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The Health Director for the state of Arizona tells hospitals to fully activate their emergency plans in response to surge in COVID cases.

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Banner Health is Arizona’s most extensive hospital system.  They are also Arizona’s largest private employer.  In response to the COVID crisis, the company already furloughed approximately 3,oo0 employees, decreased executive’s salaries by 20 percent and created a one-time bonus pay for employees who provided direct care of COVID-19 patients during March, April, and May.

A statement released by the company yesterday informed the public they had reached capacity for ECMO treatments and was nearing capacity for their ICU beds.

Our ICUs are very busy caring for the sickest of the sick who are battling COVID-19. Since May 15, ventilated COVID-19 patients have quadrupled. Banner Health also recently reached capacity for patients receiving extracorporeal membrane oxygenation (ECMO) treatment. (2/3)

— Banner Health (@BannerHealth) June 8, 2020

The rate of new infections in Arizona has been climbing.  On Thursday, Governor Doug Ducey explained the number of new infections was related to increased testing.  He added the state was not in a crisis, as “field hospitals are available if regular hospitals run out of space.”  However, Cara Christ, the state’s health official, advised hospitals yesterday to fully activate their emergency services.  Arizona dissolved the stay at home order and, Governor Doug Ducey guided reopening on May 1 for businesses to open on May 4.  The Governor allowed sporting activities to resume on May 15 and racing on May 23 at 25% capacity.  Doctors in Arizona are not surprised about the spike of new cases in the state.

Arizona is home to many retirees, and approximately 17% of the residents are age 65 or older.  The number of COVD related deaths recently passed 1,000.  Arizona is a hot, dry state prompting the department of health to tweet about heat-related health concerns three times in June.  The hypothesis of decreased infections during warm weather suggested by some health care professionals, including CDC Director Robert Redfield, has been proven wrong. Many specialists believed warm weather was not going to decrease the rate of infections.  One of the specialists is epidemiologist Dr. George Rutherford, who warned in April to not hope for a warm-weather slump.  I also urged my family and friends in mid-May to not to let their guard down due to improving weather conditions.  Unfortunately, pandemic fatigue has set in on most Americans and my post was not well received.

If you are among higher-risk individuals who’s personal plans have eased because you believe warm weather is a deterrent to the spread of COVID-19, I recommend you reconsider your beliefs. Even if you are a person who is not at an increased risk of death due to COVID infection, the long term effects of a COVID illness are still unknown.  Be wise and follow guidelines to prevent disease.  Be proactive and protect your health. Be prepared for future medical visits and become a member on MyMedicInfo.com.

Updated 6/9/2020 at 9:40 am EST

 

 

 

 

 

Long term health concerns with COVID-19 infection.

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covid can also cause....

Death from COVID is not the only concern for those who get the infection.  Long-lasting effects from the virus can affect the body. Damage to the lungs for those who recover from severe COVID lung infection may lead to an increased predisposition to future lung infections.  Confusion and fatigue are symptoms people may continue to experience after recovering from the acute effects of the virus.  While many who contract COVID do improve, the long term effects of this virus are still unknown.  As a clinician and as a patient, I continue to advocate for you and recommend preventing COVID exposure.

Lungs

A  virus caused me symptoms for months and may have contributed to other conditions that still bother me.   Within two years of starting my career as a PA, a colleague diagnosed me with infectious mononucleosis.  I had elevated liver enzymes, fevers, sore throat, night sweats, dehydration, and body aches.  When I saw my PA, she and her supervising doctor tested me for streptococcal throat infection, hepatitis A, B, C, tuberculosis, and HIV.  I tested negative for those infections.  A blood smear showed atypical lymphocytes.  An EBV titer blood test suggested it was the cause of my illness.  Epstein Barr is a virus that causes mild symptoms in most people.  However, some people develop more severe symptoms.  In my illness, the acute symptoms lasted three weeks.  I went on to battle postexertional exhaustion; I describe it as feeling like a rag doll.  Instead of feeling energized after a simple 15-minute walk in the park, I would experience overwhelming tiredness that lasted for days.  I knew I had to regain my strength, and it was frustrating when exercise made me feel worse.  I had no choice but to cope with chronic fatigue, which lasted more than six months.  I remember, at the time, my employer allowed me to return to work part-time for several months.  I was grateful I worked in a clinic and for a health care organization.  Had I worked for a less sympathetic employer, I could have lost my job.  It was physically not possible for me to return to full-time employment.  Chronic Fatigue Syndrome is a real condition.  My symptoms were debilitating.  To this day, some health care providers fail to recognize chronic fatigue syndrome and often tell patients that their symptoms are all in their heads.  The unbelieving clinicians cite a lack of blood tests and other organic tests as reasons to support their disbelief.  Yet, those same clinicians believe in the diagnosis of migraines even though there is a lack of blood tests and other tests to confirm migraines.  Both conditions have criteria for meeting the diagnosis and are found in populations around the globe.  Clinicians have had to be encouraged by their colleagues to believe in CFS.  Estimates suggest there are 2.5 million Americans who suffer from CFS.  People who have persistent chronic fatigue seek treatment from more than one health care provider before being diagnosed.  A  2008 survey found up to 44% of people with the diagnosis reported having to visit five or more clinicians before the determination made.  Patients also add they had to seek a different health care provider to find someone who believes them and, thus, treats their symptoms. Even if a person sees a clinician who recognizes CFS, the treatment recommendations may not be up to date.  To make matters more troubling, people with CFS battle symptoms for years before they get treatment. Another problem with making this diagnosis is the fact that several comorbid conditions share traits with the disease.    Conditions such as fibromyalgia, IBS, and hypothyroidism have overlapping symptoms, making it difficult for even experienced clinicians to make a diagnosis.  Research for CFS continues as this condition is expensive due to costs of care and loss of productivity.

