder removal.

About 12,000 patients were tracked across 43 hospitals. When more than half of those patients were interviewed about their pain levels, most didn't report feeling an increase in them and were satisfied with their care.

This study comes at an important time.

Opioid medications, which are highly addictive, are causing an epidemic in this country. The Centers for Disease Control and Prevention has determined that about 130 Americans die every day from overdosing on opioids.

Dr. Joceline Vu, one of the study's authors and a surgical resident at University of Michigan, thinks that these new guidelines can be a part of the solution.

"For healthy people, surgery may be the first time they are exposed to opioids," she told ABC News. So if people unfamiliar with taking opioids are given more than required, that person could become dependent on them, she added. Or the pills could find their way into the community.

Sharfstein agreed with Vu, adding that this is one part of a large and complex problem.

Before these guidelines, Vu said there wasn't a systematic way for surgeons to determine how many pills to give to patients when they're released from the hospital. Many physicians, Vu added, worried that prescribing too few pills could mean their patients feel more pain and consequently report lower satisfaction scores, which are used to judge a hospital's success.

Vu went on to say that not only have the guidelines been useful in preventing prescriptions of too many pills but that patients never felt their pain or concerns were ignored.

"It is important that this study be read, and people realize that changes are possible," said Sharfstein, adding that in fighting the opioid epidemic on several fronts, evidence-based recommendations could prove crucial.

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Jen Curran(LOS ANGELES) -- A California woman who gave birth six months ago says seeking a second opinion after one doctor told her to lose weight may have saved her life.

Jen Curran, 38, of Los Angeles, said her blood pressure was high and her OBGYN detected a high amount of protein in her urine during the second trimester of her pregnancy, which was her first.

She was quickly diagnosed with the pregnancy complication preeclampsia and put on bed rest.

"My reaction was, 'Let me stay relaxed because of this baby,'" Curran told ABC News' Good Morning America. "I definitely put it out of my mind."

Two months after Curran gave birth to her daughter, Rose, Curran's doctor observed her protein level was even higher than it had been before pregnancy. Curran's blood pressure was back to normal.

Curran, co-founder of The Ruby LA, a comedy theater and school, said the doctor told her to lose weight.

"It was like a slap across the face," Curran recalled. "As someone who's been overweight on and off for most of my life, it hasn't been a health issue for me, but I didn't feel like I should argue with her."

Curran's gut instinct told her that her medical issue was not one that could be solved by weight loss. She sought a second opinion and was diagnosed with bone marrow cancer.

"Completely shocking," Curran said of the diagnosis. "I have this memory of him telling me that I have bone marrow cancer, but I can't I don't feel like I'm in the same room with him."

Curran shared her story on Twitter to encourage other people, especially women, to be their own advocates when it comes to their health.

"Lose weight if you want to. But if you think something is seriously wrong with your body, and a doctor tells you weight loss is the key to fixing it, get a … second opinion," she tweeted.

Curran began chemotherapy on Tuesday.

Her intuition served her well again right after her cancer diagnosis when she asked her doctor is she would be able to freeze her eggs. When that doctor was against it, Curran once again sought a second opinion and was told by a fertility doctor it would be safe to freeze her eggs.

She had her eggs retrieved and now plans to continue to grow her family once her cancer goes into remission.

"So many of us are so afraid to stick our neck on the line, [to] question authority," Curran said. "When it's for our kids we will much more readily do it, but do it for yourself because your kids need you around. Your family needs you around."

"And women are so brilliant and intuitive. Women know their bodies," she said.

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Just_Human/iStock(NEW YORK) -- It's 5:00 on Sunday night and a familiar feeling of dread starts to set in, as the weekend slips away.

Sunday scaries, Sunday night blues and Sunday depression are all terms used to describe the anticipatory anxiety for the week ahead.

It's a phenomenon that has become commonplace, experienced by 81% of Americans, according to a survey by The Sleep Judge, a mattress review website.

It's also become an extremely popular hashtag, with more than 160,000 #sundayscaries posts on Instagram.

The good news for those suffering from Sunday night anxiety is that there are ways to ease the dread in order to both enjoy Sunday and start the week off well.

