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doodlebug

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  1. The owners of Hobby Lobby, who've already vowed to remain open despite any orders from the government, have also sent out a memo that, any sick employee will have to use up all of their vacation time and sick time and then will go unpaid if not back at work. Also, should the national guard forcibly close a store, all of the employees will have to use up all of their PTO before Hobby Lobby will pay them 75% of their average of the preceding 6 weeks' pay. https://www.businessinsider.com/hobby-lobby-told-managers-denied-employees-paid-sick-leave-memo-2020-3?fbclid=IwAR0I3y52JdhsMEnuaScw41GsA-5a92R30EWJxP5rJvxxVqkny4Ua9hSJ3Ds "The district manager has said that our stores will remain open until the National Guard comes in and physically shuts the buildings down," a Hobby Lobby manager told Business Insider.
  2. I understand why you want to celebrate together, but it would be best if you didn't. I live alone and have a brother and two sisters in town as well as several adult nieces and nephews. Other than my sister who lives nearby and stopped over a week ago; I don't expect to see any of them for a while. Maybe you could each order Thai food and Skype so you can share the meal at a distance?
  3. I know a couple of physicians, OB/GYN's who are hospital based, who've tested positive. They're both sick, but not bad enough to be hospitalized; their symptoms seem to be more like regular flu stuff: fevers, cough, fatigue, etc. I live in Cleveland, OH. As a health care worker, I expect I will know a lot more people with the virus soon.
  4. I believe Katie is mixing up her facts, here. Oprah was filming the family for her show when the producers received an anonymous tip about Josh molesting his sisters. They turned the information over to law enforcement, but no one from the show tipped off the tabloids then or later. As it turned out, since JB and Michelle had gone to the police after the statute of limitations had run out on Josh's crimes, the cops already knew what Oprah told them and the case was already closed. Then, years later, after Derick and Jill were married, Michelle did some homophobic robocalls for a group that wanted to ban transgender folks from public restrooms. Turns out, Josh' history was known by a lot of people in Tontitown, probably because Josh and the girls had to get up in front of their church and confess and some of those who were present spilled the beans. In any event, a lesbian couple who knew the story were outraged that Michelle was presenting herself as the crusader for all that is pure and holy and they notified In Touch of the story, giving them enough details that the tabloid was able to put together a freedom of information request which netted them the police report which had not been sealed. So, Katie conflated two separate incidents which doesn't say much for her reportorial skills. I only listened to the first couple minutes because she is a horrible speaker and it was clear she had her facts wrong and also was going to waste a lot of time rehashing ancient history which indicated to me, anyway, that she probably didn't get anything juicy.
  5. I'm so sorry to hear this. It is true that, in certain situations where the lungs are not absorbing oxygen properly despite maximal ventilator support, flipping the patient onto their abdomen has been shown to help. It improves the air flow through the lungs or something. A lot of the photos from Italy have shown ICU patients lying in that position. It is a lot harder for nursing staff to care for someone in this position and easier for various tubes and wires to get knocked out of place, which is why they want to transfer him to a place where the staff has more experience and where they may even have special hospital beds for this. My employer, which initially said they didn't want donations, is now accepting cloth masks from citizens and giving them to patients who are immunocompromised or who have non-Covid respiratory infections to prevent the spread. I believe they are also making them available to first responders who need them. N95 masks are currently only available to those working in the hospital with patients who either have COVID 19 or are seriously ill and waiting for the test to come back. A recent article published in the OB/GYN world recommends that we wear face masks every time we are close enough to a patient to touch them, even in outpatient settings, which is virtually every patient in this line of work. They also have guidelines for caring for labor patients and recommend that EVERY patient in labor wear a surgical face mask, symptoms or not. In addition, in an ideal world, this would be switched to an N95 mask during the pushing phase as most women are releasing a lot of droplets into the air as they breathe, etc. All caregivers should wear full protection at all times when around any pregnant patient with respiratory symptoms and, anytime there is a possibility of droplets from the patient entering the air, that should include an N95. Of course, there is no way any hospital has enough gear to actually do this, so caregivers are forced to choose what they or the patient will wear. We had an update again today, a lot of it was technical nuts and bolts stuff not terribly interesting in general. We talked about predictions as to when things will peak and it turns out the research numbers geeks at my institution as well as another well-known medical center have collaborated to give us the data which is based on our particular hospital in our particular Midwestern city. They say that, if we are unable to flatten the curve (and it is too early to tell yet), then we will have our peak in mid May which will include about 4500 intubated patients in the system, 12,000 patients hospitalized overall. Our facility will not survive those numbers. If we maximize our measures to flatten the curve, then the disease will peak in early August with much lower numbers. Most likely, we'll be somewhere in between. So, best case scenario is that this drags on for the next 5 months or so. We're also being organized into teams to cover the hospitals if needed. OB/GYN's would be put into a team lead by an internist and which would include nurse practitioners and residents. We would all make rounds together and the internist would make all the major decisions while we would be tasked with communicating with the patient's family and helping to coordinate the various ancillary services needed to care for these complex patients. That sounds doable. Since we are not seeing as many patient in the office these days, they're preparing some online courses to help us brush up on our internal medicine since most of us are rusty.
