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.
OUR UPDATED OFFICE SCHEDULE
DOORS OPEN
7AM - 4PM Monday through Thursday
7AM - 11AM Friday
IN OFFICE
APPOINTMENTS: MONDAY – THURSDAY
7AM – 11:15AM & 1PM – 3:30PM
APPOINTMENTS: FRIDAY
7AM – 10:30 AM
SUMMARY OF A COVID KIT:
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
COVID CHECKLIST FOR THE DOUBLE OR TRIPLE VACCINATED:
I HAVE GOTTEN 2 OR 3 VACCINES…AND HAVE BEEN DIAGNOSED WITH COVID (OMICRON LIKELY) …. NOW WHAT DO I DO?????
THIS IS CHECKLIST FOR THOSE OVER 50 (THIS LIST APPLIES TO THE YOUNGER SET BUT THE LEVEL OF CONCERN IS MUCH LESS):
1. UNDERSTAND THE TIMECOURSE OF COVID
2. QUARANTINE FOR 5 DAYS FROM FIRST SYMPTOMS (IF THIS IS CLEAR) OR FROM THE DATE OF YOUR POSITIVE TEST. MASK STRICTLY FOR ADDITIONAL 5 DAYS
3. MONITOR YOURSELF DAILY…TEMPERATURE AND OXYGEN LEVELS…IF YOU HAVE THE EQUIPMENT
4. HYDRATE WELL, EAT IF YOU CAN
5. TREAT SYMPTOMS AS REQUIRED
6. KNOW THAT THE MOST IMPORTANT SYMPTOM IS TO WATCH FOR TRUE SHORTNESS OF BREATH. IF THAT DEVELOPS, GO TO THE EMERGENCY ROOM
7. CONCERNS….BE IN TOUCH DURING YOUR ILLNESS AND PROVIDE US UPDATES ON FEVER AND OXYGEN LEVELS
8. NO TESTING IS REQUIRED AFTER YOUR ILLNESS
TIME COURSE/EXPECTATIONS:
COVID COURSE:
THREE PHASES OF COVID:
- JAILBIRD
- PAROLE BIRD
- FREE BIRD
JAILBIRD: STRICT QUARANTINE: 5 DAYS FROM DATE OF FIRST SIGNIFICANT SYMPTOMS IF OBVIOUS OR FROM DATE OF TESTING IF UNCERTAIN BASED ON SYMPTOMS (MUST ALSO BE FEVER FREE FOR 24 HOURS)
PAROLE BIRD: DAY 6-10. MASKING WHEN IN THE PRESENCE OF OTHERS INSIDE (NOT REQUIRED OUTSIDE IF SPACIOUS.) DO NOT SHARE THE SAME BEDROOM AT NIGHT.
FREE BIRD: DAY 11+ NO RESTRICTIONS.
No testing is needed to prove you are cleared!
QUARANTINING:
- Do not share a BEDROOM with housemates. Use your own bathroom.
- Wear a mask when in the presence of others.
COVID HOME KIT:
1. DIGITAL ORAL THERMOMETER: TO MONITOR FEVER.
MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
2 PULSE OXIMETER: TO CHECK OXYGEN LEVELS.
MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
OTHER ITEMS FROM THE HOME MEDICAL KIT (SEE BELOW FOR USE OF PRODUCTS):
- TYLENOL/ADVIL/ OR ALEVE (ADVIL AND ALEVE ARE SAFE IN COVID)
- Sudafed 30mg tablets
- Chlorpheniramine 4mg tablets
- Robitussin DM syrup
- Imodium AD
Most Common Symptoms
They consist of the same set of symptoms as the common cold/rival respiratory syndrome, but they are worse.
Common/Hallmark symptoms:
· High fever (over 100.4, but can range from 99’s to 104+)
· Fatigue
· Cough
Other symptoms can include milder issues:
· Loss of Smell and/or Taste
· Nausea without Vomiting
· Sore Throat
· Aching muscles throughout the body
· Headache
· Occasional diarrhea …
· Nasal congestion (occasional)
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)
Sore Throat:
· 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.
DIET RECOMMENDATIONS TO PREVENT DEHYDRATION IN ILLNESS:
Preventing dehydration is of utmost importance in an acute illness.
Clear liquids (any liquid that light can easily shine through) are the best liquids to use.
These include:
- Plain Water
- Gatorade (or other electrolyte solutions that are similar) ….do not use sugar-free versions of these drinks as the calories in these drinks are helpful is treating the illness and may be the only calories the person can absorb for the first hours or days
- Tea
- Cranberry Juice, Apple Juice (watered down…mixed ½ & ½ with water), White Grape Juice
- Broth from Chicken Soup, Matzo Ball Soup, Bullion
- Popsicles
Sipping liquids …sip, sip, sip….and pushing the fluids progressively with time is the most important treatment provided. Focus on this above all else!
Foods: Maintaining good dietary intake is important during the acute phase of illness, so long as appetite is present. Do not push foods if uninterested…focus on liquids. That said, if appetite remains acceptable, food can consist of anything that interests your appetite and is tolerable. Healthier choices are best, but if you want a hamburger…go ahead! Easy to digest foods include:
- Toast (plain white bread)
- Crackers (Saltines)
- Plain Noodles
- Breakfast cereals
- Bananas, Citrus fruits
- Apple Sauce
- Cooked chicken and meats
- Macaroni (with or without cheese)
- Plain Rice
Cough:
· 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.
