I am Dr. Monique May, Board-certified Family Physician and Founder of Physician in the Kitchen™. Through my videos and best-selling book, MealMasters: Your Simple Guide to Modern Day Meal Planning, I help busy households enjoy healthy eating without impacting their hectic schedules. Hopefully, by now the overwhelming majority of people have gotten the message to avoid going to the emergency department and urgent care, and to go to their doctor’s office (if it is even open since a lot of offices are switching to telemedicine) only if it is really necessary. I am also a telemedicine physician and almost every call these days starts with “I didn’t want to go to the ER so I thought I’d call you instead.” This virus is very contagious (I have seen some estimates that one infected person can infect up to four people). We are being advised to take precautions when opening our mail and unpack our groceries, such as wear gloves, wipe everything down, and wash our hands afterward. According to information published by Harvard University, the coronavirus can last up to 3 hours in the air, 4 hours on copper, 24 hours on cardboard, and 72 hours on stainless steel and plastic. On April 3rd, the CDC recommended that we wear cloth face coverings when in public. With that in mind here are my tips on how to monitor your health while you #stayathome so we can #flattenthecurve.
Tip #1: Make sure you have a well-stocked first aid kit with non-expired supplies, including gloves, Band-Aids, gauze, bandages, burn ointment, and the pain and fever reliever acetaminophen, among other things. Most of the items in a first aid kit have expiration dates (including the Band-Aids; they can become brittle and lose their adhesiveness) so if you already have one just go through it and check the dates on everything. If you don’t have one be sure to pick one up on your next grocery run or order one online.
Tip #2: Know how to care for minor cuts and burns. Clean the wound immediately with mild soap and water. Once bleeding is controlled, dress the wound with clean gauze and bandages. As it heals, monitor daily for signs of infection, such as redness, swelling, pus, or increased pain. Report any of these signs to a doctor immediately, especially if you are diabetic or have poor circulation. For superficial burns, run under cool water (do not apply ice). Apply petroleum jelly, aloe vera, or honey. Antibiotic ointments are not necessary, and some people may have an allergic reaction to the components. Deeper burns should be seen by a doctor.
Tip #3: Have ice packs on hands for contusions and bruises. If you don’t have an ice pack, you can fashion one out of a package of frozen vegetables, or you can just fill up a zippered storage bag and lie it flat in your freezer (be sure to let out the excess air first). It is best to apply ice in the first 24-72 hours after an injury to help prevent or reduce the swelling that is a normal reaction to injury. After that, heat may be useful to soothe sore areas. Just remember: heat makes things expand and cold makes things contract. The same is true for the human body as well.
Tip #4: Be sure to have at least a three-month supply of your prescription medications. Use the mail order option if your insurance company offers it. Similarly, have an adequate supply of your over-the-counter medications as well. Speaking of OTC meds: there is a concern that COVID-19 patients who had been taking ibuprofen (AKA Motrin, Advil) tend to be sicker, so it may be best to avoid the class of medicines called NSAIDs (non-steroidal anti-inflammatory drugs). Acetominophen (Tylenol) may be a safer bet for pain and fever relief. If you have liver problems please ask your doctor first if this is right for you. A word about medications: you may have heard about people with COVID-19 being treated with azithromycin (a commonly used antibiotic) and hydroxychloroquine (an anti-malaria drug used to treat rheumatoid and lupus). Due to the lack of definitive scientific evidence that they work, they are currently only being used for extremely sick hospitalized patients. Please do not call and ask for prescriptions for these.
Tip #5: Consider getting Dermabond. Dermabond is skin glue that doctors use to close simple, not-too-deep lacerations or cuts on parts of the body from the neck down (except the genitals). It is available without a prescription. Wounds that are appropriate for Dermabond are as follows: linear (a straight line), no jagged edges, no pieces of flesh missing, no gushing wounds, no puncture wounds or bites, not older than 2 hours old, not in an infected area or an area of poor circulation, or so deep that you can see muscle or bone. The ideal wound is deeper than a paper cut but not so deep that the bleeding won’t stop with pressure or that you cannot see the bottom of the wound. “Clean” wounds like cutting yourself in the kitchen are ideal, whereas “dirty” wounds (from working in the garage or garden) carry higher risk for bacterial infection and poor healing. The wound needs to be cleaned very well before using Dermabond. Again, clean the wound with mild soap and water, apply pressure, then hold the edges of the wound together and apply the glue with gentle brushing strokes, and apply 2-3 layers, waiting 30 seconds between each layer. Wipe off excess glue that may have dripped immediately. Be sure to follow the directions in the package. If you get a cut and have to use Dermabond, just remember to get a tetanus shot as soon as you can if it has been more than 10 years since your last one.
