Marching with Pride
We may be physically distanced, but PacMed is still committed to marching alongside our LGBTQ patients, employees, vendors and community-at-large. Here’s how to join us, virtually, and support the full rainbow of our community.
PacMed has been a supporter of the Seattle Pride Fest for many years. And we look forward to doing more this year! To learn about current events or future activities being developed, stay-tuned to Seattle Pride.
Pride in PacMed and our health care system
Diversity and inclusion are defining characteristics of PacMed. We asked one of our valued team members to share their thoughts about PacMed and its support of Pride:
“I have attended the Seattle Pride parade with my girlfriend for several years as part of the LGBTQ+ community. When I heard that PacMed was participating in Pride, I was very excited to volunteer! To me, PacMed’s participation shows just how inclusive, accepting, diverse and open-minded our company is. It was great to walk in the parade while representing our company and showing our support and love for the LGBTQ+ community. I would like people to know that all of us at PacMed are here for YOU, your health, your needs, however you identify. PacMed is a judgement-free zone.”
—Yessenia Puentes, CMA, Lead Medical Assistant, Pacific Medical Centers
What To Expect From a Telemedicine Appointment
One medical practice that the COVID-19 crisis has accelerated is a mainstream use of telemedicine, in which appointments are held remotely over HIPAA compliant video-conferencing tools. Though different forms of telemedicine have long been available, the practice is gaining serious momentum in a time when we’re avoiding heading to the doctor’s office unless we absolutely have to.
“While we had been planning to expand telehealth soon, it took this terrible crisis to take us from crawling to a full sprint in a matter of weeks,” said Dr. Nawal Alkharouf, a pediatric provider at Pacific Medical Centers’ Canyon Park clinic. “It was a little like building a plane while flying it, but our providers were incredibly understanding and enthusiastic. We have all been amazed at how much we can do just by talking to and seeing the patient.”
Telemedicine appointments can be used for myriad purposes, including diagnoses. Recently, Sara Montagne’s 8-year-old daughter, Phoebe, started experiencing violent stomach pain, which ended up being diagnosed as appendicitis thanks to a telemedicine appointment with her pediatrician, Dr. Alkahrouf.
“I called in and the person on the phone guided me through how to set up my accounts because I had never done it before,” said Montagne, who lives in Bothell. “I was linked into the doctor, and it felt like we were sitting in the room together.”
Montagne weighed her daughter and took her temperature, and then was asked to be the doctor’s hands; her husband held the computer so Dr. Alkharouf could see Phoebe’s reactions to her pressing in different areas.
“Doing a telemedicine appointment hadn’t really crossed my mind before,” she said. “It was so helpful, too, because my daughter was in a lot of pain, to just be able to do it from home.”
Once Dr. Alkharouf suspected appendicitis, Montagne was on the way to the hospital, with Dr. Alkharouf having called ahead to make the process smooth and seamless.
“While telemedicine is new for many, this form of treating patients will continue to grow,” Dr. Alkharouf said. “Rather than having to make time for a scheduled appointment and travel to the clinic, patients have the ease of conveniently being seen via telehealth.”
To get the most out of your appointment, Dr. Alkharouf recommended that you see a provider that you have an established relationship with for continuity of care and take 10 to 15 minutes before the appointment to check your patient online portal or email for instructions, complete a screening questionnaire, confirm that your health history is updated, have pharmacy and medical insurance ready, and prepare a list of questions that you would like to discuss with your doctor. She also said that you should also take your basic measurements (height and weight) and check your vital signs (temperature and pulse rate).
Mental health awareness during social isolation
The outbreak of COVID-19 has been incredibly stressful for many people, resulting in feelings of increased anxiety and depression for some. Unfortunately, for those with pre-existing mental health conditions, the stress of COVID-19 can be too much to handle, leading to feelings of hopelessness and doubt.
Pacific Medical Centers recently launched a campaign focused on mental wellness during COVID-19, designed to foster connections during social isolation. PacMed knows that COVID-19 has led to a mental health crisis, both in Washington state and around the world. The team of mental and behavioral health providers at PacMed can teach us how to properly spot mental health concerns and the right questions to ask our family and friends who may be experiencing feelings of loneliness and isolation during COVID-19.
