When Should You Choose Telemedicine and When is an In-Person Appointment Needed?

Telemed vs In Person

COVID-19 has changed countless facets of the way we interact with businesses, brands, and accomplish our daily tasks. Picking up a latté now requires an app-based pre-purchase, vet appointments are now parking lot drop-offs, and hair appointments are occurring on breezy, outdoor patios. While many such changes are expected to be short-lived, there is no denying that the COVID-19 pandemic has accelerated the adoption of technology solutions that have been available for years, but that many have not previously had an impetus to test.

Even when we conquer COVID-19 (and we will), social experts predict that virtual interactions will remain primary preferences. For example, researchers anticipate that many students will still choose online education programs, and families separated by distance will continue to convene for birthdays and holidays using video conferencing tools. Such technology solutions are changing our lives for the better—making it easier to connect and obtain services from the comfort and convenience of our homes. Similarly, telemedicine may be growing in popularity due to the COVID-19 crisis, but patients are learning that it is a convenient and confidential way to seek non-emergency healthcare treatment for a variety of routine and acute care needs.

Now is the time to embrace the best of technology alternatives and understand the long-term role they can play in our lives. The next time you need to speak with your primary care or urgent care provider, consider if you can address your healthcare needs using telemedicine.

What is Telemedicine?

The telemedicine experience for the patient is similar to a traditional in-clinic healthcare visit, except the provider interacts with the patient via an app or a web-based video conferencing tool. Using digital technology, patients and healthcare providers can see and speak to one another; however, the patient never needs to leave their home, commute to the healthcare clinic, pay to park, sit in a waiting room, or be exposed to other patients who may be seeking treatment for an airborne illness. From a time-savings perspective alone, patients stand to benefit from telemedicine, especially when one considers that the average round-trip time commitment for a typical doctor’s appointment is 121 minutes.

For What Types of Health Concerns is Telemedicine a Preferred Option?

You can make a telemedicine appointment for such needs as:

  • Allergies
  • Annual wellness visits
  • Anxiety
  • Chronic conditions if you are an established patient on a recurring treatment schedule
  • Constipation
  • Cough or cold
  • Depression
  • Diabetes
  • Fever
  • Flu
  • Follow-up consultation to imaging or lab work
  • Infection
  • Joint aches and pain
  • Medication refills
  • Nausea and vomiting
  • Pink eye
  • Rash or insect bite
  • Sinus problems
  • Sore throat

During these visits, your provider can even prescribe or refill medications. In addition to wellness visits and acute care, some specialists also accept telemedicine appointments for routine follow-ups and check-ins, though not when there is an onset of emergent symptoms. Potential specialist appointments in which you can leverage telemedicine include:

  • Allergists
  • Cardiology
  • Dermatology
  • Oncology
  • Gastroenterology
  • Immunology
  • Nephrology
  • Obstetrics and gynecology
  • Ophthalmology
  • Psychiatry
  • Radiology

You should see a healthcare provider in-person, or seek urgent or emergency care if you are experiencing:

  • A possible (or known) broken limb
  • A laceration that requires stitches
  • Abdominal pain
  • Shortness of breath or chest pain
  • Severe difficulty breathing

The next time you need a wellness exam or an acute diagnosis or treatment, consider making a telemedicine appointment. Not only will you save yourself time and travel, but you can enjoy speaking candidly to a provider you trust from a comfortable setting. To make a telemedicine appointment with a compassionate care provider at Nova Health now, click here.

Chronic Fatigue Syndrome. When is it More than Just Exhaustion?

Chronic Fatigue

Some days, you simply don’t want to get out of bed. You could curl up for hours, continually falling back into an all-consuming sleep that doesn’t ever seem to want to release you. Sometimes, such extreme exhaustion is the result of stress, depression, jet lag, intense activity, or not getting enough consistent sleep. When, however, are so many days spent feeling a debilitating sense of fatigue, a sign of a more concerning health issue?

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling and complex illness that affects 2.5 million Americans. It leaves its patients feeling stripped of their ability to accomplish daily functions, and in some cases, it confines them to bed. If you are experiencing regular, debilitating periods of exhaustion that are disrupting your life, with seemingly no lifestyle or other underlying health conditions that might trigger your symptoms, it might be time to speak with your doctor.


