Dr. Loveless will be writing a monthly article on various topics in Infectious Disease.
We hope you find Our Blog, not only interesting, but informative.


Dr. Loveless

Thomas J. Loveless, MSN, CRNA, PhD graduated from Helene Fuld Nursing School and completed his BSN at Mercy County Community College in 1995.

He completed his MSN at Thomas Jefferson University in 2002 and his PhD from the University of Wisconsin in 2013.


He has an active practice in caring for and counseling HIV patients.


  

Hello Everyone – I am excited to share this Spring Welcome Blog

As we all look forward to spring without another Nor’easter and eventually summer. these reminders are apropos. Spring is the perfect time for “Spring Cleaning” as the saying goes, and to take this opportunity to talk about important reminders and tips certain to help you stay well, while also looking forward to your spring and summer.  Let’s start a spring inventory for enjoying this year’s spring and summer.

You may remember that last year, at the same time, I offered spring cleaning ideas.  This year’s blog mirrors some of the same ideas that really are meaningful to your wellness.  So let this year’s spring cleaning prompt some thinking for you and encourage you to think about your health maintenance-control, your wellness and remind you to schedule your visit with us. We hope that you have exciting stories of wellness to share with us, since we last saw you.


So, moving on - this is also the perfect time to share some recent changes and important state and federal regulations, to which we now must adhere. Yes, Big Brother is always watching, not quite the fictional character from Orwell’s 1984 novel, but a good analogy, just the same. In December. we blogged about engagement, how health care is constantly changing, and our shared responsibilities for your wellness.  And now too, there gave been more recent changes that you should be aware of, to encourage you to stay engaged.

Here are some important things to consider.

First, all of your medical providers are expected to adhere to 049 Pennsylvania code 16.92 when prescribing, dispensing and administering drugs. What this means to you:  as responsible providers there is nothing more important to us then your absolute wellness and providing the best quality care so you have the best quality of life. In Latin we say “Primum non nocere” - First, do no harm.  In keeping that pledge, we have many rules to follow, which is why I am updating you about it here.

The 049 Pennsylvania code 16.92 essentially directs that as medical providers, we implement and uphold schedules that meet the regulations of the Commonwealth, while at the same time, we keep our promise of expert passionate care for you. This means making certain that you maintain perfect daily adherence with your medications and, just as important, that you see us on a regular schedule. That’s what 049 Pennsylvania code 16.92 is really all about.

But here’s the most important tip,  keeping current with your medications also means we must see and examine you on a regular basis. We determine the frequency that we see patients based on many factors but generally speaking we see patients every 3 or 4 months. In some cases we may see a patient every 6 months, which is more of an exception than a rule. Regardless of what surveillance schedule you are on, the most important message is that you keep that schedule.

Here’s another reason we must see you regularly. If you happen to live with HIV for example, you know how important your labs are in indicating how well you are and how precisely whether and how well the drugs are working. But, just as important, is making certain that the very drugs used to control HIV are not putting too much stress on your kidneys or liver. So in keeping with the state and federal regulation that requires we maintain regular visits and lab surveillance, and keeping our promise and commitment to your wellness and not causing harm, we must make certain that all of us, which means you too, meet these obligations, we have regularly scheduled surveillance labs, and we see you as scheduled.

As you can imagine not seeing you as scheduled puts you at great risks. Big Brother thinks this as well, which is why the Commonwealth is making certain we uphold current state regulations and follow the laws that mandate that we see you regularly and not prescribe anything if we have not seen you.  This is the sticky point, prescribing drugs when not being seen regularly.

So, the moral of the story, please respect the schedule you are on and see us as required. We simply will not prescribe drugs for patients we have not seen - no matter what. We understand emergencies do happen, and we can work around emergencies, but for example, sox months should never go by when we have not seen you. When we see you next, let’s talk more about your appointment, labs and check-up schedule.