  6. I've been bragging about Amy Acton, the leader of the Ohio Department of Health. She has done an exemplary job and is one of the main reasons Ohio has been a leader in this crisis. The other reason is our governor, Mike DeWine, who listens to her and bases his decisions on what is medically necessary not on what is politically expedient. Amy has lead a life that sounds like something out of a movie: her parents divorced when she was young, her mother was unreliable and took up with a series of unsuitable men, putting Amy and her brother in jeopardy. They moved frequently, were homeless on several occasions and actually lived in a tent in Ohio one winter. Her mother remarried, a man with a history of child molestation, and, when Amy was 12, he was arrested for abusing her and her mother finally lost custody to her father and she gained some stability. BTW, she never saw her mother again after she was arrested for child abuse. Amy tried to kiss her when she came to court for the arraignment and her mother turned away and refused. She ended up going to medical school, becoming a preventive health specialist with a master's in public health. She's married with 6 kids and started crying during a press conference while discussing her 2 adult sons who live in San Francisco and were under lockdown due to Covid. If they made a movie of her life, no one would believe it. A true hero for troubled times. https://vindyarchives.com/news/2019/aug/31/ohio-leaders-passion-comes-from-youngsto/
  7. Seems like opinions are varied. Ohio’s amazing director of public health, Dr Amy Acton, said that things should peak at the end of April in Ohio. This was at her daily press conference on Thursday. Two weeks earlier sounds good to me. She also fairly gushed about what an incredible difference social distancing has made and encouraged us to stay the course. We have another institute-wide update at lunchtime today. Word has it, reassignment is happening next week and many of us will be working second shift in a makeshift gynecological urgent care center being developed to divert non-critical patients from the ER. One of the OB/Gyn docs in my area tested positive. He’s home, doing ok. Meanwhile, several other docs in our group have serious health problems and they’ve been removed from direct patient care to protect them. One, who has been doing full time practice and taking call, is on the list to get a kidney and it would be tragic if she got sick and then one became available. So, our on-call schedule has been re-jiggered a bunch with more to come, I’m sure. Luckily, we’ve got a pretty large group, so we can re-distribute without overburdening anyone. Several of us who have quit doing OB are willing to work L&D if needed. I’ve missed the babies if not the night call. My employer is trying to avoid laying anyone off, so they’re trying to figure out ways to keep everyone busy as we wait for the other shoe to drop. i understand the fears about the economic hole we’re digging here, but I don’t see a better alternative. We’ve survived worse than this..
  8. No, the CDC really did recommend bandanas for health care providers who can't get N95 masks. Cloth masks are better than no mask at all, so it does make sense for healthcare workers to use them if nothing else is available. However, it does seem somewhat mind boggling that the wealthiest country on earth cannot provide appropriate equipment to its front line in this crisis.
  9. @SCARLETT45, your mom is a pioneer! She is one of the women who paved the way for the rest of us who chose medical specialties that were not considered 'women's work' back in the day. When I started my residency, there had been a grand total of 3 women in the OB/GYN program to that time. One was a year ahead of me, one dropped out after a messy divorce and became an anesthesiologist and there was exactly one woman who had actually completed the residency and was out in practice. I met her and she was tough as nails and had some incredible stories. My residency had 4 residents per year for 16 total. When I matched, all 4 of us were female in my year. A first for my residency and, in Columbus, only Ohio State had an all-woman class that was a couple years ahead of us. So, we went from 15 guys, one girl to 11 guys, 5 girls. By the time I finished, women were dominant and have been ever since. Now, it is kinda unusual to have male residents. The residency at our hospital has somewhere around 30 residents (I don't keep track) and, currently, all but 2 are female.
  10. I forgot to mention the most interesting part! Since we’re obviously not going to be terribly busy in our offices, the enterprise expects to reassign practitioners as need arises. One of the areas where they anticipate needing people is ICU. So, anyone interested in helping out there is invited to take a 2-3 day seminar on how to work as an ICU doc and not kill anyone inadvertently. One of the docs in my office is less Han a year out of residency and I’m sure he’ll be asked to volunteer. I haven’t regularly cared for ICU patients in almost 34 years so I’m pretty sure they don’t mean me.
