News & Announcements

Sep 5

Dear BFM Family,

We know you have been inundated with a lot of information regarding the Coronavirus Disease 2019 (COVID-19), and it is difficult to filter fact from fiction. We want to provide you with facts, obtained from the CDC, World Health Organization, infectious disease specialists and epidemiologists, with the purpose of keeping you updated on this virus, the public health response, as well as the steps we’re taking in our clinic to address this issue and remain accessible to our patients. As your primary care providers, our purpose is not to cause more panic, but to inform so that you can keep yourself and our community as healthy as possible and so that you can be prepared for the news and government directions that will continue to come out. This is not a virus to fear, but it IS a virus for which to prepare and be proactive – that is our goal and our hope for you.

Current Issues: Containment & Mitigation

COVID-19 is a very contagious respiratory illness with a tendency to cause a viral pneumonia that is already spreading quickly in the United States (far more than current “confirmed cases” suggest). Because of this, we support recent CDC and local, state and federal government recommendations regarding “social distancing” as our primary method to slow down the accelerating spread of COVID-19. The spread is currently “silent”, as we have extremely limited testing capabilities and very strict testing guidelines, so the confirmed cases vastly underestimate the actual number of cases. It is important to know that over the next 2-3 weeks, we will see a significant increase in cases. Do NOT panic, follow CDC and Health Department as well as local, state, and federal government recommendations. If we begin aggressive social distancing now, we can hopefully prevent this virus from spreading more exponentially and reaching a critical mass, overwhelming emergency rooms, hospitals, ICU beds and ventilators, as we currently see in Italy and even areas of Washington state. Again, WE CAN SLOW THIS DOWN by adopting these social distancing measures NOW, but it is the responsibility of every individual to do so – YOU can save lives by starting this NOW. Avoid gatherings of more than 50 people. If you are over 60, or have chronic illnesses, avoid even smaller gatherings – less than 10. Resist shaking hands and hugs and other physical greetings for now. Wash your hands for 20 seconds and use hand sanitizer OFTEN (>60% alcohol). Help your neighbors, especially those who are older and more vulnerable – offer to get groceries, etc., to help them minimize their risk. Wipe down surfaces, computers, and phones w disinfectant regularly. Be GOOD to each other!

Symptoms and Severity

For most healthy adults, COVID-19 presents with symptoms similar to the common cold or flu. Symptoms typically begin 2-5 days after exposure and can last for 1-2 weeks. Symptoms can include chills, fever and cough, and many people can have mild symptoms or even have none at all. Even higher risk individuals (over 65, history of high blood pressure, heart disease, diabetes, kidney disease, asthma, COPD, kidney disease, cancer or immunosuppression, among others) will by and large recover, but a higher proportion of these individuals will require hospitalization and life support (15-20%). COVID-19 appears to be more dangerous than the flu, especially because we have no immunization. It appears to be twice as contagious as the flu and anywhere from 5-10 times as deadly, especially for those vulnerable groups listed above (as high as 5%-10% fatality rate). Younger people can still become very sick and even die as well, but at a much lower rate (0.1-0.4%). Children seem to either have very mild symptoms or no symptoms at all and there have been NO deaths under 10 years old reported in the world, although children can probably spread the virus to others.

Treatment

No approved medication exists for this viral infection, so the treatment is managing symptoms at home (i.e. take acetaminophen for fever, drinks lots of fluid and rest.) until symptoms are fully cleared. At this time, it appears MOST HEALTHY PEOPLE CAN TREAT THIS AT HOME WITH NO MEDICAL INTERVENTION. The total time you may need to stay home and isolated is fourteen days. HOWEVER, if your symptoms worsen with shortness of breath, increased confusion or clouded thinking, you should contact our office or call 911.

Testing

At this time, COVID-19 testing is limited due to several factors, including shortage of testing materials and laboratories performing the test, and strict guidelines on who should be tested based on severity of symptoms and travel. Therefore, our providers will help make the decision whether a patient should get tested, prioritizing the highest risk patients first until testing becomes more widely available. As testing becomes available, we will communicate how this may change.

Office Changes

Please know our office will be working diligently to field questions from patients and determine if you can be seen in our office, or if a provider will contact you via telephone or by a Telemedicine appointment (which we will be starting THIS WEEK). Depending on the symptoms, we may also direct you to an emergency room for more aggressive treatment.

Please do not hesitate to keep or call to make an appointment at our office out of fear of exposure, although we are expanding opportunities for “virtual” appointments for routine follow-ups using Telemedicine, which should roll out this week. In addition, our office has implemented every safety precaution to prevent exposure to you and our staff.

Finally, help us all to stay healthy by practicing prevention, being prepared but not panicking, and knowing our providers and staff are working hard to ensure the health and safety of our patients, staff and community.

