Managing Children’s Anxiety About COVID-19

Talking with Your Children About COVID-19

If you’re dealing with kids who are home from school due to the new coronavirus, a lot of questions are probably popping up. Understandably, your kids are concerned about the outbreak and they’ll look to you for answers. Here are some things you can do to that’ll make those conversations easier:

  • Provide just enough information about COVID-19. Try to strike a balance between answering their questions well enough without fueling any anxiety they may have. A lot of this will depend on the age of your child. Children have vivid imaginations and if you don’t talk enough or at all, they can create worse scenarios in their minds. Be honest, accurate and provide information that’s appropriate for their age and level of development.
  • Find out what your child already knows. For older children, ask them what they’ve heard from other kids at school. Ask your younger children if they’ve heard about the new sickness that’s going around. This will help you learn how much they know and if the information they have is correct. If your child isn’t asking questions or doesn’t seem interested, that’s okay.
  • Remain calm and reassuring. Your child will react both to what you say and how you say it. They’ll also pick up on your demeanor during the conversations you have with others, so try to remain calm.
  • Avoid language that might blame others and lead to stigma. Viruses can make anyone sick, regardless of their race or ethnicity. Avoid making assumptions about who might have COVID-19.
  • Focus on what you’re doing to stay safe. A great way to reassure your kids is to remind them of all the safety precautions you’re taking. Let them know that washing their hands frequently for 20 seconds, or for the amount of time it takes to sing Happy Birthday twice, is one of the best ways to stay safe. Explain that by staying at home, they’re helping reduce the spread of the virus. 
  • Limit exposure to news and social media. Watch the news when the kids are asleep or early in the morning when your kids are occupied. 
  • Keep talking. Let them know that, even if you don’t have all the answers right now, you’ll let them know as soon as you do. Assure them that you’ll be available to talk whenever they need to. 

What Are Some of the Questions Kids May Ask About COVID-19?

When your kids ask questions, try to keep your answers simple and remind them that health and school officials are working hard to keep everyone safe and healthy. Here are a few questions you may be asked and some simple, kid-friendly answers that won’t overwhelm them:

  • What’s COVID-19? COVID-19 is the short name for “coronavirus disease 2019.” It’s a new virus that doctors and scientists are still learning about. This new virus has made a lot of people sick, but doctors and scientists think that most people will be okay, especially kids. Some people might get pretty sick.
  • How do you get COVID-19? The virus spreads like the flu, or a cold or cough. If a person who has COVID-19 coughs or sneezes, the germs come out of their body and into the air. Those germs can travel up to six feet, so that’s why it’s important to stand six feet from people, other than your immediate family. A healthy person can also touch something that a sick person coughed or sneezed on, which is why it’s so important to wash your hands a lot. This keeps the germs out of your body. 
  • What can I do so that I won’t get COVID-19? You can practice healthy habits at home to help prevent the spread of COVID-19.
    • If you cough or sneeze, do it into your elbow. If you cough or sneeze into a tissue, throw it in the trash right away. 
    • Keep your hands out of your mouth, nose and eyes. This will help keep germs out of your body.
    • Wash your hands with soap and water for at least 20 seconds (show them the proper way), rinse then dry. You can sing the Happy Birthday song twice. 
    • Keep things clean. (Have them help you clean the things in the house that get touched the most).
    • If you feel sick, stay inside. Just like you don’t want to get germs from other people who are sick, they don’t want to get your germs either. 
  • What happens if you get sick with COVID-19? COVID-19 affects people differently. Some people get a cough, fever or have a hard time taking breaths. Most people who get COVID-19 haven’t gotten very sick. Only a small group of people who get it have had more serious problems. From what doctors have seen, most children don’t seem to get very sick. While a lot of adults do get sick, most of them get better. 

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What Can I Do to Help Manage Their Anxiety and Keep Them Busy?

With most schools closed and many people working remotely from home, it can be difficult to keep your kids occupied. Here are some things you can do to help calm their fears, manage stress and keep things running smoothly:

  • Maintain routines. Sticking to your regular schedule is key. Kids should get up, eat, and go to bed at their normal times. Consistency and structure are calming to kids, which helps reassure them in times of stress. 
  • Be creative with new activities. Introduce new activities to your routine, like board games or doing a puzzle. Let them pick their favorite meal, then enlist their help in the kitchen. Plant a garden. Have them create an illustrated storybook to share with their grandparents.
  • Stay in touch virtually. Just because they can’t see their relatives or play with their friends in person doesn’t mean they can’t stay in touch. Set up virtual chats and playdates on FaceTime or Zoom. 
  • Exercise. This is a big one. Stay active. Get outside. Go on family walks or bike rides. Play outside in the yard. Teach them yoga. Exercising clears the mind and improves the mood for everybody.
  • Keep it positive. For many kids, being home from school is a dream come true. Let them know you’re glad that they’re excited and use that good energy as a springboard to help them feel calm and happy. Let them know you’re glad to be able to spend so much time with them. 

More Questions about COVID-19 and Your Family?

If you’d like more information about COVID-19 and protecting your family, read our blog How Can I Help Protect My Family From COVID-19.

HealthTalks NOW Podcast: COVID-19: What You Need to Know

Baptist Health Floyd’s Chief Medical Officer, Jayakrishnakamal “Krishna” Konijeti, MD, issued a public service announcement this week. His message was clear: Stay home, southern Indiana.

Speaking by phone for this podcast, Dr. Konijeti expands upon this plea to those in the community where he lives and practices medicine. He explains what it means to “stay at home” and how doing so can help his hospital and others control the anticipated peak of COVID-19 cases. He speaks frankly about the pandemic, including current case numbers, the need for widespread testing, and the steps Baptist Health has taken to prepare and protect both patients and staff.

Listen now to learn what you need to know to keep your family safe.

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Episode3: Transcript

Welcome to HealthTalks NOW, bringing you the facts you need to keep you and your family well. We’re happy you’re tuning in today. Baptist Health is committed to providing compassionate, high-quality care that is centered on you. Listen to all of our podcasts to hear from Baptist Health physicians about the latest medical advancements and treatments, and get trusted information on timely health topics from our health care professionals. Whether you want to learn more about a specific condition or procedure or find tips for living a healthy lifestyle, Baptist Health is here to help you become a healthier you.

Kerri: Hey guys, I’ve got a special episode of the HealthTalks NOW podcast. I know you’re cooped up at home right now, and it hasn’t been easy. We’re certainly in this together, but we’ll get through this together. I turn today to a unique guest for a timely conversation, Chief Medical Officer, Baptist Health Floyd. I think you’ll enjoy this one

Kerri: Baptist Health Floyd released your public service announcement yesterday, and the audience reach was wide. The message was clear. And we’re talking today, on March 31st, over the phone to learn more. Dr. Krishna Konijeti, thank you for making time to speak with me today.

Dr. Konijeti: No problem.

Kerri: You’ve issued a warning to Floyd County residents, in a PSA that caught readers’ attention, saying that the county has become a COVID-19 hotspot. Why?

Dr. Konijeti: The main reason is we were one of the first counties to start really testing. We’ve been much more advanced in our relationships with different labs including the U of L Research lab that does testing, so I think we picked up more, and when you look at our rate of incidence, even based on the public service announcement I gave yesterday when you say that there are over 50 positives and a little over 200 positive tests that came back, that’s almost a 20 to 25% incidence of positives. That’s a high rate of positives, and when you look at the statewide distribution and map, pretty much, we’re the third-highest region outside of Hamilton/Marion County, which is Indianapolis, and then Lake County, which is outside of Chicago, so Floyd and Clark County become the next biggest spot, percentage-wise, per capita.