  11. My employer had an information session for those of us working in OB/GYN today. As you might recall, I work for a big corporate hospital system in the Midwest. Some of the takeaways: 1. Based on projections, the pandemic won't peak in Ohio until mid-May. We are currently not having any big issues with staffing and people are avoiding the ER at all costs which is great, since 90% of the people I see who've gone to the ER did not have anything resembling an emergency. BTW, if staying home is really going to make a difference, it needs to be practiced at least until the numbers peak and begin to fall (which is about a month longer than certain politicians would like). 2. Cloth masks work well if you are the patient and wearing it to prevent spreading your infection to others. They are not very effective when a healthy person wears one in hopes of not catching something from others. Specifically, they really are not useful to healthcare workers who are taking care of Covid-19 patients. We were told to tell our friends and family who want to make masks and donate to the hospital, 'thanks, but no thanks'. 3. We currently have enough supplies including masks, etc mainly because we are a big hospital conglomerate (and they came out to everyone's office and took all our stored PPE stuff last week). We also have not begun to see the numbers that we anticipate are coming. 4. Ohio's governor ordered all non-essential surgeries canceled and so virtually no one in my department is doing anything except emergencies. A couple of the gyn cancer guys are doing some cases but they are virtually the only ones scheduling stuff. The system has multiple outpatient surgery centers which have been closed and the staff sent elsewhere and their gowns, gloves and masks rounded up for the crisis. We are not planning to re-open for elective surgery until May at the earliest. 5. Every patient who calls the office for an appointment is screened by one of the practitioners and no one is seen unless they must have a physical exam. We have a platform for doing virtual visits using the phone, but it is overloaded with Covid-19 screening calls; so we are using our regular cell phones and apparently, HIPPAA has loosened up for the moment and we're allowed to FaceTime or Skype if we want. We enter charges for virtual visits because that is how the enterprise keeps track of what we're doing but patients are not going to have to pay anything out of pocket. The insurers who endorse virtual visits are hopefully gonna toss a couple bucks our way. I saw 3 patients today (usually see around 20) and talked to 3 people on the phone and took care of maybe 20 other phone calls with the nurses. I also hemmed a pair of pants and did some CME. My dogs accompanied me this morning as emotional support for the staff, but don't tell anyone. I have 1 patient in the office and one phone visit set up for tomorrow. Two patients in the office on Thursday and nothing on Friday. One of my partners gave everyone in the office gratitude journals this morning and several of us hung out and discussed our entries while maintaining our social distance. 6. With the restrictions on visitors, apparently a goodly number of pregnant women have expressed interest in homebirth, asking if their caregiver would bop on out to the house and catch the baby. As you can imagine, the answer is 'no'. Anyone who wants to plan a last minute home birth on the fly so that half a dozen family and friends can watch them birth has a lot more problems than Covid at this point.
  12. Anyone interested in learning another language, Duolingo is great-and free. I agree, a couple of years ago, I had a knee replaced and found myself getting nothing accomplished as the days dragged into weeks and months. I started making a daily schedule with at least 3 things I wanted to accomplish each day and checking them off. It got me back on track. Start simple, with stuff like showering, washing your hair, putting on a nice outfit (it doesn't matter if no one sees it) and putting on makeup if that's your thing. Promise to do a load of laundry, write a single 'thank you' note or clean out one kitchen drawer. You'll be amazed at what you can get done if you just write it down first. BTW, take a look at your Christmas card list or your address book, electronic or otherwise). Surely you know someone who would appreciate a card or a note, especially in these unsettled times. I wrote 3 little cards to elderly friends who I know are alone yesterday. It took maybe 20 minutes and I know those people are going to appreciate it. Think of all the people you've lost touch with because you were so busy. Now, you're not so busy. Reach out.
  13. Jessica said her mother had to work. I presume what she meant was TLC's shooting schedule was set in stone and Gwinn didn't want to play along. And/or, TLC was willing to fly Jessica and Jessa to Atlanta for filming but everyone else had to pay their own way and her mom either didn't want to or couldn't afford the cost.
  14. Not to mention that most homeless people staying in shelters are forced to leave during the day. In normal times, they could go to the library or the mall or fast food joints to hang out until the shelter re-opened. It is 40 ish and drizzling in Cleveland today, I cannot imagine having to be outside for 12 or more hours; it must be miserable for them. Remember, too, that many of those using the shelters are also dealing with mental illness and a lot of other chronic conditions. My brother, who is disabled due to mental illness, was homeless by choice (his, not ours) a few years ago. It was heartbreaking. Pray for all the people on the margins of society.
  15. Everyone's favorite evangelical financial guru, Dave Ramsey, has shown just how much Christian concern he has for his fellow man. It seems that one of his employees has tested positive for Corona virus. Not only did he send out an email to his employees violating that person's privacy by giving out their name; he also told them they may NOT work from home, that it is business as usual at his establishment. https://www.nashvillescene.com/news/pith-in-the-wind/article/21123156/dave-ramsey-keeps-offices-stay-open-after-staffer-tests-positive?fbclid=IwAR0fTkhPjW95BvEI_S1SjpwV0lUgNPV3TEJx2iC65QoZTk2O6syG9ayWGMk
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