COVID-19 Tips

In general:

  1. Wash your hands, arms, and face often.
  2. Remain quarantined, unless you are headed to your medical appointments or the grocery store.
  3. Keep hydrated and don’t forget to eat your vegetables. If you were to become infected, having a healthy baseline immune system will get you far.
  4. Continue all prescription medications. Now is not the time to have uncontrolled blood pressure, a glucose level through the roof, or a crazy thyroid.

How to wear a surgical mask properly:

  1. The colored side goes on the outside.
  2. Stretch out the mask such that it’s covering your nose, mouth, and chin.
  3. Pinch the nose of the mask so it hugs your nose, minimizing droplets from getting in and out.
  4. Lastly, the mask itself is not enough. You should be wearing a plastic face shield to cover your entire face. If that’s not available, wear some glasses to cover your eyes and please stay more than 6 feet away from other people.

How to wear an N95 mask properly:

  1. These masks are supposed to be properly fitted by certified specialists.
  2. If you have one but haven’t been fitted, make sure it fully covers your nose, mouth, and chin.
  3. Add a plastic face shield if possible. If not, add some glasses to cover your eyes and please stay more than 6 feet away from other people.

If you think you are sick:

  1. Stay quarantined away from other people and pets.
  2. If you have a fever of 100.4 degrees Fahrenheit or higher, call your primary care doctor and let them know you’re on your way with a fever, cough, sore throat, and shortness of breath (the symptoms of COVID-19) so they can prepare for your arrival.
  3. If you don’t have a primary care provider, go to the health department. Again, call ahead so they can prepare for your arrival.
  4. If you do NOT have a fever of 100.4 degrees Fahrenheit or higher, STAY PUT. Stay hydrated and get plenty of rest.
  5. If you don’t have a thermometer, go to your primary care provider or the health department if you are exhibiting symptoms of COVID-19.

When to go to the emergency department or call 911:

  1. If your fever is greater than 103 degrees Fahrenheit after taking Motrin/Tylenol. Although this is not a hard set rule, this is my general rule as a primary care provider because I worry about dehydration, the need for proper COVID19 testing, and close monitoring.
  2. If you have an underlying lung disease (COPD, Asthma, Sarcoidosis, Interstitial Lung Disease, etc) and your shortness of breath is much worse than normal. You may need oxygen, a chest x-ray or chest CT, etc. Call 911.
  3. If you have chest pain, trouble breathing, difficulty walking or getting up, or don’t feel safe traveling to the hospital on your own, please call 911.
  4. If you’re unsure as to what to do, call your primary care provider and they can triage you over the phone. If you can’t get through to them, call 911 and they’ll triage you when they arrive.
  5. My general rule is that if you don’t feel well, JUST CALL SOMEONE so you can get help.

Lastly:

  1. Pray
  2. Pray
  3. Pray
  4. Pray for those infected and for those who are putting their lives at risk around the infected.

Because without prayer, the only thing that remains is panic. But if we pray, the power that comes from God replaces the panic and provides strength not only to the one who is praying but also for the people they are praying for.

And if you don’t know how to pray, I’ll help you. All you have to do is start with, “God, I don’t know how to pray, what to say, or what to do. But I know you’re listening. So let me just talk to you for a few seconds and ask for your help.” Then tell him how you feel and what you need. You’ll be amazed at how you feel afterwards and how quickly your prayers are answered.

“Don’t worry about anything; instead, pray about everything. Tell God what you need, and thank him for all he has done. Then you will experience God’s peace, which exceeds anything we can understand. His peace will guard your hearts and minds as you live in Christ Jesus.” Philippians 4:6-7 NLT.

Quarantine Survival, Part 2

Since we’ve discussed previously that the best way to survive the COVID-19 quarantine is to “survive together” (please see my previous blog at https://kristinapolley.com/2020/03/22/quarantine-survival/), now we need to discuss just exactly how we’re going to do that.

Naturally, all of the toilet paper, bread, and meat are gone from the grocery stores. But did you remember to stock up on Motrin, Tylenol, Benadryl, and a first-aid kit? If you did, amazing! I like you already! If not, there’s still time.

But what about your mental health?

How do you feel? What are you thinking?

