Tag: covid

Patience

Joanne Dragun, M.D.

It’s toilet paper all over again. Are you still working down your stock of paper supplies acquired 6 months ago in a frenzy? Did you know that there is plenty on the shelves now….. and probably at less cost? Don’t be embarrassed, we all did it. What I refuse to do however is playing out currently, queuing up for hours for the vaccine. On new years day the local news showed a line of cars down Route 1 in St. Augustine that started 4:30 AM. It goes for miles and at 9 AM they haven’t started vaccinating yet. Are diapers involved? A friend thought he was clever and went on Sunday at 4 AM but there were hundreds of cars ahead of him and they ran out before getting to him.  A “deputy” from the health dept was interviewed- obviously from her home yesterday who said that since sitting on the phone for hours wasn’t working they would roll out an email sign up.. duh. Obviously that is bust and they decided to just vaccinate first come, hence the line up of hopeful recipients. Of course, if you know me, I’ve written to the Governor, Senators and health depts several days ago. A plan tor success needs to hatch- NOT the flat footed “health depts” working from home in a dither. Bring in the military, send the vaccines to hospitals for storage, provide staff to jab the needle into arms and let’s get this show on the road.

The vaccine is sitting waiting for the roll out that is stuck. So that’s my crank today- you are not surprised at my ire for poor performance are you? So here’s the deal. Please don’t sit for hours in your car lined up in the hopes when they get to you there is still a dose. Let things settle down and when the pharmacies get it and more sights are involved it will be smooth. It’s not as if you are headed on a cruise as soon as you are inoculated. After dose 1 you will be about 50% protected in 12 days, then 90% about 2 weeks after the second dose so we are still talking a few months.

 Patience is required, so as I said a few weeks ago- you got this, just from going to Disney. But you don’t have to rush to be first in line next week because frankly they haven’t figured it out. (PEOPLE GET OUT OF THE TUB AND GO TO WORK!). Ugh. Today I asked the Governor to get the military involved.

When I did call the health depts , they said everything is closed til Monday- sure take a break for the holiday its not as if there is a pandemic. 8th grade computer wiz kids would have had this knocked out quickly. In spite of my disgruntled tone, I am still preaching patience. If you are over 65 expect to sign up in the next month. If you are undergoing active cancer treatment, check with your oncologist. Many patients on chemo should not get the vaccine while their immune system is compromised, and so the medical oncologist needs to advise you. Hopefully you’ve already gotten the flu shot for the year because you need a few weeks between the vaccinations- you can’t get them together.

The good news is that it is in the government’s interest to get you vaccinated and so they will work out a system and as more companies are approved and produce, you will get vaccinated….. don’t be an anti vaxer please; if you read this you actually care about yourself and loved ones and know that good health and strength do not come from osmosis. The effort is worth it. It’s just not necessary to sit in your car for five hours. Have faith. You and your loved ones will get the vaccine and in a few more months life will improve… I didn’t say return to normal and your patience will be rewarded. Keep calm. Help is on the way.

PS: When you do get the vaccine avoid alcohol since it reduces the immune system and the vaccine may be less effective!

Rescue

Joanne Dragun, M.D.

More threatening than covid, more dramatic than hurricanes, the scariest this week are the weather channel meteorologists. Not satisfied with the quick moving Isaias, they pile on that 89% of hurricanes are yet to arrive in the US in a very active year. Look, we have no more room for any more toilet paper or water so stop threatening us. From Florida to New England, we prepared and alerted. Then we get a reminder of just how life can change in an instant last week.

Following death and destruction in North Carolina, further inland the storm traveled as far as West of Philadelphia. Dr. Brian Lally, a good friend and radiation oncologist in Doylestown Pa with U Penn tells me, “The sky darkened, something hit my window, the power went off and I went to the vault to help the patient off the table. As the accessory power went on, there was crashing as a tornado blew the wall of glass into the lobby. The cars upended in the parking lot and everyone was escorted into the vault.” The roaring was terrific he tells me as the storm swirled. He made his way out to find the hospital daycare in the adjacent building had its roof caved in.

Dr. Lally, staff and teachers formed a human chain with tiny figures, some small enough to be in arms, and evacuated to his department. The concrete and lead lined vault filled with small frightened faces. Fourteen were missing in the head count! A tech working there knows the daycare well and went to investigate. They found them all huddled into a small room/closet where the tree had fallen through the roof. EMT’s arrived and everyone was triaged with only minor injuries.

