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

Thomas J. Loveless, MSN, CRNP, PhD graduated from Thomas Jefferson University College of Nursing in 2002, where he completed his BSN and MSN. He completed his post-masters in Nursing Education and Curriculum design from Thomas Jefferson University College of Nursing in 2006.

He completed his PhD in Nursing from the University of Wisconsin-Milwaukee in 2013.

He is Board Certified as an Adult Primary Care Nurse Practitioner through the American Academy of Nurse Practitioners and has recently been certified by the American Academy of HIV Medicine as a HIV Specialist.

Dr. Loveless has an active practice in caring for and counseling HIV & AIDS patients and those with Sexually Transmitted Diseases.

Happy Spring Everyone

Good riddance to the snow and ice - It’s Spring-Cleaning Time

I think it’s the perfect time to share some exciting initiatives underway at IDA.

First, I think you’ll find this interesting.  I recently attended a medical conference at Drexel University in Philadelphia.  It was “Philadelphia’s 2nd Anal Health Symposium - “Making Your Bottom a Top Priority.” There were nearly 200 attendees.  The keynote speaker – Dr Michael M. Gaisa, MD, PhD, traveled from Mount Sinai Hospital, where he delivered a staggering presentation. The statistics of missed anal cancer was more than just scary and the risks of getting anal cancer even scarier. And when I left, I worried about several things – for example, are we doing enough? Here is why.  Human papillomavirus (HPV) is the commonest sexually transmitted infection, and the resultant diseases have significant morbidity and mortality and this is where anal cancers come from.

Without a doubt, the incidences of anal cancer are on the rise among HIV-infected men who have sex with men (MSM).  Did you also know that HIV-infected MSM are reported in the literature to have the highest rates of anal dysplasia (skin changes that suggests cancer may be hiding) and anal cancer, when compared to other groups?  Studies from across the globe continue to suggest raising awareness is key to wellness and making sure that certain cases of anal cancer are not overlooked.   In one study from Miami, it was also discovered that most participants had never heard of anal cancer. Men reported lack of awareness and recommendations from their health care professionals as the greatest barriers to screening. Partly because there is no standard protocol in place to screen for anal dysplasia in this high-risk group. There are no real guidelines to launch a program.

Do not be fooled into thinking it is just the HIV positive MSM population though. HIV-negative MSM, HIV-positive women and heterosexual men and women with a history of cervical cancer can get anal cancer too. It comes down to the HPV virus.  HPV has been detected in over 90% of anal cancers. However, there are a few strains of HPV. HPV16 is the most common genotype detected in about 70% of anal cancers.

That is why you can rest assure, on our own, we have taken the initiative for practice improvement here at IDA, and  have embarked on raising awareness! We are having candid and honest discussions with our patients about their risk profile for anal cancer, and making certain that any patient at risk, who is interested in anal cancer screening, can have this done is our office. We are here to help!  It’s simple, painless, and quick! it’s called an anal PAP.  Our goal:  improved surveillance, improved anal PAPS, and treatment of precancerous lesions, decreasing morbidity and mortality. What could be easier?

Aside from the actual anal PAP screening, one other counterpart to this initiative, is making certain that anyone who meets the criteria for vaccination, receives this vaccination.   If there is no hiccup from your insurance company, we’d like to make certain you are vaccinated. Given the heavy disease burden of cervical and anal cancer, prophylactic HPV vaccines were developed to target the most common high-risk and low-risk HPV genotypes.  We carry this vaccine in our office.  It’s called Gardacil (human papillomavirus 9-valent vaccine (recombinant) 9vHPV).  

So be sure to take advantage of this 2-part initiative: an anal PAP, and proper vaccination to avoid HPV.

Here’s another initiative. By now, many folks have heard about Pre-exposure prophylaxis (PrEP).  We are happy to report many folks are wise and eager to stay protected.   PrEP is an effective tool in preventing HIV infection among high risk MSM, and our discordant (where one person is HIV-positive, and one is HIV-negative) couples with men and woman, and our transgender patients too.  Considerations are open to discussion about on-demand Prep compared to daily PrEP.  And the most important message to hear is that PrEP is here, and we are here to help you!  No matter which you believe is better for you, a comprehensive HIV preventative package could improve prevention efforts for those wanting PrEP. All you must do is ask.

