Summertime and sun safety

It’s summertime and the sun is blazing.  Let’s talk about how to protect your skin from the summer sun.  According to the American Academy of Dermatology, 1 in 5 adults in the US will develop skin cancer, making it the most common type of cancer. They state that “Even one blistering sunburn during childhood or adolescence can nearly double a person’s chance of developing melanoma.”  The importance of sun safety is critical and should be considered from an early age and continue through adulthood.  There are a number of ways you can keep safe and still enjoy the sun. 

How can I limit sun exposure?

Blocking the sun prevents exposure to harmful UV rays.  Make sure you have a thoughtful plan for prolonged sun exposure.  Limiting time in the sun is the best way to avoid harmful rays.  The sun is strongest during the hours of 10am and 4pm. During these hours, limit direct sunlight exposure by seeking shade. Remember, you can get a sunburn and expose yourself to harmful rays even on a cloudy day.  Keep that in mind as you head out!

There are a number of tools we recommend to help you block the sun:

    1. Broad brimmed hats: There are really nice hats that use UV blocking material for both children and adults that will protect not only the sensitive top of your head and ears, but also your eyes, face and shoulders.  Look for a nice wide hat for optimal coverage.  
    2. Sun shirts:  Protective clothing is another great way to block UV rays.  There are lots of nice options available for babies, children and both men and women.  Long sleeved sun shirts provide nice coverage to the high sun areas on your shoulders, back and arms and allow you to feel cool and comfortable in the summer heat.  They dry quickly and make summer sun fun, easy and breezy!  Regular clothing provides some coverage, but you can get sun damage through your regular clothes, which is more likely with prolonged sun exposure. 
    3. Umbrellas and pop-up tents:  These come with UV protection, as well.  They can be found at your local grocery store as well as most sports stores and baby gear shops.  They help adults and kiddos catch some shade at the beach or an outdoor event where they may otherwise be stuck under the blazing sun.  These tents and umbrellas can adjust with the sun as it moves across the sky and provide continued protection while you are outside and unable to find natural shade.  Stroller shades can be adjusted to keep those babes out of direct sun, too!
    4. Sunglasses:  Don’t forget those eyes!  Wearing sunglasses provides protection to not only your eyelids, but your eyeballs, too. Protect those corneas, lenses and other sensitive parts.  Using sunglasses with both UVA and UVB protection is key not only to skin, but eyes too.

Sunscreen usage for babies, children, and adults

Sunscreen use is a common concern for children and babies.  When can you use sunscreen on your baby? There are so many options!  Parents of winter and spring babies are ready to roll outside when summer hits and oftentimes are unsure about slathering sunscreen all over that sensitive baby skin. 

According to American Academy of Pediatrics (AAP), if you can avoid using sunscreen until your baby is 6 months of age, this is ideal.  It is best to use sun shirts, wide brimmed hats and be sure to keep your baby out of direct sunlight, especially under 6 months of age.  If you absolutely cannot, it is advised to use sunscreen sparingly on the face and exposed skin until they are over 6 months old when it is considered safe to use sunscreen.  The best choice for babies and all children in general is to keep them in a shaded area and avoid harsh sun exposure. 

Once your child is moving and grooving, it is going to be a challenge to keep them safe from the sun’s rays.  They are wiggly and picky, and usually slimy sunscreen isn’t on their agenda.  The best option for applying sunscreen is at home, before you head out into the sun.  Sunscreen works best if applied 30 min before sun exposure.  This also eliminates trying to slather lotion on a sandy or already wet child who wants to run and play!

AAP recommends looking for the words “broad-spectrum” on the sunscreen label in order to have protection against both ultraviolet B (UVB) and ultraviolet A (UVA) rays.  Using a zinc based cream on the face, ears, nose, cheeks and shoulders can provide extra protection for high sun-exposed areas.  We will talk more about these different types of sunscreens, as they can be confusing!

The best, most consistent coverage will come from a water-resistant sunscreen.  Regardless of which type you use, be sure to reapply at least every two hours, or after swimming, sweating or towel drying. No sunscreen is waterproof, and will need to be reapplied often, based on your activities and sun exposure.  

For adults, choosing a daily moisturizer with SPF is a nice easy way to get some coverage on your face, ears and neck regularly.  You can then add additional sunscreen and protection with prolonged sun exposure.  

What kind of sunscreen should I buy?

The most important thing to remember is to sunscreen yourself and your child.  A common question is which sunscreen has the least amount of chemicals or works the best.  The FDA has proposed that sunscreen becomes more regulated so that consumers are ensured that they are both safe and effective.  It is important to read the ingredients and see what works best for you.  There are two basic types of sunscreen based on ingredients and how they protect the skin: chemical sunscreen and physical sunscreen.  

  1. Chemical sunscreen absorbs the sun’s rays and may contain one or more of many possible active ingredients, including oxybenzone, octinoxate, octisalate, octocrylene, homosalate and avobenzone.  This type is usually easier to rub in and doesn’t leave a thick film but can be more irritating.  
  2. Physical sunscreen acts by deflecting or blocking the sun’s rays, and includes active ingredients titanium dioxide and/or zinc oxide. This type of sunscreen is usually best for those with sensitive skin, but doesn’t rub in well.  It commonly leaves a white film, but you can find more clear options these days, as it has become a more popular product.

There are ongoing studies to determine if the chemicals in sunscreen are harmful.  What we do know is that some studies have shown these chemicals get into the bloodstream because they are absorbed into the skin.  More studies need to be done to determine how safe it is to have detectable levels of these chemicals in your body. 

Some of the more common chemicals in question are currently being studied.  In 2019, the FDA concluded that the risks of using aminobenzoic acid, or PABA, and trolamine salicylate outweigh their benefits, and it proposed classifying them as unsafe.  What we do know is that two ingredients, zinc oxide and titanium dioxide, are recognized by the FDA as safe and effective.

How do I find the right sunscreen for my family?

There are many options for sunscreen choices and there are lots of opinions on which ones are best.  The best is to be sure to use a sunscreen that is at least 15+ SPF (30+ is best) and keep in consideration that your child may have sensitive skin so it may take a few tries to find the right sun care regimen for you.  The AAP recommends about 1 oz of sunscreen per application per child, which can add up quickly. 

Once you find a sunscreen you love, make sure you have some with you whenever you leave the house as you may need to slather up on the go.  Keep in mind that leaving sunscreen in a hot car can decrease its effectiveness, so try and keep it in a travel bag that comes inside with you and isn’t left out in the sun all day.  

If you are looking for some sunscreen options that work well and have low amounts of chemicals, you can check out EWG (Environmental Working Group), who reports on different products with reviews, so you can make the best choice for you and your family.  

