Thursday, February 11, 2021

TEXT2MD: PANDEMIC-FRIENDLY VIRTUAL HEALTHCARE

NYCRA NEWS recently interviewed Dr. Miguel Antonatos, board certified physician in internal medicine at a major medical center in Chicago, Illinois.. He completed his residency in 2011 at Morristown Memorial hospital in New Jersey (an affiliate of Mount Sinai in NYC) and has mostly worked as a hospital based physician for the last 10 years up to today throughout the pandemic.

Dr. Antonatos is the visionary founder of TEXT2MD.com.  He started with what he considered "a little idea using TELEMEDICINE with local patients". This idea took off quite well when more and more people started asking if he knew any home-based physicians- mostly for those with limited mobility, with frail parents or those who may be at highest risk for infections. He recognized  the many challenges for home-bound patients, making telemedicine and virtual healthcare a reality for so many.  Dr. Antonatos also appreciated the ability to serve so many more patients electronically even while on hospital duty or at home. 



INTERVIEW 1: 
THE NEW WORLD OF DIGITAL INTIMACY & FACE-TO-FACE CARE
Since 2018, I formalized a virtual Home-based physician and called it TEXT2MD.com using the the Medici platform.  This would allow me to schedule my patients starting with mostly text messaging, then we would work together through video conferencing.  I supported programs like weight loss, lifestyle management and men's health consults but I grew a following in so many other areas as a virtual primary care - especially with Covid making doctors' visits a problem for so many.

Part of healing is the ability to directly and closely interact with the patients.  Because of the way our world is today with cell phones being the everyone's social bridge,  my patients are greatly attracted to the comforts of text messaging their doctor.  It's (now) how they talk to their closest friends and family, so being part of this channel raises the appeal for a physician's connectivity.  Better than phone, text lets them remember everything, much like a grocery list or a note pad.

 Where patients are used to scheduling an appointment with the front desk or service for weeks down the road, a medical care platform like this is a more immediate and streamlined connection. It's private, safe and response-friendly during any part of the day, allowing the physician to answer any questions at any given moment, even while on hospital duty. This level of communication access quite priceless.  

As consultations go, I usually coordinate establishing a new patient with a video conference first. This face-to-face creates our people connection. Getting to know one another is critical when it comes to learning how to help the patient and video is very useful for that. Meanwhile earning the patient's trust is equally important, and video (again) is a great way to connect this way.  We can always schedule more video meetings, but after the first F2F consult, texting or emails are the way to go, including prescribing meds or recommending other diagnostic or treatment solutions.

Currently, TEXT2MD can to work with and prescribe medication for patients in 23 states and should have over 31 by the end of February.  We are working to build a complete national access by acquiring licenses in all 50 states. 



THE VIRTUAL HOUSE CALL: A SAFE ALTERNATIVE TO DOCTORS VISITS
Within the past several decades, the medical community has been put into overdrive to come up with new solutions (or modify existing ones) to implement safer, more efficient and cost-effective ways of working with the public. From the global demand for active medical personnel, to the rising wave of safety concerns that of the many at-risk patients, we face a great need to upgrade patient care. Elderly patients with chronic conditions or those with compromised immune systems may find it difficult (and even precarious) to travel to their doctors' office and sit in a waiting room next to strangers with unknown health conditions. Upgrading to an electronic doctor's visit or TELEMEDICINE is an available reality that addresses this concern. http://telemedscans.com/


RESEARCH ON IVERMECTIN (AND OTHER ALTERNATIVE MEDS)

Even before the beginning of the pandemic, I have conducted major research when the first cases in China started.  I followed the theories of this pandemic (and even had to get Chinese documents translated)- then followed it to Italy and joined the Italian society of critical care.  By the time we had our first cases in my hospital, I was a little more prepared than the rest of my colleagues.  Then, the treatment trend was mostly supplements like Vitamin C & Zinc and meds like Hydroxychloroquine to avoid ARDS and other pulmonary complications from Covid where patients end up in the ICU and get ventilated.  (We all followed this from areas like the New England Journal of Medicine).

By March of 2020, I learned about Australian research on Ivermectin and this opened more options for me towards the treatment of COVID.  After a while, I discontinued using Hydroxychloroquine based on a secondary therapy because it didn't  really show much improvement in patients. With more and more literature growing available,  I found the FLCCC (Front Line Critical Care Alliance) and found the data from Dr. Pierre Kory and Dr. Paul Marek to align with my experiences at the hospital as far as inducing high doses of Vitamin C to avoid complications.


Through TEXT2MD, I started implementing Ivermectin mostly through my tele-medicine sessions. Unfortunately most hospitals are not familiar with Ivermectin to apply it on their patients. I wasn't able to treat any patients in the hospital with this, but I definitely felt the necessity of Ivermectin for early therapy to avoid patients from ending up in the hospital where high risk patients increase their mortality dramatically up to 25%.

