Blog Posts

Pink Eye? It Could Be the Coronavirus

April 24th, 2020

The most common symptoms of the coronavirus that has stopped the world in its tracks are fever, coughing and breathing difficulties. But doctors are finding that the respiratory disease known as COVID-19 can also cause an eye infection called conjunctivitis.

The discovery of conjunctivitis in COVID-19 patients is rare. As of mid-April, doctors believed that only 1 to 3 percent of all the people who could contract COVID-19 would also suffer from conjunctivitis, most likely during the middle phase of the illness.

According to one report in the Journal of Medical Virology, a study of 30 COVID-19 patients in China showed that only one had ocular secretions or tears containing SARS-CoV-2 RNA, which is the carrier of the coronavirus’s genetic information.

But another study detailed in the New England Journal of Medicine Journal Watch claimed that a third of the COVID-19 patients in that study had confirmed cases of conjunctivitis, a finding that has since been challenged.

Also known as pink eye, conjunctivitis is what develops when the clear tissue that lines the inside of the eyelid becomes inflamed. The result is red, itchy and swollen eyes, and while conjunctivitis is not a serious condition, it is highly contagious.

Children are highly susceptible to conjunctivitis, which is known to spread easily throughout schools and day care centers. However, having conjunctivitis alone does not mean a person also has COVID-19.

Though it can develop as a result of exposure to viruses, conjunctivitis can also be caused by exposure to certain bacteria as well as more common irritants such as shampoo, dirt, smoke, pool chlorine and eye drops.

Though it’s best to be treated for conjunctivitis by an ophthalmologist, home remedies such as warm compresses and over-the-counter medicines can treat its symptoms. No matter the approach, it usually takes about two weeks for conjunctivitis to disappear.

During that healing period, several steps can be taken to expedite the healing process and protect your eyes from further damage. For example, if you wear contact lenses, wear glasses instead until the conjunctivitis is completely healed.

And don’t rub your eyes. Granted, that’s easier said than done, but treating your itchy eyes with moistening drops or dabbing them with a tissue and immediately throwing the tissue away can help you avoid spreading the condition.

Because conjunctivitis is highly contagious, it can be transmitted by the hands just as the coronavirus can, so washing your hands regularly and avoiding handshakes is another way to avoid spreading the infection.

Melbourne Retirement Community Embraces Virtual Normal

April 20th, 2020

With seniors among the most vulnerable to the spread of the coronavirus, retirement communities are having to step up their efforts to keep residents safe. The real trick, though, lies in not just keeping residents safe but in maintaining a sense of normalcy within such communities.

One community that has managed to meet those two objectives is Hibiscus Court of Melbourne, where the new normal can best be described as a virtual normal. For example, in place of personal visits from family members, Hibiscus Court is conducting virtual visits using video conferencing software such as Zoom.

“We’ve all seen the viral posts of people meeting at windows, and we started with that, but we’ve actually found that it’s better for our residents and their families to have these meetings through Zoom,’’ says Charisse Durham, director of sales and marketing at Hibiscus Court of Melbourne.

“So what we’re doing is teaching the families how to use the Zoom technology, and once we’ve done that, we set up a Zoom meeting for them. During that visit, we are there with the resident to help them navigate through it or translate if they have any trouble hearing or seeing their family members. It’s working out really well.”

Another example of the new virtual normal at Hibiscus Court of Melbourne took place last week, when the community changed up its regular Rolling With Laughter event. When the Hibiscus comedy troupe, “Off Their Rockers” had to cancel its event, the community held a virtual Rolling with Laughter event.

“We accepted submissions from residents, family members, referral sources and care partners,” Charisse explains. “All of them sent in different jokes and we had several different showings for small groups where our programming director and residents presented the jokes.

“It went over very well, and for some of our residents who could not attend one of the showings, we went to their rooms and shared the jokes with them individually. We also printed some of the jokes that were short and sweet and took photos of our residents with the joke and a smile then posted them on our Facebook page to share them that way.”

One of the biggest challenges retirement communities now face comes at meal time, when residents typically gather en masse to dine and socialize. Social distancing guidelines prohibit such mass gatherings, however, so at Hibiscus Court of Melbourne, residents are now served the same meals they would receive in the dining room in their own suites or in small, adequately spaced common areas.

