What is the best age to transition a young adult with a chronic illness into the adult healthcare system?

   As you know transition of persons with complex chronic medical conditions is dear to my heart.  I can remember like it was yesterday one of my young adult patients lay lifeless in the local ER who we we unable to transition into an adult sickle cell program.  From that point, I always asked myself -what went wrong?  Why wasn't he able to articulate with the ER staff information about his condition and to call Marian Anderson Comprehensive Sickle Cell Center for the doctors to obtain specialty recommendations for providing care for crisis in other complications in the ER.  Also,these outcomes were around the time when the New England Journal, 1995 published research findings on Hydroxyurea. Studies found that sickle cell crisis and acute chest were cut in half and became a game changer in the mid-nineties for sickle cell population.  Moreover, Philadelphia, PA and Atlanta, GA both have Comprehensive Adult Sickle Cell programs.  

I truly believe more research and public policy initiatives (Delaware Complex Chronic Disease Task Force) need to be launched as these tender-aged young adults need intensive wrap around services as they continue to grow and mature.  The other probing question is, What is the best age to transition?  I would say around 25-26 years of age.  I know the pediatric community/hematologists probably disagree.  Butt children's brains are not fully developed until 25 years of age.  So why do we expect them to act like adults?  All the best, Dr. Nina

TOVA Health

Primary Specialty Care

213 Greenhill Ave

Wilmington, DE 19805

(302) 429-5870 ext. 120

www.tovacommunityhealth.org

Combating the Opioid/Pain Killer Epidemic: It’s All About Harm Reduction

The Veterans Administration (VA) study is a game changer by making providers more accountable for treating persons with acute and chronic pain. Yes, this is a hard sell to patients! But, I have been somewhat successful in reducing the amount and dosage of opioids used for persons with sickle cell anemia and other chronic pain disorders. Explaining that long-term use of opioids can sometimes make chronic pain worse is not easy. Opioid Induced Hyper-Analgesia means that pain receptors in the brain have a hyperexcited response to painful stimuli from the opioids. Working with a doctor with expertise in treating chronic pain and Opioid Misuse is important. Slowly weaning down the meds takes time and is best done when working with a team of providers such as a physical therapist, mental health providers and etc. Fear and anxiety of withdrawal are a normal response that can be overcome with support and working with your doctor to put together a treatment plan. Most patients who follow through actually report less mood swings, feel better and have improved overall health. Again, it’s all about Harm Reduction.

TOVA

213 Greenhill Ave.

Wilmington, DE 19805

302-429-5870 ext. 120

www.tovacommunityhealth.org

Planting the seeds for a Healthy West Center City Community in Wilmington, DE.

TOVA envisions the investment from the City of Wilmington in a Neighborhood Medical Home.

Support this initiative to improve the health a community in desperate need of an Integrative Health Community-Based Model.

Did you know 60% of youth who live in the West Center City Neighborhood do not graduate from High School. 








TOVA Community Health
213 Greenhill Ave.
Wilmington, DE 19805
(302) 429-5870-p
(302) 429-9285-f
www.tovacommunityhealth.org

TOVA examines the role of Geography on transitioning children with sickle cell into adult programs at the ACCEL symposium. What is the best age to transition?

   As you know transition of persons with complex chronic medical conditions is dear to my heart.  I can remember like it was yesterday one of my young adult patients lay lifeless in the local ER who we we unable to transition into an adult sickle cell program.  From that point, I always asked myself -what went wrong?  Why wasn't he able to articulate with the ER staff information about his condition and to call Marian Anderson Comprehensive Sickle Cell Center for the doctors to obtain specialty recommendations for providing care for crisis in other complications in the ER.  Also,these outcomes were around the time when the New England Journal, 1995 published research findings on Hydroxyurea. Studies found that sickle cell crisis and acute chest were cut in half and became a game changer in the mid-nineties for sickle cell population.  Moreover, Philadelphia, PA and Atlanta, GA both have Comprehensive Adult Sickle Cell programs.  

I truly believe more research and public policy initiatives (Delaware Complex Chronic Disease Task Force) need to be launched as these tender-aged young adults need intensive wrap around services as they continue to grow and mature.  The other probing question is, What is the best age to transition?  I would say around 25-26 years of age.  I know the pediatric community/hematologists probably disagree.  Butt children's brains are not fully developed until 25 years of age.  So why do we expect them to act like adults?  All the best, Dr. Nina

TOVA Health

Primary Specialty Care

213 Greenhill Ave

Wilmington, DE 19805

(302) 429-5870 ext. 120

www.tovacommunityhealth.org

Did you know 1 in 10,000 Caucasians carry the Sickle Cell Trait?

Get Screened for Sickle Cell Trait

TOVA 

Primary Specialty Care

213 Greenhill Ave.

Wilmington, DE 19805

www.tovacommunityhealth.org

Happy Woman Week: Paying Deference to a phenomenal Psychologist

I  sent to me in a personal message from a phenomenal Psychologist, Dr. Renee Robinson. I worked with her at the Marian Anderson Sickle Cell program at St. Christopher‘s Hospital. I am also not ashamed to admit also getting free Therapy Counseling Sessions as well. Dr. Robinson has followed my career & struggles trying desperatively improve sickle cell awareness. Trying to set a Benchmark for quality of care for the adults in Delaware has been a serious struggle experiencing racism, sexism & other ‘isms’ along the way........ Much respect to one of my Counselors & Mentors. Best, Dr. Nina

 

“I look at you and I am very proud of you! After so many battles faced some lost, defeated others, I believe you are a warrior. You are standing there and with great faith, no one will bring you down because God is the one who sustains you, my warrior friend! HAPPY WOMAN WEEK! Send to the warrior women you admire!” Dr. Renee Robinson

Make a Donation to help support the Sickle Cell Treatment Center

TOVA Community Health

213 Greenhill Ave.

Wilmington, DE19805

302-429-5870 ext. 120

www.tovacommunityhealth.org

Delaware State University Alumnae & Sickle Cell Warrior attends the Healthy Hornets Health Fair

Delaware State Health Hornets Health Fair was held at the MLK Center in Dover, DE this week.  I want to thank Sickle Cell Warrior and DSU Alumnae Leslie Evans-Johnson for attending on behalf of the TOVA Sickle Cell Specialty Center.  Leslie has surmounted many obstacles and suffered many problems from her sickle cell.  Despite her health challenges, Leslie  graduated from DSU with a BA in Education after having to leave college due to the local hospital not having hematologist with the expertise to care for her sickle cell.  Leslie taught in the Delaware public school system for over 30 years as an elementary school teacher and recently retired. She now enjoys spending time with her family, her first grand-daughter and volunteering for her church and TOVA.

TOVA

Primary Specialty Care

www.tovacommunityhealth.org