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2 year anniversary of covid- what isn't in the news or really discussed publicly:
What is working?
What is not working?
What's next? What do I want more of?
Okay, so what does my list of "stuff" have to do with you? It's meant to be a guide or a tool for you to do your own quarterly review. What is working? What is not working? What do you want more of? Or less of? What have you learned in the last 3 months? I encourage you to take a few moments to yourself in one of those cracks of time we all barely get these days. Write it down. Type it in your phone notes. Say it out loud if you want to do that. But give it some THOUGHT. Consistent quarterly reviews or seasonal reflections can be life-giving and increase your productivity, contentment, and enthusiasm for what lies before you! Godspeed. ❤️
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When I sat down to do my YEARLY REVIEW at the end of 2021, I was literally drained. I was exhausted: mentally, physically, emotionally, and spiritually. I could barely even form a sentence in my head. As I started PLANNING MY YEAR AHEAD as I usually do each holiday season, I started to see just how many things were already on my calendar. I am not sure if I felt disbelief, disgust, or disenchantment. "That will be cancelled. That won't happen. I doubt we actually do that." After two years of cancelled, postponed, and rescheduled plans, I almost reached for a pencil instead of a pen. I am eternally optimistic, but I am TIRED. You know those days where you sit down in the evening and you feel like you've been to DisneyWorld with 2 toddlers and 2 strollers and a newborn? Those days where you are driving home from a busy day in family practice and you aren't even exactly sure what your own name is (much less a disease or dosage of medication)? I feel like we've all had TWO YEARS of those days. So I decided to just boycott goals altogether for 2022. I wasn't going to make goal(s) for Health, Finance, Education, Personal Growth, Career, Family, Marriage, Spirituality, Home, etc like I usually do every year. The thought of doing that after I wrote my GOAL SETTING post was just as insurmountable as climbing Mount Everest (for this girl who already battles a chronic lung disease). Choosing a word for the year? Meh. And usually I am ALL OVER THAT!. But the only words that have come to mind lately (that don't include mild profanity) are flexibility, change, resiliency, and stamina. And I realize all of those words are entrenched in what I have LEARNED FROM THIS PANDEMIC as a frontline family NP. So I haven't chosen a word just yet. And I'm not sure that I will choose one for 2022.
And what I'm finding is that wearing ACTUAL CLOTHES (no scrubs, no standard mom "leggings and a tee" uniform) makes me feel better. It makes me feel better about myself, my life, my marriage, my work, and my day. I never thought I would be typing this, but it's TRUE. I choose healthier foods and move more when my pants have a zipper and a button. 👖 I try to have healthier emotional reactions when I don't look like I just rolled out of bed. 🧘♀️ I am reminded of my passion for medicine when I am dressed the professional part. 👩⚕️ I am even nicer to my husband when I like my reflection in the mirror. 👩❤️👨 I feel better about spending all the money I have spent on clothes now that I am actually wearing them. 😜 So there you have it. I set one goal for 2022. It is simple and it used to be automatic. What happened to the girl who loved shoes and purses and dressing up? Where did she go? Who and what took her from me? I feel her trying to emerge again. She is ready for this new year. She has no idea what's going to happen and no control over any of it. But she is showing up. And she looks and feels AMAZING. 👗 *** most of the time
*** except on Mondays *** or on days when her kids are off the chain *** but she is trying ☀️
Before deciding if you love me or hate me, let's look at each of these in a little more detail. If you are reading this and you don't work in healthcare, I encourage you to close your eyes. Imagine driving to work where patients are very sick and you are responsible for their health. Imagine being extremely exhausted - mentally, physically, and emotionally. Imagine having the same conversations day in and day out. Imagine wearing a mask and face shield all day every day AND if you work in certain healthcare settings, full plastic gowns (sweaty and HOT) with even more restrictive masks (n95). Think about having heart-wrenching conversations about death and dying with families and patients that you have come to love over many years. Consider praying on your drive in and your drive home because you've worked in healthcare since you were 19 years old, but you've never seen anything as dark and dangerous, cold and pointless, savage and destructive as THIS. Imagine that you, like everyone else, have also been unable to see loved ones, travel, send your kids to school without a mask, and that you- like everyone else- have your own political and religious beliefs but you cannot mention those since ALL eyes and ears are on you. Now imagine doing that every single day for 20 months in a row.