Here are three tips to try from Michelle Bombacie, L.Ac., Healthy Monday Adviser and program coordinator for the Integrative Therapies Program/Center for Comprehensive Wellness at Columbia University Medical Center:

1. Get off your technology

Bombacie recommends staying away from your cellphone, emails and computer throughout the weekend, or at least set limits.

"Try to resist the urge or maybe set a time commitment," she said. "Commit to powering down by 5 p.m. so that you allow relaxation time on Sunday."

"If we don't give ourselves that opportunity to relax and reboot we're not going to be as functioning on Monday we can," she added.

It can also be helpful to set a routine to improve sleep habits as you enter the work week, according to Bombacie, who suggests using blackout curtains or eye masks and ear plugs, setting the blue light filter on your smartphone, putting your smartphone out of sight and turning the TV off about one hour before bed.

2. Practice a deep-breathing exercise

A simple breathing exercise recommended by Bombacie starts with placing one hand over your chest and the other over your lower belly.

Then, breathe in through your nose and exhale through your mouth. Focus on your breath while breathing in for four counts and exhaling for four counts.

"You can do this laying down in bed, or when you wake up in the morning instead of reaching right for the cell phone take a few minutes to just start with breathing because it will help you ground," she said.

3. Get a new perspective

Bombacie recommends thinking of every Monday as a chance to start over, as if you have "52 mini-resolutions," a new chance each week of the year.

"We have to change our perspective on Monday," she said. "Instead of looking at it as a day to dread, we look at it as an opportunity to restart and refresh."

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Courtesy Comprehensive Cranium Care(NEW YORK) -- Kylie Bamberger was diagnosed with alopecia areata, also known as patchy hair loss, at age 12.

By her 15th birthday, as her condition become more severe, Bamberger said she decided to shave her head.

"I really wasn't comfortable with my bald head at all," Bamberger told ABC News' Good Morning America. So for years, she hid behind a wig full-time and didn't face her hair loss head-on.

But ultimately, she accepted her journey and learned to embrace her baldness.

"I found my tribe, and once I became comfortable with myself ... I was able to embrace who I am," she said.

Now bald and proud, Bamberger was introduced through her work with The Children's Alopecia Project to a line of products from Comprehensive Cranium Care made just for her and others who are bald.

"I think it's a cool way to help people who maybe aren't feeling very confident with their hair loss to have something that makes them feel like, hey this is for me," Bamberger said. "Like, you people with hair can't use this, this is specific for me."

The company makes personal care products just for bald, shaved and buzzed heads, so people can embrace their baldness. It's the first product line in this space.

"We are driven by the desire to empower our community and promote a message of bald positivity," company co-founder Adam Fitting told Good Morning America.

The Chicago-based company is trying to help everyone embrace their baldness by using the hashtag #OwnYourDome on social media to spread awareness.

Fitting said he started the company after not being able to find a product that worked well for his shaved head.

"I simply couldn't find any grooming products that worked well for my shaved head, and I knew I wasn't alone in this frustration," said Fitting, who passionately set out to create a "clean" product that he would use himself.

The company has gained a following among communities ranging from people with alopecia and pattern baldness to those fighting cancer.

Like Bamberger, Keya Trammell told GMA that having a custom product created for her is empowering.

"It's special for me because when I was younger I didn't have anything specifically for my head and I wasn't even comfortable sharing my head," said Trammell, who also has alopecia. "But now that I am, it's like something is made just for me."

A portion of Comprehensive Cranium Care's sales benefits The Children's Alopecia Project, and the company also donates products to events around the country that raise money for the St. Baldrick's Foundation to fight childhood cancer.

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releon8211/iStock(NEW YORK) -- The Federal Communications Commission is moving forward with a plan to create a new three-digit hotline number, similar to 911, to enable quick access to national suicide prevention resources.

In a report sent to Congress earlier this week, the FCC’s Wireline Competition Bureau and Office of Economics laid out its recommendation to designate 988 as the three-digit dialing number to quickly access the nationwide suicide prevention and mental health hotline, the agency said on Thursday.