As a parent, do you feel exhausted? Angry? Sad? Happy? Do you feel like a failure completing online homework? Do you spend most of your days yelling and arguing?

As a spouse, do you feel drained? Supported? Do you feel as if you and your spouse make a good team at home with the kids?

Again, how do you feel? If you’re fighting back tears or internalizing anger after reading this article, it’s time to stop simply surviving. It’s time to flourish.

So many people compartmentalize these feelings because they need to feel in control of their emotions and of their situation. Some people compartmentalize these feelings because they don’t want to feel like a failure. But when faced with a country-wide quarantine, it is normal and acceptable to lose control. So when the finances, employment, and stress come crashing down, you have to make a decision on whether or not you will crash with this disaster, or rise above it.

This is where I promote Behavioral Health.

Many of my patients refuse to see a Behavioral Health specialist because they don’t want to talk about their issues. This drives the issues deeper within your soul…to a point where your internal pile of mess will build up so high that…you guessed it…you finally explode. Why not find a compassionate, unbiased, objective, healthy release?

Why not take 15 minutes with a professional who can not only make you feel like a successful parent, but give you tips and advice on how to better handle mayonnaise spread over your red sofa?

Why not take 15 minutes with a professional who can not only see your spouse’s affection, but help you understand your love language in order to deepen your relationship with your spouse?

Why not…talk? What do you have to lose? When you empty yourself of that internal mess in your soul, you leave an infinite amount of space to be filled back up with love, peace, and rest. Then, you can flourish.

The night that Christ was betrayed, he prayed to God his father in the garden of Gethsemane. Why? Because he was overcome with the stress and the weight of knowing he was going to die soon. Jesus even said, “My soul is crushed with grief to the point of death.” (Mark 14:32-34 NLT) He needed to pray (to talk!) to God. Jesus! The son of God! Needed to talk?! Yep.

And sometimes, we do too.

So, during a time of crisis, both internal and external, talk to a Behavioral Health specialist about your daily struggle. And talk to God. He knows what you’re going through and he’s waiting to hear from you.

If you, or someone you know, are in need of free counseling services, please visit https://www.donscounselingservices.com/

Quarantine Survival

Quarantine. Just a few weeks ago, some of us dreamed of our own private quarantine in paradise. A dream of isolation, peace, sunshine, the sound of crashing waves, and a good book.

Now, quarantine has transformed into isolation for an unknown period of time. A time period without pay, without proper education, and spreading illness. Quarantine and fear now go hand in hand. Questions of survival, peace, financial stability, and good health float around in our brains daily. Maybe even hourly.

How do we survive?

Together. We survive together. What an oxymoron during a quarantine, right?

As I lift my mask over my mouth, pull down the plastic face shield over my eyes, and sport gloves, who do I think of? Everyone. I think of my patients as I approach them in the parking lot for “curbside medicine”. I think of my family and reducing exposure to them. And I think of my employees. I think of their paychecks, their families, and their fear of this illness. I survive by thinking of others.

Often times, I have replayed the image Christ carrying his cross to his crucifixion. After being beaten and ridiculed, how in the world did he survive all those excruciating steps while carrying a cross larger than Him? Because he thought of us. All of us. He thought of our well being and our eternal lives. And that helped him take one step at a time, despite the weight on his shoulders.

And at this moment, he is also thinking of our paychecks, our health, and our fears.

Jesus is the vine and we are the branches. Any branch cut off of the vine will not produce much of anything (John 15:5). As Christians, this scripture is as important now as when it was said thousands of years ago. Let us rely on our vine to flourish.

Let us survive together.

My prayer for you: Lord heavenly father, as we home-school our kids, let us remember that our strength comes from you. As we live in fear of the spreading of COVID-19, let us remember that “no weapon formed against me shall prosper” from the book of Isaiah. And as those in the healthcare field take care of patients, may you protect them, guide them, and let their light shine so that each and every patient sees the glory and the love of God. Amen.

Coronavirus FAQs

Who should be tested for the Coronavirus?

If you have a fever (defined as 100.4 degrees Fahrenheit or greater), lower respiratory symptoms (cough, wheezing, shortness of breath), and have had a KNOWN exposure to a person with COVID-19, you will more than likely be tested.