What is ME/CFS?

Also known as systemic exertion intolerance disease (SEID), chronic fatigue immunity deficiency syndrome (CFIDS), and post-viral fatigue syndrome (PVFS), ME/CFS is a multi-system, chronic disease characterized by feelings of extreme fatigue that sometimes worsen with physical or mental activity, but don’t improve with rest or sleep. Individuals living with ME/CFS are often unable to perform daily tasks, including working, going to school, caring for their family, socializing, and even performing personal hygiene tasks. At least 25 percent of ME/CFS sufferers become bed or house-bound for long periods. Some individuals who develop ME/CFS suffer for years, and in some cases, it becomes a severe disability


ME/CFS Symptoms

The primary symptom of ME/CFS—the extreme exhaustion, is known as post-exertional malaise (PEM). Other symptoms can include:

  • Unrefreshing sleep and other sleep problems
  • Difficulty thinking and concentrating
  • Memory loss
  • Dizziness
  • Muscle or joint pain
  • Headaches
  • Sinus and nasal problems, including swollen glands and sore throat
  • Light sensitivity and chills
  • Abdominal pain, bloating, and nausea
  • Enlarged lymph nodes in the neck or armpits

For some, standing upright can exacerbate ME/CFS symptoms.


What Causes ME/CFS?

The cause of ME/CFS is currently unknown. Some health care experts and scientists believe a combination of factors might trigger the condition. They believe such triggers might include psychological stress and viral infection. While no one virus has been definitively linked to ME/CFS, those studied for a relational effect include:

  • Epstein-Barr virus (EBV)
  • Human herpesvirus 6
  • Ross River virus (RRV)
  • Rubella virus

Bacterial infections also studied concerning ME/CFS include coxiella burnetii and mycoplasma pneumoniae.

There is currently no diagnostic test or FDA-approved treatment of ME/CFS. Since there is no definitive known cause of the disorder, and because many other conditions can trigger extreme fatigue, such as infections or psychological disorders, ME/CFS can be challenging to diagnose.

For some patients, ME/CFS appears along with another condition, such as:

  • Fibromyalgia
  • Orthostatic intolerance
  • Irritable bowel syndrome (IBS)
  • Interstitial cystitis
  • Temporomandibular joint (TMJ) disorder
  • Chronic pelvic pain
  • Multiple chemical sensitivity disorder


Who is at Risk of ME/CFS?

While anyone can develop the condition, it is most common among women in their 40s and 50s. The illness also affects children and adolescents.


When to Get Help

If you are experiencing extreme exhaustion lasting more than 24 hours after physical or mental exercise, talk to your doctor. They will be able to eliminate other possible causes of your symptoms and determine if you are suffering from ME/CFS. Together, you will create a treatment plan to help you adapt to your illness and continue living your fullest possible life.

Brett O’Connor, NP-C joins Nova Health’s Florence Clinic

Brett O'Conner

Eugene, OR – July 21, 2020 – Nova Health, a comprehensive provider of quality urgent care, primary care, physical therapy, and musculoskeletal services in Oregon and Montana, has announced the addition of Brett O’Connor NP-C, to its team of healthcare providers. O’Connor will begin treating patients at Nova Health’s Florence clinic, located at 4480 Highway 101 N Suite G Florence Oregon 97439 this August.

As a registered nurse and nurse practitioner, O’Connor brings to Nova Health over thirty years of health care experience that includes inpatient, outpatient, long-term care, and specialty treatments. He received his early healthcare experience as a Navy Corpsman, working in San Diego and Japan on a special surgery unit. He obtained a Bachelor of Arts Degree in Liberal Arts from Eastern Washington University and a Bachelor of Science Degree in Nursing from Columbia University. Most recently, O’Connor worked as a Nurse Practitioner in Sandpoint, ID. During this time, he completed a third-year Masters Certification program at Vanderbilt University to increase his knowledge and hone his urgent and emergency care skills.

