Shift Change

Several weeks ago I was a volunteer at the hospital taking temperatures. My job was basic, not surgery, not complicated, no ventilators. The apparatus I used at the hospital is called a temporal thermometer. It takes a quick swipe across the temporal nerve (the middle of the forehead to below the curve of the ear). Like most things that are expensive, use alternative technology and lightening speed: it has drawbacks. The thermometer doesn’t like, sweat, humidity, condensation, glasses, earrings, or hair. It really does not like if you cycled or jogged to work or even if you walked across parking lot B. The infrared technology is fickle. It also does not care for alcohol. I do not mean a nicely salted margarita, bourbon on ice or a chilled chardonnay. I mean the tiny little pads of alcohol used to wipe down stethoscopes, thermometers, and the top of the sanitizer bottle (yes at the hospital we sanitized the sanitizer-which should make us all happy since you don’t really realize how many people touch the pump!).

I showed up to do my first shift a 4:45 am. My name was not on the excel list, but the list hadn’t been updated yet since administration had not arrived. I was dressed, caffeine induced and not leaving. I had my temperature taken, was asked a few pertinent questions and then a kind nurse told me she thought instead of standing at the ED door I would probably be most useful at another entrance to the the hospital where all staff had to be screened. That would be roughly 400 active medical personnel, 200 visiting staff, and 1700 others that include janitors, chefs and administration. Of course they are all not there on one day, but that leaves at least 200 people who must have their temperature taken to remain at work each shift.

This is good news.

Hospitals are not allowing anyone to come to work who has even the slightest hint of an infection. The bad news is temporal artery thermometers are quick but they prefer a faultless environment to be efficient. That perfect atmosphere means it is being operated one time every twenty minutes for a routine doctor visit. It does not mean taking over 200 temperatures between 6:47 and 7:03 am. As I mentioned alcohol also alters the reading. We were wiping, scouring, scrubbing and cleaning as fast as possible between each evaluation. I also live in Bend, Oregon: we can have 5 seasons in one day. It can be as low as 20 degrees before dawn and then 68 during the peak of sunshine: tell your forehand to make sense of that.

Due of the current shortage of bodies the labor pool can get sent down to take temperatures. The egocentric moment of this makes my thousands of dollars spent on medical terminology feel dismissed. However, anyone with a medical history or education must perform the oral temperatures.

On day 1 there were two people from bookkeeping, one from scheduling, an ER nurse who was called away and a phlebotomist (that is a person who draws and prepares blood for all types of testing). In the medical hierarchy the phlebotomist and I were at the top of the food chain. If anyone failed the first thermo scan we were instructed to take an oral temperature. Due to the speed and necessity of rapidly examining everyone for shift change it was too late before I was aware that I had no gloves, nor was I wearing a mask because they were being conserved for floor 2 (and you can imagine what is on floor 2). In less than a quarter of an hour on my first day of work I stuck my hand into over 50 mouths. I tired to make people laugh, tell them when they passed inspection that I was very conflicted because they were not good to go- but good to stay and even one charge nurse who was extremely agitated by my tenacious turtle tactics laughed when she finally passed and I confided I didn’t believe what they said about how cold blooded she was.

And then I was told not to come back. Stunned, I called my supervisor. Was it me? Was it that really grumpy surgeon who didn’t like my jokes? Was it because the organ guy (whose truck is very cold) had to wait until he warmed up while I delayed transplants? No- she assured me. They need to rotate the labor pool (accountants, schedulers, staff and security) to take temperatures. I understood. The frailty of our bodies and bank accounts is humbling.

I quarantined myself because I live with a cancer survivor who is compromised. Today, my 51st birthday (two weeks after my volunteer work) I evolve from the solitude with no fever or side effects. I compliment our local hospital: no one who entered the building, from the person who scrambled eggs to the man who delivered organs was allowed past the sentinels.

The virus reminds me of the world of the Red Queen when she says to Alice in Wonderland, “you have to run as fast as you can just to stay in the same place.”

Flu You! COVID-19

All around us is the fear of flu? How can we stay healthy?

This year there is a tough battle against the flu. Even with a progressive flu shot many have found themselves with unexpected health obstacles and with the invasion of the COVID-19 Virus we are overwhelmed and confused about proper self-care and quarantine management. We now spend a lot of time washing our hands and taking precautions to ward away germs but often we forget to pay attention to what happens from the inside out.