To help share further insights on how COVID-19 has impacted our mental health – and how Pacific Medical Center’s COVID-19 campaign aims to help those currently suffering from mental health illnesses — nurse practitioner Simon Katumu with Pacific Medical Centers’ can help. Katumu answers common questions about social isolation and its impact on mental health during COVID-19, along with the importance of understanding the connection between physical health and mental health.
Who is most at risk for depression?
Everyone can be affected by depression during this pandemic but most specifically, people that have had a prior history of mental/emotional conditions can be at a higher risk. This may include prior episodes of depression, anxiety, postpartum depression, etc. Also, people whose lives have been affected significantly by the pandemic such as job losses, losses of loved ones, experience with COVID-19 (such as being severely sick with the virus and being intubated in the ICU), etc. may also be at a higher risk for depression.
The economic impact of this pandemic has also affected us in one way or another, but some of us have been affected more than others. Also, people who are outgoing and derive energy from being around others may be affected by social distancing and the inability to go out and socialize. Those who consume news continuously, including social media, may find the information emotionally draining and depressing as well.
What specifically can readers do to avoid depression?
Try as much as possible to maintain your usual routine, which includes waking up at the same time every morning, exercising safely and regularly, eating healthy, getting enough sleep every night, limiting your consumption of the news / making sure your news sources are reliable and trying to stay in touch with friends and loved ones virtually, via FaceTime, Zoom, Skype, etc.
When should someone seek help?
If you notice that your emotions and feelings are affecting your ability to function and/or your relationships, then it may be time to seek professional help. Some people may notice that they are more irritable, impatient, not sleeping well, constantly worrying or being anxious about getting the virus, their financial wellbeing.
We all get concerned by what goes on around us and have thoughts and discussions about our jobs, families, the economy, and that’s perfectly fine, but there’s a level of nervousness, worry and uncertainty that is not healthy. When this happens, it is wise to seek medical help.
Why is it important to seek help?
Sometimes we go through life thinking that we are alone and no one else understands what we may be going through. We may think that we are the only ones who feel the way we do and maybe even think that something is wrong with us, but there’s help. Many of the issues that we face are also experienced by so many around us and there is professional help available.
Anything else we should know about depression during this time?
The brain just like all our other body organs can be sick. Just like there is no shame in seeking help for our hearts, livers and lungs, there is no shame in seeking help for our brains as well. It is perfectly fine and there is help available.
Parents Use Telemedicine to Get Daughter Life-Saving Care
Paying it forward: Physician’s mother was saved as a child by the same procedure
With stay-at-home orders in mind, many people are reluctant to venture out, even for needed health care. One family, however, learned firsthand that virtual visits—a new offering to keep medical appointments safe during COVID-19—are not only more convenient, but can also save lives.
On a Wednesday night this past April, 8-year-old Phoebe complained of not feeling well. She began throwing up. Her parents, Sara and Robbie, initially thought it might be her lactose intolerance acting up, thanks to recent quarantine dinners of pizza and ravioli.
“But every hour she kept vomiting,” her mother, Sara, said. “And I thought, Oh wow, she’s really got something.”
Sara stayed up with Phoebe through the night, posted near the bathroom. After a brief lull in early morning, they tried having Phoebe drink water, but the vomiting became worse and she began complaining of side pain. At 9:40, they decided to call PacMed.
PacMed Nurse Valentina heard the symptoms and, with extra stay-at-home precautions in place, immediately scheduled Phoebe for a 10 AM virtual visit. The family had never used the Zoom platform in MyChart (PacMed’s patient portal), so Medical Assistant Nyeelah called first and walked them through the technology. By 10:05, they were seeing the doctor, virtually.
“I’m glad they called and had the visit with us,” said Dr. Nawal Alkharouf, one of PacMed’s newest primary care physicians. “The alternative would have been a perforated appendix.”
Through the Zoom app on their computer, Dr. Alkharouf performed an initial assessment, including guiding the parents through a physical exam and asking clarifying questions to rule out similar conditions. “I tried to get her to do a jump test,” said Dr. Alkharouf, “to get up and just jump, but she couldn’t even get up. Just going from a laying to a sitting position was very difficult for her and she complained of pain. I could see on the camera that she was really guarding her right side.”
