COVID-19 Update

Updated 4/22/20 at 10:00 AM

Dear Southeastern Fertility and NEDC Patients and Families,

We hope that all of you have remained healthy and hopeful as we all continue to navigate the new normal here in our great nation.

The exciting news here at Southeastern Fertility is that our building construction is wrapping up… although we can barely hear ourselves think as the workers reattach the awnings with power drills. We have had an extended period of sunny skies and low humidity so Praise the Lord that we ended up right on schedule!

As previously planned, we will be back doing egg collections and embryo transfers the end of this week and those patients who had planned to undergo their FETs in April will not be delayed on our end! With the exception of scheduling surgery and HSGs (over which we have no control), we are continuing normal operations within certain limitations.

For example, we continue to follow our social distancing rules within the office at this time and are encouraging patients to continue to take advantage of telemedicine for visits that do not require an exam nor an ultrasound.

We continue to ask patients to prayerfully consider their decisions to resume fertility evaluation and treatment.

Remember that “Hope starts with a conversation…. ” and we are here to help in any way that we can.

Be strong and take heart, all you who hope in the Lord.

Psalm 31:24
  • John David Gordon MD
  • Jeffrey A. Keenan MD HCLD

Updated 4/3/20 at 10:00 AM

Dear Southeastern Fertility and NEDC Patients and Families,

Every day we are asked by patients: “What should I do?”

Although Dr. Keenan and I can certainly offer our professional perspective (and rest assured that we are continually discussing the decisions that we are making here at Southeastern Fertility), ultimately the decision will rest with you, our patients.

In such times, we are reminded that the concept that we are in control of our lives is an illusion. The situation is summed up by Pastor Alistair Begg who writes “In recent days, we’ve been reminded that the world can be a scary place. But whether we face a personal crisis or a worldwide pandemic, God remains our refuge.” There is an old adage that there are no atheists in foxholes during war. We are at war right now with an invisible enemy and it is indeed frightening to not be sure what to do.

As people of faith, turning to God in such times should be our first instinct, but sometimes we get distracted by our desire to figure it all out on our own. That is a losing proposition.

So as you seek to reach difficult decisions we would suggest that you go to the Lord in prayer.

May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope.

Romans 15:13

Please remain hopeful and faithful.

  • John David Gordon MD
  • Jeffrey A. Keenan MD, HCLD

Updated 3/31/20 at 11:00 AM

Dear Southeastern Fertility and NEDC Patients and Families,

Seems like everyday we are making changes to how we live and work in these uncertain times. Currently, as a country we are engaged in social distancing to “flatten the curve” and lessen the potential impact on the healthcare system from a wave of very sick infected individuals. This concern has led many businesses including medical practices to limit patient contact by reducing services, changing scheduling slots or closing entirely for an uncertain length of time. In addition, some locales, including Knox County, have instituted restrictions governing non-essential business activity and recommended that residents “shelter in place.” Some states have imposed travel restrictions and recommended 14 days of quarantine for those arriving from certain “hot spots” within the United States.

So what should we do? At Southeastern Fertility we continue to remain open with appropriate modifications including patient screening, transitioning to virtual or phone consultations whenever possible and rescheduling certain non-essential visits. The response among fertility clinics has been varied as some are high volume centers in close proximity to where there is a cluster of cases and others (like Southeastern) are lower volume clinics in areas where there is currently a paucity of positive patients. Our plan has been to make changes as appropriate given the evolving situation.

At the present time all patients seeking to pursue fertility treatments are provided with a waiver that Dr. Keenan and I have written and amended as the situation evolves. All such patients are provided with the ASRM Recommendations and the update that was released on Monday March 30, 2020.

We are allowing patients to pursue IUI cycles after reviewing our recommendations. As I described in an earlier post, we had a scheduled prolonged shut-down of the IVF Program for March and most of April as we complete construction on the building.

Here at Southeastern Fertility we certainly agree with the concerns raised by the ASRM, but believe that community prevalence and patient choice must also play a role in the decision making process. We have advised all of our patients to consider deferring their upcoming treatments (including scheduled Frozen Embryo Transfers) but allow patients who are fully informed of the known consequences and willing to accept that there may be unknown consequences to continue their treatment for now.