I usually wrap up my posts with some heart-swelling, tear-jerking, or funny concluding thoughts. I try to connect us as humans, mothers, fathers, daughters, sons, sisters, brothers, neighbors, and friends. I find a way to touch you, soften you, move you even if it’s only for a moment. I don’t know how to do that with this post. I’m tired. I’m sad. I’m frustrated. I’m still hopeful. I still believe. I guess I will end by asking all of us to consider the division we have all felt over the past 2 years. Consider the lost lives and energy we have all spent to prove we are right. And hug your family. Hug your loved ones. And look your “enemy” in the eye before you judge their choices. We really are all the same. Imperfect. Scared. And trying to stay alive. 🌎 State Prints from Jane- White on White Frames from Amazon These are the 4 states in which I've lived!
LUG Switch crossbody bag - came with free phone holder that you can touch through (though I haven't tried it) and it has that RFID technology that keeps people from scanning your card #s. Ya'll, this was my first ever QVC purchase and I am 45 years old. I love, love, love the bag though for shopping as it's the perfect size for my small LUG Splits Wallet (got it from amazon- will link on my tools page), my phone, keys, lipstick, coupons, mask, and hand sanitizer. I think the QVC chic showed it worn as a fanny pack also, but I haven't been to Disney since I got it. :-). I know I paid under $50, but I would have to look back at the exact price. I can't find the exact one on Amazon but I linked one very similar in my "tools" page. This bag is still available on the QVC site but the colors are very limited. 👀
I was surprised 🧐 when the vaccine came out for frontline HCW (healthcare workers) in December 2020 and the general public started claiming it caused sterility. Let’s use common sense. 🧠 It takes 1–24 months 📆 to conceive before most providers start to investigate infertility. It takes 40 weeks to carry a baby 🍼 to term. Let’s average conception time to 12 months and add the gestation time of 9 months🤰 to = 21 months. Covid REALLY started to hit the US hard about 18–19 months ago. The vaccine was available to some of us 9–10 months ago but MOST of the women of childbearing age could not receive it until 5 months ago. How can anyone claim infertility at this point in time? 🤔 I never say never because I am constantly learning in medicine. Every day I see something I never thought I would witness. I have had pregnant women🤰contract Covid and pregnant women🤰receive the Covid vaccine. I have also seen pregnant unvaccinated women with Covid whose babies had to be delivered while mom was on the ventilator. My community just lost a 28 year-old mother of 3 who never got to know her newborn. 🥲 The American College of Obstetrics & Gynecology and the Society for Maternal Fetal Medicine issued a joint statement encouraging the vaccine for all pregnant women🤰 in July 2021. I recognize that I have the benefit of being "done" having my babies as I navigate this pandemic. That fact is NOT lost on me. I know young adults are faced with a very hard decision with such a new vaccine and their entire lives in front of them. Early in the pandemic, I even advised some of my young, healthy patients to wait until we had more long-term data... that I saw no serious health risk if they were to contract covid. 2021 changed that. I have had YOUNG, healthy patients on the ventilator and near death. I still believe it is a personal decision, but please be sure you are getting your information from reputable sources and people you trust. Much love... Reflection is a beautiful thing. It is often overlooked, but when we slow down and DO IT, we can learn and grow. Now that I'm in my forties, I sometimes look back at times in my teens and twenties and try to "hold on" to that feeling. We really can't do that, though, can we? Frequent reflection allows us to "hold on" right now. To really "feel it" right now... before it passes. Reflection gives us room to take note, consider future improvements, and relish in current joy. I'm hoping to start reflecting every quarter here. A public diary entry of sorts. A record of the good and the bad. A glimpse in time.