It is essential to remember some viral infections are associated with long term risks.   After an EBV diagnosis, a person has an increased risk of developing lymphoma.  Varicella virus infections can return later in life, causing shingles that may present with a variety of symptoms and possibly severe consequences.

The number of new COVID infections reached all-time highs last week in the states of Arizona, Florida, North Carolina, Oregon, and South Carolina.  As the country reopens, the virus spreads, and new infections abound.  Sign up for member-only benefits, including:

Prepare for your next medical visit.

Improve communication between you and your health care providers.

Comprehensive guidelines for at-risk individuals to prevent infection.

Have questions about the service or membership?   Contact me, and I will answer your questions about membership.

Stay informed and stay well.

Updated on 6/6/2020 at 2:07 pm EST

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Why I Created MyMedicInfo

 
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I’ve been a physician assistant for 25 years.  I have worked in family medicine, internal medicine, addiction medicine, and orthopedic surgery.  I have seen patients struggle with remembering the specific names or doses of their medication.  I know the questions your health care providers ask when you see them in the clinic, urgent care, emergency room, hospital, and ambulances.  I’ve seen patients in agony trying to answer my questions when they had migraines, chest pain, abdominal pain, or shortness of breath.

When the encouragement from changing from paper charts to electronic medical records developed, it was sold to us as ways to improve patient care.  There would be fewer medical errors, better communication, and improved outcomes for patients.  Over the years, the government enforced electronic medical records by reducing medicare reimbursements year after year on those hospitals and clinicians who did not use electronic medical records.

Your medical information is encrypted and protected on those web servers.  However, all of your medical treatments and information are probably on different systems.  If you have a primary care physician, a cardiologist, and an endocrinologist, the odds that they are all on the same electronic medical system is low.  To get access to all of that data is cumbersome and often complicated.  MyMedicInfo simplifies access to your medical history by using Trusona for user authentication and no password to remember.   Plus, you control your medical information—highly sensitive and confidential information you can omit.  For example, if you have a history of a sexually transmitted infection, simply skip that information.  An emergency room physician or paramedic is more interested in your allergies, medications, and what diagnosed conditions you have.  MyMedicInfo will enhance your medical care.

As a health care provider who has worked in a variety of clinics and environments, I can get frustrated with the technology intended to make things better.  I’ve worked at a hospital where the health care providers had to take classes to use the hospital’s electronic medical records.  Health care electronic systems should not be so complicated that you have to take classes to navigate through them.

I developed this website to keep your information secure.  It has three levels of security.  First, it has the highest level of SSL encryption available.  A firewall is frequently scanning and preventing unauthorized access: Additionally, it uses a password-free two-factor authentication login to verify your identity.  The service does not allow a user to upload files to protect the website.  I know that with any medical care, you need to trust the people involved to protect your information and promote your health. 

You probably have received medical treatment from a physician assistant.  You know they are highly skilled, knowledgable practitioners.  I am proud of my career and my chosen profession.  Physician Assistants are sometimes called patient advocates.  We have a reputation for explaining complex medical terms in a way that is easier to understand.  We have a reputation of spending more time with patients, especially when doctors are pressured for their time.  Physician Assistants tend to be thorough in their evaluations and have a high rate of patient satisfaction.