The Nurse-1-1 team has a few family favorites that we are happy to share (with no affiliation!)  Since we know that zinc oxide and titanium dioxide are reported as safe, we have stuck to these options:

  • Nurse Kim has found Think Baby products work really well for the kiddos.  They are also rated as one of the cleanest products by EWG.  We especially love the face stick for easy application to those sensitive areas of the face, hair part, ears and chest. 
  • Badger products are a close second for Nurse Kim’s fam. Their product is a little thicker but works just as great and is just as clean. Sunbum is a newer find and we’ve found the face stick to work great! 
  • Nurse-1-1 CEO Mike Sheeley’s family loves Blue Lizard sensitive SPF 30+ for the kiddos and Vanicream for Mom, both rated highly on the EWG rating for clean products.
  • The Nurse-1-1 Dads prefer spray sunscreen with no brand preference.  We have to agree with the Dads that something is better than nothing. The most important thing is to avoid a sunburn!
  • Dr. Igor loves to supplement his sunscreen use with a Sundaily skincare gummy, which is thought to decrease sun damage with plant-based antioxidants.
  • Marketing Director Bailey sticks to the clean products at BeautyCounter and loves their Countersun Mineral Sunscreen Lotion SPF 30 (they also have daily moisturizer and mist versions available).

We would love to hear which sunscreens you love!  Drop us a comment on our Instagram. 

Sunburns and skin damage – when should I get checked out?

It is important to try and avoid getting a sunburn in general.  Even a mild burn is an indicator that you have sun damage.  The more often you burn, the greater the risk for skin cancer.  All skin types and colors are at risk for skin cancer with prolonged sun exposure and sun damage. Skin damage can occur over time to everyone, even without a sunburn so it is very important to keep sun safety on our minds all year round.  

Any blistering rash or burn should be checked out, especially if it covers more than 20% of your body.  If you aren’t sure, call your primary care provider.  Also, if you have a sunburn along with a fever, chills, severe pain, extreme thirst, dry mouth, dizziness, decreased urination, or fatigue, you should be seen right away. Heat stroke and heat exhaustion are preventable heat-related illnesses. They can occur quickly in the heat even without a sunburn. Learn more about avoiding heat exhaustion and heat stroke. Remember, you can always ask a nurse first if you are unsure!

Skin cancer warning signs include changes in size, shape or color of a mole or other skin lesion, the appearance of a new growth on the skin, or a sore that doesn’t heal.  If you notice any spots on your skin that are different from the others, or anything changing, itching or bleeding, it is important that you make an appointment with a board-certified dermatologist.  If you are unsure, we are here to help determine what your next steps should be.

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

Understanding racial health disparities in America

Nurse-1-1 was founded to increase access to affordable and compassionate healthcare for everyone. Significant racial health disparities exist in our country, particularly for the Black population, and our goal is to decrease these disparities by providing a digital connection to a trusted nurse, whenever, wherever, and for whoever you are. This problem is big and complicated, as exemplified by the fact that Black Americans’ “mortality rates are about 20% higher than those of Whites, resulting in a 4-year lower life expectancy”. Nurse-1-1 hopes to be a part of the solution addressing this public health crisis.

Healthcare innovation often focuses on the well resourced patient rather than the marginalized one. We want Nurse-1-1 to be different. In order to reach underserved patients, we made the decision to provide our digital triage platform for free to Federally Qualified Healthcare Centers. We also help hundreds of uninsured patients a month, keeping many out of the ER and an associated $2,000 bill. We know it will take a village to bridge the enormous gaps in health outcomes that exist across our country, but we all have to start somewhere. It is important to acknowledge there are gaps in healthcare based on race and ethnicity, socioeconomic status, geographic location, disability, and sexual orientation. These gaps aren’t an easy fix and will require change in the way we care for others, not only in healthcare but in all aspects of life.

Here we are in 2020 and we are still fighting for equal treatment and opportunities for all. Nutritious food for all. Clean water for all. Jobs for all. These disparities have been made even clearer as COVID-19 has changed how we approach and access healthcare. We know that a person’s health isn’t just measured by disease—there are many factors to health, such as access to:

  • High-quality education
  • Nutritious food
  • Decent and safe housing
  • Affordable, reliable public transportation
  • Culturally sensitive health care providers
  • Health insurance
  • Clean water and non-polluted air

Disease may be visible and immediate while these other factors have a slower, longer-term impact on a person’s health. But that doesn’t mean they aren’t just as important to a person’s wellbeing. For example, families living in food deserts may be forced to eat more processed, unhealthy foods, leading to higher rates of diabetes, high blood pressure, and heart disease. 

The trickle down effect on health starts with a secure, well-paying job

The COVID-19 shutdown took on an entirely different meaning for those who lost their job and couldn’t provide food for their family. Rates of COVID-19 infections are higher in poorer communities, mimicking healthcare trends generally seen in patients living in poverty. Crowded living spaces due to inadequate affordable housing, inability to afford and access healthy food, and subpar access to healthcare are just a few factors that stem from not having a consistent, well-paying job. These factors increase the risk of contracting an infectious disease such as coronavirus and then exacerbate the associated mortality rates when you avoid healthcare given the associated out-of-pocket costs. 

Chronic conditions more commonly associated with poverty – diabetes, obesity, and heart disease – also are a setup for increased chances of dying from COVID-19. To put it simply, living in poverty worsens your health for many reasons, especially during this pandemic. 

According to the CDC, nearly 25% of employed Hispanic and Black workers are employed in service industry jobs compared to 16% of non-Hispanic Whites. As the pandemic began, this employment sector took the biggest hit, leaving many people of color unemployed at higher rates than their White counterparts. Even pre-COVID, unemployment rates for these segments of the population were not equal. According to the US Joint Economic Committee, historically, the unemployment rate for Black Americans has been approximately twice the rate for White Americans. In 2020, pre-COVID, this continues to be the case: 6.0% for Black workers and only 3.1% for White workers. The trickle down effect on health starts with a secure job. 

It is also quite easy to fall into poverty once unemployed if you lack financial reserves or family members who have the ability to support you. In Boston, for example, the median net worth of non-immigrant African Americans is $8, while it’s $247,500 for Whites. Unfortunately, this enormous disparity did not happen by accident, and instead stems from systemic racial injustices causing immeasurable consequences to the Black community. Whether it be atrocities such as the massacre of Black Wall Street or keeping minority populations from purchasing real estate in desirable areas through redlining, systemic racism has continually prevented wealth accumulation for Black communities

You can’t have good health without proper housing, access to food and health insurance, and a good, stable job.

You can’t talk about health without talking about race

We know that a person’s race contributes significantly to their health. According to US News and World Report, Black Americans are sicker and die younger than their White American counterparts, even when education and income factors are controlled for. This also extends to Black children, who have a 500 percent higher death rate from asthma compared to White children. 

The Journal of Perinatal Education reports that Black women are 2-6 times more likely to die from complications of pregnancy than White women, depending on where they live. Expressed differently, Black expectant and new mothers in the U.S. die at about the same rate as women in countries such as Mexico and Uzbekistan. Read that twice. 

