Coronavirus (COVID-19): Click here to learn how we are protecting our patients, community, physicians and staff.
News & Announcements
A Note from Dr. Maloney
Dear patients and friends,
I wish to inform you of an upcoming change. I will be leaving Downtown Family Healthcare to join Sentara Martha Jefferson Internal Medicine located at Pantops near Sentara Martha Jefferson Hospital. It is with real sadness I leave my friends and co-workers at DFHC, but I am excited to take advantage of a new opportunity with Sentara Martha Jefferson.
I will have the same type of practice there that I have now. I would be honored if any of my patients would like to join me at my new practice. For those of you who would like to remain at DFHC, I would be most happy to recommend a new provider.
I will be starting at the new office May 1, 2021. Appointments at my new practice will be able to be scheduled within the next several weeks. My new practice contact information is as follows:
William Maloney, MD
Sentara Martha Jefferson Internal Medicine
590 Peter Jefferson Parkway Suite 100
Charlottesville, VA 22911
Please let me know if you have any questions by sending me a portal message or by calling Downtown Family Health Care at (434) 817-1818.
Catherine Buck is Retiring
To all my dear patients,
After 38 years of practice, and nearly 20 at Downtown Family Health Care, I am getting ready to retire. This year of televisits and no hugs has not been the way I had hoped or expected to wind down my career! I had hope to connect with each of you, say goodbye, reflect on the past and think about what provider will work best for you in the future. However, the pandemic has changed all of our plans and we are all adapting. Click here to read more- Catherine’s retirement letter
As of 1/14/2020, we do not know when the COVID 19 vaccine will be made available for those other than Health Care Workers. We will update you as we learn more from the department of health in the coming weeks. Please help us by being patient and feel free to schedule an appointment to discuss specific concerns related to your condition. At this point, however, we do not have any further information about when or how the vaccine will be distributed. Monitor our web page for additional updates as they become available. We will not be making individual phone calls to our patients. Thank you for your understanding and patience.
The Virginia Department of Health is still in stage 1a of the vaccination program, vaccinating health care workers. However they are beginning to prepare for vaccinating group 1b, front line essential workers, individuals 75 or older, and those living in correctional facilities and other large group settings.
FRONT LINE ESSENTIAL WORKERS: need to be referred *by their employers* who need to fill out the survey at this link
INDIVIDUALS 75 OR OLDER: fill out the survey at this link
INDIVIDUALS 65 OR OLDER: fill out the survey at this link
Patients in the 1b vaccination cohort (>65 or 18-64 w/specific co-morbidities) who lack a computer and/or email access can call the BRHD COVID-19 Vaccine Hotline (434.972.6261) to provide their information and be put in the queue for when vaccine becomes available.
We Are Members of Privia Medical Group
As of September 15, 2020, we are proud members of Privia Medical Group!
Farewell to Dr. Ross Isaacs
We are sad to inform you that Dr. Ross Isaacs is no longer practicing at Downtown Family Health Care. His skills and compassion will surely be missed by us and by you. We want you to be aware of the rest of our providers as some of you have only seen Dr. Isaacs.
Bill Maloney, MD MPH, in particular, who rejoined us this year, is an internist and works with ages 13 and older, especially with adults who may have chronic diseases.
Our office may be calling you soon to switch over and to schedule your followup. We wish Dr. Isaacs the very best in his future, he is a gifted physician.
Has COVID 19 Caused you to Lose Your Job? Your Health Insurance? Your Mind?
At Downtown Family Health Care, our mission is to care for the members of our community. We are committed to doing so during both good and bad times. We know people don’t stop needing healthcare when times are hard. We are aware that for many members of our community the COVID epidemic counts as an extremely hard time.
If you have lost your job or your health insurance and you still need care, we are here to help. We are offering office visits in person and virtual visits via telemedicine and we will make your care affordable during this difficult period. For more information, or to enquire about registering as a patient, call 434-817-1818 x 101 and ask for Chastity.
A Special Thanks!
Our hearts and bellies are full of gratitude due to the generosity of Shaconda Brown, Nick and Jan Glennie-Smith, and Tammy Rose!
Downtown Family Health Care would like to extend our gratitude to Alice Howard, Tracy Bennett Hilton, and Joann’s Fabrics.
