According to conventional beliefs, I should be degenerating. After all, I'm a 72-year-old grandmother with Parkinson's. But the first word I use to define myself is strong. I exercise daily. I've lost 20 pounds, and I believe I will feel even more powerful next year.
Boxing has been shown to help many people with Parkinson's improve their balance, hand-eye coordination, mental focus, muscle strength and body rhythm. I attribute this radical optimism to a team of three characters in this drama that is my life. First, my supportive husband devours books and articles about anti-aging, giving out encouragement and information freely. Then, there is a functional neurologist I've seen since my diagnosis. He has taught me about neuroplasticity. 
In my twice-monthly sessions with the functional neurologist, we work on exercises that strengthen my gait, balance and cognitive functions.
The Functional Neurology Society explains that "research has confirmed that we have the ability to create new neurons (neurogenesis), a process long considered impossible." This is how we learn new skills and how a person who has suffered a stroke of the brain's language centers may still regain the ability to speak. 
In my twice-monthly sessions with the functional neurologist, we work on exercises that strengthen my gait, balance and cognitive functions. I'm also learning to protect my nervous system with diet, exercise and stress-reducing behavior (like prioritizing experiences that bring me joy – spending time with my grandchildren and getting outside in nature hiking, walking and kayaking).
A Fighter on Many Fronts 
My boxing coach is the third part of my support team and has turned me into a fighter on many fronts. Yes, boxing! If you had told me in my youth that I'd be punching speed bags, water bags and mitts while collecting Social Security checks, I'd have laughed you out of my red Malibu convertible.
But five years ago, fate floated down, took me by the hand, and fitted me with boxing gloves! I had joined a gym to follow my neurologist's prescription to "keep moving." Several research studies support this advice. 
A study in January 2022 concluded that "regular overall physical activity levels over time were significantly associated with slower deterioration of postural and gait stability, activities of daily living and processing speed in patients with PD." 
Another study reported in February 2022 Neurology on a clinical trial in Parkinson's patients states "aerobic exercise stabilizes disease progression in the corticostriatal sensorimotor network and enhances cognitive performance." 
If you had told me in my youth that I'd be punching speed bags while collecting Social Security checks, I'd have laughed you out of my red Malibu convertible.
I became a devoted student in the Fitness Over Fifty class. One day, I was leaving the gym when I noticed a sign: "Neuro-Boxing with Ron." I had heard that people with PD were getting benefits from boxing. 
A September 2022 article in Harvard Men's Health Watch reports, "The wide-legged stance used in boxing and the shifting of your center of gravity when you throw a punch are excellent training for improving balance and posture." 
Boxing also strengthens arms, shoulders, core and lower body. Furthermore, there is a thinking component in which you must memorize and execute combinations of punches.
Laurie Keating, a physical therapist assistant with Harvard-affiliated Spaulding Rehabilitation Network and a boxing coach, is quoted in the article: "Non-contact boxing fitness has been shown to help many people with Parkinson's improve their balance, hand-eye coordination, mental focus, muscle strength and body rhythm." 
I Could Be Fierce
Even with persuasive research, I needed to figure out if boxing was proper for me. As I told Ron when I finally got the nerve to call him, "I'm a peaceful person. I don't know if I can be violent." And yet, for some reason, I agreed to try it. 
At first, I did not feel at home in the hand wraps Ron wove through my fingers and the boxing gloves he laced onto my hands. This was serious boxing. Ron had fought in the ring himself. He was a retired NYPD detective and a former Marine. 
He had chased suspects through the most challenging projects in the city and dug through the rubble of Ground Zero after 9/11. He may call his sessions "neuro-boxing" for people who want to challenge the brain to jab, punch and hook on command, but he gives the same training to athletes and weightlifters who work with him.
 I will have a powerful voice telling me I know how to stand steady and defend myself against whatever punches life throws me.
By my second training session, not only was I having fun, I wanted more than anything to please my coach. He was seeing something in me that I never knew was there. I could be fierce. I could be powerful. I could be relentless. Boxing is more than a sport. It is an attitude. 
The walls of the boxing room are covered with bravado quotations by Muhammad Ali and other greats. When my attitude was sub-par, Ron shouted many wise words at me. In one of my first sessions, I responded to an exercise with, "I'll try." 
Ron shook his head and quoted Yoda: "Do. Or do not. There is no try." And so, I take it all on, never stopping to ask myself, "who do you think you are calling yourself a boxer?" The words on the wall may have been born in the ring, but they fit all that we deal with in life:
"I don't know how I'm going to win. I just know I'm not going to lose." 
"You don't lose if you get knocked down; you lose if you stay down."
"It's not over when you lose. It's over when you quit."
Ron has nicknamed me Tyger. "Tigers are beautiful but fierce," he says, an image I keep in my head when I work out. He spells it "T-y" after Mike Tyson, whose peek-a-boo style I imagine I can replicate. I've learned that I can punch faster than many others who have more power behind their punch. 
This means that in a competition with Ron's other fighters (including a professional athlete), I threw more punches (718) in three minutes. 
I'll call that: scrappy. That self-definition propels me to scramble up a daunting hiking trail, paddle my kayak against a strong wind, and speak up when I feel dismissed.
On the door of the boxing room is a column of sticky notes. The top one says Tyger 718. This means that in a competition with Ron's other fighters (including a professional athlete), I threw more punches (718) in three minutes. This distinction gives me more pride than my combined SAT scores, college diploma and job promotions.
I can't imagine ever giving up my twice-a-week boxing practice. No matter how tired and draggy I may feel in the morning, I know the pumped-up music and energy of the boxing room will transform me into someone strong and relentless. 
Though will I ever develop the bad intentions that a professional boxer cultivates? Maybe not. But hopefully, for the rest of my life, I will have a powerful voice telling me I know how to stand steady and defend myself against whatever punches life throws me. 
And if I forget, I'll glance down at the T-shirt Ron gave me that says:
Fate whispers to her, "You cannot withstand the storm."
She whispers, "I am the storm."


Boxing in My 70s Gives Me a Renewed Sense of Power

Sally Isaacs

The U.S. confirmed its first case of the novel coronavirus in January. Looking back, we couldn't have imagined how quickly and drastically American life would change — particularly for older adults.
Chalk art spotted on a daily walkKnowing that COVID-19 disproportionately affects people over 65, we've been working hard serving those of you who may be at risk or are caring for those who are. We've turned to medical professionals, mental health experts and thought leaders. Now, we're turning to you.
We asked our readers on Facebook to tell us what you've learned due to the pandemic, why that's been meaningful and how you're finding your own way forward. Some of you sent photos. Others inspired us with the wise, poignant and sometimes funny things you said:
Family
My 90-year-old mother-in-law lives in assisted living and hasn't come out of her room in over a month. A Great Depression baby who lived through World War II, she's sharp, healthy and doesn't complain. We can all take advice from her — she's my hero.  - Kim M., Dunlap, Ill.
"My mom is a native of Japan, lived through World War II as a child and immigrated to the U.S. in 1958. I want to give her just enough detail so she knows why I'm doing or not doing certain things — like breaking our usual rituals — but not so much that she's overwhelmed and propelled back into wartime."
- Gwen I., Buffalo, N.Y.

Our Commitment to Covering the Coronavirus

We are committed to reliable reporting on the risks of the coronavirus and steps you can take to benefit you, your loved ones and others in your community. Read Next Avenue's Coronavirus Coverage.