Kerri: Sure. And I saw the update that 96 people alone were tested today.

Dr. Konijeti: Yeah, that’s correct, and that’s been a great feat by Dr. Harris and the Floyd County Health Department. They worked tirelessly to set up the first drive-through testing area in Floyd County, and the drive-through is not drive through in the sense that anyone who wants to can come there and get tested, but it’s drive-through in the sense that you call ahead of time and you have a referral from your primary care physician, or you get screened by the health county official and you get that testing done. So the majority of the tests that we’ve done today, were actually at the Health Department drive-through. The emergency department has actually tested a little less today, which is a good thing.

Kerri: Okay. What’s your projection for these figures? Where are we trending?

Dr. Konijeti: The trend is definitely up every single day. The numbers are increasing, and we’ve had a couple of days where we had exponential increases, so very significant increases, but overall, we haven’t had any days where we’re decreasing overall in total numbers tested, which is good, because we’re screening and testing more people, but obviously, that’s also bad in the sense that also means there are more patients that are meeting the criteria for testing, so that means there’s been more wide exposure.

Kerri: Okay. So given that answer, we have not hit the peak of the surge. What will that look like when we do ?

Dr. Konijeti: No one knows when the peak of the surge is, just like no one knows when the flatten the curve is going to occur, and as I said in my PSA yesterday, I think a lot of us in the health care industry are looking more towards keeping that peak as low as possible for as long as possible as we can, and getting it on the downward slope. When it finally levels off, we don’t know. In our best estimations based on what Dr. Fauci and the NIH, and the CDC have said, and what our state epidemiologists are saying, it’s looking like somewhere around the end of April, beginning of May is where we’re potentially going to hit this peak, and I say this peak, because there’s always the possibility that it goes down for a period of time, and then peaks again.

Dr. Konijeti: That’s the general path of viruses, as we don’t have cure for viruses. So when that peak surge occurs, it’s going to look much worse than it does now. Right now, as we’re talking, at the hospital today, we have 13 positive patients hospitalized, plus 28 other what we call PUIs, or persons under investigation. So that in and of itself is a high number. We’ve already had to open up a second dedicated what we call COVID unit or coronavirus unit, that is handling the patients that are strictly positive or persons under investigation. So when we’re talking the peak or surge being three weeks away, or four weeks away, or five weeks away, that definitely makes me nervous and makes all health care providers nervous.

Kerri: Sure. Looking at the demographics for positive cases, the groups most affected are 50 to 59 years old, followed by 60 to 69, but I found it interesting that 30 to 39-year-olds outnumber the 70 to 79-year-old group. Should we anticipate that the trend for younger people to become more infected, to continue increasing? Is that going to continue to be a problem?

Dr. Konijeti: I think that’s more a function of, and the answer is, first of all, that this virus doesn’t discriminate on age. There’s been international reports of newborn babies having COVID-19, obviously, the majority of people hard hit by the disease are elderly patients in that greater than 60 population. Having said that, there have been very severe cases, deaths in all age groups. So I think the trend we’re seeing, more of that middle-aged group that’s getting tested positive, is just because our screening has increased.

Kerri: Okay. Okay. With each update and streaming news conference, we hear of the changes in recommendations. What should we do when we hear of the increasing numbers, and what should families do who are impacted, when it’s their loved ones that have tested positive?

Dr. Konijeti: So when their loved ones are tested positive, first and foremost, follow the Health Department’s instructions for quarantine, whether it’s, obviously if they’re able to be healthy enough to be quarantined at home, then make sure that you’re following the Health Department’s direction on quarantine, and then for them to self-monitor, again under the direction, as family members in this context, of the positive person for them to be self-monitoring at home and taking the proper precautions as recommended by the Health Department, so they can be screened potentially if they need to, if they start developing symptoms, so they can get screened. But again, it’s hard to say, because the virus can often lay asymptomatic for days while you’re positive. So if you’re a family member of a known contact, the recommendations are getting stronger every data to self-quarantine, so.

Kerri: Okay. Is there anything that we can do as the public to show them support?

Dr. Konijeti : Living up to your social responsibility, living up to your civic responsibility, making sure that you’re helping people that can’t help themselves. If there’s friends or family members, elders, people that are more hardly affected, making sure that you’re offering to help them, whether it’s making that grocery trip for them so they don’t have to get out, and so you can get yours, and a family or a friend’s groceries or something done all at once to do that. Obviously, our community as a whole needs to get together to support everyone. I mean, undoubtedly, this has affected all of us in different ways to different levels, but it’s affecting us economically, socially, and health-wise. So just recognizing that everyone’s going through this, and obviously, it’s human nature to wait until it hits home, or someone you know or love has been affected. I hope that as a community that we can see and just do the right thing to embrace helping other people, while also maintaining the orders given by the federal, state, and local government. So just-

Kerri: Certainly. I’ve seen an increase of blood drives, as well as charities and the hospital foundations as well.

Dr. Konijeti: So one of the big issues is with all of this, just like personal protective equipment, other medicines, other resources, we are short on things like blood because people, rightfully so, aren’t going out for unnecessary trips. But if there’s a dedicated blood drive, and that’s controlled by The Red Cross, by the Health Department, those are things that all the proper precautions are being taken to decrease and minimize impact, and definitely encourage people to still do those things so we can help our community. For example, in Floyd County, also going back to what you said about the foundation, our foundation has set up a COVID specific charity pod that they’re using to help providers, help nursing staff, help ancillary staff get the things that they need, and to help the community with the things that they need, with those dedicated funds. A lot of times, we have to work within certain confines as a hospital institutions or system, in order to procure certain items like personal protective equipment, and the foundation can sometimes go a little bit outside of that box to help us. So there’s a lot of things like that that can be done.

Dr. Konijeti: The other thing I would say, from a community standpoint is, is remember, there’s different ways that people are affected, not always just from the health care standpoint, but from the community standpoint. I always like to use the example of my wife is an old hospital administrator, and now she’s finishing up her graduate social degree, and she works at the new Albany County schools for her practicum, and she tells me every day that she’s been worried sick because of the schools closing, that the kids that came to school and were getting their primary meal at the school aren’t getting that, those resources, and those abilities. So it’s important for us as a community to remember all those things too, and to do what we can to support everything, and not just our health care facilities, but everything.

Kerri: Sure, it is a big picture. As the chief medical officer of Baptist Health Floyd, you’re also a practicing nephrologist in the region, and as I understand, you’re a resident in New Albany. You pointed out something yesterday in the PSA, the community hasn’t fully embraced the warnings by Governor Holcomb, his stay at home order that was issued six days ago. How does that impact community transmission?

Dr. Konijeti: So the definition of community transmission is when a disease is transmitted without a clear cut cause, and the way this virus is stealthy, like I said earlier, is that patients or people are asymptomatic for days, before needing to go get tested. So during that time, they can transmit, so that’s how community transmission is worse. So if you’re out and about, you can be healthy, you can still pick it up, you can still transmit it before you even have signs, and that was the biggest reason why I put out that PSA after talking to Dr. Harris, the County Health Department director, is because of that, is because if everyone’s just out and about in business as usual and not taking heed to it, this is going to get even more exponentially worse than it has to. So we all have the ability to help that apex from getting too high, so.

Dr. Konijeti: Yeah. Leading into the next question I was going to ask you, I’d love for you to elaborate a bit more, is, people are still going out and about, and if they’re honoring the six feet social distancing rule, can you make that clear distinction why it’s so much more important and critical to remain at home? As you said yesterday in the announcement, to shelter at home and in place.