Since I started implementing Ivermectin for those with symptoms or prophylactically, I have only seen great success for COVID-19. So far we have supported almost 900 patients and we have ZERO hospitalization.  We follow up on every single patient with symptoms each day from the course of their treatment since day one, and not one of them has required hospital admission.  They improved dramatically after one or two doses.  Those who have had tougher symptoms, I follow them daily with the Ivermectin treatment schedule (I-MASK+) with aspirin at 325mg. daily.

Another drug being researched in Canada now is the use of Colchicine for outpatient treatment for COVID to decrease hospitalization rates.  That's something I'm looking to implement alongside the I-MASK+ protocol.  The thing about Colchicine is that you need to be careful.  For elderly patients, there are certain contradictions and side effects.  But definitely, for certain selected patients, colchicine could be a good adjunct treatment.  I have personally treated a few patients already with colchicine with much improvement of their symptoms.

As an out of the box thinker, I always seek out good research from the global stage. I seek out data and validated success to offer new possibilities for medications that can better help patients and areas safe to use.   If the research shows convincing proof of efficacy, I'm open to exploring it.  Ivermectin is just one story; it was widely used in Africa by millions of people resulting in very minimal side effects or complications and a very high rate of response.


VAX REVIEW: FROM THE CANCER CARE COMMUNITY
"The vaccine is something that I'm recommending not only for my family, but all of our patients. This is going to be the way that we hope to stop the spread of this disease... and to make it as a safer place for all of us to be.  It's going to  allow us to shake hands with people again and give hugs again and to see our family members that we haven't been able to see in ages. It is accessibility- and freedom.  I have a lot of patients that are concerned that it was rushed, but these vaccinations go through all the same standard methods of clinical trials. There's no way to cheat that. They still have to go through the same systems and processes that any other vaccination has to go through- so nothing was cheated. This is evidence-based medicine showing us that these vaccines are accurate and they're safe."
Troy Shell-Masouras, MD - Breast Surgeon / Paradise Coast Breast Specialists Comprehensive Breast Center
Naples, Fla.


EPILOGUE: NOTE FROM THE PUBLISHER

By: Dr. Robert L. Bard
NYCRA-NEWS and Prevention101.org reports on innovators in healthcare as part of our global mission to provide new options and current resources in support of complete wellness. We found the creative vision of the "digital house call" of Dr. Antonatos' plan to offer what might just be the framework to the future of home-based healthcare.  His effective use of TeleHealth and remote collaboration technology shows the potential of advancing the doctor-patient access, while also offering a safer and more affordable alternative to our current personalized care solutions.  Upon further review (during and beyond our interview), his business model of Text2MD appears to offer a streamlined model in time-management for all physicians.  

A year into the Covid pandemic, access to medical care continues to recover.  Even with the vaccine in our midst, patients and all healthcare workers alike continue the fear for contamination- such that TRUSTING in the return to our old patient care format does not seem possible.  This dilemma begs for new ideas, but our Covid era also calls for faster real-time medical response solutions. We support expanded education and the type of research employed by Dr. Antonatos about proven drugs like IVERMECTIN, COLCHICINE and the other solutions that bring significant results in other countries.   It is this type of expanded information gathering that raises the bar in the medical community and adding new answers to all health concerns- including our pandemic.   

This form of leadership reflects on the adage that "it takes a crisis to bring worlds and minds together to a solution that unites us all"



HEALTH & SAFETY MOVEMENT 2021: "GET THE SHOT" - NYCRA NEWS and PREVENTION101 continues its mission to share the viewpoints of experts, renowned educators and health advocates in the spirit of expanding public knowledge. For this series, we connect with healthcare worker Dr. Michael Schulder, a leading Northwell Health neurosurgeon in Manhasset, NY. He is one of the first to share his insights and his personal research on the safety and efficacy of the recently deployed Coronavirus vaccine. Dr. Schulder also addresses his views on public skepticism about the vaccine over some of the unknown factors of the coronavirus. He shares his confidence in the science and the preventive strategy of the vaccine as well as its social impact on the global stage.  See Feature article


PAVING MEDICAL HISTORY FROM THE FRONT LINES: THE ULTRASOUND MOVEMENT From a military call of duty in Thailand (1921) to a Post-9/11 First Responders Cancer Screening program to the first Covid-19 triage units in Italy, ultrasound imaging has evolved to support medical diagnostic needs of all FRONT LINES. Both Dr. Robert Bard and the many scanning benefits of ultrasound technology have dedicated an entire work history of responding to some of the highest demands in emergency scanning  (See Feature article)





