Corona Virus

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In: Blog, Corona Virus, Disease information, Frequently Asked Questions

Comments Off on Keeping the show on the road (safely)

Many of you attending the practice are on treatments that increase could your risk of infection and are appropriately trying to stay close to home. With social distancing and stay home advice, attending appointments in person can be difficult.

However those with arthritis and other related conditions, are all too aware that flare ups can occur at any time (especially at times of stress). People will remain unwell from their underlying conditions regardless of whether they develop a Corona virus infection. There are certain problems can wait, but others that require more urgent medical attention.

We are trying to offer a service that is both appropriate to acute medical needs of our patients but also one that is as safe as possible. We have therefore put a number of measures in place to allow us to continue to help our patients as safely as possible.

Office Measures

In addition to strict office staff adherence to the Health Protection Surveillance Centre (HSPC) guidance on social distancing and hygiene in the workplace, we have put in place a number of other measures to reduce the likelihood of Corona virus infection in our office.

These are to allow us to maintain essential medical services for our patients while ensuring the safety of our patients and staff.

Postponing Non Urgent Visits

Only patients with semi-urgent, urgent problems, or emergencies are being seen in person. All non-urgent appointments have been postponed or are being performed remotely using video consultations or phone visits. Each patients problems will be assessed in their own right but we will be erring on the side of caution where infection risk is concerned.

Video Consultations and Phone visits

All efforts are being made to carry out visits over internet based video consultations and phone to minimise unnecessary visits to the office. This in turn will reduce the number of patients attending the office in person and traffic through the waiting room area.

Minimising likelihood of exposure to Corona Virus infection for those who need to attend in person.

Suite 19 is in a part of the building separated from main hospital by a lobby and restaurant (which is currently restricted to staff). The Galway Clinic is not a designated receiving hospital for patients with Corona Virus infections and is not receiving visitors.

Pre-screening

All patients who need to attend in person are pre-screened within 24 hours of attendance for common symptoms or risk factors of Corona Virus infection including; recent travel abroad, contacts with those infected (or suspected of being infected) with Corona Virus.

All patients screened again at main entrance of the hospital by Galway Clinic staff. Those with symptoms or risk factors will be asked to phone office and assessed by doctor before entering office.

Staff Measures

The practice is following HSE / HSPC guidelines in relation to management of health care workers, and measures are in place to reduce the potential risk of spread of infection between members of staff and between staff the our patients.

Waiting room measures

  • All those attending will be asked to wait in their car and will be contacted when it is time to come to office to reduce minimise spent in the waiting room.
  • Appointments are also spaced appropriately to reduce congestion in the waiting room.
  • All waiting room chairs are spaced 2 meters apart.
  • All patients asked to clean hands on entry at reception with alcohol gel and on leaving.
  • Protective screens have been put in place to limit contact between patients and staff in the office and all of non-essential paper work between patients and staff has ceased.

Doctor measures

Doctors assessing patients will wear appropriate protective masks, gloves, aprons and goggles and maintain appropriate social distancing except where close physical examination or a procedure are required.

All relevant surfaces will be disinfected between patient visits

Appointment visit times will be kept to a minimum to reduce any potential exposure to infection.

These measures may change over the coming weeks so please check back here for further updates.

Questions?

If you have any concerns of questions about your visit or these measures please email us on suite.19@galwayclinic.com

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In: Blog, Corona Virus, Disease information

Comments Off on Cocooning for high risk individuals

I have prepared some short videos which I hope address most questions that my patients might have about cocooning and who needs to do it.

The HSE guidelines relate to all patients who are immunosuppressed which includes many of you who are attending my practice.

For more detail check the HSE guidance for those at increased risk of serious Corona virus infection.

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In: Blog, Corona Virus, Disease information, Frequently Asked Questions, Rheumatology

Comments Off on What if I can’t get my Plaquenil prescription?