"Our family has postponed several repairs that need to be done around the house, my son and I have postponed medical procedures and surgeries, and his dad and I have postponed the date we'll file for divorce."
- Megan B.
From reader Adrienne B: "Jack the therapy cat in grandma’s lap""I'm 84 and I live 200 miles away from my family. If you don't connect with your family, now is the time to start. They will be healthier and happier if you do."
- Carolyn W., Pismo Beach, Calif.
"I'm fortunate in that, while both sons live out of the area, we Zoom weekly and text nearly every day."
- Freda G.
"My mother's birthday is today. I have not seen her since mid-March. She has hearing and vision deficiencies. I know she asks for me; it's very sad."
- Lynn C.
Caregiving
"I've been going back and forth to visit my husband at a rehab facility. He's recovering from a brain biopsy which proved to be cancer. It's a scary situation. What if his treatment is delayed? What if it blows through the rehab center before he comes home?"
- Janie R., Dallas
"I am a caregiver. Today, one of my clients said to me, 'You are a breath of fresh air, just having you here to talk to me.' She's 102 and still lives at home. Her kind words made my day, but also show how lonely older adults can be."
- Jeanne H., Akron, Ohio
"My husband has dementia. I pray every day for his safety. If he gets hospitalized, I'll fight to be with him."
- Bev M.
"Good thing my mom lives with me, so I can keep an eye on her. I don't want to see her get ill; she's my favorite woman in the world."
- Lily O., Pomona, Calif.
Grief and Loss
From her home, reader Melissa H. gazes down at the Adirondack Mountains "with fond memories of a life well walked.""Mom was buried early. No service, no flowers, only five people permitted. I managed to buy some flowers at the local grocery store. We will do what she had planned, later. Mom grew up during the days of isolating due to polio. She would understand."
- Holly A.
"I am missing my grief group during this time. Some had become good friends."
- Rose T., Bloomington, Minn.
"We just lost our aunt on Friday. The last of her generation, she leaves a big hole in our hearts."
- Kathleen F.
"If you can't attend a service in person, send a card to the family, sharing how their loved one impacted your life and what wonderful memories you have of times spent with them."
- Shirley U., Fairmont, Minn.
Daily Life
"I follow Native American traditions, so my spiritual practices haven't changed. Mother Earth is still Mother Earth and my 'church' is still among the Standing People and the Four- and Two-Legged. My prayers are always for the health, safety and education of all. May we all have an 'attitude of gratitude' and follow the good red road."
- Melissa H., Niskanunya, N.Y.
"I color my hair every five weeks to keep it red. I get my nails done every three weeks. It's always kept my spirits up. Now I am so depressed. I can't wait until this is over."
- Lynn P.
Work
"My small business is devastated by the coronavirus, since it helps seniors and families find assisted living or memory care. God only knows what the outcome of this is going to be."
- Cheryl C., Campbell, Calif.
Handmade mask by reader Wendy F."Have to keep going to work, but feeling very anxious there, because of where it is — not quite 'on the front lines' but essential. There is lots of attention given to nurses and doctors, and rightfully so, but I hope people also remember the support staff."
- Denise J.
"I'm a psychotherapist and have been using FaceTime with some of my clients. It seems to be helping them, but it's not the same as in-person."
- Patricia S., Silver Spring, Md.
Acts of Kindness
"I put money as store credit at our local pet food store for a neighbor who didn't have money to buy it. My reward is knowing her pets have their proper food."
- Dolly S.
"I am 78. I sit at my sewing machine and make masks for friends, neighbors and relatives. I mail them all over. It gives me purpose and I hope it helps. I feel useful."
- Ann P.
"One of my golf partners is in complete seclusion. So, I decided to perk him up. Got lunch at his favorite, Texas Roadhouse, delivered it to his home and then I FaceTimed him from the car. Had a good talk and great burger."
- Lloyd K., Le Claire, Iowa
"My entire career was spent working with the have-nots, the disenfranchised, the often invisible. Yet it has taken the current situation to bring this simple truth to my attention in a deep and profound way: There are people who care about others, and there are people who don't."
- Renee M., Effort, Pa.
Finding the Silver Linings 
Sanibel Island sunset by reader Cyndilu L."For my anxiety and depression, I've found getting out to walk on good-weather days really helps, even if it's just around the neighborhood."
- Theresa H., San Francisco
"The Virginia bluebells I planted. Reminds me that planting is a statement of faith and hope for the future."
- Melissa S.
"By the time this crisis ends I might get caught up on laundry."
- Carol N.
"Since my gym is closed, I took up jogging. I don't go far, but I'm going to work up to it over time."
- Kim W., Des Plaines, Ill.
"I have been calling people. Relatives I haven't talked to in a very long time. Casual acquaintances I wouldn't normally call. How are you doing? How are you holding up? How do you get groceries? What are you doing to occupy your time?"
- Nancy K., Royal Oak, Mich.
"I'm learning that I am very rich in ways that have absolutely nothing to do with money."
- Mollie H., Guadalupe, Calif.
Some comments have been edited for length and clarity.


From Our Readers: Persevering in the Pandemic

Sabrina Crews

I am 69. I ran my first triathlon when I was 59, and as of August 2019, I will have competed in 50 triathlons. (A triathlon typically consists of running, cycling and swimming.)
My first running race, the Hudson Relay, was in 1972 during my senior year in college in Cleveland. In August 2018, I returned to Cleveland — a mere 46 years later — to participate in the USA Triathlon Nationals for triathletes from across the country. I’d call it an athletic bookend, but I’m not done competing.
I had never been an athlete before. In fact, I still somewhat joke about how great it was that when I was growing up there were no sports programs for females and no Title IX, so I didn’t have decades of abusing my body, sports-wise, as many men have.
I learned how to swim when I was 6, bike when I was, probably, 8, and started very low-level jogging sometime in my 40s. When I say low-level, I mean jogging maybe 50 yards, then walking.
So what if I started at 59? Take this to the bank: It's never too late.
So how did I morph from being an overweight widow, whose jogging was more like walking than anything else, to a triathlete? It probably sounds disingenuous to say it just happened — but that’s actually the truth.
In my desire to date again after my husband died, I started dieting and doing minimal exercises at home, so I could feel good about what I looked like. I was 57. So, I had already started eliminating the overweight part.
Inspired by a Gift
I signed up for my first triathlon after a friend bought me a racing bike. I don’t know where the thought came from, but when he bought me the bicycle, I said to him: “Great, now I can do triathlons.”
I hadn’t contemplated doing even one — I had only run a couple of 5K races in 2007 and 2008. My office liked to participate in the Race for the Cure (the Susan G. Komen series of 5K fundraising runs and walks for breast cancer) and I thought: “Hmmm, I can do that.”
Up until a couple of years ago (when I went through an awful saga of dealing with two pinched nerves in my back and sciatic leg pain, which precluded walking, let alone running in a race), I would compete in about 12 races a year; seven running and five triathlons. “How else,” I’d ask friends, tongue firmly in cheek, “could I collect a dozen new T-shirts every year?” The wryest of them would say: “Um, at a store.”
Even with my back problem, the severe leg pain happened between triathlon seasons. So, while I didn’t train much during that time, I still kept up with five triathlons every season — and have no real end in sight.
Susan Paisner competing in a racePassing and Getting Passed
At Nationals last year, I ran past an 88-year-old woman. How did I know how old she was? Because in triathlons, your age is written in marker on your left calf. One upshot of this is that I’m often the oldest woman in the race and hordes of young’uns run past me delivering affirmations as they go: “You’re awesome!” “You’re an inspiration!” “I want to be as active as you when I’m your age!”
I’ll admit, it’s rather sweet. But even sweeter is running past men and women younger than me. Because, you see, while I hardly qualify as an elite competitor, I have never, ever, come in last.
I didn’t train for my first triathlon; I figured I knew how to swim and bike and could handle the 5K. My biggest stumbles had to do with the transition periods between each of the three events and not wearing the right clothes. (Hint: don’t wear cotton, because it holds on to your sweat and becomes a wet towel).
What I've Learned
Initially, I actually changed my clothes after the swim and before the bike portions of the race! Dumb, unnecessary and hugely time-consuming.
These days, depending on where the transition area is relative to where we swim, I take two to three minutes to get from swimming to biking. In my first triathlon — when I changed my clothes in the port-o-john — I took more than eight minutes. I used the port-o-john again between the bike and run for its intended purpose, and that visit took more than five minutes (versus my current, and usual, one minute or less).
Today, during my triathlons, I wear a tank top and special biking shorts (not as long in the leg and not as much padding in the seat) from beginning to end.
And I pay it forward, as much as people want, in terms of giving advice to first-timers.
Having done this for 10 years, I am now well cross-trained and don’t think about what I do as being an “endurance” sport. I work out five to six times a week.
In warm weather, I mainly bike (usually about 20 miles) and run (3+ miles), with occasional swimming. In the cold months, I mostly run and swim.
Happy With the Results
All of this working out results in a body I’m proud of — and to be blunt, a body that men like. As I’m fond of saying regarding being a triathlete, I love the returns. All of them.
My just-retired favorite doctor and I once had a conversation about quality of life. He said, “There’s what you get, your genetic inheritance; there’s what you opt to do with it and there’s that third thing that you have no control over.”
I’m living the hell out of my life and taking every advantage possible of the genetic gifts my parents gave me. So what if I started at 59? Take this to the bank: It’s never too late.
But I’ll easily admit that when people ask me my favorite part of a triathlon, my answer is always: “The finish.”


