Wednesday, June 11, 2014

Lyme Disease Lecture Scheduled for June 18

Dr. Joshua Jakum
Dr. Joshua Jakum Will Speak on Lyme Disease June 18
Warrenton Pediatrician Joshua Jakum, M.D., will present “Lyme Disease Season is Upon Us” at 7 p.m. on June 18 in Fauquier Hospital’s Sycamore Room. 

Dr. Jakum will discuss possible health risks and treatments for Lyme disease, and what to do if your child is bitten by a tick. Lyme disease is a complex disorder, and a quick response to the infection is crucial to a good outcome.

Initial signs to look for in the first days after a tick bite include: a red, expanding rash; fatigue; chills; fever; headache; muscle and joint aches, and swollen lymph nodes. Symptoms in the following weeks and months can escalate to additional rash lesions in other areas of the body, as well as facial or Bell’s palsy; severe headaches and neck stiffness due to meningitis; pain and swelling in the large joints; shooting pains that may interfere with sleep; heart palpitations, and dizziness.

In the long term, approximately 60 percent of patients with untreated infection may begin to have intermittent bouts of arthritis, with severe joint pain and swelling, particularly in the knees, as well as other symptoms.

To register for Dr. Jakum’s talk, visit or call 540-316-3588.

Jack Dueck, 6, had a serious Lyme disease
infection, but antibiotics treated the illness.
Lyme Disease is Scary, but Treatable
In April 2012, Kirsten Dueck noticed that her 4-year-old son Jack wasn’t himself. Before making an appointment with her pediatrician, Joshua Jakum, M.D., she made a list of symptoms she’d noticed over several weeks: a stuffy nose for a day or so; a fleeting low-grade fever; Jack’s cheeks were especially rosy more often than not; he complained once or twice about aching legs; and most noticeably, he was increasingly irritable and edgy. As time passed, his face became very pale and dark circles developed under his eyes.

When Dr. Jakum pulled up Jack’s shirt to examine him, there was a large, round rash below his armpit; it had not been there just hours before. The disease was moving into the second phase and needed to be treated quickly. Dr. Jakum sent the family directly to the Fauquier Hospital Emergency Department (ED) for tests and to start treatment. “It was really scary,” Dueck says. “By the time we got to the ED, three more blooming rashes had appeared.”

At the hospital, Jack underwent a lumbar puncture to test for Lyme meningitis, a complication Dr. Jakum suspected because of the preschooler’s personality changes and rash. Dr. Jakum says that for Jack, this test was particularly key to the correct diagnosis; it changed the duration of treatment and the modality for his care (oral versus IV antibiotics).

Dr. Jakum worked with Tam Ly, M.D., infectious diseases specialist, to develop a four-week treatment plan. Kirsten only had two questions: “Will there be side effects,” and “Is this going to work?”

She remembers, “Dr. Jakum looked me in the eye and said, ‘We are going to treat this very aggressively. It’s going to work.’” 

Jack spent two nights in Fauquier Hospital, receiving antibiotics via a PICC line (an intravenous tube that can remain in place for weeks). Kirsten says, “They wanted to make sure that he was handling the medicine well and that there was no sign of blood clots or infection.”

When Jack returned home, a home health nurse showed Kirsten and her husband Colin how to administer the antibiotics intravenously. Kirsten says, “We were very nervous about doing this
ourselves until the nurse showed us how. She was wonderful.”

Kirsten recalls that the improvement in symptoms was almost immediate. “The rashes, the dark circles, the irritability – all gone overnight. It was very reassuring.”

Two years later, Kirsten and her husband remain vigilant, but not on high alert. They do regular tick checks from March to November and keep an eye out for the symptoms that were the first clues to Jack’s Lyme disease.

Diagnosis can be difficult
Dr. Jakum says, “Lyme disease does resolve. However, the antibodies that we use to correctly diagnose it do not always disappear. Once you have Lyme disease, you cannot always use the
same test for confirmation of the illness. This is very hard for families to understand and is why if you test in the same fashion over and over, you will remain ‘positive.’ ”

Tuesday, June 10, 2014

Fauquier Health Rehabilitation & Nursing Center Again Receives Prestigious Accreditation

FHRNC resident Vivian Draper waters the plants in the wheelchair accessible garden.
Residents enjoy the chance to get some sunshine and help tend the flora.
FauquierHealth Rehabilitation & Nursing Center in Warrenton, VA, has been granted a three-year accreditation in both Inpatient Rehabilitation and Person-Centered Long Term Care, by CARF, the international accrediting body (Commission on Accreditation of Rehabilitation Facilities). FHRNC is the only skilled nursing facility in Virginia with an Inpatient Rehabilitation accreditation. FHRNC is one of only two facilities in the nation holding both accreditations. The recognition is actually a reaccreditation; FHRNC has been accredited continuously since 2008.
A team of three surveyors spent several days at FHRNC in March, completing a comprehensive survey on patient care and medical outcomes. Dr. Julie Ross, director of Inpatient Physical Medicine and Rehabilitation, said that the visitors were especially impressed with two aspects of patient care at FHRNC: communication and quality.
“The surveyors were amazed at how many recreational and educational choices we provide for residents – everything from Bingo (always popular) to classes, to special events, like a Senior Prom or a Pet Expo. We have big boards in several different areas that make it easy for residents to see what options are available and when.”
Communication extends to patients’ families as well. Family members are welcome anytime, and are encouraged to talk to staff members about concerns or specific needs their loved ones may have. The CARF survey talked with all the stakeholders at FHRNC and found that communication among them – patients, family, staff – was excellent.
Dr. Ross said, “To earn the patient-centered care accreditation, the surveyors want to be sure that the long-term care facility is seen – by staff and residents alike – as the residents’ home. A lot of emphasis is placed on dignity. At FHRNC, residents have the same freedoms they would have in their own homes. They can wake up, eat, sleep and participate in activities when they like. We don’t impose our schedules on them.”
Communication intersects with quality when it comes to patient care. Dedicated to preventing problems like medication interactions, falls and pressure ulcers that can be common in long-term care facilities, Dr. Ross said that the facility uses patient care quality metrics on a daily basis to drive the best care.
On the short-term rehabilitation end, the staff focuses on good communication to make sure patients are healing as quickly as they are able. Dr. Ross said, “We place a strong emphasis on providing a plan of care, right from the beginning of a patient’s time with us. We work to make sure that the discharge information and transition to home care is as complete as possible. We want to make sure that when the person is ready to leave our care, that they have the means to continue improving at home. That’s our commitment to our patients – get better, and get home.”
Dr. Ross notes that the CARF survey is voluntary and is above and beyond already stringent state and federal regulations. “Applying for the CARF accreditation helps to us to maintain the highest standards. We want to be sure we are performing at a superior level. ”
She added, “Our dedicated staff deserves special kudos for all the work they do every day to ensure our commitment to quality and improvement is clear, not only to surveyors, but to our residents, patients, their families, and this community.”