Dr. Konijeti : So again, the mandate from the governor’s mandate, and I’m not a lawyer or politician by any means, no one knows what the enforceability of any of that is, but it’s all based on scientific research and protocols, and guidance from our CDC and National Institute of Health. Initially, it was thought that we could flatten that curve, decreasing the incidence of the disease by trying social distancing of six feet, because generally speaking, the virus, for the most part, is not airborne. It’s spread through droplets, whether it’s coughs, sneezes, respiratory droplets. Now, it can be transmitted off of certain surfaces and things like that, but the whole idea behind social distancing initially was that you’re going to decrease that risk. So that was the initial step, okay?

Kerri: Okay.

Dr. Konijeti: But social distancing as a whole across the world, hasn’t really panned out. The shelter home and in place is that next step. It’s about not only staying away from people six feet when you do have to go out and do those essential things, like going to the grocery store, or picking up your drugs, or going to a doctor’s office, but it’s also about basically, if you’re not living with a person, you shouldn’t really even be around them, because that’s the real way that you’re going to decrease the transmission of the disease. Unfortunately, we can’t, I shouldn’t say unfortunately, I don’t want people to get it wrong, but I mean, we’re not a communist country like China where everyone’s forced to stay at home, and they have drones flying around the city of Wuhan and Hubei province to make sure everyone’s home, so we have to rely on our society doing the right thing and trying to stay home.

Kerri: Got it. Well, so if someone believes that they are experiencing symptoms, what should they do and where should they turn?

Dr. Konijeti: So obviously, there’s a whole basket of symptoms that have been identified. Obviously, the predominant symptom is fever, and then second-most, cough, and then shortness of breath and congestion, sneezing, labored breathing, feeling like you can take a good deep breath, and even more recently, it’s been shown that if you lose your sense of smell, that may be a sign of a COVID-19. So all these things, if you’re feeling symptomatic, one, obviously you should check your temperature, you should self-quarantine, call your primary care doctor, run everything by them so they can screen you with the appropriate questions, make sure there’s not something else going on that could explain a fever, for example, a urinary tract infection, or a wound, or something else like that, but obviously, if you’re having respiratory symptoms, they’ll screen you and then they’ll make the referral to the Health Department.

Dr. Konijeti: If you don’t have a primary care physician, you can still call the Health Department, and they’ll screen you and determine whether or not you need to get tested. The reason to go to the emergency department, or not go to the emergency department and self-quarantine at home is all dependent on the clinical symptoms. So if you have mild symptoms and you’re otherwise healthy, you can follow your primary care doctor’s guidance and just self-quarantine at home, and potentially not get tested. There’s other options where they may refer you to our testing site, the Baptist Health Urgent Care Center at Highlander Point. They may send you up there, they may send you to the Floyd County Health Department, or if your symptoms are severe enough, then you obviously need to come into the emergency department and get checked out.

Kerri: Okay. We also have an assessment tool on the website and I know that the team has also been busy with eVisits and virtual care video visits as well to communicate, but if someone believes they do need to come to the hospital and they’re wary about coming to the hospital right now for care, what would you say to that person, and are there services still being offered at Baptist Health Floyd?

Dr. Konijeti: Yes, there are still services being offered at the hospital. If you’re concerned that you’re ill and sick, you need to come to the hospital after talking to your primary care physician, and you need to get evaluated and treated. As far as services at the hospital, we’ve, in the idea that we need to preserve personal protective equipment and resources for this search, whenever it happens, we have already proactively discontinued all non-emergent procedures and testing. Having said that, we’ve set up alternatives for a lot of noninvasive testing and procedures, such as, for example, a patient that’s going to see a cardiologist needed to get a stress test or needed to get an echocardiogram, even though we’re not doing those at the hospital right now, there’s other sites where those kinds of tests are available. We’re still doing outpatient labs, we’re still doing other noninvasive tests at different locations. We’re trying to minimize the traffic at the hospital with the intention of minimizing exposure to the community and to our staff, and preserving our resources, but if you need to come to the hospital, that’s what we’re here for.

Kerri: Sure. Well, speaking of PPE, is Baptist Health Floyd prepared? Do you have enough PPE?

Dr. Konijeti: Yes, we do have enough PPE, as of right now. PPE is always a concern, and it’s a moving target depending on day-to-day, depending on the number of patients we have that are under investigation or are positive, and the number of people caring for them that have to wear PPE going in, and the one thing that we have is the help of the system. We have a kind of a system with our sister hospitals in Louisville, La Grange, Lexington. We have a system number that we keep. That’s how we know really what we have. So a lot of media outlets, a lot of people ask, “Well, how many days on hand of something do you have?” Well, we can’t really say that, because everything’s allocated by the system, but even locally, we have enough, and the public has been great. We’ve had dentist’s offices, we’ve had [inaudible 00:20:41], we’ve had multiple different people, construction companies that have, even Target, have dropped off any masks that they’ve had, both N95s and non-N95s, so all of our donations for personal protective equipment are going through the Floyd foundation.

Dr. Konijeti: So definitely, we’re still interested in receiving actual masks. We will not, as of right now, based on CDC guidelines, we’re not taking any homemade masks at the present time, for multiple reasons, but I would suggest to provide anyone that wants to do those kind of masks, provide those to some long-term care facilities around the areas, other entities that could use that, maybe even like Kroger, where the people that work there are getting exposed, them having a homemade mask is better than nothing. But so, and again, we have the fund through the foundation that the public can donate to.

Kerri: Great. Yeah, the support has been amazing. I’ve seen across the system, even tattoo parlors and nail salons donating masks, in addition to the businesses that you’d mentioned.

Dr. Konijeti: Yeah, it’s been wonderful.

Kerri: I want to ask you about providers. If a staff member tests positive, will they receive support?

Dr. Konijeti: They do. They receive support, one, locally at the institution. Obviously, we care about our providers, our nursing staff, and our ancillary staff. I mean, that’s our bread and butter, that we can’t be good or help anyone if we’re not healthy and taking care of ourselves. So at Floyd, we definitely understand that our staff is the most important asset, and that’s why starting yesterday, we started masking everyone in the hospital that works in the hospital, whether they be environmental services, or a nurse, even in low risk areas, just to decrease that risk of community transmission, or transmission for them or to a patient. So if a provider is positive, and luckily, we haven’t had the kind of positives in our providers and our staff as some of the other institutions in the greater Louisville area have, we have the Employee Health and the Health Department, and our infection control and infection prevention team here at the hospital can help in getting that patient’s needs taken care of.

Kerri: Great. So there something I’ve been wanting to ask you. We’ve been reading about the possibility of being asymptomatic with this disease. If that person is tested later, can antibodies be tested and detected, and along that line can someone be tested twice?

Dr. Konijeti: So there are a lot of patients that are asymptomatic and that never do become symptomatic. Theoretically, based on virology and immunology, yes, that person could have antibodies detected. As of right now, the majority of the tests that are used to detect the presence of the virus are PCR-based, or polymerase chain reaction-based, where they test for fragments of the virus RNA. The antibody tests are still under development, for the most part. There are a few that are coming out, and hopefully out soon. So theoretically, yes, in practicality, right now, no.

Dr. Konijeti: And can someone be tested twice? There has to be a pressing need and indication to get tested twice, because of the methodology of our testing, which is that as I said, is that polymerase chain reaction of three different mRNA spots on the virus. The likelihood that you have a false negative is extremely low, and coupled with the overall national scarcity of tests and test kits, that makes it very unlikely that a person can be tested twice. Having said that, if there’s enough clinical indication and we have a triage committee with our infectious disease doctor, or pulmonary doctor, and myself, we can look at a case and if there’s worry that maybe the specimen wasn’t collected properly, maybe the swab wasn’t done properly, and maybe the patient has really pressing symptoms that are indicating this, we’ve made a couple of exceptions to get a patient tested twice.