Morphing from Infrequent Exerciser to Triathlete

Susan Paisner

The start of England's Premier League soccer season on August 13th marked the end of a tumultuous year in the sport. After a year of empty stadiums during the pandemic lockdown, England's national team progressed to the final of the Euro 2020s only to lose to Italy on July 11th, resulting in the racist targeting of Black players who missed the all-important penalty kicks.
The author, Jeff Vasishta, on the Livingstone Academicals soccer team in the U.K. He's in the top row, far left.
It led to five arrests and outrage from politicians and the public alike, sick of the cancer of racism that continues to pollute European soccer. Recent England games against Hungary and Poland have only served to exacerbate things with Eastern European nations seemingly ambivalent about the racist targeting of Black English players by their fans. As a British Indian and former amateur soccer player, it's a culture I am only too familiar with .
The swift condemnation after the abuse of the three players was followed up by arrests, public shaming, immediate job losses and pressuring of social media companies by the British government. More important was the disgust voiced by increasing numbers of the public who have grown up with Black British sporting heroes, most recently celebrated at the Olympics, surely showing that the tide is finally turning against the haters.For England's ethnic minorities, the online racism and defacing of murals honoring the players that followed the Euros loss was expected. It was partly why I left the country over 20 years ago. I played amateur Sunday league soccer in one of London's roughest leagues, on a team that was one of the most racially integrated to take the field in any of our games.
I joined the Livis when I was at University and was relieved to find so many talented fellow Asian players. The racism we encountered shocked me.
Livingstone Academicals, as we were called, after the university hall at North East London Polytechnic that some of the players attended, comprised Asian (Indian and Pakistani), white and Black players. We were a fair representation of the neighborhoods in which we lived in Stratford, Leytonstone and Leyton, the former stomping ground of future England captains David Beckham and Harry Kane. 
Born in the East End, I grew up in a middle-class Indian family in a quiet, mostly white town in coastal England, about 100 miles from London. I joined the Livis when I was at University and was relieved to find so many talented fellow Asian (Indian and Pakistani) players. The racism we encountered shocked me. 
I didn't realize it at the time, but we were trailblazers. Most teams we played against were white. As a mix of Asians, Blacks and whites, we were a United Nations of players doing battle every Sunday morning in the capital's traditional hotbed of racial hatred, East London.
The first Iraq War had ratcheted up hatred against brown-skinned men like me. The insults were hurled in the locker room and on the field. But nothing I experienced compared to the stomach-turning concrete aggregate of slurs my defensive partner, Errol Brown, a mild-mannered architect of Jamaican ancestry encountered. 
The hatred wasn't restricted to England, though. We went on a spring tour of Belgium and someone spat in Errol's face. By then, I'd already made up my mind. I was out of there.
No Escaping Racism 
I'd spent a lot of time in America before I moved to the U.S. at 26. I was relieved that, in New York, at least, my skin color went mostly unnoticed. That remained the case for decades. I married, had kids and then divorced. 
As my children prepared for college, my family encouraged me to consider moving back to England. However, a Brexit-ed Britain had brought out the worst. Hatred seemed to be on the rise and while the same was true in the U.S., I didn't feel it. 
That was until one morning a few weeks before the pandemic struck.I was taking a shower at a YMCA in Westchester, N.Y. where I went before dropping my kids, who lived there, to school (I lived in Brooklyn). I noticed the shower stall next to me was running with no one under it. Instinctively, I turned it off to conserve water. A few seconds later, a man strode in and angrily asked, "Did you turn this off?""Yeah, I didn't know you were using it," I said."Don't touch my shower!" he yelled with expletives.
Stunned, I looked at the guy, taking him in as men do when threatened. He was white, late 50s, lean but ripped with tattoos. I was also in decent shape, but a few inches shorter. I couldn't let him intimidate me. I shook my head and turned my back, dismissing him. But he wasn't done."You Muslim terrorist," he screamed. "Go back to your own country!"I turned around and looked at him square in the eye, my hands upturned as if to say, "Why did you have to go there?" There was something immediately familiar about his insult which allowed me to maintain my composure. I had no intention of getting into a fight. I was naked, surrounded by hard tiles and metal.I was on a tight schedule to pick up my two daughters, yet I knew I couldn't let him get away with insulting me. I decided to report him, which meant delaying my whole day. I walked out of the shower while the man, angry veins bulging in his neck, continued to hurl abuse.  
There were two other men in the locker room, both white. I looked over at them, expecting one or both to intervene on my behalf. Neither did. 
I wrapped a towel around my waist, put on a T-shirt and went to the front desk to report what had happened. The man there was sympathetic and asked me if I wanted to wait outside until my abuser had left. To do that would prolong me even more. I knew my girls were waiting. It would show I was scared. I wasn't. I was angry.  I'd had a lifetime to analyze how bigotry affected me. 
As a teen, I longed to be white. "Paki bashing" was a popular term used when skinheads went around beating up brown-skinned men, whether Hindus — like me — or Muslims. I cowered whenever I saw them, paralyzed by fear. I was only too aware of the dangers of stepping into the wrong neighborhood.
Then, playing for Livingstone Academicals had been the final straw. I wasn't letting racism win, I just wanted to avoid dealing with it. I should have known better.
Bigotry Needs to Stop 
I pushed open the YMCA's locker room door. The guy, apparently a regular, was still yelling while someone tried to calm him. When he saw me, he exploded again, this time screaming so loud that members could hear him in the hallway outside. 
Angered by my non-reaction, he motioned to punch or head-butt me. I didn't flinch. He was clearly unhinged; if he had a gun, I could be dead. My would-be attacker was finally ushered out of the locker room and I took my shower. When I came out, two cops were waiting for me with questions.I was glad the assailant was later to be banned from the Y. In my car, my hands were shaking and I wondered if I was in the right frame of mind to drive my girls. On the way to their mother's, I stopped at a Starbucks, taking deep breaths to stop my heart from pounding. Smooth jazz sounded around me and patrons ordered Frappuccinos and bagels.I thought seriously about going home, not to a Middle Eastern country as my assailant thought I came from, but to England. When I lived there, however, I'd been told to go back where I came from, too. So where was home? India, where my parents were from? I'd been there twice.
I'd had a lifetime to analyze how bigotry affected me. 
Since I'd left, the Premier League had become the wealthiest soccer league in the world, broadcast throughout the globe. Hate is bad news for business. All the top teams are owned by foreign billionaires. 
Last season's European Champions League Final was between Manchester City and Chelsea, soccer teams owned by the Abu Dhabi royal family and a Russian oligarch. The last thing they wanted was their clubs, with passionate followings in Asia, the Middle East and Africa, to be associated with racism. 
Not that the bigots care or understand. When Chelsea fans leveled anti-Semitic slurs against their London rivals, Tottenham Hotspur, Chelsea owner Roman Abramovitch embarked on a campaign to educate his supporters and wipe anti-Semitism from the stands by handing out lifetime bans to anyone caught spewing hate. Apparently, his fans didn't comprehend that their much-loved owner was both Russian and Jewish.Change won't happen overnight and it will never be absolute. But until a utopia exists where English bigots don't vent their frustrations against fellow Black and brown citizens, we can only hope that the antiracism uproar evoked this summer means that change won't be far away.


