We Are Here to Take Care of Your Healthcare Needs.
We Are Here to Serve!
Our office is using all techniques to reduce exposure to a minimum during your visit. These include:
· Temperature checks of all patients and staff.
· Masks for all people in the office.
· Cleansing of hands and surfaces repeatedly.
· Multiple Super-HEPA filters to filter out potential virus and particles in the office.
· High Level UV light air cleansing in the office to eliminate bacteria and viruses in the air.
We have expanded our Telehealth Visits during increased COVID-19 cases, but are still seeing patients in the office.
In addition, we are connecting with you via
phone, fax, email, and telehealth.
OUR CURRENT UPDATED
7AM - 4PM Monday through Thursday
7AM - 11AM Friday
DO NOT JUST ‘DROP IN’…YOU MUST HAVE A SCHEDULED APPOINTMENT FOR THIS COMING WEEK.
IN OFFICE APPOINTMENTS: MONDAY - FRIDAY
ARE BEING ADJUSTED…..WE WILL CALL YOU TO CONFIRM IF APPOINTMENTS WILL BE KEPT OR CHANGED TO A TELEHEALTH VISIT
MONDAY - FRIDAY from 10:30AM - 12 Noon
We will be conducting TELEHEALTH/PHONE visits with patients.
MONDAY - THURSDAY
WE WILL BE SEEING POSSIBLE COVID-19 PATIENTS 3:00PM - 4:00PM (IN YOUR CAR…APPOINTMENT ONLY…. IN PROTECTIVE GEAR)
REDUCE RISK BY REDUCING CONTACT WITH THE VIRUS
REDUCE CONTACT WITH THE VIRUS BY:
1. Washing hands frequently….20 seconds is advised, but any hand washing is helpful.
2. Wear a mask or face covering when out in public.
3. Use hand cleanser in between washings…if available.
4. Clean your cell phone daily with a cleansing wipe or UV light.
5. Shower or bathe daily. Twice daily if you want to feel more relaxed.
6. Do not Pick Nose, Rub Eyes, or Pick Teeth with your fingers
7. Do not go out or to work if you are ill…. or think you are ill. If you are unsure, check your temperature. If over 99.8 you should not be going out.
8. If someone in your house is ill, treat them as though they have COVID. Have them get tested and you should quarantine as well.
9. Stay away from people who are sick with COVID. Only caregivers should be in contact with COVID patients and they practice high level cleaning to prevent spread.
10. Maintain physical distancing practices, avoid getting within 6 feet of people (other than immediate household occupants)
11. Limit your activities to the minimum interactions you can do to maintain your daily living.
12. Leave mail and other paper products for one to two days on the shelf or in the garage (outside the house) …then bring them in after sitting for 24-48 hours to reduce the potential for transmission.
13. Groceries cleaning should be considered, although not as strict as initially indicated when the pandemic began. See this video link for excellent detailed information: Click Here
IF YOU ARE SYMPTOMATIC AND HAVE BEEN TOLD YOU MAY HAVE COVID ……BUT TESTING HAS NOT BEEN DONE YET …….DO AS FOLLOWS:
· Self-Quarantine for 14 days from the start of illness and FOR at least 3 days after fever and major symptoms have resolved.
· Do not share a bathroom with housemates if possible. Use your own bathroom.
· Do not share utensils with others and clean your own utensils and/or use paper/disposable eating materials.
· Wait 1 day to wash the clothing you wear. Clothing can be washed after sitting out for 24 hours (virus is not transmissible at that point via clothing). Others can wash your clothes using this approach.
· Avoid sharing living spaces with housemates, to the extent your living situations allows.
· Wash your hands frequently. Use cleanser on surfaces frequently.
· Wear a mask & gloves when in the presence of others. Wear when you are with others as much as possible.
· Shower/bathe twice daily if possible.
· All household contacts should self-quarantine as well with only minimal outside interaction.
MORE EXPANSIVE TESTING IS CURRENTLY AVAILABLE IN OUR OFFICE. Results within 24-36 hours generally.
It is being done at the end of the day, in your car, by myself…. wearing protective gear.
IF YOUR ARE ILL AND CONCERNED YOU MAY HAVE COVID INFECTION OR SIGNIFICANT COVID EXPOSURE:
Contact the office via phone or email first for instructions:
Please do not walk into our office if you think you have COVID infection. We will not see you in the office. Only in your car, and with that, you should contact the office to be seen end of day.
If you think you have COVID and are truly short of breath, you need to go to the Emergency Room, not to our office. We are not equipped to handle low oxygen levels.
WHAT IS OUR CURRENT EXPECTATION FOR THE COURSE OF COVID?
At this point in time there are many uncertainties about the course of COVID in the US and in Arizona, but I can provide some educated speculation:
· Nationally…. a slow decline in cases for 1-2 months, then a significant upsurge in cases… to 100,000 per day or more this fall and winter.
· Arizona is likely to do better generally than cold weather states, but we will still have a significant surge due to back to school for younger kids and college kids.
· Travel back to Arizona is best done sooner rather than later for those who live back East, as we anticipate a significant rise in cases as we move into the late fall and winter.
· Influenza will complicate the picture during the fall, winter, and early spring, making it more difficult. That said, we anticipate a milder flu season this year (still, we recommend the flu shot to prevent infection).