A Message to Young People
Another video in our COVID-19 Series urging young people to take social distancing and precautionary measures seriously!
Please Wear a Mask When Coming to the Office or Going Outside
As hopefully many of you are aware, the CDC recommended on Friday 4/3/2020 that everyone going outside of the home wear a face covering if they will be within 6 feet of another person. Accordingly, if you come to our office please wear a homemade mask or some type of face and nose covering. If you are going to the grocery store, the hardware store or any other essential business please wear your face covering. Please continue to keep the physical distance of 6-8 feet or more between yourself and others when possible in those establishments. All our employees will continue to wear masks and eye protection for their and your safety.
Please remember to wash the mask daily after use and to wear gloves that can be thrown away or washed after your outing. Cloth face masks should not be placed on children under the age of 2.
Thank you for helping keep each other safe and healthy.
Medical Information Resource, “Up to Date”
More information for our patients about how to protect yourself from Covid-19 and other valuable information about this virus. This source, Up to Date, is one we use often for detailed medical information in our office.
Farewell From Jessica Wunderlich
A farewell. First of all, I would like to start by thanking you for allowing me to participate in your health care for the past 2 years. It is vulnerable to ask someone to share their health and personal history. Thank you for trusting me to care for you. It was a hard decision for me, but I am leaving my position at Downtown Family Health Care. I wanted to personally reach out and tell each of my patients, unfortunately I have not been able to. My last day is the end of March, on the 26th. I am confident that there are many members of Downtown Family Health care that will be able to continue your care with skilled and complete medical care. There are three new nurse practitioners that have been hired recently and are taking on new patients. Robyn Nohling, Sydney Hanabury, and Adam Navone. All have experience prior to coming to our practice. For those that are interested in a provider that can communicate proficiently in spanish, Adam Navone can speak Spanish.
For those that are interested, I am headed to Seattle, WA to help my twin sister with her first newborn! I will be out there working at a hospital temporarily. Plan is to return to Charlottesville by the fall, but at this moment, I am unsure where my future will take me. Any update I have of my whereabouts, will be posted on the webpage. Take care, eat consciously, protect your sleeping hours, stay active, and keep friends and family close!
Una despedida. En primer lugar, me gustaría comenzar agradeciéndole por permitirme participar en su atención médica durante los últimos 2 años. Es vulnerable pedirle a alguien que comparta su salud y su historia personal. Gracias por confiar en mí para cuidar de ti. Fue una decisión difícil para mí, pero dejo mi puesto en Downtown Family Health Care. Quería comunicarme personalmente y decirle a cada uno de mis pacientes, desafortunadamente no he podido. Mi último día es a fines de marzo, el 26. Estoy seguro de que hay muchos miembros de la atención de Downtown Family Health que podrán continuar su atención con atención médica completa y especializada. Hay tres nuevas enfermeras practicantes que han sido contratadas recientemente y están recibiendo nuevos pacientes. Robyn Nohling, Sydney, Hanabury y Adam Navone. Todos tienen experiencia antes de venir a nuestra práctica. Y para aquellos que estén interesados en un proveedor que pueda comunicarse de manera competente en español, Adam Navone puede hablar español.
¡Para aquellos que estén interesados, me dirijo a Seattle, WA para ayudar a mi hermana gemela con su primer recién nacido! Estaré allí trabajando temporalmente en un hospital. El plan es regresar a Charlottesville para el otoño, pero en este momento, no estoy seguro de dónde me llevará mi futuro. Cualquier actualización que tenga de mi paradero se publicará en la página web. ¡Tenga cuidado, coma conscientemente, proteja sus horas de sueño, manténgase activo y mantenga a sus amigos y familiares cerca!
DFHC would like to extend a special thanks to Donna Dyer, Joyce Martin, Katie Emanual, Amy Sherman and Mahana Fresh for all your love, comfort and generosity given to our office and staff. You are so very appreciated!
Cimetidine: Recommended Alternative to Ranitidine
he FDA Wants All Ranitidine Products Off the Market — Finds levels of probable carcinogen increase during storage.