That said, socializing is not a thing of the past at Hibiscus Court of Melbourne. Just as it did with its comedy show, the community now conducts several exercise and activity periods each day where small groups of six residents gather and participate while maintaining a safe social distance from one another.

“Another thing we did recently was hold a virtual 99th birthday party for one of our residents,’’ Charisse explains. “We also had a no-contact pet parade, where local participants came and walked their dogs around our parking lot and we let our residents know so they could watch from their rooms or at a safe distance.”

It’s not just the residents of Hibiscus Court of Melbourne who are getting special attention during these difficult times. The community’s staff members, who are working extra hard each day to ensure residents are safe and comfortable, have not been forgotten.

“We’ve had families provide lunch for the entire team; other families have sent gourmet caramel apples or bulk boxes of treats,” Charisse reports. “They know our team works tirelessly to provide the best care for their loved ones. Many families’ have taken the opportunity to say thank you. Even though we’re not in a hospital or skilled setting, we are providing health care and life care and many are working additional hours and occasionally double shifts.

“Our leadership team is also committed to thanking our direct caregivers daily with some item of appreciation. Somebody every day is doing something to say thank you to our team, because they know that we’re here trying to protect people and that our care team also has to take additional measures to protect themselves and their families when they leave, because they can’t bring the virus back into our community.

“It’s a difficult time for everyone but everyone is pitching in and doing what they can to help each other out. The dedication to our residents’ care and the creativity in that is truly remarkable. I’m inspired every day.”

Fort Myers Vein Specialist Answers Call For PPE

April 16th, 2020

The “Hats 4 Heros” program was started by Dr. Joseph Magnant of Vein Specialists and his wife Patty.

Patty Magnant was already busy sewing scrub hats for some local hospital nurses when her husband, a Fort Myers vascular surgeon, learned just how critical the shortage of personal protective equipment (PPE) caused by the coronavirus really is.

“My sister is an emergency room doctor and she shared with me that at hospitals everywhere right now, they’re running low of surgical hats, gowns and masks,” shares Joseph Magnant, MD, FACS, RPVI.

“That’s their equipment and they need it badly, and that got Patty and I thinking that we should start making more of these reusable cloth scrub hats for the nurses and doctors in the ERs and ICUs.”

Dr. Magnant, the founder and CEO of Vein Specialists, which is dedicated to the minimally invasive treatment of leg vein disorders and has offices in Fort Myers and Bonita Springs, began his initiative in early April.

He is one of a host of medical professionals across the state of Florida who are devoting time to helping others during the coronavirus crisis, and within days of he and his wife beginning their initiative, it was already expanding.

“So our initial thought was to make these surgical hats that were more durable, that the doctors and nurses could take home and

Dr. Joseph Magnant is using his surgical skills to produce personal protective equipment for medical professionals fighting on the front lines of the coronavirus pandemic.

wash and wear the next day,” Dr. Magnant explains. “But then we came up with another idea, another way to help out during this crisis.

“When the CDC (Centers for Disease Control and Prevention) came out the other day and suggested that people start wearing face coverings whenever you’re outside of the home, we came up with a way to make those as well.”

Dr. Magnant’s idea for a face covering was inspired by the buffs he’s seen at area sporting goods stores. He and Patty made their first few “re-buffs’’ out of old t-shirts but soon began making them out of a better grade of material they purchased online.

“They’re tubular knit cloths that you can pull up and cover your mouth and nose with,” Dr. Magnant says. “We gave the first few away to friends and neighbors and my parents, and now we’re making them to sell to benefit the Ronald McDonald House Charities.

“I’ve supported the Ronald McDonald House Charities for years, and because volunteers are not allowed to help them cook meals at this time, what they really need right now is money. So, we came up with this idea that we’re calling Hats 4 Heros.”

Every $10 donated to the Ronald McDonald House Charities of Southwest Florida, Hats 4 Heros will donate one hand-sewn surgical cap to a doctor or nurse fighting on the front lines against the coronavirus.

Through the Hats for Heros program, Vein Specialists will donate one hand-sewn surgical scrub hat to an emergency and acute care medical professional somewhere in Southwest Florida for every $10 donated to the Ronald McDonald House charities.