MEDICAL IMAGING REVIEW: WHAT DOES A COVID LUNG LOOK LIKE? -
All research and testing programs undergo an evolutionary staging of its data-gathering and problem solving approach. In the case of testing for the physiological effects of Covid-19, researchers have employed standard medical diagnostic protocols from genetic/blood testing to biopsies to all available medical imaging devices) to gather all necessary data.  These protocols independently and in concert provide the necessary answers leading to treatment, prevention and early detection.  (See Feature article)


What's REALLY in the Air?  - Reviewing the Presence of SARS-Cov-2 Recent headlines show evidence of Coronavirus pathogens in hospital air supply and air passageways- creating a systemic hazard for the staff and patients under critical care. Reports showing "substantial controversy whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted through aerosols.Initiatives are in full swing from health departments and hospital safety leaders to advance sanitization measures and decontamination initiatives in hospitals. Agencies indicate that without adequate environmental controls, patients with airborne infectious disases will pose a risk to other patients and healthcare workers. Heating, Ventilation and Air Conditioning (HVAC)  expertise is essential for proper environmental management when planning control of airborne infectious disease outbreaks. (see feature).






Disclaimer & Copyright Notice: The materials provided on this website/web-based article are copyrighted and the intellectual property of the publishers/producers (The NY Cancer Resource Alliance/IntermediaWorx inc. and Bard Diagnostic Research & Educational Programs). It is provided publicly strictly for informational purposes within non-commercial use and not for purposes of resale, distribution, public display or performance. Unless otherwise indicated on this web based page, sharing, re-posting, re-publishing of this work is strictly prohibited without due permission from the publishers.  Also, certain content may be licensed from third-parties. The licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.

Saturday, January 23, 2021

THE PULSE OXIMETER + SMART WEB SEARCHING

 Does the Pulse Oximeter Belong in Your Home Health Monitoring Kit?
by: Dr. Robert L. Bard


Almost a year into the pandemic, we have seen waves of empty shelves of specific items due to panic shopping or the recent burst of proactive health trends. This reflects a significant part of "the Covid Culture"- comprising the demand for personal safety measures (beyond the holy trinity of masking, distancing and hand hygiene).  A large part of our population also subscribes to proactive health measures  in the home which includes a daily regimen of immune-boosting health supplements.  In addition, more and more drug store shelves continue to stock up on self-check devices including the hand-held infrared THERMOMETERS, BLOOD PRESSURE CUFFS, SPIROMETERS and THE PULSE OXIMETER.     


THE PULSE OXIMETER- is an electronic device that clips onto a patient’s finger to measure heart rate and oxygen saturation in his or her red blood cells—the device is useful in assessing patients with lung disease. 

According to a report from the Yalemedicine.org, "Pulse oximeters started to fly off store (and online) shelves when people learned that low oxygen saturation levels can be a sign of COVID-19.  The logic is that shortness of breath, a symptom of the disease, may not be easy—or even possible—for a person to reasonably self-assess. What’s more, doctors report that some COVID-19 patients suddenly develop a condition called “silent hypoxia,” where people look and feel comfortable—and don’t notice any shortness of breath—but their oxygen levels are dangerously low. It happens to patients both in the hospital and at home, but it is a particular problem in the latter case because the symptom may indicate severe COVID-19-related pneumonia, requiring a ventilator. That’s why some people may want or need to monitor their oxygen saturation levels at home." [1]

There are various schools of thought when it comes to this device. Physicians often use this as a preliminary for gathering a patient's vitals.  Though highly useful for its quick and portable data-grab, common belief is that the oximeter is not relied upon for more than this.  In fact, interviews with paramedics have recommended the use of the Capnograph vs. the Oximeter as a portable diagnostic for presence of lung disease and forms of congenital heart disease. [2]

The idea of home testing remains a valid protocol for wellness maintenance and prevention, and having a small arsenal of home testing devices (if used correctly) can certainly support this. Regular self-checks of one's circulatory performance strongly supports a lifestyle of safety and survivorship from the pandemic and disease in general.   But nothing tops primary monitoring like watching for coughs, shortness of breath, muscle pain and loss of taste and smell [1]. 