Like any other woman who is considering pregnancy, a patient pursuing fertility treatments should consider the benefits and risks of that decision. At this time none of our professional organizations are advising potentially fertile women to avoid pregnancy.  IF such recommendations were made THEN all fertility providers would really need to consider ceasing all operations.

The recommendations of the ASRM are based on the efforts to minimize the risk to patients, staff and the general public. However, we agree with many fertility providers around the country that a “one-size fits all” approach may not make sense given geographic differences.

We have already instituted appropriate safety measures consistent with the guidelines of the CDC including providing sufficient minimal staffing, spacing in-clinic appointments throughout the workday to allow for 6-foot social distancing policies in shared spaces, enabling staff to work from home, and implementation of mandatory health screenings at our front door to patients who must be seen in person (temperature checks, recent history). Our staff members are wearing surgical masks, practice compulsory hand hygiene, and follow 6-foot social distancing policies in shared spaces. Patients remain in their cars until being brought into the clinic. We are blessed to be in a free-standing clinic with parking directly in front of the building. No one needs enter into the hospital or ride in a crowded elevator to reach us.

In addition, since we have a small staff the number of staff members that each patient would encounter is probably fewer than you would experience at the grocery store. At larger clinics this is not the case as one fertility specialist working in a such a program estimated that each patient would interact with over 35 different staff members during a treatment cycle. That is simply not the case here at Southeastern Fertility.

Fear without faith leads to panic. Let us all be faithful and not fearful.

  • John David Gordon MD
  • Jeffrey A. Keenan MD, HCLD

Updated 3/24/20 at 9:00 AM

Dear Southeastern Fertility and NEDC Patients and Families,

I hope that all of you remain safe and healthy during these trying times. At midnight last night all of Knox County was placed under a “Safer at Home Order.” As a medical practice we are not in the non-essential business category, so therefore we are technically exempt from a mandatory shut-down. However, prudence dictates that we respect the spirit of the directive in terms of doing our part to “flatten the curve” by limiting face-to-face encounters.

As of this afternoon we will transition to performing all consultations via telephone, Skype or Zoom. Office visits will be limited to those patients with acute problems such as bleeding in early pregnancy or other Reproductive Endocrinology emergencies.

Patients who need blood work performed as part of their current cycles or to monitor their pregnancies will be able to have their blood drawn here in the office between 8-11 am daily. Semen analyses will be scheduled but samples will be received at the front door as no samples will be collected here at the office.

Current IUI cycles will be completed if desired by the couple but no new IUI cycles will be initiated at this time.

I will be providing additional details regarding Zoom in a separate blog post.

Our nonprofit partner, the National Embryo Donation Center, is maintaining business as usual. The NEDC team is still scheduling appointments, processing applications and addressing inquiries. Each member of the NEDC staff is working in isolation, from home, which may lead to some slight delays in these matters. We thank you for your patience and understanding.

Don’t be fearful…be faithful. We will come out the other side of this crisis with a new appreciation for all of our blessings.

John David Gordon MD

Updated 3/23/20 at 9:15 AM

Dear Southeastern Fertility and NEDC Patients and Families,

These past few days have seen such rapid changes in our lives that it is hard to contemplate. The near constant barrage of news from around the country and around the world affects all of us in different ways. Dr. Keenan and I have been discussing the situation on a daily basis. In addition, I have been in touch with my friends and colleagues around the country to see how they are handling the practice of reproductive medicine in such unusual times.

So where does that leave us here at Southeastern Fertility? First of all, I want to emphasize that Dr. Keenan and I are dedicated to the health and welfare of our patients, our combined staff, our clinic and the NEDC.

If all non-essential businesses here locally are asked to close then we will shut down.
If all travel is restricted then we will shut down.

At the present time we have elected to pursue the following approach.