In place of Ranitidine (Zantac) and other Prilose type medicines, we recommend another over the counter medication, Cimetidine (Tamagmet). If this applies to you or you have questions, please bring it up during your next office or TeleHealth visit to discuss with your physician.
adopted from Nicole Lou, Staff Writer, MedPage Today, April 1, 2020
How to Stay Healthy and Keep Your Students Engaged
To our patients and their families,
Thank you again for trusting us with your care. We are in unprecedented times, which will require understanding, and patience from all of us. In that spirit, we ask for your cooperation as our community tries to manage this situation in the best way possible. If you have not already seen this resource on the importance of SOCIAL DISTANCING, PLEASE take the time now to review it now. Obviously, do this while socially distancing; please share by any means other than personally.
Also, please ensure you are actively participating in your health by:
Washing your hands frequently
Getting great nutrition – cruciferous vegetables (there’s a ton of them), dark berries, variety of probiotic foods, foods high in zinc, magnesium, vitamin C, vitamin D, B vitamins, garlic, ginger, onions, curcumin, rosemary, thyme, and mushrooms.
Ensure you are adequately hydrated, with best quality water of course; green tea is welcomed as well, as this has many compounds in it that are beneficial
Getting adequate sleep: for most people this means getting about 7-8 hours a night, starting around 10-11pm
Remaining active, while ensuring about 6 feet of distance from others; please get outside to take walks, visit a nature trail, ride your bike
Having fun and attempting to control all this stress – put your energy into actively staying healthy rather than the stress of worry
STOPPING smoking anything and everything you may be inhaling into those precious lungs of yours.
We are happy to provide you care and certainly happy to do appropriate testing. Currently, COVID-19 testing is recommended for those with:
fever, cough, or SOB, AND
risk of travel or contact (this will likely change), AND
negative flu test or strep test (if sore throat included in symptoms)
IF you have been isolating with these symptoms, and you are becoming increasingly SOB, making breathing difficult, please call 911 and present to your nearest Emergency Room.
While you are playing your part to keep the community at lower risk, to pass the time, consider playing games as a family, reading all those books you have wanted to read, or simply relaxing and listening to an old CD or vinyl.
Some other resources passed on by a local pediatrician and K/1 teacher:
Other Goose – a lot of my friends have been posting on social media about this. It’s a homeschooling resource they’ve made free for 21 days..
Circle Round – a podcast that adapts folktales from around the world and sparks great conversations between kids and parents.
BrainPop Jr and BrainPop – educational videos on tons of topics. You can use the login abp2, password abp. They even have videos on colds/flus and washing your hands.
Go Noodle – they have awesome guided movement videos, including a 30-min indoor recess. You can click on the “for families” button and don’t need a login.
Storyline Online – one of my favorites! Celebrities read their favorite kids books.
The COVID19 virus is in Virginia. This is our first update with more to come. We are doing our best to provide for your healthcare needs as well as keep our staff, providers and patients safe.
Effective Monday, March 16, 2020:
Patients coming to DFHC for a scheduled evaluation and have ANY FEVER OR UPPER RESPIRATORY INFECTION (URI) SYMPTOMS including SORE THROAT, COUGH, RUNNY NOSE OR SHORTNESS OF BREATH will be asked to remain in your vehicle when you arrive. Please let us know ahead of time if you have HAD EXPOSURE TO A KNOWN COVID19 POSITIVE person.
All patients with FEVER or URI symptoms should please call us at 434-326-7059 to let us know you are here and waiting in your car. You will be interviewed over the phone before a provider comes outside to see you. There will be designated parking spaces for you to park after arrival.
Based on our evaluation of your condition we will advise you on our recommended course of action, including testing you for influenza and CoVID19 if appropriate. As of today the testing for CoVID19 is limited. We expect this will change as we move forward and will send further notices.
If you have NO FEVER OR URI SYMPTOMS please feel free to schedule an appointment as usual or you can keep already scheduled appointments as you are able.
If you are ILL at time of a follow up appointment or complete physical with even mild symptoms- PLEASE CALL TO CANCEL OR RESCHEDULE that appointment to a time when you are not ill.
If you believe you are ill with mild symptoms (fatigue, mild fever, sore throat, runny nose, body aches) and you do not need to seek medical care, you should be aware that CoVID19 can present with mild symptoms. Please be cautious about hand washing (20 second minimum), disposing of tissues and reducing exposure to others especially those who are elderly or have underlying lung and heart disease. Please remain at home while you recover.