How to get a Proper OxySat Reading
 
In symptomatic patients, monitoring with HOME PULSE OXIMETRY is recommended (due to asymptomatic hypoxia). The limitations of home pulse oximeters should be recognized, and validated devices are preferred. Multiple readings should be taken over the course of the day, and a downward trend should be regarded as ominous. Baseline or ambulatory desaturation < 94% should prompt hospital admission.  The following guidance is suggested:

o Use the index or middle finger; avoid the toes or ear lobe 
o Only accept values associated with a strong pulse signal
 
o Observe readings for 30–60 seconds to identify the most common value
 
o Remove nail polish from the finger on which measurements are made
 
o Warm cold extremities prior to measurement 

[3] Source: FLCCC.net (Front Line Covid-19 Critical Care Alliance) / Contributor: Dr. Pierre Kory



The ARDS / Covid-19 Connection?
Acute Respiratory Distress Syndrome (aka: Acute Lung Injury / Noncardiac Pulmonary Edema) is a serious lung condition that causes low blood oxygen where fluid builds up inside the tiny air sacs of the lungs (alveoli).  This condition disables air from properly entering the lungs and moving enough oxygen into the bloodstream and throughout the body. [4]   
Experts from Yale Medicine state that "when the virus that causes coronavirus disease enters the body, it frequently attaches to cells in the upper airway... When this occurs, COVID-19 can lead to ARDS, typically setting in about eight days after the onset of initial symptoms. Certain risk factors increase the likelihood of the development of ARDS in people with COVID-19, including advanced age, diabetes, and high blood pressure". [5]





Covid-19 Resources: WHO (and HOW) to Believe 
"In our complex information age, what we choose to believe defines us." The explosion of materials about the Coronavirus pandemic has reshaped the relationship between digital media and public readership. Today's web searcher is inundated by a tsunami of information, such that selective and intelligent searching, fact-checking and source-validating (or vetting) has become a major necessity in the daily course of education through the web.  

The widely promoted prevention protocols (of masking, distance and hand hygiene) have conditioned us all toward proactive health consciousness- driving us to want to learn more and stay in touch with the current pandemic updates.  Public health agency sites like  CDC.govNIH.gov and the WHO.int are some of the top sources for these updates, offering a comprehensive list of resources and the latest proven information on personal safety, care, prevention and treatment solutions. 

Meanwhile, medical experts and societies have also joined this worldwide coalition for public awareness and info-sharing. One such association is the IDSA (Infectious Disease Society of America), a 50+ year old community of public health experts allied with major groups like the American Federation for Clinical Research (AFCR), the American Society for Clinical Investigation (ASCI), and the Association of American Physicians (AAP). The ISDA formed a branch called the Covid-19 Real-Time Learning Network, featuring a complete, well-maintained resource forum for the general public and the medical community. (see: link)  This type of institutional resourcing brought full access to expert information, empowering the proactive researcher to a wider level of understanding- from current health news, updates on Covid safety guidelines and infection prevention.




How Healthcare Pros Battle the Pandemic

Due to the many risks in outpatient care, I hope that my receiving the first dose and publicly promoting it will encourages cohorts, colleagues, patients and others to follow suit in registering to receive theirs.  Pfizer, Moderna and so many others are reputable Biotech/Pharm companies with a long history of success in their respective field.  This vaccine stands for so much today in the eye of public health and science. With the advancements in science, the opportunity to push forth with mRNA vaccines for other diseases and viruses sheds light on future health. With early work showing a 94/95% success rate, that demonstrates and presents an opportunity for those at risk for getting ill, or those at high risk due to comorbidities of getting ill a sense of hope and resolution.  The question will be- for how long? 

As for prevention and prophylaxis, constant hand washing and gloves have always been a part of my routine, however face masks will definitely become an everyday routine.  I have always been an advocate for overall wellness and health.  At present, I personally find comfort in taking daily multivitamins in addition to vitamin C, Vitamin D and Zinc, all of which “may help in supporting a healthy immune system.  I encourage others to be sure to consult with their pharmacist to discuss possible interactions and to consider taking as well.   

Image Source: Evan Ludin's Linkedin post



Additional Features:

HEALTH & SAFETY MOVEMENT 2021: "GET THE SHOT"
NYCRA NEWS and PREVENTION101 continues its mission to share the viewpoints of experts, renowned educators and health advocates in the spirit of expanding public knowledge. For this series, we connect with healthcare worker Dr. Michael Schulder, a leading Northwell Health neurosurgeon in Manhasset, NY. He is one of the first to share his insights and his personal research on the safety and efficacy of the recently deployed Coronavirus vaccine. Dr. Schulder also addresses his views on public skepticism about the vaccine over some of the unknown factors of the coronavirus. He shares his confidence in the science and the preventive strategy of the vaccine as well as its social impact on the global stage.  See Feature article

MEDICAL IMAGING REVIEW: WHAT DOES A COVID LUNG LOOK LIKE?
All research and testing programs undergo an evolutionary staging of its data-gathering and problem solving approach. In the case of testing for the physiological effects of Covid-19, researchers have employed standard medical diagnostic protocols from genetic/blood testing to biopsies to all available medical imaging devices) to gather all necessary data.  These protocols independently and in concert provide the necessary answers leading to treatment, prevention and early detection.  (See Feature article)