"The Lifeline has become the nation’s mental health and suicide prevention safety net," the report said. "In many communities the only immediately available resource for a suicidal person would be an emergency room or the Lifeline and its network of crisis centers."

FCC Chairman Ajit Pai said the services are already provided by the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK), but he said a three-digit number could help combat the country's growing "suicide epidemic."

National Suicide Prevention Lifeline counselors answered more than 2.2 million calls and 100,000 online chats last year, according to the FCC's report, which was mandated under President Donald Trump's National Suicide Hotline Improvement Act of 2018. The hotline receives an average of about 188,000 calls and 9,000 crisis chats per day, according to the report.

The new number would be the same hotline that would offer 24/7 free and confidential support for anyone in distress and best practices for professionals, but with a simple and easier-to-remember number.

“There is a suicide epidemic in this country, and it is disproportionately affecting at-risk populations, including our Veterans and LGBTQ youth,” Pai said in a statement. “Crisis call centers have been shown to save lives."

"This report recommends using a three-digit number to make it easier to access the critical suicide prevention and mental health services these call centers provide," he added.

Pai said he plans to push forward with a rule-making proceeding. The proposal will be subject to a period of public comment and a final vote among the agency's commissioners before it can go into effect.

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bombuscreative/iStock(NEW YORK) -- For many hospital patients, pain is part of their reality. According to a new study, however, an unreal environment could help. Virtual reality can help.

Researchers at Cedars-Sinai Medical Center tried virtual reality (VR) technology as a new treatment for pain -- and it seemed to work. From orthopedic pain to cancer pain, the patient's pain level went down across the board.

Adults who were enrolled in the study were admitted patients of Los Angeles’ Cedars-Sinai Medical Center and had different types of pain. VR worlds were as different as mountain scenery with meditations and cartoon worlds with target practice.

Dr. Brennan Spiegel, Professor of Medicine and Public Health and Director of Health Services Research at Cedars-Sinai Medical Center, was a study author. He believes that VR should claim a legitimate place in pain management.

"This is not voodoo science. We can do better at findings ways to engage our patients in managing pain and distress without always reaching for a pill,” he said in an interview with ABC News.

His overall message: “The time has come to introduce this option in patient care."

According to Spiegel, VR should be considered the same way proven therapies like cognitive behavioral therapy and even mindful meditation. It’s a new "technological platform to achieve time-tested results."

Researchers compared the effectiveness of VR in managing pain by dividing 120 people in pain into two groups: one group had VR experiences, the other watched health and wellness videos on TV. The VR headset gave them a choice of 21 VR scenarios, and suggested they use them three times daily for 10 minutes at a time and whenever they had extra pain. They indicated their pain levels on a scale of zero to 10; zero meant “no pain” and 10 was the “worst imaginable pain." They looked at differences in the amount of pain medications used between the VR and television groups, and included the level of opioid pain medications they were using.

The VR group said their pain scores went down by approximately two points; the TV group had about half a point decrease in pain.

While the notion that VR might reduce pain may surprise some, Spiegel explains, "We are modifying the way people are experiencing their illnesses. [VR] can modify how the illness is perceived."

Dr. Houman Danesh, director of Integrative Pain Management at Mount Sinai Medical Center, has occasionally referred patients to use VR for treatment and sees the study results as promising. Using VR in addition to other pain treatments is consistent with Danesh’s view that pain needs tend to go beyond using a single tactic.

“For pain management, you do need a multimodal approach to achieve effects,” Danesh told ABC News.

In general, pain medications are not all created equal; effects -- and side effects -- vary. Some are addictive, some cause nausea, some work better than others.

VR’s side effects are different.

"When used for healthcare -- in contrast to use for gaming and entertainment -- we have not observed signs of addiction with virtual reality. We do see some low-grade cyber sickness," says Spiegel, describing the dizziness that commonly occurs with VR headset usage. Spiegel reassures, however, that this symptom "almost always" resolves after the headset is removed.

Whether or not VR can take the place of available pain medications, however, is not a question that the study can answer. Spiegel believes that ”a future study may help answer if [VR] could be an alternative [to opioids].” He hopes that VR can be added, not only to treatment with opioids, but to any pain management program.