Based on the exam, Dr. Alkharouf suspected appendicitis, but there were a few atypical symptoms as well. With the added risks associated with exposure during COVID-19, the doctor wanted to be sure before sending them to the emergency room. So, she prescribed anti-nausea medicine, which the family picked up immediately. The doctor called them back 90 minutes later.
Phoebe was still vomiting, even on the medication, so once again, Dr. Alkharouf led them through a physical examination, with the parents’ assistance.
“She said, ‘Okay, you’re going to be my hands,’” related the mother, Sara. As Robbie held the camera up close to see Phoebe’s reactions, Sara performed the exam just as the doctor would have in the office, pressing down gently across Phoebe’s stomach to find the source of the pain.
They both noticed that Phoebe’s pain was more pronounced now on her right side—where the appendix is located—so they decided to bring her in to Seattle Children’s Hospital. After informing the hospital of Phoebe’s condition, Dr. Alkharouf called the parents back with details on the hospital’s COVID-19 visitor policy, as well as its valet service so Phoebe wouldn’t have to walk far.
After a wait (the hospital had to test Phoebe for COVID-19 before admitting her), she was cleared for laparoscopic surgery for her appendix later that night. When Dr. Alkharouf called the family in the hospital to follow up the next morning, Phoebe was already feeling better, keeping liquids down and enjoying Jell-O.
Looking back on the experience, Sara reflected, “The part I liked was using the camera like I did with the doctor. Phoebe could barely move, so if I had to go into the doctor to get it diagnosed, that would have been—torture for her.
“So, having her just lay on my bed and the doctor talking to us, just like we were sitting in front of her—that was really cool.”
Exactly 75 years earlier, another little girl was threatened by appendicitis, and a doctor took similarly innovative action at the time to save her life.
That little girl was Dr. Alkharouf’s mother.
It was in India, in 1945, before the country had partitioned into Pakistan, when the five-year-old began vomiting with abdominal pain and a fever. Her mother (Dr. Alkharouf’s grandmother) became very worried.
The only local hospital was British and was designated to treat only British military families in India. Still, the child’s uncle knew the hospital was their best hope. Against the odds, he biked to the hospital to plead with a doctor in person, saying she was only five and would die if they didn’t help her.
While it was against policy, the doctor was kind and agreed to visit the family in their home. After his examination, his face became grim. He told the family that the situation was dire, and she needed surgery right away. The family would later learn that the previous week, three British children had presented at the hospital with similar symptoms, indications of appendicitis. Sadly, all had died.
Immediately, they transported the young girl to the military base and operated—discovering that her appendix had already perforated. Nevertheless, they were able to perform a successful appendectomy. She became known around the hospital as “the miracle child.”
The hospital had a courtyard with a pond. During the girl’s recovery, the doctor would sit with her by the water. He taught her the ABC’s—her first exposure to English.
Rejuvenated and inspired by her introduction to this new world, that young girl grew up healthy and went into medicine herself. She became a family practice provider, married and started a family of her own. Her daughter, Nawal, would grow up and also become a physician, join PacMed—and save the life of young Phoebe the same way her mother had been saved.
“Seeing Phoebe made me remember my mom,” said Dr. Alkharouf. “I feel like it’s paying it forward, you know. Because if no one had saved my mom’s life, I wouldn’t be here. Not only that—they also inspired her and encouraged her; she became a doctor because of it. There’s a lot one person can do—sometimes we don’t realize our effect. Our words matter, our actions matter. They change lives, and we don’t always realize that.”
A few weeks after Phoebe’s surgery, PacMed called the family to check in. Phoebe was back to her normal self, facing the challenges of childhood these days. “Yeah she’s pretty active,” said Sara. “She keeps trying to do her math right now and she’s distracted, so I told her to run up and down the stairs, and move around.”
We shared the story of Dr. Alkharouf’s mother with Sara.
“That is very cool,” she said. “Since the surgery, we keep saying, Wow! We are just so thankful for medical care. Because if we didn’t have it”—she paused—“that would be awful.
“That would be terrible, just being in that much pain, and being able to do nothing about it. But the medical teams get it handled so quick these days, and help your child get out of pain.
“Yeah, it’s pretty awesome.”