Kerri: Okay. I’d like to get your opinion on this. Should people be masking when they go in public for essential items, if they’re running to the grocery store?

Dr. Konijeti: In my opinion, yes. If they’re otherwise unhealthy, immunocompromised, again, the big play in this is that they should be trying to stay at home as much as possible and only doing the essential things. The problem with wearing a mask and doing it for prolonged periods of time, is the integrity of the mask and whether or not it’s soiled, and whether or not the mask has been contaminated, and whether or not you’re just using a dirty mask, and that makes you even more likely to get the virus. So the answer is yes, if used properly and for the right patient population, yes.

Dr. Konijeti: In my opinion, yes. If they’re otherwise unhealthy, immunocompromised, again, the big play in this is that they should be trying to stay at home as much as possible and only doing the essential things. The problem with wearing a mask and doing it for prolonged periods of time, is the integrity of the mask and whether or not it’s soiled, and whether or not the mask has been contaminated, and whether or not you’re just using a dirty mask, and that makes you even more likely to get the virus. So the answer is yes, if used properly and for the right patient population, yes.

Dr. Konijeti: Okay. Well, anything else you want to share with the audience today?

Dr. Konijeti: I just want everyone to know that here at Floyd, we’re there for them, if and when they need us, and I can’t express enough how awesome our team has been and risen to the occasion in terms of everyone looking out for each other in the community, and doing what they need to, to get everything implemented as quickly as possible, and doing it ahead of the curve, compared to many other places. So I just have to do a shout-out to everyone that works at Baptist Floyd, so.

Kerri: I really appreciate you jumping on this call with me today.

Dr. Konijeti: No problem. Have a good night.

Kerri: You too, take care.

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Disinfecting Your Home for COVID-19 Protection

Along with washing your hands and social distancing, cleaning and disinfecting your house is an important part of protecting you and your family from COVID-19. It’s important to note that cleaning and disinfecting are two very different things:

  • Cleaning is about removing contaminants from a surface. 
  • Disinfecting is about killing pathogens.
  • Do both daily if anyone or anything has entered your home.

Although transmission of COVID-19 is a much greater risk from person-to-person, the CDC recommends that we clean and disinfect high-touch surfaces in our homes daily just to be safe. 

High-Touch Surfaces That Should Be Cleaned Daily

The novel coronavirus that causes COVID-19 is capable of living on surfaces such as cardboard for 24 hours, but up to three days on plastic and stainless steel. That means that you should clean and disinfect the following high-touch surfaces every day:

  • Doorknobs
  • Table surfaces
  • Hard chairs (seat, back, and arms)
  • Kitchen counters
  • Bathroom counters
  • Toilets (seat and handle)
  • Light switches
  • TV remotes
  • Game controllers

Everyone’s household and habits are different, so think about the surfaces you and your family interact with the most and make sure to clean and disinfect those surfaces regularly. 

How to Clean and Disinfect Your Surfaces

First, clean the surfaces by removing contaminants like dust and debris by wiping them down with soapy water (or a cleaning spray) and a hand towel. Then use a surface-appropriate disinfectant, such as disinfecting wipes or disinfectant spray. That’s it. If you clean and disinfect your surfaces every day, you’ll be helping to lower the risk of infection for you and your family.

Here are some disinfectants you can use:

  • Disinfecting wipes (Clorox, Lysol, or store brand)
  • Disinfectant spray (Purell, Clorox, Lysol, or store brand)
  • Isopropyl alcohol
  • Hydrogen peroxide

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What If I Can’t Find Store-Bought Cleaners or Disinfectants?

Just like the empty toilet paper aisles you’ll find in most stores, cleaners and disinfectants are also hard to come by. That said, using more soap and water when you’re scrubbing surfaces makes a big difference. Here’s how you can make homemade cleaning spray and disinfectant spray:

  • How to make homemade vinegar cleaning spray:
    • 1 ¼ cups water
    • ½ cup white vinegar
    • 10 drops of your favorite essential oil (optional)

Spray liberally on surfaces and wipe clean with a soft cleaning cloth or spray directly on cloth before wiping.

  • How to make homemade bleach disinfectant spray: 
    • 4 teaspoons household bleach
    • 1 quart of water
    • Pour both into a quart spray bottle, shake vigorously
    • Spray on surface, let sit for 10 minutes, wipe with wet cloth

You should never mix bleach with any other cleaning chemical. It’s also important to note that bleach can damage or discolor sensitive surfaces, so use sparingly, wear gloves and make sure the area is properly ventilated.

How Do I Clean If Someone in My Home Is Sick With COVID-19?

If someone in your home is infected with COVID-19, here’s what you should be doing to keep you home clean and disinfected:

  • Keep a separate bedroom and bathroom (if possible) for the sick person. Keeping the sick person away from everyone in the house is crucial to limit the spread of COVID-19 in your home.
    • Limit cleaning to as needed (e.g. soiled items and surfaces) to minimize contact with the sick person.
    • Provide cleaning products to the sick person (if appropriate).
  • Shared bathroom. Clean and disinfect after each use by the sick person using the methods described above. 

More Questions About COVID-19?

If you have more questions or concerns about COVID-19, go to or visit other reputable sites, such as the World Health Organization or the Centers for Disease Control and Prevention (CDC).

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How to Maintain a Routine

These are indeed stressful and unpredictable times. Visiting friends and family is out. We can’t go out to catch a movie or enjoy a nice meal. Aside from the occasional trip to the grocery,  we’re pretty much homebound. One thing that can bring a semblance of sanity is creating and sticking to a routine.

Benefits of Creating a Routine

Routines don’t have to be, well, routine. They can be fun. In fact, creating and sticking to routines offers health benefits that include:

  • Reduced stress levels. No routines can leave you overwhelmed with worry about when you can get everything you need done. Creating a routine makes it easier to accomplish your tasks and leaves more time for you to relax, which reduces stress. 
  • Better sleep. When you’re not staying awake worrying about what didn’t accomplish, you sleep better, which makes you feel more refreshed.
  • Better health. Setting aside time for exercise, eating breakfast, and taking breaks makes you feel better, which improves your overall health and well-being.
  • Creating structure. By creating a framework for how you live and conduct your life, you become comfortable with what you have to do each day. More doing, less planning.
  • Prioritization. Creating routine forces you to determine to prioritize what’s important to you, which makes it easier for you to accomplish your goals. If you want to be healthier, for example, adding exercise to your routine makes it happen. 
  • Reducing procrastination. When tasks are incorporated into a routine, there’s a better chance that they’ll get done. Whether it’s yoga or cleaning your house, once you work those tasks into a routine, you stand a better chance of accomplishing what you want or need to do. 
  • Saving time. By following a routine, you free up valuable time that would otherwise be spent catching up. That leaves more time for you to do what makes you happy.

How to Create a Daily Routine

In order to create a routine, you have to know what you’re spending your time doing every day. Here are some things you can do to help create and maintain a daily routine:

  • Record what you do on a typical day. Write it down. At the end of the day you’ll have a list showing exactly what you did that day. This may take a few days to accomplish as some days are less common than others. 
  • Reduce or remove unwanted activities. Look at your list and determine which activities you want to do more or less of. Cross the ones that aren’t beneficial to you off the list. Move on.
  • Turn your day into a schedule. Allot times for the activities you want to accomplish and put them on your schedule or calendar. Knowing how long each activity will take can help you make a realistic schedule. Don’t worry about the order in which you do the activities but try your best to get them done.
  • Make enough time for sleep. Most adults need seven to eight hours of sleep to remain alert and high functioning. Going to bed the same time every night and waking up at the same time will give you the energy to accomplish all the tasks on your list.
  • Make time for breaks. This is important. Always schedule at least one 30-60-minute break during your day to eat lunch, go for a walk, or anything else that energizes you. Also build in some time for interruptions, which are common, especially if you’re at home dealing with kids during these stressful times. 
  • Give your new routine a test drive. Do your best to follow it to a tee and, if you don’t, write down what, if anything, you did differently.
  • Make changes based on your experience. What went as expected? What took longer than you thought? Was your schedule realistic? Creating a successful routine can take some time but knowing what worked and what didn’t is a crucial step.
  • Repeat until you’ve got a routine that works. Maintaining your routine regularly will make it easier to make adjustments that will help you stay on track. 