Please wash your hands regularly and avoid touching your face. Getting adequate rest, being in nature, being mindful, managing stress and eating healthy as well as avoiding smoking are going to be our best advice to recover from as well as prevent any virus.
Below are websites with further information regarding CoVID19:
Thank you for your patience and understanding as we work to both provide you with the care you need while simultaneously keeping you safe.
Your DFHC Family
New Moms: Get Some Sleep!
Note to young mothers: GET SOME SLEEP. Right, sounds so easy! We nurse our beautiful newborn and expect them to sleep for three hours, but wait…” she’s got her nights and days mixed up”. Another difficult scenario to live through is, “it’s been two months and my baby’s not gained enough weight AND hasn’t slept well forever!”.
Some moms feel shame when their baby doesn’t sleep and some of us health care providers don’t always have good answers in the midst of our well-baby visits. There are many answers and not all of them work, please seek us out for help. A tired mommy is no fun for anyone and there is no shame in seeking help.
Whether it is unwinding a process that several providers in our office and in the community perform, or Craniosacral or massage, or just old sage advice. If babies don’t sleep well then no one in the family does well. A two month old, ideally, should be sleeping in 2-3 hour stretches, although some sleep longer. If they are gaining weight then they can be allowed to sleep longer without waking them up.
The bottom line, seek help from us at Downtown Family Health Care, at the resources mentioned above, or in this Washington Post article.
Limiting our Children’s Technology
Within the average well child check up we try to cover as much as possible about your child’s physical and emotional health. It is becoming increasingly clear that many of our children face the difficulty of balancing technology use and turning off the screens. “back in the day” many of spent most of our time outside, screen time was an occasional TV show, maybe a cartoon after school. As our children grow, peer pressure begins to rise and this often includes media use, whether it’s on line gaming or just social media or videos. It is up to us as parents to resist our children’s interest in screen time.
Screens are addicting, it’s as if we have brains that are geared to electronics. We recognize in medicine the serious effects of screens on our children. One simple fact is: cortisol, the hormone secreted when we are running around outside, is secreted in similar amounts when we are simply sitting in front of a screen, doing nothing physically. This affects our attention span and builds up stress hormones our children DO NOT NEED.
Please read this New York Times article and if you have not already, discuss the limits of screen time with your children. No doubt they will be upset, it is our role to not be their friend but be their parent… Read the Article
Local Doctor Leads Free Lunchtime Workouts
Dr. Martin Katz holds a free outdoor lunchtime workout just blocks from the Downtown Mall at the corner of Sixth and Garrett streets, in a field behind Friendship Court.
The workouts start around 12:50 p.m. at the corner of Sixth and Garrett streets from Tuesday to Friday and the workouts are short, typically about 15 to 20 minutes. And he’ll modify the intensity or moves so they’re appropriate for people of any fitness level. Participants should wear comfortable clothes and bring water. Friday is yoga.
As a family and sports medicine specialist, Katz says holding these free workouts are part of his mission of promoting health in the community.
Measles Outbreak: Update 2019!
Recently we have all been hearing the news, that measles has returned to the US. In the past 5 months there have been 839 cases of Measles confirmed in the US in 23 states, the highest we’ve seen since 1994. Why is this happening? The majority of people who get measles are unvaccinated. The virus is still very common in many parts of the world such as Europe, Asia, the Pacific and Africa, so when an unvaccinated individual travels they can easily bring it back to the states.
What does it look like?
The virus presents with a high fever, runny nose, cough and red- watery eyes. The measles rash usually starts 2-4 days after the other symptoms begin and spreads from the head down to the rest of the body and appears very bright red.
How does it spread?
Measles is a very contagious disease caused by a virus. Prior to widespread immunization there were approximately 500,000 cases each year and of those 400-500 people died, up to 50,000 were hospitalized. The virus spreads extremely easily through the air when an infected person coughs or sneezes and can remain in the air for up to 2 hours. There is a 5 day window on either side of rash appearance that the individual is contagious.