Next – Medical Marijuana- have you learned about this? My colleague, Dr William Pace has been keeping very busy with our medical marijuana initiative.  Of course, you remember, the Commonwealth of Pennsylvania has listed HIV as a certifiable diagnosis for legal medical marijuana.  He is committed to making certain that those folks asking for help, get it.  Medical marijuana continues to gain acceptance.  Two cannabinoids seem the most clinically relevant: Δ9-tetrahydrocannabinol (THC), which tends to produce the psychotropic effects commonly associated with marijuana, and cannabidiol (CBD), which may produce therapeutic effects without appreciable psychoactive properties. This is a learning curve for all of us – but most important is that we have made sure to be ahead of the curve and offer services to our patients that say – we care and we’re always on the lookout for what is best for our patients.  Preliminary studies have suggested that medical marijuana and related cannabinoids may be beneficial in treating people with chronic pain, inflammation, spasticity, and of course, HIV.  Of course, we must be responsible, and educated about medical marijuana, and not be tricked into thinking, it has no risk.  Medical marijuana can produce untoward effects on cognition, coordination, balance, and cardiovascular and pulmonary function.  It is up to you! However, we all need to be vigilant for any problems that may arise if our patients are using cannabinoids, while living with HIV.

I am excited to remind you about our relationship with Family Services of Bucks County.   They remain our good friends.  They are as committed to our HIV patients, as we are.  So much so – they will again have a Medical Case Manager at our practice – just in case!  In case, someone needs help with insurance, the Special Pharmaceutical Benefit Program (SPBP), and a host of other issues.  They are committed to helping folks having issues with not only HIV.  They cast a wide web of help.  Many folks struggle with substance abuse, need housing, or some good ole’ fashion hand-holding.   Your quality of life means the world to us, and them.  That is why we are committed to this interdisciplinary team approach to enhance all things social and psychological coupled with medical.  We are all here to serve you – don’t be afraid to ask for help.

I’d be remiss, if I did not remind you about Tick Season. Yep – those nasty creepy-crawly little monsters have awakened and they’ll be awake until at least October.  It is fascinating how much damage that teeny-sized critter can cause.  Lyme is indeed, a very real problem.  Lyme disease is the most common tick-borne illness in the United States, and Bucks County is in the heart of this nasty web. The growing deer and Ixodes species tick populations in our very neighborhood, underscores the importance of us in reminding you to properly recognize and treat Lyme disease.  Do not hesitate if you think you have been bitten by a tick.  We are a phone call away.   

Beware - recently, there has been considerable interest on the topic of fake news. For our infectious diseases group here, false and misleading information about the diagnosis and treatment of Lyme disease, is not new.  But it is increasing in frequency and prominence, creating so much confusion among primary care physicians, their patients and us – that all our heads are spinning. The confusion comes from labs test that are simply not 100% reliable, and the symptoms of Lyme are like syphilis – the Great Masquerader.  In fact, some experts espouse the viewpoint that the validity of 2-tier testing is “no better than that of a coin toss”.  I have an interesting commentary from The American Journal of Medicine - available to you – just ask on your next visit.  It is called “False and Misleading Information About Lyme Disease”. 

Here is the bottom line.  No one is saying it is not real.  We’re just saying - please come see us – and we’ll talk.  We’ll educate you from an infectious diseases’ perspective – not some fake, new hype.  In the meantime, protect yourself.  Use a chemical repellent with DEET, permethrin or picaridin.  Wear light colored clothes.  Tuck your pants into your socks.  As much as possible – avoid tick infected areas.  If you do go out – do daily inspections!

Summer is the time for Fun, Relaxation and Vacations! We also have a Travel Medicine Clinic to help you with the vaccinations you need before traveling to all parts of the globe. We have written materials for our LGBTI folks to provide important information covering your travel needs. There is currently a world-wide Measles outbreak. CDC is recommending the MMR vaccination to anyone who will either be traveling by plane or just going to an airport. Measles is the most easily transmittable respiratory virus known to man!

Finally – meet Teddy.

I like to call Teddy Our Zen Friend.   Until you have met the most adorable furry little long-haired stress-reducer – you haven’t smiled.   All one needs to do is stare into his big loving eyes and say, “Hi Teddy.”
His tail wags, the excitement is obvious, and you’ll forget all your woes.  He is our perfect mascot – and he has an uncanny way of suddenly being at your feet.  And suddenly – your worries are not so important. In fact, they disappear!  And of course, if he gets a simple treat – magic happens.

Okay folks – I think this has lots of sharing to get the spring and summer started.  Don’t forget about the importance of keeping regularly scheduled appointments.  If life gets in the way – please, please – call us and cancel your appointment. 

Never forget – we’re here for you – we’re just a phone call away.   .   .  Call us at 215-355-9634!

Dr. Thomas J. Loveless

Advance Notice: Dr. Loveless will be changing his hours after Labor Day.

His Tuesday morning and afternoon hours will be moving to Friday.