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Need More Information About What You Can Do to Reduce Stress?

Creating a routine will help reduce stress for you and your family, but if you need more information about how to stay calmer during these unpredictable times, read our blog on Coping with Coronavirus Stress.

Can I Get Coronavirus from Packages?

According to the Centers for Disease Control and Prevention (CDC), the chances of contracting coronavirus, which causes COVID-19, from delivered packages is very low. A recent study published in the New England Journal of Medicine found that the virus was detectable for up to 24 hours on cardboard, but that no COVID-19 cases have been linked to contact with packages.

Do Delivery Conditions Affect the Ability of the COVID-19 Virus to Survive?

Alan Koff, MD, chief fellow of the infectious disease program at Yale School of Medicine said, “It’s likely that the temperature outside and the length of time the package is in shipping may impact the survival on that surface.” That’s not to say that the virus can’t ever be found on packages. According to Joseph Vinetz, a Yale University infectious disease specialist said that doesn’t mean it will infect you, saying, “Detection does not mean transmissible.”

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Can I Get COVID-19 From Packages Delivered from China?

The World Health Organization said, “People receiving packages from China are not at risk of contracting the new coronavirus.”

Can I Get COVID-19 From Touching Food, Food Packages, Or Food Contact Surfaces If the Virus Was Present on It?

According to the Food and Drug Administration (FDA) there’s no current evidence of food or food packaging being associated with transmission of COVID-19. It’s possible that the virus that causes COVID-19 can survive on surfaces or objects. For that reason, it’s critical to follow the four key steps of food safety – clean, separate, cook, and chill.

What Should I Do When A Package is Delivered?

Many companies like UPS and FedEx have stopped requiring in-person signatures for most package deliveries to follow social distancing guidelines. That said, there are other things you can do to make sure your package deliveries are safe:

  • Avoid contact with the delivery person.
  • Wear gloves when picking up your package or wash your hands directly after touching it.
  • Place the package in a designated location in your house, or, if possible, outside on your porch for at least 24 hours before opening.

More Questions About Protecting Yourself and Your Family?

If you have more questions about the coronavirus that causes COVID-19, visit the CDC or Baptist Health websites.

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Can COVID-19 Cause Problems for Pregnancy?

Right now, it’s not known if COVID-19 causes problems during pregnancy or affects the health of the baby after birth.

In a recent webinar put on by the Centers for Disease Control and Prevention (CDC), they shared their findings from evaluating the health data from 34 women in China diagnosed with COVID-19 in the third trimester. They reported that women with COVID-19 have a greater risk of premature delivery and, on average, give birth around four weeks before their due date.

In more severe cases, COVID-19 can cause pneumonia, which is a concern for pregnant women because their lung capacity is already diminished. 

Can Pregnant Women Pass COVID-19 to Their Babies?

Based on limited information, it doesn’t appear that COVID-19 is passed from mother to fetus in the womb. 

How Can Pregnant Women Protect Themselves from Getting COVID-19?

Pregnant women should do everything the general public is doing to avoid getting infected with COVID-19, including:

  • Cover your cough with your elbow
  • Practice social distancing
  • Clean your hands often with soap and water or a hand sanitizer with at least 60% alcohol.

Learn more about protecting yourself and your family from COVID-19.

Can COVID-19 Be Transmitted Through Breast Milk?

While COVID-19 is mainly thought to be transmitted person-to-person through respiratory droplets produced when an infected person coughs or sneezes, or touching an infected surface,  it’s not known if mothers with COVID-19 can spread the disease through breast milk. In limited studies on women with COVID-19, the virus hasn’t been detected in breast milk.

According to the CDC, a mother who has COVID-19 or who’s symptomatic should take all precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask while the baby is feeding.

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The Bottom Line

Even though the research on how COVID-19 impacts pregnancy is limited, health experts are saying that the data they do have is reassuring:

  • The virus doesn’t seem to spread though the womb
  • With one exception in the UK, all newborns have tested negative for COVID-19
  • Pregnant women don’t appear to be any sicker than non-pregnant women

Because this is a rapidly evolving situation, make sure to keep up on all current updates from the CDC. 

Reach out to our Mother & Baby Care specialists if you’re experiencing symptoms of COVID-19 during pregnancy and need professional medical advice.

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Tips on Working from Home During Coronavirus

Before you’d ever heard of COVID-19, nearly half of the US workforce was able to work from home (that’s up from 29% just two years ago). If you don’t work from home regularly, you might find yourself sitting at your kitchen table thinking, “now what?” Here are some tips to maintain some normalcy in these not-so-normal times.

Keep Your Routine

As best you can, keep to your normal workday routine. Adhere to bedtime and wake-up routines, eat breakfast, shower, even get dressed in your normal work or casual work attire. The less you disrupt your routine, the more productive you’ll be.

Make Your Workspace

If you don’t have a workspace at home, declare one. A kitchen or dining room table makes a fine substitute desk. Spread out as much as you would at the office. If you’re in the office mindset, you’ll get more accomplished. 

Reboot as Necessary

Make regular breaks part of your routine. Like in the office, it’s good to get up every 30-60 minutes. Weather permitting, go for a walk to clear your head. It might just make coming back to the task at hand easier to tackle.

Use Technology to Maximize Productivity and Collaboration

There are dozens of online tools beyond Google Hangouts and group texting. Chances are, your employer has a preferred platform for online collaboration. If not, some popular tools include:

Zoom – for video conferencing

Slack – for texting and file sharing; a paid version includes multi-user video calls

Google Docs – collaborate via word processing, spreadsheets and more

Plugin with headphones to minimize distractions and keep your hands-free during phone calls. This is especially helpful if you’re not the only one at home. 

Kids Need Focus, Too

If you have children in the household, they benefit from maintaining routines as much as you do. So, like you, keep them on their school day schedules. Most schools have implemented remote learning plans which will keep school-aged children occupied while you’re taking care of business. 

While preschool ages will require more attention, declaring “mommy/daddy work time” can include a special toy or movie viewing. Nap times can be your most productive times.

Expect interruptions at the least opportune moments. Hopefully, your co-workers and clients will find those conference call intrusions amusing and even endearing. Yet, if those intrusions get out of hand, politely excuse yourself and reschedule for a more productive time. 

Eat Healthy Foods

Remain mindful of your snacking while working from home and avoid stress eating.

If you have access to a grocery, get fresh fruits and vegetables and stock your pantry. Fresh fruits and vegetables with long expiration dates are an excellent choice. If fresh isn’t available, the frozen food aisle is full of nourishing options. Beans, legumes, canned fish, nut butters, whole wheat pasta, quinoa, canned fruits, and vegetables can offer sustaining meals for weeks to come. 

Making sure you keep your immunities high is also essential right now. Beef, salmon and shellfish are among immune system boosting foods.

You’re not Going to Ace this Overnight

Give yourself some latitude when it comes to being productive. There’s a lot going on out there in the world and maintaining focus is more difficult than ever. So, don’t expect a perfect score on working from home – especially for those of us who are new to it. Keeping to a routine and an office mindset will help get you there.