These poor health findings are not just simply explained by genetics or poverty. We are seeing that persistent discrimination and racism directly impact these disturbing statistics.

COVID-19 exacerbates health disparities for Black communities

According to a recently published article titled COVID-19 and African Americans, Black populations in major metropolitan areas are seeing disproportionately higher rates of COVID-19 cases and deaths. This includes cities like Chicago and states such as Louisiana, Michigan, and New York. They also report that the COVID-19 infection rate in predominantly Black counties in the US is more than 3-fold higher than that in predominantly White counties, and the death rate 6-fold higher. These figures should be terrifying, but may not be that surprising given what we have reviewed thus far. COVID-19 has highlighted the longstanding divide in health between White and non-White Americans. The ability to telecommute and social distance from clean and affordable housing is a privilege that fewer people of color have, thereby resulting in higher infection rates among a community already plagued with higher chronic health conditions.

How racism worsens health outcomes directly

Poor health outcomes in the Black community are shocking. There is no easy way to fix this, especially since the cumulative effect of many years of unjust treatment based on skin color is one of the main contributors to poor health. New research is showing that common, repeated exposure to stress in the form of racism and discrimination causes increased health problems in the Black community. The American Journal of Men’s Health reports the main psychosocial stressors linked to poor health outcomes for Black men include: (a) negative, narrow stereotypes of Black males; (b) interpersonal and structural discrimination; (c) disproportionate poverty, unemployment, and underemployment; (d) residential segregation in investment-poor, underserved, and decaying neighborhoods; (e) inadequate health care; (f) negative interactions with the criminal justice system; and (g) barriers to fulfilling valued masculine roles. Stress in the body can be measured by certain hormones, specifically cortisol levels and patterns. In this same report, it was shown that Black men have cortisol trends that are correlated with poor physical and mental health outcomes as well as an increase in mortality rates as compared to the cortisol levels in those of White men. The American Psychological Association reports that Black adults are more likely to have feelings of sadness, hopelessness and worthlessness than are White adults. Somehow, Black women have increased rates of mortality during childbirth even when health, income and education levels are controlled for. Years of systemic discrimination, everyday racism, and microaggressions continue to increase stress in the Black community, thereby leading to poorer health outcomes.

Improving patient care for Black Americans

Lastly, when we are considering poorer health outcomes for Black Americans, we also have to consider implicit bias and outright racism in healthcare. We’ve seen it throughout history, and we certainly see it today with COVID-19.⁣ A 2012 report found the Black community receiving lower quality of care 43% of the time in measures ranging from quality of annual exams to life threatening treatments for disease. In this particular study, all participants, White and Black, were of the same socioeconomic status with equivalent insurance. Color of skin was the main contributing reason for poor care, and it is thought that racial bias among providers was the contributing factor. 

New statistics coming out during the pandemic show one is less likely to get tested for COVID-19 if they are Black. Check the news and you will see numerous stories of Black men and women dying from COVID-19 without receiving the necessary support or treatment, possibly due to implicit bias

Instead of 2020 being labeled as the year that COVID-19 shut us down, let’s try and make 2020 the year of change, the year that racial bias and injustice ends and health improves for all Americans, regardless of race and ethnicity, socioeconomic status, geographic location, disability, and/or sexual orientation.

The opinions expressed in Nurse-1-1 Health Center Blog are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

Anxiety During COVID-19

Article Disclaimer 

This article is aimed at giving you and your family some helpful tidbits on how to stay mentally and physically fit during this pandemic. This is just helpful information. This is not medical advice. If your stress, anxiety, or mental health is concerning you, or becoming difficult to live with, please speak with a licensed medical professional.

Anxiety During COVID-19

The word “anxiety” has a whole new meaning in 2020. COVID-19 has changed how we think, act, and feel.  We need to learn how to live in this new world and accept our new normal.  But, let’s be honest, we don’t have answers yet and nobody really knows what next week will bring. COVID-19, or coronavirus, has really thrown us for a loop.  We are now worried that one breath or cough in the wrong direction can land our parents, family, friends, patients, or loved ones in the hospital.  Transitioning back to our old ways is uncharted waters with new normals and new fears. We just have to do our best with what we know. Remember, you aren’t alone.

How can I decrease COVID-19 (and COVID stress) in my home?

When you feel out of control about something, one of the best ways to cope is to figure out what can be done, and understand what you can’t control.  In this case, with the COVID-19 pandemic, there may be many unknowns, but there are also many knowns.

According to the CDC, COVID-19 is primarily spread from person to person, through a few ways:

  1. You can become infected by coming into close contact (about 6 feet or two arm lengths) with a person who has COVID-19. 
  2. You can become infected from respiratory droplets when an infected person coughs, sneezes, or talks near you. 
  3. You may also be able to get it by touching a surface or object that has the virus on it, and then by touching your mouth, nose, or eyes.

Remember, the virus may spread by people who do not even know they have COVID-19 (i.e. they have no symptoms). 

So the good news: we know how to best prevent getting the virus. We can control our behavior in our own home and when we are out in public by following some basic rules of thumb.  We can ease our worried minds by continuing to follow social distancing, staying away from others when possible, wearing masks in public places, washing our hands frequently, and avoiding touching our faces. These are some of the best ways to decrease the spread of this virus. 

Worrying about the symptoms of COVID-19

Patients with COVID-19 can exhibit many different symptoms, often  not consistent or specific, which can make this seem even more stressful.  Symptoms vary and can include cough, runny nose, chest pain, shortness of breath, vomiting, chills and aches. Sometimes, people with the virus show no symptoms at all. Often times, people convince themselves that they have any of these symptoms. Add in the new symptoms children are experiencing, such as fevers, rashes, diarrhea and more, and you could self-diagnose anyone in your house with COVID-19.  

This is going to be hard.  We will worry.  The news is full of new symptoms to watch out for and fear levels are high.  Worrying is inevitable but the important part is that you are able to take care of yourself and family. If you feel you’re unable to do that, let’s go over what you should do.

What kind of stress are you having?

Ask yourself or a loved one if they feel you are able to carry on with your daily activities.  If you are finding your stress is preventing you from getting work done, caring for yourself or loved ones, or keeping you from completing your usual tasks and routines, then please don’t delay care.  It is important to talk to a trained professional such as your primary care provider, a therapist or licensed mental health provider so that you can stay healthy.  It’s possible that you need some regular therapy sessions or medication to help you get through these times.  It’s ok!  If you are feeling this way, contact your healthcare provider now.

According to the WHO, one in four people in the world will be affected by mental or neurological disorders at some point in their lives.  The American Psychological Association found in a poll from 2004 (well before COVID and increase in telemedicine) that 48 percent of those polled reported a visit to a mental health professional by someone in their household during the year.  Now with mental health providers doing telehealth visits and people with all time high stress levels, this number is likely to be much higher.  Video visits are much more accessible and you can access this care quickly from the comforts of home.  We can help you find a telehealth visit now.

