When to call the doc

Our primary care physicians, and nurse practitioners, and physician assistants, are being inundated with calls about sniffles, being in the same grocery store with someone who was coughing, along with all the other typical calls they get on a day to day basis.  So, if you or a loved one is feeling out of sorts, is it time to call the doctor?

Let’s talk a minute about the actual symptoms for COVID19. Fever, cough, shortness of breath – those are the big ones that everyone agrees on.  Note that sniffles, sneezing, headache, tummy ache, and fear of running out of toilet paper do not make the list.

If you have a loved one, specifically someone elderly or immunocompromised, who is not feeling like themselves today, how do you know when is the right time to call to doctor? Let’s look at a few signs to really look out for:

  • Fever – a fever is a temp of 101.5ºF or higher.  This is certainly a reason to call a doctor, especially if the temp doesn’t go down with a fever-reducing medication.  But’s let’s not totally depend on this one.  The elderly tend to have a normal temperature that is below our ‘accepted’ norm of 98.6ºF, and they don’t spike fevers the way younger folk do. So a lack of fever doesn’t mean we’re in the clear.
  • Too tired to stay hydrated.  If you’re trying to get Pop-pop to take a few sips of broth and he won’t do that, it’s time to call a doctor.  If you or your loved one isn’t taking in at least 24 oz of fluid in a day, call for medical advice. Dehydration is a serious problem as we fight infection, and even more so when we’re fighting a lung infection.  When we’re not hydrated, those lung secretions get thick and sticky, making them harder to cough up. If you can’t keep your loved one hydrated, he or she may need to be in the hospital, at least long enough for IV fluids.
  • Too tired to move around. If you or your loved one is getting out of bed less than every few hours during the day, it’s time to think about calling a doctor. Lying in bed all day isn’t good for our lungs – it allows secretions to consolidate and fester, and that’s no good.
  • Shortness of breath – we hear about it on the news, but how many of us know what it looks like? If Gramma has to stop mid-sentence to catch her breath, or pause between words to breathe – even when she’s sitting down – it’s time to call the doctor.

These are the big reasons I’d call a doctor for a loved one.  But the bigger picture is, when in doubt, go ahead and call.  That’s what your family doctor would want.  As for 9-1-1 – save it for true emergencies, and when we’re talking about medical emergencies, that would be if you can’t wake Gramma up, Pop-pop has chest pain, you see signs of a stroke (facial droop on one side, speech or vision changes, single sided weakness), etc.

Pandemic, shmandemic…

What does it mean that we now have a pandemic on our hands? If you visit your local grocery store you might think it means buy all the toilet paper, water, hand sanitizer, and soap.

If you’re an investor you might think it means “watch your dollars become pennies.” And if you’re a basketball player it might seem like the end of ever-loving world (goodbye, March Madness – we’re in for a different kind of March madness…).

But really, it just means that there’s a new pathogen spreading beyond what we can control.  Are you at risk? Maybe. Are your loved ones at risk? Probably, especially if they’re elderly or immunocompromised, or if they have pulmonary issues.

I would like to see people start using actual caution and planning, instead of losing their minds. Y’all, people are losing their minds. I went to the store today. I bought enough meat, frozen veggies, and carbs (rice and pasta) to last a couple of weeks. I also bought a bit of ice cream for the kiddos, ingredients to make a batch or two of chocolate chip cookies, and some cheese, nuts, and crackers to snack on. I did not buy an industrial supply of toilet paper (and would not have, even if it had been on the shelves…). Thankfully, I already have plenty of hand soap and surface disinfectant to last a while. Since all the people bought it out.

I guess what I want to say, is calm the heck down. This is not the apocalypse. We’re not being overrun by zombies. Use some common sense, and stop listening to fear mongering.

6 steps to prevent coronavirus – from a nurse

The news outlets are sensationalizing, and the politicians are downplaying the coronavirus, so where can people go to get practical tips to keep themselves and their families safe? Ask a nurse.

Here are 6 simple things you can do to make sure you and your family stay safe.