Staying aware of your mental health throughout this time will help you remain calm and make good decisions. Click here to learn more about our behavioral health services available at Baptist Health.

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Coping With Coronavirus Stress

With every new development in the spread of coronavirus disease 2019 (COVID-19), the collective stress level in our country gets higher. Fear and anxiety about the disease is affecting everybody. Learning how to cope with this stress will help make you, your family, and your community stronger.

Recognizing Your Stress

Different people respond differently to stress, but there are common symptoms that show up when people are feeling overwhelmed by the pandemic, including:

  • Fear and worry about your health and the health of loved ones
  • Sadness, confusion, irritability, anger, uneasiness, suicidal thoughts
  • Reduced concentration, efficiency, and productivity
  • Social withdrawal and isolation 
  • Interpersonal problems, such as lies, defensiveness, communication concerns
  • Tension, like headaches, jaw clenching, teeth grinding
  • Body pain, including headaches, muscle spasms
  • Reduced energy
  • Sleeping problems, including insomnia and nightmares
  • Increased use of alcohol, tobacco, or other drugs

Feeling stressed because of the outbreak is a healthy, natural response. Before you can work to manage your symptoms, you have to recognize that they are related to stress. By skipping the phase of acknowledging that you are stressed, you will impede your ability to manage it. 

Manage what you can, let go of what you can’t

With the increasing amount of information available about COVID-19, there is still a lot we don’t know. It’s important to learn what you can do to protect yourself and your family, but it’s also important to understand there is a lot you can’t control. Distance yourself from the myths and conspiracy theories that are being passed around, because they take away focus from the things you actually can control.

For reliable information about what you can do to protect yourself, turn to trusted sources such as the Centers for Disease Control and Prevention (CDC).

Know your limits

There’s no shortage of news coverage about COVID-19, but spending all day reading news can add unnecessary stress. Staying informed is important but try to set a time during the day to get caught up rather than constantly checking your phone or computer for updates.

Practice Self-Care

Eating a balanced diet, getting plenty of sleep, and engaging in enjoyable activities help you stay psychologically and physically balanced during stressful times. Good self-care also boosts your immune system, which is especially important now. Make the most of your situation by enjoying activities, such as:

  • Pick up a craft, like knitting or woodworking
  • Meditate
  • Exercise – take a walk or practice yoga.
  • Clean – in addition to sterilizing, which is important now, it’s also comforting to spend time in a clean environment
  • Play with your pets
  • Read a book
  • Watch a new series or a movie
  • Call your loved ones
  • Take an online class
  • Listen to music
  • Cook healthy meals
  • Host a virtual gathering

Seek Professional Help

If your mental health is being impacted by the stress of the coronavirus, you may want to seek professional help. A licensed mental health professional can help you manage your fears while empowering you to make the best decisions for you and your family.

It’s important to note that people with preexisting mental health issues should continue with their treatment and be aware of worsening conditions. 

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How Does Dehydration Affect the Body?

Do you know all the effects of dehydration on the body? It’s important that you drink eight 8-ounce glasses of water every day. Drinking other beverages, such as tea and soda, are not good substitutes because they contain large amounts of sugar and salt that is removed from our bodies with the assistance of water. The dehydration process begins before we even feel thirsty. Drinking water throughout the day is the best way to prevent this.

Effects of Dehydration on the Body

There are four main dehydration effects on the body:

  • Weaken your immune system
  • Negative impact on your heart health
  • Increased risk of obesity
  • Premature aging

Weakened Immune System

A person can survive about a week without water because the human body consists of 75% water. Eliminating toxins and waste materials becomes a difficult task when dehydrated. Not being able to remove this debris, your body is more susceptible to infection. Not staying hydrated can also diminish energy levels, leading to lack of exercise and a weakened immune system.

Dehydration can Affect Heart Health

When our bodies become dehydrated our blood becomes thicker and restricts blood flow. This can lead to an increase in blood pressure and a rise in blood cholesterol. This is the body’s way of preventing any further water loss from the cells. According to the American Heart Association, high blood pressure and blood cholesterol increase your risk of coronary heart disease.

Increased Risk of Obesity

Drinking less water slows down our metabolism. Our bodies will also have difficulty eliminating toxins, as mentioned above, leading them to store them in fat cells. These cells will not release any fat until the body is hydrated so that they can safely remove the toxins stored. One way to combat this is to drink two 8-ounce glasses of water before breakfast, lunch and dinner. Doing this regularly can help increase your metabolism, decrease your appetite and promote your overall health.

Premature Aging

If you continuously allow yourself to become dehydrated, you may notice some unwanted wrinkles. The body’s organs wrinkle and weaken when dehydrated, including your largest organ: the skin. The skin consists of approximately 20% water, but when dehydrated can drop below 10%. This affects the collagen in your skin, which keeps your skin firm. Therefore, less collagen increases premature aging.

Dehydration can take a toll on your body. Staying hydrated can boost your immune system, keep your heart healthy, battle obesity and slow unwanted aging. It’s important to drink the recommended water intake to avoid these unwanted effects.

general effects of dehydration on the body

How To Stop Emotional & Stress Eating

Is stress about the coronavirus affecting your eating? If you’ve eaten to deal with stress or emotions, you’re not alone. It’s common for Americans to experience changes in their eating patterns during an infectious disease outbreak.

How to Stop Emotional & Stress Eating

Emotional eating involves eating as a means of dealing with or suppressing uncomfortable feelings, including stress. High-calorie foods with low nutritional value, like sugary and salty junk foods, are typical choices for emotional eating. Sugars and fats release opioids, so the calming effect we get from those “comfort” foods is real and addictive. This can present challenges at any time in our life, but it can quickly derail a healthy diet or weight loss effort.

Emotional eating is usually triggered by everyday life events like those encountered in relationships and the workplace, as well as problems with our health and finances. Fatigue brought on by lack of sleep can be another trigger. Major life events, though occurring less frequently, can also spark emotional eating.

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Tactics to Stop Emotional Eating

Awareness of emotional eating is a necessary first step. Taken a step further, mindfulness is a focused awareness of any activity. Train yourself to be mindful in your eating, by noticing whether or not you’re eating because you’re hungry. If not, is the food in front of you helping suppress something that happened today? “I am eating because I’m hungry,” is different than “I’m eating because I had a disagreement with my boss.”  A food diary can be a useful tool in strengthening awareness of the relationship between emotions and eating.

Expressing emotions is generally frowned upon in our culture, so we tend to suppress them with food or other negative behaviors. If you’re not practiced at it, acknowledging and addressing feelings can be difficult, especially at first. Try talking about them with a trusted friend or family member who will empathize with your feelings. It doesn’t have to solve your present issue, but just sharing your burden can lighten it as well as provide a new perspective.

Replace food with healthy distractions. Take a walk, go for a run or read a book. Even laughing at a rerun of your favorite sitcom will alleviate your emotional discomfort temporarily. Even a temporary distraction can put some space between you and the trigger, providing a different perspective than when you were initially impacted.

Making sure you sleep 7-8 hours per night goes a long way in reducing stress. Lack of sleep can heighten existing stresses or create new ones. Cortisol is the hormone released to help our bodies deal with stress. It also triggers cravings for fried, sweet and salty foods. Over long periods of time, cortisol also increases blood sugar. This could intensify other factors of emotional eating that lead to type 2 diabetes – including unhealthy eating and being overweight.

Life comes with a wide range of challenges, creating stress and other emotional discomforts. Positive and healthy coping with those discomforts can make a big difference in how we get through them.

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Take Advantage of Receiving Care Through Your Smartphone, Tablet or Computer

As cases of the Coronavirus (COVID-19) have been increasing throughout the United States, Baptist Health is committed to ensuring the safety and health of all of our patients.