“Seeing people reach their highest potential of well-being as defined by them is what I love most about practicing medicine,” said O’Connor. “I couldn’t be more excited to join the team at Nova Health, which has an outstanding reputation for ensuring quality care. I am excited to begin giving back to the Florence community where everyone has been so welcoming.”

Dr. Lyle Torguson, Nova Health Medical Director of Primary Care Services, said O’Connor’s commitment to lifelong learning should be an inspiration to healthcare professionals everywhere.

“Brett is a tremendously accomplished medical professional,” said Torguson. To earn a third advanced degree after nearly thirty years of experience shows how committed he is to continued learning, collaboration, and self-improvement, which are three skills we value highly at Nova Health. We are thrilled to have Brett as part of our team of trusted caregivers.”

Sharon DeHart, PA-C joins Nova Health’s Florence Clinic

Sharon DeHart

Eugene, OR – July 17, 2020 – Nova Health, a comprehensive provider of quality urgent care, primary care, physical therapy, and musculoskeletal services in Oregon and Montana, has announced the addition of Sharon DeHart, PA-C, to its team of healthcare providers. DeHart will begin treating patients at Nova Health’s Florence clinic, located at 4480 Highway 101 N Suite G Florence Oregon 97439 this August.

In 2002, after twenty years working as an emergency medical services responder, DeHart obtained her Physician Assistant certification to expand her capacity to provide quality care to patients in need. Since earning her certification, DeHart has treated patients in a variety of settings, such as a free community clinic, a community hospital, and a comprehensive medical clinic in which she focused heavily on adult and pediatric acute and chronic care. Committed to ensuring that all patients, regardless of their ability, can receive high-quality healthcare, DeHart also treated nursing home patients and provided at-home care.

“What I love most about practicing medicine is helping people understand their bodies and what they can do for themselves—and then helping them when they can’t,” said DeHart. “I am excited to be joining the team at Nova Health and to expand my ability to provide for patients throughout the continuum of their lifetime healthcare needs. Nova Health is known for its commitment to rural communities, and its compassionate, high-quality care culture. There is nowhere else I’d rather be at this phase of my career.”

Dr. Lyle Torguson, Nova Health Medical Director of Primary Care Services, praised DeHart’s ability to obtain her patient’s trust by providing honest and hopeful insights and treatment options.

“Sharon is precisely what we look for in a member of our team,” said Torguson. “She is knowledgeable, comforting, and persistent in her passion for helping her patients achieve their best possible outcomes. We cannot wait to introduce her to the Florence community.”

DeHart received a Bachelor of Science Degree with Honors in Pre-Medical General Sciences from Oregon State University and a Bachelor of Science Degree in Physician Assistant Studies from Oregon Health & Sciences University School of Medicine. She received the Karen Whitaker Knapp Service Award from the Oregon Health & Sciences University Physician Assistant Program in 2019 and is a 2018 recipient of the Rural Health Hero of the Year award from the Oregon Office of Rural Health.

Joshua Middlekauff, DNP joins Nova Health’s Junction City Clinic

Joshua Middlekauff

Eugene, OR – July 16, 2020 – Nova Health, a comprehensive provider of quality urgent care, primary care, physical therapy, and musculoskeletal services in Oregon and Montana, has announced the addition of Joshua Middlekauff, DNP, to its team of healthcare providers. Middlekauff will begin treating patients at Nova Health’s Junction City clinic, located at 355 W Third Avenue, Junction City OR 97448 this August.

Middlekauff graduated from the University of Michigan in 2015 as a Doctor of Nursing Practice. Before joining Nova Health, he offered his clinical expertise both in healthcare and higher education settings. He helped to inspire the next generation of health care leaders by working as a clinical nursing instructor at both Davenport University in Grand Rapids, Michigan, and Umpqua Community College in Roseburg, Oregon.

“I could not be more pleased that the next step in my career has brought me to Nova Health,” said Middlekauff. “It is rewarding to be part of an organization that is expanding its footprint to ensure accessible care in rural communities, and that is committed to bringing modern telemedicine services to all its patients. Nova Health is well-poised to address patients’ needs in this evolving healthcare landscape, and I am thrilled to be part of its growth.”

