Kentucky Doc Summer 2020

summer 2020 • volume 12• issue 2

PROFILE

Dr. Steven Stack

ONE OF THE LEADERS GUIDING KENTUCKY THROUGH THE PANDEMIC

ALSO INSIDE

Paying it Forward UKCOM Students Efforts to Help Healthcare Workers during COVID-19

Managing Stress Skillfully Relax by Practicing the Relaxation Response

PROTECT YOURSELF AND YOUR FAMILY THIS FLU SEASON!

Kentucky’s Leading Hair Replacement Facility • Genetic Hair Loss • Chemotherapy • Alopecia • Cosmetic Hair Replacement

GET YOUR SHOT! CONSULT YOUR DOC! STOP THE SPREAD!

859.263.9811 Hair Institute offers several surgical and non-surgical hair restoration options, including Virtual Reality®, full and partial prostheses, hand-knotted wigs, and human hair extensions.

- Laser Light Hair Therapy - Surgical Hair Restoration Options

- Full Cranial Vacuum Prostheses - Enhancements and Integrations

1795 Alysheba Way Suite 7101 Lexington, Kentucky 40509

HAIR REPLACEMENT • HAIR RESTORATION • HAIR EXTENSIONS Professional • Confidential • Meticulous www.kyma.org/flu

AMERICAN HAIR LOSS COUNCIL

www.hairinstitutelexington.com

®

Foresight in 2020.

We believe that your malpractice insurance team should be ready and available when you need them most. SVMIC is built on this kind of reliable and dedicated relationship, so you can focus on your practice and we can focus on protecting it.

Move forward with us at

www.svmic.com

CONTENTS Paying it Forward: UKCOM Students Efforts to Help Healthcare Workers during COVID-19 • PAGE 5 Crusading Through COVID • PAGE 10 PHYS IC IA N HEALTH AND WE L L BE I NG Managing Stress with the Relaxation Response • PAGE 14 COMMUN I T Y NE W S Announcements, Awards, Events & More • PAGE 20 PE T HEALTH Sponsored by Uptown Hounds • PAGE 22 COVID-19: Patients, Families, Healthcare Workers and the Mentally Ill • PAGE 26 P R OFI LE I N COMPASS I ON Lifelong Curiosity: Emergency Medicine,

SUMMER 2020

FROM THE

EDITOR

Public Health and Organized Medicine • PAGE 28

Robert P. Granacher Jr., MD, MBA, Editor-in-Chief, Kentucky Doc Magazine

EDITORIAL

BOARD MEMBERS Robert P. Granacher Jr., MD, MBA editor of Kentucky Doc Magazine Tuyen Tran, MD John Patterson, MD Thomas Waid, MD Nicholas Coffey

STAFF Brian Lord Publisher David Bryan Blondell Independent Sales Representative Jennifer Lord Customer Relations Specialist Barry Lord Sales Representative Anastassia Zikkos Sales Representative Kim Wade Sales Representative Janet Roy Graphic Designer Aurora Automations Website & Social Media

Welcome to our summer edition. This quarter’s magazine focuses on the COVID-19 pandemic with LMS member Steven Stack, M.D. gracing the cover of our publication. Steve is Kentucky’s current Commissioner of Public Health and a recent past president of our American Medical Association. He is immersed in our state’s management of the public health issues surrounding the outbreak of COVID-19. Please check out LMS member, John Patterson, M.D. with his “Profile in Compassion” portraying Dr. Stack.

We lead off our Summer Edition with an article by new KentuckyDoc Editorial Board member, and second year UKCOM Bowling Green student, Nicholas Coffey. Nicholas shares how UKCOM medical students are assisting health-care workers serving on the front lines while serving COVID-19 victims.

The next article, by LMS member Tom Waid, M.D., “Crusading Through COVID”, is the chronicle of Beth Burbridge’s gallant journey to save a child on dialysis by donating a life-saving kidney. Moreover, by Beth’s tireless testimony in Frankfort to support the passage of HB 46, Kentucky employees will have leave from work approved in order to donate organs or bone marrow and recover from associated procedures.

John Patterson, M.D. has authored a second article for this Summer Edition of our LMS magazine: “Managing Stress with the Relaxation Response.” Since Dr. Benson developed this technique 40 years ago at Harvard Medical School, it has become the “go-to” technique for relieving acute and chronic stress reactions. John gives readers a tutorial in its personal application.

After Dr. Patterson’s second article, Dr. Granacher explores the impact of COVID-19 upon the mental health of healthcare workers, patients, families and the mentally ill. He also introduces the concept of moral injuries associated with healthcare workers caring for pandemic patients. These derive from military mental health concepts. Dr. Granacher’s message leads the reader to the profile of Dr. Stack’s COVID-19 public health journey.

Stay well, — Bob

Mailed to 100% of physicians licensed in Fayette County. Mailed to 75% of doctor office managers & other decision makers in Fayette County Practices. For advertising rates and to find out how to get your article published, please call

859-368-0778

brian@rockpointpublishing.com

© Copyright Kentucky Doc Magazine 2020. All rights reserved. Any reproduction of the material in this magazine in whole or in part without written prior consent is prohibited. Articles and other material in this magazine are not necessarily the views of Kentucky Doc Magazine. Kentucky Doc Magazine reserves the right to publish and edit, or not publish any material that is sent. Kentucky Doc Magazine will not knowingly publish any advertisement which is illegal or misleading to its readers. Kentucky Doc Magazine is a proud product of Rock Point Publishing.

doc

www.kentuckydoc.com | Summer 2020 | Kentucky

5

d r a w r o F T I G N I Y A P

UKCOM

Students

Efforts to Help Healthcare Workers during COVID-19

By Nicholas Coffey

Even though I was 5 years old when the attacks on the World Trade Center occurred in New York City on September 11th, 2001, I do not recollect any information from that time.

However, everyone that I have talked with who was old enough to remember these events have such clear memories of where they were and what they were doing when they found out about this national tragedy.

I never really understood this feeling until the rise of COVID-19 and the extremeness of the disruption that occurred with everyday life. I will remember the last time my medical school class met to take our last in-person neuroanatomy exam. Immediately afterward, I drove home for the weekend to relax, see family, and prepare for our Objective Structured Clinical Exam the following week.

Little did I know at the time that I would not return to Bowling Green for months as the pandemic moved the rest of my first-year medical school classwork completely online and flipped normal life on its head.

UKCOM Continued on Page 7

Christina Mattingly

Sameer Fraser

Kathryn Perry

SECOND-YEAR MEDICAL STUDENT AT THE UKCOM NORTHERN KENTUCKY CAMPUS

SECOND-YEAR MEDICAL STUDENT AT THE UKCOM BOWLING GREEN CAMPUS

SECOND-YEAR MEDICAL STUDENT AT THE UKCOM BOWLING GREEN CAMPUS

Are you between the age of 45-75?

UKCOM continued from Page 5

GOOD

COLON CANCER SCREENING SAVES LIVES

While everyone was figuring out this new world, many University of Kentucky College of Medicine (UKCOM) students saw a world that was in desperate need of help and ran to answer this call to action. They saw the actions and sacrifices taken by true heroes of this pandemic: the healthcare workers across the nation. They saw the effects that the virus and the subsequent lockdown had on those in the community. Examples of the actions undertaken by these humble servants include making masks for those in the community, leading donation drives, Is COST a keepin volunteering in the state’s COVID-19 response, and other programs. for G Oand OpetD B U T O N L screened Y IF One such program was the childcare service that arose across the UKCOM Lexington YOU campus, Bowling Green campus, and Northern Kentucky campus to help local providers N E during W S !

GET TESTED! COVID-19. Christina Mattingly is a rising secondyear medical student at the UKCOM Northern Kentucky campus that coordinates their childcare YOU MAY QUAL and pet service for St. Elizabeth Healthcare, the Is COST a keeping you from being hospital associated with that campus. When asked COLONOSCOP screened for colon cancer? why she helped start this program, she said, “I have a passion for working with children and knew this Uninsured or Uninsured or would be a great opportunity for other medical Age 45-7 undersinsured students who shared that passion. I knew this45-75 was under 45 may Underinsured Age a great way we could give back to (St. Elizabeth) Uninsured: No public/private insurance 45 may qualify Uninsured: providers who have been so welcomingunder and will be Undersinsured: High deductible plan some cases No insurance. withpublic/private out-of-pocket training us in our clinical experiences.” inShe is one of Y Omaximums U M A Ygreater Q U Athan LIFY FOR A FREE 5% individual annual income the eight students at the Northern Kentucky campus Underinsured: Uninsure C O L O N O S C O P Y IF YOU ARE: to take part in this program.

