Tampa Bay Times: Yes it’s awkward, but more dentists should talk to patients about oral cancers and sex

By Justine Griffin

Dentists and dental hygienists see nearly 85 percent of children and their parents in the U.S., making them an important group of health care providers who could address HPV prevention and detection -- even if the conversation can be awkward, says Ellen Daley, a professor studying women's health at the University of South Florida. [DOUGLAS R. CLIFFORD | Times]

Dentists may soon be prying deeper in their patients’ sex lives.

The human papillomavirus, or HPV, is now the most common sexually transmitted disease, and one local researcher is urging dentists to get on board to warn patients about it.

But talking about HPV — and how it can be spread through oral sex — can be awkward.

“This is an emerging topic for dentists and not really one they ever expected to have to talk about,” said Ellen Daley, the lead investigator of a recent study on this topic published in the Journal of the American Dental Association this month. “It’s controversial and uncomfortable. No one wants to talk about these sensitive topics.”

HPV is the cause of 72 percent of oropharyngeal cancers, which can impact the base of the tongue, tonsils and walls of the pharynx, said Daley, who is also a professor studying women’s health at the University of South Florida.

Younger patients, usually pre-teens and teens, are the most at risk for HPV. But the virus can also be dormant for years, which could impact older patients who won’t necessarily experience symptoms for many years.

It’s transmitted during vaginal, anal or oral sex with someone who has the virus.

Nearly 80 million people — or about one in four — are currently infected with HPV in the U.S., according to the Centers for Disease Control and Prevention. About 14 million people become infected each year, and 30,700 of those cases cause cancer in men and women.

The HPV vaccine can prevent most of those cancers, or 28,000 of them. An estimated 50,000 cases of oral type cancers will be diagnosed this year, according to the American Cancer Society.

The Florida Legislature is currently considering companion bills in the House and Senate that could add the HPV vaccine to the child immunization requirements for school.

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Tampa Bay Times: Free clinics respond as more people head to the ER with dental problems

By Justine Griffin

Charles Lee had been dealing with an excruciating toothache for days.

The pain made it hard to eat or sleep or focus on work. But Lee, 54, didn’t have dental insurance. His job as a delivery truck driver offered only a supplemental policy that was too expensive. He feared he needed a root canal, which he knew could cost hundreds of dollars even with insurance.

The Department of Health in Pinellas County referred Lee to a free dental clinic in Clearwater, just blocks from his home, where a volunteer dentist found the cause of his issue and replaced two fillings for the price of a donation.

“I had nowhere to go. I had no affordable health care. I went into a Walgreens to see what they could do, and walked out with my tooth still killing me because they wanted $119 just to see me,” said Lee, one of the 27 percent of U.S. adults ages 20 to 64 who, according to the Kaiser Family Foundation, are living with untreated dental issues.

Most adults who don’t have dental insurance end up in emergency rooms because of tooth or gum problems. The number of patients who go to the ER with dental-related issues surged from 1.1 million in 2000 to 2.1 million in 2010, and continues to rise, according to the American Dental Association. The organization says that up to 1.65 million ER visits a year could be better handled at dental clinics.

While the Affordable Care Act and low-income insurance programs like Medicare and Medicaid have improved Americans’ access to health care, barriers still remain for adult dental care.

Local health departments, including in PinellasHillsborough and Pasco counties, offer some low-income dental plans to residents who qualify. And children’s dental care is covered nearly in full through Medicaid, the federal Children’s Health Insurance Program and the ACA.

But Florida Medicaid plans for adults provide dental-related reimbursements only to participants who need emergency services to alleviate pain or infection or denture-related procedures, according the Agency for Health Care Administration.

At the Community Dental Clinic in Clearwater, dentists and hygienists convinced Charles Lee to come back for several follow up appointments, which helped get his dental care on track. And Lee didn’t have to worry about how much he was paying for the continuing service.