For every $5 donation to the Ronald McDonald House charities, Vein Specialists will donate a hand-sewn Re-Buff to anyone in need of facial protection. A $5 donation can feed one family in need, while a $10 donation can feed two families.

“My expertise is in cutting the patterns,” Dr. Magnant says of his role in the production of the hats and buffs. “Patty does the sewing, and like anything it takes time, but it’s starting to take off.”

Patty and Dr. Magnant have also started a GoFundMe account in an attempt to bring awareness to their cause. It can be found at gofundme.com.

Lighting the Way to More Comfortable Eyes

April 12th, 2020

We all shed tears. Our eyes produce tears continually, and when we blink, those tears spread across the front surface of our eyes to lubricate them. Tears also clear our eyes of debris and protect them from infection. But in some people, tears don’t work the way they’re supposed to and dry eye disease is the result.

If you’re one of those people, you’re not alone.

In the United States, more than 16 million people suffer from dry eyes.  That’s nearly seven percent of the population. And that figure is likely much higher because not all people with dry eye symptoms see a doctor for treatment. But about 33 percent of patients who visit eye doctors complain of dry eye symptoms.

Symptoms of dry eye can be very uncomfortable and include decreased vision or occasional blurry vision, dryness, redness, itching, burning, eye fatigue and the feeling there’s something in your eye. And believe it or not, some people with dry eye experience excessive tearing.

There are two types of dry eye disease. There’s the aqueous-deficient type, which is when your eyes don’t make enough tears. Then there’s the evaporative type, which is when your tears don’t stay on your eyeball long enough to keep it properly lubricated.  Evaporative dry eye disease is the more common of the two.

Most of the time, evaporative dry eye occurs when the eye’s oil glands, the Meibomian glands, become clogged and can’t release the oils necessary for healthy tears. The oil component of tears helps keep them from evaporating off the surface of your eyes.

When the Meibomian glands are clogged, inflammation and an overgrowth of bacteria on the eyelids can also occur, which makes dry eye symptoms even worse. These conditions make it difficult for the Meibomian glands to work properly, which is referred to as Meibomian gland dysfunction, or MGD.

Treatment for MGD typically begins with artificial tears, warm compresses and eyelid cleansing. When these steps fall to improve MGD, and subsequently your dry eye symptoms, there’s a newer treatment available called intense pulsed light, or IPL.

IPL was originally designed for use in dermatology to treat conditions such as rosacea and acne but was introduced into ophthalmology a few years ago. IPL is the use of short bursts of powerful light in various wavelengths to treat MGD. The wavelengths chosen for your treatment depends on your skin color and tone.

The IPL light generates heat below the skin of the eyelids, warming and thinning the thickened oil, or meibum, blocking the glands. Once the meibum is thinned, it can more easily be removed through Meibomian gland expression or MGX. During MGX, the doctor uses a cotton-tipped applicator and manual pressure to squeeze out the meibum from the glands.

In addition to thinning the meibum, IPL also closes the small blood vessels on the surface of the skin that contributes to inflammation. The heat IPL generates also kills the problematic bacteria flourishing on the eyelids. All of these functions have beneficial effects on MGD and, as a result, dry eye symptoms.

During an IPL treatment, the doctor will first place shields on your eyes to protect them from the light. The doctor will also place a thin layer of cooling gel on the areas of skin to be treated. The pulses of light are delivered from the outer area of the right eye, across the cheeks and nose to the outer area of the left eye.

You may feel a warm sensation during treatment, but that’s all. IPL treatment is not painful. A typical treatment consists of about 30 pulses and takes 15 to 20 minutes to complete. Afterward, you may be instructed to use low-dose anti-inflammatory eye drops for a few days.

Many people experience improvement in their symptoms after one IPL treatment, but for best results, a series of four treatments over four months is typically recommended. Maintenance treatments are also recommended every six months to a year.

A number of studies confirmed that IPL reduces both signs and symptoms of MGD and dry eye. In one study, more than 90 percent of patients improved in the three areas used to assess MGD. Results are validated subjectively through your report of symptom improvement and objectively when your doctor examines the surface of your eyes under a light.

Florida Clinic Pitches In To Help Volusia Residents Fight Coronavirus

April 3rd, 2020

The staff at Coastal Integrative Healthcare in Edgewater specializes in physical medicine and stem cell therapy, but when the impact of the coronavirus hit their community this week they put their skills to work in another way.