Uninsured: N High deductible plans Sameer Fraser is a rising second-year medical Underinsured student at the UKCOM Bowling Green campus that out-of-pocke No Medicare Part B Age 45-75 serves as one of the co-directors of the childcare under 45 may qualify in come cases individual inc Coverage service for Warren County healthcare workers at our campus. He shared similar thoughts as Ms. Mattingly when asked why he wanted to the SCREENING SAVES LIVES Astart Kentucky A Kentuc Uninsured or Underinsured program at the Bowling Green campus. He said, “At but ONLY if you get tested!

This program is funded by the includes legal Resident Uninsured: No public/private health insurance the beginning of all this, as medical students, there Kentucky Colon Cancer green card ho Underinsured: High deductible plan with Includes Legal Immigrants: was very little we could do in terms of helping out out-of-pocket maximums greater than 5% of work/student Call 859-309-1700 or 877-597Screening Program green card the healthcare system, but this childcare service washolders individual income refugees work/student visa one of the few ways... We’re all in school so we can 4655 A Kentucky help our communities in times like this…refugee So, if we to discuss eligibility! couldn’t do anything hands on, the next best thing A Kentucky Resident Resident was to help out the people who actually were doing CREENING includes legal immigrants: Includes S Legal the hands-on stuff.” Kathryn Perry, another rising green card holders Immigrants: BUT ONLY IF YO second-year at the UKCOM Bowling Green campus work/student visas refugees who serves as co-director of the childcare service, • green holders C A L L card 859 .309.1700 Funding provided by: expressed that she wanted to get involved with this Don’t let cost keep you from being • work/student visa Kentucky Colon Cancer Screening Program program because school age kids were suddenly TO DISCUSS screened for colon cancer.

• refugees You may qualify staying at home due to schools canceling. She wanted S C R E Efor N I NaG free SAVES LIVES to help healthcare workers that were still working by colonoscopy if you are: BUT ONLY IF YOU GET TE S Tgoing E D ! back for your fol BUT ONLY IF Not providing free childcare.

NEWS!

You may qualify for a free Youare: may qualify for a colonoscopy if you OO D free colonoscopy ifGyou are:

GOOD NEWS!

COLON CANCER SCREENING SAVES LIVES

UKCOM Continued on Page 8

YOU GET TESTED!

The Childcare and Pet Service Program arose across UKCOM campuses to help local providers during COVID-19.

SCREENING SAVES LIVES

C A L L 8 5 9 . 3 0 9 . 1 7 0 0 O R 8 7 7 .because 5 9 7 . 4 6 5your 5 deductible is T Age 45-75 CALL to see if yo T O D I S C U S S E L I G I B I Linsurance?

ITY

BUT ONLY IF YOU GET TESTED!

FREE colonoscopy!

Uninsured: No private/public health Not going insurance or back for your follow-up colonoscopy because your deductible is TOOplan HIGH or you LOST your Underinsured: high deductible CALLmaximums to see if you are eligible to receive a with insurance? out-of-pocket TO5%DISCUSS ELIGIBILITY FREE colonoscopy! greater than individual income

CALL 859.309.1700

A Kentucky Resident Includes Legal immigrants: THIS PROGRAM IS FUN green card holders COLON CANCER SC student/work visas THIS PROGRAM IS FUNDED BY THE refugees KENTUCKY COLON CANCER SCREENING PROGRAM THIS PROGRAM IS FUNDED BY THE KENTUCKY COLON CANCER SCREENING PROGRAM

8

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

Jessica Geddes FOURTH-YEAR MEDICAL STUDENT AT THE UKCOM LEXINGTON CAMPUS

"I saw stories on the news about healthcare workers living in garages or hotel rooms in order to self-quarantine away from their families. I figured I had an empty apartment close to the UK Medical Campus that could be a good alternative."

– Jessica Geddes, fourth year UKCOM student

UKCOM continued from Page 7

Another noteworthy cause was the housing for healthcare workers project started by Jessica Geddes, who is a current fourth-year medical student at the UKCOM Lexington campus. Through this program, she supplied free or discounted living arrangements to physicians in the Lexington area that wished to quarantine away from their families. She was able to achieve this by offering vacant medical student apartments as well as partnering with a Lexington RV business. When asked why she started this program, Ms. Geddes said, “I saw stories on the news about healthcare workers living in garages or hotel rooms in order to self-quarantine away from their families. I figured I had an empty apartment close to the UK Medical Campus that could be a good alternative.”

We are currently living through a historical time period on a global scale. Much like previous pandemics and the September 11th attacks, future students will be learning about the events that are going on right now for ages to come. Some individuals, such as healthcare workers, medical researchers, and politicians that helped to plan and coordinate an appropriate response, will be remembered forever because of these events. However, there are still individuals that helped in significant, but less recognized ways, with each crisis in history. These individuals do not often get the recognition that they deserve, such as the willing UKCOM student volunteer efforts mentioned in this article, that have tried to make a difference in this state during these historical and unprecedented times.

About the author Nicholas Coffey is a former Western Kentucky University (WKU) football player and current University of Kentucky College of MedicineBowling Green Campus second year medical student. While at WKU, he earned a Bachelor of Science with majors in Biology and Chemistry along with a Master of Science in Biology. He hopes to someday be a rural practitioner that serves southcentral Kentucky.

Your Family, Your Health, Our Passion Family Practice Associates of Lexington, P.S.C. Proudly serving Kentucky for 35 years.

NEW

• Family Practice • Pediatrics • Internal Medicine • Primary Care for your entire family!

Hamburg Pavilion Location

Brannon Crossing Location

1775 Alysheba Way #201

615 East Brannon Road, Ste. 100

Lexington, KY 40509

Nicholasville, KY 40356

859.278.5007 www.fpalex.com

10

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

Crusading Through

COVID

By Thomas Waid, MD

Heroes don’t always get the Congressional Medal of Honor, nor do they come bounding off the pages of Marvel or DC Comics. They are not always enshrined in the Hall of Fame. True heroes come from all walks of life. Altruism knows no ethnic or geographic boundaries, and when a life is saved because of a selfless act of kindness, that is heroic. Such a person is Beth Burbridge, UK scholarship athlete, wife, mother of three and a kidney donor to a child on dialysis who needed a lifesaving kidney transplantation. Her decision to donate to a child of a family she didn’t know, who’s plea for a donor was posted in the neighborhood Facebook, was kind and brave by itself. However, it is what she did afterward in her crusade to protect living organ donation that truly sets her apart.

When Beth was approved to be a living kidney donor, she encountered some of the obstacles that plagued other live donor candidates, and which have sometimes caused them to rethink their donation. When she requested leave for the donor surgery, her HR department informed her that her surgery was deemed to be elective since she was healthy. Furthermore, any additional time-off needed to come from paid vacation, and after that it would be unpaid leave. Since her family required two incomes, she tried to return to work within a week which became a difficult endeavor. When Beth was being evaluated as a potential donor, she was given a stack of paperwork to read. Therein was a list of Bills in states with legislation protecting living donors: the line for Kentucky was blank.

She contacted her State Representative, Mr. Jerry T. Miller, District 36, and Bill Request 179 (BR179) relating to the promotion of living donor organ and bone marrow donation was authored.

I first met Beth when she testified to the Interim Joint Committee regarding BR179 in September 2019. Members of the University of Kentucky and University of Louisville/ Jewish Hospital Transplantation programs were asked to give testimony in support of this Bill Request. The four of us: Beth, Representative Miller, Dr. Dylan Adamson (transplant surgeon at Jewish Hospital) and I presented facts supporting the Bill Request to the Committee chaired by Senator Ralph Alvarado. The request cleared committee and went on to the House as HB46 “An Act

relating to the promotion of living donor human organ and bone marrow donation”. On January 16, 2020 we were again in Frankfort testifying to the House State Government Committee. HB46 passed unanimously, or as they like to say in Frankfort “with favorable expression”.

On March 4th, on the brink of the COVID19 statewide shutdown, HB46 passed the House 94-0. On March 18th, Beth was asked to testify to the Senate Health and Welfare Committee. She was asked to come alone due to travel and gathering restrictions imposed by COVID social distancing. She didn’t need Dr. Adamson or me. HB 46 passed on the Senate consent calendar 34-0, and on April 24th it was signed into law by Governor Beshear. During the timeframe when the Bill was proceeding through the legislature, I was able to assist in securing the endorsement of the KMA and the Lexington Medical Society. By July 15th, Commonwealth employees will have organ and bone marrow leave available.

