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SARASOTA

Health Matters Observer

OCTOBER 2020

The Faces of

COVID-19 Locals recall their experiences with the virus, as well as what they learned to help them recover. SEE INSIDE

SLOW PROGRESS

IN FOR 6, OUT FOR 8

FIRST STEP

PAGE 7

PAGE 8

PAGE 9

Antibody tests not yet proof of immunity.

Breathing exercises help lung health.

If COVID-19 has worsened your mental health, youâ€™re not alone.

HEALTH MATTERS

YourObserver.com

OCTOBER 2020

Fighting COVID-19 together Mask Up Manatee and Brain Health Initiative focus on educating the public about COVID-19.

have several small manatees printed on them. In Sarasota, the Suncoast Science Center Faulhaber Fab Lab created an online learning module built like a storybook to help students learn about COVID-19 in easy-to-understand terms. An education team of 13 people from the lab’s Student Community Innovation Program, which provides high school and college students an opportunity to give back to the community by helping solve a problem facing it, partnered with Sarasota County Schools to create “COVIDucation,” which provides factual information about the disease in elementary-aged terms. In the storybook, the character, Arthur the Knight, battles COVID-19. Kids learn what COVID-19 is, how it impacts people and how their actions can affect those around them. Another measure focused on educating the public about COVID-19 is the Brain Health Initiative. The initiative is a collaboration among the Academy for Brain Health and Performance; Massachusetts General Hospital, a Harvard Medical School teaching hospital; and Lakewood Ranch. The initiative is focusing on the neurological and mental health aspects of COVID-19 and how it impacts people. According to BHI’s website, more than half of individuals who test positive for COVID-19 might experience one or more neurologic symptoms, which include dizziness, feeling disoriented, loss of coordination, seizures, and numbness or tingling in the hands. Neuropsychologist Stephanie Peabody, the founder and director of BHI, said because neurologic and mental health symptoms are often not known, individuals might experience these as the earliest symptoms and not recognize them as symptoms of COVID-19. “From our perspective, understanding the symptoms could contribute to a decrease in the spread of the virus, and it can increase morbidity and mortality outcomes, meaning if people recognize these as earliest symptoms, we can take action more quickly as opposed to waiting for respiratory complications,” Peabody said. COVID-19 will play an important factor in the BHI’s study in Lakewood Ranch as it examines how people’s surroundings and life factors impact brain health.

LIZ RAMOS | STAFF WRITER

OVID-19 has taken everyone on a roller coaster ride. The number of daily con-

firmed cases has gone up and down unpredictably since the pandemic shut down the world in March. For the first 10 days of October, Sarasota and Manatee counties averaged 43 and 60 new cases a day, respectively. Health and safety guidelines have changed month by month, which has left many questions on how people get COVID-19 and how to protect themselves and their loved ones. It has caused an increase in stress due to uncertainty, sleep disruption, financial loss, job loss and more. Social distancing has caused some to feel isolated. As we hit six months into the pandemic, we’re dedicating this Health Matters issue to what the region looks like now. People who test positive for COVID-19 are impacted differently. Some have severe symptoms that land them in the hospital while others walk around with no symptoms but still spreading it. Pages 2-5 feature four locals who tested postive sharing their experiences with the disease. On Page 7, we dive into antibody testing, which is supposed to find if having COVID-19 once creates an immunity, like chicken pox, though scientists say you can’t yet base health decisions on test results. Even if you haven’t had the disease, your mental health has likely been affected by the pandemic. On Page 9, Tracey Weeden, of First Step of Sarasota, explains how the behavioral health agency has seen an influx in clients since March. CONTINUING EDUCATION

Other organizations have come together to ensure the public knows the latest information in hopes of slowing and stopping the spread. The School District of Manatee

File photos

Top: Scott Hopes, a member of the Manatee County School Board, shows the children’s mask distributed as part of the Mask Up Manatee Coalition. Above: Neuropsychologist Stephanie Peabody, the executive director of Brain Health Initiative, says people might not recognize neurologic and mental health symptoms as early symptoms of COVID-19.