Bea Johnson fills a container with Coastal Integrative Healthcare’s own home-brew of hand sanitizer.

After learning that many of the people in and around Edgewater were running out of hand sanitizer, the Coastal Integrative Healthcare staff created a homemade version of the disinfectant that is offered up for free to area residents.

“We started hearing about a lot of at-risk people who didn’t have hand sanitizer or ran out of it, and because you can’t find it in the stores right now, we decided to make it ourselves to help people out,” says Timothy Steflik, DC, at Coastal Integrative Healthcare.

Using a recipe that one of their staffers knew, the CIH staff created about six gallons of hand sanitizer by mixing four gallons of isopropyl alcohol with two gallons of aloe gel. They then added some scents to it to erase the clinical odor of the alcohol.

“The isopropyl alcohol is what kills the viruses and mixing in the aloe gel gave it some consistency,” Dr. Steflik states. “The different scents make it smell nice, and once we had it made up, we set up a tent in our parking lot and distributed it from there.”

“We set up the tent so that people wouldn’t have to come into our building and touch the doorknobs and stuff, so it was just like some of the restaurants and places like that offering curbside service.”

Coastal Integrative Healthcare began distributing its homemade hand sanitizer this past Tuesday at 2:30 p.m. Shortly before that, a line of people, many of whom had brought their own containers, had assembled to take advantage of the giveaway.

“We also gave out some small containers that we made up ourselves to people who didn’t have one,” Dr. Steflik says. “The people we served were really happy because they literally couldn’t find it any of the stores.”

Coastal Integrative Healthcare’s giveaway also benefitted a nearby medical clinic that had run out of the disinfectant.

Coastal Integrative Healthcare remains open during the coronavirus crisis.

“We had several nurses and nurse practitioners come over from the Florida Health Care facility that’s just two businesses away from us,” Dr. Steflik confirms. “And that was important because they’re one of the eight testing centers for COVID-19 in our county and they had run out of it. So we filled up the bottles they brought and then gave them some more.”

Dr. Steflik says he is hoping to make another batch of hand sanitizer to give away to area residents and businesses next week. He’s worried, though, that a shortage of one of the key ingredients will prevent that from happening.

“We’re having a hard time buying isopropyl alcohol right now,” he says. “We have access to it through a distributor that most people don’t have and that’s how we got enough to make the first batch.

But it’s getting harder and harder to find. You can’t even buy it on Amazon right now, but we’re going to keep looking because we want to continue to do what we can to help the people in our community in some way.”

 

 

 

 

Anxiety Amid COVID-19

April 3rd, 2020

A national survey conducted March 18 and 19 by the American Psychiatric Association (APA) showed that the COVID-19 pandemic is significantly affecting the nation’s mental health. In the survey, half of US adults reported high levels of anxiety.

Among the survey respondents, 48 percent reported feeling anxious about the possibility of contracting COVID-19 themselves, and 40 percent said they were anxious about becoming seriously ill or dying from the virus. In addition, 62 percent reported being anxious about the possibility of a loved one contracting the illness.

The president of the APA, Bruce J. Schwartz, MD, suggests that this level of anxiety is appropriate given the current circumstances in this country. But he warns that the rate of mental distress in America could surge if the COVID-19 crises continues much longer.

It’s the uncertainty surrounding the COVID-19 pandemic that can cause the physical, emotional and mental reactions in people. If you have a high level of anxiety, you may experience feelings such as anger, rage, confusion, helplessness, sadness, depression and guilt. Other symptoms of anxiety that may occur include:

  • Tenseness or nervousness
  • Constant exhaustion
  • Difficulty sleeping
  • Difficulty concentrating
  • Increased heart rate
  • Stomach upset
  • Constant crying
  • Isolation
  • Heavy use of alcohol and/or drugs

When these feelings don’t go away after a few weeks or get worse, it may be a good idea to seek professional help. Seek help from a trained professional if you or a loved one is unable to return to a normal routine, feel helpless, have thoughts of hurting yourself or others, or begin to use alcohol and drugs to excess.

People with pre-existing mental health conditions are especially vulnerable to stress and anxiety during crisis situations. During this current COVID-19 crisis, these individuals should continue with their treatment and be aware of new or worsening symptoms.

