General Wellness

As we already know, any chronic condition, even just being overweight, puts you at increased risk of getting infected with the SARS-Cov 2 virus but also of developing a more severe case of Covid-19, the disease caused by the virus. This is particularly true of people with lung diseases including asthma, Chronic Obstructive Pulmonary Disease (COPD), emphysema and damage from smoking.

Initially, we thought of this disease as primarily a lung disease, like the flu, however we now know that just about any organ system can be affected since almost all tissues, including fat cells, have the ACE-2 receptor on their surface. They are in higher concentration in the lungs, along with the kidneys. There are fewer ACE-2 receptors in kids resulting in fewer infections and more moderate courses but there are more of these receptors in people who smoke or have lung disease. In addition, a recent model of covid disease progression, the “bradykinin hypothesis” describes how this virus hijacks the interplay between this receptor, the enzyme that binds to it, the breakdown of this enzyme and the progression of inflammation leading to severe lung symptoms and long term scarring. In a nutshell, in addition to direct damage to lung tissue, a gel forms in the most distant parts of the lung impairing oxygen exchange. The patient basically can’t get enough oxygen and “drowns” in their own fluids. 

Early on, many patients were put on ventilators thinking that this would allow for better breathing support and oxygen exchange but this actually made things worse. Frequent position changes and lung therapy allowed for better movement of fluid and secretions in the lungs and actually prevented many patients from needing ventilators or more advanced forms of treatment such as ECMO.

Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. This is also known and being put on a “lung and heart by-pass” machine, used regularly during lung resection for heart bypass or valve replacement procedures. The blood is taken out of the body, oxygen is infused and the blood is put back in. If you need this, it’s not a good sign.

The bottom line is that any chronic disease, especially lung disease, but even something as innocent as being a little overweight, puts you at greater risk.

DISTANCE. Physical distancing, not social distancing. We need each other.

WEAR A MASK.Wear an effective one and wear it correctly.

WASH YOUR HANDS. Don’t rely on hand sanitizers unless it’s an emergency.

DON’T TOUCH YOUR FACE. 

VENTILATE. 

VACCINATE.

GET HEALTHY.

Stay safe and be well. 

AC 😎✌️🌱❤🐖🏃🏻🧘🏻‍♂️🌎😷

We have become numb to the news. Numb to the tragedy. 

Unfortunately, Coronavirus-related deaths have passed 205,000 in the US and approaching 1 million worldwide, and the daily ticker tape scrolling of new cases, hospitalizations and daily death counts have become background noise for most of us. 

Not of course to those immediately affected. If it affects you, the odds are 100%!

Even though we ARE all affected by this pandemic (work,schools, LIFE…), not to mention the social/racial upheaval and political insanity we are in the middle of, we still cling to and complain about what only immediately impacts on us.

Thinking about what is necessary to do now to make tomorrow better is lost on us. That’s not how we think. If it affects someone else, or if our personal diseases or behaviors have some side effects which will occur in the distant future, we tend to ignore them or play them down. It takes too much effort to change. It’s easier to do what is…easier.

It irks me every time I see someone out not wearing a mask, wearing one below their nose or wearing something which is useless, or potentially even or even potentially harmful, like a gator. The information is out there but it is ignored. It’s easier to do what is easier. It feels better to hear and cling to notions which support what you believe and which make life “easier”. Our leaders continue to downplay the role masks and other basic behaviors have on the progression of the disease.

I can’t tell you how many times I have heard of someone quitting smoking once diagnosed with cancer or having had their first heart attack or bypass procedure. “I’m an ex-smoker” meanwhile, they quit only 2 weeks ago after decades of puffing. It’s better than nothing I suppose.

On the flip side, I have had many patients who have had so much improvement in how they look and feel with only some moderate changes in lifestyle, although those are the minority. Those few are the impetus to keep moving forward. But it takes WORK. The more work you put in, the better off you are. 

“Moderation” only results in moderate improvements.

I know this is a little rambly, but I’m frustrated. With everything going on, with people’s lack of caring, with the inability for people of opposing views to come together and find common ground… The daily inondation is too much. Just as an aside, I’m not immune to apathy and I’m frustrated and disappointed with myself as well.

The bottom line is that we need to do what is right for everyone.

I can’t speak to politics. Everyone needs to put emotions aside and make what they think is the best decision. That is what democracy is all about. As far as race is concerned, we are all equal human beings. Treat everyone with respect and compassion. Even a simple smile is infectious. A simple act of compassion has massive trickle down effects.

I CAN speak to what I think we need to do medically. The operative word there being “I” and I am not always correct but I at least am able to admit when I am wrong and am willing to research for the best answer based on what we know.

What we know works is the following.

DISTANCE. Remember that it’s physical distancing, not social distancing. We need each other.

WEAR A MASK. Wear an effective one and wear it correctly.

WASH YOUR HANDS. Use warm water and soap. Rely less on sanitizers. They are loaded with chemicals. Remember that if it’s on you, it’s in you.

DON’T TOUCH YOUR FACE. The average person touches their face 2000x a day!

VENTILATE. More airflow = more particle dispersal.

VACCINATE. It works. It helps and it saves lives.

GET HEALTHY. Even a tiny loss in weight translates into major health benefits. 10 lbs of loss lowers risks of diabetes and vascular disease by 30%.

Stay safe and be well. 

AC 😎✌️🌱❤🐖🏃🏻🧘🏻‍♂️🌎😷