References

1) Yale Medicine: Should You Really Have a Pulse Oximeter at Home? By: K. Katella 5/8/2020 / https://www.yalemedicine.org/news/covid-pulse-oximeter

2) Capnography: Wikipedia source (link)

3) Front Line Covid-19 Critical Care Alliance / FAQ: https://covid19criticalcare.com/

4) Acute Respiratory Distress Syndrome: https://www.nhlbi.nih.gov/health-topics/acute-respiratory-distress-syndrome

5) Yale Medicine: What is the relationship between COVID-19 and ARDS? https://www.yalemedicine.org/conditions/ards



CONTRIBUTORS (in order of appearance)


ROBERT L. BARD, MD, PC, DABR, FASLMS
Advanced Imaging & Diagnostic Specialist & recipient of the 2020 nationally acclaimed Ellis Island Award for his lifetime achievement in advanced cancer diagnostic imaging. Dr. Bard co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- www.CancerScan.com



PIERRE KORY, M.D., M.P.A.
Board Certified in Internal Medicine, Critical Care, and Pulmonary Medicine. He served as the Medical Director of the Trauma/ Life Support Center at the University of Wisconsin. Most recently, Dr. Kory joined the emergency volunteer team during the early COVID-19 pandemic in NYC at Mount Sinai Beth Israel Medical Center. He is also a founding member of the Front Line COVID-19 Critical Working Group. (www.covid19criticalcare.com/)



EVAN M. LUDIN, MS, OTR/L, CHT
Practices in the Commack community, specializing in orthopaedic rehabilitation and splinting for sports related injuries, as well as fabricating custom mold splints for post-op care and conservative management of CTS, DeQuervains, trigger finger, arthritis, wrist fractures, elbow & forearm fractures.  He works alongside many Stony Brook University MD's listed in "Top Docs" for 20 years, in addition to the many other Orthopaedic and Plastic Surgeons.  (www.Ludinhandtherapy.com)


Disclaimer & Copyright Notice: Copyright (c) 2021, IntermediaWorx inc. All Rights Reserved.  Additional copyrights shared by: The AngioFoundation (501c3) and the publishers of Prevention101.org  & The NY Cancer Resource Alliance [NYCRAlliance.org].  Contents in this article are provided publicly for informational purposes within non-commercial use and not for purposes of resale, distribution, commercial display or performance. Unless otherwise indicated on this web based page, no reproduction of any or all materials of this page is allowed without express/written permission from the publishers.  Additional permission may be required from third-parties who have provided limited permission for our publishers to use their content, whereas licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.

Tuesday, January 19, 2021

"GETTING THE SHOT" (part 2)- with Rebecca Nazario

Prevention101.org is proud to introduce our next pandemic health support advocate, Mrs. Rebecca Nazario, vice president of Consultative Care for The Medical Group of ChristianaCare (a major Delaware healthcare provider and private employer).  With a longstanding leadership career in the healthcare industry, Rebecca is responsible for the strategic and operational direction of ChristianaCare's specialty services, including their Helen F. Graham Cancer Center & Research Institute, the Center for Heart & Vascular Health, and over 10 additional sub-specialty departments including Endocrinology and Neurology. This work includes bringing to life their momentous initiatives around Population Health for the Delaware community and its surrounding areas.  

Through LinkedIn, we recently noted Mrs. Nazario's efforts to shed light and add support to ChristianaCare’s efforts to roll out the vaccine to employees – which ChristianaCare refers to as “caregivers” and the community. She modeled these efforts both by getting vaccinated and helping her colleagues register for the first dose of the vaccine. 


A Move Towards Progress...TOGETHER!
Getting the vaccine is a key way that we can protect ourselves, our families, our community and our colleagues. The vaccine is safe and effective. Although its development happened quickly, it went through all the same kinds of testing and rigorous approval that any vaccine does.  

I posted my selfie on LinkedIn "getting the shot" because there's so much apprehension out there... especially in our minority communities.  As a Cuban American I know there’s a lot of the mistrust and fear is based on rumors that run rampant through our communities, not the science.  I strongly believe we can lead through example, and a picture is worth a thousand words! My goal is to be a small drop that creates a lot of ripples that ultimately instills more confidence. We need to empower each other to pass that message along, and dispel the rumors in whatever way possible.

United Global Network
It will take time to get everyone vaccinated. Therefore, in order to maintain the progress we are making in this pandemic we need to ensure we are also inhibiting further spread of the virus. Everyone can do this by wearing our masks properly when in public or around others, maintaining good hand hygiene with frequent washing or sanitization, and remaining socially distant when necessary.    

