Friday, March 30, 2018

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

Tuesday, March 13, 2018

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

Saturday, March 10, 2018

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


Sunday, February 25, 2018

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
                                                                                        
                                                               


Saturday, February 24, 2018

Pre-Pregnancy Screening for Sickle Cell Trait... That is the Question?

        To Screen or Not To Screen...That Is The Question?

It was easy to say that I would get screened for Sickle Cell Trait, until I actually scheduled the appointment only to find myself contemplating the cancellation of that appointment. This was the case when I started interning for Tova Community Health Sickle Cell Specialty Center. More concerned for the results than the hemoglobin electrophoresis required to screen my blood, I found myself reluctant to schedule the appointment. However, if I remained ignorant of my own status, I couldn’t advocate for others or express to the community the importance of having self-awareness. Prior to the appointment, I contacted Delaware Newborn Screening to learn if I had already been tested for Sickle Cell Trait considering the administration of this test began in the early 90’s. Unfortunately, no record could confirm this test had been conducted as I was born when the program first originated.
          Following the receipt of news that a blood sample had not been collected, the apprehension began to increase. I questioned whether the result was truly necessary information and if I had lived for so long without knowing my status, what was the point of discovering such information now. Dr. Anderson proceeded to explain that as someone who is very active in the gym, it is pertinent to be aware of my status as over-exertion combined with dehydration could trigger an acute crisis (episode of excruciating pain). After acquiring this information, I finally scheduled the appointment, which was quite painless. The phlebotomist drew a sample of my blood to be sent to the lab for a hemoglobin electrophoresis, which evaluates the different types of hemoglobin in the blood. The test had been conducted and the waiting period commenced. The waiting game was probably the worst part of the entire process because during this time I deliberated all of the “what if” scenarios. A few prolonged days passed and the results arrived providing a sigh of relief.
          Once I received my results, I felt more self-aware and more empowered that I had chosen to be in control of my health. I had chosen to live a healthier lifestyle and live free from fear of the unknown. During this experience I learned that when it comes to my health surprises can be avoidable. In order to prevent an occurrence, I must remain scrupulously conscious of my health and should anything arise, immediately take action.

Paris Davis, Tova Scholars Intern

TOVA Community Health, Inc,.
www.tovacommunityhealth.org