Dr. Lyle Torguson, Nova Health Medical Director of Primary Care Services, says that Middlekauff’s clinical expertise and knowledge of chronic and complex conditions make him an asset to the Junction City clinic.

“Josh is tremendously knowledgeable and insightful,” said Torguson. “In addition, I am confident that his warm disposition will give his patients the hope, help, and support they need. He is the ideal addition to our compassionate care team.”

Five Ways to Lower Your Cholesterol Without Medication

people running

Cholesterol—the waxy, fat-like substance found in all the cells in your body—can cause severe health risks if not maintained within healthy levels. High cholesterol can result in heart attack, stroke, and peripheral arterial disease; all conditions that can lead to death. While for many patients, statins—prescription medications used to help lower cholesterol levels—can successfully mitigate associated health risks, there are also lifestyle changes that you can make today to start lowering your cholesterol tomorrow. What follows are five such suggestions to help you take the first vital steps toward a healthier, longer life.


1. Reduce Your Consumption of Saturated Fats

Saturated fats can raise total cholesterol levels. Foods high in saturated fats include red meat, full-fat dairy, milk and white chocolate, fatty meats such as lamb, processed meats such as burgers and bacon, butter, lard, fried foods, baked goods, and coconut and palm oils. By decreasing your consumption of foods rich with saturated fats, you can reduce your levels of the bad-for-you low-density lipoprotein (LDL) cholesterol.


2. Replace Foods High in Saturated Fats with Heart-Healthy Items

Once you clean out your pantry and refrigerator to rid your diet of bad-for-you foods, you’ll need to stock up on healthy alternatives. Choose no-calorie beverages such as water and sugar-free tea, fruits, vegetables, whole grains, olives and olive oil, tree nuts such as almonds and cashews, avocados, and lean meats instead. By following a heart-healthy diet, not only will you help lower your cholesterol, but you will feel better and can maintain a healthy weight.


3. Move Your Body

Reducing your cholesterol levels is a lot about diet, but it’s also about exercise. Working out at least two and a half hours per week can raise high-density lipoprotein (HDL) (the good kinds of cholesterol) and lower LDL. If you have not been working out regularly, do not feel the pressure to jump into triathlon training or join a cross-fit gym. Simply walking every day can help you reach your fitness goals until you feel well enough to increase the intensity of your workouts. Always consult with your doctor before beginning a new fitness routine.


4. Swap Your Egg and Sausage Breakfast Sandwich for Oatmeal

Oats are a superfood that are particularly impactful for those looking to lower cholesterol. Commit to a healthy serving of oatmeal or cold, oat-based cereal for breakfast daily. It’s the fiber in the oatmeal that will help you lower your cholesterol. If you don’t love the taste of oatmeal, toss some heart-healthy blueberries on top for some added sweetness. Other foods high in fiber include barley, beans, nuts, apples, berries, citrus fruits, and pears.


5. Boost Your Intake of Foods Rich in Omega-3 Fatty Acids

Don’t let the word “fatty” fool you. Foods that are rich in omega-3s can help to reduce blood pressure, which is critical for those at risk of health complications due to high cholesterol. Foods to add to your shopping list include salmon, herring, mackerel, flaxseeds (which are an excellent topper for light yogurt and salads), and walnuts.

If you need support and guidance to help lower your cholesterol, talk to your doctor. Depending on your risk factors, They may still recommend medication, but they will likely also recommend lifestyle changes that will offer comprehensive health benefits. Being active and eating a healthy diet will not only lower your total cholesterol, but it can help you lose weight, sleep better, and feel more energetic, so you’re ready to take on every beautiful, fulfilling day.

What Women Need to Know About Cervical Cancer

woman with mug

Cervical cancer is the third most common gynecologic cancer in the U.S. The American Cancer Society estimates that about 13,800 new cervical cancer cases are diagnosed annually and that over 4,200 women lose their battle with the disease each year. Fortunately, if detected early, cervical cancer is one of the most treatable forms of cancer. Every woman needs to understand the risks of cervical cancer, how to minimize their likelihood of developing the disease, how to recognize symptoms, and when to get help.