What can you change?

If you feel like you are doing ok, just more overwhelmed here and there throughout your day, you may be able to eliminate some stressors by limiting your triggers.  For example, if 5pm usually brings a mix of stress—scary news on the TV, kids getting hangry, increase in the phone ringing—consider eliminating what you can control such as turning off the TV and maybe, just maybe, silencing your phone.  

Think about what helps and what doesn’t and try and put some protective measures in place to cushion the stressors from directly reaching you.  Be in charge of some of what stresses you out.  We all know you can’t manage every stressor, but we can limit some of them.  

A little bit of self care goes a long way

We recommend setting aside some time for yourself each day. Here are a few ideas to get you started:

  1. Journal or doodle to relieve stress.
  2. Try a free online yoga class, or go for a brisk walk to clear your head.
  3. Try meditation.  Think happy thoughts.  
  4. Take a cold shower. Cold water can release endorphins!
  5. Send kind handwritten notes or texts.  
  6. Donate to a charity.  
  7. Color some inspirational sidewalk chalk messages. 
  8. Offer to pick up an elderly neighbor’s groceries.  
  9. Schedule some time to connect with a friend if you’re feeling lonely.
  10. Go outside and clip a few flowers from your yard or some wildflowers from the edge of the road.

Do what makes you feel good. Small amounts of self care will go a long way!  

Take care of your medical needs

Don’t put off your regular visits to take care of any chronic illnesses or new symptoms.  We don’t want to see otherwise preventable and treatable issues causing long-term health effects for those that are too afraid to seek care. Call your provider and start with a telehealth visit when possible.   

Stress can make things worse

Keep in mind that stress can make your symptoms, aches and pains, and health issues seem worse.  It can make you tired, wear you out and shorten your ability to cope.  Chat with Nurse-1-1 if you are having symptoms you want to discuss, and we can help you find a mental health professional if you are worried your stress is interfering with everyday life.  Sometimes, all it takes to relieve stress is chatting with someone who is compassionate, knowledgeable about your concerns, and can help point you in the right direction when you need additional care.  Our nurses are all of the above!  

Remember, if you or a loved one has thoughts of self-harm, please call the suicide prevention hotline at 1-800-273-8255, or seek emergency care by calling 911. Mental health is a serious topic, so please take the necessary precautions to keep you and your loved ones safe. 

Kim Liner, PNP

Nurse-1-1 Chief NP

The opinions expressed in Nurse-1-1 Health Center Blog are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

Snoring and sleep apnea: what you need to know

How often have you been startled awake at night by your partner snoring away? Have you ever shook your partner, gave them a little kick to stop the snoring or a nudge to see if they were still breathing? If this is you, your partner may have sleep apnea.  

What exactly is sleep apnea?

First off, sleep apnea is a medical condition that needs attention. It is a sleep disorder that causes you to temporarily have periods of involuntary breath holding, and is characterized by loud snoring and episodes of observed pauses in breathing. Now, not everyone who snores has sleep apnea, so don’t panic. Sleep apnea is, however, the cause of serious sleep disruptions and can lead to other health problems. According to sleephealth.org, one in five adults suffers from sleep apnea in the US. Sleep apnea not only causes daytime fatigue and mood swings, but can also lead to more serious issues such as heart disease, diabetes, stroke and cognitive disorders. 

Types of sleep apnea

There are a few types of sleep apnea. Obstructive Sleep Apnea and Central Sleep Apnea are the most common types. Remember, sleep apnea isn’t just snoring. We can help you to determine if you need to be checked out.

Obstructive Sleep Apnea occurs when the muscles in the back of your mouth relax while you are asleep and block your airway. When this happens, your body automatically wakes you up and signals your body to take a big breath, often resulting in a gasp for air. This can occur over and over throughout the night (from a few times to hundreds of times!!) but most people don’t realize it’s actually happening.

Central Sleep Apnea is less common and occurs when your body forgets to signal you to breathe while you sleep. You awaken as you catch your breath.

Both of these types of sleep apnea cause sleep disruption and prevent you from falling into a restful phase of sleep. Your provider can rule out more serious causes and help determine which type you may have.  

What are the symptoms of sleep apnea?

The most common symptoms of sleep apnea are snoring, waking at night, gasping for air, and apnic episodes (periodic stopped breathing). People with sleep apnea often wake up tired, with headaches, poor concentration, daytime fatigue, poor memory and dry mouth. If your partner is noticing that you are gasping for air at night and/or snoring loudly, you should get checked out for sleep apnea.  If you are waking up at night to the jabs of your partner, ask them, am I snoring loudly? Does it seem like I am not breathing normally?  If the answer is yes, it may be worth getting a sleep evaluation.

How do I know if I need treatment?

If you are experiencing symptoms of sleep apnea, it is important to get evaluated. Your provider will determine if there are other causes for your symptoms and order a sleep study if appropriate. Sleep study?? Sounds awful! Don’t fret! 

Sleep studies can now often be done from the comfort of your home (we know that people don’t sleep well in labs!) According to National Heart, Blood and Lung Institute, testing can:

  • Detect apnea events (when your breathing stops or slows during sleep–think breath holding)
  • Detect low or high levels of activity in the muscles that control breathing
  • Monitor blood oxygen levels during sleep
  • Monitor brain and heart activity during sleep

Once you have this data, you will know how severe your sleep apnea is and what treatment you may need.

Is there a treatment for sleep apnea?

The answer to this question is yes! There is treatment and hope that everyone will sleep soundly in their rooms with a little help! The most common treatment for sleep apnea is a Continuous Positive Airway Pressure (CPAP) machine. This machine does exactly what the name says: it gives continuous air pressure to keep your airway open while you sleep. Your provider will determine what pressure you need based on your testing results. They can also help tailor the air flow to allow for the most natural sleep possible while preventing you from having episodes of apnea. 

There are different mask types that administer the flow of air and in most cases, the mask can be worn over just the nose or both the nose and mouth based on your preference for comfort. The goal is that the patient uses the CPAP machine nightly by making it as comfortable as possible while providing the appropriate amount of air flow to best treat your sleep apnea. The machine has become more discrete over the years, making it a very user friendly option. Your provider will recommend settings for your machine based on your specific needs and you should not adjust your recommended settings without medical guidance.

Can I fix my sleep apnea without a machine?

In some cases, a healthy lifestyle can improve symptoms. Things like diet, exercise and weight loss can improve symptoms, especially in obese patients. Stopping smoking and eliminating alcohol before bedtime can also help decrease symptoms. People can decrease risks for many chronic illnesses like sleep apnea by adopting a healthy lifestyle in general.  

Some more invasive options for treatment include surgery, mouth pieces, and in very rare cases when nothing else works and there is risk to the patient, permanent devices in the body.

Can untreated sleep apnea really cause me to have other health problems?