But Beth hasn’t finished yet. On May 20th, an Ordinance for protection of city employees wishing to donate was presented to a committee for the Louisville Metro government. And, on May 28th Louisville Metro Council passed the ordinance unanimously. We hoped to present the same proposal to the Lexington Fayette Urban County Government in April, which is organ donor month, however COVID restrictions delayed the effort.

Soon there will be a presentation in Lexington and other HERO Continued on Page 12

doc

www.kentuckydoc.com | Summer 2020 | Kentucky

11

12

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

Beth Burbridge (left) and Thomas Waid, MD (right) HERO continued from Page 10

municipalities until there is donor protection throughout the Commonwealth. In April 2018, the University of Kentucky adopted a living organ and bone marrow donor policy providing additional leave of 30 days for solid organ and 7 days for bone marrow donation. Such a policy could become a model for the entire Commonwealth.

When HB46 passed Beth could have sent an email or

called on the phone. But no, on May 4th she appeared in my office with hero balloons, another selfless act of thanks. For those of us who have been privileged to accompany her on this mission, we know that there is nothing as powerful as an idea set in motion, and not even COVID19 could slow it down. So, thanks to Beth Burbridge, who gave the gift of life herself and will assist many others who wish to do the same. Many thanks to the hero on my right!

Pr o

14

•

Iss ue

8

•

M ay

M

20 17

A

Z

I

PL EA SE

N

E

TA KE

ON E

su m m er

20 17

•

vo lu m e

9

•

is su e

2

IN

Th Cold eD o iffe r Flu re ? nc e

D

E

TA

D AN

R IN M EN T •H LT H •B A R G A IN S •L

&

EA

IF ES TY

Co Fluld

Is Sh Ge ot ttin Ne g ce a F ss lu ar y?

Ho d wt sp urin o st re g ay ad th h in e g ea l g se erm thy as on

M Rev ort e ga rse ge s

SI

be yo nd

Ch ick Re en cip So e up

Sp en Sa de ve rs rs vs .

SO

an d

AL

eg g

Sa Ra vin in g fo y Da r a y

Yo ur ne st

TE

Vo l.

LE

13

O

•

L.

7

13

Iss ue

O

/A

N

LY

V

JU

AT I

•

17

W ESSAY C

3

M ar ch

M

20 16

A

IN NI

NG

ES

S

ID

E:

G A Z I

PL EA SE

N E

TA KE ON E

D

Pr of ile in Co m pa ss io n

M is ed Jo C ici hn a Gu lli ne AL SO rle ng yM IN S

AY “H S do ea be cto lthy ba tte rs an to rrie r ca pro d h ph rs re vid ap ys an , de e py icia d fi n solu ne w ell tio ne ns ss .”

WIN NE

E

20

SU

G

IS

U

RS

M a C ed INSID os ic tA a E na l S lys c is ri be s:

A

EST

AL SO

He ar t

cti on of po help rta in nt g p th eo ing pl e ."

G

NT

Dr file in C Bl . C ompas si He ay ar ar d y on a K t Do e in cto s d r

Vo l.

SuFU mm N er!

&

O

fa ll

20 16 • vo lu m e

8 • is su e

3

ev b ice le s 17 F Lo ood se s W to eig He ht lp

EN

A

R

ES

O

U

R

C

E

G

U

ID

Li Wvin

A He ge ari -Re ng la W ted oe s

AL SO

“N ea “S tnik lo s” bs v ” s.

IN SI DE

Th of e M M ale en op Ve au rsio se n ?

TE

R

TA

IN

M

EN

T

•H

EA

LT H

•B

A

E FO

R

Y

O

U

R

G

EN

ER

M

AT I

R

G

A

IN

S

•L

IF

ES

TY

LE

V

O

AY

N U E

16

2

20

SU

E

IS

N

A M Loo ed k ica In l F sid itn e B es od sF y ac Str ilit uc y tur e

FIT NE SS ISS UE

N

Th e

EA S E T TM UC EC EN CE TIO T SS N FU CA L

Os SI te 12 LEN o M T Pr ILLIONDISEAS poro Ca ost MEN E AFF si s EA EC a n TS M RL ce te TR EAN Y D r

He ar t

At ta ck s

U SI ND M GN ERS AY S T SA AN AND VE D S IN YO YM G UR PT TH E LI OM FE S

M HE e AL n TH 's

A Fit nsw ne er 5 ss s to Qu C Go Rea es om od so n Ch fo s W tion mo Sh oo rY a s n s o o lk Ac e e tiv s fo the ur H ing ea is ity r Y R lth ou igh r t

12

/J

L.

O

PA eL g RK L60 P I N lu DI S s SE O AS N’ E S

C co opin ne nd g co rve itio wit nt c n t h a ro ell ha c lm s hr t us in t dam onic cle he a m bra ges ov in em th en at t

Die H t E ow ffe to cti ve ly

ss t e 11 •A ug us t2 01 7

Vo l.

14

E

•

Iss ue

6

•

M ar ch

M

20 17

A

G

A

Z

I

PL EA SE

N

E

TA KE

ON E

H ke ow in ep can fu ter yo yo th nct nal ur u eir io or pe nin gan AN ak g a s th D ? t yo ey – w an u h do ha d ea to t we lt ke ll. hy ep

• R rs ek in dle

Pr Pa ac ss tic io Ex 20 pe 1 e nf rie 7 E nc of o es ssa th y C M r th at Ig on ed e nit te e • st ici Su W sta in ne in ne

sp rin g

•

vo lu m e

9

•

is su e

1

Go od He Kid alt n h ey Ho fo me rK R id em ne e y P die ain s Cle 10 F an oo se ds th Th e L at ive r

RG

20 17

KI O D AN

SHARE YOUR STORY. BUILD TRUST. REACH YOUR TARGET.

GROW YOUR BUSINESS. We curate and publish local content in a family of magazines created for health-conscious readers in the Central Kentucky area. Share your story, build trust and grow your practice through targeted advertising.

& M A G A Z I N E

REACH OVER 75,000 READERS

60 Plus

REACH OVER 60,000 READERS

REACH OVER 11,000 READERS

Contact us today for feature story, educational-based marketing and print advertising information:

859-368-0778

brian@rockpointpublishing.com

14

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

PHYSICIAN HEALTH AND WELLBEING

Managing Stress with the Relaxation Response

By John A. Patterson MD, MSPH, FAAFP

Just relax! It sounds so simple.

Relaxation does indeed sound simple but skillful relaxation isn’t necessarily easy. While there are many unskillful, unhealthy ways to relax, you can achieve significant cardiovascular, emotional and other health benefits from the regular practice of skillful relaxation for stress management.

One of the best ways to skillfully relax is by practicing the Relaxation Response. Harvard cardiologist Herbert Benson coined the phrase ‘Relaxation Response’ in the 1970s after studying mind-body approaches to cardiovascular health and disease. He initially showed that the simple practice of the Relaxation Response helped lower blood

pressure, even helping some patients reduce their medication needs.

The Relaxation Response has been the primary technique used over the last 40 years at the BensonHenry Institute for Mind Body Medicine at Harvard Medical School. It has been shown to help a wide variety of stress-related medical conditions including chronic pain, sleep disorders, anxiety, depression, arthritis, intestinal disorders, skin conditions and much more. It has also been shown to improve the quality of life for those with life-threatening diseases such as cancer and HIV/AIDS.

doc

www.kentuckydoc.com | Summer 2020 | Kentucky

Here is the first step for practicing Benson’s Relaxation Response:

1

First, choose a focus word (or short phrase, prayer or internal sound). You can choose a word that has a religious or special meaning to you or a neutral word such as: One, Now, Being, Ocean, Love, Peace, Calm, Relax, Present or Present Moment. The thing to remember is that the meaning of the focus word is not the point. Rather, you are cultivating the gentle resting of your attention on the word. Eventually, the word may fade away as you repeat it - leaving you in a physiologically healthful state of ‘restful alertness’. That is the goal.