I’ve included a link to a video clip of one of my recent discussions on the COVID pandemic. Watch it if you want to learn more about me.  I want to earn your business.  I wish you wellness and continued excellence in medical care as you interact with professionals in the future.

We are all interconnected and must do our part to prevent COVID 19 spread.

 
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world in his hands

If you didn’t believe before that we are all interconnected, I am confident you believe it now.

One new viral infection has led to a pandemic.  While pandemics are not new, it is new for most of us in the United States.  Few of us were alive in 1918 when the Spanish flu affected the world.  And if you were here at that time, it is highly unlikely that you even remember it.  If you are now age 105, you would have been age 3 or 4 during the Spanish flu.

I’ve heard many people say, “it is like we are living in a sci-fi movie”. If you would have asked me two months ago, that most flights overseas are grounded, that major sporting events canceled, that nonessential businesses would be closed, and physical distancing measures be implemented,  I would have stated that it is impossible.  However, that is the reality.  If you are among the percentage of people who believe the outbreak to be a hoax, try to not deny what is happening.  Denial will trick you into thinking you will not get sick or the virus does not have any direct impact on you.  Denial will allow you to not follow the recommendations of specialists and experts who understand how pandemics work and are advocating to save lives.  Even if you never get exposed to COVID 19 virus, the implications of this virus have already changed societies and will continue to do so.  For some of us in minor ways, for some of us in tragic ways.

Now is not the time to place blame on other countries.  Now is not the time to blame politicians.  It is not the time for political figures to point blame at travelers, nursing home health care administrators, etc. Blaming one another for this crisis is not allowing us to work cooperatively to solve new problems.  If scientists and experts recommend guidelines on how to move forward, they are the experts who we need to be listening to.  We are still learning about how the virus spreads, infects, and how to medically treat it so we can save lives.  Until more effective treatments are discovered, prevention is your best medicine.  Our world has been through pandemics before and we should learn from the past.  Many have used the lesson learned with two cities during the Spanish Flu that took two different approaches to fight the spread.  Our country is doing similar things.  Every state is making local decisions.  While each location has its own unique circumstances, we will look back at what we did right and what we did wrong.  We just have not seen anything on this grand of a scale for quite some time.  It is my opinion that it is not wise to compare it to the H1N1 virus of 2009, SARS, MERS, or Ebola.  Each of those viruses had a unique impact on the world.  The Spanish Flu of 1918 is probably the best pandemic to compare it to, however, even that was influenza and this is a coronavirus.  We should not compare apples and oranges.  Another parable is that of the blind men and elephant.  We need to listen to experts.  Listen to the infectious disease specialists, epidemiologists, historians, and professors.   

There are times to be offensive and there times to be defensive.  If you want to be successful and win the game, a team works together and knows when to be offensive and knows when to be defensive.  These are lessons we are taught early in life.  The consequence of not winning this war on this virus can have a vast toll on us.  We are in this together.  At some point, medical professionals and/or scientists will find successful treatment and in the process save millions of lives.  Yes, millions. If we do not listen to the experts, we will continue to see sad and difficult days ahead.  We have no idea how long that will be.  You have to do your part.  Now is the time to play defense.   Even if you live in a remote part of the world and do not get exposed to the virus, you can show your support by leading by example.  Stay home.  Rural areas have cases.  No one is immune to a new virus.

Please follow the recommendations of the CDC.  The only recommendation I do not agree with by the CDC is the one that healthy people do not need masks.  I understand the importance of first responders and health care providers to have masks.  Yet, people have the right to protect themselves.  Plus, even if you do not have a mask to wear – consider wearing a bandana over your mouth and nose.  In my observation and opinion, South Korea has been more effective at reducing the spread of the COVID virus.  I read that 70% of the population has been wearing masks over their nose and mouth when they are out in public.  We should be doing the same.  When we do go out for groceries or to the pharmacy, wear a protective mask or bandana. If it is being recommended for those health care professionals who are treating the infected, the same guidelines apply to you to protect yourself from the virus.  You still should try to stay six feet away from others in addition to the other guidelines.  Keep in mind, not all people who are sick will be staying home.  To complicate matters, some infected people may not have symptoms and are unintentionally spreading the virus.

Hope.  The FDA has allowed the ability to begin using antibodies of infected individuals who recovered as a way to treat the severely ill in New York.  I heard today that the virus is not mutating easily.  This is good news.

Some people, like Jahova Witness believers, may not agree to this form of treatment.   Yet, for those who want it, it is a way to possibly defeat the virus and save lives.  Other measures are being discussed and will be attempted.  Until we have an effective treatment, continue to play defense.

Updated 3/25/2020 at 12:14 pm EST