Protecting Your Mental Health

Maintaining your mental health during isolation and social distancing can be challenging. This is even more important when we are out of our normal routine and lack connection with our social network. The tips and resources below are designed to support you during this time.

WHAT TO EXPECT: TYPICAL REACTIONS

Everyone reacts differently to stressful situations such as an infectious disease outbreak that requires social distancing, quarantine, or isolation.

People may feel anxiety, worry, or fear related to:

  • Your own health status
  • The health status of others whom you may have exposed to the disease
  • The resentment that your friends and family may feel if they need to go into quarantine as a result of contact with you
  • The experience of monitoring yourself, or being monitored by others for signs and symptoms of the disease
  • Time taken off from work and the potential loss of income and job security
  • The challenges of securing things you need, such as groceries and personal care items
  • Concern about being able to effectively care for children or others in your care
  • Uncertainty or frustration about how long you will need to remain in this situation, and uncertainty about the future
  • Loneliness associated with feeling cut off from the world and from loved ones
  • Stigmatization: If you are sick or have been exposed to someone who has COVID-19, you may feel stigmatized by others who fear they will contract the illness if they interact with you.
  • Anger if you think you were exposed to the disease because of others’ negligence
  • Boredom and frustration because you may not be able to work or engage in regular day-to-day activities
  • Uncertainty or ambivalence about the situation
  • A desire to use alcohol or drugs to cope
  • Symptoms of depression, such as feelings of hopelessness, changes in appetite, or sleeping too little or too much
  • Symptoms of post-traumatic stress disorder (PTSD), such as intrusive distressing memories, flashbacks (reliving the event), nightmares, changes in thoughts and mood, and being easily startled

If you or a loved one experience any of these reactions for 2 to 4 weeks or more, contact your health care provider

EXISTING CONDITIONS

Those with preexisting mental health conditions should continue with their treatment plans and monitor for any new symptoms. If you notice any changes, contact your healthcare provider right away.  You may inquire about televisits (virtual visits) to help avoid exposures.

WAYS TO SUPPORT YOURSELF

  • UNDERSTAND THE RISK: Consider the real risk of harm to yourself and others around you. The public perception of risk during a situation is often inaccurate. Media coverage may create the impression that people are in immediate danger when really the risk for infection may be very low. Take steps to get the facts:
    • Stay up to date on what is happening, while limiting your media exposure. Avoid watching or listening to news reports 24/7 since this tends to increase anxiety and worry. Remember that children are especially affected by what they hear and see on television.
    • Look to credible sources for information on the infectious disease outbreak
    • Accentuate the positives: Focus on what you are able to do during this time. You’re finally home — organize, read, rest, cook, and play. Take advantage of the time this provides.
    • Separate what is in your control from what is not. There are things you can do, and it’s helpful to focus on those. Wash your hands.  Remind others to wash theirs. Take your vitamins. Limit your consumption of news (Do you really need to know what is happening on a cruise ship you aren’t on?).
    • Create a schedule in order to encourage yourself to stay both mentally and physically active. This will also provide you with something to look forward to!
    • When bored, be careful to manage alcohol consumption, vaping, and overeating – these are habits that can be hard to break.
    • Connecting with others about your concerns and how you’re feeling will allow those feelings to surface and will provide you with a sounding board for them. Facebook groups have already formed to facilitate communication and support among individuals asked to quarantine.
    • Practice anxiety management breathing techniques, such as 4-7-8 breathing
      • To start, put one hand on your belly and the other on your chest as in the belly breathing exercise
      • Take a deep, slow breath from your belly, and silently count to 4 as you breath in
      • Hold your breath, and silently count from 1 to 7
      • Breath out completely as you count from 1 to 8. Try to get all the air out of your lungs by the time you count to 8.
      • Repeat 3 to 7 times or until you feel calm
    • Use social media to stay connected to other people (If you see posts that are causing stress, take a break by turning it off)
    • Call or facetime your friends as opposed to only texting – this allows you to open up more with the other person and feel connected
    • For those who find it therapeutic, turn to your Bible, prayer, or religion
    • If you feel yourself in a panicked state or anxiety spiking, stop immediately and USE ALL FIVE SENSES.
      • LOOK around and focus on one thing in the room
      • Tune in to one NOISE
      • Allow one SMELL to fill your nose
      • Smack your tongue and notice any residue TASTE
      • FEEL your feet on the floor
      • Repeat