As England’s Soccer Season Starts, Its History of Racism Must Be Left Behind

Jeff Vasishta

It's rare for a U.S. government agency to acknowledge making a mistake, let alone apologize to Americans and begin making amends. But that's exactly what the Social Security Administration is doing to address what its new Commissioner, Martin O'Malley, calls the agency's "heavy-handed" practice.
Martin O'Malley, Commissioner of the Social Security Administration, said his agency would soon begin taking dramatic action to address what he called the "grave injustice" to individuals subjected to clawback claims.He's talking about "clawbacks" — a Social Security term for demanding more than one million Americans to immediately return Social Security benefits that the agency said were overpayments.
Demands for Quick, Big Payments
The Social Security Administration recovered $4.9 billion in overpayments last year and says another $23 billion is still due.
"I've never heard the Social Security Administration talk like this."
Some people have been ordered to quickly repay tens of thousands of dollars in cash or risk having all of their future Social Security benefits withheld. One 73-year-old widow wrote to personal finance journalist Terry Savage that the Social Security Administration had sent her a letter saying she owed $87,000 and had 30 days to repay it or the government would cut off her benefits.
"I was shocked," said Savage on an episode of the "Friends Talk Money" podcast she co-hosts with Pam Krueger and me. "I thought: 'There's got to be a mistake.'"
'Worse Than a Kafka Novel'
Social Security maven and Boston University economics professor Laurence Kotlikoff, who has heard many sad clawback tales himself, said: "Almost all the clawbacks come with: 'You owe us X and we have no obligation to tell you why, how we came up with that number or give you any proof.' It's worse than a Kafka novel."
But in a recent Congressional appearance, O'Malley — the former Democratic Governor of Maryland and Mayor of Baltimore — said his agency would soon begin taking dramatic action to address what he called the "grave injustice" to individuals subjected to clawback claims.
Some beneficiaries have lost their homes or faced dire financial straits after suddenly seeing their benefits cut off to recover decades-old overpayments, he noted.
"These injustices shock our shared sense of equity and good conscience as Americans," O'Malley told the Senate Special Committee on Aging.
Said Krueger: "I've never heard the Social Security Administration talk like this."
Radical Change by Social Security
O'Malley's acknowledgement is far different from the way Social Security has handled clawbacks until now.
Perhaps you watched Anderson Cooper's "60 Minutes" clawbacks segment in November 2023, when four people described Social Security's resistance to their pleas to waive what they maintained were debts they didn't owe.
It took the harsh "60 Minutes" spotlight for the agency to halt those clawbacks. "Social Security only acts when they get embarrassed," said Kotlikoff.
New 4-Pronged Plan
Now, the Social Security Administration has a four-pronged effort to address overpayments nationwide with what O'Malley calls "urgency, diligence and speed." The agency's new and coming policies:
It has stopped intercepting 100% of a monthly Social Security benefit by default if the person doesn't respond to the agency's demand for repayment. Instead, the Social Security Administration is shifting to a default withholding rate of 10% of monthly benefits.The burden of proof will no longer be on the beneficiary to prove whether they were at fault in causing the overpayment. The agency has started to reframe its guidance and procedures on this.It will become much easier for beneficiaries to ask for a waiver of repayment if they believe they weren't at fault or lack the ability to pay.The Social Security Administration will now approve repayment plans of up to five years for most beneficiaries asking for extra time. Previously, the plans were just three years long. For approval, you must only provide a verbal summary of your income, resources and expenses. Social Security's Supplemental Security Income (SSI) beneficiaries — people with disabilities or little or no income or resources — won't need to provide this summary.Good Start, More to Do
Kotlikoff and Savage, who have written the new book on clawbacks, "Social Security Horror Stories," said on "Friends Talk Money" that they were pleased about the new clawback policies and what O'Malley's been doing.
"Right now, things are going exactly in the right direction. We could not be more happy," said Kotlikoff. "O'Malley is trying to change the culture of the organization overnight, and that's a big job." 
Kotlikoff believes fewer people will wrongly receive overpayment notices in the future because O'Malley set up a better system for payroll companies to report workers' employment earnings to the Social Security Administration.
"They should have been doing this decades ago," Kotlikoff said.
A Need for Specifics
But he and Savage say the Social Security Administration needs to do more, including getting specific about how it will address clawbacks.
 "I think it's not a Democrat/Republican thing. I think it's a human being versus Neanderthal thing."
For example, said Kotlikoff, O'Malley has said there would be a statute of limitations on clawbacks, but hasn't made clear exactly what that means.
He and Savage have been pushing for an 18-month limit. "So, if they've been overpaying you for more than 18 months, it's their mistake," said Kotlikoff, co-author of "Get What's Yours: The Secrets to Maxing Out Your Social Security."
Kotlikoff and Savage have been meeting privately with Social Security Administration staffers and think the agency will adopt their 18-month cap.
Kotlikoff also believes the agency must say how it will assist Social Security beneficiaries who've made repayments even though the government never proved the money was owed.
The Political Side of Fixing Clawbacks
He concedes that fixing the clawbacks problem will require spending by the Social Security Administration even though it's expected to soon run short of money to pay beneficiaries. But Kotlikoff believes the overpayment fixes are "completely doable."
His big worry: "That we have an election, a new administration comes in and all these things get reversed."
But Kotlikoff thinks Republicans and Democrats in Congress will hold Social Security's proverbial feet to the fire. "I think it's not a Democrat/Republican thing. I think it's a human being versus Neanderthal thing," he said.
Sen. Ron Wyden, a Democrat from Oregon, has said he plans to meet monthly with Social Security Administration officials until the clawback problems are fixed.
Advice for Social Security Beneficiaries
Meantime, if you receive an overpayment notice and believe you didn't cause the overpayment, you believe the demand is unfair or you can't afford to repay the money, complete the Social Security Administration's newly simplified Request for Waiver of Overpayment Recovery, SSA-632-BK.
Savage offers this advice for anyone who has received a Social Security clawback letter: "Immediately, call Social Security at 1-800-772-1213 to make sure they adjust the repayment, and you get at least 90% of your check."