Yes. Untreated sleep apnea can lead to other chronic health conditions. It is important that you take care of your sleep so that you can decrease this risk. Treating sleep apnea is similar to seeking care for any other medical condition, so don’t hesitate. Correcting sleep apnea can improve mood and concentration, reduce blood sugar levels, and decrease risk for stroke and heart attacks, according to John Hopkins Medicine. Treating this medical condition is important to achieve optimal health. Poor sleep, fatigue, and prolonged breath holding results in low oxygen, and can strain other parts of the body such as the heart and lungs. It is important to include sleep health in your plan for a healthy lifestyle. 

Harvard Medical School reports “The sleep disorder is found in 47% to 83% of people with cardiovascular disease, 35% of people with high blood pressure, and 12% to 53% of people with heart failure, atrial fibrillation (a heart rhythm abnormality), and stroke. Researchers estimate that untreated sleep apnea may raise the risk of dying from heart disease by up to five times.” These serious health issues can be decreased with sleep improvements and treatment of sleep apnea.  

Talk to a healthcare provider about your concerns about sleep apnea

Talk to a nurse first or contact your primary care provider if you have one. Snoring, waking at night and poor sleep will not only cause health issues, but also make you moody and tired. If you think that you should get checked, you probably should! Your partner, your pillow and loved ones will thank you!

Kim Liner, PNP

Nurse-1-1 Chief NP

The opinions expressed in Nurse-1-1 Health Center Blog are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

The science behind coronavirus testing

Coronavirus testing– the science

Ever been tested for the flu? If you have, you may have noticed there are two different types of tests: the quick one that comes back with an answer within minutes, and the longer one that takes 45-60 minutes. These same techniques are used for coronavirus testing, with PCR testing being the long one, and antigen testing the quick one. Then there’s antibody testing, which is used to help determine if a person has previously been infected, and in certain cases, can identify patients with current infection (see details below). 

In this article, we’re going to break down the science behind how each of these tests work—for somebody with a non-medical background, of course. Want the high-level overview on these three tests, their reliability, and how to access them? Check out our post on “Coronavirus testing: what you need to know”. If you’re looking for a more in-depth explanation, however, keep reading below.

PCR or Diagnostic testing

The PCR test takes a sample of mucus from your nose or mouth and then puts the sample through what’s called a “polymerase chain reaction” (PCR). This is a laboratory process that helps identify if any of the virus’ genetic material (think DNA) is present in the mucus. This process takes a bit longer than the antigen test (the “rapid flu” or “rapid strep” test of coronavirus) because it requires a lab technician to literally run the sample through the PCR process. In order for the test to be positive, the virus must have enough time to multiply and actually get into the mucus in your nose and throat. Said another way, the test may be negative for the first few days after you are infected. 

Antigen testing

Antigen tests identify the presence of certain proteins from the virus in upper respiratory secretions from your nose or mouth (e.g. saliva, mucus, and of course, “boogers”). It uses the same technique as the rapid strep test, which you may have previously done for yourself or your children. 

Unlike the rapid strep test, which has been around for awhile and is relatively accurate, the coronavirus antigen test is fairly new (the Food and Drug Administration only approved the first test of its kind in early May of this year) and the jury is still out on how accurate it will be. For example, the rapid flu test, which also uses this type of lab technology, isn’t as accurate as the rapid strep test. In summary, we still need to learn more about the effectiveness of this type of coronavirus testing before we can truly rely on it. 

Antibody testing

Finally, we get to antibody testing, the one that seems to be always in the news. But what is it exactly and can we trust it? Antibody testing has been around for a long time, so this method of testing is well known and tried and true. Unlike PCR and antigen testing, which looks for evidence of the virus, antibody testing is completely different and measures specific parts of your immune system. Unfortunately, this type of testing is only done with a blood specimen (ouch). 

See, whenever you get infected with a virus, your immune system says to itself, “how can I kill this virus now? How can I ensure that I’m ready to prevent it from coming back in the future?” To answer these questions, your immune system starts creating what’s called “antibodies”. 

The really cool thing is that (through a pretty complicated process that isn’t worth explaining here) your immune system makes a few different types of antibodies: an antibody for actively fighting off the infection (let’s call that Antibody A), and an antibody for after you fought off the infection to help prevent future infections (let’s call that Antibody B). Why is that cool? Well, because it makes it easy to test both types of antibodies and come up with one of the following conclusions:

  1. You have never been infected with coronavirus (you don’t have either type of antibody against coronavirus, neither A nor B)
  2. You currently have coronavirus (you only have Antibody A but not Antibody B)
  3. You had coronavirus in the past, but not now (you only have Antibody B, as Antibody A slowly went away as the infection passed)

With all that said, it is a bit unclear how effective antibody testing for coronavirus actually is at the moment. We simply don’t know if this virus will act like other viruses when it comes to the way antibody testing is looked at (as above). Early reports show that it takes several days to weeks for your body to produce the initial antibodies to coronavirus (the Antibody A type ones that come when you are actively fighting the infection). One study showed it took 12 days from the first sign of symptoms. This means antibody testing may not be great at telling us if someone has an active coronavirus infection. 

But isn’t antibody testing great at telling us if someone has had COVID-19 before and is now immune to it (i.e. they have the Antibody B type)? Well, honestly, the jury is still out on this question too. Yes, antibody testing should be pretty reliable at telling us that someone has had the infection before, but, unfortunately, there isn’t enough evidence yet to prove that having had the infection before actually protects you from future infections by a similar, yet different form of COVID-19. 

This can be complicated to think about, especially if you are worried about being sick, so feel free to leave the thinking to us! Chat with a nurse if you are unclear about what to do next. We can help! 

– Igor Shumskiy, MD

Coronavirus testing: what you need to know

I’m sure by now you’ve probably heard the words “coronavirus” and “testing” in the same sentence. Yet, for most people, coronavirus testing is still somewhat of a mystery. We’ve broken down the expert information in one place for clarity on what tests are out there and what it all means.

What types of coronavirus tests currently exist?

  1. PCR or Diagnostic Testing – PCR tests can tell you whether or not you are currently infected with COVID-19. They are the type of test patients are most likely to encounter right now. They test for the presence of genetic material from the actual virus within mucus in your nose and mouth, which means the virus must be in your body (and in sufficient enough quantity) at the time of the test. If you test positive, you are currently either sick with coronavirus or infected but not having symptoms. If negative, you do not currently have the virus in your body, meaning you are not infected with coronavirus and not contagious.
  2. Antigen Testing – Antigen tests can also tell you whether or not you are currently infected with coronavirus. They are easy to use and return results rather quickly (usually, while you wait), but aren’t as foolproof as PCR testing. For that reason, and until more research is done to ensure quality, they may be typically used as a screening tool for large groups of people, and then the PCR test will be used for anyone who tests positive by the antigen test. 
  3. Antibody Testing – This is a blood test that measures whether your immune system is creating or has created immunity (aka “antibodies”) against the virus in question. It does not test for the actual virus. In this case, the virus does not have to be in your body at the time of testing (but could be). It gets a bit complicated on what “positive” means in this case, so I’ve left that explanation for another blog post (check out “The science behind coronavirus testing”). But, basically, if positive, you either currently have the virus in your body or have had it in your body in the past.