What is Cervical Cancer?

Cervical cancer occurs in the cells of the cervix, the lower part of the uterus that connects to the vagina.

What Causes Cervical Cancer?

While it is unknown what causes cervical cancer, it is known that some strains of the sexually transmitted infection human papillomavirus (HPV) can play a role in its development. For some, when exposed to HPV, the immune system is not able to protect the body from harm. As a result, the virus survives for years, ultimately causing some cervical cells to mutate into cancer cells. If untreated, cervical cancer can metastasize, or spread to other areas, including the bladder, vagina, rectum, liver, or lungs, making it significantly more challenging to treat.

There are two main types of cervical cancers: squamous cell carcinoma and adenocarcinoma.

  • Squamous Cell Carcinoma – 90 percent of cervical cancers are squamous cell carcinomas. This type of cancer develops in the exocervix (the outer part of the cervix that a doctor can see during a speculum exam)
  • Adenocarcinomas – This form develops from the mucus-producing gland cells of the endocervix.

Other forms of cancer that most often develop in other parts of the body can also develop in the cervix, including melanoma, sarcoma, and lymphoma.

Who is at Risk of Developing Cervical Cancer?

All women are at risk for cervical cancer; however, it most often occurs in women over age 30. Other cervical cancer risk factors include:

  • Having many sexual partners, which can increase the risk of contracting HPV
  • Becoming sexually active at an early age
  • Contracting other sexually transmitted infections including chlamydia, gonorrhea, syphilis and HIV/AIDS, as they increase one’s risk of contracting HPV
  • A weakened immune system
  • Smoking
  • In utero exposure to the miscarriage prevention drug diethylstilbestrol (DES) that was given to some pregnant women in the 1950s

Signs and Symptoms of Cervical Cancer

For many women, particularly in the early stages of the disease’s development, there are no symptoms. When cervical cancer grows and begins to affect nearby tissue, symptoms may include:

  • Abnormal vaginal bleeding, (e.g., after vaginal sex, after menopause, between periods, heavy menstruation, or after douching)
  • An unusual, watery vaginal discharge that contains blood and may have a foul odor
  • Pain during sex
  • Pelvic pain
  • Swelling of the legs
  • Difficulty urinating or with bowel movements
  • The presence of blood in the urine

How to Minimize Your Risk of Cervical Cancer

One of the best things women can do to minimize their risk of cervical cancer is to obtain regular pap tests from their doctor. Also, by preventing HPV, women can reduce their risk of cervical cancer. Women should practice safe sex, receive regular screening tests, and receive the HPV vaccine.

When to Get Help

If you are experiencing any of the signs of cervical cancer, talk to your doctor. While a different condition might be causing the symptoms, you should be examined by a physician who can identify the cause of your symptoms and help you begin a healing treatment plan.

What is Celiac Disease? Causes, Symptoms, and Treatment


Gluten-free foods and food products have been popping up on restaurant menus and grocery store shelves for the past several years. While some may mistake gluten-free choices as the latest weight-loss trend, for individuals living with celiac disease, consuming gluten can trigger painful and dangerous symptoms. Experts estimate that about one in 100 people has celiac disease, and that 2.5 million Americans are suffering undiagnosed, putting themselves at risk of severe complications if the condition continues to go untreated. If you believe that you may be at risk of celiac disease, or are experiencing its symptoms, talk to your doctor.

What is Celiac Disease?

Celiac disease, also referred to as celiac sprue or gluten-sensitive enteropathy, is a serious, genetic autoimmune disease triggered by consuming gluten. Gluten is a protein found in barley, wheat, rye, and other grains. When an individual with celiac disease consumes gluten, it damages the villi of the small intestine—small, finger-like projections that increase the surface area of the small intestinal walls, creating more areas for absorption. When the villi are damaged, it is more difficult for the body to properly absorb nutrients into the bloodstream, resulting in malnourishment and other dangerous complications, such as anemia, thyroid disease, osteoporosis, infertility, some cancers, and other autoimmune diseases.