Nausea Treatment:
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 hospitalized. Best to go the ER if shortness of breath is a significant symptom
COVID CHECKLIST FOR THE UNVACCINATED:
I HAVE BEEN DIAGNOSED WITH COVID…. NOW WHAT DO I DO?????
THIS IS CHECKLIST FOR THOSE OVER 50 (THIS LIST APPLIES TO THE YOUNGER SET BUT THE LEVEL OF CONCERN IS MUCH LESS):
1. UNDERSTAND THE TIMECOURSE OF COVID
2. QUARANTINE FOR 10 DAYS FROM FIRST SYMPTOMS (IF THIS IS CLEAR) OR FROM THE DATE OF YOUR POSITIVE TEST
3. MONITOR YOURSELF TWICE DAILY…TEMPERATURE AND OXYGEN LEVELS
4. HYDRATE WELL, EAT IF YOU CAN
5. TREAT SYMPTOMS AS REQUIRED
6. KNOW THAT THE MOST IMPORTANT SYMPTOM IS TO WATCH FOR TRUE SHORTNESS OF BREATH. IF THAT DEVELOPS, GO TO THE EMERGENCY ROOM
7. CONCERNS….BE IN TOUCH DURING YOUR ILLNESS AND PROVIDE US UPDATES ON FEVER AND OXYGEN LEVELS
8. NO TESTING IS REQUIRED AFTER YOUR ILLNESS, ALTHOUGH YOU CAN HAVE A BLOOD TEST FOR ANTIBODIES AFTER 21 DAYS WHEN YOU ARE FREE
TIME COURSE/EXPECTATIONS:
COVID COURSE:
TWO PHASES OF COVID:
JAILBIRD: STRICT QUARANTINE: 10 DAYS FROM DATE OF FIRST SIGNIFICANT SYMPTOMS IF OBVIOUS OR FROM DATE OF TESTING IF UNCERTAIN BASED ON SYMPTOMS (MUST ALSO BE FEVER FREE FOR 3 DAYS AS WELL)
FREE BIRD: DAY 11 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.
QUARANTINING:
- 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 if possible.
- Avoid sharing living spaces with housemates, to the extent your living situations allows.
- Wear a mask when in the presence of others. Wear when you are with others as much as possible.
- Wash your hands frequently. Use cleanser on surfaces frequently.
COVID HOME KIT:
1. DIGITAL ORAL THERMOMETER: TO MONITOR FEVER.
MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
2 PULSE OXIMETER: TO CHECK OXYGEN LEVELS.
MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
OTHER ITEMS FROM THE HOME MEDICAL KIT (SEE BELOW FOR USE OF PRODUCTS):
- TYLENOL/ADVIL/ OR ALEVE (ADVIL AND ALEVE ARE SAFE IN COVID)
- Sudafed 30mg tablets
- Chlorpheniramine 4mg tablets
- Robitussin DM syrup
- Imodium AD
HYDROXYCHLOROQUINE IS NOT RECOMMENDED TO PREVENT OR TREAT COVID AT THIS TIME. THE DATA DOES NOT SUPPORT Its USE.
CARING FOR YOURSELF IF YOU THINK YOU MAY HAVE COVID OR IF YOU HAVE BEEN DIAGNOSED WITH COVID:
1. 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.
2. Check oxygen level twice daily and keep a log. A declining oxygen level can indicate early decompensation 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 checked at the Emergency Room (which is safe to do!) If you have concerns…be in touch.
3. Manage symptoms just like any other viral infection (see below)
Most Common Symptoms
They consist of the same set of symptoms as the common cold/rival respiratory syndrome, but they are worse.
Common/Hallmark symptoms:
· High fever (over 100.4, but can range from 99’s to 104+)
· Fatigue
· Cough
Other symptoms can include milder issues:
· Loss of Smell and/or Taste
· Nausea without Vomiting
· Sore Throat
· Aching muscles throughout the body
· Headache
· 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.
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)
Sore Throat:
· 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.
DIET RECOMMENDATIONS TO PREVENT DEHYDRATION IN ILLNESS:
Preventing dehydration is of utmost importance in an acute illness.
Clear liquids (any liquid that light can easily shine through) are the best liquids to use.
These include:
- Plain Water
- Gatorade (or other electrolyte solutions that are similar) ….do not use sugar-free versions of these drinks as the calories in these drinks are helpful is treating the illness and may be the only calories the person can absorb for the first hours or days
- Tea
- Cranberry Juice, Apple Juice (watered down…mixed ½ & ½ with water), White Grape Juice
- Broth from Chicken Soup, Matzo Ball Soup, Bullion
- Popsicles
Sipping liquids …sip, sip, sip….and pushing the fluids progressively with time is the most important treatment provided. Focus on this above all else!
Foods: Maintaining good dietary intake is important during the acute phase of illness, so long as appetite is present. Do not push foods if uninterested…focus on liquids. That said, if appetite remains acceptable, food can consist of anything that interests your appetite and is tolerable. Healthier choices are best, but if you want a hamburger…go ahead! Easy to digest foods include:
- Toast (plain white bread)
- Crackers (Saltines)
- Plain Noodles
- Breakfast cereals
- Bananas, Citrus fruits
- Apple Sauce
- Cooked chicken and meats
- Macaroni (with or without cheese)
- Plain Rice
Cough:
· 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.
Nausea Treatment:
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 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.
Stay Safe!