How reliable is each test?

Generally, PCR tests are very reliable. However, in order for this test to accurately detect the virus in your body, it’s necessary that the virus has had enough time to multiply and actually get into the mucus in your nose and throat. Said another way, the test may be negative for the first few days after you are infected. If you think you have the virus, have been exposed and/or are exhibiting symptoms, even with a negative test you should still self-isolate to prevent possibly spreading COVID-19 or whatever is causing your current symptoms. 

Antigen tests are not as reliable as PCR tests, so may be used as a screening tool and the step before PCR testing. Keep in mind that the same goes for antigen testing as it does for PCR testing—it may take a few days (after you are infected) before this test becomes positive, as it requires a sufficient amount of the virus to be in your mucus. 

While antibody testing has been around for a long time, it is still unclear how effective antibody testing for coronavirus actually is at the moment. Unfortunately, there just isn’t enough evidence yet. We still need to prove that having had the infection before will protect you from future infections by a similar, yet different form of COVID-19. Per the Centers for Disease Control and Prevention, “We do not know yet if having antibodies to the virus can protect someone from getting infected with the virus again, or how long that protection might last.”

How can I access coronavirus testing?

COVID-19 testing is more available now than when the outbreak first occurred. There are fewer restrictions on testing so if you are worried that you need a test, and have symptoms, you are more likely to be able to access one. If you are currently having symptoms, you should talk to a nurse first (assuming it’s not an emergency; if it is you should get help by calling 911 or going to the ER), or call your primary provider to decide if you should be seen for a visit or just need the testing.  

Many places may require a medical order from a provider in order to get the test done so don’t expect to drive up like at a Dunkin’ or Starbucks to order yourself that test. Call ahead to the testing site or check with your provider first. Some providers want to rule out other, more common reasons for fever, especially in pediatrics, so they may have you come into the office for a strep or influenza test first, for example. In some cases, you may be able to do an online screening to determine if you need the test.  Some high risk patients such as health care providers, immunocompromised patients, elderly, those experiencing severe symptoms and those with exposure risks are likely to have testing more available to them.  

Per the Coronavirus Aid, Relief and Economic Security (CARES) Act, antibody testing should be covered by your insurer. Many insurers are also waiving copays or deductibles for coronavirus related testing. However, we suggest calling your insurer to confirm or checking this website to get specific information regarding your insurer as some coverage is time limited.

The CDC lists each state’s health department website for more specific information on testing sites available in your area along with other COVID-19 resources.  

– Igor Shumskiy, MD

Time to Celebrate Kangaroo Mother Care

Kangaroo Mother Care Awareness Day is celebrated every May 15th, and with good reason. It’s a natural method of post-birth baby care that’s been shown to help premature babies stabilize, promote a close parental bond, and improve breastfeeding outcomes.

What is Kangaroo Mother Care?

While the term “kangaroo care” often makes us think of just holding baby skin-to-skin, there’s a bit more to the Kangaroo Mother Care method than that. When practicing KMC, parents strive to have as much skin-to-skin contact with their baby as possible. For some premature babies, this may require the use of assistive technology.

KMC also includes breastfeeding techniques and improves breastfeeding outcomes by allowing baby to naturally find their way to the nipple when they’re hungry and learn to latch without pressure. This is achieved through natural skin-to-skin contact when holding baby or wearing them in a sling. The care method is also centered around early hospital release when possible, allowing parents to care for their child in the low-stress, comfortable environment at home.

KMC’s ability to stabilize premature babies, some as early as 28 weeks gestational age (3 months premature) was illustrated in a noteworthy 2004 study in which Dr. Nils Bergren observed two groups of premature babies; one group received Kangaroo Mother Care, while babies in the other group were supported in an incubator. While all the babies in the KMC group stabilized within six hours, only half of the incubated group were able to stabilize within that time.

Why does Kangaroo Mother Care work?

Skin-to-skin contact between parents and baby stimulates the development of neural pathways, and allows for a connection that makes baby feel safe and calm. This steadies breathing and heart rate, stabilizing vital signs and preventing the stress that’s caused by separation. When premature babies are removed from their mother in an unstable state, they’re unable to access the benefits that Kangaroo Mother Care can offer, and they may be worse off for it: this 2017 study from the Official Journal of the American Academy of Pediatrics indicated that KMC had significant, long-lasting social and behavioral protective effects even 20 years after the intervention in adolescence and young adulthood.

Wearing your baby makes Kangaroo Mother Care a breeze, and there’s plenty of good reasons to continue on with babywearing as they grow. We The Parents have detailed the science behind 23 ways babywearing can benefit you, so take a peek at their infographic to get educated.

Kawasaki Disease in Children

If you have been listening to the news or reading articles online lately, you may have heard some reports that COVID-19 can cause Kawasaki Disease-like symptoms. What is Kawasaki anyways? We don’t know exactly if or how Kawasaki and COVID-19 are linked, but what we can do is go over Kawasaki Disease, what you need to know, and when to get checked out.

What is Kawasaki Disease?

Kawasaki Disease (KD) or Kawasaki Syndrome is the most common cause of acquired heart disease in children in developed countries, according to the American Heart Association. It usually affects children younger than five years of age but can affect children of all ages. It is also more common in boys than girls, and although it can affect any race or ethnicity, it is more commonly seen in those of Asian descent. 

Kawasaki causes inflammation of the heart vessels and different tissues of the body, including the hands, feet, mouth, nose, throat and whites of the eyes. It can cause damage to the coronary arteries, which are the blood vessels that supply the heart with oxygen, and this can worsen if undetected. 

Early detection is important, as the sooner the treatment for KD starts, the more likely your child will fully recover with no lasting effects. Most children don’t have long term damage to their coronary arteries, so don’t panic. However, in some cases KD can cause permanent damage such as weakened vessels, coronary artery aneurysms and very rarely, death.

Although this sounds scary, remember that Kawasaki Disease is quite rare! Most children with high fevers and other symptoms that may sound like the disease most likely have some other infection that is way more common in childhood, such as a viral infection (most common!). 

How do I know if I have Kawasaki Disease?

Kawasaki Disease is rare but we do see it here in the US. The exact cause of the disease is not super clear and it’s likely that there are multiple factors that put certain children at an increased risk of having the disease. For some children, it occurs after being ill with viral-type symptoms, such as with cold symptoms or stomach bug symptoms like diarrhea and vomiting. 

