Vaccine

As a physician, I get a lot of questions about various health care topics both within and outside my clinical setting.

They usually range from issues relating to colds, rashes, surgical options, the latest diet and so forth. With the advent of the Covid19 pandemic- all the questions are pretty much in the same vein.

In the past, when asked medical questions outside the workplace I am always careful to remind the individual that they should really speak to their personal physician and that I cannot comment on any healthcare practice that has occurred since I am not their treating physician. I also am careful to say that I cannot offer an expert opinion unless we schedule an official appointment (as anything I say can and may be used against me should an adverse event occur based on said opinion).

Lately though, I have been receiving hypothetical questions. Especially as relates to the new vaccines that have been rolled out under Emergency Use Authorization.

Why was the vaccine made so fast?

Because we had the entire world concentrating all resources on the same project, advanced technology was available, the number of volunteers for the study was in the thousands and we had a large number of sick individuals with whom to compare.

Will it change our DNA?

This is with regards to the mRNA vaccines (there are other types that will be released shortly as of this post). It does not alter your DNA. It sends a message to your cell to create a portion of the spike protein of the virus. Not the whole virus itself. Your body them creates antibodies to attack this foreign spike protein and creates memory cells so it knows what to attack should the virus present itself in the future.

Can someone be infected by the COVID-19 virus after the vaccine?

Yes. If you were exposed to the vaccine close to the first dose of the 2-dose vaccine, your body will not have built up its full immune response (which happens around 2 weeks after the second dose). So until that point you can still be infected by the virus. The expression as symptoms depends on the individual. You can complete your second dose after you are symptom-free.

Do we still need to wash our hands, wear a mask and social distance after we receive the vaccine?

Yes for now. Your having the vaccine means that your body is ready to fight the virus should you be exposed to it, which will help to keep you from getting sick. However we do not know enough about someone who is carrying the virus in their upper respiratory tract and the potential to spread it to others even though they themselves are protected by the vaccine. Remember, the regular mask helps you to keep your germs to yourself and not spread to others. Once we get to herd immunity (more than 70% of the population vaccinated) we should be able to ramp down those other protective measures.

Why not have a natural herd immunity?

Because natural herd immunity would require millions of people to be infected of which hundreds of thousands would be very sick and may die. It’s better to build up your immune system from a piece of the spike protein of the outer layer of the virus (current mRNA vaccine) than by being exposed to the live virus.

What about the new variants?

The new variants of the virus which are currently in the United Kingdom, Brazil and South Africa have spread globally – even here in the US. They appear to spread faster than the original virus but also seem to be affected by the current vaccines. The vaccines may not give the same 90% plus protection but any protection is better than none.

What about people with chronic conditions or other illnesses?

This is basically deciding if being exposed to the virus will put one at risk for a serious complication, hospitalization and/or death versus having your immune system built by the vaccine. That is a conversation to be held with your health care provider. The current teaching (as of this past week- depending on your source) is that every non-pregnant adult is eligible unless they have an allergy to the vaccine or it’s ingredients or has had Guillain Barre Syndrome).

What about kids and pregnant women?

Some vaccines are approved for 16yrs and up, others for 18yrs and up. Studies are underway for 12yrs and up and eventually for those younger. For pregnant women, current recommendations are that those on the front line should get the vaccine since being infected by the live virus could cause complications leading to hospitalization and other adverse outcomes. For others, they should seek the advice of their health care providers.

Is the vaccine mandated?

No it is not (as of this post).

What people need to do is have a conversation with their health care provider and with their family. Discuss any concerns. Do appropriate research. Ask questions and make a decision.

For health care providers- the key is to listen to everyone’s concerns. Address them based on information that we have at hand today. Allow people to process the information and discuss with their family. And do not bully or shame anyone while providing the education.

The bottom line is we all want to get to a place of normalcy where we can travel freely, congregate, visit loved ones, hug and smile without wearing a mask.