You can schedule a virtual or in-person visit with PacMed by visiting doctors.pacificmedicalcenters.org, or by calling 1.888.472.2633.
Dr. Nawal Alkharouf provides care as a pediatrician out of PacMed’s Canyon Park clinic in Bothell.
Well Child: Staying Healthy at Home With Telehealth Care
What to know before your child’s virtual doctor’s visit
We’re following recommendations to stay healthy at home, but bumps, scrapes and sick days still happen. Thankfully, it’s never been easier to see a doctor without leaving home. As health-care providers and families adapt to COVID-19 and social distancing recommendations, more medical visits are taking place remotely via telehealth (also called “telemedicine” or “virtual care”).
Prior to COVID-19, telemedicine was already trending; virtual visits were projected to increase 16.5 percent by 2023, according to a report by Market Research Future consultants. Then, the coronavirus pandemic hit, and telehealth surged. In March 2020, telehealth visits spiked 50 percent.
The growth of telehealth in pediatric health care is good news for busy parents, many of whom are now juggling work and home-based schooling, says Nawal Alkharouf, M.D., a pediatrician with Washington-based health-care provider Pacific Medical Centers. “One of the main benefits we’re seeing for telehealth is convenience, especially in times like these. If families don’t want to come into the clinic or can’t make it in, this is another way to care for their child’s health,” she says.
Virtual care works best with your regular doctor.
Although telehealth can work well in urgent-care scenarios or help people who don’t have a regular primary care provider, it works best in an established doctor-patient relationship, says Dr. Alkharouf. “Telehealth is most beneficial if it’s your own pediatrician or someone who has seen the child before, because that provides the greatest continuity of care,” she says.
Some conditions are better suited to virtual care than others.
Virtual visits work particularly well for certain types of pediatric care — for example, managing some chronic conditions, such as asthma and diabetes; follow-up appointments; behavioral health; and mild cold and flu symptoms. Other situations, such as a suspected ear infection or broken bone, warrant an in-person visit. “Telehealth doesn’t work for every condition or all situations. If the provider needs to look into the child’s ear to diagnose an ear infection, they’ll likely need to go in,” says Dr. Alkharouf.
You don’t need any special equipment (but some advance prep won’t hurt).
There’s no need to buy an otoscope, a special thermometer or any other medical equipment for a virtual well-child visit, says Dr. Alkharouf. But taking 10–15 minutes to prepare for an appointment paves the way for a productive virtual session. Check your email or your provider’s online patient portal for instructions, complete any screening questionnaires, update your child’s health history (including making a list of all specialists or other health-care providers your child sees and assembling any medications), fill in insurance and pharmacy information, and make a list of questions or concerns you would like to discuss with the doctor. In preparation for the visit, take basic measurements (height and weight, and head circumference for children age 2 and younger) and check vital signs (temperature, pulse rate).
Your provider still wants to ‘see’ your child.
“Telehealth” can be a misleading term, since most virtual visits include a video component. And even though your provider may be miles away, they still want to get a good look at your child. For video visits, find a quiet spot in the home with good lighting so your provider has a clear view of your child. “For babies and small children, placing your laptop or device on a bed can work well,” says Dr. Alkharouf.
You may still need an office visit.
A sick-child appointment (say, for a rash or pink eye) can probably be carried out completely online. But a well-child visit may have two components: Caregivers can complete screening questionnaires and other paperwork virtually, then come in later for a physical exam and vaccines. “A good physical exam is an important part of a well-child visit, so it is important to bring your child in,” says Dr. Alkharouf. “But the good news is that you don’t necessarily need to come in right away unless your child needs a vaccine right now. So, you could do the virtual component of the exam now and wait until the summer, once things have calmed down with the pandemic, to come into the office.”
Behavioral health care at home has special considerations.
Behavioral health care can work well via telehealth since it usually doesn’t require a physical exam and can be easily carried out via video phone or video chat. But virtual health care makes it harder for providers to ensure patient privacy, an essential component of behavioral health. “Privacy is a major concern for behavioral health care at home, especially for our adolescent patients,” says Dr. Alkharouf. “If a private bedroom isn’t an option, some families have their teenager do their virtual health care in their car, so [the teen] can have complete privacy.”