TIPS FOR WORKING REMOTELY

  • Create a dedicated workspace that’s clean and free of distractions
  • Set an alarm like a normal workday
  • Get ready like you are going to leave the house
    • Get dressed
    • Brush or fix your hair
    • For those who wear it, do your make up – even if minimal
    • Eat breakfast
    • Brush your teeth
  • Do your best to adhere to a working schedule
    • Set an alarm to remind you to take breaks
    • Consider using an app like Time Out to remind you to take a breather
    • Don’t forget to eat lunch and/or healthy snacks during your breaks
  • Maintain a work connection.
    • Maintain a connection to the office by choosing to make calls rather than sending emails, and keep in contact with your department members via video conferencing.
  • When family or children are at home with you
    • Set expectations of your workspace being “off-limits” to limit interruptions
    • During your breaks, spend extra quality time with those in your home

Additional Resources

  • Substance Abuse and Mental Health Services Administration (SAMHSA): Disaster Distress Hotline: 1-800-985-5990 or text TalkWithUs to 66746
  • Crisis Text Line Anxious about coronavirus? Text HOME to 741741 to connect with a Crisis Counselor.
  • Time Out: This downloadable application reminds you throughout the day to take a breather
  • TalkSpace: Visit Talkspace.com or download the Android or iPhone app.  This is a paid service.
  • BetterHelp: Visit Betterhelp.com.  This is a paid service.
  • If you are feeling overwhelmed with emotions such as sadness, depression, anxiety, or feel like you want to harm yourself or someone else, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
Continue ReadingProtecting Your Mental Health

NHFM is Now Offering Virtual Visits

As concerns grow over community-spread COVID-19, North Hills Family Medicine is now offering virtual visits with the hope of keeping sick patients at home and reducing exposures in the office. A virtual visit is an appointment with your provider during which live video is used. All aspects and quality of the visit are similar to an in-person visit, except you don’t have to commute to the clinic.

Your first virtual visit (telehealth visit) might feel intimidating, but it shouldn’t worry you one bit.  With some preparation, you can be sure to have a great first visit and finish the session satisfied, and not feeling like the technology was at all a hindrance to connecting with your provider.

The platform that we use is Zoom, one of the industry leading providers for secure, efficient video conferencing that allows us to provide HIPAA compliant, secure visits. Virtual visits are never recorded and are encrypted to ensure privacy.

Here are some tips to make your virtual visit a success.

  1. Choose an appropriate setting and technology

What you will need:

      • Either a laptop with a camera or a smart phone with a camera.
      • Internet connection/wireless connection
      • Private area

Plan ahead to make sure that you have a private setting for the entire duration of the appointment.  Most individuals have the appointment in their home or apartment, but on occasion, some individuals need to leave their home, go out to their vehicle or to a nearby park.  If you are going to be at work, you might want to schedule the appointment during your lunch break so that you can step away easily.

  1. Installing Zoom on your device.

You must have Zoom downloaded on your device, but you do not need to create a Zoom account.  Zoom usually downloads automatically when you click the meeting link that is emailed to you when your appointment is made., but you can install Zoom before the appointment on your device here: https://zoom.us/support/download

Zoom is available to be installed on a laptop, iPhone or Android device.

  1. Checking your internet speed

Having fast, reliable internet is integral to the visit.  If your bandwidth/speed is slow, the video will lay and cut out causing a frustrating experience.  For some people in poor cellular coverage areas, this means getting on a wifi network.  If you live in a city, and have good cellular signal strength, you can most likely use your cell service, but keep in mind that if you use your cellular network, the data transferred will add to your monthly limit.