Other complications that can occur and are located on the CDC, are ear infections that can cause hearing loss, severe lung and throat infections including pneumonia, diarrhea, and brain swelling (encephalitis). Another serious but less common issue secondary to measles is subacute slcerosing panencephalitisi (SSPE). SSPE is a rare but fatal degenerative disease of the central nervous system that presents as changes in behavior and intellect and seizures that develop as much as 7-10 years after measles infection
Is this preventable?
The best way to prevent Measles infection is to get the vaccine to prevent it. The MMR vaccine is available at the clinic and if you know your child is not yet vaccinated for this please call the clinic and we can get your child in to receive it. We can administer for children >12 months old. The 1st dose is up to 93% effective in preventing measles. With the 2nd dose the effectiveness of the vaccine increases up to 97%.
Those at risk are children under 5 yo, adults older than 20 yo, pregnant women, and anyone that has a low immunity such as individuals on steroids, HIV patients and cancer patients to name a few.
If you were born before 1957 then you most likely are immune to Measles as you were very likely exposed as a young person as Measles was so prevalent. If you know you have received 2 doses of the vaccine as a child or as an adult then you will also be protected. If you were born between 1957 and 1989 and would like to receive an MMR 1 time booster to make sure you are protected please schedule a nurse visit to do so. Checking titer levels is another way to make sure you are immune however insurance will not cover this and cost can be between $200-300 depending on your insurance. The vaccine takes up to two weeks to become effective.
Children Under 5 Should get no More Than 1 Hour a day of Screen Time
The World Health Organization (WHO) has released new guidelines on the importance of physical activity and adequate sleep for young children, which includes recommendations on how little screen time they should get. Read More
Chemicals in Food May Harm Children, Pediatricians’ Group Says – The New York Times
Parents, please read this book Sicker, Fatter, Poorer and lobby for better government control of chemicals our children and we are exposed to daily. Plastics 3,6 and 7 should never have food in them and certainly not heated in them, these are truly dangerous, causing a release of chemicals that act like hormones in our bodies. Imagine grade school children reaching puberty by age 7 or 8, and consider that the increase in autism is partially caused by these chemicals like BPH, Pthalates and flame retardants. Read More
Can Inuit Moms Help Me Tame My 3-Year-Old’s Anger?
Those of us who have children know that our patience can be tried, and after a long day or long week or long year, our nerves can be on edge. So when one of our children screams a little more than we can handle, or bites or hits, it’s all too easy to scream back, use the NO word or worse.
This article speaks of the Inuit tribes who use other techniques to keep from raising the emotional intensity of the home. Waiting several seconds or minutes until the child calms down is one technique some of us have already learned, trying to reason with a distraught child is probably NOT the best time to instruct. I hope this article helps all of us raising children!! Or, we can also apply these techniques to our relationships with our spouses or partners…Read More
Measles Vaccine Doesn’t Cause Autism!
Measles vaccine doesn’t cause autism, says a new, decade-long study of half a million people. Read More
Spotlight on Excellence – Downtown Family Health Care
Downtown Family Health Care, in Charlottesville, VA is being highlighted as an exemplary practice in November’s “Spotlight on Excellence” for implementing a workflow that doubled the number of annual wellness visits for Medicare beneficiaries to 732 in 2017. This allowed them to identify high-risk patients for care management and improve their health outcomes. Read the rest of the article
Flu Season is Arriving
Yes it’s sadly true, another winter means another attack of influenza viruses leaving almost all of us at risk.
While we do not have good records on how effective the flu shot is this year, and may not know for another month or two, PLEASE GET A FLU SHOT! This applies to anyone over six months of age. First time infants and children up to eight years of age need two half doses (four weeks apart) so get them soon. Many pharmacies, the health department and of course, our office, offer them.
BUT DON’T FLU SHOTS CAUSE THE FLU?
The old flu shot from prior to about 20 years ago was made differently and did occasionally cause flu like symptoms. Yuck!
The newer ones have very rare side effects. Thousands die each year from the flu, particularly infants and the elderly, 80,000 during last year’s season. Three children have already died this year in the US.
1) Shake fewer hands, fist bumps are safer!!
2) Avoid coughing people, even carry a mask with you to put on if you are in a public line or small room.