Since the study took place in a hospital instead of a laboratory, it might give a more “real world” result.

"This was a very pragmatic study to understand the real-life impact of VR in the hospital setting," says Spiegel.

Just how practical is it for pain patients to have access to VR while staying in the hospital? According to Danesh, “Virtual reality is easier to use in an inpatient hospital setting. [VR] is readily available, [it] can be reused. It can get rid of any environmental stimuli, as well.”

Even if the means by which it is achieved is virtual, the hope is that the difference patients feel in their pain is real.

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Paolo_Toffanin/iStock(SAINT PAUL, Minn.) -- The Minnesota Department of Health (MDH) is asking health care providers to be on alert for lung diseases related to vaping and e-cigarette use among young adults after a Minnesota hospital reported several “severe” cases.

Children’s Minnesota hospital has reported four cases of “severe lung injury” in the Minneapolis area that it says are similar to cases recently reported in Wisconsin and Illinois. The hospital also said it is “too early to say whether they are connected.”

The patients spent several weeks in the hospital and some were admitted to the intensive care unit for symptoms including shortness of breath, fever, cough, vomiting and diarrhea. Other symptoms reported by some patients included headache, dizziness and chest pain.

“We are encouraging providers and parents to be on the lookout for vaping as a cause for unexplained breathing problems and lung injury and disease," said Dr. Ruth Lynfield, state epidemiologist and MDH medical director.

“These cases are extremely complex to diagnose, as symptoms can mimic a common infection yet can lead to severe complications and extended hospitalization,” Dr. Emily Chapman, chief medical officer at Children’s Minnesota, added. “Medical attention is essential; respiratory conditions can continue to decline without proper treatment.”

E-cigarette use is “unsafe” for kids, teens and young adults, according to the Centers for Disease Control and Prevention (CDC).

In part, this is because the nicotine present in most of them is addictive and can harm parts of the young adult brain that control attention, learning, mood and impulse control, all of which are still developing until about age 25, according to the CDC.

E-cigarettes, vapes, e-pipes and other vaping products are battery-powered devices that allow users to inhale aerosolized liquid. The aerosol in these products, the MDH says, also contains harmful chemicals like ultrafine particles; oil; heavy metals, like nickel, tin and lead; and other cancer-causing chemicals.

E-cigarette use increased 78% among high school students between 2017 and 2018, according to the CDC. In 2018, more than 3.6 million U.S. youth, including one in five high school students and one in 20 middle school students, said that they currently used e-cigarettes, the CDC said.

In December 2018, the surgeon general released an advisory on e-cigarette use, calling it an “epidemic” among youth.

Patients and people with a history of vaping who are experiencing lung symptoms should seek clinical care, the MDH said. Patients and those experiencing symptoms should avoid using e-cigarettes and other vaping products.

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JosuOzkaritz/iStock(NEW YORK) -- Teenage girls are affected by social media use more than boys, with the harmful effects being driven by three factors, according to a new study.

In girls, frequent use of social media harmed their health by leading to inadequate sleep, inadequate physical activity and exposing them to cyberbullying, according to the study published Tuesday in the journal Lancet. The same did not hold true for boys who frequently use social media.

Researchers from University College London tracked the social media use of nearly 13,000 teens in the U.K. from when they were 13 to 16 years old. They also evaluated the teens’ own reports about their well-being, exposure to cyberbullying and time spent sleeping or being physically active.

The study found that 27% of the teens who were frequent users of social media reported high psychological stress. Among the teens who were infrequent users, only 17% reported high psychological stress.

“The culprit appears not to be social media but that they weren’t getting enough sleep and physical activity,” ABC News chief medical correspondent Dr. Jennifer Ashton said of the study’s findings. “[The sleep aspect] is huge and I can’t overemphasize this.”

Teenagers should get nine to 10 hours of sleep per night, according to Ashton. In addition, it’s important that teens keep their sleep schedules consistent, instead of skimping during the week and trying to make up for it on the weekends.

“There are cardiovascular, heart disease effects, mental health effects to inadequate sleep,” said Ashton, noting that parents and medical providers “need to think of the long game” when it comes to teens and sleep.