One other strong recommendation I have is that if you have any questions or concerns about the vaccine, or you want to get more specific information about what this process would mean for you, speak to your primary care provider. Your primary care provider can be a great resource for information, especially applicable to your specific healthcare needs and concerns. If you do not have one, now is the time to get one. If you are worried about going to a doctor's office and getting exposed, it’s important to know that many hospitals and doctors’ offices now offer virtual visits through your phone or computer. ChristianaCare, for example, developed a strong virtual primary care practice, as well as subspecialty access to virtual visits for many specialists, like an endocrinologist for diabetes or a behavioral health specialist for behavioral health needs, so you can access timely care. 

Remember that through knowledge and communication you can keep yourself and your loved ones safe and healthy. 




ChristianaCare has been vaccinating its caregivers and the community during the COVID-19 pandemic. These sample video clips are part of their Covid-19 Vaccine FAQ section.  It is filled with the most insightful information about this treatment protocol. For more videos on this topic, visit: https://christianacare.org/coronavirus-vaccine/
 After the vaccine, do I still need to wear a mask? YES. Not enough information is currently available to say if or when CDC will stop recommending that people wear masks and avoid close contact with others to help prevent the spread of the virus that causes COVID-19. The combination of getting vaccinated and following CDC’s recommendations to protect yourself and others will offer the best protection from COVID-19. 

What side effects can I expect? It is important to know that the side effects are your body’s way of telling you that it is mounting an immune response to protect you from COVID-19. Data from the clinical trials, which included tens of thousands of participants, show that side effects of the vaccine are typically mild, and they are more common after the second dose than the first dose. 
For more information, visit www.cdc.gov/coronavirus



ADDITIONAL FEATURES:

HEALTH & SAFETY MOVEMENT 2021: "GET THE SHOT"
NYCRA NEWS and PREVENTION101 continues its mission to share the viewpoints of experts, renowned educators and health advocates in the spirit of expanding public knowledge. For this series, we connect with healthcare worker Dr. Michael Schulder, a leading Northwell Health neurosurgeon in Manhasset, NY. He is one of the first to share his insights and his personal research on the safety and efficacy of the recently deployed Coronavirus vaccine. Dr. Schulder also addresses his views on public skepticism about the vaccine over some of the unknown factors of the coronavirus. He shares his confidence in the science and the preventive strategy of the vaccine as well as its social impact on the global stage.  See Feature article


MEDICAL IMAGING REVIEW: WHAT DOES A COVID LUNG LOOK LIKE?
All research and testing programs undergo an evolutionary staging of its data-gathering and problem solving approach. In the case of testing for the physiological effects of Covid-19, researchers have employed standard medical diagnostic protocols from genetic/blood testing to biopsies to all available medical imaging devices) to gather all necessary data.  These protocols independently and in concert provide the necessary answers leading to treatment, prevention and early detection.  (See Feature article)



Ever since the early pandemic, when quite a few healthcare providers got sick, INFECTION CONTROL was really consistent with what you needed in order to operate in a clinical area, whether it's COVID or any other event. The routine mask wearing regular hand-washing and gown donning has gotten us all through.  Based on TONS of epidemiologic data, which shows that the incidence of infection and transmission plummets when you have a certain percentage of people even wearing standard masks. ...If everybody around you is wearing a mask, (as well as you) the dual mask wearing is as good as if one of you had an N95 to protect themselves. And the reason for that is because those tiny droplets that you can inhale are bursts from larger droplets. And if you're wearing any covering the big spindle or the large droplets that emit when you talk, they all get trapped in those standard masks. They're actually quite protective. 


Disclaimer & Copyright Notice: Copyright (c) 2021, IntermediaWorx inc. All Rights Reserved.  Additional copyrights shared by: The AngioFoundation (501c3) and the publishers of Prevention101.org  & The NY Cancer Resource Alliance [NYCRAlliance.org].  Contents in this article are provided publicly for informational purposes within non-commercial use and not for purposes of resale, distribution, commercial display or performance. Unless otherwise indicated on this web based page, no reproduction of any or all materials of this page is allowed without express/written permission from the publishers.  Additional permission may be required from third-parties who have provided limited permission for our publishers to use their content, whereas licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.

Friday, January 15, 2021

"GET THE SHOT!" - Taking the Covid Vaccine (part 1)

NYCRA NEWS and PREVENTION101 continues its mission to share the viewpoints of experts, renowned educators and health advocates in the spirit of expanding public knowledge. For this series, we connect with healthcare worker Dr. Michael Schulder, a leading Northwell Health neurosurgeon in Manhasset, NY.  He is one of the first to share his insights and his personal research on the safety and efficacy of the recently deployed Coronavirus vaccine.  Dr. Schulder also addresses his views on public skepticism about the vaccine over some of the unknown factors of the coronavirus.  He shares his confidence in the science and the preventive strategy of the vaccine as well as its social impact on the global stage.