We can get there by getting this virus under control using all of the tools in our toolkit – washing hands, wearing a mask, social distancing and taking the vaccine if eligible.

When everything is under control, we can put our toolkit away. (Except maybe the vaccine which may become routine as is the flu vaccine).

Until then, please use the tools we have available.

Wishing everyone a safe and healthy week.

(Disclaimer – this post is a commentary and not meant as medical advice; please contact your health care provider for more information)

Reach Out

This morning I was going about my schedule for today.

Pray, exercise, decaf, shower, dress up, click open laptops, start the “to do list”.

Then I got a message that the sister of my schoolmate/friend had died.

Mind you, we were last together almost 30 years ago (medical school). This is actually when and where I met her sister.

My first recollection of this sister was that she was extremely graceful and elegant. She kind of reminded me of royalty. But she wasn’t snobbish or condescending. Just gracious.

I remember thinking that I wanted to be just like her.

And I made a concerted effort every day after that to do my part to be graceful and elegant.

I didn’t always succeed, but sometimes I would stop and look in the mirror and say in my head “I hope I’m getting this right” as I thought of her.

So for 30 years I have thought of this wonderful person off and on.

And I never told her how she inspired me.

And I never told my friend how her sister inspired me.

I am now just letting her family know through their memorial site.

But it would have been better to let her know while she was alive.

That is my regret.

So my task for this year is to reach out to those people from my past (and present) who pop into my head from time to time, and let them know how they have touched my life.

Whether by phone call, text, email or snail mail.

And I will continue to reach out to others I encounter to hopefully inspire them as well.

So the song that comes to mind (because I always have a playlist in my head) is Diana Ross singing the 1970 song…

“Reach out and touch, somebody’s hand, make this world a better place, if you can.”

Who will you reach out to this week?

The Sound of Silence

“Hello darkness, my old friend
I’ve come to talk with you again
Because a vision softly creeping
Left its seeds while I was sleeping
And the vision that was planted in my brain
Still remains
Within the sound of silence”

This tune is actually the ringtone for my phone.

I love the haunting melody, it doesn’t make me sad, just reminds me of my childhood.

For those not in my age bracket, the song was originally by Simon & Garfunkel in the 1960’s (gasp!) To be accurate it alternated between Sounds of Silence (album) and The Sound of Silence (song).

The current generation may know the remake by the group Disturbed done in 2015 (now that version is dark).

Anyway, let me get to my main point.

Silence.

It can be comforting or it can be torture. And there are times where we have no control over its presence in our life.

But if our days are full of noise, there are times when we need a bit of quiet.

The song continues…

“And in the naked light, I saw
Ten thousand people, maybe more
People talking without speaking
People hearing without listening
People writing songs that voices never share
And no one dared
Disturb the sound of silence”

Kind of reminds me of where we are today with people saying things for the sake of talking and people hearing others but not truly listening.

And with all the noise, sometimes one needs a moment of silence.

To think.

To reminisce.

To grieve.

To reflect.

To plan.

To just be.

So I’m starting my week with a moment of silence.

For me.

Sacrifice

It’s been an interesting week to say the least.

Someone posted a meme on social media with the Joker (as 2020) showing the clown from It (as 2021) around, helping him navigate his new workplace (the world). I actually chuckled a bit for that one.

Anyway- the common theme that came across during this past week for me was “sacrifice”.

I had recently joined a book club and the book of the month is “Too Heavy a Yoke” detailing the sacrifice black women make to be strong and resilient.

Yesterday I watched the first few episodes of “Bridgerton” (yes I am a Shondaland fan- no shame whatsoever- don’t worry, no spoilers here) and it kept referring to the sacrifice different people would make for their personal honor, for their families, for their community.

Then I was going over my schedule for the week. My vacation was supposed to end yesterday but I ended up cutting it short by 3 days because of the current upsurge in Covid-19 cases. Will I really get those days back? It’s hard to say when you are involved in healthcare- we cannot predict the rest of this year.

Sacrifices.

For the greater good.

