HPC providers partner with patients to manage chronic diseases.

By Catherine Rice, Vice President of Marketing/Outreach

Chronic Disease

Chronic DiseasesAbout 24 percent of our medical patients at Health Partnership Clinic have one or more chronic diseases such as diabetes, depression and hypertension. Our providers and support staff partner with these patients to help manage their disease to ensure optimal outcomes.

This month, Family Nurse Practitioner Maureen Caro, FNP-BC, shares important insights about what chronic disease is and how the clinic approaches chronic disease management.

To learn more, click here.

Here at Health Partnership, we are dedicated in managing acute and chronic diseases to help patients live happier, healthier lives and save healthcare dollars.

Chronic Diseases Chronic Diseases

When it comes to the flu… Don’t guess. Test!

Sharon TrongaardBy Sharon Trongaard, RRT, MS, MPH, Clinic Director/Risk & Compliance Officer and Respiratory Therapist at Health Partnership Clinic

As we head into Fall, colds and the flu will return, joining COVID-19 as illnesses that can cause severe illness and keep you from doing the things you enjoy with others.

According to the Center for Disease Control and Prevention (CDC) many of the symptoms of the common cold, flu and COVID-19 overlap, so it may be difficult to determine what you have. In medicine, our moto is Don’t Guess, Test!  There are rapid and laboratory testing available for both flu and COVID-19, and HPC offers flu and COVID-19 testing at all of our clinic locations. It’s best to call the clinic so that we can offer the safest way to complete testing. We offer both walk in and drive-up testing.

Vaccination

The great news is that you can dramatically lower your risk of getting the flu and COVID-19 by getting vaccinated. Flu vaccines are 40-60 percent effective, and COVID-19 vaccines are 70-95 percent effective in preventing transmission and illness.

Flu vaccination is recommended for children and adults six months of age and older. COVID -19 vaccination is recommended for children and adults 12 years of age and older. If you do still get the flu or COVID-19 after vaccination, you are less likely to get very sick or die. Getting vaccinated against flu and COVID-19 also helps protect the people around you who are at high risk, such as older adults, people with medical conditions and pregnant women.

COVID-19 and flu vaccination are offered at HPC, contact us at 913-648-2266 to schedule your vaccination.

Flu: Don't guess. Test.Flu infection rates were dramatically low during the 2020-2021 season, even though the number of tests that were done was high. Scientists at the CDC believe this is due to the measures put in place for COVID-19, such as hand washing, physical distancing, school and other closures, increased ventilation in closed spaces, staying home and wearing masks. These same practices can lower your chance of getting a cold, the flu and COVID-19.

Here are some simple healthy habits you can follow to lower your chance of getting a cold, flu or COVID-19:

  • Stay home if you are sick.
  • Isolate from others in your home as much as possible.
  • Cover your face with a cloth or other mask when you are unable to maintain a safe physical distance from others (at least six feet) especially when inside.
  • Wash your hands (this is best) or use a hand sanitizer that is at least 70 percent alcohol after touching hard surfaces or other people, before eating, and after using the restroom.
  • Avoid touching your mouth, nose and eyes as it is easier for viruses to spread this way.
  • Clean the hard surfaces in your home frequently, especially countertops, door handles and tables.
  • Keep your immune system in great shape by eating a plant rich diet, exercising regularly and getting enough sleep.

References:

https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm

https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/keythingstoknow.html

https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm

Breaking the Stigma: Know the HIV facts and communicate.

Maureen CaroBy Maureen Caro, FNP-BC, Family Nurse Practitioner at Health Partnership Clinic

HIV (human immunodeficiency virus) care is a subject near and dear to my heart. I was born in the 1980s, and the history of this illness interweaves with my life. I decided to become a nurse in the early 2000s when anti-retroviral therapy was still very new. My final paper for undergrad discussed how to handle the first diagnosis of HIV in a family. HIV stigma is extremely real and affects how people will trust you to provide their care.

Silence Kills

As a provider, you must be very sensitive to cultural issues while also impressing on people how life-changing therapy is for this illness. Many people still think of HIV/AIDS as the death sentence that it was in my childhood. Many others have incorrect ideas of their own levels of risk. Everyone on earth is at risk for this illness, in one way or another. The only way that we can control this illness is by discussing it honestly. Silence literally kills.