Here’s one example of worsening symptoms. A British charity for people with obsessive-compulsive disorder reports that it has received an increase in calls and emails from people with the disorder who were developing a new fixation on the coronavirus.

For help coping during these anxious times, try these tips, courtesy of HelpGuide article Coronavirus Anxiety:

  • Stay informed, but don’t obsess —  It’s important to check the news to stay informed about what’s going on, especially as circumstances change daily. You need to follow the news to know what to do to stay safe and help slow the spread of the virus. But there’s a lot of misinformation circulating and sensational reporting can fuel anxiety and fear, so be discerning about what and how much you read and watch.
  • Focus on things you can control – There are many things out of your control right now such as how long this crisis will last and how others will respond to it. Focusing on questions without clear answers will make you feel drained, anxious and overwhelmed. Try focusing on things you can control, such as following the recommended steps for preventing the spread of the virus.
  • Plan for what you can do – If you’re worried about your workplace closing, your children being home from school, having to self-quarantine or about a loved one getting sick, make note of these worries. Then, make a list of possible solutions and draw up an action plan. Concentrate your efforts on problems you can solve.
  • Stay connected – It’s been shown that social distancing is helping to curb the spread of the coronavirus, but being physically isolated can add to stress and anxiety. Make it a priority to stay in touch with family and friends. Schedule regular phone calls or chat via video or Skype. Connect with family and friends via social media. But don’t let the coronavirus dominate every conversation.
  • Take care of your body and spirit – The rules of staying healthy are especially important during times like these. Be sure to eat healthy, get plenty of sleep and exercise regularly. Practice a stress-relieving technique such as yoga, deep breathing or meditation to help keep stress at a minimum. Be kind to yourself if you’re experiencing more depression and anxiety than usual. Take time out for activities you enjoy, and try to maintain a normal routine while you’re stuck at home.
  • Help others – Focusing on others in need supports your community, and this is especially true in times of crisis. People who focus on others tend to be happier and healthier than those who act selfishly. Focusing on others can also make a positive impact on your mental health. Doing kind and helpful acts for others can help you regain a sense of control over your life and add meaning and purpose.

Remember, we’re all in this together!

The CBD Story

March 23rd, 2020

It seems like everywhere you look these days, there are ads for products containing CBD. I get emails almost every day hawking these products. But what do we really know about CBD and how does it work? Here’s a little overview of what I’ve learned about it, and it just touches the surface of the CBD story.

CBD, an abbreviation for cannabidiol, is one of the major active ingredients of cannabis, essentially marijuana. CBD is a vital constituent of medical marijuana, but it’s actually derived from the hemp plant, a close relative of the marijuana plant. Unlike its common co-ingredient tetrahydrocannabinol (THC), CBD doesn’t cause a “high.” CBD and THC are called cannabinoids.

In recent years, CBD has been reported to have beneficial effects on a wide variety of health disorders, including epilepsy, Parkinson’s disease, post-traumatic stress disorder, anxiety and chronic pain. Researchers are still studying CBD’s exact method of action on the body, but one thing they’ve uncovered is its effect on the body’s natural endocannabinoid system (ECS).

The ECS is a complex cell-signaling system in the body. It plays a role in regulating a range of functions and processes including sleep, mood, appetite, memory, and reproduction and fertility. There are three main components involved with the ECS: endocannabinoids, receptors and enzymes.

Endocannabinoids, or endogenous cannabinoids, are molecules that are similar to plant cannabinoids, but are made naturally by the body. The two key endocannabinoids are anandamide (AEA) and 2-arachidonoylglyerol (2-AG). These molecules work to keep the body’s internal functions operating efficiently.

There are special receptors found throughout the body that the endocannabinoids can bind to, signaling the ECS to perform a function. The main receptors are CB1 and CB2. CB1 receptors are found primarily in the central nervous system, the brain and spinal cord. CB2 receptors are located primarily in the peripheral nervous system and immune cells.

CB1 and CB2 act as a lock, and the endocannabinoids are the keys. AEA and 2-AG can bind to either receptor, but their effects depend on where in the body the receptor is located and which endocannabinoid binds to it.