This is what you should have at home to prepare for possible COVID, to monitor yourself if you were to get infected:
DIGITAL ORAL THERMOMETER: MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
PULSE OXIMETER: TO CHECK OXYGEN LEVELS. MANY BRANDS ARE FINE...HERE IS ONE EXAMPLE:
OTHER ITEMS FROM THE HOME MEDICAL KIT:
· TYLENOL, ADVIL, OR ALEVE
· Sudafed 30mg tablets
· Chlorpheniramine 4mg tablets
· Robitussin DM syrup
· Imodium AD
THREE PHASES OF COVID:
· JAILBIRD Day 1-10
· PAROLE BIRD 11-17
· FREE BIRD 17+
JAILBIRD: STRICT QUARANTINE...... 10 DAYS FROM DATE OF FIRST SIGNIFICANT SYMPTOMS IF OBVIOUS OR FROM DATE OF TESTING IF UNCERTAIN BASED ON SYMPTOMS
PAROLE BIRD: DAY 11-17…. VERY CAREFUL WITH ALL ATTENTION TO MASKING, DISTANCING, HAND CLEANSING: NEXT 7 DAYS AFTER QUARANTINE
FREE BIRD: DAY 17 AND BEYOND..... NO RESTRICTIONS.
Although I do not recommend testing to prove the virus has cleared after infection, if you have testing and are clear, then the above protocol is not applied.
CARING FOR YOURSELF IF YOU THINK YOU MAY HAVE COVID OR IF YOU HAVE BEEN DIAGNOSED WITH COVID:
Most Common Symptoms
They consist of the same set of symptoms as the common cold/rival respiratory syndrome, but they are worse.
· High fever (over 100.4, but can range from 99’s to 104+)
Other symptoms can include milder issues:
· Loss of Smell and/or Taste
· Nausea without Vomiting
· Sore Throat
· Aching muscles throughout the body
· Occasional diarrhea …
· Nasal congestion (occasional)
Symptomatic treatment for the most bothersome symptoms
· Plan to: Monitor temperature twice daily and record.
· Monitor oxygen levels twice daily and record. If dropping
significantly you should be in touch.
For the oxygen/Temperature:
- Check your temperature twice daily and keep a log. No temperature is dangerous…adults do not have to worry about this. This is just about monitoring your condition. If you have concerns, be in touch.
- Check oxygen level twice daily and keep a log. A declining oxygen level can indicate early de-compensation from COVID. Normal oxygen saturation is 97-100%. If lower than that it may be normal for you, but the trend is what matters. If you are declining into the low 90’s, if you are feeling particularly short of breath…then it is time to check at the Emergency Room (which is safe to do!) If you have concerns…be in touch.
Aches and Pains and Fever:
· Tylenol 650 – 1000mg four times per day is preferred for treating these symptoms, but if not working well, you may use:
· Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets...1 – 2 x per day,
· Drink good amounts of clear liquids (anything you can see through)
· Saltwater gargling
1. Dissolve 1 teaspoon of salt in a glass of warm water.
2. Gargle for 15 seconds and spit.
3. Repeat during the day every 2 – 4 hours to relieve pain.
· Pain relief medications: Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets...1 – 2 x per day, or Tylenol 650 – 1000mg four times per day.
· Steam: Either in the form of a hot, steamy shower or using a hot pot of water and covering with a towel and put your head under the towel. Both methods will provide humid air to the irritated air passages and soothe the cough.
· Cough Syrup: Robitussin DM or Delsym cough syrup can be used to suppress cough.
· You may require a prescription cough syrup with Codeine. Contact me if that is the case.
Sinus Congestion and Drainage (RARE SYMPTOM):
· Use a decongestant such as Sudafed 30mg, 1 – 2 pills up to four times per day, or use a drying antihistamine such as Chlortrimeton 4mg, up to four times per day. Other cold medications (over the counter) can be used.
· Claritin, Zyrtec, Allegra will not work for congestion symptoms from an infection. Do Not Use.
This is the most difficult issue to treat at home as there is very little one can do to settle the stomach. Coca-Cola with the carbonation eliminated (Flat Coke), Ginger Ale, or Ginger Root…. can be tried, but these are often inadequate, and the key to getting the stomach to settle is getting a good nausea medication.
If nausea is persistent, then calling for a prescription medication is often a good idea. Phenergan (Promethazine), Compazine (prochlorperazine), Zofran (Ondansetron) are very effective in treatment. Sometimes we use them in combination either as a pill or a suppository.
The KEYS are:
1. Settling the Stomach…so that liquids can be taken
2. Focusing on Liquids…so that dehydration does not set in
3. Eating light foods… if possible (to provide energy for healing). This is not a requirement for healing from an acute GI illness; so, do not feel that the sick person needs to eat food. The only requirement is liquid intake!
When to Seek Medical Assistance
• There is no medication to treat this virus, so the resolution takes time.
Worsening symptoms/Signs of Complications:
• If you are getting significantly short of breath please be in touch. If progressive and worsening, you need to be seen and possibly hospitalized. Best to go the ER if shortness of breath is a significant symptom
How Long to Recover
• The COVID is a viral infection that will generally take from 3–7 days to develop, 3-7 days to improve and then from 3-7 days to completely resolve.