First, we need to discuss particular people at risk.

HIV FactsEthnicity, sexual orientation, gender identity—all of these conspire to make certain populations at risk. I was shocked to find that there is a 50 percent lifetime risk of HIV of black men who have sex with men (MSM). White MSM also have increased risk, as opposed to heterosexual couples. Some sexual activity is riskier than others. Receptive anal sex is the highest risk, followed by receptive vaginal intercourse. Women who have sex with women (WSW) HIV transmission is practically nonexistent. Condom use and other barrier methods like dental dams can dramatically decrease risk. Condoms should be used for all kinds of sex.

Injection drug use is also a huge cause for initial infection.

HIV FactsNeedle exchange programs and harm reduction strategies can help. Mother-baby transmission (perinatal) is becoming increasingly rare as HIV screening is routine, and anti-retroviral therapy during pregnancy is increasingly effective at preventing perinatal infection.

One of the most exciting things to come along is the PrEP – Pre-exposure Prophylaxis. This means people at increased risk of HIV take a low dose of antiviral therapy as a form of prevention.

The numbers of new HIV infections that we can prevent this way is staggering. It decreases risk of sexual transmission by 99 percent and of injection drug use by 74 percent. MSM, sex workers, people who use injection drugs and those in a relationship with a HIV-positive person are all eligible for this therapy.

Attaining stable antiviral levels in the blood mean that with every exposure, there is enough medication in your system that with your immune system, will be able to fight off a new infection. It is literally life changing.

HIV is treatable and preventable.

Over the course of my lifetime, I have seen HIV gone from being an unaddressed pandemic and an unspoken terror to being a treatable and preventable chronic illness. HIV care covers many intersecting circles of illness, family relationships, language barriers, stigma and access to care. I am 100 percent committed to my patients receiving respectful and thorough care.

Please set up a visit with myself or my team to discuss your care if you feel that any of this affects you or someone you are close to.
To schedule an appointment at Health Partnership Clinic, call 913-684-2266.

Additional resources can be found at:

https://www.cdc.gov/hiv/basics/hiv-transmission/ways-people-get-hiv.html

https://www.cdc.gov/hiv/basics/prevention.html

https://www.cdc.gov/hiv/basics/prep/prep-effectiveness.html

February is Heart Month: Know the Risk-Factors

By Debbie Sparks, Development and Marketing Manager

Each year in February, the United States recognizes American Heart Month, a time when the nation spotlights heart disease, the number one killer of Americans.

According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death for men, women and people of most racial and ethic groups in the United States. One person dies every 36 seconds in the United States from cardiovascular disease. About 655,000 Americans die from heart disease each year—that is one in every four deaths.


There are steps you can take to reduce your risk of developing heart disease. Kare Lyche, MD, Family Physician, at Health Partnership Clinic (HPC), outlines this information in the video below:

Tips to Keep Your Heart Healthy and Prevent Heart Disease

 


To learn more about HPC’s cardiac services view the video below:

HPC’s Cardiac Services: How We Keep Your Heart Healthy

 

HPC, a federally qualified health center that serves adults and children, is accepting new patients. In person or Telemed appointments are available by calling 913-648-2266.

For more information about heart disease, visit the American Heart Association or the Centers for Disease Control and Prevention.

What is atrial fibrillation, and why should I take it seriously?

Tony AnnoPost written by Tony Anno, DNP, ACNP-BC CEPS, CCDS, FHRS, Nurse Practitioner, Cardiology Clinic

February is American Heart Month and the perfect time to increase your heart knowledge. The heart is an important organ that needs to function properly in order to maintain a healthy body. Dr. Tony Anno, Health Partnership Clinic’s Nurse Practitioner in the Cardiology Clinic explains Atrial Fibrillation, one type of heart arrhythmia.

Atrial fibrillation comes with many faces! It can be debilitating, mildly irritating or produce no symptoms at all. One can have palpitations or a fluttering feeling in your chest, chest pain, shortness of breath or extreme fatigue.