RELAX Continued on Page 16

15

16

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

RELAX continued from Page 15

Here are the remaining steps for practicing Benson’s Relaxation Response:

2 3 4 5 6 7 8 9

It is good to turn off phones and arrange it so the dog or cat won’t startle you by jumping into your lap. You may want to inform others that you are taking a health break and close the door. You can make a sign for the door saying ‘Quiet Please’ or ‘Meditating’. However, it is not absolutely necessary to create a protected quiet zone.

See #6 below for advice on handling distractions.

It is best to assume a comfortable seated or reclining position and allow the eyes to close. You can also lie down but that will increase the likelihood of falling asleep.

Sleep is wonderful, but ‘restful alertness’ is the goal of the Relaxation Response practice.

Allow your muscles to relax, especially paying attention to the jaw, neck, shoulders, back and other places you know you hold tension. Over time, you may feel tension and relaxation more easily throughout the body.

Breathe slowly and naturally, and as you do, repeat your focus word, phrase, or prayer silently to yourself. At least in the beginning, this repetition may be easier to coordinate with the out breath. Over time, however, try to repeat your word without timing the repetition to the breath.

Be non-judgmental about distractions. When sounds, body sensations, feelings, emotions and other thoughts come to mind, simply notice them without judgment and gently return to the repetition of your focus word, phrase or prayer.

A recommended time of practice is 10-20 minutes, although even 1 minute (especially during stressful times) can help manage stress and cultivate a sense of selfmastery and self-care.

After your practice period ends, rather than quickly returning to activity, continue sitting quietly for a minute or so, allowing other thoughts to return. Then, open your eyes and sit for another minute before returning to regular activity. Notice this important transition time. Your eyes are open as in daily activity yet the mind is quieter than usual after your practice. Later in the day, by simply remembering this calmness with open eyes, a hint of relaxation and self-care can be cultivated at any moment throughout your day.

Practice! Practice! Practice! This technique is most effective if practiced once or twice daily. Although anytime is fine, ideal practice times are before breakfast and before the evening meal. Practicing the Relaxation Response before meals can help digestion, which is another important ingredient in self-care, cardiovascular health and managing stress-related conditions.

About the author Dr Patterson is board certified in family medicine and integrative holistic medicine. He teaches mindfulness-based stress reduction (MBSR) for the University of Kentucky Wellness Program and Saybrook College of Integrative Medicine and Health Sciences (Pasadena). He operates the Mind Body Studio in Lexington, where he offers classes and consultations for people with stress-related conditions and burnout prevention for health professionals. He can be reached at www.mindbodystudio.org.

TAKE CARE OF YOUR PATIENTS BY TAKING CARE OF YOURSELF.

the lexington medical society

PHYSICIAN WELLNESS PROGRAM Go to LexingtonDoctors.org/services/wellness-program/ for information

The LMS Physician Wellness Program was designed as a safe harbor for physicians to address normal life difficulties in a confidential and professional manner.

• • • •

Starting its 5 th year and has helped dozens of physicians 8 free sessions each calendar year Easy access: 535 2nd St., Ste. 207 Complete confidentiality

CALL 1-800-350-6438

to make an appointment Leave a message in either Dr. Smith's or Dr. Hough's voice mailbox. They will call you back to schedule—it's that simple!

CURRENTLY OPERATING USING TELEHEALTH DUE TO COVID-19

18

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

All I Need to Know is Where I Need to Go! Call 1-844-249-0708!

For Information on FREE Mammograms and Pap Tests Eligibility Requirements: • Age 21 or older • Has a household income at or below 250% of the federal poverty level • Has no health insurance (no Medicare, no Medicaid, or no private health insurance) The Kentucky women’s cancer screening program (KWCSP) offers FREE breast and cervical cancer screenings. The program provides Mammograms and Pap tests and follow up services, education and outreach to low income, eligible women. Once in the program, if a woman has an abnormal screening, the KWCSP covers the cost of most diagnostic tests. If a pre-cancer or cancer is found, the program connects her to treatment through Medicaid’s Breast and Cervical Cancer Treatment Program (BCCTP). The KWCSP provides services through Kentucky’s local health departments, community health clinics and other healthcare providers. A woman does not have to reside in the same county in which she receives services. Healthcare providers, please refer eligible women to a participating KWCSP clinic/provider. For a participating clinic/provider listing call KWCSP, 1-844-249-0708.

doc

www.kentuckydoc.com | Summer 2020 | Kentucky

Quick Guide for Health Care Providers to Kentucky’s Breast & Cervical Cancer Screening and Treatment Programs All I Need to Know is Where I Need to Go! Call 1-844-249-0708!

• The Kentucky Women’s Cancer Screening Program (KWCSP) provides breast and cervical cancer screening and follow-up diagnostic services for eligible Kentucky women.

• KWCSP eligibility requirements: – Age 21 or older – Has a household income at or below 250% of the federal poverty level – Has no health insurance (no Medicare, no Medicaid, or no private health insurance)

• The Breast and Cervical Cancer Treatment Program (BCCTP) provides treatment for breast or cervical cancer, or precancer of the breast or cervix for eligible Kentucky women.

• Women who may qualify for the KWCSP or BCCTP must be referred to the local health department or contract provider PRIOR to screening or treatment by the health care provider.* • The local health department or contract provider will facilitate completing the application for Medicaid who will determine participant eligibility for BCCTP.

• BCCTP eligibility requirements: – Has been screened and diagnosed with cancer by the Kentucky Women’s Cancer Screening Program through a local health department and/ or contract providers – Has been found to be in need of treatment for either breast or cervical cancer, including a precancerous condition or early stage cancer – Age 21 or older and younger than 65 – Has a household income at or below 250% of the federal poverty level – Does not otherwise have credible health insurance coverage – Is a United States citizen or qualified immigrant

* Please refer program eligible patients to the local health department, contract provider or call 1-844-249-0708 prior to screening or diagnosis.

– Is a resident of Kentucky – Is not eligible for medical assistance or public insurance in any other eligible group – Is not a resident of a public institution (e.g. prison)

19

20

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

COMMUNITY NEWS A N N O U N C E M E N T S , AWA R D S , E V E N T S & M O R E

Dr. Ben Kibler Retires from Lexington Clinic William Ben Kibler, MD, FACSM has retired from Lexington Clinic Orthopedics – Sports Medicine after 43 years of dedicated service.

Having joined Lexington Clinic in 1977 and establishing The Shoulder Center of Kentucky, Dr. Kibler has been at the forefront of comprehensive shoulder repair and rehabilitation, and has had a profound impact in the field of sports medicine.

Throughout his stellar career, Dr. Kibler has provided specialized shoulder surgery, scapula, acute knee injury surgery, sports medicine and arthroscopic surgeries of the knee, ankle and elbow. Countless patients and healthcare providers have and will continue to benefit from his outstanding scientific and scholarly contributions to sports medicine.

“Dr. Kibler’s passion for healthcare and his inspiring spirit will be greatly missed here, but we wish him all the best in his well-deserved retirement,” said Dr. Andrew Henderson, CEO of Lexington Clinic. “We seek to honor Dr. Kibler’s contributions in the field of orthopedics and sports medicine by continuing with the elevated levels of service we provide to our patients and the community at large.”

Prior to joining Lexington Clinic, Dr. Kibler completed a Neuromuscular Diseases fellowship at Vanderbilt University. He completed his residency in Orthopedic Surgery at Vanderbilt as well, an internship at Parkland Hospital, Dallas, and graduated from the Vanderbilt Medical School.

As an internationally recognized and renowned visionary in his field, Dr. Kibler has shared his expertise through speaking engagements and educational symposiums both domestically and abroad. Those in the field have benefited from his hunger for excellence, his wisdom, the enthusiasm of his teachings, his discipline and his mentoring. Dr. Kibler has held many important posts over the years with various organizations such as the American Academy of Orthopedic Surgeons,

the American Orthopedic Society for Sports Medicine, American College of Sports Medicine, the Society for Tennis Medicine and Science, ISAKOS etc. He has also contributed to many professional publications and been honored with numerous awards including the coveted Thomas Brady Award by the American Orthopedic Society for Sports Medicine, which recognized Dr. Kibler for his service and dedication to sports medicine and the impact he has made on his community.

