KaiMD

What Mask Should I Use to Protect Myself?

May 29th, 2020

Right now, we are all concerned about protecting ourselves from the dangerous COVID-19 virus.  Mask-wearing by everyone has two benefits. It protects the wearing from breathing in dangerous droplets containing the virus and catches droplets expelled from coughs or sneezes.  We are learning that many people can feel perfectly fine in the first few days of COVID-19 infection, yet they can still spread it to others.  The key point is that we all need to wear masks when we are around other people.  There are many different masks on the market.  Here is a ranking of commonly used masks from most effective to least effective.  Combinations of masks can also provide some added benefit.  I’m excluding some of the more expensive, industrial grade masks as those are not feasible to wear for most people.  Mask-wearing of any kind will always provide more protection than not having a face covering.

  1. N95 or KN95 Mask- the gold standard for protection.  However, it must fit right to be protective.  Be sure to mold the wire on top around your nosebridge.  When you put it on right, you should see a little bit of the mask “suck inward” when you breathe in. You can cover the N95 with a cloth mask to increase the protection.  I would recommend using these masks when you will be in close contact or in enclosed spaces, with people who potentially could be infected.
  2. ASTM level 2,3 surgical mask.  These are medical grade masks which provide some more protection than the average paper mask, are more comfortable than N95’s but the downside is that they allow for leakage of air around the sides.
  3. ASTM level 1 surgical mask, can improve the quality by adding an additional cloth mask on top
  4. Any surgical mask, usually have a lot of leakage on the sides, I would advise using a gaiter (see below) to close up those gaps
  5. Cloth mask doubled up with filter (coffee filter, air filter or paper towel) inserted between the layers
  6. Cloth mask- the thicker the fabric and tighter the weave the better.  If you hold the fabric up to the light, you should not be able to see too much light through it.  If the material is thin, double it up by folding it in half.
  7. Gaiter– these were originally designed for skiers but are quite comfortable and provide decent protection.  What’s nice about them is they often have ear loops to keep the mask from falling down.  They also feel a little less restrictive.  Wearing a surgical mask underneath would provide more protection.
  8. Scarf or bandana- these can be used alone or ideally with a paper mask underneath.  I would recommend these if you are in an area where you don’t plan to come into contact with other people, like when you are hiking in the woods.  You never know if you may come across someone and these can provide just enough protection.
  9. Any piece of clothing or paper towel wrapped around the face.  If you find yourself without a mask, lift up your shirt collar above your nose or place a folded paper towel around your nose and mouth.  These are not the best, but can provide some protection for short periods of time.

We should all be used to wearing face coverings at this point.  The key to staying safe is knowing what protection you need and in what situation.  Think about it like part of your wardrobe choices for the day, would you wear a T-shirt to a wedding?  Would you wear a tuxedo to a picnic? Again, some protection is better than none, but planning ahead is very important.  Put an extra mask or scarf in your pocket if you are not sure.  It could save your life!

Be Sure Your Home Office Helps You Stay Healthy!

May 29th, 2020

As all of us have started working from home for long periods of time, it is more important than ever to adjust your home workstation to prevent unwanted strain and injury. The neck, back, wrists, and eyes can become painful or irritated even after one day, and with prolonged work in an improper desk setup can cause severe inflammation. Here is some information to determine if your home setup is appropriate for you along with exercises to keep you mobile throughout the day.

Ergonomic Tips for Setting Up Home Work Space

  • Avoid doing any work in bed or on a sofa.
  • Make sure your chair and table/desk height are appropriate and that you are not hunched over.
  • Adjust the monitor to arm’s length away to reduce strain on eye. The top of your screen should be at eye level. If you need to use a laptop, place it on a kickstand or books to raise the screen to eye level.
  • If you are using two monitors, your body should be in the middle of the two screens
  • Make sure the elbows are bent at 90 degrees
  • Make sure the keyboard is placed in a position to protect wrists from being in extended position for too long.
  • When using a mouse, move from elbow not shoulder to reduce overuse injury.
  • Avoid resting your wrists on the desk surface as this can cause a painful condition called carpal tunnel syndrome. There are mousepads with built in wrist bumpers, but you can consider placing a rolled up hand towel to remind yourself to keep them elevated.
  • When using a phone, use a headset or headphones.
  • Your feet should rest comfortably on the ground. If not, then use a footrest or reams of paper
  • If you have a standing desk, be sure to wear comfortable and supportive shoes. You can even stand on a yoga mat to reduce strain on the arches of your feet, as they will be supporting your weight for several hours throughout the day.