Stay Well and Stay Calm.

Dec 27

We know many of you have questions about the COVID-19 Vaccine. The question we are getting most is “when will it be available for me?”

Currently, Boerne Family Medicine has NOT RECEIVED AND HAS NOT been approved by the state to administer this vaccine – storage requirements are very difficult to attain. More than likely, local pharmacies will be the primary outlet for these vaccines initially. So to repeat, Boerne Family Medicine will not be able to administer this vaccine in the near future. We will send updates as we receive them.

As far as availability from other community sources, local pharmacies and possibly an urgent care clinic may have the vaccines available soon. If you are over 65 or an adult with certain chronic health conditions like diabetes, severe immunosuppression, chronic heart or kidney disease, it seems likely that at some point in January the vaccine will be made available for administration to this group. The rest of the population will be open for available vaccine administration in the months after that, most likely later in the spring, depending on manufacturing capacity.

Vaccine distribution is being regulated by the State of Texas and is a work in progress. They have set up a tier system to help prioritize vaccine doses as they become available. It is possible the state will decide to administer the vaccine to “essential workers” as a group earlier, but they have not made that decision at this time. The tiers outline are as follows:

Tier 1A: Nursing Home patients, Healthcare workers and First Responders

Tier 1B: Over 65 and Over 16 with certain chronic health conditions

Tiers 2 and beyond: “to be determined”

More information about these tiers can be found here: https://www.dshs.state.tx.us/coronavirus/immunize/vaccine.aspx

Vaccine Efficacy

In trial studies, these mRNA vaccines have proven highly effective in preventing symptoms of COVID-19 and preventing severe illness from COVID-19: studies showing 90-95% effectiveness. As a comparison, the flu vaccine is usually 40-60% effective depending on the year. Much more research needs to be done about how these vaccines affect a person’s ability to transmit the virus to others, but researchers are optimistic about this. Time did not allow this specific datapoint to be analyzed in detail yet, but it remains an important question.

Vaccine Safety

In trial studies, these mRNA vaccines appeared to be very safe. Adverse events were similar to most vaccines and included local pain, redness or swelling at the injection site, as well as muscle aches, fatigue and low-grade fevers. No significant catastrophic adverse effects were noted in the studies. The second dose of the vaccine was more likely to cause muscle aches and fever, especially in younger people, but these symptoms resolved after 1-2 days in the vast majority of cases.

The majority of our office staff and all our medical providers received the covid-19 vaccine last week. Approximately 15% of us had general muscle aches and fatigue, lasting 1-2 days, but no fever. Almost everyone had some arm pain at the injection site similar to a flu or tetanus shot, and 15% had mild local redness. We had no severe reactions.

Vaccine Takeaway

At this point, the vaccine remains our most likely way to begin to see fewer of our of at-risk neighbors and friends hospitalized, or worse, succumb to this virus. It is also our most likely way to avoid transmitting this virus unknowingly to at-risk people around us, putting them at risk of complications from COVID-19. In addition, receiving the vaccine means those who are recipients are unlikely to need to quarantine when exposed to COVID-19 in the future, after the vaccine has taken full effect following the second dose. As a result, this vaccine remains our best option for returning our businesses, social organizations and activities, sporting events and lives in general to a more normal routine, not to mention the lives protected. Those are the reasons we chose to receive our vaccine: protect those around us and get our neighbors businesses and lives back to normal.

At Boerne Family Medicine, we care about your health. We want to make sure you have all of the tools that you need to manage your health during this uncertain period.

Mar 2

What you need to know

1. COVID-19 is a flu-like illness, with symptoms primarily consisting of fever, body aches, cough and sometimes diarrhea or nausea, with more severe cases causing shortness of breath and chest pressure and occasionally low oxygen levels. This virus has a greater tendency to cause viral pneumonia and occasionally dangerous lung inflammation, especially in people over 60-70 and people who smoke or have heart or lung disease.

2. Currently, COVID-19 appears to be more deadly than flu overall, but mortality will NOT be the 2-3% currently reported, as we anticipate these numbers to go down as more data is gathered. It is important to remember that the flu is responsible for between 30,000 – 75,000 deaths every year in the United States alone, we just don’t see the news reporting them one by one and town by town all day long.

3. The virus seems most dangerous for those over 70 and those with heart disease and lung disease, with a significant percentage of those requiring hospitalization.

4. Nursing home patients will be at very high risk.

5. Children appear to have very mild illness with NO deaths reported so far under 10 years old.

6. Face masks are NOT helpful to prevent disease if you are NOT sick. If you have a cold, wearing a mask can prevent YOU from spreading virus droplets to those around you as long as you don’t touch the mask.