Benefits of activating CB1 receptors include relieving depression, reducing fear and paranoia, and lowering inflammation, blood pressure and anxiety. Targeting a CB1 receptor in a spinal nerve may also ease pain.

Changes in CB2 receptor function affects many human diseases including cardiovascular, gastrointestinal, neurodegenerative, psychiatric and autoimmune. Targeting a CB2 receptor in the immune cells can alert you that inflammation is present, which is common with many autoimmune disorders.

In addition, activating CB2 receptors induces immune system cells called macrophages to destroy the beta-amyloid protein that makes up the plaque found in the brains of people with Alzheimer’s disease.3

THC and CBD work on these endocannabinoid receptors as well. THC can bind to either CB1 or CB2 receptors. By doing that, THC has effects on the body and brain. Some of these effects are positive and some are not so positive. THC can bind to receptors and help reduce pain and stimulate appetite, but it can also make you paranoid and anxious.

The way CBD interacts with the ECS is still being investigated, but researchers do know that CBD doesn’t bind to CB1 or CB2 receptors directly. Most researchers believe CBD works by preventing AEA and 2-AG from being broken down, allowing them to have a stronger effect on the body’s proper functioning.

One of the indirect ways CBD induces therapeutic effects is by activating special receptors in the body called TRPV1 receptors. These receptors are involved in regulating pain, body temperature and inflammation.

CBD also inhibits fatty acid amide hydrolase (FAAH), which creates higher levels of the cannabinoids such as AEA, also known as the “bliss molecule.” It plays a role in the neural generation of pleasure and motivation. It also performs other important functions related to eating and embryo implantation during pregnancy.

Because CBD has an effect on the ECS, it helps to promote balance, or homeostasis, in the body. It also reduces the sensation of pain and inhibits inflammation. Research continues on the methods of action of CBD on the body. And as more information is uncovered, more practical uses for CBD may also be discovered. Stay tuned!

New Technology Brings Back the Old-time House Call

March 17th, 2020

What was old is now new again.

House calls, where a doctor arrives at your door with a black bag and stethoscope, are making a comeback.

Only this time, medical providers come equipped with portable X-ray machines, labs and even EKG machines.

“We’re bringing house calls back to medicine because we believe in high-quality patient-centered, convenient care,” says Dr. Paul Nanda, chief medical officer of Tampa General Hospital Urgent Care powered by Fast Track. “As medical providers, we want to provide a concierge service for our patients, convenient care when they need it most in the comfort of their own home.”

The hospital and its urgent care partner recently began offering house calls in South Tampa and Riverview, with plans to expand the service to other areas. A discounted fee of $149 is offered through Nov. 30; after that, the standard fee is $199 per visit.

The service provides treatments for cough, colds, sore throat, ear infections, eye problems, urinary tract infections, vomiting, rashes, fevers and sprains. Urgent Care at Home powered by Fast Track also provides medical testing and diagnostics for flu, strep, rapid RSV, urinalysis and more for anyone ages three months and older.

Tampa General Hospital’s move comes as startups threaten to disrupt the health care system across the nation with technology that allows physicians access to equipment and supplies that once bound them to offices.

Here’s how it typically works: patients can contact the services through an online app, the website or simply make a phone call. A staff member takes information about the person’s symptoms and determines if a house call is the appropriate method of treatment.

Anyone with an emergency is urged to call 9-1-1. Otherwise, the staff member schedules an appointment and sends the care team to the patient’s home. A mobile unit arrives with everything available at a traditional urgent care center.

DispatchHealth, a Denver-based company, offers in-home services in 10 markets across eight states. Florida is not one of those states, but according to its website,  the company is “coming soon” to Tampa.

It accepts most forms of insurance and says those with private insurance plans can expect to pay about $50 per visit. For those without insurance, services are available for a flat fee of $275.

DispatchHealth spokeswoman Andrea Pearson confirmed that the company will begin offering services to Tampa in 2020 but did not provide further details.

She said the house call services are “ideal for seniors and people who have frequent needs for acute medical care” as well as for those “who think the emergency room is their only option.”

The new doctor’s offices on wheels are getting the attention of more than just potential patients. A four-year-old tech startup called Heal has raised more than $75 million in venture capital and is backed by celebrity investors such as Lionel Richie and former Florida Gov. Jeb Bush. Unlike Dispatch Health, which defines its role as an urgent care partner with established health care providers, Heal also provides preventive and primary care.