Some of his other achievements include: • Developing the first comprehensive sports medicine program in Kentucky • Being the first to provide athletic training services to area schools and sports organizations in Kentucky • Developing 3 Consensus Conferences on Disorders of the Scapula • Performing over 23,000 surgical procedures • Founding member of the Society for Tennis Medicine and Science • Head Team Physician for the Lexington Legends since 2001 • Within the realms of medical innovations, Dr. Kibler: • Was the first to describe kinetic chain in sports activities • Was the first to describe scapular kinematics and scapular dyskinesis • Wrote and co-edited first and only book on scapular disorders • Developed concepts of core stability and closed chain rehabilitation • Developed protocols and programs that set the basis for comprehensive shoulder rehabilitation • Developed and described 3 clinical exam tests for shoulder pathology • Developed and determined outcomes for 2 operations for AC injury and scapular muscle detachment • Developed the Personal Insight Program to address issues of professional and personal burnout.

We wish Dr. Kibler the very best in this new chapter of his life.

Saint Joseph Berea Foundation Announces 2020 Board Members The Saint Joseph Berea Foundation is proud to announce members of the 20202021 board of directors effective July 1. The board will continue to help strengthen Saint Joseph Berea’s acclaimed facility and medical services.

Board members are Chair Wendy Hechemy, Vice Chair David Mayo, Secretary Dominique Martin, Jakob Duerson, Mark Carl, Mark Catron, David Gregory, Brad Hylton, Mike Hogg, Brad Lewis, Robbie Little, Danny Miller, Stephanie Moore, Chad Tate, Judge Executive Reagan Taylor, Saint Joseph Berea President John C. Yanes and Saint Joseph Berea Foundation President Leslie Smart.

“We are looking forward to the growth that our new and returning foundation board members will bring to Saint Joseph Berea,” said Smart. “They play an integral role in supporting the needs of the facility’s programs and services in the Berea area.”

Foundation board members will assist with driving charitable initiatives that benefit Saint Joseph Berea. Their duties include organizational planning, monitoring and managing financial resources, assessing and developing skills, serving on committees, recruiting new board members and advocating on behalf of the foundation.

To learn more about the Saint Joseph Berea Foundation, visit https://www. chisaintjosephhealth.org/give-to-saint-josephberea.

Baptist Health offering customized COVID-19 Testing Solutions to Employers “Baptist Health is helping to get Kentucky and Southern Indiana back to work by offering customized COVID-19 testing solutions and digital tools to employers,” said Michael Newkirk, MD, vice president of Physician Services. “We understand employers have

doc

www.kentuckydoc.com | Summer 2020 | Kentucky

SHARE YOUR STORY WITH THE COMMUNITY. E M A I L B R I A N @ R O C K P O I N T P U B L I S H I N G . C O M T O H AV E Y O U R N E W S P U B L I S H E D.

specific, individualized needs that we will address together as they put our economy back on track while protecting the safety of employees, customers and our communities.”

Baptist Health is ready to share a page from its COVID-19 playbook with area employers anxious about safely reopening. The health system has a web-based solution to the state requirement to screen employees for COVID19 symptoms before they report for work. With 19,500 employees across its eight hospitals and more than 300 points of care, Baptist Health is Kentucky’s largest health system.

“We would have to hire 200 people to perform these types of employee screenings at all of our facilities,” Dr. Newkirk said. “Instead, Baptist Health employees go online to answer a few health questions, take their temperature and log that information into the website. From that information, the employee is either given the green light to go in to work, or referred for COVID-19 testing.” Managers can easily access and monitor this information.

That web-based screening is being offered to employers, along with a COVID-19 testing solution, Dr. Newkirk added.

“Baptist Health has the resources and expertise of its infectious disease and other medical experts to help employers determine the most efficient and cost-effective options for their operation and workforce,” Dr Newkirk added. “With more than 25 years’ experience in occupational medicine, Baptist Health has the network, the know-how and the commitment to work with employers to create customized solutions geared to the specific needs they may have.”

For employers who partner with Baptist Health specifically for testing solutions, there can be enhanced testing for employees with COVID-19 symptoms, as well as co-workers who potentially had contact with them – helping to ensure the safest workplace possible for those that trust their care to Baptist Health.

Baptist Health Urgent Care locations have been testing people with COVID19 symptoms. Find the site nearest you at BaptistHealthClinics.com.

The first employers to access this COVID19 workplace reopening service will be those

already using Baptist Health services through its strategic alliance with BluMine Health, a Direct Primary Care provider in Kentucky and Southern Indiana. BluMine Health supports employer-sponsored health and wellness initiatives by providing direct primary care to mid- to large-size employers. Twenty-nine companies and more than 17,000 covered lives are now served by BluMine Health.

For more information about Baptist Health’s COVID-19 workplace reopening service, contact the nearest Baptist Health Occupational Medicine office location. You can find location information at www.baptisthealth. com/services/occupational-medicine/ locations/.

Lexington Clinic Celebrates 100 Years Anniversary Lexington Clinic is celebrating its 100 years anniversary this July, a milestone enabled by the organization’s unwavering commitment to providing excellent care and perfecting the patient experience.

On July 1, 1920, Lexington Clinic was founded by a group of physicians who came together to form a multi-specialty medical group that focused on providing quality care to their patients. From establishing the first radiology department in Lexington in the 1920s to developing the first cardiac care unit in Lexington in the 1960s; from performing the very first thoracic ablation surgery in 2006 to providing healthcare at the touch of a button via telehealth visits in 2020 … Lexington Clinic has been the leader in innovation and technology.

With more than 200 providers in 30 different specialties, and 25+ locations throughout Central Kentucky, Lexington Clinic has indeed come a long way. To not only survive for 100 years, but to be a major provider of healthcare in Central Kentucky is quite an accomplishment.

“Our journey started 100 years ago and continues today as we strive to provide the best care for our patients by keeping them at the center of all we do,” says Dr. Andrew

Henderson, CEO of Lexington Clinic.

“We faced many challenges, disruption and uncertainty but withstood the test of time thanks to our hardworking physicians and employees. Our people are dedicated to delivering an exceptional patient experience and it is through this commitment and dedication towards our patients and the communities we serve, that we have been able to build a legacy of success.”

Though Lexington Clinic has had to postpone plans to celebrate this milestone due to the ongoing COVID-19 pandemic, it is still moving ahead with construction plans for its new South Broadway building, which will replace the current Lexington Clinic flagship that has been serving the community since 1957. “We are proud to have been a part of this great community for 100 years, and we are excited to reinvest and recommit to continue serving our patients,” says Henderson.

The new building is set to open by early next year. The current building will remain open and functional until the new building is operational.

For the most current updates, please visit our website at www.Lexingtonclinic.com

RENT THIS CABIN

In the Beautiful Red River Gorge CAMPING CABINS AND PRIMITIVE CAMPSITES ALSO AVAILABLE

Call or visit website for reservations.

(606) 668-2599 ksbrown@mrtc.com www.kentuckywildflowersllc.com

21

SPONSORED BY UPTOWN HOUNDS 466 Angliana Avenue | Lexington, KY 40508 859-255-2275 | www.UptownHounds.com

pet health

Looking for the best pet care options for the health and wellness of your 4-Legged friends? Then welcome to our “Pet Health” Section, where we will bring you the finest businesses in Central Kentucky that will tend to the care and well-being of our furry loved ones.

In this issue we feature “Uptown Hounds,” an upscale pet resort in downtown Lexington that will pamper your pooch in the way he or she deserves, as well as all the good things that are happening at the Lexington Humane Society.

ANIMALS FIND SECOND CHANCES

T

AT LEXINGTON HUMANE SOCIETY

he life-saving work the Lexington Humane Society (LHS) provides is accomplished by our community’s desire to give animals another chance at a healthy and happy forever.

Every program LHS has in place guides animals in their journey to adoption day. The Second Chances program was developed as a way to provide extraordinary treatment for animals in need of special medical intervention that would otherwise prevent them from thriving.

Second Chances funding assists with inten-

sive surgeries, diagnostic work, equine rescue, prescriptions, formula for foster care and special food – resources that many animals in need would typically not receive. Having an on-site veterinarian and in-house pharmacy allows us to stretch our dollars further, in turn helping a greater number of special-needs animals each year. Typically, an amputation surgery would cost at least $800.

However, we are able to perform the same surgery on-site for approximately $250. Bladder surgery normally costs up to $3,000, yet our cost is only

$1,000. The average amount spent on each Second Chances animal is approximately $1,000.

We are reminded, now more than ever, that we must lean on each other for support. Even during these unprecedented times, we are sure our community will continue to rise to the occasion when there are animals in need. Every dollar counts when providing life-saving care to animals waiting to meet their forever families. They need us. We need you. Donate today to give an animal their second chance.

pet health by Uptown Hounds 23

SUMMER MEANS G” IN P P O H S P O T -S E “ON S AT UPTOWN HOUND

By David Bryan Blondell, Special Sections Dir.