7. This virus has most likely been spreading in the US for the past 6 weeks, so the number of cases the media and others report is misleading and will increase significantly in the coming weeks, not because of rapid growth of new cases (which will continue to increase, unfortunately), but because we will be testing many more people (although tests are extremely limited and so far unreliable).

What can you do?

1. Stay calm…panic will not help at all. As mentioned, the “mortality rate” will be lower than currently reported and most people are at low risk of severe illness.

2. Wash your hands regularly and try not to touch your face.

3. Cover your cough w tissue or your elbow and wash your hands with soap and water often.

4. Don’t buy masks, these are needed for medical professionals to be able to see the more sick patients and we can’t get them right now because of supply shortages.

5. Get plenty of sleep – this is the best immune system booster.

6. If you have an upper respiratory illness and you have no shortness of breath, no chest pressure, no confusion or excessive sleepiness, it will be best to remain home to avoid spread, as there is no treatment for this illness other than time – your body WILL get rid of it, but it will take up to 14 days for you to NOT be contagious anymore. If you develop symptoms of cough, body aches, and fever, call your doctor for advice about what to do next.

At Boerne Family Medicine, we care about your health. We want to make sure you have all of the tools that you need to manage your health during this uncertain period. Consider making it a priority to get your flu vaccine this year, as the fewer flu cases, the easier it will be to detect the COVID-19 cases. Contact us or local pharmacy for flu vaccine availability.

Feb 21

Tuberculosis (TB) is a contagious infection that most commonly affects the lungs.  It is spread through air droplets released when a person with active tuberculosis coughs or sneezes, similar to how a cold or the flu is spread.  Different than the common cold or flu, the bacteria grows very slowly and is fairly difficult to catch, so you typically have to spend a lot of time around a person who has TB to catch it. People at most risk are very close contacts such as family members, co-workers, or very close friends.

Doctors make distinctions between two types of TB:  Latent and Active.

• Latent TB is when the bacteria is present in the body in an inactive form.  The person will not have symptoms and will not be contagious.  About 10% of those with latent TB will go on to have an active TB infection.
• Active TB is when the bacteria is active and an individual will have all or some of the following symptoms. Cough for 3 more more weeks with fevers, night-sweats, weight loss and blood-tinged sputum.

You should see your healthcare provider if you have any of the above symptoms or have known contact with someone who has tuberculosis.  TB is detected by a doctors evaluation followed by a skin test or a blood test and a chest xray.  Higher risk individuals will be tested with microscopic examination and cultures of their sputum.

While difficult to treat, TB can be treated with a long course of antibiotics, so while it is a serious infection, the vast majority of patients will be completely cured!

Nov 21

If you’re wondering why you are experiencing fatigue, some common reasons we see in the Boerne community are poor sleep, poor nutrition, or a sedentary lifestyle.

Make an appointment at our office to rule out some medical causes like anemia, thyroid disorder, sleep apnea and vitamin deficiency (hint: it’s probably NOT your thyroid!).

Sep 8

Be careful with herbal supplements, especially those promising weight loss. Often, it’s too good to be true & may damage your liver. Check out this link for more information: http://goo.gl/vaS4Ov

Aug 28

If you’re looking to lose weight, we tell most of our patients to NOT make dramatic diet changes.  Just be CONSISTENT with small changes & portion size control to lose weight.

Feb 13

As we move from Cedar Fever Season to Oak Allergy Season, I want to give you a few useful tips to avoid my office and stay away from a sinus infection this spring.

Did you know that allergies are the 3rd leading reason for missed work and the 6th leading cause of chronic disease in the United States?  If you suffer from allergies, this may not be a suprise, because you know how bad they can make you feel!

Our goal at Boerne Family Medicine is to enhance your quality of life by improving your health, so here are some tips for treating your allergies:

1. Avoidance: this can be difficult, but attempt to avoid things you are allergic to. For example, if dust mites are an issue, try a mattress-cover and pillow-cover.  If necessary, we can do allergy testing to identify what is affecting you most.
2. Antihistamines: over-the-counter medications like Zyrtec, Claritin, and Allegra can be very effective and safe treatments for allergies.  Antihistamine drops such as Zatidor and Alaway for the eyes are available as well.
3. Nasal Corticosteroids: corticosteroid nasal sprays such as Flonase or Nasacort are probably our most effective pharmaceutical treatment for allergies, especially those affecting the nose, throat and eyes.
4. Immunotherapy: modifying your immune system’s response is currently the only “cure” available.  If you have persistent symptoms, we can perform allergy testing and potential treatment with immunotherapy to allow you to start to take control of this chronic illness.

As always, we will continue to keep same-day appointments available for  you to come in and get a jump start on managing this common, nagging, and potentially significant medical illness.

Stay Well!

Jun 17

As of month day, year, we are proud members of Privia Medical Group!