VACCINE CONFIDENCE FROM A HEALTHCARE WORKER
Transcript by: Dr. Michael Schulder

As of now, there has been no requirement to take the Coronavirus vaccination.   I chose to “get the shot” because it is my belief that you can't practice any kind of medicine (neurosurgery included) if there's not some element of trust in the peer review process (or) in the general research process.  This process has been overseen by academic organizations and by governmental organizations such as the Centers for Disease Control (CDC) and the Food and Drug Administration (FDA). So we need to accept this as a baseline allowing for the fact that though human errors may occur, those errors tend to flatten out over the course of large studies that involve a much larger number of people. That's what makes those results credible. 

When vaccine trial results had been reported, it involved tens of thousands of people over months, clearly reporting no major side-effects. I believe the randomization to these trials was done on a 2:1 basis, where two thirds or of people got the vaccine. If there were going to be major safety concerns, we would've known about it for sure, because it would have happened during these trials. This is equally true if the randomization was 1:1.

The underlying science of the messenger RNA (or mRNA) based vaccines from Pfizer and Moderna is understandable and makes sense. The descriptions of the safety of the vaccines are credible and I'm relying on all those things for safety. Regarding efficacy, it is natural to have some skepticism because the idea of a 90- 95% infection prevention rate sounded too good to be true. Many of my colleagues and I have many curbside conversations about this sort of thing. If it was going to be as good as the flu vaccine, meaning an est. 70% infection prevention rate, that's still pretty darn good, especially if societally, it gets us ultimately to herd immunity. Either way, this is really why I and many people who work in my field signed up to get vaccinated as soon as possible.

WHAT DOES IT MEAN- AND WHAT IT DOESN’T MEAN TO BE VACCINATED?
Yes, you still need to mask up and social distance! The vaccine is not an invisible shield -- and it's only part of the ongoing process that we need to do to finally suppress the virus and get out of the pandemic. Even if it is 95% efficacious, it's still not enough... it's still 5% non-efficacious.  Antibacterial antibiotics don't work 100% of the time. If you're one of those 95 out of a hundred people for whom it's going to be effective, you won't get infected or develop the COVID-19 illness. But nobody wants to be in that 5%.

What we don't know is whether you can still transmit the virus; that's still an unknown.  But in advance of you getting vaccinated, we don't know if you're going to be one of the people who still gets infected despite the vaccine.  Our societal goal is not to use the virus to prevent infection in everybody. It's to create herd immunity like the smallpox, polio and the MMR (measles, mumps and rubella) vaccines that have made those illnesses no longer a public health threat to the general population -- (and) get us to the point of eradicating it. The CDC states that “the goal is to make coronavirus like the common cold… it'll be around… you might get some seasonal illness from it, but it won't be a pandemic”--  and it won't be life-threatening in the way that it has been over the last 10 months.

I posted my message in social media in response to the many billions worldwide currently affected by this virus socially, economically and physically.  I urge my colleagues to get vaccinated and to get the word out there that it's safe and it's effective and everyone should do it ASAP.


VIEWPOINTS

STEPHEN A. CHAGARES, MD FACS- Cancer Surgeon/ General,Laparoscopic, Robotic Surgery
 
“A popular concern from people is contracting the virus from this vaccine; NO, it's a piece of RNA, and not a live virus. For this m-RNA virus, the vaccines that we have out now are extremely effective- over 95%.  And for that other theory that 'they rushed the vaccine'... this vaccine came about when the government elected to fund over 125+ labs at once- researching and developing a working vaccine.  They collected all that data, totaling about 62.5 years’ worth of science bunched into six months. And now that we can duplicate genetic sequencing, it's really helping to plug it in. So that even in the future, as other viruses come up, the companies are now able to plug that new RNA, whether it's M-RNA -- they'll be able to plug that in and put out a vaccine even quicker because now they have the technology to do it."


"As a surgical oncologist predominantly taking care of patients who have cancer ...I believe it's important that all healthcare providers be advocates and be transparent about their experiences.  I would like to encourage my patients to get the vaccine but also those in communities where there's a lot of medical mistrust and they may not have the resources to learn about it. Currently, I am seeing a big drive in the healthcare community, probably 80-90% of physicians are getting the vaccine! I know in Texas are enthusiastically receiving it because they want to protect their immunocompromised patients, whether they be patients who are actually on immunosuppressive or getting chemotherapy, or they're elderly patients, diabetics who otherwise would have risk factors. Healthcare providers are definitely stepping forward and getting vaccinated more than I thought..."  [The info provided in this statement is published - 3/17/2021]