A

s a pet owner, are you tired of dragging around your beloved pooch to two, three, or four different places for the services & products your dog needs? Then make your summer more restful by eliminating all those extra trips: give Uptown Hounds a try for the “One-Stop Shopping” of Grooming, Daycare, Boarding, Food, Gifts and numerous Playtime options!

America’s Uptown Hounds Luxury Resorts was created as an all-inclusive, high-quality, highenergy environment where your four-legged family member can play, primp, relax and stay.

And let’s face it — you AND your pooch deserve the best single place available when it comes to providing them everything they need.

Conveniently located in downtown Lexington near office buildings, the University of Kentucky campus and all of the downtown hospitals and healthcare facilities, Uptown Hounds’ guests — pets and their owners — have a multitude of luxurious amenities to enjoy.

Uptown Hounds features large, plush hotel suites for short- and long-term boarding, private daycare rooms, a top-notch grooming Salon & Spa and a boutique with the finest of toys, treats, food and pet-related merchandise. In addition, extremely large heated indoor and manicured outdoor play areas provide your pooch the most fun and friendly environment possible. Moreover, the beautiful marble floors and walls and the upscale fixtures that are part of the facility’s luxurious decor simply reflect the upscale treatment your four-legged member of royalty deserves.

UPTOWN Continued on Page 24

Enjoy “ONE-STOP SHOPPING” at Uptown Hounds!

www.UptownHounds.com

24 pet health by Uptown Hounds

July Dog Days of Summer

EVENTS PRESENTED BY

with Oscar Diggs

Dog Days of Summer are Here! We are thrilled to partner with Oscar Diggs during the month of July for the Dog Days of Summer. Stop

by Oscar Diggs located in downtown Lexington and enjoy an animal-themed cocktail and a meal for your pooch on the patio.

A portion of sales from the cocktail and pup meals will benefit the homeless animals at the Lexington Humane Society.

Visit AdoptLove.net for more information.

Join the Lexington Humane Society for a virtual version of our annual Critter Camp. Kids will learn about kindness and compassion, animal advocacy, and responsible pet care through a mixture of online and offline activities at home. The best part is you will receive a take-home camp kit delivered directly to your house by an adoptable animal! Ready for some “furtual” fun?

Visit AdoptLove.net to register!

UPTOWN continued from Page 23

SHEABELPETS.COM • 859.320.0274 2568 Richmond Rd, Lexington, KY 40509

In addition to Uptown Hounds’ weekly daycare services, a special new weekend daycare schedule is now available: Saturday and Sunday from 8 a.m. to 5:30 p.m.!

Also inquire about the “Daycare Referral Bonus.”

The Daycare Services at Uptown Hounds are considered second to none, with newly expanded weekday hours of 6:30 a.m. to 7:30 p.m. Monday through Friday to make it more convenient for working owners. In addition, there are new weekend daycare hours: Saturday and Sunday from 8 a.m. to 5:30 p.m. Once there, the friendly Pet Services Staff makes sure your dog is well-cared for and is having a happy, fun stay with up to three play-time sessions with its new-found friends (grouped by weight and activity level).

Individual playtime and extra attention is also offered, as is supervised usage of the popular 30-foot-by-50-foot outdoor pool during its seasonal operation.

Which brings us now to summertime, the most anticipated time of the year for owners and pets alike: the opening of the oversized doggie-only pool!

Fondly referred to as the “Cool Pool,” this very popular and in-demand venue provides hours of fun for Uptown Hounds’ clients (and guests; dog vaccines required) to bring and watch their dogs romp and stomp and have the best time of their lives! Towels and lifejackets are available; the staff will provide supervision for pool use during daycare or boarding visits. For further enjoyment, poolside chairs

and tables with large umbrellas surround the pool, giving shade and a comfortable place to rest for owners and swimmers alike.

Summer is here, and “One-Stop Shopping” is a reality that will fulfill your pet’s needs at Uptown Hounds. They recognize the proper, professional care of your pets is among the most important considerations you have — and for anyone wanting to give as much love and special care to your dogs as they give you, this summer please give America’s Uptown Hounds Luxury Resorts a try.

Please visit their website at www.UptownHounds.com or call Guest Services at (859) 2552275. A new texting service is now available as well — text any questions or boarding requests to (859) 255-2275. Uptown Hounds is conveniently located just off South Broadway at 466 Angliana Avenue, just a half mile from downtown and a block from The Red Mile. They invite you to a quick tour of the facility and look forward to welcoming you and your dog as a part of the Uptown Hounds family!

Note: As the conditions surrounding the pandemic and its restrictions change, please call Uptown Hounds or visit their Website to verify what services are currently being offered or affected.

As a Physician in the U.S. Air Force, you’ll have one job: treat patients. We’ll give you all the support you need so you can be the doctor you were meant to be.

For more information, contact your local recruiter or visit airforce.com.

Call 1-800-588-5260 or

E-Mail: James.Porter.18@us.af.mil ©2014 Paid for by the U.S. Air Force. All rights reserved.

26

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

Patients, Families, Healthcare Workers and the Mentally Ill

By Robert P. Granacher Jr., MD, MBA

The COVID-19 pandemic is the first major pandemic to hit our country with such violence since the 19171918 Type B Influenza pandemic.

Extensive research in disaster and mental health has established that emotional distress is ubiquitous in affected populations such as COVID-19.1 However, this disaster has some unique properties compared to other disasters that have hit the United States, such as multiple hurricanes, etcetera. After environmental disasters, most people are resilient and do not succumb to mental illness or psychopathology. However, it is not unusual in such conventional natural disasters, technological accidents, and intentional acts of mass destruction that posttraumatic stress disorder (PTSD) would be a possible outcome, which will be discussed further. Interestingly, medical conditions from natural causes, such as life-threatening viral infections, do not meet the current DSN-5 criteria required for a diagnosis of PTSD2, but other psychopathology such as depression and anxiety disorders may ensue.

This pandemic is new to most living Americans and goes beyond stresses inherent in the illness itself, mass homeconfinement directives, stay-at-home orders, quarantine, and isolation. These

raise concern about how people will react individually and collectively, and we have not seen the last of this yet.2 In the current pandemic, the home confinement of large swaths of the population for indefinite periods, differences among the stay-at-home orders issued by various jurisdictions, and conflicting messages from government and public health authorities, is most likely intensifying distress.1 Ideally, the integration of mental health considerations into COVID-19 care should be addressed at the organizational level through state and local planning; mechanisms for identifying, referring, and treating severe psychosocial consequences; and ensuring the capacity for consulting with specialists.3 As expected, families are suffering greatly with posttraumatic stress disorder, grief, and severe loss due to the COVID-19 virus. Psychological symptoms of PTSD and depression are relatively common among family members of patients who die in the ICU. Studies of impacts upon families after a loved one dies in the ICU predated the COVID-19 virus. We have learned a lot that can be applied to the current COVID-19 pandemic. For example, we have learned that family members who are present at the time of death of a loved one have higher rates of PTSD than family members that are not present. Moreover, family members of younger patients suffer greater likelihood of PTSD than do family members with very elderly loved ones. Lastly, family members of those for whom mechanical ventilation is not withdrawn are at increased risk for psychological symptoms compared to those who are present when

mechanical ventilation is withdrawn. Thus, with this paradox it is felt that the family should be offered the option of not being present for some of these procedures or events.4 There is emerging evidence that our first-line healthcare workers are suffering greatly from the COVID-19 pandemic. Neil Greenberg and colleagues have provided cogent directions for institutional care of healthcare staff in the British Medical Journal.5 They note that many healthcare workers will suffer a moral injury, a term that originated in the military, and is defined as the psychological distress that results from actions or the lack of them, which violates someone’s moral or ethical code. Moral injury is not a mental illness, but those who develop moral injuries are likely to experience negative thoughts about themselves or others. These symptoms can then contribute to the development of mental health difficulties, including depression, PTSD, and even suicidal ideation. Some people who suffer a significant moral or traumatic experience develop a degree of posttraumatic growth. Whether someone develops a psychological injury or experiences psychological growth is likely to be influenced by the way that they are supported by their institution, during and after a challenging incident.5 Greenberg et al.5 provide some key thinking for institutional administrators of healthcare agencies regarding their healthcare staff. Those are as follows: • Healthcare staff are at increased risk of moral injury and mental health problems when dealing with challenges

doc

www.kentuckydoc.com | Summer 2020 | Kentucky

Many healthcare workers will suffer a moral injury.