The study's authors also recommended including "efforts to prevent or increase resilience to cyberbullying" as an intervention to improve the mental health of teen girls who use social media.

"Cyberbullying" is defined as bullying that takes place over digital devices like cellphones, computers and tablets. It includes sending, posting or sharing negative, harmful, false or mean content about another person, according to stopbullying.gov, a website managed by the U.S. Department of Health and Human Services (HHS).

The findings appeared to be consistent with research that has focused on U.S. teens.

Last month a study in the U.S. found that girls report three times as much harassment online as boys.

Among middle and high school students, 21% of girls say they have been bullied online or by text messages, compared with less than 7% of boys, according to the National Center for Education Statistics (NCES).

Many social media platforms and schools now have clear ways you can report cyberbullying.

If parents are concerned that their teen is being cyberbullied, the site stopbullying.gov recommends they take time to investigate their child's digital behavior.

First, parents should take notice if their child has had a change in mood or behavior. Next, they can initiate a conversation about what is happening, as well as document what is happening by taking screenshots of online harassment.

Parents can also lead their child on a social media detox. Here's a full guide to follow if you want to try a social media detox with your own family or community.

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LIgorko/iStockBY: DR. LAITH ALEXANDER

(NEW YORK) -- A new study from Stanford University published in JAMA Internal Medicine shows surprise medical bills – when you visit a hospital and, some time later, get charged a bill – are on the rise.

Dr. Eric Sun, lead author of the study and assistant professor of anesthesiology, pain medicine and health research and policy at Stanford University, and his colleagues used a national database to look at surprise billing from 2010 to 2016, all from one large commercial insurer.

"We looked at situations where people were admitted to an emergency room – where people have less choice of health care provider," Dr. Sun told ABC News. "We also looked at care within in-network hospitals – where receiving a bill would be a surprise because it should be covered by insurance."

If you visited the emergency department in 2010, there was a 32% likelihood you would receive a surprise medical bill. But in 2016, Sun and his team found it rose to just under 43%.

But it's not only that they are becoming more common -- they're becoming more expensive, too. The average cost rose from $220 to $628, the study found.

The situation is just as bad for inpatients. Twenty-six percent received a surprise medical bill in 2010, but 42% received one in 2016. The cost situation was even worse, rising from $804 to $2,040.

These surprise bills come from a variety of sources, but primarily it has to do with insurance coverage, according to the researchers.

"Whenever you get hospital care, the decision to participate in insurance is made independently by every doctor you see," Sun told ABC News.

"If you see an in-network doctor, they agree to an amount that the insurance company pays, but an out-of-network doctor doesn't like that agreement and so they bill more," he said. "That comes as a surprise medical bill, and [it] can even happen at in-network hospitals."

It isn't fully clear why they're on the rise.

"A lot of this is driven by insurers and doctors agreeing an amount to be paid for treatment," Sun said. "The insurers might be putting more pressure on doctors to reduce costs by suggesting an amount the doctor doesn't accept – and so the doctors choose to go out-of-network for additional revenue."

Ambulance services, an often overlooked source of medical costs, resulted in a surprise bill for 86% of ER visits and nearly 82% of hospital admissions.

"It's possible that the coverage of many networks still isn't broad enough," Dr. Robert Steinbrook, editor-at-large at JAMA Internal Medicine, told ABC News.

And as a patient, it can be really hard to avoid these bills. In fact, the situation is often impossible to avoid in the emergency room.

"In these settings, you often can't choose who you're treated by, so surprise bills are very difficult to avoid," Sun said.

For inpatient admissions, Steinbrook has some advice: "If you have a choice of insurers, you should consider the breadth of the network. … If a hospital advertises that all physicians are part of an in-network insurance, you could go there and avoid out-of-network charges."

In terms of what's being done about the surprise bill epidemic, "different states have different laws," Steinbrook said. Some approaches include setting a state-wide payment standard or using arbitration – where a third party resolves disputes between doctors and insurance providers.

"Congress has been debating various bills, but as of now, they haven't enacted anything," Steinbrook told ABC News. "In my view, a federal solution would be better because it would go beyond state boundaries."

