Health Matters - Fall 2020

Fall 2020

A publication of

Health Matters est. 1851

MENTAL HEALTH CARE

COVID 19’s affect on mental health SEE STORY ON PAGE 2.

Shaw Media photos/Goldie Rapp Haley Fritz (from left), mental health case manager; Mike Miroux, licensed clinical professional counselor and board certified telemental health provider and Petrita Salazar, licensed therapist (LCP) pose for a photo inside the conference room at Open Doors Community Counseling in front of the motto, “Empowering people, enriching community.”

Bureau County Republican / bcrnews.com • Saturday, September 12, 2020

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MENTAL HEALTH CARE

Open Doors counselor weighs in on mental health challenges during COVID

Compiled by Goldie Rapp

sure why more have not been seeking counseling.

PRINCETON — Natural disasters, infectious diseases and other human- How are you addressing the fear, anxiety itarian crises come with many mental and feelings of isolation during these health challenges and the COVID-19 times? pandemic is no exception.

Initially, like most, we shifted to teleDuring times of uncertainty, most people experience some degree of fear mental health counseling, We are now seeing most clients in the office and and stress.

Mike Miroux, a licensed clinical following safety guidelines. We still professional counselor and board cer- provide telemental health but most tified telemental health provider at of our clients prefer in-person sessions. So, we try Open Doors Comto balance their munity Counselneed for in-person ing in Princeton, said these sort of “There is certainly worry connection while keeping everyone emotions are not as safe as possible. among our clients about always a bad thing We try to address because they preCOVID-19, but we are not our clients’ menpare people to tal health and soact against a perceived threat, sure why more have not been cial needs through counseling. We commonly known seeking counseling.” recently hired as the fight-ora social worker flight response.

Mike Miroux, Open Doors who has been But too much Community Counseling helping our clistress and fear can ents find employquickly surpass ment, community the ability to cope resources, transportation and financial with these feelings.

“There has been a lot of discus- assistance. sion around decision fatigue from the stress of COVID-19. We have had to Are you finding that people are turning make some very unprecedented and to drugs and alcohol to cope with their difficult choices regarding the health feelings? How can this be counterproand safety of ourselves and our loved ductive? ones,” he said. “These seemingly endWe see a lot people turn to prescripless decisions can be physically and emotionally exhausting. In addition, tion medication, tobacco and cannaCOVID-19 has created many other bis to cope with intense feelings, stress stressors including job loss, child care and sometimes boredom. This is very challenges, social isolation, food/hous- concerning to us because it can lead to medication misuse, addiction, worsening insecurity, etc.”

Miroux has shared some insight on ing mental health problems, financial how he and fellow counselors are ad- problems, long-term health consedressing COVID-19 and some advice quences, etc. As the coronavirus panon how to overcome the negative im- demic wages on, I think this problem pact the pandemic can have on mental will continue to worsen. We try to not only teach alternative, more healthy health. ways of coping, but also help our cliHave you seen an uptick in clients since ents find meaning and fulfillment in their lives, especially during this time the start of the pandemic? when our health, jobs and safety is We have not seen an uptick in cli- pretty uncertain. ents and that is concerning to us. We have been waiting for that sudden For people feeling isolated, what are good influx of requests for counseling, but ways to overcome that? so far it has been manageable for us.

It is important that people conThere is certainly worry among our clients about COVID-19, but we are not tinue to find ways to connect with

Haley Fritz (from left), mental health case manager; Petrita Salazar, licensed clinical professional counselor and Mike Miroux, licensed clinical professional counselor and board certified telemental health provider, discuss mental health challenges they are seeing during COVID. each other while practicing social ant that you take time to do the things distancing. Many people have been you enjoy. Give yourself permission to using social media and other forms prioritize your own mental health. of technology to connect with family and friends, but there are many other • Get organized. This can help reduce ways. Join an online discussion group the number of stressors and decisions or start your own. Pick up the phone we are faced with each day. Some and call someone. Take part in collec- of my clients use a weekly planner, tive mutual aid for disaster relief or for prepare meals in advance, schedule a cause you are passionate about. Vol- transportation, set reminders, follow a unteer at a local nonprofit. Write a let- routine, etc. ter of encouragement to someone in a long-term care facility, group home or • Stay active. Stress and depression prison whose only contact in months can lead to unhealthy eating habits, may be with paid staff and other resi- weight gain and fatigue. Try to resist dents/inmates. Talk to a friend about urges to withdraw from daily activities. how they are overcoming isolation.

Go for a walk, bike ride, do chores around that house or yard work, start What is some common advice you give a new project, anything to invite moveyou reduce the strong emotions OR ways ment into our bodies. to cope with stress?