County — in partnership with the Manatee County government and dozens of county agencies, nonprofits and businesses — created the Mask Up Manatee Coalition. The coalition’s goal is stopping the spread of COVID-19 by educating residents and encouraging people to follow CDC guidelines, wear masks, maintain social distancing and practice good handwashing techniques. When it was first introduced in August, Cynthia Saunders, the Manatee superintendent, said the purpose of the coalition is to speak with one clear voice specific to Manatee County. “We believe we can do more if

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we are fighting this battle together,” she said. Both the Manatee school district and Manatee County government created videos to encourage residents to wear masks in public. Members of the coalition went to six businesses, organizations and nonprofits throughout Manatee County on Sept. 18 to distribute some of the 50,000 masks that were purchased by the county using coronavirus relief funds. The masks are being distributed to areas hardest hit by COVID-19. Masks are available for children and adults. The adult masks have a manatee wearing a mask on them while the children’s masks

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HEALTH MATTERS

YourObserver.com

OCTOBER 2020

COVID-19 SURVIVORS

Andrew Neuman Neuman says he felt isolation and an emotional toll after testing positive. HARRY SAYER STAFF WRITER

ndrew Neuman doesn’t miss work. Even if he’s feeling under the weather, the 38-year-old retail innovation and design worker makes sure to push through to get work done at home. It’s something he prides himself on. COVID-19 changed that. He doesn’t know exactly where he got the coronavirus, but he knows when it started — sometime in mid-June. Neuman was wearing a face mask at work, routinely having his temperature checked and being careful with his family. But all the same, he started coming down with a fever. The first temperature check was more than 100 degrees, just shy of the CDC guidelines but higher than what his work would accept. Hours later, he started getting chills and woke up sweating. At that point, he said, he knew something was up. Neuman played it safe and started working from home, also getting tested at his doctor’s office on a Friday. He started feeling better and wasn’t sure if he had the virus in the first place. He received his positive result that Monday, and new symptoms

“There’s the physical aspect of having it, but there’s this underside of the emotional toll of being one of the first people.” came with it. By that afternoon, he was exhausted just trying to listen to someone. He describes it as an intense brain fog. “I’ve never had anything like it, and it just got worse,” Neuman said. “By 3 o’clock, I felt like I was going to pass out.” Simply listening to music or watching TV was too much for him to handle, he said. Neuman didn’t want to alarm his two children and just wanted to power through, but that’s hard to do when he had to lie down every two hours. His wife tested negative, and his kids never showed symptoms, but the entire family quarantined nonetheless. Neuman was the first in his family and friends circle to test positive and found it to be a lonely experience. His son’s little league team had to self-quarantine for

because we

Harry Sayer

two weeks to be safe, which didn’t help the feeling. “There’s the physical aspect of having it, but there’s this underside of the emotional toll of being one of the first people,” Neuman said. “Your friends and family don’t really know what to say or how to act. “Even after I tested negative, I would walk into a room, and people would put on a mask right away. I felt like no one else knew what I was going through.” His doctor was testing him once a week; he tested positive three times in as many weeks. His fatigue began subsiding after two weeks, though he lost his sense of taste and smell relatively late.

CARE

To prepare for his return to work, Neuman would take an hour each day to mimic sitting down at his desk and starting his work day. He only returned to work when he was free of symptoms and tested negative twice. Neuman said he is feeling better now but added that it was a long time coming. He has tested positive for antibodies and started giving convalescent plasma, wanting to give back where he can. He’s still wearing masks to set a good example. “I could walk and say, ‘Hey, I already had it; I don’t need to wear a mask,’” Neuman said. “But it’s not just about you. It’s about having respect for other people.”

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HEALTH MATTERS

YourObserver.com

OCTOBER 2020

COVID-19 SURVIVORS

Bill Gardner

“Knowing that you have something that there’s no cure for, you just keep thinking, ‘When is it going to end?’”

Gardner experienced COVID-19 along with his wife and daughter. BRYNN MECHEM STAFF WRITER

hen Bill Gardner came home from work Aug. 21, he found his wife, Eny, quarantining herself with a face mask on. Eny was experiencing total exhaustion, chronic headaches and body aches, so Gardner took her to University Town Center to take a COVID-19 test. He took one too, for good measure. Eny’s test was positive, though Gardner’s was negative. However, as a county bus driver, Gardner still had to quarantine for two weeks before returning to work. After a few days at home, Gardner decided to again get tested. He brought his two children for tests as well. This time, he and his 8-yearold daughter’s tests came back positive, though he still wasn’t experiencing any symptoms. The next day, however, he

Brynn Mechem

ordered a pizza for himself and his family. He thought he hadn’t waited long enough for the cheese to cool before biting into it and had burnt his tongue. He soon realized, however, that he couldn’t taste the pizza. “All of a sudden I felt like a ton of bricks,” Gardner said. “I had problems with my nasal cavity, I had a chronic headache, I couldn’t smell or taste anything, and I had sharp pains jabbing through my whole body.” From there, his 10-year-old son quarantined himself in his bedroom, which Gardner said he didn’t seem to mind. His daughter experienced the least amount of symptoms, with just a lack of

appetite causing an issue. When she found out threequarters of the family was sick, Eny took on most of the household functions. “My wife is the backbone of the family,” Gardner said. “She never complained, and she was just truly the backbone through all this, keeping us all together.” In addition to Eny’s cooking, Gardner said friends and family dropped food off, but he found it difficult to get out of bed to pick it up off the porch. Mostly, he laid in bed listening to Sirius XM’s yacht rock station. “It’s so exhausting,” he said. “It’s so much worse than any other thing I’ve ever had.”