In the meantime, surprise medical bills may not be as out-of-the-ordinary as the name suggests. Whether it's an ambulance or a hospital bed, your wallet might need to be braced for a bruising.

Dr. Laith Alexander is an MB/PhD student at the University of Cambridge, U.K., working with ABC News Medical Unit.

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BootySprout(NEW YORK) -- Behold the BootySprout -- the at-home, glute-training device that will soon be taking over your Instagram.

The BootySprout is designed to tone your butt by simulating weighted hip thrusts, but without any heavy weights.

Ever since Kim Kardashian's infamous Paper magazine cover in 2014, booty workouts have become all the rage. The $155 BootySprout, which is lightweight and folds up for easy storage, is designed to make them easier to do without leaving your home.

The device is designed and engineered by Michael Ballestero of California, who created it after trying the exercise at the gym and finding it difficult to set up the bench and weights.

"BootySprout is designed to easily and safely perform high resistance hip thrusts in the comfort of your home," Ballestero told ABC News' Good Morning America. "Hip thrusting is a fun exercise, and the results from weight training your booty are amazing."

The patent-pending device is only 22 pounds and can easily be assembled at home.

"BootySprout is very easy to use, no matter where you are in your fitness journey," Ballestero said.

The device can fold up to be stored under a bed or in the closet.

Videos of the workout have already gained viral attention.

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Instagram: Pigeonpup(NEW YORK) -- After a dog named Pigeon was in a car accident, her rear legs were left paralyzed and her owner abandoned her.

As it happened, the owner of a dog-sitting business in Savannah, Georgia, had just lost a dog who bore a striking similarity to Pigeon. After seeing a picture, she knew it was meant to be.

And now, thanks to an adoring owner and a specially-made wheelchair, Pigeon is living her best life.

“She looked exactly like my dog who had just died and I knew we were meant to be together,” Pigeon's owner, Erin, told ABC News' Good Morning America. “She’s just so capable that you forget that she’s paralyzed."

Erin has a deep love for animals, so she knew she could give Pigeon everything she needed.

But when she took Pigeon home for the first time, she says she could already tell Pigeon was a wild child.

“I remember thinking, 'Wow, this dog has more energy than I’ve ever seen,” she said.

 From the beginning, Pigeon hopped around the house on her front two legs without any assistance.

“She just hit the ground running and was fast, if not faster than the other dogs,” said Erin.

She had the personality of a fighter, and Erin called her “the most inspirational being I have ever been around.”

After an initial surgery to ensure she wouldn’t be in any pain, Pigeon was getting around fine, bouncing her way through life. But Erin wanted to get her a wheelchair so she wouldn’t have to hop and could truly run.

She took her to get fitted for a wheelchair at Eddie’s Wheels, an organization that specializes in making wheelchairs for animals.

What resulted is a moment of complete, unbridled joy. A video of Pigeon running and bouncing the second she got put in her new wheels quickly went viral.

"It's hard to describe her — she's joy personified. Joy and tenacity probably," Erin said. “She’s stronger and more resilient than I’ve ever been and she inspires me every single day. It is difficult to have a bad day around Pigeon.”

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bankrx/iStock(WASHINGTON) -- The federal government is urging the public not to drink a solution that has been touted as a treatment for numerous conditions, including autism and cancer, but which it says is akin to drinking bleach.

The U.S. Food and Drug Administration on Monday warned consumers again -- as it has been since 2010 -- of the “serious and potentially life-threatening side effects” of drinking Miracle Mineral Solution products after "a recent rise in reported health issues."

The products have been promoted on social media as a remedy for treating autism, cancer, HIV/AIDS, hepatitis and flu, among other conditions, according to a press release from the FDA.

However, the Miracle Mineral Solution and similar products are not FDA-approved. Ingesting the products “is the same as drinking bleach,” the agency said.

Miracle Mineral Solution products are described online as a liquid that is 28% sodium chlorite in distilled water which should be mixed with a citric acid, such as lemon or lime juice, before drinking, the FDA said.

In many cases, according to the FDA, the sodium chlorite is sold with a citric acid “activator.”

Yet what many consumers may not be aware of is that when the acid is added, the mixture becomes chlorine dioxide -- a powerful bleaching agent, the agency said.

