Clinic And Vaccine Update for Edmonton and Grande Prairie_Winter 2020/2021

Clinic Hours | October 12, 2020

EDMONTON CLINIC

Greetings everyone, this is just an update of the current situation in Edmonton. Winter is here and I think we can all agree, this has been a most challenging year. A Christmas like no other, the province locked down with restrictions on social gatherings that has impacted our usual traditions of family togetherness, worship, travel and vacation time. Our hospitals are under pressure with increasing numbers of Covid related admissions and many have required management in the Intensive Care units. I certainly do understand the frustrations everyone is experiencing, my appeal is that regardless of your personal convictions, adhere to the guidelines laid down by Alberta Health Services, we need to get through this together. Masks are compulsory in the clinics, if you cannot or do not wish to comply, a telephone consult can be arranged. The encounter with me is a close one, I cannot do my job 6 feet away from you, so let us make the encounter as safe as possible!!

Please remember, as it gets colder to dress in layers so that I will have ready access to examine and scan you!!

Please be on time, make allowance for bad weather, especially If you have been booked first in the day, at 0900am

As winter is upon us,  will develop viral respiratory infections that are not related to Covid and it is not always going to be possible to tell them apart, this is going to be a big challenge as Winter digs in so this is what we plan to do:

PLEASE, MAKE SURE YOU GET YOUR FLU INOCULATION, BOOKINGS WITH YOUR PRIMARY CARE PROVIDERS AND THE PHARMACISTS ARE REQUIRED AND THE VACCINE WILL BE AVAILABLE FROM THE 19TH OF OCTOBER. PLEASE BOOK AND GET IT DONE AS SOON AS YOU CAN.

If you have a flu like illness, call us and we will re-schedule or arrange a telephone consult. If there is a need for a face to face visit, I will arrange that but I must speak to you first to asses the situation, there will be other people in the clinic so everyone’s safety must be taken into account. Please be considerate, no-one will have their health care needs ignored.

Do try and come to the clinic alone, if a driver, carer or translator is required we will accommodate them but no one else is to attend the visit.

The winter months will be challenging for all of us, we must all work together to make sure that health care services continue to be provided to everyone without taking unnecessary risks.

Please remember that especially with follow up visits I am quite happy to consider virtual consultations by telephone or Video.

VIRTUAL CONSULTATIONS

We are set up for virtual consultations, our provider is: MEDEOHEALTH.

You can register with them by visiting MEDEOHEALTH, WHEN YOU RECEIVE THE LINK FROM THE MEDICAL CLINIC/PROVIDER

WWW.MEDEOHEALTH.COM

To register, we will need the Email you will use  to register. It must be an Email only you use, family members may not share an Email!! An iPad, tablet or laptop is preferable, phones are really too small and not ideal for this purpose. There is no cost to you to register.

The forms page has been updated, use this abbreviated contact form to send us just the Email which we need for Medeohealth registration, when we book your appointment you will receive a link on the Email to register with Medeohealth and your appointment details will also be available. The detailed New Patient form can be filled in before your first visit and Emailed to us. You may also complete it again if personal and medical details have changed.

Let us do our best to get through this Winter safely and get those numbers in Edmonton down!! This lockdown over Christmas and New Year has been unpleasant for everyone!

 

COVID VACCINES.

TWO VACCINES HAVE BEEN REGISTERED BY HEALTH CANADA, both mRNA vaccines, one from Pfizer and the other from Moderna. More are on the way. European union has registered the DNA vaccine engineered by Astra-Zeneca.

 

Have a look at this video which does a good job of explaining how the Covid 19 mRNA vaccines were engineered. This video is just an update from the University of Alberta. The speed with which these vaccines have been registered is without parallel in the history of drug development! As I come across more videos that explain the vaccines and I feel are appropriate I will add them. These vaccines are new to all of us and we are all doing our best to read the information on these vaccines from the experts in Infectious Diseases, Basic Sciences and from the laboratories that developed them. There are some unanswered questions of importance to us in Rheumatology.