EROW N AR IN W

IN S R EA 4Y

R E T I R E M E N T

Please welcome Dr. O’Neill to The Eye Associates

Lakehouse West

He received about six phone calls in one week from the Centers for Disease Control and Prevention asking about how the family was doing. “I was being bombarded with people that were very caring and who were asking how we were feeling, how we were coping,” Gardner said. “They truly cared how we were all doing.” For him, the worst part wasn’t the bodily symptoms; it was the uncertainty around the virus. “Knowing that you have something that there’s no cure for, you just keep thinking, ‘When is it going to end?’” Gardner said. After two weeks of quarantine, Gardner was cleared to return to work. The first week back, however, was not easy because he was still experiencing exhaustion. After going through COVID-19, Gardner said people should always wear their masks in public and remember that if they do contract it, the effects won’t last forever. “People need to know that the CDC is not just the CDC — they care about you,” Gardner said. “It’s going to end. It’s not permanent. The CDC knows what it’s doing, and you’re going to make it. You just have to hang in there. Be strong.”

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E S T A T E

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HEALTH MATTERS

YourObserver.com

OCTOBER 2020

COVID-19 SURVIVORS HARRY SAYER STAFF WRITER

obyn Faucy-Washington likes to exercise. Be it powerwalking, running or yoga, the CEO of Neuro Challenge Foundation for Parkinson’s keeps active five days a week, every week. Testing positive for COVID-19 in June put a wrench in her schedule and has left her in a different way. She says she’ll never forget the first walk she took after recovering from it. “I could tell my lung capacity was different,” she said. “I could tell that I was super slow. Not that I was trying to push it, but when I looked at my pace, I realized … being in a bed for four weeks can mess you up.” Faucy-Washington is unsure where she picked up the coronavirus, but her husband came down with a fever in June, and she started feeling sick the day after. She felt aches and congestion with a low-grade fever but nothing too extreme. The pain came later. FaucyWashington knows headache pain and migraine pain and the difference between the two. But the searing pain that wracked her head and body for two straight weeks was something different entirely. “I was taking Advil. I was taking Tylenol. I was taking my migraine medicine,” she said. “I was taking anything I could get my hands on, and that pain just would not stop.” She didn’t have a cough but said she felt something wrong in her chest. Her smell and taste left her, though she couldn’t care much

Harry Sayer

Robyn FaucyWashington Faucy-Washington spent weeks in bed and is now grateful to have her energy back.

Helping you live the life you want, the way you want.

about it while in horrible pain. The real fear was when she started experiencing a disorienting confusion that left her unable to form words and have conversations. She started sleeping 16 hours a day and saved her energy for basic upkeep. She didn’t go to the emergency room. As bad as it was, she said she didn’t want to take a hospital bed if it would block someone who might need it more.

“I could tell that I was super slow. Not that I was trying to push it, but when I looked at my pace, I realized … being in a bed for four weeks can mess you up.” “I washed my hair [one morning], and that was it,” FaucyWashington said. “I had to go back to bed at 8 o’clock in the morning. I had completely expended everything I had for that day, and so it was a solid two weeks of the really bad stuff.” Eventually, the pain and sickness subsided, but the anxiety remained. It didn’t help she started feeling tingling in her body, and she still felt a heaviness in her chest. She’s never been an anxious person, but she knows what anxiety feels like now. The worst

part of her experience was the uncertainty, both with what was happening with her body in the moment and what could happen to it in the future. “When I’m in the middle of being sick, I just don’t want to be in pain anymore,” Faucy-Washington said. “But then when I start feeling better now, I’m thinking: ‘Oh, my God, am I going to be cognitively damaged? Am I going to develop dementia 10 years early than I normally would have because I had COVID-19?’” The fatigue continued for weeks, but Faucy-Washington began working back up to doing her job and exercising again. She’s now exercising five times a week. Her son also tested positive for COVID-19 while living at the house but never showed symptoms, something for which she’s extremely grateful. These days she feels gratitude for getting through the worst of it. But she also feels deep anger at people who still refuse to wear masks, especially around others. “When I see people still fighting masks, it’s infuriating,” Faucy-Washington said. “I wonder ‘Did my family get this because some idiot didn’t want to wear a mask?’ … I’m not going to go into the bar or the club, but I do have to go to Publix with you.” The immediate damage is done, but Faucy-Washington worries what the long-term effects on her from the virus will be. In the moment, though, she’s happy. “When my energy started coming back, I was incredibly grateful,” Faucy-Washington said.