MORAL INJURY: A TERM THAT ORIGINATED IN THE MILITARY, AND IS DEFINED AS THE PSYCHOLOGICAL DISTRESS THAT RESULTS FROM ACTIONS OR THE LACK OF THEM, WHICH VIOLATES SOMEONE’S MORAL OR ETHICAL CODE.

such as a COVID-19 pandemic.

• Healthcare managers need to proactively take steps to protect the mental wellbeing of staff.

• Managers must be frank about the situations staff are likely to face.

• Staff can be supported by reinforcing teams and providing regular contact to discuss decisions and check on wellbeing.

• Once a crisis begins to recede, staff must be actively monitored, supported, and where necessary, provided with evidence-based treatments.

In fact, critical care nurses have been shown for years to suffer higher rates of posttraumatic stress disorder when compared with other general nurses.

This is currently being augmented by the COVID-19 pandemic. In 2006, the vacancy rate for nurses and critical care positions was approximately 17%. It is projected to increase after COVID-19.6 Interestingly, to determine the impact of COVID-19 on the mentally ill, most research seems to be coming out of China.

The author of this article will eschew that and describe likely more representative literature. However, this paper is too early in the COVID-19 evolution to capture much research that has not been generated in China. Most research systems outside of China are providing speculation of what may occur based on prior information about pandemic impacts upon communities of mentally ill people.

The Asian Journal of Psychiatry reports on the impacts of COVID-19 pandemic on preexisting mental health problems in India. It seems a bit more speculation than

true science, but notes that COVID-19 is expected to have a more severe impact.

Obsessive-compulsive disorder patients, especially those who have checking, hoarding, and washing compulsion, are at higher risk for exacerbations. Personal hygiene measures such as handwashing, may increase the contamination obsessions and washing compulsions. In the face of ongoing lockdown, patients with mental illness are more likely to resort to panic buying and excessive hoarding of essential items, even though a continuous supply of essential items may be assured.

For recurrent depressive disorder patients, lockdown is a major stress, jeopardizing normal daily routines and social rhythms, thereby increasing stress levels that would further escalate cortisol levels, resulting in a vicious exacerbation of depressive symptoms. The same is felt to be true for generalized anxiety disorder with chronic insomnia. Quarantine may lead to different kind of problems. It can precipitate fear, anger, anxiety, and panic about worst possible outcomes, as well as boredom, loneliness and guilt about not being there for the family.7 There is currently as yet no quality research on populations of people who are in situations of lockdown or quarantine that can fully enlighten or inform us.

Unfortunately, we are dealing with a virus formerly unknown to the science community of the world, which has now unleashed a terrible pandemic on the world. Thus, we have limited scientific data at this time to inform us about how to care for our patients, how to care for patient families, how to care for our healthcare workers, or how to care for ourselves.

References 1. Pfefferbaum B, North CS. Mental health and the COVID-19 pandemic. New England Journal of Medicine, online ahead of print, April 13, 2020, 13.doi:10.1056/ NEJMp2008017 2. Brooks SK, Webster RK, Smith LE, et al.

The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet; 395: 912-920, 2020 3. Phefferbaum B, Schonfeld D, Flynn BW, et al. The H1N1 crisis: A case study of the integration of mental and behavioral health in public health crises. Disaster Medicine and Public Health Preparation; 6: 67-71, 2012 4. Kross EK, Engelberg RA, Gries CJ, et al. ICU care associated with symptoms of depression and posttraumatic stress disorder among family members of patients who die in the ICU. Chest; 139: 791-801, 2011 5. Greenberg N, Docherty M, Gnanapragasam S, et al. Managing mental health challenges faced by healthcare workers during COVID-19 pandemic. British Medical Journal; 368: 1-3, 2020 doi:10.1136/BMJ.m1211 6. Mealer ML, Shelton A, Berg B, et al.

Increased prevalence of posttraumatic stress disorder symptoms in critical care nurses. American Journal of Respiratory Critical Care Medicine; 175: 693-697, 2007 7. Chatterjee SS, Malathesh BC, Mukherjee A. Letter to the editor: Impact of COVID-19 pandemic on pre-existing mental health problems. Asian Journal of Psychiatry; 51, 2020

27

28

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

PROFILE IN COMPASSION

Lifelong Curiosity Emergency Medicine, Public Health and Organized Medicine

Interview of Steven Stack MD, (pictured) Kentucky’s Commissioner of Public Health, an emergency medicine physician and past president of the American Medical Association. He was interviewed as Kentucky entered its 4th month of the COVID-19 pandemic.

By John A. Patterson MD, MSPH, FAAFP Why did you want/decide to be a doctor?

“My choice to pursue medicine was pragmatic. I enjoyed science and engaging with people; being a physician seemed a good combination of the two. I have a wide-ranging curiosity. I was a Classics/Pre-Med major in college. My life is a tapestry of those who have strongly influenced who I am, including my 6th grade science teacher who supported my curiosity in biology and chemistry in the classroom and on field trips.”

Why emergency medicine?

“I like the variety. I’ve had a broad-based curiosity about the world for as long as I can remember, and emergency medicine has satisfied my curiosity. In my first two years of medical school, I did a clinical research project that made it possible for me to spend hundreds of shadowing hours in the ED. Before my clinical years, I had learned to read EKGs and suture lacerations. I found the unique vibes of the ED night shift really exciting, so much so that I was an all-night physician my first five years in clinical practice.”

Why organized medicine?

“I enjoy interactions with people. I went to my first AMA meeting as a second-year medical student. I met so many interesting doctors and interacted with attending physicians in a different way, away from the educational hierarchy. These senior physicians were initially my superiors, then mentors, and now career-long friends. I’ve spent thousands of hours engaged in organized medicine over

nearly 25 years and have loved nearly every one of those hours, benefited many times over from the informal learning I gained, and have a large array of professional colleagues and friends. Organized medicine has been a great blessing and cherished part of my life. I hope in some small way I’ve been able to contribute to our profession and the patients we serve.”

Why public health?

“In a real way, emergency medicine is applied public health. In the ED, we see poor choices resulting in chronic disease, social inequities causing disparities, and inadequate prevention yielding calamities. And the ED is the great equalizer. The ‘mighty’ and the ‘least among us’ can both be brought face-toface with their humanity and mortality. After I fell and cut my face in Seattle, I went to the ED and identified myself as an emergency physician in town for a meeting. I was told to take my seat in the waiting room where I waited 90 minutes with a homeless man and a psychotic woman.”

“And, inversely, the least among us can be treated with a dignity and respect they might not otherwise find. It’s not uncommon in an ER at 2am for a physician with 11 years of combined collegiate, medical, and residency education to fetch a blanket and cup of coffee for a homeless person seeking shelter from a cold and rainy night. I never imagined I would one day be a public health commissioner for an entire state but, in hindsight, my combined background as an emergency physician and organized medicine leader sure do seem to have been a pretty good preparation for the role.”

Have you ever felt burnout or compassion fatigue?

“Yes. There are degrees of this. Compassion fatigue is a more common condition that can result from overwork and lack of proper selfcare. Burnout is a different sort of exhaustion.

It becomes more difficult to be patient and tolerant with others. Desensitization and depersonalization of patients becomes a danger. Each of us has only so much emotional reserve and we have to take care of ourselves to refill our tanks.”

“I have felt that mental and emotional exhaustion. It’s not a good feeling. A number of years ago, I was an over-committed ER doctor and AMA trustee. I remember a patient encounter in which I was simply unable to focus, unable to even hear the patient’s words.

I had to ask a colleague to cover for me and left my shift early. Luckily, I had vacation time scheduled soon after and was able to recover.”

“You have to be aware of compassion fatigue and burnout and recognize they are self-protective human mechanisms- not personal failings. Without this awareness, it can get worse. We must titrate our workload to our personal tolerance and capacity and not let them impact patient care. Whether it’s emotional exhaustion or facing routine daily challenges, you have to stay centered and grounded and instill a self-care discipline in your life.”

“Promoting our own resilience includes the functioning of the systems in which we workbeing engaged, maximizing our potential for STACK Continued on Page 30

doc

www.kentuckydoc.com | Summer 2020 | Kentucky

Remain curious and explore what interests you. Find what makes you tick – what you enjoy.