For our loved ones, friends, colleagues, communities, states, country and the world.

But one has to also remember that sacrifice goes both ways.

One can sacrifice something today or in the future for the greater good of ourselves.

We need to be aware that some things must be given up in order to create room for our betterment – be it mentally, physically or emotionally.

The difficult part is being astute enough to discern what you are willing to sacrifice for yourself and for others. Making sure it balances out in the end.

If you are not whole, it’s difficult to do better.

So please remember to be smart as you sacrifice.

Wishing you safety and wellness.

Resolutions

Admit it.

Every year around this time we start writing down all the things we resolve to do by the end of the year.

Lose weight.

More money.

Learn a new thing.

There is absolutely nothing wrong with having resolutions for the year. The key is making those resolutions manageable strategically.

Oh, you thought I was going to say “make them reasonable”?

It is absolutely reasonable to have goals that may seem unattainable to some. Your job is to figure out a way to make them happen.

Step 1 – write down one to two goals you have for each category of your life (you, family, friends, career, health, fun, other things important to you and the “just because”)

Step 2 – Now divide your year into quarters (Jan-Mar, Apr-Jun, etc) and write down what you can accomplish in each category for the first quarter. (Don’t map out the entire year! Things change and you need to be able to adapt).

Step 3 – For the first quarter, break each goal into the tasks needed to get there. Assign one task per month.

Step 4 – Each week work a little bit on the tasks. Can be once a week or 3-5 days a week. It’s up to you and you must allow yourself room to slack.

Step 5 – Tell someone else your plan so you can report out weekly and be held accountable.

An example would be the inevitable “resolve to exercise more”.

Quarter Goal: workout 30 min daily by the end of March, so maybe work out 5 x week by the end of February, therefore start by working out 3 x week by the end of January.
OR 10 minutes a day in Jan, 20 minutes a day in Feb, 30 minutes a day by March.

Break it down.

And forgive yourself for missed days.

And at the end of the quarter reassess. What you wanted to accomplish in January may have adjusted in April. Make the necessary changes for the next quarter and keep going.

Resolutions are supposed to make you feel good not guilty.

Give you a sense of purpose.

And it is for you.

Wishing everyone a safe new year with health and prosperity.

Butterfly

This morning as I was looking for the right necklace to match my stay at home outfit (yes- I am one of those people), I came across a butterfly pin that made me pause.

Mind you, I had seen this pin on many occasions while looking for the right accessory for the day. And usually I just quickly scanned past it because it made me feel uncomfortable.

You see, I made this butterfly despite every ounce of my being wanting to do nothing of the sort.

I was in the hospital (as a patient, not a doctor), feeling ill and despite my usual optimistic nature, I just wanted peace and quiet.

Into my room comes a bright and cheery volunteer artist who insisted I make an art piece to keep my mind centered and bring me a bit of peace.

I wanted to tell her to please please go away.

But I decided to give in and partake of what she had to offer.

Picked the butterfly.

Colored it.

Made sure to do my best to ensure the colors and patterns were symmetrical. (My internal mechanism of being able to control something in my life when everything else was out of my control).

And after she shrunk the artwork with heat, she added a pin to the back and handed it back to me.

It wasn’t half bad.

I made sure the butterfly came home with me and placed it with my other jewelry but never brought it out because it reminded me of a tough time.

Today I looked at it and thought, “Hey butterfly, we’ve both come a long way”.

So I brought it out.

Held it for a while.

And was truly grateful.

Grateful that I was not in the same place I was when I made it.

Grateful that I have today and am looking forward to tomorrow.

Planning to soar.

Reminds me of the lyrics Deniece Williams sang in 1984;

“Black butterfly, set the skies on fire
Rise up even higher
So the ageless winds of time can catch your wings.”

T’is the Season

Where I am, there is snow on the ground and the temperature is a bit cold.

Our teams are manning the antibody infusion tents for those with mild to moderate Covid19. These same team members are also getting their vaccines to protect their patients, colleagues, friends and family.