Most of those taking hydroxychloroquine (Plaquenil) for illnesses like rheumatoid arthritis or lupus, will be aware that the drug is in demand as a an experimental treatment for Corona virus infections.

As a result, some patients are finding it difficult to get timely supplies from their pharmacy.

Despite reassurance from the HSE that stocks are being managed to ensure supply, I have had a few calls from patients experiencing difficulty getting their medications.

If you are on Hydroxychloroquine and are unable to get your regular supply, here’s a few suggestions I have been making to my patients;

Phone around. Some pharmacies may stocks in place even if your regular pharmacy is having difficulty sourcing your medications.

Don’t panic. In the same way it can take some time for hydroxychloroquine to start working, it may also take some time to wear off.  It takes approximately 40 days for the drug to clear completely from your system (although your symptoms may return before that). Manufacturing of this drug is being ramped up so it is my hope that additional supplies will become available soon.

A dose reduction can be considered. For patients who have some drug left, it may be possible to reduce the dose to delay the time it will take for your disease to flare. If you are a patient of mine and want to consider this, please ask before doing this.

If you get a flare of your arthritis / lupus. In the event that you are a patient of mine and develop a disease flare, please arrange an appointment. I am doing nearly all of my appointments using video consultations at the moment so should be able to help.

How to contact us. If you are an existing patient of mine, please contact my office on suite.19@galwayclinic.com (not entirely GDPR compliant but I’ll leave that up to you). The phones are rather busy at the moment – thanks for your patience.

This post should not be taken as medical advice and is for informational purposes only. 

 

 

Having spoken to dozens of patients on the phone this week, and having spent more than a few sleepless nights myself, I am all too aware of the impact that this strange, strange time is having on all of us.

It can be particularly difficult for those with rheumatological conditions. Many of my more experienced patients will be all too aware of the impact that sleep disturbance and stress can have on their symptoms and their ability to cope.

Although I don’t have any easy solutions for this crisis here are few (non medical) things that you might find helpful;

Coping with Corona Virus: How to stay Calm and Protect your mental Health – A Psychological Toolkit by Professor Brendan Kelly. 

“How worried should I be? What information can I trust? What should I tell the children? Can I survive the panic, let alone the virus?”. All these questions and more answered by Irish Psychiatrist, writer and master communicator, Brendan Kelly in this Kindle edition. It costs $1.14 (US store only at the moment). If you’re lying awake at night worrying and feeling bit overwhelmed this might be a good place to start.

 

Ten Percent Happier have a meditation app which I use from time to time. They have a free resource called Corona Virus Sanity which is worth a look. It includes a number of talks and meditations for relaxation for Corona virus induced anxiety. My favourite (!) is ‘How to Wash Your Hands and Meditate at the same time’. They have generously made their meditation app available to health care professionals for the duration of the pandemic. They also have a great podcast.

This is a wonderful new poetry podcast by Irish poet Pádraig O’Tuama which has become hugely popular since its timely launch in January. In each of his series of 8 minute podcasts, Pádraig reads a poem that has given him comfort, solace or meaning in his life. It includes poems about friendship, home, memory and love –  from poets you may know, and from many you may not have heard of.

Here’s the link to the website but you’ll, be able to find it on all of the usual podcast platforms.

What resources would you recommend?

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In: Blog, Corona Virus, Disease information

Comments Off on News update: Research project to determine risk of Corona Virus to rheumatology patient

 

Exciting news about a global research project designed to find out more about the real world risk of Corona Virus infection in rheumatology patients on immunosuppression. It goes live today.

Link to Global Rheumatology Alliance

For information on how the project came together read here.

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In: Blog, Corona Virus, Disease information, Frequently Asked Questions

Comments Off on News update: Hydroxychloroquine and Corona Virus infection. What’s the story?

Updated 25/3/2020.

Update from HSE in a letter 24/3/20 to doctors and pharmacists about availability of Hydroxychloroquine supplies in Republic of Ireland.

