FRANKFORT, Ky. -- Many rural health clinics primarily serving Medicaid recipients as well as the uninsured are navigating ways to help their patients manage chronic conditions such as diabetes and high blood pressure during the pandemic. One million Kentuckians see a health professional at more than ninety rural health clinics across the state.

David Bolt, chief executive of the Kentucky Primary Care Association, said rural clinics increasingly rely on telehealth phone and video appointments amid COVID-19, "and the concern there is that, in a lot of rural areas of the state, we still don't have appropriate connectivity in that last mile for people to take advantage of it."

Kentucky currently ranks 44th among states for broadband access, and statewide health organizations are calling for federal funding to expand reliable internet access in rural areas as part of continued coronavirus relief efforts.

With many patients continuing to avoid non-urgent care, clinic revenues are expected to decline as COVID-19 continues. But despite the challenging road ahead, Bolt said clinics are determined to continue providing primary care in communities hardest-hit by unemployment because of the pandemic.

"Some of these clinics have jumped in to continue to build primary-care operations in communities that have need," he said.

In April, Congress approved a $225 million grant program specifically aimed at helping federally certified rural health clinics cover coronavirus-related expenses, including testing.


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Holiday stress is a concern for most people, but when you mix in travel plans and chronic health issues, those worries might be elevated.

A Minnesota expert said now is the time to ensure a safe and healthy trip this season.

Dr. Mary Boylan, cardiothoracic surgeon at St. Luke's Hospital in Duluth, said whether you're flying to a warmer destination or driving a few hours to a relative's house, preparation is vital for those with a chronic health condition like heart disease or being at risk of stroke.

To start, she recommended checking in with your doctor to find out if you are healthy enough to travel. If so, getting the logistics down should be the next priority.

"It's really easy to think, 'Oh, I'm just gonna fly here, fly there,' and forget about the details," Boylan pointed out. "If we can take those actual itinerary items off the table and have arranged to have a cart, if we need a cart, to get us to our gate that's a really good step."

Safely transporting medical devices, such as portable oxygen machines, is another priority. Boylan recommended checking with transportation agencies and companies about their policies for storing and screening them. Having enough medication is important, too. And if you are traveling to another time zone, experts suggest talking with your doctor about adjusting your medication schedule.

Boylan also is president of the American Heart Association's Midwest region Board of Directors. She noted when you get to your destination, having fun is the goal but don't feel like you have to go beyond your comfort zone.

"And we should really build in downtime," Boylan advised. "It is a very, very good thing to -- in the middle of the day or before the end of the evening -- just settle down, have a little time for peace."

She added it can help to keep blood pressure in check amid all the travel and activities you are trying to squeeze in. Other tips include locating nearby health facilities during your trip, and for long flights, wearing compression socks to prevent blood clots.

This week is Crohn's and Colitis Awareness Week, shedding light on what some call an invisible disease.

Crohn's disease and ulcerative colitis are also known as inflammatory bowel disease, and they affect a person's food choices and many other aspects of life.

Ryan Boyce - executive director of the Northwest chapter of the Crohn's and Colitis Foundation - said symptoms include abdominal pain, rectal bleeding and diarrhea.

But Boyce said many suffer in silence because those symptoms aren't usually visible.

"It's a difficult disease to diagnose and it's very common for folks to really struggle with these symptoms for a while," said Boyce, "before they get properly diagnosed and can begin a treatment path to help improve their health."

A recent study found about one in 100 Americans has been diagnosed with inflammatory bowel disease, or IBD.

Boyce said there's no cure for the disease, although there are a few approaches that can alleviate symptoms, such as medication and changes to a person's diet.

"The unique thing with IBD is that it impacts everyone a little bit differently," said Boyce. "So, there's not one set strategy and plan, or a blueprint if you will, that if everyone follows then it kind of limits symptoms. There's just so much variance with the disease."

Boyce said there have been major strides in the search for solutions for this affliction.

"What we're really trying to do is find cures," said Boyce, "and cures, plural, because it will take more than one cure depending on the disease and the treatment - and pushing toward that."




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November has been Diabetes Awareness Month - but heading into the holidays, people who are diabetic know they can't lose their focus on keeping it in check. And technology is making it easier to monitor the disease from home.

More than 520,000 Washingtonians have been diagnosed with diabetes.

Dr. Mamatha Palanati is the medical diabetes program director for Kaiser Permanente Washington. She said the disease needs to be managed closely, because it can lead to serious health complications.

Palanati noted that fortunately, people don't need to leave their homes to do this in some cases.

"In today's world, there's a much easier way to do it, like telehealth," said Palanati. "Telehealth provides multiple ways for the follow-up and connection to the health care for any individual."

Palanti said people managing diabetes still should plan to see their physician in person at least once a year. Management of other factors, like blood pressure and cholesterol, can also help reduce complications.

Palanati said monitoring technology can also assist people.

"The family members and caregivers, or anyone who can take care of that particular individual," said Palanati, "can do it remotely and manage their diabetes in a much better way."

Palanati stressed that diabetes is a chronic disease.

"Don't look at this as an additional chore or anything," said Palanati. "Make it as a part of your life. So, be active, making sure you adapt to the healthy lifestyles. It may not be perfect, but try your best to get what you can do."




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