– Steven Stack, MD

29

30

doc | Summer 2020 | www.kentuckydoc.com

Kentucky

STACK continued from Page 29

control over our work environment. This was a big part of my efforts over 11 years on the AMA board and as president. Our mixed results reflect the difficulty of the task.”

How have you handled stress/ burnout? What is your go-to stress reliever?

“I like to read, particularly history and biography but I go off on far-flung detours and read business, science, finance, economics, and other books. I plan to read a biography of every U.S. president. History and historical biographies ground me. A cup of coffee at 5 AM while reading for 20-30 minutes is a daily routine that helps me get centered, grounded and balanced and keep in perspective my place in the world and in this time in history. I learn by doing this and it helps me be more patient with the challenges I have to face later in the day.”

I worry about some of my colleagues in public health who are putting in 16 hour days, 7 days a week during this pandemic. I’ve done it, too, but when I see it affecting me, I back off and make space to recharge. Peak performance includes time and space to connect with friends and family and recharge by doing activities you enjoy. This provides perspective and helps take me away from the concerns of the moment. It also provides a broad perspective as Kentucky’s top public health officer during this unprecedented pandemic.”

Describe your personal mission, purpose, values and how you express them in your job?

“During a Chicago Tribune interview in 2015 during my AMA presidency, I was asked what I wished I had learned earlier in my life.

I said I wished I had learned to say ‘thank you’ more often. Over time, I have developed a deep, sincere gratitude for the contribution of others.”

“My mission statement for leading a personal life could be summed up by my favorite Bible verse, Micah 6:8- ‘What the Lord asks of you, you have been told, it’s only this- to act justly, to love tenderly and to walk humbly with your God.’ Justice, tenderness, compassion and humility. I aspire to these in my effort to improve myself. I am not what I aspire to be. My aspirational goals are higher than what I have become.”

“I aspire to be a servant leader- leading without being ego-attached to the process, helping those I work with and making the world better than I found it. I have accepted that some will think I am doing a great job while others will think I am destroying the world because of very different worldviews.

Humility leads me to accept that what is right for one person seems wrong to another. I have come to accept that as the nature of the human journey. Humility doesn’t feel like a failure but rather a mature recognition of the way things are. In the ER it means getting a homeless patient a cup of coffee at 2AM or having to intubate and manage a difficult airway in a crisis- these can be equally important in their own right. I am aware that the little things can be as important as the big things.”

“Being a servant leader also reveals itself in my relationship with the governor. I am an advisor and feel my input is respected. This is a great opportunity and privilege. Over the years, the value of humility has become much more important to me. I’m not the most devout or religious person but I went to Catholic grade school, high school and college.

High school and college were within the Jesuit order, known for their intellectualism and academics. I am thoughtful and philosophical with a far-ranging curiosity and a component of religion and faith. I find it helpful in press conferences with the governor to be able to draw upon my lifelong curiosity and a deep

reservoir of metaphor, analogy and stories from history, theology or philosophy.”

“This pandemic has caused so much harm to human health and the economy. There is so much pressure to reopen long before a public health determination of safety. I am really concerned that the combination of the pandemic, premature reopening and large public demonstrations over social injustice may result in further harm.”

How can we help our colleagues, residents and students navigate these stressful times in medicine and society?

“Remain curious and explore what interests you. Find what makes you tick – what you enjoy. Some may exercise, attend church services or journal to ground themselves. It isn’t the specific activity that is important as much as the routine discipline to center and ground yourself to be prepared for whatever you face in your day. It helps promote resiliency. I’ve learned it’s not selfish to take time for yourself, be offstage, be with family and recharge your batteries. This is a necessity- not selfish.”

“Students and residents need a relationship with money as a tool- a means to an end, not an end in itself. When your income goes up, don’t change your lifestyle for a year. Retire your debt. The enjoyment we get from material things fades very quickly.

Focus on acquiring life experiences rather than things. Experiences enrich us- things impoverish us. My biggest challenge for the life I have remaining is to do things that are meaningful and personally fulfilling- while noticing what makes other people passionate and inspires them to love what they do.”

About the author Dr Patterson is board certified in family medicine and integrative holistic medicine. He teaches mindfulness-based stress reduction (MBSR) for the University of Kentucky Wellness Program and Saybrook College of Integrative Medicine and Health Sciences (Pasadena). He operates the Mind Body Studio in Lexington, where he offers classes and consultations for people with stress-related conditions and burnout prevention for health professionals. He can be reached at www.mindbodystudio.org.

dependable. thorough. trustworthy.

LANDSCAPING, MOWING, MULCHING, LEAF REMOVAL, GUTTER CLEANING, PRESSURE WASHING

Leave the cleaning to Kentucky’s Finest!

Take the stress of cleaning off of your plate.

With ten years of dependable service to Lexington families, seniors and businesses, Kentucky’s Finest offers experience you can trust.

Pilot Landscaping 859-447-5075

FREE QUOTES • CALL SHAWN HILL great for seniors and busy families

FLEXIBLE SCHEDULES: WEEKLY • BI WEEKLY • MONTHLY

ard How e y t s ot Mi Call free qu for a

1 0 7 3 -275 Kentucky’s Finest

606

LLC

HOME & COMMERCIAL CLEANING

Make a Difference in a Young Person’s Life:

Become a Mentor

Lexington Medical Society Mentorship Program What: We are requesting physician mentors for our incoming 3rd year U.K. College of Medicine medical students. The program runs September, 2020 to May, 2021.

Why: Help shape the future leaders of the practice of medicine.

For more information: go to lexingtondoctors.org/mentor-program or contact Cindy Madison, LMS Director of Membership & Communications, cmadison@lexingtondoctors.org or call (859) 278-0569.

BUSINESS DEVELOPMENT || |MARKETING & || |SOCIAL MEDIA || |VIDEO COACHING BUSINESS DEVELOPMENT MARKETING SALES SOCIAL MEDIA PRACTICEISSUES ISSUES|| |COACHING COACHING BUSINESS DEVELOPMENT MARKETING &&SALES SALES SOCIAL MEDIA VIDEO PRACTICE ISSUES COACHING BUSINESS DEVELOPMENT | MARKETING & SALES | SOCIAL MEDIA |VIDEO VIDEO|| ||PRACTICE PRACTICE ISSUES

Helping Helping you you Develop Develop the the Practice Practice

20+ Years of Results, 20+ Years Driving Results, 20+ Years ofofDriving Driving Results, 20+ Years of Driving Results, and Being Measured by and Being Measured by Them andand Being Measured byThem Them Being Measured by Them

You You Envisioned Envisioned

businesses grow.

II work to businesses grow.

I work businesses grow. work toto to businesses grow.

I work

What Whatcan canaaconsultant consultantdo dofor foryou? you?

Think of me as both an “outsource resource, ”” as well as aa acoach to help: Think me both “outsource resource, ”as well coach help: Think ofof me asas both anan “outsource resource, well asas toto help: Think of me as both an “outsource resource, ” as as well as acoach coach to help:  Make sense of your competitive environment, Make sense your competitive environment,  Make sense ofof your competitive environment, Make sense of your competitive environment,  Leverage available tools to your advantage, and Leverage available tools your advantage, and  Leverage available tools toto your advantage, and Leverage available tools to your advantage, and  Ensure you accomplish goals important to your personal vision.

Ensure you accomplish goals important your personal vision.  Ensure you accomplish goals important toto your personal vision.

Ensure you accomplish goals important to your personal vision.

Arrange Arrange confidential discussion about the challenges you face.

Arrange confidential discussion about the challenges you face.

Arrangeaaaaconfidential confidentialdiscussion discussionabout aboutthe thechallenges challengesyou youface. face.

I’m with practical I’maI’m coach with practical I’m a acoach coach with practical a coach with practical experience helping professional experience helping professional experience helping professional experience helping professional help you market your practice, help you market your practice, help you market your practice, help you market your practice, differentiate your services and differentiate your services and differentiate your services and differentiate your services and increase your patient base. increase your patient base. increase your patient base. increase your patient base.

 502.208.9639 502.208.9639 502.208.9639  jimrayconsultingservices.com jimrayconsultingservices.com jimrayconsultingservices.com  jimrayconsultingservices.com  /JimRayConsultingServices /JimRayConsultingServices /JimRayConsultingServices /JimRayConsultingServices  /jimray4 /jimray4 /jimray4 /jimray4  to My Business Podcast on iTunes Listen My Business Podcast on iTunes Listen My Business Podcast on iTunes Listen Listen tototo My Business Podcast on iTunes