“Hydroxychloroquine has been in use since 1955 and so has a proven record of relative safety. It has a very important role in the on-going management of rheumatoid and lupus conditions of many individuals.

We want to reassure you that
we are managing stocks to ensure these individuals will continue to have access to their regular medication in the normal manner.”

 

Hydroxychloroquine (also known as Plaquenil) is a commonly used drug in the treatment of rheumatoid arthritis and lupus and also used in the treatment of Malaria.

There have been a lot of news stories identifying it as a potential treatment for Corona Virus infection. I have recorded a few short videos summarising my thoughts on this for patients under my care.

These are for informational purposes only and should not be considered medical advice.

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In: Blog, Corona Virus, Disease information

Comments Off on Anti Inflammatory Medications and Corona Virus Infection

There has been some reports in the international media (and some hoax messages on social media circulating in Ireland) suggesting that anti-inflammatory medications may increase the risk of severe Corona virus infection.

My advice to patients of mine is that there is no reason to stop anti-inflammatory medications at this time unless you have had side effects, or have been told stop them for any reason by your own GP or other doctor.

Additionally, the Chief Medical Office of the HSE Dr. Colm Henry advises:

“Only take one anti-inflammatory medication at a time.  It is okay to take paracetamol and an anti-inflammatory like ibuprofen at the same time. There is no evidence to stop any medication at this time.”

 

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In: Blog, Corona Virus

Comments Off on Corona Virus infection screening and your appointment

As part of a number of measures we are taking in our office to ensure the safety of vulnerable patients and our staff, we are asking patients a few questions to help and identify those patients who may have an infection.

Patients will be contacted before their appointment to ensure that they don’t have any symptoms of Corona virus, or risk factors that might increase the likelihood of their having it. Thanks for your co-operation.

 


If you have any of the following apply to you please call before you attend on 091 720095.

Cough, Difficulty breathing, a fever of flu like symptoms

Symptoms of a cold or other viral illness.

Recent exposure to someone with confirmed or with suspected Corona Virus infection

Travel outside the country in the past 2 weeks

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In: Blog, Corona Virus, The practice of Medicine

Comments Off on Rheumatology Appointments During Corona Virus Pandemic (Revised 21/3/2020)

This is just to let you all know that I have decided to suspend physical appointments in my office for the foreseeable future. These will be replaced, where possible, with video and telephone consultations which  have been in place for the last week, and are working well.

I will still be available to provide emergency, in person care, where necessary.

As the spread of the Corona virus in the community deepens, so does the likelihood of being exposed to the virus, particularly to those carrying the virus, who have not yet developed symptoms. This makes it very difficult to identify those at risk of spreading infection.

I have made this difficult decision to to protect all of those under my care, my staff, and myself from unnecessary exposure to the virus, and to assist public health efforts to slow its spread through social distancing.

I also have a duty of care to provide on-going care to existing patients, and I will continue to provide support using video consultations and the phone.

I am also asking all patients with non urgent problems to postpone their visits for the moment. All non-urgent new patient appointments will also be postponed.

This situation will remain in place until April 19th 2020 in the first place. Please check back here for updates.

Where patients need to attend in person, additional special precautions will be taken to protect patients and staff.

Infusion therapies will continue as scheduled but extra precautions are in place. If there is any change to this situation the infusion centre will contact you.

I have a scheduled appointment. Do I need to contact the office?

No. My office will contact you directly to arrange a video or phone appointment, or to reschedule.

I don’t have an appointment but need one. What do I do?

Rest assured the office team are all still working and contactable. The best way to contact the office at the moment is by email on suite.19@galwayclinic.com (not GDPR compliant but I’ll leave that up to you). The phone has been particularly busy this week so it currently the easiest way to get in touch.

Thanks for your patience and understanding at this difficult time. Stay safe.

Dr. Ronan Kavanagh MD FRCPI