If you have a fever and lower respiratory symptoms but there is NO KNOWN exposure to a person with COVID-19, you may still be considered for testing. If you have these symptoms and are a healthcare worker, have traveled outside of the country within the last 2 weeks, have an underlying chronic lung disease, are 65 years or older, or are immunocompromised in any other way, you will probably be tested.

Why aren’t we testing everyone with a fever and cough?

The survival rate for the average healthy adult infected with COVID-19 is very high (approximately 97%). The treatment for COVID-19 in those individuals is what we call “conservative treatment”. Stay home for 2 weeks, stay hydrated, get plenty of rest, and take Tylenol/Motrin as needed for fever.

The test for the Coronavirus is in very short supply. Therefore, we have to make smart decisions on who should be tested.

If you think you should be tested, please, please, please go to your primary care doctor (while wearing a mask) and discuss your symptoms.

If I’m positive for COVID-19, do I really have to stay home, isolated, for 2 weeks?

Yes! Yes, please! As the infected person, you need to rest, stay hydrated, and take Motrin/Tylenol for your fever. Also, the droplets from your sneeze and cough can infect people within a 6 foot radius. We really don’t need to share germs, especially with those who are not at their best health and those who are elderly. So, I’m begging you. Stay home.

Are people overreacting about this?

Yes and no. Sure, we probably shouldn’t be running out of toilet paper, milk, and bread at the grocery stores.

But this virus is a bit unique. This virus can affect anyone within a 6 foot radius of an infected person. Last time I checked, most grocery stores have aisles full of people squeezing past each other, even bumping into each other while reaching for a snack on the top shelf. Once a person is infected, it goes straight to the lungs. Therefore, anyone with COPD, asthma, interstitial lung disease, history of frequent pneumonia infections, or other lung disease are at high risk.

I believe that the reaction to this virus is panicky but more like “panic preparation”. People are panicking in order to figure out what to do with the schools closed for 3 weeks. People are panicking on how to pay their bills while they’re out of work for 3 weeks. And people are panicking on making sure they don’t get sick and pass it on to their loved ones who may not be strong enough to fight it off.

So, are we overreacting? Yes and no.

Kristina, how can you tie in these questions with a biblical story/lesson like you always do?

Well, I always pray for my patients and my staff. Easy enough.

But this sense of panic and preparation really reminds me of the book of Revelation. In this book, John writes letters to various churches on what they are doing right and/or wrong. It also gives us a depiction of the end of times, what to expect in the end, and straight forward instructions (throughout the whole bible) on how to avoid a treacherous eternal ending in hell.

It makes me wonder, “Have I really done all that I can to prepare for this virus? Have I really mentally prepared for what is inevitably coming to my city in NC?” And then I ask myself, “Have I really done all that I can to not only prepare myself for the second coming of Christ, but have I really done all that I can to prepare my family, friends, co-workers, and acquaintances for the second coming of Christ as well?”

If you saw Christ traveling from city to city, casting judgement on who goes to heaven or hell, wouldn’t you prepare quickly? Dare I say even “prepare in a panic”? And if you knew…knew…when He was coming, wouldn’t you tell everyone to prepare as well?

No one knows when the Coronavirus will hit our city. We also don’t know when Christ is coming again. But we do know that it will happen. So, let us all be prepared.

My friends. If you die today, where are you going? If you don’t know, please contact me. I’ll tell you about my Jesus and eternal life in heaven. If you aren’t sure, please contact me. It doesn’t take much to get to heaven. It just takes Jesus. And if you don’t agree that Jesus, heaven, and hell are real, please contact me. I will welcome you into my arms and tell you why they are real.

Are you prepared?

All information about the Coronavirus was obtained from UpToDate.com, the CDC, and the WHO.

Coronavirus: The Panic

As new cases of COVID-19 continue to emerge in numerous counties in NC, toilet paper and bottled water have now become a rare commodity. A once abundant product is now a prized possession. Some schools have shut down their campuses and engaged in distance online learning. Others are preparing for that inevitability. Travel and cruising are not longer desirable. As “social distancing” becomes the new norm, “social panic” has become the norm as well.