Social Security Is Starting to Do Right by People It Wronged

Richard Eisenberg

Shown above from left to right: Joseph Gaxiola, Stephanie Stuart, Sharon Bosley and Robert Toth — four long-term survivors of HIV
As we near the end of 2020, we're highlighting some of our most memorable stories from this very challenging year. Here, editor Grace Birnstengel profiles four individuals growing older while HIV-positive. Their life stories are full of wisdom, hope and resilience that all of us can learn from. This story was made possible with support from The John A. Hartford Foundation.More than 500,000 people over 50 in the U.S. are growing older with the human immunodeficiency viruses (HIV) that, if untreated, cause acquired immunodeficiency syndrome, or AIDS.
While some have contracted HIV/AIDS in their later years (sparse sexual health promotion for older adults is often to blame), the bulk of these survivors were diagnosed decades ago, back in the throes of the AIDS epidemic of the 1980s and 1990s, when attitudes and treatment of the virus were inapt at best, inhumane at worst. Before the terminology we use now was around. Before effective medication emerged. Before an understanding of how HIV/AIDS is actually transmitted. Before life expectancy was more than a handful of years.
Long-term survivors of HIV/AIDS have prevailed through traumatizing combinations of adverse life events and are now aging into their 50s, 60s, 70s and beyond. And they are struggling: PTSD and other mental illness is essentially ubiquitous; housing and financial insecurity (when you're not expected to live, you don't plan for a future); health issues doctors can't explain and don't completely understand and debilitating community-wide isolation and loneliness.
But these are fighters, and they're not without hope. These conversations with them present four of their stories.
Stephanie Stuart at home in New Port Richey, Fla., where she displays memorabilia from competing over the last 35 years for titles like Miss Tampa Pride and Miss Daytona. Stuart was diagnosed with HIV 27 years ago.Name: Stephanie Stuart
Age: 54
Location: New Port Richey, Fla.
Diagnosed: June 1993
Grace Birnstengel: How has the world and the conversation around HIV changed — or not changed — since you were diagnosed? 
Stephanie Stuart: I think the stigma is still there. I have met guys that expect me to be on PrEP [daily medicine that prevents HIV], expect me to know my status, but are not taking care of themselves. They're not on PrEP. They don't know their status. And when you question them: Why? It's, 'Oh, I don't need to be, I'm not at risk.' We're all at risk, darling. Everybody should know their status. People are worried about getting this deadly disease that's not a deadly disease anymore.
I think the conversation has quieted, and it needs to be louder. I feel like I'm standing on a street corner by myself with a sign that says, 'Hey, I still got HIV. I've still got it.' Everybody's driving by. Nobody wants to help. Nobody wants to talk about it. People are still being infected every day. Unfortunately, people are still dying from the disease, but a lot of us are living a lot longer, and it's not the death sentence that they gave me. It is building a complacency in our community. If your status is positive, then go to the doctor, start taking this medication, get your status to undetectable and then nobody can transfer the virus to anybody. Undetectable equals untransmittable.
What do you want people to understand about you and living with HIV?
I don't want them to forget us survivors, what we've been through. Because a lot of us carry a lot of survivor's guilt. When I was first diagnosed, that was the time period where someone would come in the bar and the word would get around that they've just been diagnosed and you really could pull out a calendar and mark a year and a half to two years and somewhere during that time they would be gone. And it happened a lot. I lost a lot of friends during that time.
I'd wanna remind people: Don't forget what we've been through. But then you also need to celebrate the fact that — look at the strides we've made with HIV treatment and how healthy a lot of us really are now. When I tested HIV positive. I came home… It's a wonder I didn't drive myself off the road that day coming home. I cried all the way home. I got home, I literally threw myself on the floor and had a temper tantrum and a meltdown. They had just told me I only had two years to live.
"What if the government is going to change their view on HIV and all of this goes away?"
What concerns you most about growing older with HIV?
I'm only fifty-four but because I've been on HIV medicine for so long, they say it ages your organs. So my organs could be about sixty-four. I feel my strength waning sometimes. I worry about not having enough food. I worry about not having a place to live at some point. What if the government is going to change their view on HIV and all of this goes away? But the one thing I worry about the most — and this probably comes from taking care of my [late] wife — and that is not being able to take care of myself, because I don't really have anybody I can rely on to help me. At this point, if I get sick, it may not be the HIV doing it. It might be a heart attack. It might be a stroke — something along those lines that can debilitate you. And then you've got that on top of having to remember to take the HIV meds.
I'm just kind of hoping it doesn't happen. I am really hoping that when my time comes, I'm on stage somewhere and I do the ultimate death drop and check out. Several years ago [in St. Petersburg, Fla.], there was a benefit and one of my sisters walked off stage into the dressing room and collapsed. And she was gone. They said her heart exploded. And I kept thinking, 'I'm going to miss you, but damn girl. That's the way to do it. Go the way you want to go, doing what you love to do.' If it turns out that way with me and I need somebody... I'm deeply spiritual, and I'm sure the Lord will provide and somebody will be there.
What message would you like to send to younger people living with HIV or people who are newly diagnosed?
There's no need to be afraid anymore. When I was diagnosed back then, it was a situation where someone would be diagnosed with HIV, and they'd go back two weeks later and then it's, 'Oh, you're not only HIV, you're full-blown AIDS' — barely having time to digest the fact that they've tested positive, to now they've got this awful disease. And those situations are almost obsolete nowadays.
Robert Toth leaving his apartment in Lakewood, Ohio, on a walk to a nearby sculpture park. Toth has lived with HIV/AIDS for 32 years.Name: Robert Toth
Age: 61
Location: Lakewood, Ohio
Diagnosed: October 1988
Grace Birnstengel: How has the world and the conversation around HIV changed — or not changed — since you were diagnosed? 
Robert Toth: Well, it's gotten real confusing. I had an appointment with my HIV doctor, and I said, 'Can you settle the question? Am I a person living with AIDS or am I a person living with HIV?' She goes, 'Well, you're both, but you are a person living with AIDS.' The word AIDS needs to be used. If you were ever diagnosed with your T cells at two hundred or below, no matter where they are now, you are still a person living with AIDS. That was a surprise to me. I was like, 'That's really depressing, but thank you for clarifying that.' It's important to make that distinction because it's important to not erase all those people that died of AIDS. We're lucky that we live in a country that we have the Ryan White CARE Act that provides those medications free of charge to anyone who needs them. Thank you, Ryan White. God bless you. Jeanne White, his mother, she's an AIDS activist. God love her for doing what she's doing.
What do you want people to understand about you and living with HIV?
I've had the life experiences of a ninety-year-old and I'm only sixty-years-old. I've lost all my peers. My contemporaries are dead. I buried them, sprinkled their ashes, went to their memorials. So say hi to us. Invite us out to lunch. It can be a cheap place. I can afford lunch. I never expect anyone to pay. Let's go to a movie. It's nice to get out of my apartment. Know we're still here. Hug us. A hug changes the body chemistry.
"Maintain your friendships. It's a job that I failed to do, or I did, but they died anyway."
What concerns you most about growing older with HIV?
Well I was just in the hospital in the ER about three weeks ago, and there was nobody I could call. There was nobody who would, number one, answer the goddamn phone, and if they did, they wouldn't know what to do. So it's just this feeling of loneliness. It's not healthy. I have a cat, and cats are cats. Can I take a cat out for a walk? I can try, but it ain't gonna work.
What message would you like to send to younger people living with HIV or people who are newly diagnosed?
Number one, take a deep breath because you can live a full, average adult life because the medications do work if you take them properly. You can get married, which is something I didn't have when I was young and gay. I didn't have that future to envision — to be allowed to envision a future with a man, with a partner. Use it [the right to marry] if you find someone. Stop doing the drugs, period. If you can stop smoking cigarettes, do that, or at least smoke less. If you have a problem with alcohol, get into recovery. Don't be around the people who are still dabbling. Maintain your friendships. It's something you've got to work at. It's a job that I failed to do, or I did, but they died anyway. Undetectable is untransmittable. U equals U.
Sharon Bosley in her Baltimore home. Bosley, diagnosed as HIV positive 32 years ago, is studying computer information systems at Baltimore City Community College.Name: Sharon Bosley
Age: 59
Location: Baltimore
Diagnosed: October 1988
Grace Birnstengel: How has the world and the conversation around HIV changed — or not changed — since you were diagnosed? 
Sharon Bosley: It really hasn't changed 'cause stigma's still existing. People are still denied housing because of their status, losing jobs because of their status. The medicine has advanced. We can live longer now. It's a chronic illness like anything else, but the way we're treated is not good. Down in the south, like in Atlanta and South Carolina and North Carolina, their care down there sucks. And I think I was blessed that I was living in Baltimore when I found out because I think about living anywhere else — I wouldn't be living. You get great care here in Baltimore, but I had a friend, she was born with HIV because her parents were drug users, and she lived in [nearby] Howard County, and she had to move from Howard County to Baltimore city because Howard County didn't have the care or the support that she needed.
What do you want people to understand about you and living with HIV?
We're just like everybody else. It's just like people with cancer, diabetes or heart problems. You can't get it from looking at us or using the same bathrooms. There's still that mentality that you get it from hugging or kissing. As long as you take your medication, you can live well.
"I just pray and keep it pushing. That's all you can do."
What concerns you most about growing older with HIV?
It affects your body. It ages your body by ten years. I'm fifty-nine, but my organs — because of the virus and how it attacks your immune system — my organs are like sixty-nine. I don't know why. They don't know why it ages our organs faster, but it does. You might have disease a lot sooner than expected or mental problems a lot sooner. But I just pray and keep it pushing. That's all you can do. You can't change anything. When I go to support group, I try to encourage the newly-diagnosed people to take their medication as prescribed. It makes a difference. Take it all the time. You can't take no breaks.
What message would you like to send to younger people living with HIV or people who are newly diagnosed?
Take your medicine. Hook up with somebody that's a long-term survivor — like a buddy system — that can explain to you the importance of taking your medication and how to live well. 'Cause you can live well if you do what you're supposed to, just like any medication.
Joseph Gaxiola, who has lived with HIV for 21 years, in his office at the Joshua Tree Feeding Program — a food pantry for the HIV positive community in Phoenix — where he volunteers as chairman.Name: Joseph Gaxiola
Age: 48
Location: Phoenix
Diagnosed: November 1999
Grace Birnstengel: How has the world and the conversation around HIV changed — or not changed — since you were diagnosed? 
Joseph Gaxiola: The biggest thing I would say that changed from then to now was the fact that we're still here. Before that it would be like, 'Oh, I have this length of time.' I was given five years, so I was literally counting, 'I've got three more years to go. I got four more. I've got two. This is my last year.' Now it's like: I'm here. I'm still here. I'm fat. I'm grumpy. I'm talking. I'm functional.
Recently, I was taking an Uber here in Phoenix, and my Uber driver, he thought it was done. He thought there was a cure. He didn't realize that HIV was still around because it's not in the public eye, not in the news. I stupidly thought that the stigma was gone, but then it reared its ugly head when Charlie Sheen came out as being HIV, and all I heard was, 'Well, what do you expect — with his lifestyle?' The vice chair here [at the Joshua Tree Feeding Program], Peter Rodriguez, he always states the fact that when you tell people you have HIV, they look at you while going, 'Oh, what did you do?' But if you tell people you have cancer, it's like, 'Oh, I'm so sorry.'
What do you want people to understand about you and living with HIV?
Don't count me out. Just because I've had this for twenty years... I'm not going anywhere. The HIV community here in Phoenix or even Arizona, we're a tight-knit group. We take care of ourselves; we take care of our own, but we could always use more help.
"We're on the fast lane of getting old."
What concerns you most about growing older with HIV?
Those of us who are longtime survivors — there are other things popping up now because we weren't expected to live this long. My pills I take for HIV are basically poison 'cause it has to kill the virus that's living in me. So you don't know what else it's going to do to your other organs.
It's all the other things that are now creeping up to us, between the medications that we're taking as well as just the fact that we're getting old. We're on the fast lane of getting old. The fatigue, my liver, the colon cancer. My father went through colon cancer. He's twenty years older than I am. So I equate that the inside of my body is basically twenty years older than I am now. Things are happening to me health-wise, outside of HIV, that are happening to people basically twenty to twenty-five years older than I am. I wear progressives, and I'm going to have to go to trifocals.
What message would you like to send to younger people living with HIV or people who are newly diagnosed?
In San Diego, I was briefly a one-on-one counselor. I was part of a program. I would literally put twenty dollars on the desk in front of somebody who was newly diagnosed and said, 'If you follow your doctor's rules, take your medications, I guarantee you'll be undetectable in six months, and if you are not and you did all that, then you can have this twenty dollars.' I only had to give that up once just because the doctor couldn't figure out the right cocktail. Take your medications, listen to your doctor and listen to your body. And as long as you do what you're supposed to do, you'll be fine.
(This story is part of Still Here, Still Positive: A series on the first generation of Americans aging with HIV/AIDS, with support from The John A. Hartford Foundation.)