Understanding Atrial Fibrillation

Atrial fibrillation is an abnormal heart rhythm where the atrium beats chaotically and inefficiently. Usually, the heart chambers, the atrium, and the ventricles complement each other, with the atrium leading the way, followed by the ventricle to complete one heartbeat. The atrium is a thin-walled, low-pressure chamber compared to the ventricle and provides 20 percent of the overall contribution to the heartbeat.

Atrial fibrillation can be lone, where you only experience it for a single episode. It can be paroxysmal where it comes and goes. It can be persistent, where it comes and stays until you do something (medication or electrical shock) to make it go away. Or it can be permanent.

Atrial fibrillation in and of itself is not a life-threatening heart rhythm for most people. When you have a fast heart rhythm or rapid ventricular response for an extended period, it can cause the heart ventricles to become weakened or develop cardiomyopathy. And untreated atrial fibrillation is a major contributor to stroke, which is the fifth-leading cause of death in the United States.

Atrial fibrillation is diagnosed with an electrocardiogram. The 12-lead electrocardiogram is the standard; however, you may also be diagnosed with atrial fibrillation from a mobile or wearable monitor.

Risk Factors

Heart Health Month: Wear Red DaySeveral conditions make a person susceptible to developing atrial fibrillation:

  • Age
  • Obesity
  • Sleep apnea
  • Diabetes
  • Coronary artery or other diseases in your arteries
  • Diets high in caffeine or other stimulates
  • Thyroid conditions
  • High blood pressure

Once you have been diagnosed with atrial fibrillation, the decision to anticoagulate or use a blood thinner is discussed. The risk factors for stroke are:

  • Age over 65
  • Hypertension
  • Diabetes
  • Coronary artery disease or vascular disease
  • Weakened heart muscle or other structural heart diseases
  • Previous stroke or TIA

Heart Health MonthIf you have any two of the risk factors, you are considered a high-risk (2.2 percent annualized risk of stroke), with anticoagulation recommended. The good news is when taking a blood thinner, you have no greater risk of stroke than that of a person with similar characteristics without atrial fibrillation.

Your heart rate needs to be under 90 beats per minute most of the time, so medications will be used to achieve this, along with the blood thinner. This treatment strategy is referred to as “rate control and anticoagulation.”

You do not have to remain in this heart rhythm, though. Various methods are available to restore a “normal” or sinus rhythm. Sinus rhythm can be restored with a shock of the heart, or cardioversion, in conjunction with or without medication. The medications are called antiarrhythmic medications. Unfortunately, most of these medications have side effects that limit their use or keep them from being used indefinitely.

Finally, there are procedures called ablation that can cure or eliminate atrial fibrillation. The ablation procedure is accomplished by putting catheters in the left atrium and sometimes the right atrium and using radiofrequency heat to “cauterize” or very cold temperatures to “freeze” areas in the atrium to isolate or prevent the atrium from sustaining itself. These procedures are highly effective, especially if you have them early in the disease process.

With the identification and treatment of atrial fibrillation, you can preserve heart function and prevent strokes. If you think you have atrial fibrillation, get checked at your provider’s office.

About Tony Anno, DNP, ACNP-BC CEPS, CCDS, FHRS

Dr. Anno has been practicing nursing since 1987 and specializes in cardiology and electrophysiology.

At Health Partnership Clinic, Dr. Anno provides care to individuals with pacemakers and defibrillators that do not have access to traditional care. He also cares for patients with general cardiac problems such as atrial fibrillation and coronary artery disease.

Health Partnership Clinic, a federally qualified health center that serves adults and children is accepting new patients. Call 913-648-2266 to schedule an appointment today.

 

Understanding Colds, Flu and COVID and your treatment options!

Maureen CaroBy Maureen Caro, FNP-BC, Family Nurse Practitioner

This winter is gearing up and along with it are the cold and flu! Everyone is very concerned about COVID-19, and there is considerable overlap with symptoms from cold, flu and COVID-19. Of course, the best information comes directly from your provider! At Health Partnership Clinic, we encourage our patients to utilize the patient portal and email any questions or concerns.