  1. Know what disinfectants to use at home. Guess what – even though Coronavirus can arguably live on hard surfaces for up to 9 days, it’s actually quite easy to kill. It’s an ‘enveloped’ virus, which means that the same products used to disinfect from the common cold or the flu should also be effective against coronavirus.  Pick your favorite household disinfectant, and here’s the key – read the label to see how long the surface needs to stay wet to truly disinfect. It could be as brief as 30 seconds, or as long as several minutes. But follow the label, and clean high-touch surfaces frequently. Door knobs, light switches, your steering wheel, cell phone, faucet handles…
  2. Wash hands properly, and teach your family to do the same. Here’s a nurse’s guide to handwashing:
    • Wet your hands
    • Add soap, and lather all hand surfaces for 20 seconds – don’t forget your knuckles, between fingers, under the nails, and up to the wrists
    • Rinse the soap off under running water
    • Use a paper towel to dry hands
    • Use a paper towel to turn off the sink
  3. Keep your hands away from your face – that means no nail biting, eye rubbing, resting your chin on your hand, etc.
  4. If you’ve been around someone sick, visited someone in the hospital, been to the doctor’s office, or you’ve been in a crowded area: take off your clothes when you get home, wash hands, then put on clean clothes.  Viral particles can live in your clothes, so take them off instead of spreading germs around your home.
    • As a caveat to this one, try to stay away from places sick people congregate. Need stitches? Try urgent care instead of the Emergency Room. Have a friend in the hospital? Send a card or gift basket instead of visiting.
  5. Stay home if you’re sick. Keep your kids home if they’re sick. There are delivery options for groceries and meals. You have neighbors and friends who can leave groceries on your front porch. Keep your germs to yourself, whether it’s coronavirus, the flu, or the common cold.
  6. Cough into your elbow. Sneeze into a tissue. Then throw it away and wash hands. In healthcare we call it “respiratory hygiene,” and it helps to prevent the spread of contagions.

Starting a journey to health

JoyfulTurtleStopGivingUpWell, it’s rather misleading to say I’m just starting this journey.  In fact I’ve started and failed many, many times.  This past April I had my annual physical and found that ohmywordimdying.  Well, that might be an overstatement.  But, my HgA1C was high (an indicator for diabetes/prediabetes), my cholesterol was way high, and my BMI seems to be creeping up a bit each year.  And all of this because I love both food and relaxing (read: not running).   Continue reading

Reason #453 that I love nursing

I meet the coolest people! Some of my patients in the last year have been:

  • An MLB hall of fame member.
  • A lady who grew up on the same street I lived on, 20 years before I was there.
  • A nationally-recognized rodeo champion.
  • A WWII infantry officer from a glider battalion who served at Battle of the Bulge and was in Berlin on VE Day. When I gave him some good news about his recovery progress he said, “That’s the best thing I’ve heard since WWII ended!”
  • The daughter of plantation slave, born and raised on a South Carolina plantation. She had some incredible stories to tell.

Everyone has their own story, and if you take time to listen they’re all fascinating. My only wish is that nursing could be more bedside-focused and less computer-intensive. I spend more time checking little boxes in automated forms than I do face to face with my patients. Nursing informatics needs a makeover, and hospitals need to revamp staffing to get nursing back to what it was meant to be – patient advocacy, caretaking, not robotic box-checking.

Mind. blown.

3? Really?

Yesterday this little treasure turned 3. Can you believe it? I can’t. Bruiser was just learning to walk yesterday! Or so it seems…

Today was a different story though. Today we took him and Little Man to the neurologist. Today we started Bruiser on anti-seizure meds.  The same anti-seizure meds that caused Little Man to stop talking, stop smiling, and stop laughing for more than 5 months. I’m looking forward to see what tomorrow brings. We have Bruiser scheduled for an EEG, and both boys are up for MRIs of the brain. Bruiser has no idea what’s coming, but Little Man listened carefully to the conversation with the neurologist and pumped me with questions on the way home. What’s an EEG? What’s an MRI? Why do we have to go the hospital? Will I get a shot? (I gracefully side-stepped that one, not wanting to burden his already anxious mind with images of the IV.) What’s a neurologist and why do I have to see him? Why doesn’t Bean have to see him?

Fun conversations, and just the tip of the iceberg today. Here’s Little Man, monkeying around to entertain everyone on Bruiser’s birthday:

Back on the roller coaster

Until last night, Bruiser had been seizure free (or nearly so) for a year and half. His seizures were so bad when we lived overseas that we had to move back to the US just to find him proper medical care. Funny that almost immediately after relocating state-side his seizures stopped.