This is what I'm learning right now, September 2021:
Bonus question: what can I do to help? I feel so helpless!
***as always, consult your PCP for your healthcare. I’m trying to raise awareness. Let’s not bicker and judge over vaccine status. Let’s educate ourselves and let’s come together to get out of this public health crisis!!!***
When to test after known exposure (kid, adult, masked, unmasked, vax, unvax, PLEASE READ):
⁃ are the CDC recs confusing? Yes ⁃ Is your school or work throwing out different recs? Yes ⁃ I say this is when our common sense 🧠 MUST play a role ⁃ This is Sally 🙋🏼♀️ and she was around 🤒Bobby who tested + for 🦠Covid ⁃ I don’t care about Bobby’s 🤒 vax status but I do want to know Sally’s 🙋🏼♀️ ⁃ I want to know if 🙋🏼♀️ & 🤒 were unmasked and close to each other for longer than 15 minutes or if something “crazy” happened like 🤒 sneezed or they 🤝 or they were 🍷🍽 together. Maybe they LOL’d next to each other or hugged. How close were they? Maybe they cried together at a funeral? ⁃ Next I want to know if 🙋🏼♀️ has any fever, cough, chills, body aches, sinus congestion, sore throat, loss of taste or smell, joint or muscle aches, diarrhea, nausea, abdominal pain, headache, shortness of breath, wheezing, chest tightness, confusion, or dizziness when standing and if/when she does, I’m testing her regardless of vax status. If neg, I’m testing her again in 2 days. Meanwhile I’m keeping her home because she is symptomatic. ⁃ The only reason I’m testing 🙋🏼♀️ if she never shows symptoms would be: ⁃ the exposure was risky based on above mentioned factors, or 🙋🏼♀️ has someone who is immunocompromised, elderly, young, or unhealthy that she sees regularly ⁃ Work / school requires it ⁃ Peace of mind ⁃ I would test at day 3 or 5 or both ⁃ I’m seeing exposed folks (symptomatic and asymptomatic) test too soon. Then test + a few days later. This burdens the testing sites. So wait until day 3-5 if you can! ***as always, consult your PCP for your healthcare. I’m trying to raise awareness. Let’s not bicker and judge over vaccine status. Let’s educate ourselves and let’s come together to get out of this public health crisis!!!*** This is a great question and one I have seen asked many times on many platforms.
I have 2 autoimmune diseases (sarcoidosis and psoriasis) and take Humira. Prior to Humira, I was on Methotrexate. I took my first Pfizer dose in December 2020, second in January 2021, and I received my third in Aug 2021 since I qualify for the third dose now. I read the pfizer trial and the data is phenomenal. I had zero side effects all 3x other than a sore arm. That is my patient experience. As a primary care provider, I manage a panel of about 1800–2k patients. I’ve had ZERO deaths or serious side effects from the vaccine in my panel. I have had 2 deaths (age 78 with lung disease, age 49 and healthy), over 225 infections, countless hospitalizations - some requiring ventilation, and I am seeing long-term effects from COVID: stroke, pulmonary embolus, neuropathy, still haven’t regained taste / smell, palpitations & arrhythmias, chronic fatigue, chronic brain fog, and lung damage. I think the vaccine is being “pushed” because I know I can’t keep up with the volume of sick patients I’ve seen in the past 18 months. I know every ICU in my state is now on diversion. I know we as healthcare workers are leaving the field due to burnout. I’ve never seen anything like it and I’ve been a nurse 23 years, an NP for 17 of those. ***Always consult your PCP for your healthcare. I trust and believe in the vaccine, but I do not think it should be mandatory. Let us not bicker over vaccine choices, but let us come together and try to get out of this public health crisis!*** What can I do at home for Covid? 1. Zoom with your provider 2. Walk around as much as you can- covid causes blood clots 3. Lay on your belly when you’re resting, not necessarily when asleep. We are proning Covid patients (placing them on their belly) even when they are on the ventilator to help move mucus / fluid and drain the lungs. 