A general rule of thumb for differentiating cold and flu is that you can work through a cold, but you can’t work through flu. Of course, I am not recommending anyone go to work with any kind of symptoms this year! However, people coming in pajamas and uncombed hair and falling asleep in my clinic are likely suffering from flu versus a simple cold. Flu tends to cause a fever (often high grade, over 101.3 degrees Fahrenheit), muscle aches, severe headache, fatigue. Cough, congestion, and sometimes diarrhea (more often in children) is also common. Colds tend to be more of an annoyance, a little cough, post-nasal drainage, feeling tired.

Over-the-Counter Recommendations

Understanding Colds, Flu and COVID and your treatment options!

For over-the-counter recommendations, it depends on what symptom you are treating. For cough and nasal congestion, I prefer guaifenesin

to loosen up that drainage. The important thing is to drink a full glass of water with each dose. Guaifenesin is also called Mucinex. You can also get a product containing guaifenesin with dextromethorphan, which is abbreviated DM like Mucinex-DM, this is a cough suppressant. This can sometimes make you drowsy; I recommend it at night.

Dayquil/Nyquil are a good daytime/nighttime combination, just be sure you measure the portions! Pseudoephedrine, also called Sudafed, often abbreviated with a D at the end of the medication name, like Mucinex-D, is a good choice for nasal congestion. Sudafed can act as a mild stimulant, so it is labeled non-drowsy, but it can affect mood. I only recommend it for morning time. I also do not recommend it for anyone with hypertension or heart issues.

Sometimes people will take antihistamines to help dry up nasal drainage. Antihistamines like Benadryl (diphenhydramine, the little pink pills) are going to make you sleepy, so don’t take it and then try to work.

Understanding Colds, Flu and COVID and your treatment options!As a general rule, I only like one combination product to be used at a time, like Dayquil in the morning, Nyquil in the evening, in addition to plain ibuprofen for muscle aches. It is too easy to take too much of one individual medication if you take multiple combination products. Dayquil and Nyquil both contain acetaminophen, so if you take additional acetaminophen on top of that you can damage your liver. Advil/ibuprofen is in a different drug class than Tylenol/ibuprofen, so it is fine to combine ibuprofen doses with Dayquil/Nyquil. Easiest thing to do is to ask a pharmacist when you are there at the pharmacy!

Testing

For certainty that something is not COVID-19, the best answer is to call the clinic for a test. I have been seeing a fair amount of diarrhea/GI symptoms without a cough or nasal congestion, although cough and shortness of breath are very common. A fever over 100.4 is common, and one of the consistent symptoms I have seen is loss of smell or taste.

We have the rapid test at HPC that can be used on symptomatic patients in the first seven days of symptoms, so please call the clinic directly to see if we can schedule you for a test. Our main number is 913-648-2266. We might need to schedule you for a telemedicine visit, prior to testing, to evaluate further.

Emergency Room

Understanding Colds, Flu and COVID and your treatment options!Deciding when to go to the ER, can be tricky. Any of my patients telling me they feel short of breath is always concerning. A patient that is struggling to breathe, using chest and throat muscles to breathe, or running out of air with only talking always gets me worried. A fever that cannot be controlled at home with antipyretics such as Tylenol/acetaminophen or Advil/ibuprofen, or a temperature over 103.5 degrees Fahrenheit is also a good reason to go to the ER. A child that is not drinking normally and has dry mucous membranes is also concerning, and if the parent is concerned for their child, their instincts are usually right on the nose. However, if you have a slight sore throat and/or manageable symptoms, stay home and call the clinic!

References:

https://www.cdc.gov/flu/symptoms/coldflu.htm

Fighting Colorectal Cancer – A salute to our relentless champions of hope.

By Catherine Rice, Vice President of Marketing/Outreach

At Health Partnership Clinic (HPC), a small but mighty team of clinical and non-clinical professionals are working to end barriers to colorectal cancer screenings. And we’re making a difference—one patient at a time. A year ago, we screened 36 percent of eligible patients. Today, we’ve improved that measure to 50 percent! Colorectal cancer is one of the most commonly occurring cancers and is the third leading cause of cancer-related deaths in the U.S. It is the third most common cancer in men and women.

Our Chief Health Officer Wael S. Mourad, MD, MHCM, FAAFP, and Quality Improvement (QI) Committee Chair says the goal is to combat colorectal cancer with vigorous screening efforts because it saves lives. Dr. Mourad has been really pleased with the progress, which has been the best performance on record at the clinic!

