Saturday, May 9, 2020

Doctor Visits and Covid-19: Dealing with Medical Appointments

While many Americans, especially senior citizens, are staying socially isolated at home as much as possible, one concern many of them have is how to handle their medical appointments with their doctors, dentists, physical therapists, chiropractors and other healthcare providers. Nearly everyone is asking the same questions. Should you go to the doctor's office or try to handle everything over the phone or during a video chat?  What should you do about routine physical examinations, getting your teeth cleaned, or emergency healthcare?  How should you handle a change in your health, such as heart palpitations, difficulty breathing, an unusual rash, sudden exhaustion or weakness?

Follow the Instructions of Your Healthcare Provider

Since Covid-19 began sweeping through the country, most healthcare providers and physicians have written or emailed their patients and provided them with information regarding what changes they have made to protect their patients from Covid-19 during medical visits.  Make sure you read this information and follow their instructions. In an emergency, doing the right thing could save you time and, possibly, your life.

My California healthcare provider, Kaiser Permanente, has reorganized their offices so that certain locations are exclusively for patients with respiratory problems and suspected cases of Covid-19, while the remaining locations are now reserved for patients with other healthcare issues.  Prescriptions can be mailed to you or, if needed immediately, picked up curbside outside their in-house pharmacies.  If you must go into one of their facilities for an appointment, they ask you screening questions and take your temperature before you enter.  They have sent us this information several times, by both mail and email, so we are fully aware of the correct procedures we need to follow.

My husband recently discovered he had been exposed to someone who later was hospitalized with Covid-19, so his doctor directed him to go to a specific facility where they tested him.  Fortunately, he tested negative!

If your physician provides you with information about what to do, make sure you understand it, so in an emergency, you go to the right location.  It could save your life.

Monitor Your Own Health

Before you make a medical appointment during the Covid-19 pandemic, you should monitor your own health, take steps to keep yourself healthy, and avoid seeing a doctor if it is not necessary.

Here are ways experts recommend you can reduce your Covid-19 risk:

     Stay home as much as possible
     Wear a face mask when you do need to leave the house
     Wash your hands and/or use hand sanitizer frequently
     Avoid touching your face without cleaning your hands first
     Eat healthy foods to keep your immune system strong
     Get aerobic exercise to maintain good lung capacity
     Take your temperature if you suspect something may be wrong
     Avoid coming within six feet of anyone outside your home.

If you do these things, you may be able to avoid Covid-19 until a vaccine is available, and keep other health problems to a minimum, as well.

However, if this pandemic goes on long enough, you may find that you need to see a doctor occasionally, especially if you are living with a chronic health condition.  What should you do if that happens?

Plan Your Routine Appointments

Whether you are planning to see your doctor in person, or doing it over the phone or by video chat, you should prepare ahead for the appointment, unless it is an emergency.  Here are some tips to guide you.

1.  If it is the first time you are seeing a new physician, or if it has been a long time since you have seen your doctor, or if you are concerned about a new medical issue, the visit should be in their office, despite Covid-19.  Your healthcare provider should take appropriate precautions to protect you.

Whenever you see a new physician, it is important to bring your medical history with you, including the following items:

List of your medications
Names of other doctors and specialists you see
List of prior surgeries and treatments
Known family history of illnesses
Any records you have of recent lab tests, hospital records and ER records
   
When you go to the appointment, ask if you can bring a family member with you, especially if you are afraid you might forget what the doctor tells you.

Whether it is a physician who is new to you, or one you have seen for years, you should take these precautions when you go to their office:

     Wear a face mask to your appointment
     Use hand sanitizer and wash your hands before and after your appointment

2.  If this is a follow-up appointment with a doctor you have seen before, ask if you can do it by phone or as a video chat.  In my experience, if you have any kind of virtual doctor's visit, it is easy to forget some of the things you wanted to ask.  As a result, before you get on the phone with the doctor, do the following:

     Review your current medications and treatments
     Write down all your questions in advance
     Ask a family member for other questions you may want to ask

 If possible, perform whatever do-it-yourself health tests you can at home.  For example, take your own temperature, blood pressure and pulse rate before your remote doctor's appointment. If you have a fingertip oximeter, which measures your blood oxygen levels, make a note of the number. Weigh yourself and mention to the doctor if there has been a significant change.   Note any other health changes you have experienced such as skin rashes, slow-healing sores, an increase in headaches, or intestinal problems.

When you talk with the doctor, take notes during your conversation. Make sure you understand any instructions the doctor gives you.  Ask follow-up questions if you are confused.

Ask a family member to join you on the call, if possible, so you have someone else who listens to what is said.  If the two of you remember something differently, email the doctor afterwards to make sure you have the correct information.
    

Call Ahead, If Possible, Before Going to the Emergency Room

It is not possible to plan so carefully for all medical visits.  If you suspect you are having a heart attack or stroke, bleeding heavily, broken a bone, or been injured in an accident, you may need to go immediately to Urgent Care or the Emergency Room of a local hospital. Depending on the situation, you may either want to call 911 and take an ambulance, or have a family member drive you to the local hospital.

If a family member is driving you, and there is time, it is important that you call your healthcare provider or the hospital to ask if they have any specific instructions you need to follow.  They may have a separate entrance or location for normal patients, in order to separate you from patients with suspected cases of Covid-19.  If you are having a heart attack, the last thing you need is to be accidentally exposed to Covid-19, too.

If possible, it is ideal if a family member can accompany you to the hospital or doctor's office.  If you are in pain or extremely ill, it may be difficult for you to answer questions, explain your symptoms, or remember what they tell you.  However, because of Covid-19, many healthcare providers will not allow anyone other than the patient to enter their facility.  This is another reason why it is important to know in advance what to expect.

Other Healthcare Appointments

Our dentist has temporarily stopped performing any services other than emergency dental care. You may want to check with your dentist and ask them what precautions they are taking in their office and when it will be safe for you to have a routine teeth cleaning.

My elderly father, who has trouble walking, has a physical therapist come to his apartment twice a week.  The therapist wears a face mask and gloves, and my father wears a face mask, too.  If you need to have a physical therapist, caregiver, or other healthcare provider come to your home, ask them what precautions they are taking, and follow up with precautions of your own, such as wearing a face mask, washing your hands, and disinfecting everything they touch.

My chiropractor is still doing adjustments, and has encouraged his patients to keep their appointments in his office.  Some people have gone, but I have not.  I felt it was something I could postpone as long as the number of Covid-19 cases are increasing steadily in my community.  My chiropractor assures everyone that they are keeping patients in separate rooms and disinfecting everything after each patient, but I still feel nervous.  This is something which everyone will have to decide on their own, depending on their personal situation, the pain they are experiencing, and the advice of their own doctors.


If you have a child in your family who does not understand what is going on, they may benefit from a copy of the children's book, "Paula and the Pandemic."  It is a highly rated way to help them understand social distancing and what is going on, without frightening them. (Ad)

The bottom line is that the longer Covid-19 is spreading through our communities, the more likely it is that something will happen which will require us to contact our doctors.  When that happens, it is important that you have a plan and fully understand the correct procedures.

To learn more about common medical problems as we age, Medicare, Social Security, financial planning, where to retire and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

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