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Tampa Bay Times: ‘Pregnancy centers’ draw scrutiny as lawmakers seek to elevate their status

By Justine Griffin

Rose Llauget, director of pregnancy and adoption services with Catholic Charities Diocese of St. Petersburg, Inc., replaces a doll representing the early stages of pregnancyat at her office in Tampa. Llauget oversees five Tampa Bay area centers that offer pregnancy tests, ultrasounds, adoption services and general counseling for women who find themselves in an unwanted or unscheduled pregnancy. [CHRIS URSO | Times]

Annie Filkowski used to see the signs during her drive to school each morning. “Free pregnancy tests,” they said.

So when she feared she might be pregnant at 16, shortly after starting to have sex with her boyfriend, she remembered them. And walked into a center in Fort Myers.

Keisha Walters, saw the signs too, outside an old Tampa home on Armenia Avenue that had been converted into an office. Walters, 32, was pregnant for the first time and had lost her job. She felt alone, far away from her family in the Caribbean islands of Saint Kitts.

“I didn’t even know what to ask for, or what I needed,” she said.

Both women had found their way to one of the 105 publicly subsidized “pregnancy support centers” in Florida, part of a network of mostly faith-based organizations that provide emotional support and limited medical services for unplanned pregnancies — while also working to prevent abortions.

But their experiences could not have been more different. Filkowski said she left feeling pressured and duped, while Walters found a welcoming source of help that she continues to rely on today.

The contrast goes to the heart of a simmering debate as Florida lawmakers prepare to make a key decision on the future of the centers: Should the state continue to fund them every year as part of the budget process, or give them a more exalted position by enshrining them in state law as a permanent program overseen by the Department of Health?

Welcome to the latest battleground in a long-running war over state government’s role in the abortion issue.

Many Floridians know of the centers from the now-familiar billboards that have lined the state’s rural highways for years, urging women to find options other than abortion, reminding them that a heartbeat begins just days into a pregnancy.

The centers are part of the Florida Pregnancy Care Network, which has received more than $21 million in state funding since 2007, according to the Florida Department of Health, including $4 million in the current fiscal year. With services that range from testing for sexually transmitted diseases to parental counseling, they are largely unregulated and can vary significantly depending on the location. Some employ nurse practitioners or physicians. Others rely on church volunteers to take ultrasound images, provide medical information with sometimes questionable accuracy and deliver a clear anti-abortion message.

Companion bills in the House and Senate that would make the centers a permanent fixture have drawn heavy criticism from groups like the National Organization for Women and Planned Parenthood.

“The funding for this network umbrella has steadily increased over the years to the tune of millions,” said Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates, whose members receive no state funding. “Women should have all the medically accurate information they’re seeking, without bias and without shaming. The women who have been to some of these pregnancy centers have felt this way and are later harassed for their decisions.”

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Tampa Bay Times: Patients face delays, bureaucratic headaches after marijuana clinics close

By Justine Griffin

The remaining Tetra Health Care center is located at 2814 W Martin Luther King Jr. Blvd. in Tampa. Similar to a walk-in urgent care center, Tetra Health Care is a place where patients can see a licensed doctor about obtaining medical marijuana as a form of treatment. [Photo by ALESSANDRA DA PRA | Times]

Thousands of patients who received medical marijuana access from physicians at a half-dozen recently closed clinics in Tampa Bay may be forced to find another doctor soon, which is no easy task due to state restrictions.

Tetra Health Care, a California-based chain that hires licensed doctors to write medical marijuana recommendations at six clinics in Florida, shut down all but one of them last month to focus on working with state lawmakers to make access easier for patients, a company spokeswoman said. But a former doctor with the chain said Tetra ran into financial trouble and stopped paying its physicians and staff in October.

Those in the industry say Tetra’s downsizing is just one sign of many growing pains doctors and companies will face as Florida heads into its second year offering medical marijuana products to registered residents.

“When they stopped paying us is when I left,” said Dr. Kelly King, who worked for Tetra Health Care since the company began opening clinics in Tampa Bay last summer. She said Tetra was still using the passwords of departed physicians to access the state registry that tracks which patients were assigned to them.

“I noticed after I left, they were still putting new patients into my registry,” she said. “People I had never seen or treated before.”

King, who said she treated hundreds of patients during her time with Tetra, also said the company grew too big too fast. Tetra Health Care had one clinic in Sacramento, Calif., before expanding into Florida.

“They never really opened a lot of offices at one time before,” King said.