3) We ask anyone I’ll to wear masks in our waiting room. You may also ask for one if you want to be cautious even if you are not Ill yourself.
4) Get plenty of sleep , don’t smoke of course or even drink more than 1-2 alcoholic drinks a day.
5) Continue working out but stop immediately when you become symptomatic.
Remember the flu hits hard and within a few hours and our lungs are particularly vulnerable. Tamiflu May help protect you if your loved ones are infected and for treatment it may help, as well as oscillococinum, which is available at our office or any pharmacy. This product has been studied and published in peer reviewed journals. Some people keep a few tubes are home to take immediately when symptoms start.
If you come down with the flu or flu like illness, get rest immediately, don’t stress your mind or body, and stay hydrated with water and soups. Old home remedies like bone broth soups do help. Call the office if you have high fevers, shortness of breath, or have a sick looking child or baby! And watch comedies or read funny stories to boost your immune system. War and Peace could bring your immune system down!
Dozens more breakfast foods test positive for trace amounts of weed killer
“Dozens of common breakfast cereals and snack bars have trace amounts of a controversial herbicide found in the weed killer Roundup, according to a report released today by an environmental advocacy group.” Read more
NYTimes: Is Your Child a Phone “Addict”?
As this article from the New York Times reports, “there are reasons for concern … half of teenagers felt addicted to their devices, and 78 percent checked their devices at least hourly. Seventy-two percent of teens felt pressured to respond immediately to texts, notifications and social media messaging. Please follow this link to read the article.
In today’s world it is easy to become anxious, to have a mind which has multiple conversations at once, thoughts that are distracting and at times negative, which draw us down in mood, make us anxious and have no good effect on us. We know this because we hear these issues in our office every day. This is also the human experience and this accelerates each year, with more technology, more stress from work and home and from our little minds. It is not easy to ignore that “cocktail party in my mind” as one friend called it, or that “monkey mind” as others have aptly named it. And so quieting the mind is a goal all of us want. There are many techniques we can do for ourselves, some are as simple as breathing, others involve balancing our lives so our minds become more quiet quite naturally. This essay is going to talk about one of the techniques I’ve found quite effective. It’s a simple exercise that I do daily and teach daily to my patients when anxiety or stress comes up in conversation.
Breathing. Hmmmm, yes we do this every day thousands of times. Mostly it’s automatic, controlled by our brainstems (thankfully we don’t have to think about it). So we can pay attention to our breathing, deliberately slowing the breath, breathing like babies with our stomachs or diaphragms which causes us to focus somewhere other than on that conversation going on in our minds.
I’ve explored every major religion and found some form of breathing in each one. Even if we don’t follow any religious belief, however, listening to our breath, and focusing on our inhale and exhale, holding it for a few seconds in between, will calm the mind. SO…. I count, inhale to the count of 4, hold for two, exhale for 4, and repeat for at least 10 minutes but sometimes for an hour. And during this time, I switch from counting to a sound, a mantra as some call it, or a word that is meaningful. It could be a word like love, a name like God, a thank you, an expression of gratitude.. All this will bring us to Quiet, that place in the midst of the storm of life where we can go daily and go to especially when our minds are overactive and not helping us function. Contact us if you need more information
Cellphones Really are Addictive
Sometimes my cellphone feels like it’s wired directly into my brain. My text message bing goes off and I seemingly have no control to ignore it. This is true whether I’m driving, sleeping, reading or meditating. Why? I know I’m not the only one which is why I’m writing this blog. The fact is, we are wired for this little device. It connects us to our world and the world beyond. Whether it is a spouse, a friend, a child who might be texting us, we are destined to react to that little sound. It’s the same reflex as if someone tapped us on the shoulder , we can’t help but turn around and see if it’s a friend or a foe.
And then there’s the device itself. How often do I open the phone to look for a message or email and then wind up down some rabbit hole looking at something totally fascinating but so obtusely related to what I was looking for, I then forget why I pulled the little sucker out of my pocket.
So how do we disconnect? A recent Washington Post article suggested we do it slowly. That’s right, not cold turkey. Keep it a bit further away from us, leave it alone for a set period of time every day where it cannot disturb you. Make dinner time and other times cellphone free periods. In other words, pay attention to the people around us, don’t let a phone come between you and an important conversation between you and someone important in your life. If you are sitting to read, meditate or pray, make that time holy, make it special and remove the alerts on your phone or simply remove it from the room. It’s that easy. Start slow and go further each week.
