Cast & Curious

Tag: pandemic

  • Coping with Pandemic Induced Stress

    In early 2019, I was assigned several innovative projects because of technical, educational and administrative “troubleshooting” abilities. I was happy with what I considered as a promotion, embracing additional responsibilities to a mildly busy orthopedic practice and academic duties. The projects entailed mostly online work, with few face to face meetings as needed.

    Inspite of my supposedly “stress-proof” lifestyle, stress began creeping in early January of 2020. I was trying out some “stress mitigation tactics” when this pandemic happened.

    Stress, is at a unprecedented level.

    My adult life was about balancing the pursuit of dreams, self care and positive contributions to society. Many medical professionals eat stress for breakfast and most survive, unscathed. We’re “stress-proof” so to speak. We’re confidently resilient, agile and unbending to “pressures” . When COVID-19 pandemic came, I’m confident about surviving stress. One year after and though I’m alive and coping, I’m still trying out new things to stress proof my life inside a bubble.

    I’m having a hard time “managing” this unprecedented level of stress.

    Here’s the deal. I am very much interested in how you, a medical professional, is coping with this pandemic induced stress. I’m an action guy and I like knowing details or specifics of your coping mechanisms. Verb, I repeat specifics and the context of its application. Yes, you may include all those memes, tiktoks, food galore, plants and what nots. Just have the “decency” to spell out if and when these whatever, helped you cope with stress. What metrics did you use. Yes, let’s be scientific- evidenced based coping mechanisms measured by. This will be our tweet chat topic later 9PM manila time. Game?

    T1. How did pandemic-induced stress got you?

    The first step in coping with stress is knowing or accepting you are stressed. I has had sleepless, anxious nights thinking I got COVID after inadvertently bumping one sneezing person. There were times I had to wake up, read online messages for fear of missing out some important news. I easily flare up when people disregard health protocols. I had eating binges and didn’t exercise. I get angry when people don’t follow procedures or are offering excuses . I lost that “what-if-you’re-in-this person-shoes” empathic mind battle completely. I am on a self preserving mode. When I argued with a family member over some trivial stuff, I called up a friend for help. I was breathing stress and I needed help.

    T2. How did you cope with pandemic induced stress?

    Accepting everyone’s in the same stress boat as I am, I started looking for “positives”, a way out, an opportunity to act rather than blame. I was letting go of things or actions that is beyond my influence. Watched less TV, social media fasted and tried a phone-less existence as often as I could. I focused on plants, food then some healthy routines. Pre COVID I had this weekly, daily routine of exercise, creative and challenging pursuits, journalling. When COVID came, all that is left is journalling thoughts, because all the actions were severely limited. I struggled much adapting my exercise, exploring and discovering routines. Am still am. Refocusing is hardest, particularly with greying of the work and personal time with a work from home arrangement. Rereading stoic literature was helpful in this. Then there is this social media hiatus. I often turn off my phone, lock it inside drawer so people could not call me at night. One of I think the best coping I learned this pandemic is being grateful. Even with the smallest of things or failures that made me a better person.

    T3. How did you know your coping mechanism is effective?

    First, I slowly regained some restful sleep at night then wake up early in the morning to exercise. I’ve learned to reply to essential messages at day time. There’s this seemingly relaxed and unperturbed attitude at the breakfast table or a leisurely coffee while trimming plants. I could also now walk away from whatever I work from without guilt, accepting everyone’s is entitled to some reprieved in this pandemic. I’m still working on my stingy often cold, stoic demeanour about so many things. I’m still whinny as hell, but I laugh, or give self demeaning jokes about more often. I’m still a work in progress and hopefully, this tweet chat will give me ideas on how to have breakfast with sarscovid.

    Image by KamranAydinov on Freepik

  • Telemedicine’s What, Weird and the Wacky! in the New Normal

    COVID 19 whacked this privilege almost overnight and we’re left to deal with providing care, as much as possible from a distance, or we risk harming the patient or us in the process. Even a decade old Telehealth hobbyist like me was unnerved by this disruption. As a healthcare professional, do I really have other choices? So how do we deliver care from a distance? Is it really possible to do this?