Where are the healthcare workers? The doctors, physician assistants, and nurse practitioners? At work. Because in times of panic, we have been trained to act. Because in times of a healthcare crisis, we strive to create solutions and heal those who are suffering.

So, we hide our stock of hand sanitizer, gloves, and masks and enter each exam room as if it’s another day in the office. We introduce ourselves, shake hands, ask questions, complete a physical exam, and wash our hands again. We answer the “social panic” questions from our patients: “Should I be worried? What do I need to do? What if I’m infected? Is there a pill I can take to prevent it? Or a shot to prevent it?” We smile and educate our patients on the high survival rate and encourage some “social distancing” per CDC guidelines.

But where is God in all of this? The same place when H1N1 killed thousands of people. The same place when hurricane Matthew devastated NC. The same place He’s always been: Everywhere. Because in times of panic, He is in control. There is no panic for God. He was there when approximately 36,000 COVID-19 patients were discharged from a hospital in China recently. And he was there some of the doctors died from treating patients with this virus. And he’s here now, in NC, as schools shut down and the costs of N95 masks skyrocket. He was, He is, and He is to come.

As a physician assistant, please was your hands and face frequently.

As a child of God, please seek God as your comfort and cleanse your hearts of panic.

For any further information about the Coronavirus, please see the CDC website. https://www.cdc.gov/coronavirus/2019-ncov/index.html

Exhausted?

Have you felt tired lately? Most people would answer yes. But have you felt tired lately? So tired that it was difficult to start and continue your day? That your normal desire for a 2pm nap became a need for a 10am nap? So tired that you even went to the doctor to discuss your level of fatigue? That’s where I come in. And the workup and results can be surprising.

Let’s start with some possible sources of fatigue, no matter the age or gender, which can be pretty easy to identify. Are you using your cell phone/tablet/television within 2 hours of bedtime? If so, that’s an easy fix. Read a book instead haha! Are you drinking caffeine within 4 hours of bedtime? If so, switch to decaf! Are you getting at least 6-8 hours of solid sleep per night? If not, go for it! Most adults need about 7 hours of sleep to have a wonderfully productive day the next day. If one of the above criteria apply to you, then congrats! It’s an easy fix. Now get some rest and read the rest of this blog tomorrow.

Sometimes, it’s hypothyroidism, anemia, low Vitamin D, or low Vitamin B12, all of which can be caught in routine bloodwork by your primary care provider.

However, a lot of my patients do not fit into these categories. Let’s start with men. Men who report fatigue don’t want to admit that there may be erectile dysfunction and depression too. And if you’re one of these men, you should have your testosterone level checked. If it’s low, you’ll receive proper treatment to replace this normal male hormone and you’ll be feeling better in no time!

Now off to my favorite topic: Women’s health. When women report an unusual increase of fatigue…drum roll please…it’s sometimes heart disease. Yep, heart disease. A woman walks into my office with complaints of “feeling tired” or “not feeling like myself” over the last few days. Her previous routine bloodwork was normal. She doesn’t really have any other concerns. Upon further investigation, after I ask about possible symptoms of various organ systems of the body from head to toe, she reports some nausea on and off, but she’s never had reflux before. She’s not pregnant either. So how in the world did I come up with heart disease as my diagnosis?

An EKG. A simple machine in my office that shows me how well the electrical pattern of your heart is. And from this, oh my goodness, I have caught many women that were in the middle of a heart attack, were about to have a heart attack, or that some underlying heart disease was caught and treated by the cardiologist.

From my experience, women report fatigue and nausea more than chest pain when it comes to their heart.

If you’re feeling more tired than usual, please, please, please go to your primary care provider and get a full work-up. Don’t simply tough it out and drink more caffeine because there may be something off. Maybe it’s a low Vitamin D level. But maybe…just maybe…it’s underlying heart disease.

My prayer as a primary care provider: Thank you, God. Thank you for providing me with the patience and the listening skills necessary to hear my patients’ needs. Thank you for my medical training so that I can recognize when fatigue isn’t just fatigue. And thank you, for trusting me enough to take care of these patients from day to day. I pray for good decisions and I pray for the well-being of their health overall. Amen.

Are these pills forever?

One of the most prevalent diagnoses that I see in my daily practice is hypertension, also known as blood pressure. Patients frequently ask me if they have to take these pills everyday for the rest of their lives. My goal is to shed some light on this topic and to throw some curve balls into the mix as well.