“It’s a concept for health care that is so simple, so cost-effective and so personal,” Richie told CNBC. “Patients love the individualized attention. Doctors love the fact they can practice medicine without all the administrative paperwork and expense of operating an office or clinic.”

Bush, who also sits on the Heal’s board, said the company, which now serves nine metro areas, told the network that he sees Heal eventually going national.

“There are managed-care companies interested in partnering with Heal, and doctors love it,” he said. “But scaling services in each market will take time.”

Even the federal government has gotten in on the act. A pilot project that was approved along with the Affordable Care Act incentivizes house calls for chronically ill Medicare patients in an attempt to keep them out of emergency rooms and lower health care costs.

The Independence at Home program reported a total savings of $24.7 million during the first three years, which included 10,000 patients in 15 locations.

According to the Center for Medicare and Medicaid, statistics from the fifth year in 2017 found that costs were reduced by an average of $2,711 per patient, about 8.4 percent below target expenditures.

In 2018, Congress extended the program until the end of 2020.

“Home-based primary care allows health care providers to spend more time with their patients, perform assessments in a patient’s home, and assume greater accountability for all aspects of the patient’s care,” according to Medicare officials.

“This focus on timely and appropriate care is designed to improve overall quality of care and quality of life for patients served while lowering health care costs by forestalling the need for care in institutional settings.”

Doctors Without Borders

March 8th, 2020

When much of the area in and around Managua, Nicaragua was destroyed by an earthquake in December 1972, humanitarians from all over the world pitched in to help the Central American country recover.

Among them were legendary baseball player Roberto Clemente and a team of volunteers, all of whom perished when the cargo airplane they were flying in crashed on New Year’s Eve 1972.

Also coming to the aid of Nicaraguans in the wake of that disaster was a fledgling organization known as Doctors Without Borders, which faced its first test as a relief agency during the Nicaraguan tragedy.

What, precisely, is Doctors Without Borders? It is an independent humanitarian non-government agency that provides various forms of medical assistance throughout the world.

Internationally, it is known as Medicines Sans Frontiers (MSF), for it was founded in Paris, France in December 1971 by a group of journalists and physicians who were of the belief that much international aid was obstructed by legal barriers and was also medically inadequate.

The simplest definition of the organization comes from a MSF promotional video: “Doctors Without Borders…provides aid to people whose survival is threatened by violence, neglect, or catastrophe, primarily due to armed conflict, epidemics, malnutrition, exclusion from health care, or natural disasters.”

In 2009, MSF was awarded the Nobel Prize for Peace. Accepting the award was MSF’s then President of International Council, Dr. James Orbinski, a Canadian physician and one of the many doctors, surgeons, and nurses who mostly comprise the medical sector of MSF.

MSF receives approximately three million dollars in fiscal assistance each year. More than 80 percent of those funds are used to finance MSF programs. The remainder goes to administrative, management, and fundraising duties and responsibilities.

More than 23,000 people work in all sorts of vocations for MSF, which has approximately 3,000 paid employees and 20,000 volunteers working across the globe.

Five of the 24 MSF offices are referred to by MSF officials as Operational Centers, or OCs, and all five are located on the European continent in Amsterdam, Barcelona, Brussels, Geneva and Paris.

Other MSF bureaus can be found in Toronto, Canada; New Delhi, India;  Rio de Janiero, Brazil; Dubai, United Arab Emirates and Taipei, Taiwan, which is the site of the first office on the Asian continent.

Interestingly, although MSF exists does work in more than 70 countries, the United States is not one of them. The reason for this is, according to the Doctors Without Borders website, is that “there are other organizations with experience serving these populations that are better placed to address these challenges.”

MSF employees and volunteers are independent of any political ideology and only once in the organization’s history – during the 1994 genocide between the Hutus and Tutsis in Rwanda – have its workers asked for military intervention.

Some of the more recent examples of MSF’s work include providing medical care for those affected by the outbreak of Ebola in the Democratic Republic of Congo earlier this year; the admittance of more than 50 people to a hospital in Yemen after they were injured while publicly demonstrating against various governmental policies in that country, and the providing of various psychotherapy services to people living with extreme pressures north of the West Bank.
Much of the world’s populace continues to have problems but MSF’s work to help people cope with their problems continues as the organization seeks to provide independent, neutral and impartial medical aid where it’s needed.