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HEALTH MATTERS

YourObserver.com

OCTOBER 2020

COVID-19 SURVIVORS

Harry Sayer Sayer says the worst part about COVID-19 isn’t the bodily pain; it’s the uncertainty it brings. BRYNN MECHEM STAFF WRITER

hen Harry Sayer, a selfdescribed 26-year-old man of relatively good health, had trouble catching his breath walking up the 39 stairs to his third-floor apartment, he knew he had a problem. Sayer typically walks up and down the stairs several times a day without any issue. However, on one Friday in June, he barely made it to the landing. “At that point, I knew I was in trouble,” Sayer said. “I was leaning against my door like, ‘What the heck just happened?’” Sayer, an Observer journalist, had been following the news and Centers for Disease Control and Prevention guidelines closely. He always wore a mask outdoors, he stayed 6 feet away from others, and he avoided bars and restaurants. However, the weekend of June 12, he went to visit a friend in Orlando. “I thought it was worth the risk, and I was wrong,” Sayer said. “It

was definitely not worth it.” It was about five days later that he couldn’t make it up the stairs, and six days later he could barely get out of bed. “I woke up and felt really crummy,” Sayer said. “It steadily got worse throughout the day, and by about 6 p.m., I had chills everywhere and almost felt delirious.” The next day, he awoke with a high fever and intense pain throughout his body. He felt a lump in his chest that made it hard to breathe correctly. He went to get tested three days after he couldn’t walk up the stairs. By that point, he lost his senses of smell and taste and knew before he received a positive diagnosis that he had COVID-19. “It’s really weird to eat a full plate of hot wings and just get nothing from it,” he said. “It’s very bizarre. I was sniffing my orange juice carton every day to see if my senses were coming back.” Although his breathing got better, the fatigue worsened. It became hard for him to make simple meals or focus on working from home. Although he said the physical ailments weren’t fun, the mental toll the virus took was worse. “We understand it in the broadest terms, but we don’t know the after effects and how long it’s going to take and how long it will affect each individual person,”

Brynn Mechem

Sayer said. “It’s kind of a wild card, and the uncertainty of it really got to me.” During his two weeks of quarantine, Sayer watched a lot of movies — about three a day. His friends dropped off groceries to his doorstep and talked from a safe distance. Still, the mental effects took their toll. “The psychological effects of being stuck in a box for two weeks with nothing to do but watch movies and think about how bad your body feels is not fun,” he said. “But eventually, my body started improving.” After receiving two negative tests, Sayer felt confident leaving his apartment and resuming his normal life, though he still doesn’t feel 100%. Now he’s trying to walk — while

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“I thought it was worth the risk, and I was wrong. It was definitely not worth it.” remaining socially distanced, of course — to rebuild some of his strength. After having gone through it, Sayer advises people not to take any risks. If a person does test positive for COVID-19, the best advice he can give, he said, is to remember that it will get better. “For someone going through it, I would say, ‘Be easy on yourself, and trust yourself to get better,’” Sayer said. “‘Don’t try to stretch yourself out and make the situation worse.’”

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HEALTH MATTERS

YourObserver.com

Courtesy photo

A COVID-19 antibody blood test

The search for answers COVID-19 antibody tests and their results are complicated, even for scientists.

RYAN KOHN STAFF WRITER

arasotans looking to COVID-19 antibody tests as a potential rescue from the pandemic will have to wait a while longer. Ever since the coronavirus hit the U.S. in March, scientists and doctors have been working to create an accurate antibody test, one that would tell people whether their body was equipped to fight off the virus thanks to already having it once. There are many tests on the market, but that

one test to rule them all has not arrived. Many researchers say to look at antibody test results with caution, which leaves people with little answer as to if they are safe to continue life as normal, or for how long. Why is there so much controversy around these tests? The short answer: Antibodies, and the immune system in general, are complicated, even for scientists. For example: A King’s College London study made waves in the science community in July. The study found deep drops in patients’ neutralizing antibody

levels three months after infection, especially for people with mild or no symptoms. It was a worrisome result, but some in the science community believe the study was flawed. To understand why, it is important to understand how an adaptive immune system works. Antibodies are Y-shaped proteins that seek out and bind to pathogens when they enter the body. They are an adaptive immune system’s version of bomb-sniffing dogs. They are an important piece of the immune system but aren’t the entire thing. This is what gives some scientists pause about the King’s College London study: It only looked at the bodies’ B cells, which produce antibodies when a pathogen enters the body, and not the bodies’ T cells, which are the cells that actually destroy the infected cells. Eric Topol, a cardiologist and the founder and director of the Scripps Research facility, told The Atlantic in July that conducting a study like this one without including T cell results is incomplete. He pointed to another study, this one from Strasbourg University Hospitals in France, that found some COVID-19 patients had a strong T-cell response to the virus without seroconversion (antibodies showing up in their blood). “There is a chance that if a similar longitudinal study looked at T-cell response, the outcome would be far more optimistic,” Topol said. Because data on the coronavirus is so new, neither study has yet been peer-reviewed, normally a critical step in determining a study’s validity. Unfortunately, society does not have the luxury of time on its side.