The FDA has received multiple reports of people experiencing severe vomiting, severe diarrhea, life-threatening low blood pressure, and acute liver failure after drinking the product, according to the press release.

The FDA also noted that it is not aware of any scientific evidence that supports the claimed health benefits of the solution.

The specific products listed in the FDA’s warning were Miracle or Master Mineral Solution, Miracle Mineral Supplement, MMS, Chlorine Dioxide (CD) Protocol, Water Purification Solution (WPS) and other similar products.

“Our top priority is to protect the public from products that place their health at risk, and we will send a strong and clear message that these products have the potential to cause serious harm,” FDA Acting Commissioner Ned Sharpless said in a statement.

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Motortion/iStock(NEW YORK) -- Two of four experimental treatments being tested in the world's second-largest Ebola outbreak will now be offered to all patients after showing promise in saving lives, scientists and health officials announced Monday.

Preliminary findings from a randomized controlled trial that began last November in four Ebola treatment centers in the eastern Democratic Republic of the Congo indicated that patients receiving either of two therapies, known as REGN-EB3 and mAb114, had a greater chance of survival compared to those receiving two other drugs, known as ZMapp and remdesivir, according to Dr. Anthony Fauci of the U.S. National Institute of Allergy and Infectious Diseases, which is co-sponsoring the clinical study.

After a meeting on Friday to review the initial results, an independent monitoring board recommended all future patients be offered either REGN-EB3 and mAb114, while the other two treatments be stopped.

"It means we do have now what looks like [two] treatments for a disease which, not too long ago, we really had no therapeutic approach at all," Fauci told reporters during a telephone briefing Monday, stressing that more research needs to be done.

Both drugs, which were developed using antibodies from Ebola survivors, proved particularly successful in the early days of infection. Among the patients admitted with low levels of the Ebola virus detected in their blood, researchers found 94% on REGN-EB3 and 89% on mAb114 survived. By contrast, 76% on ZMapp and 67% on remdesivir survived.

"From now on, we will no longer say that Ebola is incurable," said Dr. Jean-Jacques Muyembe, director general of the Democratic Republic of the Congo's National Institute for Biomedical Research, the study's other co-sponsor.

REGN-EB3 is made by American biotechnology company Regeneron Pharmaceuticals, and mAb114 was developed by the U.S. National Institute of Allergy and Infectious Diseases, which licensed production last year to American biotechnology company Ridgeback Biotherapeutics.

The trial is being carried out by an international research consortium coordinated by the World Health Organization (WHO), the global health arm of the United Nations, which last month declared the current outbreak a global health emergency.

"Getting people into care more quickly is absolutely vital," Dr. Michael Ryan, executive director of the WHO's health emergencies program, said during Monday's telephone briefing. "The fact that we have very clear evidence now on the effectiveness of the drugs, we need to get that message out to communities."

This is the 10th outbreak of the disease in the Democratic Republic of the Congo and the most severe in the country since 1976, when scientists identified the deadly virus near the Ebola River.

The WHO's director-general has described the current outbreak as more complex than the deadlier 2014-2016 outbreak in multiple West African countries due to the region's political instability, attacks on health workers, a highly mobile population and community mistrust and misinformation. It's the first Ebola outbreak in an active war zone.

According to the latest data released by a technical committee running the Ebola response and reporting directly to the Congolese president, a total of 2,816 people have reported symptoms of hemorrhagic fever in the Democratic Republic of the Congo's northeastern provinces of North Kivu and Ituri since ‪Aug. 1, 2018. Among those cases, some 2,722 have tested positive for Ebola virus disease, which causes an often-fatal type of hemorrhagic fever and is transmitted through contact with blood or secretions from an infected person.

The ongoing outbreak has a case fatality rate of about 67%. There have been 1,888 deaths so far, including 1,794 people who died from confirmed cases of Ebola. The other deaths are from probable cases, according to the committee.

More than 190,000 people have been vaccinated against Ebola in the current outbreak zone in the Democratic Republic of the Congo, using an experimental vaccine developed by American pharmaceutical company Merck that was tested in the West Africa epidemic.

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