Well, we are officially 1 year into our Hepatology program and treatment for Hepatitis C continues to be a very exciting area for us at Charlton Health.  With EVERYONE now being funded for the cure of hepatitis C, we continue to accept new patients and referrals to our program.

Are you living with Hepatitis C or know someone who is??  Everyone is now funded and offered the cure for this virus as Canada works hard to eradicate Hepatitis C completely.  If you have Hep C or know someone who does, please have the family doctor send a referral to one of our Hep C programs to discuss treatment.

Hamilton– Dr. Marco Puglia

Phone 905-526-7002 x 1104

Fax 905-522-7477

Brantford– Dr. Stephen Somerton

Phone 519-756-3830

Fax 519-756-6315

Jennifer Heipel has approximately 12 years of experience working as a hepatology nurse/clinical research coordinator for several gastroenterologists, hepatologists, infectious diseases and addiction specialists. She is trained in the treatment of Hepatitis B and C therapies as well as general hepatology and pre/post liver transplant follow up. Jennifer serves as Charlton Health’s full time Hepatology Nurse and manages the Hepatology Program. She has worked and continues to work with Dr. Puglia at McMaster University and other area Gastroenterologists to develop a comprehensive, in-house Hepatology program and Hepatitis C program here at Charlton Health.

Happy New Year! With 2019 just beginning and countless year-end lists from 2018, we thought we would share our Top 5 Blogs of 2018. Here they are, in case you missed them!

5. The use of Fibroscan to determine if you have liver disease
4. Fatty Liver Disease: Part 1
3. New Treatment on The Horizon For Ulcerative Colitis
2. Raynaud’s Phenomenon is more than cold hands and feet
1. The Ontario Government Extends Coverage of Prolia to Men

We hope you enjoyed learning with us throughout 2018. We’re excited to bring you lots of new helpful information in 2019!

• An automated phone call will be made to advise you of the date of medication delivery or clinic appointment. ​
• If you are able to answer the call, you will be asked to press “1” to confirm the delivery/appointment date or press “2” to reschedule. ​
• If you press “2”, one of our team will call you back to make alternate arrangements.
• The system will make three attempts to call you and will only leave a message on the third attempt.  If there is no answer on the third try, a message will be left  with your delivery/appointment details.

We hope you find our new system helpful and efficient. If you have any questions, please do not hesitate to contact us.

We’ve written about Project ECHO in the past and today we’re excited to bring you more information about this great initiative. ECHO (Extension of Community Healthcare Outcomes) is a not-for-profit project that was initiated in New Mexico by a hepatologist to educate community health care providers on Hepatitis C treatments. Weekly two-hour sessions include a small lecture followed by the presentation of patient cases by the community members who are attending via online video conferencing. The community members are often family physicians, nurse practitioners, pharmacists, chiropractors, physiotherapists, naturopaths etc., After attending the weekly sessions, community health professionals feel confident in initiating treatments that patients would have otherwise had to wait to see the specialist.

Ontario is the first Canadian province to launch Project ECHO and it is funded by the Ministry of Health and Long Term Care. For the last two years there has been a specific ECHO session for Rheumatology. There are also sessions for hepatology, chronic pain, and mental illness. I have had the pleasure to serve as the pharmacist expert for the ECHO Rheumatology sessions.

Last Saturday many of the community members had the opportunity to meet face to face at a ‘bootcamp’ held in Toronto. The highlight of the session was the patient partners who educated the community members on how they live with inflammatory arthritis. If you know of health professionals in the community that would like to learn more about rheumatology or the other sessions held by ECHO refer them to;

Toronto Rehabilitation Institute, University Centre
550 University Avenue Room 7-141
Toronto, ON M5G 2A2
PH: 416-597-3422;4435
E: echo.ontario@uhn.ca

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

At the October American College of Rheumatology meeting in Chicago, research from around the world was shared.  A featured study regarding osteoarthritis assessed 240 patients, half using acetaminophen and anti-inflammatory medications and the other half using opioid medications (codeine, morphine, hydromorphone, fentanyl etc.) They compared the level of general pain intensity and pain related to movement for the two groups. The intensity of pain was lessened in the group NOT using opioids. Pain with movement was no different between the two groups. This information emphasizes the need to avoid opioid use in osteoarthritis.

Weight loss and continued movement are the main focus of treatment. Even while sitting, keeping moving is important. Pushing through some discomfort to maintain movement and lubrication of joints is vital. Water exercise programs are also very beneficial for those with limited mobility. An example of these programs is the GLA:D physiotherapy program, which was first established in Denmark and is now offered at many centres in Canada. It is a well researched program showing improvement in osteoarthritic joints.

Stay tuned for more information on osteoarthritis…

At the recent American Rheumatology Association Meeting in Chicago, several reports were presented in the area of fibromyalgia. Many of these studies were done at the Rush Medical Centre in Chicago.

In 2010, the criteria for diagnosing fibromyalgia were updated. Despite the estimated 5 million people living with fibromyalgia, scientific articles on less common rheumatic diseases are published with much greater frequency than those focused on fibromyalgia. Some researchers feel that there is a publication bias which can limit the exposure to information clinicians can learn from in the area of fibromyalgia.

Some rheumatologists have limited their practice to exclude patients with fibromyalgia fearing that these patients are more time consuming and difficult to treat. A survey of a rheumatologists and rheumatology nurses asked them to rate patients from 1-3 (easy to difficult) based on several factors. Only 13.7% of patients were identified to be exhausting and difficult to treat. The authors concluded that these patients may have an undeserved reputation for being difficulty to care for, as the majority are not.

Researchers used a word recognition test to assess cognitive function in people with fibromyalgia. In a rheumatology clinic, 28 patients with fibromyalgia and 42 patients without fibromyalgia were selected to do the testing. Those with fibromyalgia had a time delay of 0.07 seconds in processing information compared to the non-fibromyalgia group. Slower processing may account for feelings of fibro fog where the synchrony of certain circuits in the brain are disturbed.