COVID-19: An Update

February 14th, 2020

The spread of the novel coronavirus, recently named COVID-19, which originated in the Chinese city of Wuhan, continues to dominate the news, and with good reason. As of Tuesday, February 11, the death toll from this virus topped 1,100.

(Krysten I. Houk/U.S. Department of Health and Human Services via AP, File)

FILE – This Wednesday, Feb. 5, 2020, file photo provided by the U.S. Department of Health and Human Services shows evacuees from China arriving at Marine Corps Air Station in Miramar, Calif. An evacuee from China has tested positive for the coronavirus and has been isolated at a San Diego hospital, a person with direct knowledge of the matter tells The Associated Press, Monday, Feb. 10, 2020.

That exceeds the death toll from the Severe Acute Respiratory Syndrome, or SARS, epidemic of 2003. During that epidemic, 8,000 people in China were infected by the virus and nearly 800 people died.

According to The World Health Organization (WHO), there are currently more than 45,000 confirmed cases of COVID-19 infection in China alone. There are another 395 confirmed cases of infection in 24 other countries including the United States.

In fact, the total number of cases in the US rose to 13 when an evacuee transported from China to California was diagnosed with COVID-19 on Monday, February 10. This person left Wuhan on a State Department-chartered flight that carried 167 people from China to Marine Corps Air Station Miramar in Sand Diego on Wednesday, February 3.

Initially, four of the Wuhan evacuees were hospitalized when they showed signs of the pneumonia-like illness caused by COVID-19. These signs include cough, fever and shortness of breath. The four individuals were isolated in “negative pressure” rooms that prevented the inside air from escaping and spreading the virus. Fortunately, only one of the four ended up positive for COVID-19. It was the seventh confirmed case of the virus in California

Hundreds of other people were evacuated from China to other military bases in California, Texas and Nebraska. Five people who went to Travis Air Force Base between San Francisco and Sacramento were taken to the hospital when they showed symptoms of illness, but none of them tested positive for the virus.

Elsewhere, about 200 people who were sent to March Reserve Air Base in Southern California were scheduled to be released from a two-week quarantine. And no symptoms were reported among evacuees taken to Lackland Air Force Base in San Antonio or Nebraska’s National Guard training base in Omaha.

In addition, at least 24 Americans are among the 135 people infected with COVID-19 aboard a cruise ship stranded in Japan.  More than 3,000 people are stuck on that ship, which became a floating quarantine zone after dozens of people tested positive for the virus. Currently, non-infected passengers are permitted to briefly leave their cabins to get fresh air, but they must wear masks and stay one meter away from each other.

Fortunately, there are some positive steps being taken to combat the COVID-19 outbreak. In China, Suzhou-based BrightGene Bio-Medical Technology announced that is has begun mass-producing an experimental drug from Gilead Sciences called remdesivir to battle the highly infectious COVID-19.

BrightGene said it must license the patent for remdesivir from Gilead Sciences, conduct clinical trials and get regulatory approval before it can put the drug on the market. Gilead Sciences invented the drug and patented it in China for use on coronaviruses. The company is working with Chinese, US and WHO officials to determine whether it can be used with COVID-19.

In addition, WHO officials announced that a vaccine against COVID-19 could be ready in 18 months. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, reported that early testing of the vaccine will likely begin in April. In the meantime, countries will have to use what resources they have to fight the virus.

For us, the best way to battle COVID-19, or any virus, is to take pre-emptive steps to prevent contracting and spreading it. To stay healthy, try following these tips:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Cover your cough and sneeze with a tissue, then throw out the tissue.
  • Regularly clean and disinfect frequently touched objects and surfaces.
  • Stay at home when you are sick.
  • Wash your hands often with soap and water, especially after going to the bathroom, before eating and after blowing your nose, coughing and sneezing

Fortunately, it’s unlikely you will become infected with COVID-19 unless you recently traveled to China, particularly Wuhan, or are in close contact with someone else who has. But if we all take steps to prevent and detect this virus, maybe we can keep the infection rate in the US from skyrocketing.

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