 

desk ergo

 

 

Take Breaks and Stretch Often

  • Get up every hour and take breaks to walk around house, get a snack, stay hydrated, and chat with family.
  • Stretching exercises have been designed to warm up muscles, improve flexibility and help prevent soft-tissue injuries. Stretches should be brief, no longer than five min in duration to complete.
  • Stretching should not cause pain or discomfort. In general, you want to stretch your body parts in the direction opposite to the positions while working.
  • Low Back Stretch: While standing, place both of your hands on your low back. Slowly bend backwards as far as is comfortable. Do not extend the neck to prevent straining the muscles around the neck.  Hold for five seconds then return to upright posture.  Repeat five times.
  • Overhead Stretch: Reach above your head by stretching your arms up and interlocking your fingers.  Hold for five seconds, repeat five times.
  • Shoulder Circles: Raise both shoulders up as far as possible toward your ears. Now make shoulder circles bringing shoulders backward, downward, forward and upward again.  Perform ten times in one direction, repeat ten times in opposite direction
  • Neck Side Bend: Tilt your head sideways, pulling your ear towards shoulder.  Hold for five seconds and repeat three times on each side
  • Neck Rotation: Turn your head as if looking over the shoulder, return to center.  Repeat to other side.  Hold for five seconds and repeat three times on each side.
  • Wrist Stretch: Extend your arm in front with palm facing down, with your opposite hand, bend your wrist downwards until you feel a comfortable stretch. Hold for five seconds.  Repeat with palm up. Repeat in the other arm.

Lighting Tips

  • The light source near your workspace should be positioned ideally at a 45 degree angle from the eyes
  • Avoid having windows or bright lights behind the computer screen.
  • Adjust the brightness and contrast of monitor to suit the environment. Reduce the brightness of screens (computer, phones, or tablet) at night before bedtime.
  • Workers over fifty years old often require twice as much light to complete tasks comfortably.

Preventing Eye Strain

  • 20/20/20 rule. Every twenty minutes, look at a point twenty feet away for twenty seconds.  This allows the eyes to stretch out muscles and reduce eyestrain.
  • Use natural tears and blink often. When we stare at computer screens for long periods of time, we naturally stop blinking, which is how our eyes normally stay moist.  Blinking and using natural saline tear drops can help soothe your eyes and feel less tired.  Applying a washcloth moistened with warm water, with gentle pressure over the eyes can also be effective.

Take some time to make sure you feel comfortable in your workspace and not try to “make do” with your current setup.   You may find this could improve your productivity and prevent injuries.

 

Gratitude

May 28th, 2020

Guest Author: Karen Duzy, MSN, FNP-BClotus

Gratitude is the thankful appreciation for that which is received. Research has shown that practicing gratitude is strongly associated with greater happiness. It can improve overall health and build stronger relationships. It can be hard to feel thankful these days, but if you take a deeper look, you begin to notice that we have much to be grateful for.

Here are a few things worth considering:

  • The well-deserved recognition of healthcare workers for the absolutely critical work they do, sometimes at great personal risk, without abandoning their post, every single day of their careers.
  • The guidance and worldwide collaboration of the scientific community, which has been quietly at work for years, even decades, to help prepare us to better navigate through this current health crisis.
  • Recognition of the value of each person’s contribution to the whole. Never having considered how goods get to market, I now have the utmost gratitude for those who manufacture and transport the necessities I had taken for granted (Yes- even toilet paper!)
  • The opportunity to spend more time with our families and notice the small things that can bring joy, like snuggling together on the couch, that are often overlooked in the hustle and bustle of our busy lives.
  • The godsend that technology has provided in keeping us connected to each other through what otherwise would have been a dark and very, very lonely time.
  • A chance to reboot and consider what really is important to us. We have been given the opportunity to see our own strengths and how we adapt under pressure.