OCTOBER 2020

Even when looking only at antibodies, putting T cells to the side, things are murky. William Petri, a professor of medicine at the University of Virginia, wrote an article for The Conversation in June breaking down these complications. Petri said there are different kinds of antibodies, the most powerful being ones that block the coronavirus from attaching to a host cell by binding to it; those are the only antibodies that guarantee immunity, in large enough numbers. The problem is that not every antibody test measures these antibodies, and even ones that do can be inaccurate, especially in areas where infection rates are low). The more rare a disease is, the harder it and its antibodies are to find. Scientists also do not know what amount of those blocking antibodies makes someone immune. The Centers for Disease Control and Prevention and the American Medical Association both recommend not to use antibody tests in making decisions about whether to return to work or school because the results are too inconsistent. Although taking multiple antibody tests, ideally from different manufacturers, can produce more accurate results, those results say nothing about the types of antibodies found or how long an immunity will last. Antibody tests are not the comfort people thought they would be, at least not yet. People can get them if they want — antibodies can appear as soon as two weeks after infection, and the tests to find them are done through either a blood sample or a saliva sample — but for now, the CDC maintains the best way to stay healthy is to not get the virus in the first place.

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HEALTH MATTERS

YourObserver.com

OCTOBER 2020

FOCUS ON YOUR

By Freya Robbins, CDFA™ Is your relationship a source of strength for you? Or is it a drain? Couples who mesh well, intuitively understand each other and naturally desire to meet each other’s needs. One is up when the other is down, but rarely are they both down at the same time. No marriage is perfect though. Marriage is the merger of two imperfect people, so do not think yours should come without its challenges. We all come from some dysfunction. As John Bradshaw, self-help evangelist from the 1900’s, says it just depends on what degree of dysfunction we come from.

fresh start? Did you know that you can accomplish this through the mediation process? You can! We have helped hundreds of couples just like yourselves maneuver peacefully and honestly through the process of separation and divorce without it getting ugly. You are two people who started out loving each other and maybe even had children together, right? Surely there is enough care and concern to not tear each other up. Furthermore, if you have children (regardless of their age), do you want your emotions and frustration to spill over onto your children? Do not fool yourself. Your children know what is going on. Some couples say the children do not know yet, because we have not told them. They know by your lack of affection; they do not need to see you fight. But if you are fighting that surely is not meant for a child to experience.

Marriage is the merger of two imperfect people, so do not think yours should come without its challenges.

Many times, we see people who have identified a need for divorce because of their own mental health and wellness. They have determined that their relationship, their life as it stands, is unhealthy, toxic, and unsustainable. If you both agree on this assessment of your relationship and there is nothing that can be done to turn it around, the next question is, “Why do you want to add more stress and toxicity to the situation by starting up an adversarial legal fight?”

Wouldn’t it be great if there were a way to wipe the slate clean calmly and amicably and give yourself a

If you are feeling lost and uncertain about the future, give me a call and we will answer your questions. We can talk about your next steps. I have been where you are and know the apprehension you are feeling. Mediation can help you move forward in a fair and nonaggressive manner.

Take a deep breath Regular exercise and not smoking are two ways to improve lung health. MARK BERGIN STAFF WRITER

hen it comes to keeping yourself healthy, your lungs might not be the first thing to come to mind. But every one of the roughly 20,000 breaths you take in a day is a chance to bring pollutants into your body. And as you age, your lung function slowly decreases. Courtesy photo

COMMON DISEASES

Doctors with the University of Florida Health said there are three types of lung disease — airway diseases, lung tissue diseases and lung circulation diseases — and many lung diseases involve a combination of the three. The most common lung-related diseases include lung cancer, asthma, chronic obstructive pulmonary disease and pneumonia. Lung cancer is the third most common cancer in the U.S. behind skin cancer and breast cancer, according to the Centers for Disease Control and Prevention. The CDC states more of both men and women in the U.S. die from lung cancer than any other type of cancer. Cigarette smoking is the biggest risk factor for lung cancer. In the U.S., the CDC found cigarette smoking is linked to 80%-90% of lung cancer deaths. According to the CDC, people who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. PREVENTION