There were no masks, there was no hand washing, there was surely no distancing. There was massive surge of loving care and in an instant, heroes were born. The tiny faces with big eyes break  your heart. Privacy keeps me from sharing the photo but babies, toddlers all crunched under the large intimidating radiation machine in the concrete vault bring awe and tears. 140 children saved.

Thank you, Dr. Brian and staff for reminding us all how in a moment of crisis, care for each other is the only matter. Diving in to rescue with no thought of personal safety. The  “managing” for months this new reality in our homes and work, the threat of more hurricane drama ahead, the grieving for suffering and loss that many have and will face, all disappear in an instant. When we rescue someone, we are saved.

Cancer and covid

Joanne Dragun, M.D.

After 9/11 we witnessed the disruption in travel and the loss of innocence. We gave in and believed if we line up at the airport, put security and barriers around everything we would be safe. There are many similarities this week with the new threat. If we allow, it will be all-consuming and steal our money, entertainment, family and friends interactions even toilet paper. For cancer patients, it may even steal their cure.

Jeanine starts her therapy this week. “Doc, shouldn’t I just wait until this all blows over? I don’t want to get sick” I express to this frightened patient that as long as she is careful (you know the drill: hand washing, no touching the face, avoid others, stay home) we should treat the disease she has, not the one causing fear. The common flu is ubiquitous and deadly* but we don’t stop our lives. We live, we manage, we are brave and not giving into this. Not to be brazen and unwise, just to maintain control. Being anxious, fearful and paralyzed does nothing to contribute to our wellness.

This virus is not seeking us out. It isn’t tracking us down and attacking us in our beds. It’s all in the way the information is approached. We never ever had this level of tracking with other non-curable viruses that caused tens of thousands of deaths. You probably barely recall the bird flu, the swine flu, H1N1. You still worked and lived your life and although many people did succumb to the infection, the world and your own life didn’t stop unless you were directly affected.

In oncology, I actually do have a recommended answer for Jeanine. Medicare (CMS) has come up with suggestions for treatment. Low-risk cancer can wait a few months, medium risk are at the doctor’s and patient’s discretion and high risk should move into care. Cancer centers are well equipped with the ability to sanitize and care for very ill patients. What arrogance this virus has to make us postpone our own well being. In some cancer cases, months are short- should we just abdicate the time we have?

So what are my recommendations after hundreds of hours researching and reading, seeking counsel and advising? If you are well, do not seek healthcare at all. No followup routine visits, no testing, keep yourself away from the ill and frail for your sake and theirs. If you have started therapy or are of moderate or high risk (check with your oncologist) go full steam ahead. If you are newly diagnosed and low risk consider waiting a few months.

This virus isn’t going away but over 90% of us will survive it and even the elderly frail at risk survive 85%. If you venture out you won’t know until up to two weeks after if that was a mistake. But do go out for a walk in nature- the runs to the supermarket or home depot are over for now. A new dynamic has been birthed making communing with nature more precious. Taking a break from our busy lives is something we rarely do so enjoy the peace and solitude. Then be ready to jump back in, hopefully soon. We cannot wait 18 months until there is a vaccine to live. We should be determined to survive and thrive in spite of this virus.

I am going to be strong with you. I am not going to be still hoping a cure will rescue me or a drug will treat me. If that happens fine, but the news would have you believe it is the only way. Make your own way. Don’t be careless but don’t be frightened. Fear didn’t keep cancer away so there really isn’t any therapeutic value in it. You have the power to handle anything that comes your way.

For up to date information: http://www.cdc.gov                                                                                                     *note (hopkinsmedicine.org): flu, 1 billion cases worldwide, up to 646,000 deaths. Up to 60,000 deaths US.

Addendum: The $2 Trillion rescue plan was passed by a self-centered congress yesterday. They laughed and patted each other on the back (hubris ignores social distancing.) While we the people take out an enormous loan for politicians’ special interests, let us pray that my colleagues on the front line will receive the equipment they need and not find it necessary to wear trash bags and bandanas. Doctors, nurses, EMTs are naive- we don’t catch diseases like cancer, heart attacks, strokes, and so they jump in and rescue no matter the thought for their own safety- always. They believe they are invincible even in the face of this invisible pathogen. May God bless their bravery and provide.