What are the Symptoms of Celiac Disease?

Individuals suffering from celiac disease report such symptoms and health complications as:

  • Fatigue
  • Weight loss
  • Diarrhea or constipation
  • Bloating, gas
  • Nausea, vomiting
  • Anemia
  • Joint pain
  • Dermatitis herpetiformis (a skin rash marked with itchy blisters)
  • Mouth ulcers
  • Headaches
  • Numbness or tingling in the hands and feet

It is important to note that celiac disease symptoms can vary significantly, especially between adults and children.

Complications from Celiac Disease

Over time, the consistent malnutrition that celiac disease causes can result in such dangerous complications as:

  • A loss of bone density (osteoporosis) or bone softening (osteomalacia)
  • Infertility
  • Miscarriage
  • Some neurological diseases
  • Nervous system injuries, including balance problems and cognitive impairment
  • Certain cancers
  • Hyposplenism (reduced spleen functioning)

Who is at Risk of Celiac Disease?

Celiac disease is hereditary. People with a first-degree relative with the condition, such as a parent, have a 10 percent chance of being diagnosed. It can develop at any age after one begins consuming foods or medicines containing gluten.

Unfortunately, due to the full range of symptoms associated with the disease, doctors believe that most patients never know that they have the condition, and as a result, suffer from slow damage to their small intestines over several years before symptoms or complications exacerbate.

Treatment for Celiac Disease

While there is currently no cure, medical or surgical treatments for celiac disease, many patients who eliminate gluten from their diet can eliminate its uncomfortable symptoms and minimize their risk of health complications. Those who remove gluten from their diet for at least a year with no improvement are often diagnosed with a form of celiac disease called refractory or nonresponsive celiac disease. Researchers are working diligently to identify alternative therapies and a cure to this dangerous autoimmune disease.

When to Get Help

If you are experiencing the symptoms of celiac disease, and notice a flare-up of complications after eating foods that contain gluten, particularly if you have diarrhea or digestive discomfort that lasts for more than two weeks, talk to your doctor. They can provide a thorough examination, assess your genetic history, and if they diagnose you with celiac disease, help you make the necessary dietary changes to suppress symptoms and avoid complications.

Nova Health Acquires Basin Immediate Care, Expands Urgent Care Locations

klamath falls

Eugene, Ore. – July 1, 2020 Nova Health, a comprehensive provider of quality urgent care, primary care, physical therapy, and musculoskeletal services in Lane and Douglas Counties, has announced that it has acquired Basin Immediate Care, an urgent care center located in Klamath Falls, Oregon. All former Basin Immediate Care providers will continue to provide services as part of Nova Health.

According to Nova Health Chief Executive Officer Bill Clendenen, the addition of Basin Immediate Care to the expanding network of Nova Health care facilities is yet another crucial step in Nova Health’s commitment to offering easily accessible, quality care to families across the Pacific Northwest. The acquisition of Basin Immediate Care expands Nova Health’s network of clinics to 18, including 15 clinics in Lane and Douglas counties along with two in Montana.

“Our acquisition of Basin Immediate Care represents the unification of two like-minded entities,” said Clendenen. “We are both committed to offering the highest quality patient care and serving Oregon’s underserved communities. Together, we will be even stronger thanks to our combined resources and our shared vision for providing compassionate, same-day care.”

Clendenen wants both existing Nova Health and former Basin Immediate Care patients to be assured that the providers they have come to know and trust will continue to support their health and wellness plans.

“Our expansion efforts have been purposeful and strategic so that we can ensure a consistent and high-quality patient experience,” said Clendenen. “What is unique about Nova Health, and the reason we remain the place that people choose for health care, and the place that compassionate people want to work, is that we keep our patients and their wellness at the center of everything we do. By adding Basin Immediate Care to our network, we continue to achieve our goal of providing exceptional medical care across the Pacific Northwest.”


About Nova Health

Nova Health provides urgent care, primary care, physical therapy services, and musculoskeletal clinic services. Our focus is on providing the best patient care to patients in our communities. Established in 2008 with one clinic and nine employees, we have grown to 18 clinics in Oregon and Montana.