Onto some more spring tips:

The risk of transmission of vector borne (example- mosquitos) and zoonotic pathogens (infectious diseases that are spread between animals and people) are real.  Add to that, there are many tick borne illness far more than just Lyme.  Did you know the ticks that cause Lyme disease are looking forward to spring and summer too? Did you also know that ticks do not die off during the winter months? To survive the cold and snow, most ticks find shelter in leaf litter and are dormant until spring. Some ticks remain active year round. You or your pet could pick up a hitchhiker anytime the air temperature is close to freezing or above and the ground isn’t frozen or snow covered. In freezing weather, deer ticks hunker down under the snow in leaf litter, on firewood or a tree trunk, and come out during warm spells.  So now that spring is just around the corner, we anticipate strolls in the parks, and walks with your dogs – and if so - what are your plans for staying safe on those spring walks in Tyler State Park or Penny Pack Park?  We know for a fact that each year, approximately 30,000 cases of Lyme disease are reported to CDC.  Let’s make sure you are not one of the next cases.  One tip: Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours. When we see you next – let’s talk more about ticks.


And some more tips:


Women’s Health Maintenance: Ladies first! A million dollar question: how well are you doing with your women’s health maintenance. You do realize, of course, your PAP surveillance is critical. And if you happen to live with HIV it is very important to have regular GYN visits and tests for cervical cancer. The US Centers for Disease Control and Prevention (CDC) recommends that women living with HIV should have a complete gynecological examination, including a cervical screening test and a pelvic exam, when they are first diagnosed, and then another test six months later.  If both tests are normal, a repeat cervical screening test should be done every year.  Are you on schedule? When we see you next – let’s talk more about your woman’s health maintenance.


Age Appropriate Health Screenings: Ladies and gentlemen, are you age 50 or older? Did you have your screening colonoscopy? When we see you next: let’s talk more age appropriate screenings, and the varied things that you should be taking care of.


Safe Travel Tips: Does anyone have plans to vacation to lands far far away?  If so, make a point of talking to us about potential travel related risks, and where you can get vaccinated if you are traveling to lands where epidemics are problematic.  Just ask and we’ll guide you in the best plan to protect yourself while traveling. For example, did you know that malaria still exist and killed 445,000 people in 2016, mostly children. How about this, about half of the world’s population is now at risks for dengue- a debilitating viral disease of the tropics, transmitted by mosquitoes, and causing sudden fever and acute pains in the joints.. And here’s a frightening reality, the first indigenous outbreak of chikungunya, an illness caused by a virus that spreads through mosquito bites in the Americas, began in 2013.   Just remember there are microscopic critters all over the world responsible for a host of infections. Worse yet, these little invisible critters are sci-fi little critters capable of demonstrating resistance to even the most powerful drugs.  Ponder this, the first ever case of sexually transmitted Kika infection in Los Angeles County is a perfect reminder that the sexual transmission of a virus like Zika – even though it’s quite rare, it is not impossible.  We do know however that Zika virus caused more birth defects in the United States than expected.  So for us to care for you, we need to expect the unexpected.  Especially where international travel is up for consideration.  When we see you next – let’s talk more about potential travel and the risks of traveling to lands far away.


And just a few more general tips:

  1. Let’s be sure to inventory your adult suggested vaccinations - When we see you next – let’s talk more about vaccinations.
  2. Let’s be sure to talk about any new diagnosis you may have received from any other medical provider.  We need a full picture of your wellness, even if we are not the ones treating you.  So, when we see you next – let’s talk more about updated medical diagnosis – surgeries – treatments – medications – anything new form other medical providers.
  3. Let’s be sure to talk about PrEP, and the appropriate use of PrEP if this is applicable. I’ve blogged about PrEP before, and I am happy to share we have done very well in protecting many folks – your loved ones.  We believe strongly that PrEP is a wise idea, and wise way to prevent HIV transmission. When we see you next – let’s talk more about PrEP.

Last Tips for Spring:

I’m sure you realize this blog is certainly not exhaustive, but cover some important things that come to mind as spring approaches.    If you have ideas – share them too!
So for March – I’ve provided much to ponder.  There are many celebrations coming soon – St Patty’s Day for the Irish at heart - Passover -Good Friday- Palm Sunday – Easter Sunday. 
There’s even wacky days like: If Pets Had Thumbs Day (March 3rd), Learn About Butterflies Day (March 14th); International Earth Day (March 20th); Credit Card Reduction Day (March 21st); I love this one - National Puppy Day (March 23rd); I’m in Control Day (March 30th);  National Doctors Day (March 30th); and finally – Take a Walk in the Park Day (March 30th). 
And if you’re wondering where these March ideas come from – enjoy this site: http://holidayinsights.com/moreholidays/march.htm
Until Next Time.  We wish you continued wellness – happiness, and the best laid plans for maintaining your health.

Sincerely,

 

Thomas J. Loveless, MSN, CRNP, Ph.D