Finding gratitude can be key to staying emotionally healthy during this crisis of such epic magnitude. So, take a few moments to find your own gratitude. It will be well worth the effort.

Here are some tips to get started:

  • Keep a gratitude journal. Set some time aside for entries at the end of the day. Identify something that made you feel good. Was it the time you spent playing a game with your child or grandchild? Perhaps you wouldn’t have had this time if you had been commuting to the office. Or maybe it was the beautiful sunset at the end of the day, which you normally would miss if you were out shopping at a mall.
  • Meditate while focusing on something you are thankful for. Not only will you feel less stressed through meditation, but you will solidify your sense of gratitude.
  • A great way to strengthen your sense of gratitude is to state it. At first, you may only feel comfortable acknowledging it to yourself, but over time, you might let a loved one know that you really appreciated the small gesture of kindness they extended toward you. Writing a thank you note would be a great way to start. As an added bonus, by sharing your gratitude, you strengthen your relationships.

Once you begin focusing on gratitude, you will empower your positive emotions and see that happiness is possible even in the midst of a terrible situation.

karenD

Karen is a family nurse practitioner with over twenty-five years of experience in primary care, currently providing virtual care in a corporate setting. She has a special interest in lifestyle medicine.

 

Vitamin D and COVID19

April 28th, 2020

Vitamin D is a necessary vitamin that we get from certain foods, such as fortified dairy, eggs, and sardines.  Some scientists believe that low levels of this vitamin can contribute to anxiety and depression, and reduce our immune systems putting us at risk for colds/flus that many of us experience in the winter months.  Ever wonder why we feel more energetic in the summertime?  We need approximately 15 minutes of exposure to the sun to activate this vitamin.  If you aren’t exposed to the sun for this amount of time, your levels will certainly be low.

Nursing home residents almost always have chronically low levels of vitamin D as they are indoors for much of the day.     Glass blocks the rays of sun needed for us to process vitamin D, so even sitting in a sunny windowsill is not adequate.  COVID19 has ravaged nursing homes, and low levels of vitamin D, while not the immediate cause, still could have contributed to its spread and severe symptoms.

Right now, most of us are not likely to be getting adequate amounts of sun each day due to isolation restrictions or being forced to stay home if we do have COVID19.  I recommend taking a supplement with 1000 IU of Vitamin D3 per day during this time.  Be sure to take it with food as it is a fat soluble vitamin and preferably in the morning.  Take a walk whenever it is sunny (while maintaining at least 6 foot distance from others AND I would recommend wearing a mask).

The ONE thing you should do right now

March 23rd, 2020

We are in an unprecedented medical situation in the US right now.  COVID-19 is seeping into every town.  Our country has vastly underestimated the power of the coronavirus.  Unlike the flu or other cold viruses, after infecting people COVID-19 can manifest with mild symptoms at first.  Most people think it’s just a “head cold” or allergies, so they may not feel the need to stay home but during this time they can spread it to other people with even a handshake.  Over a few days, these people can become ill in varying degrees ranging from flu-like symptoms to shortness of breath requiring them to be on a ventilator.

You may think “I couldn’t possibly have the coronavirus, I feel fine”, but if you infect others, they may have severe complications which could land them in the hospital and add more stress to the already overwhelmed healthcare system.  Many hospital across the nation are experiencing unprecedented number of patients, many of whom require ventilators to help them breathe.

Right now, to help your fellow Americans and all of mankind, PLEASE STAY HOME AS MUCH AS POSSIBLE.  Do not go to buy groceries more than necessary, wash your hands and clean all common surfaces in your environment (door handles, faucets, etc.).  Here are some other tips to help stay safe if you do go outside your home.