    T1. What competencies do I need to provide care from a distance?

    This first came into mind after the COVID 19 disruption sunk in. I had to assess myself. Providing face to face care needed competent health professionals. Factor in distance and you are in what seems to be an entirely new way of way of providing car. What do I need for Telehealth or telemedicine?

    Telehealth includes a broad range of technologies and services to provide patient care and improve the healthcare delivery system as a whole. Telemedicine is a subset of Telehealth which is basically “provision of health care services and education over a distance, using telecommunications technology”. Like any technology adoption, I have a framework for evaluating what applies to me and what do I need to use it. But before that, I always do a “needs assessment”.

    T2. What aspect of telemedicine makes you uncomfortable professionally?

    When I started practicing telemedicine, the blank stares or the zombie like nod from other ends is disconcerting. I have no way of knowing whether the epatient” got what we have discussed or instructed. Limited visual cues, the ever lagging net connection and the frequent restlessness of camera shy patient or me, is disconcerting. Sometimes, no econsult ever happend because we all had the time just figuring out our eclinic.

    T3. What’s the funniest telemedicine encounter you had?

    There’s was once that I was so engrossed talking and giving instructions I didn’t noticed the connection went dead and I was talking to a microphone for 5 minutes. Or the whole mic set up collapsed in my face. Or a patient showing up on the other end with a coke and cake in tow, munching and talking at the same time.

    literary a new world for most of us. COVID-19 made it a necessity for us to provide care. I’m just starting my journey, feeling the bumps, humps and ridiculous encounters here there. I realized though that providing care will never be the same again even after this pandemic. As with any other tool in medicine and health, Telehealth will should help us do what we do most best as health professionals

    Join #HealthXPh twitter chat at 9pm Manila time Sept 12, 2020 as we discuss telehealth, providing care from a distance. 

  • “Socializing” in the “New Normal”

    Many people wished they could just stay home to avoid getting COVID 19. Even the variable successes of the community quarantine convinced us of the benefits of personal hygiene, social distancing and staying at home. Prolonged social distancing however is increasingly difficult, given that many essential human actions required “physical” socializing. The benefits of socializing has been recognized in literature, be it in health, or the survival and propagation of the human specie in general.

    T1. Do you agree with easing out the community quarantine in your respective geographic locations? Explain.

    Loud protestations from the medical community did not stop the government from easing out community quarantine, even if we had a vague idea of what the “new normal” is. The “new normal” has been the subject of many discussions, including previous COVID #HealthXPh chats. None of these “new normal” descriptions were definitive and will evolve.

    T2. Is there a benefit to “socializing” in the new normal? Please explain.

    An interesting observation about the new normal is the acceptance of the different degrees of socializing. Socializing was never a binary choice for many of us to begin with. It wasn’t a “I socialize or I don’t” choice. We all socialize in different degrees.

    Our path to accepting this begun with another less striking, but equally important adaptation- the human specie has this propensity for “risk assessment and harm reduction”. This pandemic highlighted these both and will probably be an integral part of socializing in the new normal.

    T3. Give a specific personal example of “risk assessment strategy” you employ before socializing in this new normal.

    T4. Give a specific example of socializing – personal or work related in the new normal.

    Our emergence and socializing into the new normal will be partly governed by two things- our ability to assess risk and reduce our chances of getting COVID. This will be the topic of June 6, 2020 #HealthXPh twitter chat. Join us at 9PM Manila time with this guide questions:

    • T1. Do you agree with easing out the community quarantine in your respective geographic locations? Explain.
    • T2. Is there a benefit to “socializing” in the new normal? Please explain.
    • T3. Give a specific personal example of “risk assessment strategy” you employ before socializing in this new normal.
    • T4. Give a specific example of socializing – personal or work related, you employ in the new normal.