Even after social distancing ends, telehealth will keep growing, says Dr. Alkharouf. “PacMed just launched virtual pediatric care, and the response from parents has already been very positive. Parents appreciate that they can take care of their child’s health, keep them safe and save time.”
Coping with loss and grief during COVID-19
If you are feeling lethargic, sad, distracted, disinterested in things you enjoy, or irritable—you may be grieving. There can be power in identifying that emotion.
Having lived with the coronavirus pandemic for several months now, you may have noticed changes in your emotional state. While many of my patients were experiencing deep fear, anxiety or panic in February, today you may find yourself suddenly in tears, emotionally distracted, or feeling angry or depressed. Or even just struggling to recall a common word or jumbling sentences. These are all signposts on the very human path of grief and mourning.
With the COVID-19 pandemic has come great loss. You or someone close to you may have lost a friend or family member to COVID-19. Loss during the pandemic comes in many other forms, too, such as the loss of connection with friends and family, the loss of touch, and the losses of safety, economic stability and a known future. Each of these is significant in itself; most people are processing a combination of many losses at once. David Kessler, an expert on grief, commented recently in the Harvard Business Review, “This is hitting us and we’re grieving. Collectively. We are not used to this kind of collective grief in the air.”
Although grief is universal, it expresses itself in many different ways. It can be hard to know what to say or how to act to support a loved one who may be struggling. And it can be easy to overlook your own mourning and be gentle with yourself.
Here are a few ways to honor and provide support to yourself and those around you who are grieving a death or other type of loss:
Be present. You usually can sense when something is bothering a loved one. Without pestering, it’s important to let them know that you are available to them. When they are ready to talk, respect their vulnerability and turn off your phone or the TV to show them you are there with them, to listen or just be. At the same time, if you notice changes in your own mood or outlook, slow down and take stock of the big picture. It’s natural to feel things in response to such widespread change. Give yourself space and permission to feel them.
Name your grief and reach out to others. You may feel like you need to put on a strong face for others who are struggling. But it’s more healing to be vulnerable and acknowledge that you are affected, too. By sharing your experience, your loved one will know that they are not alone and will feel less isolated during this challenging time. It’s ok to ask for the support you need.
Find new ways to celebrate a loved one’s life. Recognize that although you may not have been able to be with a loved one during their last moments, you can grieve together with family and friends. The fact that we can be connected virtually with family and friends is important. Create a collaborative video: ask friends and family to share funny, significant or other memories by posting a picture with audio about what it meant to you. Make plans for a future memorial service, for when everyone may be able to come together again. Use an online obituary service to share your loved one’s life story, and to exchange memories and condolences. Even during this time, it is important to create a shared experience to honor the death and each other’s relationships.
Move toward acceptance and inner calm. For a long time, mental health professionals have recognized that grief has some distinct elements: denial, anger, bargaining, sadness and, with time, greater acceptance. David Kessler, who worked with Elisabeth Kübler-Ross to define these stages of grief, reminds us that, “Acceptance… is where the power lies. We find control in acceptance. I can wash my hands. I can keep a safe distance. I can learn how to work virtually.” By focusing on activities that you can control, you can enter the present, open up to creativity, and build acceptance.
Being in the present is also calming. Take 30 seconds and listen, deeply, to the sounds in your home or outside a window. Take a moment each evening to express gratitude for life’s small treasures: a generous neighbor, a healthy meal, a hand to hold, music you love. If you’re feeling sad or frustrated, don’t fight it: let the emotion be there with you. When you acknowledge your emotions rather than fighting them, your relationship to the feelings—and the loss—can transform over time.
If your emotional state becomes overwhelming, don’t hesitate to reach out to a mental health professional who can help guide you through your experience of grief. You are not alone, and getting the help you deserve is part of the path of living through loss.
Read more of PacMed’s resources during COVID-19.
Maintaining eye health during telecommuting
During this time of increased computer work and digital communication, it is important to be mindful of eye strain and give yourself regular breaks. This is why Pacific Medical Centers, recommends the 20-20-20 rule. Specifically, for every 20 minutes you look at a screen, look away for 20 seconds at something that is 20 feet away.