Not smoking is, of course, one of the best actions you can take to prevent lung problems. The CDC also recommends avoiding secondhand smoke, being careful at work to avoid carcinogens and getting your home tested for radon. Radon, the leading cause of lung cancer for nonsmokers, is a natural radioactive gas that gets trapped in tight spaces, such as attics, sheds and other spaces with poor ventilation. According to the U.S. Consumer Product Safety Commission, indoor pollution is usually worse than outdoor pollution. To decrease pollutants in your home, vacuum and dust your furniture at least once a week, depending on how many people and pets live with you. You can also get an air purifier or a few houseplants, which filter some harmful organic chemicals while turning carbon dioxide in the air into oxygen. Open windows to increase ventilation, and avoid synthetic candles or air fresheners, which can release toxic chemicals into the air. EXERCISE

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Freya Robbins, CDFA™

SUPREME COURT CERTIFIED MEDIATOR

National guidelines recommend adults get 30 minutes of moderate physical activity five days a week. When physically active, your heart and lungs work harder to supply additional oxygen to muscles. Just like regular exercise makes muscles stronger, it also makes a person’s lungs and heart stronger. As you become more fit, your body becomes more efficient at getting oxygen into the bloodstream and transporting it to muscles, which is why shortness of breath becomes less likely dur-

Dr. Kirk Voelker is a lung specialist for the Sarasota Memorial Health Care System.

CORONAVIRUS AND YOUR LUNGS According to the Florida Department of Health, people with chronic lung disease or severe asthma could be at risk for complications from COVID-19. COVID-19 can affect your respiratory tract (nose, throat, lungs), cause difficulty breathing and possibly lead to pneumonia and acute respiratory disease. Sarasota Memorial Health Care System lung specialist Dr. Kirk Voelker said most of the coronavirus-related problems people can have come from an inflammatory response, which is sometimes referred to as cytokine storm. “It causes what we call adult respiratory distress syndrome,” Voelker said. “It can cause scarring on the lungs when they’re on the breathing machine for a long time, and that scarring of the lungs, some of it can be permanent. Some of it’s reversible, and you don’t know. It’s a person-by-person type thing.” Voelker said the average person who has COVID-19 will not have residual lung problems. There are times where COVID-19 patients will get inflammation of the bronchial tubes. “What’s happening there is that the lining of the bronchial tubes get sort of denuded and sloughs off, and the airwave becomes very sensitive for the time it takes for the lining to grow back,” he said. “So we will see people with viral illnesses that have a cough and sort of asthma-type symptoms for weeks or months after that viral illness.” Voelker said people with lung problems need to be extra diligent about social distancing, wearing face masks, washing their hands and limiting their exposure to other people who could potentially be asymptomatic COVID-19 carriers.

ing exercise over time. If you exercise outdoors, avoid doing so near heavy traffic to prevent inhaling exhaust and during times of poor air quality, which varies every day. In addition to regular exercise, Pulmonary Associates of Brandon and Sun City recommends practicing concentrated deep breathing. For a few minutes each day, sit somewhere quietly, and count your breaths. Inhale for six seconds, and exhale for eight. The American Lung Association recommends talking to a doctor for anyone experiencing a chronic cough, shortness of breath, chronic mucus production, wheezing, coughing up blood or chronic chest pain.

HEALTH MATTERS

YourObserver.com

OCTOBER 2020

Pandemic worsening mental health First Step of Sarasota, the area’s largest behavioral health agency, has seen a steady increase in clients over the past six months.

FIRST STEP

First Step of Sarasota offers a variety of services, such as behavioral health services, psychotherapy, grief counseling and medication management. Visit FSOS. org for more information.

NAT KAEMMERER STAFF WRITER

aybe you did yoga in the beginning of the coronavirus pandemic, and staying active helped calm your mind down. Maybe the novelty of Zoom kept a group of friends close together to keep social interaction high. Maybe work gave life structure even as everyone stayed home. Whatever life was like at the beginning of the pandemic, it’s changed and changed since then, and mental health across the country and in Sarasota is flagging for many adults as the crisis wears on. “The pandemic has definitely exposed us, all of us, to our vulnerabilities as human beings,” said Tracey Weeden, the head of First Step of Sarasota’s in-patient and residential services. FSOS is the largest behavioral health agency in town, where Weeden works particularly at the crisis stabilization unit. Clients come in with a wide range of problems and symptoms, such as depression, anxiety, psychosis and manic disorders, but the cli-

Nat Kaemmerer

Tracey Weeden says First Step of Sarasota has seen an increase of people seeking help for their mental health for the first time.