4. Hot steamy showers. Even if you don’t feel good enough to shower, sit in your smallest bathroom with the steam running to help open up the lungs. If you feel lightheaded though, stop. 5. Hydrate hydrate hydrate - covid is an inflammatory virus and hydration is key! 6. Monitor your pulse and oxygen levels as I mentioned yesterday. 7. What has fallen out of favor / lacked statistical backup and/or caused harm: ivermectin, oral steroids prior to hospitalization, hydroxychloroquine (Plaquenil), unnecessary antibiotics 8. Mucinex, zinc, Vit C, Vit D, Singulair (it’s Rx though) are all in the grey zone- I don’t think they’ll hurt you but they may not keep you out of the hospital. 9. Finish out your quarantine please and thank you. 10. Chest percussion- look it up on YouTube How do I know if it’s Delta? 1. Big testing centers are batch testing swabs for variants and extrapolating that data to identify geographic variant trends. Your local urgentcare is not. 2. Whatever the variant, we treat based on symptom severity and delta may look good on you and horrible on Sally. Alpha (the original variant) may have put me in the hospital but barely slowed Steve down. 3. I equate it to flu A and B which are always swabbed and tested together each year. Every year I hear “oh Flu B is way worse than A. I’m so sorry you have B.” Etc etc etc when patients’ flu courses can vary regardless of the strain. 4. Anecdotally, my zoom covid visits with this wave seem different than in 2020. Less fevers. Less complaints of crippling headaches. Less loss of taste and smell. More dizziness & confusion (likely from low oxygen levels). Similar diarrhea complaints. Worse shortness of breath and chest tightness. Way more trips to the hospital and ICU. . My only vent-survivor told me all of a sudden they just Could Not Breathe. I should add this person is under 40 years old and is (or was) healthy. 5. Speaking of strains, did you know the Gardasil vaccine protects against 9 strains of HPV? Did you know Prevnar13 protects against (you guessed it) 13 strains of pneumonia? Strains have been around forever as have vaccines yet sudden interest persists. Just educating- no judgment on vaccine choices. I’m too tired. How many times can a child under age 12 have Covid? Will they develop immunity? Great question. I’ve seen twice so far and I expect more. Their bodies should be developing antibodies but no children have volunteered for my quantitative antibody study yet. Stay tuned. How soon should I get my vaccine after I have Covid? I’m recommending one month not 90 days IF you’re truly feeling better. Ask your PCP as they know your health situation. If I’m + today, symptoms resolve in 2 weeks, and then I’m + in 4 weeks, is it a reinfection or residual positive from original infection? I would ask if you ever had a negative test. If you did, maybe it is a re-infection but if you did not, I know we saw some folks stay + for 6 weeks or more in 2020. ***as always, consult your PCP for your healthcare. I’m trying to raise awareness. Let’s not bicker and judge over vaccine status. Let’s educate ourselves and let’s come together to get out of this public health crisis!!!***
How to have an effective office visit with your provider: There are some tried and true ways to have a productive, meaningful visit with your medical provider. As a patient with a chronic illness AND a family nurse practitioner, I have the inside track.
If you need more frequent office visits, ask for them. Your provider is PAID to see you. Your insurance is billed for those visits where as most providers do not bill for phone calls or portal messages. If you end up needing them before your designated 3 or 6 month follow-up and you have more than 1-2 simple questions, PLEASE schedule an office visit. As a provider with complicated patients of my own, I would much rather have that patient in the office with me to have a discussion than to do multiple back-and-forths over the portal. It’s better patient care. AND my time is used wisely in my employer’s mindset. Medicine is a business. Although so many of us really do care!!! |