To meet the criteria for Kawasaki Disease, one of the major indicators is a fever that won’t break, or go away. This means that the fever lasts more than four days, which is when most fevers associated with common illnesses will break. This means the child in question must have a fever of at least 100.4 degrees Fahrenheit for five days before we even start considering Kawasaki Disease. In our experience however, children that truly have the disease have very high fevers for five or more days – fevers of 102 and above on a daily basis.

Fever for five days or more is the main symptom of Kawasaki Disease, but it’s commonly accompanied by four out of five of the following symptoms:

  1. Rash often seen in genital area, but also on arms, legs, back, belly and chest
  2. Swollen lymph nodes (small painless bumps under the skin usually around your neck)
  3. Red eyes (with no eye goop)
  4. Swelling or redness in any part of the lips or mouth such as cracked red lips or swollen tongue (sometimes called “strawberry tongue”)
  5. Swelling or redness or peeling of the skin on the hands and feet

If your child has a fever for more than five days (must be consecutive!) you should always get checked out, but if you have any of these symptoms as well as a fever, it is important to call your doctor’s office right away. In our experience, children with this disease, in addition to the symptoms above, are also incredibly fussy, uncomfortable, and agitated. If your child has daily fevers but is happy as a clam, it’s probably not this disease (though best to still get checked out). Some children have something called “Atypical Kawasaki Disease”, and have only a few of these additional symptoms with their prolonged fever. 

Your provider may order some additional testing, such as a blood or urine test, and you may need an Echocardiogram, which is an ultrasound of your heart. If there is suspicion of KD, they will send you to the hospital to be evaluated and treated.

Tell me about Kawasaki Disease treatment

If you are diagnosed with KD, your child will be hospitalized for treatment. According to the American Academy of Pediatrics, patients with KD are treated with a few medications. One of these is called Intravenous Immunoglobulin (IVIG) and the other is a small amount of aspirin. Occasionally a steroid is also given. These medications are specially dosed for your child and given based on criteria for your specific situation and child. These medications are thought to help decrease inflammation, and can decrease damage to the coronary arteries in some cases. Most children do not have lasting heart damage from KD. 

Should I be worried about Kawasaki Disease?

Kawasaki Disease is very rare and presents with very specific criteria. If you think your child has these symptoms, it is very important to get checked out. In general, it is important to know about this disease, but it is significantly less common than other illnesses that children get such as Coxsackie (Hand, Foot and Mouth Disease), Strep Throat, or the common cold

What does COVID-19 have to do with Kawasaki Disease?

Recently, there are increasing reports of children hospitalized with symptoms of Kawasaki Disease who are also testing positive for coronavirus or testing positive for antibodies against coronavirus (meaning they had coronavirus previously). One theory is that children who fight off coronavirus (even if they don’t have symptoms) may then go on to get a Kawasaki-like syndrome. NPR reports “The new condition associated with COVID-19 is called Pediatric Multi-System Inflammatory Syndrome. Symptoms include persistent fever, extreme inflammation and evidence of one or more organs that are not functioning properly, says cardiologist Jane Newburger, a professor of pediatrics at Harvard Medical School and director of the Kawasaki Program at Boston Children’s Hospital.” Why this happens is complicated and not entirely clear, but is sometimes related to the body’s immune system going haywire. 

So far, it seems that the Kawasaki-like syndrome related to COVID-19 is impacting children’s bodies differently than the disease prior to the coronavirus outbreak. It’s too early to tell exactly what the differences may be. 

We hope that you never have to experience Kawasaki Disease. We know things we read in the news can be scary, and it is very important to be knowledgeable so that you are aware of the facts. You can always ask a nurse first if you are worried about any symptoms or concerns. 

Kim Liner, PNP

Nurse-1-1 Chief Nurse Practitioner

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like how to prevent concussions in kids?  What should parents know about screen time for toddlers? What’s the best way to approach shingles prevention in the elderly? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Redness around the eyes

Ever wake up with redness around your eyes? Do you have a rash around your eyes? Eyelid swelling or drainage? 

Redness on the skin around the eyes can be from a multitude of things. Don’t panic. Here is what you need to know.

What causes eye redness?

First, get up, wash your face and assess the situation. Did you cry all night about your spilled milk? If the answer is yes, then the redness is likely from all of your crying. Grab a bag of peas and ice those eyeballs. 

Do you notice redness under your eyes? Dark circles? Are you super tired? Dark circles under your eyes can be from lack of sleep or rubbing your eyes from being tired. Rest those eyes and try some cool cucumbers to soothe those tired eyes!

When should I worry about redness around my eyes?

Redness around your eyes that seems more like a circle of redness can be a big deal. (Unless you dressed as a clown yesterday or your kid drew on his face with a marker, then disregard). Redness of the skin can be caused by infection. Cellulitis is an infection of the skin tissue. Periorbital cellulitis is an infection that occurs around the eye, in the tissue in the eyelids and below the eye. Usually with cellulitis, the skin feels warm (or even hot!), it can be puffy and you can experience fever and pain. You will need to be seen right away for this. Cellulitis may be accompanied by swelling of the eye or eye drainage. If you are experiencing pain with just moving the eyeball, then you need to be evaluated ASAP! Send us a photo and we can help you with your symptoms.

Redness around the eye from an eczema rash 

A rash around the eye can also be a cause of redness. Common rashes can be caused by eczema, which is dry, scaly skin that can occur on sensitive skin around the eye. Eczema can be caused by inflammation that usually occurs when something is irritating the skin (rubbing your eyes or an irritating substance or allergy). The skin around the eyes is delicate and more sensitive than other areas of the body and can become red or irritated quickly. 

Skin irritation around the eyes is common in babies and kids who rub their eyes when they are tired. I’m sure tired parents rub their eyes too, but likely not enough to cause a rash! Dry scaly skin around the eyes from eczema is usually easy to remedy. First, try not to rub and itch the eyes. You can also try applying a thin layer of Aquaphor to your itchy dry patches. Try not to glob it on too thick or you will get ointment in your eyes. A thin layer goes a long way. Following our eczema guidelines will help too, especially avoiding products that contain fragrance. 

Eye redness from an infection

Redness around the eye that is accompanied by goopy eyes can be due to germs in the eye. If you are noticing yellow goop, or your eyes are sticking together and you feel like they are about to be swollen shut (ew gross), this could be conjunctivitis. 

Now, conjunctivitis can be caused by a virus or bacteria. If it’s a virus, it will typically move from one eye to the next over about a day and then start to clear up. Usually, it’s bright red and runny. It clears as quickly as it starts. Normally if you wait 24 hours you can save yourself a visit to the office. 

If you find that you have nice pink eyes 👁, your eyelids are swollen, you have yellow drainage from one or both eyes 👀 and it lasts more than 24 hours with no end in sight, this is probably bacterial conjunctivitis and you will need antibiotic drops or ointment. Some people call this “pink eye.” 