• Advocate. COVID-19 is particularly harmful to the mental health of marginalized populations who have less access to socioeconomic resources, health care and social support. I encourage my clients to raise awareness through social and political action of the unique stressors and challenges • Take time for self care. It is import- they face.

• Talk to someone about how you are feeling or coping. Many of my clients feel less stressed after opening up about situations or experiences that have caused strong emotions or stress to surface.

FLU PREVENTION

Millions of people across the globe get flu shots each year. Flu shots protect people against influenza, but they might provide even greater benefits in 2020.

As the world continues to confront the outbreak of the COVID-19 virus, it’s imperative that people everywhere take every step necessary to protect themselves and others. The Centers for Disease Control and Prevention notes that a flu vaccine will not protect people against COVID-19. However, flu vaccines have been shown to reduce the risk of illness related to the flu. Those illnesses weaken people’s immune systems, making them more vulnerable to other viruses, including COVID-19.

Flu vaccines have also been shown to reduce the risk of hospitalization.

That’s a significant benefit of being vaccinated, as people who get their flu shots can indirectly help hospitals conserve potentially scarce resources.

As the COVID-19 virus rapidly spread

late in the winter of 2019-20, many hospitals across the country and even the globe were stretched incredibly thin. So anything ordinary citizens can do to alleviate such burdens can help save lives while also making hospital workers’ jobs easier and less stressful.

Many people may be concerned about going out and getting a flu shot in 2020. That’s especially likely for people who live in communities where the COVID-19 virus is spreading. However, the CDC notes that getting a flu shot in 2020 is an essential part of protecting your health and the health of your family. Many doctor’s offices are now insisting patients wait in their cars until doctors are ready to see them, and masks may be required when entering the doctor’s office.

Such measures can reduce the risk of getting the COVID-19 virus when visiting a doctor’s office for a flu shot or another visit, so patients should not be hesitant to receive their vaccinations in 2020. Patients can follow such

protocols even if their doctors are not insisting they do so. The same safety measures can be followed by people who intend to get their flu shots from neighborhood pharmacies.

Flu shots are vital to individual and

public health every year, but the importance of being vaccinated against influenza in 2020 is heightened as the world continues to confront the outbreak of the COVID-19 virus.

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HEALTH MATTERS |Bureau County Republican / bcrnews.com • Saturday, September 12, 2020

Why the flu shot is so important in 2020

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Bureau County Republican / bcrnews.com • Saturday, September 12, 2020

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HEART HEALTH

Taking control of AFib:

What you can learn from one patient’s journey (BPT) - Meet Josh, a 46-year-old father of four from Texas. Josh leads a very active life and enjoys riding motorcycles and spending time outdoors with his children and grandchildren.

Josh’s life suddenly changed after he was rushed to the hospital where he was diagnosed with congestive heart failure and spent several weeks receiving treatments. Two years later, when Josh thought his heart condition was behind him, Josh’s wife became concerned when she noticed his heart was beating irregularly.

“My wife was lying on my chest one evening and felt the irregularity of my heartbeat,” Josh said of his arrhythmia.

“I don’t know how long I had been experiencing the rhythm. She insisted I call the doctor the next day and I was admitted into the hospital for Atrial Fibrillation.”

Atrial fibrillation (also referred to as AF or AFib) is the most common heart rhythm disorder, impacting more than 33 million people worldwide.[1] AF also presents an increased risk of stroke and heart failure.[2][3] With AF, the upper chambers of the heart beat very quickly and irregularly, compromising the ability of the heart to pump blood efficiently to the rest of the body.

While Josh had a history of congestive heart failure, a common cause of AF, he never experienced any symptoms of AF. Fortunately, by addressing the signs of AF and seeking treatment early, Josh was able to discuss with his physician the best way to manage his arrhythmia.

Every patient’s journey can be different, but here are four questions to consider and discuss with your doctor to make sure you’re smart about the signs and symptoms of AF and the best ways to manage this common heart condition.

FOUR QUESTIONS TO ASK YOUR DOCTOR ABOUT AF  What are the signs and symptoms of AF? Knowing the signs, symptoms and risk factors to spot AF early can be lifesaving. AF most often affects peo-

ple with existing heart disease, or those who have had a heart attack, congestive heart failure or heart surgery. Other risk factors include high blood pressure, clogged arteries, diabetes, overactive thyroid, emphysema or other lung diseases, viral infections, sleep apnea, stress, fatigue and age.  How is AF diagnosed?