'We Weren’t Expected to Live This Long'

Grace Birnstengel

According to ear, nose and throat doctors, one of the most significant complaints for many people over 50 is difficulty breathing through the nose. This can result from a common condition called nasal airway obstruction (NAO), which impacts more than 20 million Americans.
The most common symptoms of NAO include trouble sleeping, difficulty breathing through your nose during exertion or exercising, nasal congestion and frequent mouth breathing.The structure and ability of the nose to do its job changes over time.
NAO often hinders a person's sense of smell, ease of breathing and sleep. Still, it can also affect health and lead to more serious issues including medical episodes such as anxiety and panic attacks, loss of consciousness and cardiac issues.
Nasal Issues Increase with Age
The structure and ability of the nose to do its job changes over time. The soft tissue in the nose becomes more inflamed as people age. "It's not just our skin and joints that show the passage of time; the nose also undergoes changes which can impact its function, such as the nasal tip starting to droop due to a loss of structure and the skin in the nose becoming thinner due to a reduction in collagen and elastin," said Roheen Raithatha, MD, an otolaryngologist in New York City. 
"As our nose ages, the cartilage can gradually become weaker, and the lateral (side) wall of the nose may collapse more — either at rest or especially when one takes a deep breath into the nose. It really can impact someone's ability to breathe comfortably through their nose."
Common Symptoms
People often think of seeing an eye doctor to maintain healthy eyes or a dentist for their teeth, but they might need to see a specialist to check their nose and throat. Older people may be hesitant to see their doctor for NAO as they assume that the only options available for them are invasive procedures, especially if they have not gotten relief from the standard treatments such as nasal steroid sprays and allergy medicines like antihistamines, according to Raithatha.
"People should breathe primarily through the nose most of the day, including while exercising and while sleeping at night." 
The most common symptoms of NAO include trouble sleeping, difficulty breathing through your nose during exertion or exercising, nasal congestion and frequent mouth breathing. The ability to smell can also be affected. Additionally, being able to breathe slowly through an unblocked nose can help to ease anxiety. 
The nose filters debris from the air and humidifies and moisturizes the atmosphere as a person breathes in. "People should breathe primarily through the nose most of the day, including while exercising and while sleeping at night," said Raithatha.
"Breathing primarily through the mouth can contribute to ailments that may be harmful to older adults, such as decreased lung function, blood pressure and poor sleep quality, which impacts energy. Mouth breathing can also lead to dry mouth, bad breath, periodontal disease like gingivitis and cavities and snoring," he explained.
"Allergies can be a big factor as they can lead to swelling within the nasal passages and cause nasal congestion. Other factors that may contribute to NAO include a collapsed nasal valve, deviated nasal septum, swelling of the inferior turbinates (the long thin bones of the nose covered with a layer of tissue), and nasal polyps, among other issues," Raithatha said.
No Surgery Options
Daily saline rinses can clear out triggers of inflammation and mucus from the nose. Other first-line therapies include nasal steroid sprays, decongestants, antihistamines (oral and/or nasal), Breathe-Right Strips or nasal cones. Allergy testing can assess allergic causes of NAO. A complete exam by an ear, nose and throat (ENT) doctor, including a nasal endoscopy (a small camera to look in the nose), is helpful to determine the area/causes of the nasal airway blockage.
"Allergies can be a big factor as they can lead to swelling within the nasal passages and cause nasal congestion."
"When medications or sprays aren't effective or a patient is looking for something that offers lasting relief, we start to look at minimally and non-invasive therapies, which are preferred for older adults who have preexisting conditions and may not be good surgical candidates," noted Raithatha. 
In-office options for treating NAO include an isolated inferior turbinate reduction using radio frequency ablation or a microdebrider and a procedure to place a bioabsorbable nasal implant (called Latera) into the sidewall of the nose to support the upper and lower cartilages. "These two procedures, however, each just work on one component of NAO," he said.
Another office-based treatment, VivAer, uses radiofrequency technology to help remodel the side wall of the nose to help open the nasal valve and can also be used to reduce a swollen area on the surface of the nasal septum (nasal septal swell body) and reduce the inferior turbinates. 
For suitable candidates, the treatment — covered by Medicare and some insurance plans — is done under local and topical anesthesia with minimal recovery. Reduction of nasal obstruction symptoms lasts through two years, according to one study.  
A Successful Treatment 
Diana Packard, age 65, didn't know the cause of her loud nightly snoring or why she could not breathe fully, exercise like she wanted to or get a restful night's sleep. After a sleep study, she ended up with a CPAP machine. 
"When I go for a walk, I can get more air through my nose than I can through my mouth."
"However, due to my narrow nasal airways, I just couldn't breathe properly with my CPAP. I couldn't get enough air through my nose. I saw a sleep specialist, but the doctor had no recommendations for me," she said.
Frustrated, she found her way to an ENT, who did an exam and told her that she had NAO. After trying breathing strips to no avail, she received the VivAer procedure, which enabled her to take full and deep breaths through the nose, and her sense of smell returned. 
"I'm sleeping through the night just about every night now and my physical activity has improved, too. When I go for a walk, I can get more air through my nose than I can through my mouth. I love walking my dogs and being outside, and it's easier to recover when I need to catch my breath," Packard said.
While NAO is a common condition, it's often underdiagnosed and left untreated. "People should talk to an ENT about their symptoms, have a complete examination and ask about non-surgical treatment options," said Raithatha. 