Dr. Kernie at Pacific Medical Center also recommends the following preventative steps to minimize eye strain, especially during this time of working from home. Trying incorporating the following tips:
- If you have prescription eyewear, ensure that you’re wearing them
- If you get dry eyes, remember to drink water, and use artificial tears for additional moisture (not red-eye or allergy drops, as those are for different uses)
- Try to avoid glare from windows or indoor lights
- Adjust your computer screen so the top of it is level with your eyes
- Choose a comfortable and supportive chair
- Don’t forget to blink – not blinking enough can cause red, irritated, dry eyes
Those who do most of their work on computers are most at-risk of eye strain due to the visually demanding nature of digital screens. Additionally, those who are farsighted, have astigmatism or who have problems using their eyes together have a greater risk of eye strain and may require prescription glasses or eye exercises to help manage their eye strain.
It’s also important to drink plenty of water and eat a nutritious diet which includes foods that are good for the eyes. These can include green leafy vegetables (spinach, swiss chard or kale), oily fish, eggs, legumes, nuts, and beans. Green leafy vegetables all have high amounts of Lutein and Zeaxanthin which appear to prevent or slow down macular degeneration and cataract formation.
Foods rich in omega-3 oils such as salmon, oysters, and ground flax seeds, are good for the retina and for the meibomian glands in the eyelids (the oil glands near the eyelashes next to the eyeball that produces part of the tears).
Outdoor exercise during COVID-19
Are you confused about getting outside for exercise during this trying time of COVID-19? If so, you’re not alone. Like so much about the current situation, the advice about exercise right now can be confusing.
As a sports medicine specialist, I like to think physical activity is an elixir for better health and should be prescribed to most everyone. It’s one of the most effective treatments for multiple health issues (like cardiovascular disease, hypertension, depression, obesity, diabetes and others), and even moderate exercise has been shown to boost the immune system. Exercise is a medical prescription everyone should follow. However, the long-term benefits of exercise need to be pursued while also being smart about the serious risks of exposure to the virus.
As part of our state’s Stay Home, Stay Healthy order, many businesses including gyms are closed or limited in operations. Therefore, exercise needs to be done primarily at home or outside. Yet, many options are unavailable or restricted—like parks, beaches and hiking trails that may be closed to facilitate social distancing. In addition, the WHO and CDC are now recommending universal wearing of masks when leaving your home, but a mask can make exercise more difficult. All of this information can be hard to sort through.
So how do we exercise—while exercising caution—during the current public health crisis?
Is it safe to exercise outside?
Let’s start with what we know. We know that the virus that causes COVID-19 is spread through droplets released by infected people, such as when they sneeze or cough—and possibly even when talking or breathing. We know these droplets can hang in the air, especially in enclosed spaces. We also know people breathe more deeply during aerobic exercise. A person who is infected may have no symptoms and not know they are contagious. For these reasons, it is of the utmost importance to keep your distance from people you don’t live with—both to protect yourself and to help flatten the curve.
There is also much we do not know yet—but we can apply some common sense. When virus-carrying droplets occur outdoors, it is reasonable to think the concentration will be lower due to the open space. It is possible this would make the “viral dose” you might be exposed to less dangerous. You can lower your risk outdoors even more by maintaining a social distance of greater than 6 feet. One white paper (not yet peer reviewed) recommends staying out of the direct path or lane of people exercising 30-60 feet away, to avoid catching particles in their slipstream.
If you are running, walking or cycling, there is a risk of moving through a coronavirus droplet cloud—however, my assessment is this risk is small overall, so long as you follow the social distancing rules and avoid crowded areas. My recommendation for safety is to maintain a distance greater than 6 feet if you or others are running or cycling outdoors.
Do you need to wear a mask when exercising outside?
Masks are now required in Washington outside the home, and are a good idea for minimizing risk. However, if you keep sufficient distance from others, you can pull the mask down for easier breathing while exercising. The CDC has information on wearing a cloth mask to slow the spread of COVID-19.
Remember, a cloth or paper mask plays the same role as covering your cough or sneeze: it protects those around you. And since any one of us may be infected with the coronavirus and not have symptoms, wearing a mask when exercising near others can help slow the spread of this disease.
Key takeaways The risks of exercising outside can be minimized if you follow some guidelines:
- Avoid crowded areas.
