Moving Forward: How to Live, Thrive and Stay Safe with COVID-19


May 7, 2020
Featuring Dr. Laura Connelly-Smith, Associate Professor of Medicine and the Assistant Medical Director of Apheresis and Cellular Therapy at Seattle Cancer Care Alliance, who will share her expertise and wisdom. Jennifer Gillette, our LINK licensed staff social worker.

Notes

Professional Speaker

Dr. Laura Connelly- Smith, MD

Assistant Medical Director Apheresis and Cellular Therapy, Seattle Cancer Center Alliance

We are three months past our first documented United States Coronavirus case.  The main ways to prevent contracting COVID 19 is to wash hands frequently for 20 seconds, to sanitize that which we can, to wear masks, and to be socially distant (6ft or more).

We need healthy levels of T and B cells to have good immunity.  Most people that have had a transplant within the last year or two or have Chronic Graft versus Host Disease, have some level of decreased immunity.  Ask your doctor if your bloodwork or conditions indicate whether you are at a higher risk for infection.

What do I need to do if I think I have it?

Call your doctor and discuss your symptoms.  He or she will probably have you go get tested.

Remember, most people show minimal or mild symptoms.

If you receive a positive test result, self-quarantine for at least two weeks.  Stay in one room, preferably with its own bathroom.  If you must share a bathroom, wipe it down after each use with a disinfectant.

Have frequent check ins with someone to be monitored.

Health care workers will usually call you daily to assess you.

If you have shortness of breath, pain in the chest, confusion, blueish lips, if someone is hard to arouse, or any other major concerns, take them to emergency/call their doctor.

No drug has been found to be safe and effective in treatment.  However, Remdesivir has been shown to decrease the duration of the virus.

Hydroxychloroquine is still being investigated as there are possible cardiac issues.

Using plasma from individuals that have recovered from COVID19 is currently being studies in ongoing trials as well.

The NIH has made guidelines on how to treat COVID19.  https://www.covid19treatmentguidelines.nih.gov/whats-new/

We are studying antibodies right now to see how this can help us mange this disease in the future.  We are trying to discover if contracting the virus once prevents you from catching it again.  We are also trying to make sure tests are reliable.  No antibody test is 100% valid currently but we are working on it.

19 organizations are working on a vaccine.  PLEASE get the vaccine when it comes.

Limit clinic visits if possible but do not cancel necessary medical care.  Consider asking if some visits can be done remotely.

It is best to not have your caregiver with you at appts right now.  They could wait in the car in the parking lot and phone in to the appointment with them.

Many transplants have been put on hold, but many will start happening around the end of May.

Ask about risks and benefits of care you are receiving.

Once restrictions are lifted, it is still best to live differently for now such as;

Do not allow anyone in your home if you or they show any signs of illness.

Avoid travel.

Avoid crowds and large gatherings.

Wear masks, wash hands, and use social distance.

Avoid touchscreens.

Discard masks if wet or dirty.

Do not touch your face.

Do anything remotely that you can.

Make sure caregivers take precautions.

Talk to your doctor about his or her recommendations.

Be compliant with your medications and treatments.

Avoid smoking.

Eat healthy, sleep, and exercise.  Increase protein.

Use your faith

Limit stress.  Stress ramps up inflammation which makes you more susceptible.

Do not isolate fully.  Reach out in safe ways.

Get information from only reputable resources and limit social media.

If you are concerned about returning to work, talk to your doctor about your concerns and ask your employer for accommodation.

Stay informed as we are learning new information every day.

Question?  Will we be stuck inside all summer?

                     This depends on your state, how many cases are present near you, if we begin to

                      experience a second wave, and your individual immunity.  If some things are open

                      like a beach, still be distant and wear a mask.  This virus will be around a while.

Question?  Can we visit our parents?

                     Once restrictions are loosened, you can without hugging, wearing a mask, and being

                     extra cautious.

Jennifer Gillette, LMSW- Staff Social Worker at nbmtLINK

How have you moved forward from personal crisis before, wars, the loss of loved ones, Katrina, 9/11.?  I first want you to think about one of your most challenging times, what skills did you use to move forward?  Exercise those tools again first as we know they have helped you before.

Dealing with fear during these times

Ask your doctor how cautious you should be– counts, ways to handle situations, nurses too, ask if you are immunosuppressed( some people go overboard and decrease the quality of life they fought so hard to preserve)

Minimize unnecessary exposure and perhaps look for creative ways to be a part of moments if you are advised to hold back.  Keep in mind if you are told to take precautions that you are investing in your future and those who love you.  Find ways to interact with less risk.

Understand that you might feel uncomfortable for a while.  Be aware of your triggers and find ways to push yourself a little beyond your comfort zone each time.   Exposure therapy. Are there any lies or “half-truths” associated with these thoughts?    Find ways to soothe yourself with power statements or mantras

Combat thoughts that feed fear  Thoughts create feelings that make behaviors.  An effective tool for working through thoughts is called Cognitive Behavior Therapy, CBT.  CBT combats “Record player thoughts”.  You can also ease these thoughts that keep replaying by finding activities that calm, distract, allow you to vent emotionally and physically.  If you cannot control them and it has been a heavy feeling that has lasted a couple weeks, consider talking to a professional/medication.  Thought distortions- black and white thinking, bad things will always happen to me(overgeneralizing), etc. 

Be realistic, it is okay to not be okay all the time.  If it is affecting how you function, if it is heavy for a couple weeks or more, or you cannot think about anything else, that is certainly reason to ask for help.  However, it is normal that we are not perfectly fine through a time like this.

Minimize things that feed fear– too much news, overly anxious people, over caffeinating/stimulation, highly stressed lifestyle, lack of boundaries, etc.  Perhaps consider journaling fears and fighting them on paper.  What evidence do you really have for this fear?  At the same time, maybe make a list of everything going well, a gratitude list if you will.  At the same time, feed the opposite of fear which is peace- do more of what brings you peace mentally, spiritually, and physically.

Allow yourself a little more rest- chaos drains energy.  Being overly tired can make us more emotional too.

Learn to advocate for yourself and communicate your needs.  If you are expected to reenter the work world too soon, perhaps get a note from your doctor explaining you being at heightened risk and it is advised you work remotely if possible, for a longer period.  If you have a doctor’s appointment or labs to get, call ahead and ask when the office is less busy or if you can wait in your car and they text you when it is your turn to minimize waiting in a room with others.

Some fears beyond your health accompany this.  For example, many have been hit hard financially during this pandemic.  First, remember we have many resources on our facebook page, consider liking our page to keep you updated beyond our website.  Remember to reach out to any companies you might need grace with.  Consider loans from either the bank/govt or even home equity if necessary.  Many sites have some great resources compiled for those fighting cancer during this crisis such as Imerman’s Angels, Cancer Care, AARP, LLS, United Way, Triage Cancer and more.  Look at what support is available to you and be flexible with your thinking.  For example, they may offer help with utilities.  Using this frees up this money for what you really need.