Tip #6: Know your vital signs. A lot of people already have a thermometer or blood pressure monitor, but it may be useful to get a pulse oximeter to measure your oxygen levels. COVID-19 causes a severe pneumonia that causes the shortness of breath and need for hospitalization, and in severe cases, breathing tubes or ventilators. A pulse oximeter is the instrument with a little red light that you put your finger in at the doctor’s office and after a few moments it reads your pulse and oxygen level. A normal heart rate is between 60 and 100. Most people run between 70-90. Normal oxygen levels are between 96-100%. People who smoke are of course going to have lower levels so it’s good to know what your baseline (or what is normal for you) level is. For non-smokers, If your level is less than 90% you need to seek medical attention immediately. To be sure it is really that low, cough a few times and take a few deep breaths, and then repeat. If it is staying below 90% seek help. Be aware that certain things can affect getting an accurate reading, such as cold fingertips, a very high heart rate or low blood pressure, acrylic nails, severe anemia, poor circulation, and chronic conditions that affect your fingernails such as psoriasis, scleroderma, and Raynaud Phenomenon. If you are on dialysis and have a fistula (a connection between an artery and a vein that a doctor made for dialysis), use the other arm to check your oxygen level.
Tip #7: Use telemedicine. Telemedicine is extremely useful during this pandemic, especially since we are advising people to stay at home, and avoid emergency departments and urgent care centers if at all possible. Telemedicine is a very useful tool to triage patients and help identify those who are really sick and those who can stay at home. It is a safe, easy, and confidential way to seek medical advice and treatment if needed. Many patients just need reassurance or want their questions answered. Video platforms allow doctors to see you during the visit. This is very helpful because it gives us very useful information that we cannot hear on the phone. On video we can see how you are breathing, make sure you are not pale, and can look at things like rashes or cuts and advise whether you need stitches or not. All telemedicine platforms should be HIPAA-compliant, so your privacy and confidentiality are protected. During your visit, your doctor will make sure you are who you say you are by confirming your name and birthdate. She will then ask you to describe your symptoms, as well as review your health history (including past medical problems, medication allergies, what medicines you currently take, family history, and whether you smoke, drink, or take drugs). During this COVID-19 outbreak, she will also ask if you live in or have been to an area with a lot of reported cases like NYC, and if you are having any symptoms, such as cough, fever, or shortness of breath. Depending on what is wrong with you, the doctor may have you take your vital signs, like measuring your temperature if you have a thermometer or counting your pulse in your wrist for 6 seconds and then adding a 0 to get your heart rate for a minute. She may count how many breaths you take in a minute while she watches you. If you have a rash or other area of concern, the doctor will want to see it if possible. She may guide you on performing certain parts of the physical exam to help her. Any home tests you may have taken (like a strep or urine test) would be helpful to have on hand. The doctor will use all of this information and tell you what she thinks is wrong and what you should do next. Medications may also be prescribed (but usually not controlled prescriptions like narcotics and sleeping pills, or pills for erectile dysfunction). If you are very sick you may be advised to go to your doctor, urgent care, or the emergency department. If you do not need to seek emergency care, she will likely recommend you have a follow-up visit in a few days either in person or via telehealth if you are not better. Keep in mind, if you are calling for your child, parent, or another family member, you must make an account for them, so that they have their own record. Think of it as them having their own paper or electronic chart in the doctor’s office when you go in person. We cannot document someone else’s information on your chart.
Tip #8: Monitor your blood sugars. Diabetics need to monitor their blood sugars and be in contact with your doctor if they are running too high. Since diabetics are not always quite aware of changes in their body because of the damage to the nerves from the high sugars, sometimes the only way to tell there is a problem is by checking their sugar levels. Make sure you have enough testing strips to last if your monitor requires them. Also have soda (not diet), juice, hard candy, or glucose tablets on hand in case your sugar dips to less than 60. Notify your doctor if you have a hypoglycemic (or low blood sugar) episode. It could be caused by either too much medicine or something else more serious.
It is still too soon to tell just how long the coronavirus will be with us, and it has definitely already left its lasting effects by changing the way we do things. As we all adjust to the new normal, please keep washing your hands, staying well-hydrated, getting enough solid rest, eating healthy, exercising, and practicing social distancing (or just staying home). If you are sick cover your cough and sneezes and stay home! If your symptoms are getting worse (shortness of breath, fever, or cough), call your local healthcare facility before you go.
If you need ideas on how to switch things up in the kitchen, click here to see my suggestions on getting your kids to eat their veggies without them even noticing 🙂
For more information, be sure to visit me at DrMoniqueMay.com, and join the #MealMastersCommunity at www.Facebook.com/groups/mealmasters today.