ent profile has shifted since the start of the pandemic, she said. “Over the past six months, we have seen a steady increase of individuals seeking help, who, 1) have never sought help from our access center before,” Weeden said. “And, 2) 60% of those presenting are attributing an exacerbation or increase in their symptoms of depression and anxiety, suicidal ideation primarily, to the pandemic, which is quite alarming but understandable.” The worries of clients have shifted. The more serious prob-

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lems, such as suicide and overdoses, are still there and growing, but the worries of everyday locals are more ever-present. Those without work see their fear expanding further into the future — how to pay rent or the mortgage, how to feed the kids and the deeper sense of self, such as questioning who you are or what you do now. “I think it’s fair to recognize that our culture in the U.S., really, is that a lot of us identify ourselves in the work that we do,” Weeden said. “In addition to the relation-

ships that we have, what is meaningful to us is our right to access that happiness and freedom, and so the pandemic directly defies our core values.” As core values and daily routines are rocked on their foundations, access to stress-reducing outlets has also been stripped away. Whereas once people could easily get together with friends, go shopping or fight burnout with a beach day, it’s harder to do that now, and it’s infinitely more stressful. This is trauma, Weeden said, and it’s not going to be surprising when trauma disorders rise in the country. Weeden is already seeing more acute stress disorders. “If you’re [back] at work, it might seem like: ‘Oh, great. Things are better now,’” she said. “But the fact is, there can be those sort of post-traumatic stress symptoms. Any thoughts of how life was so horrible during the past several months, that people aren’t able to move through or cope … or the prolonged fear that something bad is going to happen, … those are all changes of behavior and changes in our thought process.” Many people have developed a

pandemic routine of talking with friends or family on the phone and adding in bits of self-care throughout the day. If that starts to change for the worse, and you begin isolating yourself, sleeping or eating too much or too little, drinking or smoking more, that’s likely an indicator of depression or anxiety. A lot of people are seeking help for the first time, Weeden noted, and the stigma around mental illness could make it hard for someone to realize that something really is off. “That should definitely be a sign to say, ‘You know what, maybe I need to talk to somebody,’” Weeden said. “It may not at first, depending on the comfort level, be a clinical professional, but at least I would encourage people to talk to someone they trust.” FSOS recently merged with Coastal Behavioral Health, which has allowed them to create a holistic system of care, Weeden said. No matter where someone enters their services, there’s a smooth handoff to the next step of care available. Often when people are walking in for the first time, FSOS will work with them to figure out what they can do — if they’re anxious, it might be a review of grounding techniques or talk therapy. “Reaching out for help is one thing,” Weeden said. “I hear stories all the time that it’s like, ‘Oh, I had a really great therapist, but he or she left, and I don’t know what to do.’ [With First Step], there’s a warm transition to more help when it’s needed.”

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HEALTH MATTERS

YourObserver.com

OCTOBER 2020

RIDING HIGH NEXT EVOLUTION IN HEALTH CARE Remote Health Monitoring Unlocks Technology’s Potential

Ryan Kohn

Isaac Sierra wants to educate people about electric bikes and their uses.

E-bikes can be an option for everyone, including older riders.

An interview with Kirk G. Voelker MD

Remote health monitoring is a process which allows us to gather biometric information like blood pressure, physical activity, heart rate, oxygen level and weight at-home via personal Bluetooth devices and beam it to the cloud where your doctor and monitoring team can properly interpret and review it. Essentially , it is a way to have a team watching over your health on a daily basis, from the comfort of your own home.

Is remote health monitoring available in Sarasota?

MiHealth Monitoring is a Sarasota based company that leverages the biometric information available on wearable fitness trackers in addition to standard medical devices. By looking at minute by minute heart rate and step data, we can not only tell how far you have walked but how fast you have walked and how your heart rate has responded. This gives our monitoring team a more robust look into someone’s dynamic physiology in their own environment. This is something that you just can’t get during the average doctor’s office visit. As a physician, engineer and clinical researcher bringing innovative medicines and devices to Sarasota for over 25 years, I see this is literally the next evolution in healthcare.

Is the program only for patients that are monitoring a disease or condition?

Initially we developed this program to allow patients to recuperate safely at home after discharge from the hospital. That science then led to home rehabilitation programs for those with chronic disease such as emphysema. We have now expanded to include wellness, nutrition and exercise programs for those who desire to be a better version of themselves and just need a little structure and support.

How does the program work?

With your permission, the MiHealth app allows HIPAA compliant text, voice or video communication with our monitoring team and physicians from the safety of your home. We can send routine health questionnaires, informative articles and videos and even keep track of your nutrition using your phone’s camera. If we detect a potential problem, we contact you and then coordinate care with your primary physician or specialist. Alternatively, we can arrange a telehealth visit with our physicians. There is just a comfort in knowing that someone is watching over you, looking after your health, especially in these times.