To help you decide which network to use, go here to check your wifi speed. Greater than 10 mb/s on download and upload is recommended. If you are getting less than 10 mb/s, consider changing your network. If you are not getting internet speed greater than 1 mb/sec, you will not have a good experience and we recommend postponing the appointment until you can find faster internet.

  1. Testing Zoom

Now that you have made sure you have a reliable internet connection and download/upload speed, you should test your device to make sure the setting are correct to work properly with zoom.  The easiest way to do this is to joint a test meeting at: https://zoom.us/test

You will want to make sure you:

      • Give your computer/device permission to use the camera and audio.
      • Can see yourself in the app. If you see your name, or an icon, then your camera is not working properly.
      • Do not have an external speaker or headphones that will automatically connect unexpectedly.
      • Consider using the ‘Test my Audio’ feature within Zoom: https://support.zoom.us/hc/en-us/articles/201362283-Testing-Computer-or-Device-Audio?mobile_site=true It will have you speak into the microphone, and then it will replay the sound back to you.
  1. Video Tips

If your provider can’t see you well, it will make it more difficult for him/her to pick up on certain non-verbal cues. By ensuring we can see you, we will be able to understand you better, leaving you more satisfied that you delivered your point to us. In addition, insurance requires that we can see you, otherwise it is not considered a telehealth (virtual) session and is not covered by insurance.

      • Try to maximize front-facing lighting, and minimize lighting behind you.
      • Try to have most of your upper torso visible, from about your abdomen and up including your arms.
      • If using a phone, prop it up to make it more steady. A stable image would be very much appreciated by your provider, and will help you take your mind off having to hold your phone.
  1. Logging into your Appointment

When your appointment was scheduled an email was sent to your email address provided that contains the Meeting ID.  You will simply click the link and it will take you to the appointment.  You may join ahead of your appointment time and will wait for the provider to join the virtual visit.

If you have not joined the meeting by your appointment time, the provider or a nurse may call you directly asking you to join in.

If you have any problems joining or did not receive the email, please contact the office.

If for any reason the provider is concerned that additional testing is needing (i.e.: Flu test, Strep test, COVID-19 testing) we will instruct you to drive to the clinic and we will have a nurse with appropriate protective gear meet you at your car to conduct testing.

Please call the office today to schedule your appointment.

Continue ReadingNHFM is Now Offering Virtual Visits

Social Distancing

To slow the spread of COVID-19 through U.S. communities, the U.S. Centers for Disease Control and Prevention has encouraged Americans to practice “social distancing” measures. But what is social distancing, and how is it practiced?

What is social distancing?

Social distancing is a public health practice that aims to prevent sick people from coming in close contact with healthy people in order to reduce opportunities for disease transmission. It can include large-scale measures like canceling group events or closing public spaces, as well as individual decisions such as avoiding crowds.

With COVID-19, the goal of social distancing right now is to slow down the outbreak in order to reduce the chance of infection among high-risk populations and to reduce the burden on health care systems and workers.

Why Is the CDC Recommending It?

According to the CDC, coronavirus is spread mainly through person-to-person contact. It’s believed that people who are in close contact (within 6 feet of one another) are most likely to spread it. It spreads through respiratory droplets that are produced when an infected person coughs or sneezes.

These droplets can land in the mouths or noses of anyone nearby and may be inhaled into the lungs, which can spread the disease.

And while it’s believed that people who are the sickest are most likely to spread coronavirus, some people might spread it before they begin to show symptoms. That’s why it may be important to practice social distancing even with people who don’t appear ill.

It may also be possible to contract COVID-19 through contaminated surfaces or objects. An individual who touches a surface that has the virus on it and then touches their own mouth or nose, for example, may contract the virus.

The CDC believes COVID-19 spreads easily throughout communities. So they have recommended social distancing as a way to help stop the spread.