Tetra had five locations in the Tampa Bay area: two in Tampa and one each in St. Petersburg, Clearwater and Brandon. A sixth was in the Orlando area. Patients are being directed to one remaining center in Tampa, at 2814 W Dr. Martin Luther King Jr. Blvd., for appointments and doctor recommendations.

“The roadblocks from the state and delays in patient access have resulted in higher operational costs than originally projected for the industry statewide, including for Tetra Health Care. Tetra expects to make full restitution shortly,” said Tanya Cielo, a spokeswoman for Tetra.

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Tampa Bay Times: A day at the movies, inspired by real-life and a good friend

By Justine Griffin

*The Christmas Day 1A centerpiece story*

Collin Barnes, Reid Carlisle, Aidan Griffin, Cedric Buckley, Matthew Morgan, and Tyler Burkhart came to see the movie "Wonder" with Connor Carlisle. [Photo courtesy of Kerry Carlisle]

Connor Carlisle wanted to design an invitation, something special, and he asked Sarah Reed for help.

Reed is one of Connor’s teachers at St. Petersburg High School, and her hospitality and tourism class is his favorite. He dreams of designing roller coasters.

So they worked on a flier, and he passed them out to everyone he knew at school. He wanted them to go to a movie with him, to see Wonder.

The blockbuster film, released widely Thanksgiving weekend and starring Julia Roberts and Owen Wilson, is based on Connor’s favorite book. The young adult novel by Raquel Jaramillo — written under the pen name of R.J. Palacio — chronicles the story of a fifth-grade boy living with a condition similar to Treacher Collins syndrome, which required many surgeries. Because of his disfigurement, the main character, August, is bullied in school. The story shares what it’s like to be different, and how he’s often stared at for something he cannot control.

Connor, who is 16, says he has read the book many times. Like August, he has had many surgeries. Thirty-six, in fact.

Connor was born with a cloverleaf skull, which made his eyes bulge and his ears reach near the back of his head. His skull was more cone-shaped than round. Ultimately, it didn’t leave much room for his brain to grow.

“I had a very normal pregnancy. We had no idea until he was born,” said Connor’s mother, Kerry Carlisle, who is a nurse in the Pinellas County school system. “Back in 2001, the outlook was not very good.”

Connor also was diagnosed with the genetic disorder Crouzon syndrome and Arnold-Chiari malformation, which means he was born without a fully developed spinal cord, nor its protective covering. He lives with a tracheostomy tube in his throat, which makes his voice raspy and low. He sleeps on a ventilator, and his parents take turns being “on call” in case he needs help in the middle of the night. His long-term prognosis isn’t so clear.

His family lived in New York City for nearly 12 weeks straight when he was a few years old, as he underwent several craniofacial surgeries to reshape the bones in his skull. Family photos show a happy, young Connor on the carousel in Central Park, even as equipment halos his face.

“We always made the most out of it, vacation-wise,” said Connor’s father, Reid Carlisle.

Connor’s favorite memory was visiting the Toys “R” Us in Times Square. And he enjoyed playing with his big brother, Reid Jr., who has been Connor’s best friend and advocate all his life, while they watched subway cars zip in and out of Grand Central Station.

“I remember really liking the trains,” Connor said.

Connor’s health continues to be struggle. He fights pneumonia, tracheitis or respiratory infections nearly every year, which almost always land him in the intensive care unit. He was hospitalized twice in August. He hates that he can’t swim underwater because of the tube in his throat.

But he tries to do all he can.

Connor is a huge Star Wars fan. He went to Megacon for the first time this year. He’s been in Boy Scouts most of his life, and loves to camp with his dad and brother. His parents bring the ventilator, with extension cords, on camping trips. Last summer, he attended Camp Able in Marco Island all by himself. No aides. No parents. Just him.

He loves riding the Cheetah Hunt at Busch Gardens, but the Incredible Hulk coaster at Universal’s Islands of Adventure has been his favorite since he was cleared by his doctors to ride coasters in 2015.

“Connor is definitely not the type who likes to sit around,” said Tyler Burkhart, an 18-year-old Northeast High student who has known Connor pretty much all his life. “He’s always looking for something new to do.”

Read more here.