- Head outside during slower times. Depending on your area, these may be early morning, during the day when others may be inside working, or in the dinner hour or evening.
- Cover your mouth and nose with a light mask, if feasible, while you exercise.
- For vigorous workouts, try cooler hours, when a mask might be more comfortable (or perhaps unnecessary, if fewer people are out).
- Keep your distance from others. Aim for more than 6 feet if you are walking, running, climbing stairs or cycling, or around others who are pursuing such activities.
- Avoid touching your face during your workout.
- When you return home, take off your gear/clothes and wash your hands thoroughly before touching your face.
- Avoid touching household items (knobs, counters, fridge door, etc.) until you have cleaned your hands.
- If you wear a cloth mask, clean it in a washing machine regularly.
There is risk in life and everyone needs to decide how much they are willing to accept. I think exercise is an important part of life, and while exercising outside has risks, these can be minimized.
I wish you the best in finding ways to maintain your health through exercise, while also taking precautions that make sense.
Read more about PacMed’s response to COVID-19.
Tips for Protecting Eyes While Working From Home
Anyone else feeling some major eye fatigue from all your at-home screen time lately? From all your social interactions being over Zoom, to working from home, to spending hours bingeing TV shows, we’re all getting more than our fair share of screens during quarantine. Dr. Marie Kernie, an optometrist at Pacific Medical Centers, answered questions regarding keeping eyes healthy — during this time and beyond.
For eye wellness tips for working from home, can you share some proactive advice to maintain healthy eyes?
To keep your eyes healthy, it is important to ensure that you have a nutritious diet, which includes food that is especially good for the eyes. These include green leafy veggies, oily fish, eggs, legumes, nuts, and beans. You should be wearing UV eye protection that blocks at least 99 percent of both UVA and UVB light rays.
Additionally, there are many preventative steps that to minimize eye strain, especially during this time of working from home. I recommend trying the following:
- Make sure that your computer screen is level to the top of your eyes
- If you get dry eyes, ensure that you’re drinking enough water, and use artificial tears for additional moisture (not red-eye or allergy drops)
- Get up every two hours and take a 15-minute break from screens
- Choose a comfortable and supportive chair
- Try to avoid glare from windows or indoor lights
- Don’t forget to blink — not blinking enough can cause red, irritated, dry eyes
- If you have prescription eyewear, be sure that you’re wearing them
What should people know about blue light – can it actually be good for us?
Studies have shown that high amounts of blue light do harm the eyes. However, they have also shown that even with our increased use of blue light-emitting devices such as cell phones and computer screens, the exposure is still well below levels to cause damage to our eyes. In fact, blue light is actually beneficial to us during the day. It boosts alertness, helps memory and cognitive function, and elevates overall mood. For this reason, we at Pacific Medical Centers do not currently recommend blocking blue light with glasses, as blue light can be beneficial.
At night however, this same blue light can disrupt the natural sleep-wake cycle (circadian rhythm) and in turn trigger your body to stay awake. It is recommended to avoid personal electronic digital devices 2-3 hours before going to bed or setting devices on night mode.
If we can feel our eyes straining but it’s a long time before we can get in to see an eye doctor because of the quarantine, what can we do to help ourselves?
It is important to be mindful of eye strain when working on computers and give yourself regular breaks. This is why at Pacific Medical Centers, we recommend the 20-20-20 rule. Specifically, for every 20 minutes you look at a screen, look away for 20 seconds at something that is 20 feet away.
Are those drugstore readers actually helpful, or could they do more harm than good?
Drugstore readers do not ever damage the eyes and do work for many people but not everyone. This is because people often require a power that is not available at the drug store.
Even if drug store readers help your vision, it is still important to have regular eye exams. Vision problems you may not be aware of such as glaucoma or cataracts can be diagnosed early to help minimize damage to your vision.
Helping teens in the time of COVID-19
As we parents and caregivers seek to find answers about living with COVID-19, we also may find ourselves needing help with the teens in our lives. They likely have questions and concerns that are unique to their stage in life, and we want to support them in ways that connect with where they are at.
More than big children, not quite small adults
It’s important to first distinguish that teens are unique from children in several ways. For starters, teens have awareness of what is happening in the world—and seek and exchange information with their friends, the Internet and other media. It’s vital to be factual and honest with them about what they’re hearing and seeing, not pretend it doesn’t exist.