If individuals reduce their contact with one another, people will be less likely to pass the virus on. This can be the best way to prevent what they refer to as “community spread.”

While the CDC isn’t recommending everyone take drastic measures like isolating themselves, they are advising people to take precautions, especially those who may be at a higher risk for contracting the disease.

Flattening the Curve

You may have seen references in the news or on social media to “flattening the curve” as a goal of social distancing. When new cases spike very quickly, hospitals and other medical facilities can be overwhelmed and unable to adequately treat everyone—including patients who are not actually dealing with the coronavirus. Such spikes are more likely when social distancing measures are not enacted quickly and early enough.

By slowing the number of new cases and stretching them out over a longer period of time—or “flattening the curve” of new cases—we can keep the number of total cases (and the number of high-risk cases) below that threshold, so that our hospitals have enough space and resources to operate as smoothly as possible during this difficult time.

How do I practice social distancing?

The CDC defines social distancing as it applies to COVID-19 as “remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible.”

It’s particularly important—and perhaps obvious—to maintain that same 6-foot distance from anyone who is demonstrating signs of illness, including coughing, sneezing, or fever.

Along with physical distance, proper hand-washing is important for protecting not only yourself but others around you—because the virus can be spread even without symptoms.

The most obvious way to practice social distancing is to avoid crowded public places where close contact with others may occur. These might include movie theaters, religious gatherings, and crowded restaurants. Of course, it’s not always easy to practice social distancing.

Tips and Tricks 

  • Opt for online meetings rather than workplace gatherings whenever possible.
  • Work from home if you can.
  • Postpone major social gatherings.
  • Consider video-chatting with friends and family rather than meeting in public places.
  • Limit or postpone air travel and cruise ship travel.
  • Stock up on vital items so you don’t have to go to stores as often.
  • Order groceries from a delivery service.
  • Shop online rather than in stores.
  • Stay home if you are sick

On the broader scale, a number of actions taken in recent days are designed to encourage social distancing, including:

  • Schools, colleges, and universities suspending in-person classes and converting to remote online instruction
  • Cities canceling events, including sporting events, festivals, and parades
  • Workplaces encouraging or mandating flexible work options, including telecommuting
  • Organizations and businesses canceling large gatherings, including conferences
  • Houses of worship suspending services
  • Public and private libraries modifying their operations and restricting people from gathering by allowing people to come in only to pick up materials that have been reserved or requested on-line or by telephone
Continue ReadingSocial Distancing

What to do if you think you may have COVID-19

COVID-19 symptoms most commonly experienced include: fevers, cough and difficulty breathing or shortness of breath. Developing body aches, runny nose, sore throat, nasal congestion or diarrhea is also possible. In some cases people who are infected will not exhibit any symptoms, though most people experience a mild form of the disease, similar to a cold or flu virus. Certain groups of people may experience more serious illness, including older people (over the age of 65) and those with a history of medical conditions such as decreased immunity, high blood pressure, heart disease, chronic lung disease, chronic kidney disease or diabetes.

The current strain, known as COVID-19, is thought to spread mainly from person-to-person.

  • Between people who are in close contact with one another (within about 6 feet).
  • Through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

If you have any of the above symptoms and can answer yes to one or both of the following questions, then we ask that you stay at home and call the office to speak to a nurse before presenting to the office.

  1. Have you been in contact with anyone who either has been diagnosed with Coronavirus/COVID-19 and/or someone who is under investigation for having Coronavirus/COVID-19?
  2. Have you recently traveled to any of the following areas in the last 2 weeks?
    1. China
    2. Iran
    3. Italy
    4. Japan
    5. South Korea

Once we have established your risks, we will contact the Health Department, that will then contact you to arrange for testing.