So, do you have to take your blood pressure pills for the rest of your life? Not necessarily. When people think of medical providers, they typically think of prescribing medication. However, as medical providers, we are still taught that diet and exercise are the first efforts and the most effective efforts in reducing blood pressure and maintaining overall good health. Of course, this is easier said than done. But did you know that I’ve actually taken patients off of blood pressure medication due to losing weight and maintaining a low salt/pork-free diet? Surprising, right? And guess what? They actually never had to go back on their pills! Amazing!

But, to be a pessimist, which I hate to be, there are some populations of patients that will unfortunately never be able to come off of their blood pressure pill(s). Patients in this category are usually those that are diabetic, have had a heart attack in the past, have had a stroke in the past, or have some type of other cardiac issue that requires very specific and precise control over the rhythm of their heart and their blood pressure.

Did you also know that some patients suffer from low blood pressure? Crazy, right? Some people wish they had this problem but unfortunately, low blood pressure can be a problem too and can also lead to a heart attack or stroke. We need blood flow, just in a relatively tight range of numbers. So these patients have to take a daily pill in order to raise their blood pressure. Who would’ve thought?

So the simple answer is yes and no. When we talk about medicine, we talk about personalizing medicine and treating patients as…well…you guessed it…people. Actual human beings with different bodies, different allergies, different medical histories, and different goals for their health. But before you decide what category you fit in, please, please, please talk it over with your primary care provider. They’ll shed some insight on what you should and shouldn’t be taking. And yes, you should always re-evaluate your list of medications to see what can be removed/adjusted to better suit your needs.

Here’s my prayer for you today. God, we know that we are all made in your image and that you have a plan for us that is meant to prosper us so that we may live the life you have called us to live. As we try and do that, please allow us to remain healthy and to open a discussion with our medical provider about our blood pressure. I pray that our hearts and minds are open to hearing what they say and that their wisdom comes from you. In your name we pray, amen.

Flu shot or not?

Yes. I made that sound so simple. Yes. Yes, you should get the flu vaccine. There I go again with the simplicity. Let’s start with the contraindications for the flu vaccine, in accordance with the CDC and a medical resource called UpToDate.

Please don’t get the flu vaccine if you have a fever, are allergic to eggs, chicken, or chicken feathers, are on some type of immunocompromising medications/treatments without being cleared by your specialist (some examples include chemo, radiation, medications for Psoriasis, etc), are less than 6 months in age, if you’ve every had anything called Guillain-Barre Syndrome, or if you’ve had any prior serious reactions to the flu vaccine.

Yes. Please get the flu vaccine. Oh goodness, the simplicity. Is it really that easy of a decision? Here’s my take on the flu vaccine and why everyone should be vaccinated.

As health care providers, our number one goal against the flu is the flu vaccine. Yes, you can absolutely still get the flu even if you have received the vaccine? No, the flu vaccine does not give you the flu. So, why in the world should you get the flu vaccine? Receiving the flu vaccine gives your body enough of a defense to reduce your risk of getting terribly infected and if you end up infected, it reduces the amount of time your sick and it reduces your risk of hospitalization and death from the flu itself.

People die from the flu each year. But there are some other complications that can arise after the flu infection. Many people who are hospitalized for the flu end up with pneumonia after the flu. If you’re an overall health individual, young, and on maybe 1 or 2 medications, you’ll probably stay a couple of days in the hospital and be discharged on some antibiotics, cough medicine, and maybe a steroid. But if you don’t fall into this category (if you have any chronic medical conditions, such as diabetes, COPD, or asthma), you’re looking at up to 2 weeks in the hospital. In between breathing treatments, chest x-rays, CT scans, IV fluids, IV antibiotics, IV steroids, and consults with various medical providers asking you a thousand questions a day, you’re stuck with chest pain, shortness of breath, fever, fatigue, weakness, and a persistent cough until you’re finally healed and ready to go home. For a simple cost and time comparison, taking 5 minutes to get the flu vaccine has saved you time and money, maybe even your life itself.