If you’re sick or think you’re sick, take advantage of Baptist Health Virtual Care in an effort to minimize unnecessary visits to your provider’s office, which can also decrease the spread of illness and/or infection of many conditions, including COVID-19.

You can securely connect with a Baptist Health provider through your smartphone, tablet or computer either through a Video Visit or an E-Visit. The provider will evaluate your symptoms and provide recommendations, treatments, and/or prescription orders that same day, often within hours. Virtual Care is available to patients located within both Kentucky and Indiana.

In order to schedule a Video Visit or eVisit, you must have a MyChart account. Don’t have a MyChart account? Sign up here.

  • A Video Visit allows you to securely connect with a Baptist Health provider via your smartphone, tablet or computer’s camera feature – you will discuss face-to-face with your provider your symptoms, and he/she will provide treatment if needed. During the current health crisis this visit will be billed to your health insurance and no co-pay will be collected. If no insurance is found, a $40 bill will be sent.
  • An eVisit allows a patient to fill out a symptom-specific questionnaire which is submitted to a Baptist Health provider for evaluation and treatment. The provider may also call you to discuss your condition or illness.

If you have any of the following symptoms, use Baptist Health Virtual Care as your first step for care:

  • Sinus congestion
  • Allergies
  • Flu and Coronavirus (COVID-19) screening
  • Cold or cough
  • Headaches
  • Urinary tract infections
  • Skin conditions
  • Pink eye

Don’t let the fear of exposure prevent you from getting the care you need.

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HealthTalks NOW Podcast: What Even is a Laparoscopic Sleeve Gastrectomy?

Gastric sleeve surgery is one of the most common bariatric procedures performed in the U.S. But what does the surgery entail, and is it a safe and effective tool for losing weight?

In the second episode of Baptist Health’s inaugural podcast, bariatric surgeon John Oldham Jr., MD, stops by to answer the question “What even is a laparoscopic sleeve gastrectomy?” He explains the role metabolism plays in weight loss and why it can be so difficult to lose weight.

Describing the procedure in detail, Dr. Oldham outlines factors that determine if you’re a good candidate, the benefits of doing it laparoscopically, and how your life changes afterward.

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Episode2: Transcript

Welcome to HealthTalksNOW, bringing you the facts you need to keep you and your family well. We’re happy you’re tuning in today. Baptist Health is committed to providing compassionate, high-quality care that is centered on you. Listen to all of our podcasts to hear from Baptist Health physicians about the latest medical advancements and treatments and get trusted information on timely health topics from our healthcare professionals. Whether you want to learn more about a specific condition or procedure or find tips for living a healthy lifestyle, Baptist Health is here to help you become a healthier you.

Kerri: Hey guys, this is a great episode today that you won’t want to miss. I’m Kerri, the host of the HealthTalksNOW podcast brought to you by Baptist Health. A new way of life is possible. In Baptist Health, bariatric surgery and weight loss can help you make the lifestyle changes needed to reclaim your freedom. Imagine freedom from weight restrictions, from feeling out of control and freedom to be the best version of you. I sat down with Dr. John Oldham, an expert surgeon, to learn more about one popular option, the gastric sleeve surgery. We’ll discuss the ins and outs of getting the laparoscopic sleeve gastrectomy procedure along with the qualifications and risk factors. I hope you enjoy.

Kerri: Today, I have the pleasure of sitting down with Owensboro native, Dr. John Oldham, a board-certified general surgeon to learn about the gastric sleeve surgery at Baptist Health. It’s one of the most common bariatric procedures in the US but I’d love our listeners to understand the ins and outs of getting a laparoscopic sleeve procedure. And before you start, can you tell us what led you to become a bariatric surgeon?

Dr. John Oldham: Well, actually I did a lot of bariatric procedures in residency in the late 1990s and back then it was all done open procedures, big midline incision. And I saw that patients will lose weight with that and resolve a lot of their comorbidities like diabetes, hypertension, sleep apnea, but also saw all the complications that went along with those open procedures. So it wasn’t until, got out of residency around 2002 started, see that we can do these things laparoscopically and take all those bad risks of the majority of those out of the procedure and then that’s when I got involved.

Kerri: Sure. Well, it must be rewarding to see a transformative effect and life-altering effect that you have on patients with this procedure.

Dr. John Oldham: Yeah, it really is. I mean, I truly come to work every day. It’s awesome to see patients, improving their life. They’re off medications or preventing diseases in the future. It’s the small things, like patients saying that now they can go to an amusement park, fit into a roller coaster, they go to a restaurant — they don’t have to worry about the host is going to sit them at a booth that they can’t fit in. So a lot of daily issues that they have to deal with.

Kerri: Sure, I haven’t considered that before.

Dr. John Oldham: And taking the stairs, come up to the office now where they used to do that before.

Kerri: Yeah and not be out of breath. It would be life-changing with the changes. I’d love to hear about the patient journey and the personalized approach that’s taken when considering patient’s health. Specifically, what makes a good candidate for this procedure? And what are some considerations?

Dr. John Oldham: We actually operate on about 1 to 2% of the patients that actually qualify for the surgery. So we go by a term called body mass index, which is a height and weight calculation. So somebody with a body mass index of 40 or above as a candidate, they don’t have to have any comorbidities like diabetes or hypertension for insurance to cover that procedure. But for somebody with a body mass index of 35 to 39.9, most insurances require some type of comorbid… like diabetes, hypertension, sleep apnea, liver disease, something like that. So it actually goes by their body mass index, which again, height, weight, and calculation.

Kerri: Okay. What are some of the advantages of this procedure?

Dr. John Oldam: So the gastric sleeve is the most common bariatric procedure in the world today. Most common, as you said here in the United States. The reason why it’s becoming or is the most popular is because it’s getting similar results to the Rolux-En-Y gastric bypass, but doesn’t have a lot of the possible complications that go along with the bypass. So with the gastric bypass, we have to worry about ulcers, we have to worry about bowel obstructions, vitamin deficiencies. With the gastric sleeve, since we’re not rerouting the intestines, all we’re doing is making the stomach much smaller. We don’t have to worry about those types of issues.

Kerri: And as you mentioned, one of the advantages is certainly obtaining the surgery in this procedure is the joint pain relief along with relief from other medical conditions and improving fertility.

Dr. John Oldham: Exactly, yeah. Obesity actually causes over 60 diseases, very serious diseases. And that’s why the term is actually called metabolic surgery because it’s actually proving those metabolic diseases or resolving those metabolic diseases. So, we hear type two diabetes all the time, high blood pressure, sleep apnea, liver disease. But as I said, there are over 60 diseases that obesity causes-

Kerri: Sure, depression too.

Dr. John Oldham: Yeah. Depression, exactly. We don’t, what comes first, depression, obesity, medications that treat obesity causes obesity. So those are the things we have to worry about. Obesity is actually, it is a disease. It’s not going home, eat less and exercise kind of thing. We all have a weight that our body wants to be at. It’s called a metabolic setpoint. So when somebody could weigh 500 pounds or 200 pounds. When they go on a diet, and try to lose weight, their body sees that as abnormal and it’s going to do whatever it can to drive that weight back up to that set point. And that’s why it’s such a high failure rate with diet and exercise. So these procedures are actually changing that set point to a lower set point, to a healthy set point.

Kerri: Got it. It’s really-

Dr. John Oldham: So still tools, there’s no magic procedures out there, but very good tools.

Kerri: Yeah, absolutely. Well, what does the listener need to know about pre-surgery, some of the requirements, considering diet before they get ready for this surgery?