THE CLINICAL STUDIES EXCLUDED PATIENTS DEEMED TO BE IMMUNOCOMPROMISED, that includes patients with Rheumatic diseases on Biologics, JAK inhibitors and synthetic disease modifying drugs such as Methotrexate and Leflunomide. So what is the safety profile of these vaccines in these patients? The clinical studies did however include a wide spectrum of patients in terms of age and other co-morbidities such as Diabetes, Heart Disease and that group did not have any worse outcomes than so called healthy patients. Expert opinion is  that being on a biologic, JAK inhibitor or Methotrexate/Leflunomide is NOT a reason to avoid the vaccines, the one exception is Rituxan, not from the point of view of safety, but response to the vaccine because of the way Rituximab works. We would try to vaccinate that group of patients before they start or between infusions, we will have specific guidelines for that group of patients!!

It is likely that the initial response to the vaccination may not be as robust in patients on certain biologics but the response will provide adequate protection, remember that for the mRNA vaccines available you need two injections 21 or 28 days apart. The response will be carefully studied now that the vaccines are being used and as we have updates so we will share those updates.

It is our opinion that in the vast majority of patients on drug therapy for Rheumatic diseases, the benefit of vaccination far outweighs any potential risk and the possibility of a slight flare of the disease activity following vaccination is something we can manage and will be short-lived and hopefully uncommon.

WITH REGARD TO AVAILABILITY OF THE VACCINES, THE MOMENT I KNOW, I WILL LET YOU KNOW! ALBERTA HEALTH SERVICES HAVE STARTED TO VACCINATE HIGH RISK GROUPS AND THAT IS GOING TO BE HOSPITAL STAFF ESPECIALLY IN THE ICU SETTINGS, THEN OUR LONG TERM CARE PATIENTS AND THEIR CARERS. PATIENTS ON CERTAIN OF THE BIOLOGICS AND THE ORAL MEDICATIONS CALLED JAK INHIBITORS MAY BE ASKED TO DELAY THEIR DRUG/BIOLOGIC THERAPY FOR A WEEK OR TWO AFTER THE VACCINES ARE ADMINISTERED BUT THAT WILL BE DISCUSSED WITH THE PATIENTS INVOLVED. AS WE KNOW THERE IS A DELAY IN VACCIINE AVAIALABILITY AT THE MOMENT, IT IS OUR HOPE THAT THIS DELAY IS SHORTLIVED.

AS I RECEIVE MORE INFORMATION SO I WILL UPDATE THE SITE AND POST NOTIFICATIONS TO THE PRACTICCE FACEBOOK PAGE.

 

 

GRANDE PRAIRIE

The updated clinic schedule for the remainder of the year is on the Grande Prairie Clinic Schedule page.

Please remember to wear a mask, it is a requirement of the clinic and the Grande Prairie PCN.

Come dressed in layers so I have access to what needs to be examined and scanned.

The telephone number operating DURING THE CLINIC ONLY IS:

780-2962082

Call us when you arrive, the clinic does limit the number of people allowed in at once.

Olena, my usual assistant is back so will be assisting me with the clinics next year..

I will be driving up from Edmonton, flight schedules are still not reliable so pray for good weather on the clinic weekends, if there is adverse weather that prevents me driving up, the clinic will be virtual, telephone and or video, you will ne notified and the website will contain notification. Most people will receive text messages  a few days prior to the visit, please remember to confirm your appointment, I have a huge waiting list for Grande Prairie, a no show means someone else is denied the opportunity to be seen.

The forms page has been updated and all the forms are now fillable on the website and can be sent by Email, you may find the new patient form useful to send in before your first visit, or if personal or medical details have changed.

For virtual video visits please register with Medeohealth, please see the details on the registration process above under “Virtual Consultations”.  Use this contact form to let us know the Email, this is most important.