Pink eye is easily treated with a prescription. Call for an appointment and get your infection taken care of if you think you could have bacterial conjunctivitis. This is the type of illness that can easily be treated over a video visit with a provider. If you have access to an affordable telemedicine service through your insurance or primary care provider, definitely consider it. If you have pain with these symptoms you should be seen right away as eye pain is not typical with straightforward bacterial conjunctivitis. 

Eye redness from an allergy

You can also get redness around the eye, symptoms of eye discharge and sticking together just like an infection, but instead it could be caused by an allergy. Seasonal allergies can often cause red, itchy eyes. We also call this conjunctivitis (just like the paragraph above), but this time it’s “allergic conjunctivitis”. It is caused by airborne allergens (usually the invisible kind) contacting the eyeball and causing your eyeballs to react. Allergic conjunctivitis usually consists of redness in both eyes, watery discharge, and itching (lots of itching!). Itchiness usually means it’s an allergy problem and not an infection. 

Start by avoiding rubbing the eyes, washing your eyes out with clean lukewarm water, using cool compresses, and trying artificial tears (aka visine). Try to avoid whatever you think you might be allergic to. If that doesn’t help, oftentimes trying some over the counter antihistamine remedies such as diphenhydramine (benadryl) or loratadine can help if you have allergy symptoms beyond just the eyes. You can also find over the counter antihistamine eye drops, specifically for itchy eyes, such as ketotifen. Remember to check with your doctor and pharmacist to ensure safety for any long term use! 

Eye redness prevention

Eye redness can be serious so any time you have redness accompanied by pain, fever or warmth, or it seems like you have a circle of redness, it’s important to get checked right away!

One of the biggest ways to keep your eyes healthy and germ-free is by good hand washing! 🖐🏻 Good hand washing is a great way to prevent the spread of germs. It can keep you from getting eye infections as well as introducing other germs into your body that can give you cold symptoms or the flu. Ask a nurse first, if you have concerns or want us to take a look!

Kim Liner, PNP

Nurse-1-1 Chief NP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like how to prevent concussions in kids?  What should parents know about screen time for toddlers? What’s the best way to approach shingles prevention in the elderly? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Prepping the general population for COVID-19

How should I prep for the great Coronavirus of 2020, aka COVID-19?

So unless you live in complete seclusion, you are aware of the current fears and realities surrounding Coronavirus that are currently happening across the globe. A simple Sunday Funday trip to Costco this weekend proved to me that people are not following the CDC guidelines. Some people are panicking. We witnessed people in masks pushing and shoving each other to check out and a line that was snaking around the entire store. I mean who goes to Costco on a Sunday anyways?? First mistake made.

So I wanted to think about this virus and how the general population, including my own family, should prepare. Here is what we have done to get ready and what I think that you should do too.

Check your soap supply, and wash those hands!

First is the “soap check”. Make sure that you have soap next to all of your sinks—this will encourage handwashing. Seems like a no brainer, right? Just a simple task to help you feel ready. 

Next, remind your family that simply wetting their hands with a splash of water after using the bathroom or sneezing and coughing into their hands is not going to do much of anything. Handwashing success is based on the amount of time that you wash, the friction that you use and the surface of your hands that you actually wash. 

Here are the 5 steps the CDC recommends every time you wash your hands:

  1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  2. Lather your hands by rubbing them together with the soap. Make sure you get the backs of your hands, between your fingers, and under your nails.
  3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  4. Rinse your hands well under clean, running water.
  5. Dry your hands using a clean towel or air dry them.

Now that you have handwashing checked off your list, let’s move onto the next.

Update your health care to the extent possible

Make sure that you are up to date on your health care. What exactly does this mean? Well for starters, have you had your annual flu shot? Have you had your physical visit this year? How about those daily medications? Do you have refills left? 

Right now, influenza is getting forgotten about. Influenza, or the flu, is still in season and deserves some continued attention. The flu is still hitting hard. If you really want to protect yourself and your family, get your flu shot. Wash your hands. Stay clear of sick people. And hey, wash those hands! 

Do you have asthma or a history of wheezing with illness? Now would be the time to make sure you have refills on your albuterol and flovent inhalers and make sure you are familiar with your asthma action plan. Call for refills of your asthma medications so that you have them on hand in case you do catch any sort of respiratory illness (flu anyone?). The last thing that you will want to be doing is going into a germy pharmacy or waiting for a call back from your primary care provider if you suddenly realize you need a new inhaler. Check how many puffs of albuterol are left. Don’t wait until 2am for your refill. Be prepared. 

This goes for anyone with any health conditions. Make sure that your health is tip top. Follow your plan that you were given for your health issue and make sure that you are up to date on medication refills, appointments and hey, while you’re at it, set up auto-delivery of your medications. This will make things easier for you as things get busier around here. 

If you’re already sick…

If you or a member of your household is sick, your best bets in order to prevent the spread of germs are to:

  1. Clean all surfaces, especially door knobs, light switches, and anything else you regularly touch
  2. Wash your hands. Seriously, you can’t wash your hands enough during this time.
  3. Sneeze into your arm or a tissue!
  4. Stay home! Don’t go out and spread germs to others when you are sick with any illness. 

What not to do 

It is not a good idea to scour the internet and pay hundreds of dollars for some strange masks resembling the n-95 mask from Amazon. You really only need a mask if you are a health care provider or if you have COVID-19 and are going out on the town (which you shouldn’t). If you have a respiratory illness and need to be seen in the office or ER, they will give you the appropriate mask. If you happen to catch Coronavirus, then worry about the mask if and when you need it. It will not do you any good now in terms of prevention as they need to be fitted properly and can’t be lifted up for every itch or to talk on your cell phone. The hospital will provide you with the appropriate gear if and when it is time. Masks right now should be saved for providers and personnel taking care of sick patients. Besides, how will you activate your facial recognition on your cell? Better get that passcode ready! 

Also, do NOT go running into the ER with the sniffles or for any old fever for that matter. The Emergency Room was named that way for a reason. It is for emergencies. If you or your loved one look like a wet noodle, won’t perk up, are not drinking at all, have had no urine in over 8 hours, have persistent or worsening pain, are very ill appearing or you are concerned and feel like you should be seen, then head to the ER. Just remember the ER is not a walk-in clinic. Call your primary care provider or pediatrician for your general sick care needs. 

Leverage telehealth tools

The CDC recommends “Leveraging existing telehealth tools to direct people to the right level of healthcare for their medical needs.” Hey, that’s US! Talk to a nurse first, and get the right care. We are also on standby if you can’t get in touch with your provider, or their wait times are too long. We are here to help! Chat with us so we can help you decide the best plan for you and your loved ones. 

The CDC is keeping close tabs on current illnesses and how to keep yourself and loved ones safe. We agree with the CDC and their personal health habit recommendations for your home and hope this gentle reminder will help you too. Keep calm and wash your hands…

Kim Liner, PNP

Nurse-1-1 Chief NP