In January he had 1 seizure-like episode that I brushed under the rug – it wasn’t severe enough for me to be convinced that he was having seizure activity again. But last night there were 2. The first was minor, but the second was intense. It ended before the critical 3-minute mark, so we didn’t need to call paramedics. But today we start again – trips to the pediatrician and neurologist, which will be followed with MRI and EEG, and then we’ll see…

There’s a temptation to fall into the ‘woe is me’ attitude. But I’m reminded that God is faithful. He’s been faithful to us before, and He’ll be faithful to us again.  While the return of the seizures may come as a shock to me, it doesn’t surprise God in the least. He is aware, He knew it was coming, and He relocated us to Atlanta – where our favorite pediatric neurologist is – just in time for this.

Couch to 5K – I’m in!

Last week I started the couch to 5K program – it’s designed to train you for a 5K in only 9 weeks. You can learn more about it at Cool Running’s website.

Just before I started the program I had tried running on the treadmill at the Y. I’m finding that I like Cool Running’s program much better – it eases you into running without burning you out. Did you hear that? Without burning you out. That means I don’t dread it and find any excuse to avoid it.

I’ve found a couple apps for the iPhone that are really helpful. So, on the off chance that you want to take up the challenge, here’s how I do it.

  • Podcasts. Some guy named Robert made these super helpful podcasts that coach you through each week and give you some good music to run to. I have to say though, I find it really irritating when he says things like, “you should be able to talk while running” or “you should feel the effect of your run now, but not be exhausted or out of breath.” Ahem.
  • iTreadmill. This is so cool. It turns your iPhone into a pedometer for only 99¢. It’s not the pedometer solution if you want to clip it to your belt and see how many steps you walk each day – it would run the heck out of your battery if you used it all day. BUT, for my purposes, it tracks my steps during my run run/walk, gives me the distance, pace, calories burned, number of steps, and spits it all out into a chart for me. Instant gratification.

So, that’s what works for me. Now, want to join me? I just finished week 1, so I start week 2 on Monday (love that I’m told to only run 3 times a week).

Fun giveaway!

FedEx showed up today and I ran to the door hoping it was the mysterious gift hubbs sent me for our anniversary – 7 wonderful years and counting! Alas, not my anniversary present, but instead the Merck Manual Home Health Handbook – almost as exciting. Not much can compare to a mystery gift, but this comes awfully close! I wanted to post a picture of the book, in its pretty package with orange shreds as packing filler, but it seems that some dwarf has run off with my camera. Wait – scratch that. It seems that my dad has reclaimed his camera.

If you’ve been following Mudlark Tales for long, you probably know what I checked out first. Yep! I looked up seizures and was pleasantly surprised. They talk about all the major issues, giving special attention to anti-seizure medications. Then I looked up all sorts of things – multiple sclerosis, tuberculosis, vitamin D deficiency, ADHD, asthma (which has some really cool graphics for explanation), and vaccines, to name a few. Don’t be fooled by the mommy-blog take – this is not just for moms. The handbook covers birth to aging, including information on death and dying, DNR orders, and everything in between. It also has really helpful illustrations of the body, which I’m sure will come in handy as the kids get older and we talk about what the brain looks like or why ear tubes helped Little Man’s ear infections.

I can see how this would easily become my at-hand reference for everything health-related. Not only does it cover all the essential information about most any ailment, it also has good references for proper nutrition and even using nutrition to combat illness.

Let me forewarn you, it takes a purely scientific stance on autism and ADHD. Autism, it says, is not caused by vaccines. The rise in ADHD diagnoses could be due to a rise in occurrence or over-diagnosis. I happen to like people that stick to scientific studies, and stick to their guns without apology. Overall, it is very thorough, reader-friendly, and the helpful text boxes are a quick key-in to helpful information. Thanks to Merck for sending me a manual to giveaway to one of my fabulous readers – a $39.99 value!

So, here’s what you need to know. To enter, leave a comment about how you usually find information about health – do you google? call your RN sister? consult a magic 8 ball? actually ask your doctor? You can also enter by tweeting about the contest @kcozonac, or get an extra entry by reposting on your blog. Winner will be randomly chosen on Friday at noon, EST, by one of those randomizer thingys. And because I’m paying the shipping on this, I’m afraid I can only open it to residents of the US or Canada.