We will encourage all patients who are just having a consultation appointment to schedule these as phone, Skype or Zoom consultations. Visits that require an ultrasound or a physical exam (including saline sonograms and trial transfers) will still be performed unless a patient asks to reschedule. We may move your date and time depending on staffing and the desire to limit the number of patients in the office at any given time.

All patients who have started fertility medications for IUI or timed intercourse cycles will be given the option to continue their cycles. New IUI or timed intercourse cycles using oral medications will be allowed, but if we have to close the office fully then these cycles will be cancelled in terms of further monitoring or doing an IUI. We have an information sheet/waiver for all patients pursuing fertility treatment cycles.

Months before the current situation, we had already scheduled a shut down of the IVF Program until late April in order to accomplish some building maintenance. We will assume at the present time that late April FETs will be performed, but any patient who wishes to reschedule to a later date can certainly do so.

The status of the Stimulated Cycle and Natural Cycle IVF starts will be determined over the next few weeks since we have less control over the precise timing of egg collections compared with FETs. However, all of these cycles were already pushed off until late April because of the construction project.

Other specific changes:

  • When you arrive at the office please call 865-777-0088 #1 and remain in your car until asked to come into the office.
  • You will be asked about symptoms of fever, cough, or shortness of breath. You will be asked if there is a family member or other close contact who is currently in quarantine. You will be asked about recent travel to a country with high prevalence of COVID-19 or travel to/from a US location with high prevalence of COVID 19.
  • Once inside the door we will check your temperature.
  • Please only enter with a maximum of one other family member/friend.
  • No children at this time please.
  • All staff members will be wearing surgical masks. We are taking this step as an added precaution even though our population is very low risk .
  • Please be patient as we work out the details of our revised patient flow through the office.

These are difficult times and in such times it is sometimes hard to remember our blessings which are so very great. We pray for the safety of those medical personnel working with sick patients, for the patients who are afflicted with any and all diseases and for all of us who are just doing our best to remain hopeful about the future.

For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.”

Jeremiah 29:11

Please check back soon for additional updates.

John David Gordon MD

Updated 3/17/20 at 3:45 PM

Dear Southeastern Fertility and NEDC Patients and Families,
 
At Southeastern Fertility, the health and well-being of our patients who are seeking to conceive or receive treatment for reproductive concerns is not only our first priority, but it is also our sole reason for being in business. For this reason we want to personally update you on our efforts to continue providing you and your family the superior level of care you have come to expect in the cleanest and safest environment available during these trying times.  As of this writing, there has only been one case of Covid-19 reported in Knox County, and the risk of infection in our community is still low. However, as we are expecting that number to increase, we are taking the following safeguards at Southeastern Fertility to ensure your protection:
 

  1. We have always endeavored to provide a clean office environment for our patients, which includes cleaning the exam rooms between each patient.  Currently, these efforts have been redoubled with an even more thorough cleaning between patients, and common surfaces in our entire office are being sanitized on a nightly basis to guard against disease transmission in our system.
  2.  If any member of the care team at Southeastern Fertility reports flu-like symptoms, that individual will not report to work until testing negative for Covid-19 and the resolution of symptoms. They will receive full paid time off during their absence.
  3.  If any patient has symptoms of fever, cough, or shortness of breath, we ask that you seek treatment and testing for these symptoms first, and reschedule appointments at Southeastern Fertility until cleared by primary care.
  4. If any patient has a family member or other close contact who is currently in quarantine, then that patient should contact us to reschedule their appointment.
  5.  For patients who have flu-like symptoms or who are concerned about attending a consultation appointment then we will be providing virtual telemedicine appointments online via FaceTime or Skype in the near future.  These must be scheduled through the office like any other appointment.
  6.  Although unlikely, there may be patients with Covid-19 or flu-like symptoms who have a gynecologic emergency or urgent problem that requires direct treatment regardless of other symptoms.  Such patients receive the care needed to assist them with such a gynecologic emergency.
     
    At Southeastern Fertility we are filled with hope about the future and in the ability of our great nation and community to pull-together to prevent the spread of disease.  We commit to doing our utmost to protect you and your family.  We look forward to seeing you soon.

Jeffrey Keenan MD HCLD
John David Gordon MD

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