Our Dedicated Team

He notes that the work we are doing is so very important, and it couldn’t happen without a team dedicated to providing hope, health and quality patient care. The team includes Jenny Miller, FNP-BC, a Family Nurse Practitioner, Elizabeth Lewis, APRN, WHNP-BC,  Women’s Health Nurse Practitioner; Lee Champion, RN, Clinic Director, Risk/Compliance Officer; Traci Gentry, Medical Assistant-Ottawa, Tracie Ostermeier, Medical Assistant-Paola, and Maria Hensley, Health Informatics Manager.

Relentless Champions of Hope

Colorectal Cancer Screening – Quality Measure

According to Dr. Mourad, colorectal cancer screening is a uniform data system (UDS) quality measure that all community health systems, like Health Partnership, use to gauge their performance on fighting this cancer.

This measure, along with all UDS quality measures, is overseen by the QI Committee at Health Partnership. We quickly determined improvements were needed in this area. A multidisciplinary team was assembled to look at ways to end barriers to colorectal screenings and ensure our patients receive the best quality of care possible.

Without a doubt, success begins with our colorectal screening team that puts quality front and center. Here at HPC, we are so proud of our team, their hard work and their commitment to bring quality of care to new heights.

Colorectal Cancer - Quality Measure

Recovery Month: Put on Your Pants, Limit the Noise, Work the Problem

Christopher WoodwardPost written by Christopher W. Woodward, LAC, Substance Abuse Specialist

September is Recovery Month, and this one is marked by 2020 and COVID-19. We find that many of our co-workers, family members and community members have moved toward substance use in the past several months to cope with the stress and ongoing fear of the unknown.

In continuing to contact clients through telehealth services, we have been speaking with many clients from diverse backgrounds and support systems and have come to the realization that the COVID-19 protocols had in many cases drastically changed clients’ positive coping strategies for their recovery efforts.

The gym had closed where clients would exercise and burn off calories and stress. The parks have had to shut down, which was an excellent way for clients and their children to play and have social interactions with others. The community support groups had to move from face-to-face to virtual interactions. The workplace has drastically changed, and some of our clients are having hours reduced, while still others are out of work completely.

As we review much of the recovery plans that we had worked up over the past years it appears that the primary focus points were now not accessible for our clients. This appears to be a recipe for relapse and troubles. In my mind, this can be used as a positive if we can keep and gain recovery in a situation where our primary coping skills are not easily accessed then we can maintain that recovery in many other circumstances.

At this point most of you are saying good, you know the problem, now where are the answers?

The good news is that as always, in recovery, we adapt, we learn, and we find a new way of doing things. I have seen in our clients a resiliency to recover and open doors that were once shut to family and friends. Many of us are now near our family in some cases this is a positive; in others there are amends and positive steps that can be taken to open the lines of communication that have been shut off for years. I always find myself saying, “take a breath,” “breathe,” and “practice openness to new ideas.” Below you will find three ideals on how to find a new way to recovery.

-Put on your Pants –

Put on Your Pants, Limit the Noise, Work the ProblemI was recently talking to a parent about recovery and found myself giving the analogy of putting on your pants. We all do it, right? So, it is a common experience. We go left leg first or some are right leg first, a few of you might run down the bed and jump into your pants– firefighter style. But we do it, well I hope we do it. That might be my first point if you have not put on your pants in a while and gone out into the world because of COVID-19. This may be your first step. Take a walk, go smell the flowers, sit on a bench, listen to the birds, find peace in your surroundings. Of course take precautions and allow space for yourself and others, but simply getting outside and knowing that the trees and the grass are still growing, the wind still blows and the sun makes its daily rounds can bring us back to a grounded state of mind and have assurance that this too will pass.

Yes, back to the pants, I was talking to the parent of a client, and they were noting that they just did not understand how their child was making such poor choices where substances were concerned. I asked in a coy manner, which leg do you start with when you put on your pants. Through the puzzled looks the parents noted that they did not remember. I said but you do it every day, maybe sometimes more than once. It is an action that you should remember, correct? This for some is an action much like substance use. A task for many reasons that is frequently done and has become due to the reinforcement of the substance almost muscle memory. Much like putting on our pants.