So there appears to be hope on the horizon.

I look at this season and recall the heartbreak and sorrow we experienced throughout 2020, but I also find the moments of joy that may or may not have occurred in spite of (because of?) everything.

Birthdays, weddings, graduations, etc may not have been as expected but they happened. The significance of the events was not diminished by the method in which they were celebrated.

I will not pretend that the “good” things outnumbered the “bad” things in 2020.

But I will acknowledge that I am here today.

You are here today.

And it appears we have made it to the end of 2020 and will hopefully awake on the morning of 2021.

The holidays may be different this year but there is so much to be thankful for.

Permit yourself to smile, sing and laugh.

Fa La La La La

La La La La

Sunday Morning

There is something about Sunday mornings.

Whether I was on call or working from home or at a meeting or just home.

Sundays felt like a reset.

A day to take stock of last week and then plan for the new one.

A day to reflect on what is going on in my life and then be truly grateful for the positive things.

Because no matter how bad things are, there are little positive things happening every day.

My positive is that I woke up today. Everything else is gravy. So I am looking forward to the week ahead.

As Lionel Ritchie sang…

“That’s why I’m easy,

“I’m easy like Sunday morning.”

Happy Sunday.

Broadway

I was hanging up Christmas decorations at home and had my music tuned to, not holiday music, but Broadway show tunes.

I love Broadway.

And that includes the off Broadway productions – so I’ll say I love live theater.

Sitting in the audience, excited, waiting for the curtains to open (if not already).

The orchestra begins to play and then the show begins.

I really really miss live theater.

My promise to myself is that when we get to our steady state where live theater is allowed again, I will make a more concerted effort to attend performances.

Meanwhile I am starting to watch the live performances and/or movies that are on the various networks (on weekends, at night, when able…we are under a second wave so weekends are no longer sacred).

The recordings are not the same, but I still enjoy the chills, warmth and excitement of performers showcasing the fantastic work of writers and backstage staff and producers.

For now, I hum along to the online station, try to guess which show a song is from, laugh and cry at various lyrics, and just allow myself to feel good.

All The Leaves Are Brown

And the sky is gray.

If you are of a certain age you are probably humming the song that these two sentences trigger.

Yes, it’s not as bright and sunny in the Northeast as it was many weeks ago.

And a number of us are dealing with the new surge of Covid-19 cases because our jobs require us to step up our activities during this period.

The concern this go round is that the human capital that health care systems, transportation, food and retail industries, utilities, etc needed to keep us going may not be enough.

After going through the first wave, a number of people are tired.

Mentally, physically and emotionally.

Some have Post Traumatic Stress Disorder (PTSD) and are unsure if they can go through this again.

So what can we do?

Try to keep the number of cases with Covid19 from escalating too high (I know, it seems like that ship has sailed).

Wash hands, mask up, social distance.

If you are positive, follow the quarantine guidelines.

If you have mild to moderate symptoms and are high risk, ask about the new antibody infusion treatments that the FDA has issued Emergency Use Authorization. See if this treatment is an option for you.

You have to be 12yrs and older, 40kg and up with certain risk factors. The infusion takes about an hour. The idea being to hopefully prevent you from becoming a severe case that needs to be hospitalized.

Meanwhile the various vaccine options are almost here. Some requiring two doses which take effect two weeks after the second dose is given.

Regardless of what you decide- have a conversation now with your family and your doctor so you are prepared should you find yourself in the position of needing care later.

If you are suffering from mental, physical or emotional distress please reach out to someone.

If you notice someone is in need, please reach out to them.

Remember, hospitals are slowly shutting down visitations because of the surge.

You do not want to be faced with that prospect as a patient nor as the loved one.

And should you be in that position, things are a bit more hopeful in that we have new treatments and have a better understanding of how this virus works than we did at the beginning of the year.

Science is working.

So, I’m looking out again through my window.

All the leaves are brown

And the sky is gray

But I am hopeful we will get through this if everyone does their part.