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Physician assistant helps teen sickle cell patients navigate through treatment

By Paul Lavoie

Paul Lavoie, a physician assistant in Hematology, examines blood smear slides in the Hematology clinic’s microscope room.

Paul Lavoie, a physician assistant in Hematology, examines blood smear slides in the Hematology clinic’s microscope room.

I have a bulletin board in my office where I display invitations to high school graduations. These messages of gratitude and pride come from the patients whom I see each Tuesday in the Hematology teen sickle cell clinic at St. Jude. They serve as touching reminders of the importance of my work and why I joined St. Jude as a physician assistant (PA) in 2011.

I am one of the clinic’s advanced-practice providers. I see patients from 12 to 18 years old, working with them on their routine care, promoting the importance of taking their medications and guiding them through the questions and issues that teenagers face.

The goal of our teen clinic is to prepare them for the transition to adult care. Teenagers are very much in the moment, and we try to emphasize the importance of maintaining what they are doing. Although things may be great today, there are many complications that can arise from their disease.

The lives of people with any type of sickle cell disease are typically 20 to 30 years shorter than the average life span, but early mortality and the frequency and severity of complications decrease greatly with early diagnosis and adherence to treatment.

There are a lot of challenges dealing with a chronic disease because you often see fatigue in the teenage years. They’ve been on medications for years, and they’re also trying to fit in with their peers.

We try to relate to what they enjoy doing. Many of our kids are active in sports, marching band or other extracurricular activities, so we place an emphasis on why it’s important to continue taking their medications.

Originally from Massachusetts, I earned an undergraduate degree in biology from Holy Cross. After college, I worked in a research lab at Boston Children’s Hospital, but I felt something was missing. I wanted to work with patients and decided that the physician assistant profession best suited my goals.

I transitioned into a clinical research role at Dana-Farber Cancer Institute after college, where I enjoyed working with patients and the medical team. I applied to PA programs and was accepted at Duke University. I joined St. Jude after completing the program at Duke.

I didn’t know anybody in the state of Tennessee, but I was so excited to be able to say, “I work at St. Jude.”

As the primary advanced-practice provider for the teen sickle cell clinic, I am responsible, along with the rest of the teen sickle cell disease team, for overseeing a combined 30 to 40 patients in the clinic on a given day.

I also rotate through the other hematology clinics, including the general hematology, hemostasis and acute care clinics. Clinic visits include lab check-ups, physical exams and educational opportunities. The highlight of my work is building relationships with patients and families and helping them through their troubles and triumphs.

It’s the greatest thing to know you played a part in this child’s success to this point, and that their disease hasn’t held them back from achieving their goals. The most rewarding thing is when it comes time for a teenager to transition, and they send me an invitation to their high school graduation or show me their college acceptance letter.

Paul Lavoie is a physician assistant in the Hematology Department at St. Jude Children’s Research Hospital.

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