Detecting AF can sometimes be challenging as it often occurs without notice. Forty percent of people with this life-threatening condition experience no symptoms - which is why many doctors call it a silent killer. Patients might be able to detect AF early if they notice a skipped heartbeat, a thud or thump followed by a racing heart rate for an extended amount of time, or symptoms mimicking a heart surgical ablation procedures. attack.

Catheter ablation is performed by an Doctors may use one or more of the electrophysiologist (EP), a heart docfollowing tests to determine if a patient tor who specializes in heart rhythms.

Catheter ablation is a minimally inhas AF: vasive procedure in which the doctor advances a flexible thin tube (cathe• Electrocardiogram (ECG) ter) through the blood vessels to your • Stress test • Longer-term monitoring devices* heart. There are two types of catheter ablation procedures - one involves Event recorder using cold energy to freeze the tissue • Holter monitor (cryoablation) and the other is heat• Insertable cardiac monitor based (radiofrequency ablation). Josh For Josh, an Insertable Cardiac chose cryoablation for this treatment.

Monitor (ICM) was the chosen tool Surgical ablation also treats the abnorto help determine what was going on mal rhythms, but access to the heart is more invasive through open-heart with his heart. surgery.

ICMs are implanted through a min Can I still live my best life with AF? imally-invasive procedure, and the With early diagnosis and treatment, device is placed just beneath the skin through a small incision in the upper AF can be managed so that it doesn’t left side of the chest. This allows phy- need to impact your overall quality of sicians to continuously and wirelessly life. monitor a patient’s heartbeat for up to Take Josh as an example: after his three years. cryoablation procedure he said, “My An AF diagnosis may be overwhelm- heart is back to normal function and ing and come with a lot of questions I’m not taking any medication. I still - causes, symptoms, treatment options, have my device monitor to watch for etc. It’s important to talk with your AF and I haven’t had any AF episodes doctor to feel confident in your diag- since my cryoablation.” nosis and road forward.

In fact, Josh is back on his motor What do treatment options look like? cycle and able to fully enjoy cruising There are many treatment options down wide-open roads and spending for AF patients including medications, time with his wife and family. cardioversion, catheter ablation and

Common symptoms of AF include: • Heart palpitations (skips a beat, beats rapidly, thumps) • Fainting • Dizziness • Weakness • Shortness of breath • Angina (chest pain or discomfort) If you or a loved one are experiencing symptoms of AF, don’t hesitate to speak to a doctor. Learn more about AF treatment options at https:// www.medtronic.com/us-en/c/cardiac-rhythm/af-awareness-month.html.

[1] Chugh S, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study.

Circulation. 2014; 129:837-847.

[2] Chamberlain AM, Redfield MM, Alonso A, Weston SA, Roger VL. Atrial fibrillation and mortality in heart failure: a community study. Circ Heart Fail. November 2011;4(6):740-746.

[3] Chamberlain AM, Byrne MC, Alonso A, et al. Comorbidity Burden in Atrial Fibrillation: A Population-Based Case-Control Study.

Circulation. March 4, 2015;131:Suppl 1:AP108.

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HEALTH MATTERS |Bureau County Republican / bcrnews.com • Saturday, September 12, 2020

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Bureau County Republican / bcrnews.com • Saturday, September 12, 2020

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PAIN MANAGEMENT

Chronic pain management can’t wait for the end of the pandemic (BPT) - When COVID-19 halted all non-essential health services, it begged the question - what types of care can’t be delayed? Treatment for chronic pain, for one. Not only is pain management essential care, it’s even more critical during stressful times.

The good news is the pandemic has inspired innovations, such as telehealth and minimally invasive treatments for long-lasting pain relief, to help suffering patients, says the American Society of Anesthesiologists (ASA).

“The anxiety and isolation caused

by COVID-19 adds to chronic pain, which is further compounded by reduced access to strategies, such as physical therapy, exercise and even visits with the grandkids or other loved ones, that help people manage their discomfort,” said David Dickerson, M.D., pain medicine specialist and vice chair of ASA’s Committee on Pain Medicine. “As a result, they may be more likely to turn to medications or alcohol, increasing the risk of misuse and abuse. Physician anesthesiologists who specialize in pain medicine have gotten creative to ensure their patients have access to the safest and most effective care.”

Here are three ways pain management changed due to COVID-19.

GREATER ACCESS TO PROVIDERS THROUGH TELEHEALTH When the COVID-19 pandemic suspended in-person visits, physician anesthesiologist pain medicine specialists turned to secure video meetings or telephone calls to consult with patients. Led by the Centers for Medicare & Medicaid (CMS), health insurance companies revised their coverage to include telehealth to ensure this vital care. Using telehealth visits, pain medicine specialists see the patient face-to-face via video, ask and answer questions and formulate a plan. They can refer those struggling with stress from COVID-19 to psychologists who also can counsel them via telehealth.