Here’s my prayer during the flu season: Lord, I pray that my patients get their flu vaccine and that I am able to thoroughly explain the flu vaccine and answer all of their questions. Lord, I pray that those who are unable or unwilling to get the flu vaccine are kept behind your shield of armor. Lastly Lord, for those who are infected, may they seek you for comfort, healing, and peace on their road to recovery.

Check out the CDC for more information: https://www.cdc.gov/flu/about/index.html

Also checkout medscape: https://www.medscape.com/viewarticle/918053

Meet the Blogger: Kristina Polley

Kristina Polley is a Physician Assistant, blogger, writer, aspiring author, wife, mother, and follower of Christ.

A graduate from Methodist University in Fayetteville, NC, she has been practicing Family Medicine since January of 2015. She currently works at a federally funded clinic that focuses on the underserved, rural population of Fayetteville.

Kristina grew up as a military dependent and has lived in various places, to include Australia, Philippines, Guam, Hawaii, and Florida, before finally moving to North Carolina. Her experiences in various environments and cultures allow her to reach a diverse population of patients and effectively manage their health by understanding their background and hardships.

When she is not practicing medicine or writing, she enjoys travel and spending time with her family. She hopes to combine the vastly different worlds of medicine and Christianity through her writing. And she hopes to bring more people closer to Christ in the process.

Strength in Weakness

“My grace is sufficient for you, for my power is made perfect in weakness.”

2 Corinthians 9:12 ESV

The tricky part about practicing medicine is that most people think of actual medicine when we talk about going to the doctor’s office. We tend to think linearly when we’re considering the provider-patient relationship. Someone may go into the doctor’s office for knee pain and leave with an x-ray order and a prescription for some arthritis pills. Someone may go to the doctor for maintenance on their blood pressure or diabetes and they will leave with a prescription for medication refills and a bandage on their arm from the recent blood draw.

But what if medicine isn’t so linear? What if it’s not a simple mathematical formula of complaint + analysis + treatment = healing?

There have been numerous occasions when I’ve entered an exam room expecting to execute that mathematical formula with precision, expertise, and efficacy, allowing me to dream of a few moments of freedom in between patients. I don’t mind a straight line. But, it’s not why I chose to enter into the medical field.

Imagine a day where the formula has been executed at the expertise of a astrophysicist and right when you are about to walk out of the exam room, the patient says, “Can I ask you one more thing?” Do you politely decline and politely offer a close follow-up appointment to discuss any further issues? Some do. I don’t.

I close back the door that was once my method of escape, plop back down on the stool, and answer, “Sure.”

These are the moments when my patients break down and cry. You pause and watch as their lips curl downward, eyebrows waver, eyes swell with tears, and they say, “I’m so sorry for doing this. I know you’re busy.” They wipe their tears on the sleeve of their shirt or on the palms of their hands as you reach for a Kleenex box to pass to them. They begin to tell you how their daughter hates them, or how they’ve been in an abusive relationship for a year and they can’t get out, or how their mother died last month and the grief has finally kicked in. Then, they finish by telling you how weak, stupid, crazy, and helpless they feel. That all is lost.

As a medical provider, I have a few things that I offer. I analyze the situation for safety, the need for counseling, a referral for Psychiatry, use of medications, and a close follow-up.

But as a Christian, I offer so much more. I offer scripture and I offer prayers. I look my patients in their longing eyes, place a gentle hand on their shoulder, and let them know that this exam room is now a safe haven. It is a room of peace, compassion, love, and prayer. I tell them how strong they are for sharing a story that’s been locked away in the basement of their souls. I tell them how strong they are for letting go of the tears they kept dry in the desert of their eyes. And I tell them how strong they are for allowing me to help when they spent months, or even years, carrying the burden by themselves. And I tell them that Christ knows their physical, mental, and emotional burdens and that He is already triumphant in their battle. Because no matter how weak my patients feel, I know there is a God that will provide strength, power, recovery, and healing.

The next time you go to the doctor’s office, lay your burdens down. You’re there for healing. It’s about time you sought it. And just maybe, your medical provider will write some prescriptions, come up with a plan for follow-up, and then pray for your healing. When you leave that exam room, I hope you feel God’s presence. When you leave that exam room, I hope you are filled with God’s grace, made perfect for that moment of weakness.