Remembering that our actions and repeated actions where substances are involved has been reinforced chemically over time is important. Then to further confound the parent, I asked them to try something new, to put on their pants opposite leg first next time. The predictable outcome is that they might fall over, or at least lose balance, and create thought, to think long and hard about the first leg to go in. That is like asking our friends and family to try recovery. We are using a different set of skills than we had when we were in our dependency and need to re-work the thought process so that recovery becomes as much muscle memory as our unnoticeable tasks.

-Limit the Noise-

Limit the NoiseThis Recovery Month, many of us are attempting to re-engage into society and find the normalcy of life.  This month feels a bit to me like walking in the fog. For many of us, we have our resolutions, recovery goals and direction in life set before us. However, to get there with all the shadows and obstacles in our paths it is hard for us to identify them through the mist. These obstacles or impending shadows can be our own guilt, shame and failures. The mist (noise) however, for most of us, in and of itself is not harmful to us, it is the obstacles we don’t see that is in our path or at our feet that can cause us to trip and fall. The mist, like the noise, in our life dulls one of our five senses and can limit our sensory intake and literally create a blind spot for us.

I look at the “busyness” of our world and our involvement with social media and the access we have to information can be seen as mist or fog. All this information can blur our thoughts and our vision for the direction that we want to go. I many times have picked up my phone to make a call or answer an email and have gone down “the rabbit hole” as it were. I had my mind distracted and lost time by simply clicking a link to a message or looking at a text. This seems all to simple for most of us to get lost in the mist of the multitude of voices clamoring for our attention.

I have had multiple conversations with clients that they took a side-step toward relapse by answering a message from an “associate” or family member that “did not have my best interest in mind.” These contacts can also become the mist and fog of recovery; they are out there and can cloud us from where we want to go and send us backward in our recovery. Remember the prayer “God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.” For me, wisdom is making it through the mist/fog without bumping the trees.

Discerning what is a “recovery” thought from a “using” thought is our greatest way to limit the noise of our mind, body and untimely our soul. I know that the noise and mist will always be there to dull my perceptions of others and society in general. I have to take control of these thoughts and actions and find wisdom in myself to limit the contacts, the apps and the distractions so that I can find my way down the path for myself.

-Work the Problem –

Let us remember that our recovery, family and life in general are not a finished work. The problems that we have today can become fading memories. Remember, Thomas Edison, the inventor of the light bulb failed a thousand times before he came up with the invention that most of us take for granted every day. Each morning I flip a switch and can instantly see where I am going mist or no mist. I benefit from the inventor’s failures and eventual success each day. This is a great thing to keep in mind that my problems are temporary if I work on them every day.

Walking was a big deal when I was an infant, and I can do that pretty well most days, even putting on my pants in my toddler years was troublesome.  Words, math, kissing, all of these I learned along the way, and I have the bumps and the bruises to show for it. The same goes with recovery. The more we work the problem the better we understand ourselves and our triggers.

I need to keep working my problems and overcome each failure so that someday I will take for granted all of the lessons of recovery and life that I have learned in the past. They happen in the same form as when I click the switch to wake up each morning. Keeping in the front of my mind the thought that I am an evolving person that is teachable, allows me to look at problems differently. I can see that my interactions with others are not always perfect, and I can take responsibly for my actions and failures in the relationships. This opens the relationship up to collaboration when I partner with others in recovery. The problem can be worked on because it is not about the other person or my failures, it is about making progress on a mutual goal.

– Final Thought –

Momentum can be our greatest ally or difficult to overcome. Depending on which way it is swaying at the time. COVID-19 appears to have pulled the momentum in a way that it has never gone before, and we need to as persons in recovery and family of persons in recovery to learn a new way to sway the momentum back in our favor. Hopefully, these tips will be an avenue to making each day that much more successful.

HPC offers Substance Abuse services. For more information, call 913-730-3664.

High-Risk Diabetes Center patients achieve positive results through team approach, hard work and perseverance.

Since opening our diabetes program, more than half of the patients’ A1Cs have fallen below nine percent, with an average decrease of 1.7 percent.