    Image by Drazen Zigic on Freepik

  • Turning Quarantine into Quality Time

    Most healthcare workers and facilities were caught unaware by the corona virus pandemic. Orthopedic surgeons who answer ER calls for acute extremity trauma weren’t exempted from this onslaught. After a short stint at the pandemic frontline, I was back lining COVID-19 front liners with hospital’s emergency incident command (HEIC) group. After about a week with HEICS, a friend told me I was on the verge of collapsing. I made it through another week, just in time for another pull out for yet another task. I thought I was out of the frying pan.

    An article in JAMA Internal Medicine predicted a pandemic of behavioral problems and mental illness in the general population as a consequence of COVID-19. Health workers are already experiencing burnout and “moral injury” even prior to this pandemic. Moral injury “describes the mental, emotional, and spiritual distress people feel after perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations” says Dr. Williams. The uncertainties of COVID-19 fight all the more add to this burnout and moral injury. Little has been discussed about the health workers own mental health.

    There are myriad of reasons why many health workers does not verbalize anxiety while frontlining. Front liners are very busy saving others, often to the point of self neglect. Personally, anxiety was at its during the mandatory 2 weeks post front lining quarantine. Doing nothing while on isolation could wreak havoc on mental health if left unaddressed. For example, I had bouts of the “interns’ syndrome”- diagnosing myself to have contracted COVID-19 based on clinical symptoms of the disease. I also had sleepless nights thinking about the “what if” scenarios if I contracted the disease. Yet I survived the isolation days thanks to a network of social support (including social media) that worked from a distance, and these four essential “steps” I learned from the writings of Adam Grant, a Wharton professor. Here are those essential steps:

    Labelling. The same JAMA Int Med article predicts a substantial increase of mental health issues during and probably after pandemic. Problem is, not many in this generation have prior pandemic experience. Even with health workers who deal with a lot of stress may find this pandemic-related anxiety, on a different level. Most psychologists and psychiatrists would just call it “anxiety” but I don’t think I had this level of anxiety before. I will call it “Post Front lining Stress Disorder” just to highlight the elevated anxiety level . Not totally a very scientific way of labelling but yeah, I am very anxious post front lining.

    T1. Are you dealing with pandemic related mental health issues as a health worker ? How did you came to terms with this?

    Reframing. I’m not exactly an introvert, but I’m comfortable being alone. I read books, hike mountains, travel places and photographed landscapes on my own. The enhanced community quarantine however is prohibitive to some of these activities. So I reassessed my isolation, tried to understand and looked for “productive” opportunities in each of these perspectives. The fear of dying alone doing nothing is I’m afraid what inspired me to reframe my isolation.

    T2. What or who was your inspiration for “reframing” your isolation?

    Distraction. The most insane part of the isolation ordeal for me is distraction . I tried cooking, vlogs, zoomongering and social destalking- unfollowing apocalyptic people and news online. I’m pretty surprised about the things I can and can’t do while in isolation. What’s more important was the act of trying to distract myself from a sordid state of self isolation. Just a warning that although “distraction” may alleviate misery on the short term, some “distractions” like alcohol or drugs have destructive effect on people.

    T3. Whats the funniest distraction you did while quarantined or isolated?

    Amelioration. There was a point in my distracted state that I realized, distraction isn’t enough. I have to protect my (and the people I love) health. I have to help protect my work and colleagues and my embattled nation. I have to learn, do or produce something relevant to this COVID-19 pandemic. I learned HEICS ala “The Matrix” in 2 weeks time. But thats another story.

    T4. What was the most productive thing you’ve done while isolated or quarantined?

    Join #HealthXPh twitter chat on April 18 at 9PM Manila Time as we suggest ways of turning quarantine into quality time. Note the following guide questions and append #HealthXPh to all your tweets!

    • T1. Are you dealing with pandemic related mental health issues as a health worker ? How did you came to terms with this?
    • T2. What or who was your inspiration for “reframing” your isolation?
    • T3. Whats the funniest distraction you did while quarantined or isolated?
    • T4. What was the most productive thing you’ve done while isolated or quarantined?

    See you all!

    Image by Freepik