1) Don’t Pick! We touch our face, lips, eyes and nose at least thirty times in less than a minute. The most important thing is to not bring germs from the outside in. Stand at attention or better yet "Jazz Hands!" Pretend you’re a Tyrannosaurus - elbows at your side until you decide what to touch?

2) Drink Me! The easiest way for an infection to travel through your system is on the fast track. Stay hydrated and a cold or flu doesn’t have a chance of sticking with you. Clear tea or broth is your best friend! (The video attached has a wonderful soup recipe!)

3) Boil, boil toil and trouble! Diet becomes essential in helping you achieve a speedy recovery but softer foods are comforting and enhance healing. The heat from the broth helps cure congestion, while the fat in the broth helps cure a sore throat.

4) Sleep! Even if you are not a person who can nap or feels comfortable sleeping the the middle of a day, just allowing yourself to close your eyes for twenty minutes will revive your immune system. If you can get to bed an hour earlier and just huddle in your pillows you are still giving your body a boost. One hour of intended sleep (even before full REM) will create rejuvenation in the immune system.

5) Go for a walk! Moderate exercise repeated on a daily basis enhances immunity. Know yourself. Do not push the limits but do not forgo boosting aspects of exercise. Do not compromise the system but help it reboot and revamp.

There is no guarantee you will avoid the virus but some of these basic principles could help how fiercely you are impacted by complications.

Pulmonary success at a time of distress

I woke up the other night wondering what I would do if I was still navigating the helm of my fitness facility Studio Blue? It would be almost impossible for me to give up our intimacy and proximity. How I adored cramming us all in there for the Tough Turkey Workout each year. We (at the Blue) always participated in paramount hygiene. We still have the basics at our disposal today- wipe everything down and leave your shoes at the door! In our home we have amped this up a bit and any clothes that come into contact with over a dozen strangers (i.e. going to the grocery store) we leave those at the door too. We know “it” lives on surfaces for several days but we do not yet know about soft fibers. I am old school when it comes to aerobic activity – just ask Jane Fonda and my knees- but I have learned that ‘anaerobic’ (sprinting) mode in some way-everyday will force your lungs to open the edges of the alveoli. Those are the tiny air sacs at the bottom of the complicated tree branch of the pulmonary pathway. This is a perfect way to speed clean your house-sprinting behind the vacuum cleaner and swiffer.

By now I know most of you are COVID-19 experts. The coronavirus spreads via droplets from coughs, sneezes and exhaled air of individuals who carry the virus (irrespective of if they show symptoms). The following are recommendations to improve pulmonary health, but anyone with specific issues may wish to consult their physician before adopting them. Please note that these suggestions and are not an alternative for good old fashion hand washing.

Aerobic exercise. Before infection aerobic exercise is recommended to strengthen cardiovascular health. Preferably, exercise outdoors or with open windows or otherwise well ventilated areas (easy for me to say I live in sunny Bend, Oregon). In sufficiently warm climates, lengthy walks or even running may improve lung capacity. Jumping jacks, jogging in place, or dancing can be done even in small spaces.

Keep windows open where temperatures allow. It is best for airflows to move outward, allowing any viral particles present in the air to exit the room, rather than you (or someone else) breathing them back in. If the weather in your region is cold, consider opening the window for a set time each day.

Spend time outdoors with comfortable spacing. We might not all have access to trails and mountains but balconies, back yards, and patios, are good locations to be with family. Ensure exhaled viral particles don’t get re-inhaled while binging on your favorite show.

Breathe in through the nose. Breathing through the nose helps clean incoming air, via cilia (small hairs) and mucous membranes, thus creating a shield (or net) against diseases. Nasal breathing also warms and moistens incoming air. A little swab of Vaseline also keeps your cilia moist.

Deep breathing. Deep breathing and exhalation bring fresh air in and can improve lung capacity. We typically breathe in and out only a fraction of our lung’s capacity. Expelling viral particles from the more stagnant areas of the lung may further decrease self-exposure to viral particles. Hence- why you should sprint through the house or to the corner stop sign (if your knees allow!)

For the first time in my life I am about to say the strangest thing: those extra five or ten pounds we all want to lose for spring? Don’t. Adore them; cherish them- they will be the first things to go when you get this virus.

While out sprinting before the sun went down these branches reminded me of our complicated pulmonary system.