Now Smell This…or Not

Lisa B. Samalonis

Last summer, I bought a stevia plant with plans on snipping leaves and enjoying their flavor in my tea and lemonade all season.
After bringing the plant home, I set to work researching the different ways to use it. But I kept coming across articles declaring the dangers of stevia, and its past FDA-ban that had confusing nuances.
"Do I think a few leaves in tea is a problem? Probably not. There's a lot more problems in people's diets than a few leaves of stevia but I also don't think it's a health food."In the end, I held off and stuck to using my store-bought stevia packets. Better safe than sorry. But now it's gardening season. I occasionally use stevia packets in my morning coffee, and I was finding myself wondering about the actual stevia plant. Is there really a difference between store-bought stevia and the plant itself? Turns out, the answer to that surprised me.
Stevia and Its Uses
Stevia is a sugar substitute similar to artificial sweeteners because it doesn't raise your blood sugar, according to Claire Rifkin, RDN, a NYC-based private practice dietitian. It's about 200 to 300 times sweeter than table sugar. Unlike other sweeteners, it comes from a plant.
Is there really a difference between store-bought stevia and the plant itself? Turns out, the answer to that surprised me.
Besides eating the stevia leaves themselves, there's also the highly processed version you see in stores known as steviol glycosides. Stevia is used to flavor products you see in stores, but you can also use it to replace sugar in your drinks and baked goods.
Using it for baking isn't a one-to-one match with table sugar, so you'll have to make some adjustments in your recipe if you want to substitute stevia for table sugar. The conversion is 5 teaspoons of stevia for every cup of sugar, explains Kimberly Gomer, MS, RD, LD/N who is in private practice and director of nutrition at Body Beautiful Miami. 
It's even less when it's in liquid form, which is about 2 teaspoons of liquid stevia for every three-quarters cup of sugar. But since sugar also gives volume and texture to baking, you'll need to replace that lost bulking agent with something else, such as yogurt or applesauce.
The Effects of Sweeteners on the Body
Using a sweetener that doesn't cause a spike in blood sugar, and comes naturally from a plant has to be better, right? The American diet contains lots of sugar which can lead to health conditions such as high blood pressure, fatty liver disease, and type 2 diabetes.
"It's actually a drug, because of that sweetness and how it hits the brain."
But just because it comes from a plant doesn't make stevia healthier. Gomer explains that because it's 200 to 300 times sweeter than sugar, the body doesn't recognize stevia (and other artificial sweeteners) as food. "It's actually a drug, because of that sweetness and how it hits the brain," says Gomer.
According to the Cleveland Clinic, when you eat sugar, your brain releases dopamine, the feel-good chemical, similar to when someone smokes cigarettes. Eating sugar stimulates certain areas of the brain affected by addiction. Artificial sweeteners do the same thing, except that because they're so much sweeter than sugar, your nervous system becomes overloaded with dopamine. As Melissa Young, MD, states in the article, your body starts craving artificial sweeteners. "And it can be easier to give in to that craving because you think you're making a healthier choice."
Especially when that sweetener comes from a plant.
Can You Eat Stevia Leaves?
So going back to my garden and this beautiful stevia plant I had bought last year. It turns out, while I can pull a few leaves off my basil plant and use it on my wood-fire pizza, it doesn't work that way with the stevia leaf.
"Homegrown stevia is not going to be the same as commercially processed stevia."
"I would not recommend consuming whole stevia leaves even if you grow them in your garden," says Rifkin. You might be just fine, but you also might not be and that's simply because there's not enough research to tell us otherwise. The whole-leaf version of stevia isn't FDA-approved for use as a sweetener.
Because of concerns about it causing cancer, stevia was banned by the FDA in 1991. In 2008, the FDA revised its stance and granted high-purity stevia extracts as "generally recognized as safe" (GRAS). The same isn't true of whole-leaf stevia.
"Homegrown stevia is not going to be the same as commercially processed stevia. The safe part of stevia that we see on shelves is a specific part of the stevia leaf called steviol glycosides," explains Rifkin. She says to get to that specific part of the plant, it has to go through refinement and processing.
With whole leaf stevia, the FDA doesn't yet know the toxicological data, notes Gomer. 
"There's this distinction between the forms of stevia that highlights why it's so confusing because it's the opposite of what you think. You think 'natural' so that means the plant is healthy," says Gomer. "Do I think a few leaves in tea is a problem? Probably not. There's a lot more problems in people's diets than a few leaves of stevia but I also don't think it's a health food."
What About Stevia in the Grocery Store?
The stevia you buy in the grocery stores, the liquids and powder packets, are a different story, when it comes to safety. Because as Rifkin explains, the FDA deems stevia as safe as long as it's the highly processed and refined version.
"I think a lot of Americans, when they hear the words highly processed or highly refined, they might think it's bad, but in this case it's a good thing, because it's refining out the harmful elements of the stevia plant and making it a safe product for consumer use," says Rifkin.
With the highly processed stevia, there are still precautions. According to Rifkin, stevia can cause some people to have GI symptoms, such as diarrhea, upset stomach and bloating.
"If you add stevia to your diet and you're having these symptoms, that's a good indication to know stevia doesn't sit right for you and this isn't the sugar replacement for you," Rifkin says.
Stevia Safety
There's also such a thing as consuming too much stevia. The acceptable amount is what the World Health Organization defined as 4 mg per kilogram of body weight. For a 150-pound person, that's eating 10 packets of stevia daily.
There's also such a thing as consuming too much stevia. 
A lot of stevia, it's true, but this also calls attention to the safety of stevia for children. Children, of course, have lower body weights and Gomer warns to just avoid giving stevia to children because they can reach the toxic levels faster than in an adult.
But with whole-leaf stevia, it's probably best to just avoid it altogether. So why are these plants being sold in garden centers? It's a question I wondered about since learning the dangers of eating whole stevia leaves.
"It's because they're being sold under the assumption that people aren't going to eat it," says Rifkin. Which she agreed seems misleading. However, Rifkin explains that under the FDA rules about stevia, it's allowed to be sold at gardening centers under the assumption of it only being used for horticultural purposes, not as a sweetener for human consumption. In other words, it's pretty to look at in your garden, but could very well be toxic to you and it's probably best to not eat it at all.
Until we know more about stevia, stick to those found in stores. Better yet, says Gomer, put fresh lemon in your tea to make it taste better. If you're wanting to improve your health, try to avoid sugar and artificial sweeteners or sugar ‌as much as possible.


Is It Safe to Use Stevia?