RYAN KOHN SPORTS REPORTER

wo years ago, the Dowdell family had two cars, which they used to take themselves everywhere. Rory and Krista Dowdell simply drove their children — then two in number, now three — around town as needed. The system was fine, but something was lacking. Rory Dowdell said he and Krista both enjoy CrossFit workouts and,

at the time, were thinking about training for a triathlon. A onehour session wasn’t enough. They were craving more of a workout, he said, and started to think about creative ways to do that while still being around their kids. “We thought, ‘What if we biked to the workout?’” Dowdell said. “Our gym is about 5 miles away. Driving, it takes us 12-14 minutes. We looked, and on a normal bike it would take us 25 to get there. That was too long. But on an electric bike, it would only take 14-16 minutes. Since we could do the commute in about the same time and get that extra workout in, it became worth the investment.”

This is literally the next evolution in healthcare. Has remote health monitoring been useful during COVID?

COVID has definitely disrupted medical care, but out of this disruption has come innovation. We have used this system to monitor COVID patients safely at home. One major effect that COVID has had on most of us is in the isolation and inactivity of sheltering in place. So many of us have collectively dug ourselves into an emotional and physical rut. It is time to start taking control of our lives and treat our bodies better. That is where we come in, encouraging and walking you step by step to a healthier version of yourself.

Does Medicare cover remote monitoring?

Yes, traditional Medicare covers remote monitoring for many conditions ranging from heart and lung problems to just being overweight or deconditioned.

How does one start a program?

If you have Medicare, all you have to do is call us at 833.200.2777 or go to www.mihealthmonitoring.info for more information.

Kirk G. Voelker MD

www.mihealthmonitoring.info

833.200.2777

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HEALTH MATTERS

YourObserver.com

OCTOBER 2020

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The one drawback is cost. A sturdy e-bike intended for frequent use can cost between $1,000-$3,000. For bikes meant to be car replacements, like the Dowdell family’s bikes, that price can jump to $5,000-$6,000. But Sierra said the cost is worth it. If you buy a cheaper bike, he said, it’s likely to be a “one-time use” bike, meaning that if part of it breaks or malfunctions, it cannot be fixed, and a new bike must be purchased. Bikes from leading companies like Riese & Muller are more likely to last a long time, and if something does go wrong, they use parts from trusted companies like Bosch and Shimano that are easily replaced. In addition to brick-and-mortar stores, there are various retailers selling e-bikes online. Sierra said he urges his customers to do their research and determine which bike would be the best fit for them. The nonprofit People for Bikes, he said, is a good place for riders to begin. “We do more education than we do sales,” Sierra said. “I truly do think e-bikes will be a big component of transportation in the future, especially in urban areas. They are good for the environment. They lessen traffic on the roads. There are people here already living that life.” Rory Dowdell is one of them. Dowdell said he has no regrets about trading in a car for his family’s e-bikes, and he has since purchased another e-bike to accommodate his growing family. “It was a little challenging in the beginning,” Dowdell said. “We had to plan out our trips more. Now, 90%-95% of trips within an 8-mile radius, we’re doing on our bikes. I even went to jury duty on my bike.”

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In October 2018, the Dowdells traded in one of their vehicles and purchased two Riese & Muller electric bikes, becoming the latest family to make the switch. The U.S. is late on the trend. According to the Verge, electric bikes, or e-bikes, account for just 4% of total bike sales here. In some European countries like the Netherlands (68%), there are more e-bikes sold than regular bikes. But it is growing here: According to research firm NPD, e-bike sales jumped 91% from 2016 to 2017 and 72% from 2017 to 2018. In simple terms, an e-bike is a bike with a motor, battery and controller built into it, allowing riders to increase their speed while pedaling less frequently or with less vigor. There are three classes of them. Isaac Sierra, of Sarasota’s Shoreline Ebikes, said Class 1 bikes feature a technology called “pedal assist,” which gives you assistance based on the cadence of your pedaling. Riders can choose to have more or less assistance. These bikes are capped at 20 mph. Class 3 bikes feature the same technology but can reach speeds of 28 mph. It is the Class 2 bikes, Sierra said, where things change. These bikes do not trigger their assistance through pedaling but rather through a throttle, similar to a moped. These bikes can reach speeds of 20 mph. The benefits of switching to an e-bike are numerous, Sierra said. For older riders who don’t think they have the strength to ride a bike, an e-bike can handle the majority of the load. Sierra said it’s easy to pedal them, even for those with weak or injured legs. Because the bikes take less of a toll on your muscles, Sierra said, riders feel better afterward and are more likely to ride frequently as a result.

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HEALTH MATTERS

YourObserver.com

OCTOBER 2020

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