Dr. John Oldham: Yeah, it’s a good question. So we actually like our patients to get as much information as they can. And I think the best place to start out is to attend one of our informational seminars. We have three a month. We do two at the main hospital in Baptist and then one in a hospital in Lagrange. And that’s where we talk about obesity. We go over all the different procedures that we offer and that way, the patients can kind of get a good feel of the understanding of what we’re talking about and the different procedures. And then they’ll fill out this informational packet that we give them, determines if they qualify for surgery. And there are some insurances that don’t cover the surgery, they have an exclusion in the insurance.

Dr. John Oldham: So we discuss that with them. We do self-pay if there’s somebody that does have an exclusion in their insurance and they want to proceed, but once they fill the packet, we’ll contact them, have them come into our office and we call this the intake appointment. And this is where, they’re about five, six hours. So it’s a long visit, but it’s kind of get it all done in one-day thing. They’ll see the dietician, they’ll see the psychologist, they’ll get counseling, they’ll see nurse practitioners. We do BMR testing, which is basal metabolic rate testing. So we do a lot of education on that day. And then once they have that, there are some insurances that require their patient to do a monthly diet visit, three months, four months, six months. Some insurances don’t require it, but most insurances do. And then they’ll come back for the final visit before surgery. That’s when we go in detail about the surgery. We discuss all the possible complications, which are very rare in our hands and then we go to surgery.

Kerri: Okay. Well what are some of the risk factors and disadvantages that we need to know?

Dr. John Oldham: Very, very safe procedure. Again, everything is all done laparoscopic. The biggest concern since we have to cut the stomach, and again we’re going to take about 80% of the stomach out. So instead of having this big football-sized stomach, we have a kind of a large banana sized stomach now. So we are cutting the stomach, so the big concern is a leak. It is a very rare in our hands. It’s less than 1%, it’s less than 0.27% but that’s a possibility since they’re cutting the stomach. Blood clots, another thing that is a concern.

Kerri: Is there a risk of a hernia?

Dr. John Oldham: Incisional hernias are very rare in laparoscopic surgeries because we’re doing four to five little bitty incisions the size of my pinky, so we’re talking very, very small incisions. So the chance of incisional hernias are extremely, extremely rare.

Kerri: How about weight gain over time?

Dr. John Oldham: Yeah, it’s always a question. As I said earlier, these are only tools. There is no magic procedure and you’ll hear us talking about that all the time. We have patients lose 100% of their excess weight, but they’re not meant to do that. They’re meant to get you to your healthy weight. We also have patients that can struggle long term. And that’s why follow-ups are very, very important. We want to see our patients at least once a year for the rest of their life after the first two years. We see patients frequently the first two years but if somebody is struggling or maybe gaining some weight back down the road, that’s when we definitely want to see them back in the office to help them.

Dr. John Oldham: We have different options getting them back on track. We can look at weight loss medications. So there are all kinds of things that we can do. But that’s where the education is. And using the tool correctly, patients will do very well. But the surgery is really meant to get you, lose about 60 to 70% of your excess weight. That’s kind of an average. And that’s the long term. So 70% excess weight loss. If somebody was a hundred pounds overweight, that would be a 70-pound weight loss, 200 pounds overweight, 70% excess weight loss would be 140-pound weight loss. So, but that’s an average and that’s long term. But as I said, we have patients lose 100% of their excess weight, get down to the ideal body weight, but again meant to get you to a healthy weight.

Dr. John Oldham: And it’s sometimes hard to determine what is a success. If somebody lost, only lost 50% of their excess weight, but they get off their diabetic medications or off their blood pressure medications, they’re off their C-PAP medications, it helps with their liver disease, that’s kind of where we-

Kerri: That would be successful.

Dr. John Oldham: Yes, exactly.

Kerri: What can patients expect in terms of surgery?

Dr. John Oldham: So the surgeries are done with a general anesthetic and that’s all laparoscopic surgeries. The gastric sleeve takes about 40 to 45 minutes to do to an overnight stay. So just going home the next morning, as I said, there’s about four to five little bitty incisions. We do this through a video monitor. We have angled cameras that we put inside the abdomen, we insufflate the abdomen with CO2 gas. Again, that’s all with laparoscopic procedures. We go in and we actually resect part of the stomach called the greater curvature. So we’re making this football-sized stomach into kind of a large banana size stomach so that the part of the stomach that we removed is taken out.

Dr. John Oldham: I know a lot of patients, sometimes when they hear the word gastric sleeve where you’re taking that stomach out and it’s permanent. Yes, it is permanent. We can’t put the stomach back in, but this is the size stomach that we need in today’s environment, with our Western diet. We don’t need this big football-size stomach nowadays with our American diet, so I think that if you think of that way, just a smaller stomach kind of, it makes sense. But as I said, stapling the stomach, remove the stomach, 40, 45-minute procedure and overnight stay going home the next morning. Actually we’ll start out with some liquids right after surgery when you go up to your room. The next morning, we kind of have some protein drinks, some broth, things like that then get to go home. We have online information, but we don’t have an online informational seminar at this point. We’re actually working on that.

Kerri: Before we close out, I want to talk about some of the myths and debunking some of these myths for bariatric surgery. One that we’ve heard is that bariatric surgery is dangerous and I’d love to hear your response to that if you’ve heard that from patients or prospective patients.

Dr. John Oldham: Absolutely. Bariatric surgery kind of got a bad name when, as I was saying earlier that it was all done through open procedures and we did see a lot, a lot of bad complications. And again, that was back in the eighties and nineties but now that this is done laparoscopically, it is very, very safe. As I said, complications like bleeding, blood clots, leaks are very rare, less than 1%. Again in our hands, this can be done very, very safely.

Kerri: And it makes sense for a shorter recovery time as well.

Dr. John Oldham: Right, exactly. Exactly. So patients who right after surgery, when it’s done laparoscopically, they’re up on their feet walking right after surgery. We actually have them on a schedule, they’re walking around the nurses’ stations every two hours around the clock, after surgery. And when they go home, the only restriction that we tell them is heavy lifting. And that’s anything over 25 pounds for about two weeks. if somebody wanted to leave the hospital, they can run over to our Baptist Milestone Gym around the corner, hop on a treadmill and go at it if they want to. They’re not going to feel like doing that, but they can do that. So again, we don’t want it to limit their activity.

Kerri: Another myth that we’ve heard is that insurance does not cover the weight loss surgery,

Dr. John Oldham: Right, so insurances do cover the bariatric procedures, but there are some insurances that do have exclusions. And that’s where we can find that out for patients. Or if they have to meet that BMI criteria, the 40 and above without comorbidities or don’t have to have a comorbidity. Or if your BMI 35 to 39.9, you would need some type of, like hypertension, diabetes, sleep apnea, something like that before they would cover it.

Kerri: Okay. How about the myth medications are the best way to treat an obese patient’s medical conditions? Have you heard that one?

Dr. John Oldham: Well, for slightly overweight patients, medications are good. We want all of our patients to at least have tried different weight loss things in the past, that most of our patients have done, diets and medications, things like that. There are five FDA approved medications. We use them in our office and our practice, but it’s usually for a small percent of weight loss, only about 7 or 8% weight loss with these medications. And then usually if the medication is stopped, usually that weight does come back. Obesity is a very, very serious problem. Even somebody just with a body mass index of 30, which is only about 30 pounds overweight, has a 50 to 100% increased risk of dying prematurely compared to a normal weight individual, dying 10 to 15 years earlier than they should. So that’s what we want to change, to make patients healthier, prevent diseases like diabetes, hypertension, and sleep apnea, things like that, and make sure they’re adding years to their life and not dying prematurely.

Kerri: Sure. Thank you for joining us today, Dr. Oldham.

Dr. John Oldham: Thank you.

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