Telehealth also removes some barriers to care during a pandemic. Patients don’t need to worry about getting to an appointment, or sitting for long periods in crowded waiting rooms.

Via telehealth, they wait in a virtual waiting room in their own home. Spe-

cialists can easily access patients’ electronic medical records while talking to them virtually. As a result, 95% of people seeing pain medicine specialists have continued to do so, many of them via telehealth, which likely will remain an option for the foreseeable future.

PAIN MEDICINE SPECIALISTS EXPAND ROLE TO MEET PATIENTS’ NEEDS During the pandemic, many patients have put off seeing their primary care physicians, so pain medicine specialists have been helping fill that role.

They’re getting patients to understand the importance of seeking necessary treatment, such as visiting the emergency room if they are experiencing signs of stroke or angina, a symptom of heart disease.

pulses that disrupt pain signals; and ity of life during the pandemic and beradiofrequency ablation or neurolysis, yond.” which silences nerves that bring pain Learn more about how pain specialsignals from inflamed joints or tissue. ists can help you manage your chronic “Treatment for debilitating pain is pain and download tips for relieving complex in any circumstance and even pain during the pandemic. more so during this health crisis,” said Dr. Dickerson. “Physician anesthesi- 1. http://www.odmap.org/Content/ ologists and other pain medicine spe- docs/news/2020/ODMAP-ReportAs in-person medical appointments cialists can ensure proper and effective June-2020.pdf resume, many pain medicine special- approaches to care that improve qualists have revised their office visit practices, requiring masks and staggering appointments, to keep patients safe.

Although telehealth remains an option, having the patient come into the office is preferred in some instances.

For example, pain medicine specialists can more readily treat those with addiction issues in person. During this national health emergency, the number of patients needing treatment for pancreatitis - painful inflammation of the pancreas often due to excessive alcohol use - has increased dramatically.

Early evidence suggests drug overdoses, including those from opioids, may be increasing as well.1

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For example, rather than giving patients a series of injections that require regular office visits, pain medicine specialists can perform procedures in one visit. Some of these treatments include a procedure called percutaneous image-guided lumbar decompression (PILD), which reduces pain by removing excess tissue in people with spinal stenosis (narrowing of the spinal canal that can compress nerves and cause pain in the back and legs); neurostimulation, in which a device implanted under the skin generates electrical im-

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PEDIATRIC HEALTH

(BPT) - As we start preparing for fall, there is no better time than now to schedule a well-child visit and make sure your child’s immunization records are up to date. According to the Centers for Disease Control and Prevention (CDC), “stay-at-home and shelter-in-place orders have resulted in declines in outpatient pediatric visits and fewer vaccine doses being administered, leaving children at risk for vaccine-preventable diseases.”

And don’t forget about getting a flu shot, recommended annually by the CDC for all children 6 months of age and older. Every year, flu causes serious illness and death. This is especially important this year since it’s still unknown if being sick with COVID-19 and the flu at the same time will result in a more severe illness.

Dr. Donna O’Shea, UnitedHealthcare chief medical officer of population Well-child visits are essential for health management, suggests families tracking growth and developmental discuss the following questions and milestones, examining social behav- topics with their child’s doctor: iors, and getting scheduled immuniza Ask what vaccines are appropritions to prevent illnesses like measles, polio and whooping cough. Just last ate for your child’s age and how to year, the U.S. had more than 1,250 make up any that have been missed. cases of measles - the greatest num Learn more about vaccines, inber of cases reported in the U.S. since 1992, which is all the more striking cluding what infectious diseases they when we consider that 20 years ago, prevent, the effectiveness of vaccines, measles was declared eliminated from and how they are developed and the U.S. because of our success in im- tested. munity through vaccination.

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 Discuss the common side effects or specific hours just for children, the of childhood vaccines, which are use of masks, and maintaining secure typically very mild, such as pain or and properly cleaned waiting areas. swelling at the injection site, and can  Be sure to bring home a copy of include low-grade fever or rash. the immunization record so you can  Find out what extra steps your keep track of your child’s tests and clinic is taking to see children safely shots, and also request a copy for during COVID-19, such as dedicated school.

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HEALTH MATTERS |Bureau County Republican / bcrnews.com • Saturday, September 12, 2020

Don't let COVID-19 prevent your child's annual doctor visit

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Bureau County Republican / bcrnews.com • Saturday, September 12, 2020

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