Risa Kerslake

Capital-gains taxes occur when you sell an asset, like your home or a stock. They are paid to both the state and federal government. The government collects a percentage tax on the gain or profit of the asset while in your possession.
Capital gains tax is not something to worry about, but is something to plan for as you prepare to sell an asset.As you think ahead to tax season, understand that taxes on capital gains were lowered in 2017 and remain at the lowest rate in decades as of this writing. The average taxpayer pays a 15% federal tax on long-term capital gains, defined as the profit on an asset you have owned for more than one year.
Capital-gains taxes occur when you sell an asset, like your home or a stock.
A few people, those whose income is over $445,850, pay a 20% federal tax. There are exceptions where capital gains trigger a higher rate, but they apply to small business stock and collectible sales. More information is available from the IRS at Topic No. 409, Capital Gains and Losses | Internal Revenue Service.
The bottom line is that capital gains tax is not something to worry about, but is something to plan for as you prepare to sell an asset.
Here are three steps to make capital gains an easier process in your life:
1. Learn the Lingo
When you buy a home or stock, the price you pay for it is called the basis of that item. Knowing the basis will make your life easier when you go to sell any property or investment.
The property may get a step-up in basis if you owned it in joint name and became the sole owner through a death. Typically, property has increased in value over time which means your half of the property has had the original value and the other half is the value when it was transferred to you following the death of your co-owner.
This step-up of basis also applies to inherited assets. All property gets a step-up in cost basis to the current value for the new owner following a death. This applies to your home, monies in a brokerage account and other assets. If others inherit your property, they will receive a step-up in value, whether they are relatives or friends.
In addition, understand whether the property was held short-term or long-term. The gain is calculated based on how long you have held the property. Anything less than a year is considered short-term. Longer than a year is a long-term gain calculated at a lower rate.
2. Keep Good Records
Capital gain rules apply to investments like stocks, cryptocurrency, mutual funds and certain types of life insurance. In the case of these investments, the investment or insurance company maintains the records for you.
At the end of the year, companies send a Form 1099. On the 1099, only the proceeds are recorded. You need to ask at the time of the sale what you paid for it (if they do not note it on paperwork), any other payments you may have made such as life insurance premiums and calculate any investment fees relevant to the sale. This will give you the current basis of the property and allow you to calculate the anticipated taxes.
For more information, read IRS Publication 550, Investment Income and Expenses.
Capital gains taxes occur when you sell your home residence, but you can prepare now even in this inflated home price environment. Home improvements over the time of your ownership add to the basis of your home.
Save yourself stress and taxes in the future by keeping a tally of home-improvement costs. Even if you are not selling this year, organizing that paperwork now so you can keep those receipts and information separately will save you a hassle in future years.
Save yourself stress and taxes in the future by keeping a tally of home-improvement costs.
Keeping good records can increase the home's cost basis for tax purposes, saving you from paying unnecessary capital-gains taxes if you sell. A new kitchen, bath or outdoor patios and lights — essentially anything beyond paint and maintenance. Here's the full IRS list of what qualifies. When you sell your house, provide these numbers to your accountant.
Caution: Do not increase the cost basis of your home by making improvements you do not need or want. There is no guarantee that expenses will be offset by the selling price, no matter what your real estate agent says.
You add the cost basis to the cost of improvements you have made to the property. This is tangible upgrades like landscaping, or building additions that will sell with the property. Not the maintenance over the years of lawn mowing or painting to keep the property in good condition.
See list below for clarity and read IRS Publication 523 (2022), Selling Your Home | Internal Revenue Service. Then, review your records and dig out your calculator to find your full basis for tax purposes when you file for tax year 2023.
Examples of improvements include:
Heating system.Central air conditioning or humidifier.Central vacuum.Wired security system.Lawn sprinkler system.Exterior storm windows or doors.Pipes and duct work.Septic system.Water heater.Built-in appliances.Kitchen modernization.Wall-to-wall carpeting.Your basis when you sell the property will be the cost basis when you bought the property plus the cost of improvements. Remember, you may qualify for a $250,000 capital gain exclusion ($500,000 if you were married) if this has been your main home two out of the past five years and you meet other requirements. As a result, your capital gains tax may not be as much, especially when including the improvements in your home. More information is available at IRS Publication 523, Selling Your Home - Internal Revenue Service.
People have put off selling their homes because they fear their capital gains will exceed the exemption amount. If you are delaying selling a too-big home because of the gain and the fear of taxes, there is something you can do now to prepare.
3. Be Tax Prepared
Once you know the basis of your property and its sale price, the difference is considered the capital gains. Use this number to calculate the tax on the property. Unless you are in a state that does not have a capital gains tax, such as Florida, New Hampshire, and Wyoming, be sure to put away in savings 25% of your profit for state and federal taxes.
This set aside is critical so that you have the money to pay the appropriate tax on April 15th of the following year. The best way to do this is to have a separate saving account or short-term certificate of deposit. This way it is clearly separate money set aside for tax purposes and less tempting to dip into through the year.
If this all sounds confusing or overwhelming, then consult a tax professional who does this every day and can simplify your life even when it is not tax season. Capital gains are manageable if you are not blindsided by lack of knowledge.


Understanding Capital Gains

Christine D. Moriarty

In case you can or can't tell by looking at me, I am officially on Medicare. Starting on the first day of the new year, my new global catchphrase became: "Do you take Medicare?"
"One day you're 64, and health care emails are as gruff and unforgiving as anyone reading this rant has probably experienced. A day later, as you start planning for the big 6-5, all these sites suddenly want to hold your hand while you're crossing the street.""Why, yes, we do," squeak the millions of ads that have saturated my news feeds, social media and mailbox every day for a year now. It's almost as though this rollout prior to one's 65th birthday is on some kind of government timer, because it is! But hey, bring on the discounts, the reduced-fare MetroCard, plus the free psychological shrinkage after a $200 annual deductible — I earned that prize.
Click here, the emails say, if you want to know how you're doing this whole aging thing all wrong. . . .
However, is it possible that the Medicare team could revisit and contemporize their email copy, which presents as dated, tired and a bit gray-speak condescending. Tonally the writing style strokes the hair very gently, but content-wise it reads as a ticking bomb of the eight-to-ten subtle signs of impending death that apparently are being ignored. Click here, the emails say, if you want to know how you're doing this whole aging thing all wrong. . . .
Additionally, thematically, there's a lot of conceptual "trust" being bandied about as well. As in, "Dear So and So, we're honored to be on this Medicare journey with you as we understand this important relationship is all about trust." Well darn, there are only a few coverage options to choose from, so maybe it's about trust that we chose the least offensive and most cooperative one.
"Take your time," they say.
Don't mind if I do!
One day you're 64, and health care emails are as gruff and unforgiving as anyone reading this rant has probably experienced. A day later, as you start planning for the big 6-5, all these sites suddenly want to hold your hand while you're crossing the street.
Is this why there are parties for the momentous day, sending you off to the misty Medicare moonlight because now someone has to hold your hand for the rest of your journey?
Is this why there are parties for the momentous day, like a farewell gift, sending you off to the misty Medicare moonlight because now someone has to hold your hand for the rest of your journey?
I am aware that the hand-holding might be useful one day, but I doubt any Medicare copywriter will guide me personally to the other side of the road, unless I'm headed toward an off-ramp, so to speak.
Enroll Now or Suffer Forever
Further, this whole Medicare shebang is not free, which I didn't realize, and don't know why I didn't, so there's that story hole to fill.
Also, the government wants you to be on medication. You must put yourself on a prescription plan or you'll be penalized for all eternity. And isn't that what this Medicare stuff is about anyway, taking you to the finish line?
Even if you currently require no daily medication, there's no reward or kudos for that; in fact, you have to pay regardless. They're just saying the loud part quietly, that you will need it one day, and they "trust" you'll want to buy those products via them at a reduced rate.
Oh, and that oh-so-hilarious AARP status, the symbolic butt of the standard old-age joke, they're actually not making funny. They sell insurance. Or there is Medicare insurance with their name on it. Which happens to be the most comprehensive plan for everything that you pay for, which I thought would be free, which is not covered. Wait, what. . . ? Supposedly. We'll see.
Because ultimately, you'll step away from the computer and the boomer live TV and all the advertising that comes in the mail and on your feeds, and you'll figure out the maze that is the sign-up process, which by the way, you probably will need someone to hold your hand through.
My moodiness with this Medicare business might just be because it's ringing true.
You'll reenter the world as someone who stepped over the threshold of 65, and thank goodness for that. If it seemed impossible to be any more invisible than you once were as a middle-aged woman, think again. There are so many new roads to uncover.
Whether you're in a line at the grocery store and you're pushed to the side or can't see over the fish counter because you've always been short, but now you're shorter. Or you're draped at the corner bar, drinking beer, eating forbidden French fries, listening in on barstool conversations that mirror pieces of the lives you've lived in the past, say, for 65 years. Some of these people are old, like you. I mean, me.
Never mind the projections though, the confusing emails, the unwoke language, the societal woes related to aging. You can bounce those inaccuracies right back to their sender, especially if it happens to be you. Which is what I've learned throughout this process, that my moodiness with this Medicare business might just be because it's ringing true.
You can't pay for fries with Medicare, though. I've asked.


‘Do You Take Medicare?’

Jenny Klion

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