ELLEN MATLOFF- Genetic Counselor/Founder - My Gene Counsel, LLC
"(As of) today, more than 65M Americans have now received at least one dose of 1 of the 3 Covid-19 vaccines that currently have FDA approval in the United States (Pfizer, Moderna, J&J). That means that approximately 21% of all Americans have now received at least one vaccine dose. Yes, many people remain concerned to get a vaccine when their turns comes up in line. These concerns are understandable, and we should be empathetic to people feeling these concerns, since all 3 vaccines were developed in less than one year. However, we need to balance the risks of the vaccine against the risk of getting Covid-19, spreading it to friends, family and others, and developing long-hauler effects from Covid-19 that may last weeks, months, or may be permanent. "  [The data provided in this statement is based on the date of this entry - 3/15/2021]


REBECCA NAZARIO, MBA -  VP of Consultative Care /The Medical Group of  ChristianaCare
 Getting the vaccine is a key way that we can protect ourselves, our families, our community and our colleagues. The vaccine is safe and effective. Although its development happened quickly, it went through all the same kinds of testing and rigorous approval that any vaccine does.  I posted my selfie on LinkedIn "getting the shot" because there's so much apprehension out there... especially in our minority communities.  As a Cuban American I know there’s a lot of the mistrust and fear is based on rumors that run rampant through our communities, not the science.  I strongly believe we can lead through example, and a picture is worth a thousand words! My goal is to be a small drop that creates a lot of ripples that ultimately instills more confidence. (see complete article)



"Due to the many risks in outpatient care, I hope that my receiving the first dose and publicly promoting it will encourages cohorts, colleagues, patients and others to follow suit in registering to receive theirs.  Pfizer, Moderna and so many others are reputable Biotech/Pharm companies with a long history of success in their respective field.  This vaccine stands for so much today in the eye of public health and science. With the advancements in science, the opportunity to push forth with mRNA vaccines for other diseases and viruses sheds light on future health. With early work showing a 94/95% success rate, that demonstrates and presents an opportunity for those at risk for getting ill, or those at high risk due to comorbidities of getting ill a sense of hope and resolution..." (see full interview)


* Opinions expressed in this VIEWPOINTS section are supportive comments about the contents of this article and are solely those from the contributors credited.



The ARDS / Covid-19 Connection?
Acute Respiratory Distress Syndrome (aka: Acute Lung Injury / Noncardiac Pulmonary Edema) is a serious lung condition that causes low blood oxygen where fluid builds up inside the tiny air sacs of the lungs (alveoli).  This condition disables air from properly entering the lungs and moving enough oxygen into the bloodstream and throughout the body. [4]   
Experts from Yale Medicine state that "when the virus that causes coronavirus disease enters the body, it frequently attaches to cells in the upper airway... When this occurs, COVID-19 can lead to ARDS, typically setting in about eight days after the onset of initial symptoms. Certain risk factors increase the likelihood of the development of ARDS in people with COVID-19, including advanced age, diabetes, and high blood pressure". [5]





Covid-19 Resources: WHO (and HOW) to Believe 
"In our complex information age, what we choose to believe defines us." The explosion of materials about the Coronavirus pandemic has reshaped the relationship between digital media and public readership. Today's web searcher is inundated by a tsunami of information, such that selective and intelligent searching, fact-checking and source-validating (or vetting) has become a major necessity in the daily course of education through the web.  

The widely promoted prevention protocols (of masking, distance and hand hygiene) have conditioned us all toward proactive health consciousness- driving us to want to learn more and stay in touch with the current pandemic updates.  Public health agency sites like  CDC.govNIH.gov and the WHO.int are some of the top sources for these updates, offering a comprehensive list of resources and the latest proven information on personal safety, care, prevention and treatment solutions. 

Meanwhile, medical experts and societies have also joined this worldwide coalition for public awareness and info-sharing. One such association is the IDSA (Infectious Disease Society of America), a 50+ year old community of public health experts allied with major groups like the American Federation for Clinical Research (AFCR), the American Society for Clinical Investigation (ASCI), and the Association of American Physicians (AAP). The ISDA formed a branch called the Covid-19 Real-Time Learning Network, featuring a complete, well-maintained resource forum for the general public and the medical community. (see: link)  This type of institutional resourcing brought full access to expert information, empowering the proactive researcher to a wider level of understanding- from current health news, updates on Covid safety guidelines and infection prevention.




Michael Schulder, MD, is vice chair of neurosurgery at North Shore University Hospital and Long Island Jewish Medical Center. He is director of the Brain Tumor Center at Northwell Health's Institute for Neurology and Neurosurgery, co-director of the Center for Stereotactic Radiosurgery and program director of neurosurgical residency training at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, where he is a professor of neurosurgery. A practicing neurosurgeon for more than 30 years, Dr. Schulder is expert in a full range of brain surgery techniques. His particular areas of focus include image-guided brain tumor surgery, stereotactic radiosurgery and functional neurosurgery.



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