And for goodness sake, put your phone in some unreachable spot in the car. DO NOT pick it up to text or receive one while driving. We really CAN’T do two things at once. More teenagers are killed now from texting while driving than from any other cause. We can do this, we need to do this, and if it’s impossible and you want help, we are available to talk with you and help you!!!
Tick Bite Basics
After recently reviewing many peer reviewed articles on tick bites and the diseases they can carry, I have summarized the information for our patients.
Please remember that you can always call us to discuss your particular situation.
We are happy to help you sort things out.
Here are some facts:
The latest information as of last summer is that 30% of the deer ticks in Albemarle County carry Lyme disease and 40% of deer ticks in Nelson County are carriers.
There are many types of ticks in the United States. The risk of developing infection related to a tick bite depends on the geographic location, season of the year, type of tick and for Lyme disease, how long the tick was attached to the skin.
The risk for acquiring a tick borne infection is quite low, even if the tick has been attached, fed and is actually carrying an infectious agent.
Ticks only transmit infection after they have attached and then taken a blood meal.
The deer tick that transmits Lyme disease must feed for approximately 12-24 hours before transmission of Lyme disease.
After a person is bitten by a deer tick, the health care provider will likely advise one of two approaches.
Observe and treat if signs or symptoms of infection develop.
Treat with preventative antibiotic immediately.
There is no benefit of blood testing for Lyme disease at the time of the tick bite, it takes two to six weeks for the blood test to show a positive result if the infection has been transmitted.
TICK BITE PREVENTION
Please be sure to do a tick check if you have been exposed.
Use careful coverage while in high likely exposure.
Tuck pants into socks, use insect repellant
Shower after exposure
Wear lighter colored clothing so ticks are easier to see
The clothes you wear on your hike can be put in the dryer on high heat for five minutes, ticks do not like dry high heat,
Chickens can be great for eating tick, especially guinea hens.
Ticks like a warm moist environment, they do not like the sun.
Check your animals for ticks.
Before seeking medical attention, carefully remove the tick from the skin.
Make note of its appearance.
The best removal tool is the “Tick Key” available at Blue Ridge Mountain Sports and online.
Using fine tweezers, grasp the tick as close to the skin as possible.
Do not use any topical liquids or materials on the tick as they may cause the tick to act like a syringe and inject bodily fluids into the wound.
Pull backwards gently but firmly using an even steady pressure, no jerk or twist.
Do not squeeze, crush or puncture the body of the tick, since its bodily fluids may contain infection-causing organisms.
After removing the tick, wash the skin and hands with soap and water.
If any mouth parts of the tick remain in the skin, these should be left alone, they will be expelled on their own. Attempts to remove these parts may result in significant skin trauma.
After the Tick is Removed
Please make note of the size of the tick, whether it was attached to the skin, if it was engorged, and how long it was attached.
The size and color of the tick help to determine what kind of tick it was.
Ticks that are brown and the size of poppy seeds or pencil point are deer ticks. They can transmit the bacteria that causes Lyme disease. They are common from Maine to Virginia and in the Midwest.
Ticks that are brown with a white collar and are about the size of a pencil eraser are dog ticks. These ticks do not carry Lyme disease but can carry rocky mountain spotted fever which can cause serious illness and can be fatal.
Ticks that are brown to black with a white splotch on their back are called Lone Star ticks and can spread an illness called, STARI. This can cause a rash like Lyme disease but no other Lyme like symptoms. This tick can also carry Ehrlichiosis, another tick borne disease which can cause severe symptoms such as high fever, headache.
Only ticks that have been attached and have finished feeding can transmit Lyme disease. After arriving on the skin, the tick that spreads Lyme disease usually takes 24 hours before feeding begins. At least 36-48 hours of feeding is required for a tick to have fed and then transmit Lyme disease. At this point, the tick will be engorged.