At the same time, we need to begin treating them as equals: Ask questions and be curious about their views, rather than projecting our own fears or judgements onto them. They have independent minds and points of view. It’s important to not assume that we know what they’re thinking. Engaging in this way can help guide critical thinking for teens, which is essential to their emotional processing.
Let’s tackle this together
Be willing to say, “I don’t know, but let’s look for the answer together.” Similarly, rethink the idea of being “a rock,” that stable, reliable, in-control person for them. A position of constant strength may seem like the right way to create stability for our children, but for teens this can make you seem distant. We need to be human to validate the uncomfortable emotions your teens are having. When you are transparent about how you’re feeling, your kids take that as permission to express themselves too. Practicing vulnerability actually creates the kind of stability kids need from authority figures.
Be sure to validate your teen’s thoughts and emotions by listening closely, nodding your head and saying things like, “I can see how that would feel” or “That makes sense” and “Yeah, I hear what you’re saying.” By using validating affirmations, we get away from changing our kids’ minds and move alongside them, admitting that it’s tough and that’s ok. When kids are afraid, they need to be heard more than corrected.
Help teens seek emotional balance
During this time, we all may feel our emotional balance veering off center. In your household, try to walk the middle path between the two sides of “It feels scary/our world is so different right now” and “There are good things happening, things that are working and growing.” Acknowledging both emotional realms of fear and hope helps steer the conversation toward reality, rather than propaganda.
End and begin each day with each member of the family sharing a few things they can be grateful for, something they learned. Studies show spoken gratitude creates resiliency, especially during a crisis.
Help teens stick with social distancing
Adolescence is the perfect storm when it comes to social distancing. Teens are differentiating from parents, forming important face-to-face social and romantic connections and coming up with unique ideas and beliefs. Teens feel invincible. And because their brains are still developing, logical judgement often takes a backseat to emotional and impulsive behavior.
All of this is normal, and yet at odds with what’s going on in our world today. A few things we parents can do to help them stick with social distancing measures:
- Put yourself in their shoes, be sympathetic and express your sympathy to your child. Allow them to grieve the loss of connections and real-life social experiences.
- Collaborate with your teen as they find ways to bridge the gap between what is possible and what is impossible during this time. Brainstorm creative ways to be connected with friends while being physically distant. Lean on their adept knowledge of technology.
- Help them learn empathy, a desired trait in a healthy adult. Feeling empathy and taking action helps teens feel empowered. Show them that they’re potential “delivery systems” of the virus to older people like grandparents or teachers. Help them practice empathy by calling their grandparents more often or writing favorite quotes to residents of nursing homes. The more real that vulnerable populations become to younger people, the more likely they can see their role in “saving the world.”
Create a home field advantage
Watch your own media consumption so you can guide your kids to turn off their devices. Constant exposure to news of doom and gloom inevitably creates more anxiety and depression for yourself and them. Try turning off your phone and placing it in a shoebox in the middle of the room along with their phones. Turn on music, not the radio, filling the space with the different emotional experiences of a home, instead of a newsroom.
Focus on the aspects of your lives you do have control over and de-emphasize the aspects of the world where there is no control. Explore these ideas:
- Create a daily schedule that includes exercise, outside time and jobs, even if the jobs are not essential. Also make sure bedtime and when you get up are as consistent as possible. Studies show that consistent tasks, routines and daily maintenance help people cope through a long, slow crisis much better than rumination, excessive sleep and boredom.
- Ease up on academic growth and teach life skills: budgeting, cooking, sewing, gardening, music, construction, auto maintenance, art. Teens need these essential life skills, and they’re not usually taught in school. Right now is the perfect time to fill in their “educational gaps.”
Surviving something like this doesn’t just mean avoiding the virus, washing hands and social distancing. The real battle is in our minds and hearts. The choice exists for us to live in constant fear and anxiety or to see this as an opportunity to build inward with our families and ourselves—to not miss the greatest opportunity we’ve ever had to try something new, to live differently, more slowly, more simply.
“Pain is inevitable, suffering is optional.” —Haruki Murakami, author
Read more about PacMed’s response to COVID-19.