By: Dr. Gene Dorio
Doctor’s Diary: March 27, 2020
We were at war.
Yet, there was a second battle against an airborne virus plaguing the army as well as citizens. Those in charge quarantined solders, kept them isolated from communities, and inoculated as many as they could. Thirty percent of the population died.
In July, 1776, General George Washington was fighting for independence with his Continental Army attempting to keep a world scourge of smallpox away from his brave men.
This virus was an unknown entity, but even with rudimentary science, doctors knew once you were exposed, you developed immunity and would not get sick again. Inoculation of pox material into an incision would give you illness with the hope it would be only a “mild” case.
Today of course, medical knowledge is different, as we already mapped the viral structure of COVID-19. Despite this extraordinary scientific information, we must still utilize the same strident isolation rules of 1776.
History repeats itself, and as the revolutionary war for independence was won, this war can be won also.
Leadership, and a worthy plan by good scientists must be followed.
Doctor’s Diary: March 26, 2020
COVID-19: Monitoring destiny
You’re sick. Is it a cold, seasonal flu, or COVID-19?
Whether you know the answer or not, the fatal destination typically is your lungs. If this happens and you are not in the right place having appropriate healthcare, you can go into respiratory failure requiring a ventilator (respirator).
Some of you remain at home, and are ill. Knowing blood pressure, pulse, and temperature are important. But a critical piece of information is your oxygen level. When this starts to decrease, your lungs might not be exchanging oxygen well because of infection.
Pulse oximeters, like toilet paper, are becoming rare. They may be purchased at pharmacies or online. It is placed on the fingertip and provides an oxygen reading.
If the oxygen level is decreasing and becomes abnormal, it could be an indication of pending respiratory problems. Associated with shortness of breath and other symptoms of COVID-19, this may be a time to seek medical help.
Since nasal swab testing for COVID-19 is presently limited, don’t wait for this result if your oxygen level is dropping.
Life might be at your fingertip.
Doctor’s Diary: March 25, 2020
COVID-19: Dear bailout company
As a frontline provider of healthcare, the COVID-19 pandemic brings new urgency caring for patients. Every day I have to carefully calculate my time to insure those who might be ill are treated. There are many hoops doctors face that must be overcome.
Yesterday, I spent 20 minutes writing a letter for a patient to two airline companies because they would not refund monies after flight cancellations this week.
The patient is a caregiver for an ill loved one, but also attempts adhering to government direction on limited travel. But the airlines were not going to give a refund without a doctor letter. Oh hum…20 minutes.
Maybe, I could have evaluated one patient, called a worried family member, or perhaps tracked down gloves, gowns, and masks which are difficult to find.
Instead, I spent 20 minutes of time helping my patient get a refund from two airlines.
With this story, I hope Congress measures discretion providing bailout.
Some companies literally fly on the backs of people, even when there is a crisis.
Doctor’s Diary: March 24, 2020
COVID-19: A perfect storm
It’s a perfect storm. A pandemic colliding with the opioid crisis.
We are told to shelter in place, yet for patients under Pain Management, they must sustain narcotic medication for fear of going through withdrawal.
DEA rules require patients have a “face-to-face” visit with their doctor in order to receive their special security prescription. What if your physician’s office is closed, has diminished hours, or you are afraid to leave home worrying about viral exposure?
Twenty percent of my patients are bedridden, many with illness or catastrophic accidents resulting in faulty nervous systems. Lucky for now, I do house calls, but what if these visits become restricted? What about those who don’t have a house call doctor?
Sure, I can do telemedicine using FaceTime or Skype, but according to the law (correct me if I’m wrong), the “face-to-face” must be “in-person.”
This is a time to relax the laws for a few months.
I still fear the mega-storm…when adding to these problems is disruption in the medication supply chain causing shortages.
Then, we will all go through withdrawal.
Doctor’ Diary: March 23, 2020
COVID-19: Screening hospital personnel rapidly
Forty years ago while working in a VA Emergency Room, I examined a veteran who I thought could be anemic…low red cells. Because of limited staff, I drew a blood sample, took it to the lab, and analyzed it myself. Low. He was admitted to the hospital with my workup taking 10 minutes.
Inpatient testing for the coronavirus can take a minimum of 1-2 hours, and outpatient five days. In the pipeline is a rapid test that might take minutes.
Once this quick analysis is implemented, some of the first people tested should be healthcare workers in hospital settings.
Hospitals help those afflicted with COVID-19, but there might be unaffected patients who get exposed to the illness by carriers in these facilities. So when technology makes it possible, all potential hospital contact personnel should be tested daily prior to starting work.
We must assure healthcare professionals are protected from COVID-19, but also hospital personnel don’t become a source for spreading infection.
With advances in science, eventually all of us will be analyzed at home…maybe in 10 minutes.
Doctor’s Diary: March 22, 2020
COVID-19: No visitors allowed
Our mother, who is 98 years old, lives close by. Because of potential exposure to the coronavirus, I sometimes have to avoid visits fearing contamination, but figured out a solution using FaceTime.
Hospitals now have restricted visitation, but it does not mean the loss of contact with your loved one. Many older adults though are not adept utilizing present technology. So if your family member or friend lacks understanding using smart phones, this is the time to update their skills, even if you meet with resistance.
If hospitalized, you can leave a phone in their room, and if needed, a doctor, nurse, or CNA could help. What happens though if they are extremely ill in the ICU, and cannot respond?
Think about this, at a time when they might need you the most in life, you would not be there. Will they feel abandoned, alone, or isolated? No one wants this for their loved one.
I hope hospitals will consider a humane way of allowing one family member to be with their loved one possibly using protective equipment including masks, gloves, and gowns.
These problems are a moving target, so we must figure out a solution.
Doctor’s Diary: March 21, 2020
COVID-19: Having an end-of-life discussion, now
There are horror stories around the world. Not enough medical life-saving equipment, with difficult decisions who will live and who will die.
Do you know what you or your loved ones want? Have you had an end-of-life discussion?
Many older adults want everything done if their life is threatened: CPR, chest compressions, blood pressure support, intubation (on a ventilator), fluids, antibiotics, and feedings. Others do not want heroic measures because they have “lived a good life.”
Some have placed their wishes in legal documents including Advanced Directives, Durable Power of Attorney, POLSTs, living wills, DNR/DNI orders, Five Wishes, etc.
If you have not heard of these documents, there is a possibility you have not had an end-of-life discussion.
Ultimately, what do you want when you face end-of-life? If you are incapacitated, who do you want to make medical decisions, and what legal documents will communicate your desires insuring your voice is heard?
During this trying crisis, if you want any say or control, you should have this discussion now.Do you have a news tip? Call us at (661) 298-1220, or send an email to firstname.lastname@example.org. Don’t miss a thing. Get breaking KHTS Santa Clarita News Alerts delivered right to your inbox. Report a typo or error, email Corrections@hometownstation.com
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