If a deer tick has been attached for more than 36 hours and antibiotics can be given within 72 hours of tick removal, your health care provider may recommend antibiotic prophylaxis with a single dose of Doxcycline of 200 mg. If you cannot take doxycycline, it is not recommended that you be treated with an alternative antibiotic due to lack of clinical data and low risk of infection rate.
Many people are concerned that if antibiotics are not given early, Lyme disease will be incurable. This is not true. Even later stages of Lyme disease can be treated effectively with antibiotics.
If you have been bitten by a tick, please be aware of any signs of rash, fever, joint pain, headache.
What I Do, a Post from our Practitioner
What I do – Part 1
What is Functional Medicine? by Melanie Dorion
Given that I get this question often, I will dedicate this post to a brief discussion of my approach to health and medicine.
I took a long route to coming to this approach via my previous career as a professional cyclist and my own health challenges post career that had me exhausted, confused and frustrated for about 4 years. I clearly remember feeling very “sub-optimal” as an athlete on many occasions and feeling that my recovery from hard races or crashes (mountain biking inevitably means crashing on a regular basis!) were impacting not only my performances but health in general. I searched for years for someone who could truly help optimize no just my performance but my overall health. It was when I finally saw a Naturopathic1 and Functional Medicine2 provider who listened to my story and utilized a variety of natural approaches that significantly improved my health that I knew I wanted to study this type of medicine – this was in the late 1990s and I have never looked back since!
My approach is grounded in the Naturopatic philosophy and uses Functional Medicine principles thus is preventive, patient-centered and promotes the body’s ability for healing by using traditional and natural therapies. Functional Medicine strives to address and reverse (or at least improve) the underlying causes of disease and promote healing. This approach goes beyond relieving symptoms and attempts to facilitate the body’s innate healing processes. I take into account that individuals are just that – individuals and therefore unique in who they are and in what may have contributed to their health condition(s). I will look into the interactions between genetic, environmental, and lifestyle factors that influence health and disease. The initial Functional Medicine visit is often 45min which allows time to discuss the full picture, review/order labs and set an initial plan. Follow-ups are 30min for a few visits until we come to a good plan and at that point we can do quick 15min check-ins every few months. During these visits, I teach, coach and encourage patients to make changes that have long-lasting and beneficial effects.
Let’s remember the power of the heart. Not only is it the pump that allows for our bodies to remain oxygenated alive, the energy produced in the heart is magnetic! The heart can project a powerful magnetic field demonstrated by many studies.
In fact, researchers at HeartMath have determined that the physiology and nerve centers of the heart are so complex and active, that they constitute a “brain” all on their own, termed a “mini-brain.”
HeartMath is an institute which has been studying the heart and its many attributes for the past 24 years focusing on the intuitive qualities of the heart.
As we go through our day, connecting with the heart can have many benefits, including stress reduction, a better understanding of ourselves and more compassion for others around us. As busy as clinical practice can be, the feeling I generate as a practitioner when I am aware of my heart, can be quite incredible. Dr. Gelburd and I often refer to the this awareness as the “bubble”: that amazing sensation we are aware of connecting deeply with a patient. From this place, healing seems effortless and instinctive, for both individuals.
From this place, it is easier to discern the underlying cause of physical symptoms as well as emotional issues which can trigger our body and it’s fight or flight response.
A Connection Between Our Emotions and Our Gut
Ever get the feeling your tummy is talking to you in a real, instinctive way? I’m sure we have all heard someone say, “I’ve got a gut feeling about…”.
The science on the connection between our thoughts, our emotions and our gut is growing. In the next ten years, we will learn so much more. “I’m always by profession a skeptic,” says Dr. Emeran Mayer, Professor of Medicine and Psychiatry at the University of California, Los Angeles. “But I do believe that our gut microbes affect what goes on in our brains.”
In my daily medical practice, I often see patients with abdominal pain of all types. This pain often has a physiologic origin and usually also has an emotional component, especially if it is chronic abdominal pain.
Taking probiotics daily can help regulate the flora in our gut, which will support the immune system and may even help regulate our emotions.
One easy way to get in touch with your tummy is to do belly breathing. Take some time, and some deep breaths and see if you can allow your breath to drop into your abdomen. This type of exercise will quickly elicit a natural relaxation response.
If you are interested in this topic, take a peek at this NPR article about the gut/brain connection.