In the meantime, if you suspect you may have COVID-19, we ask that you do the following:

  • Stay at home. You might consider leaving home in order to seek medical care if your symptoms are severe, otherwise it is important to remain at home. Call before seeking medical care in a clinic or healthcare facility; the staff will be able to give you information on where to go upon arrival to prevent exposing other people to the illness.
  • Isolate yourself. Staying in a room away from other people in your home is an important way to decrease the risk of your family or friends getting exposed to the virus. Use a bathroom that is separate from everyone else in the home if one is available. Is it also recommended to stay away from any pets that live with you. Although there is no known transmission between companion animals (such as dogs or cats) at this time, it is advisable not to be in close proximity to your pets until more is understood about the virus. You should discuss with your healthcare provider when it is okay to be out in public again.
  • Wear a face mask. If you have symptoms suspicious of COVID-19, wear a face mask to prevent spread of the illness both at home and if you go to a medical facility for care. People that live at home with you should also wear a face mask if they are in the same room as you. Gloves can also be used for additional protection from the virus.
  • Follow the same precautions as with any other virus. This includes washing your hands frequently, disinfecting hard surfaces (table tops, door knobs, keyboards, for example), covering your mouth and nose when coughing or sneezing and avoiding sharing cups or utensils while sick.

If your symptoms progress in severity, go to the ER, but call ahead to let them know you are coming and may have COVID-19 so that appropriate precautions can be followed.

If you have further questions/concerns, please visit/call the following:

Tarrant County Public Health

CDC-Center for Disease Control

  • https://www.cdc.gov/coronavirus/2019-ncov/index.html

WHO – World Health Organization

  • https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

Catalyst Health Network

Continue ReadingWhat to do if you think you may have COVID-19

How to Prevent Spread of COVID-19

Although there is currently no vaccine to prevent COVID-19, the best way to prevent infection is to take the following precautions:

  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating, and after blowing your nose, coughing, or sneezing. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick
  • Stay home when you are sick
  • Cover your cough or sneeze either with a tissue or by coughing/sneezing into your elbow.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
  • Follow CDC’s recommendations for using a face mask.
    • CDC does not recommend that people who are well wear a face mask to protect themselves from respiratory diseases, including COVID-19.
    • Face masks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others.
    • The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).

 

If you have further questions/concerns, please visit/call the following:

Tarrant County Public Health

CDC-Center for Disease Control

  • https://www.cdc.gov/coronavirus/2019-ncov/index.html

WHO – World Health Organization

  • https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

Catalyst Health Network

Continue ReadingHow to Prevent Spread of COVID-19

COVID-19

Coronaviruses are part of a large family of viruses, which can sometimes cause lower-respiratory tract illnesses, such as pneumonia or bronchitis. Coronaviruses are thought to be responsible for up to one-third of upper respiratory infections, more simply known as the common cold.

COVID-19 is short for “coronavirus disease 2019.” This is the name that the World Health Organization (WHO) assigned to the illness caused by a newly discovered strain of coronavirus, which began its rapid spread in Wuhan City, China in December 2019.

The symptoms most commonly experienced include: fevers, cough and difficulty breathing or shortness of breath. Developing body aches, runny nose, sore throat, nasal congestion or diarrhea is also possible. In some cases people who are infected will not exhibit any symptoms, though most people experience a mild form of the disease, similar to a cold or flu virus. Certain groups of people may experience more serious illness, including older people (over the age of 65) and those with a history of medical conditions such as decreased immunity, high blood pressure, heart disease, chronic lung disease, chronic kidney disease or diabetes.

If you have any of the above symptoms and can answer yes to one or both of the following questions, then we ask that you stay at home and call the office to speak to a nurse before presenting to the office.

  1. Have you been in contact with anyone who either has been diagnosed with Coronavirus/COVID-19 and/or someone who is under investigation for having Coronavirus/COVID-19?
  2. Have you recently traveled to any of the following areas in the last 2 weeks?
    1. China
    2. Iran
    3. Italy
    4. Japan
    5. South Korea

The current strain, known as COVID-19, is thought to spread mainly from person-to-person.

  • Between people who are in close contact with one another (within about 6 feet).
  • Through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
Continue ReadingCOVID-19