The Blog

If you hadn’t heard, May 6-12 is national nurses’ week, with May 8th being national student nurse’s day and May 12 being Florence Nightingale’s birthday. A great time to celebrate your favorite nurse!

I enjoyed watching Tim Cook’s virtual commencement address to Ohio State University graduates this week. He talks about how the Spanish flu pandemic of 1918 shaped the lives of Amelia Earhart, T.S. Eliot, and Franklin D. Roosevelt. Many of you know that I am a proud alumnus of their biggest rival, the University of Michigan, but my nephew attended Ohio State so I think it is ok to share the link below.

We continue to be busy helping patients in the office whose care shouldn’t wait- mainly cancer patients but also other patients who would suffer undo pain or harm from a delay. I have many patients who receive Botox for Migraines. One of the conditions to receive insurance coverage is to have 15 or more headache days a month with headaches lasting for 4 hours or longer. For patients that don’t suffer from chronic headaches it is hard to imagine this much suffering. One of my migraine patients last week only called to come in because by chance she has a friend who also has migraines and had an appointment in the same week. She had thought we were closed and had delayed her treatment by 2 months. If you do the math that is 30 severe headaches lasting at least 4 hours that could have been avoided. Thankfully, she did come in and we were able to treat her to relieve her chronic headaches. It turns out that many patients across the country are delaying needed care- so please, reach out to us with any questions. We have instituted virtual consultations in the office and are getting better at it- I have a new patient who had a spot that was changing rapidly. His dermatologist biopsied it last week and found out it is a melanoma. I saw him virtually yesterday and we have arranged for surgery in the office next week to remove it. It is at a very early and treatable stage now, but unnecessary delay could have allowed it to progress to a more dangerous stage.

I treated another patient with melanoma in the office yesterday with surgery. He was anxious about leaving his house and I wanted to explain the extra steps that we have been taking to keep our patients and staff safe.

Covid Precautions in the office:

In addition to our normal processes in the office these are some of the changes we have made. We are screening all patients and staff every day. If anyone, staff, or patient has symptoms they are sent home. We ask that all patients wear a mask and we are wearing masks as well. We have spaced out patients in the office to maintain social distancing. We have asked new patients to download their forms from our website (link here) and fill them out and email them back before their visit to decrease potential time in the office. We ask that you not bring guests or friends to your appointment. When you arrive, you will be given a Covid screening questionnaire to complete and Ashley will check your temperature and pulse oximetry. Ashley is also screening all the staff each day, including myself. Here is a photo of Ashley checking my temperature with the forehead scanner.

In addition to our usual cleaning, Marina at the front desk is wiping down all surfaces that may have been touched in the reception area including the limited seating, doorknobs, and credit card machine.

Once the Covid screening has been completed you will be brought directly to the exam room. All surfaces that you might touch are cleaned and disinfected between each patient. We have hand sanitizer available for your use in patient rooms and at the front desk.

At check-out we have Apple Pay which is touchless for copays or Botox/filler treatments, and the credit card machine is wiped down between each patient.

We are able to do many follow-up visits virtually now, which will save a visit back to the office after a treatment or minor surgery.

And speaking of virtual visits, I wanted to let you know a way to get $50 by making a virtual visit. We are not yet seeing routine patients for Botox and filler treatments in the office and are hoping that Governor Baker allows this soon. You should have gotten my email last week for Botox patients with information on how you can go on your Brilliant Distinctions account and buy up to 4, 100$ gift certificates for $50 each. Allergan has a limited supply and told me today that they are almost sold out.

The cautious good news is that Governor Baker may be allowing limited reopening on May 18. It is too early to celebrate but hospitalizations have been declining in Massachusetts since the peak on April 21. Daily updates are available on the mass.gov website.

The FDA has granted Remdesivir emergency use authorization – This antiviral is not the “silver bullet” that many of us were hoping for but does decrease hospital stay by 30% and is a good start while other antiviral medications are tested and while we await a vaccine. I have put a link below to an excellent article in Nature about the different types of vaccines that you might find interesting.

I always enjoy reading the MIT Technology review which we get in the mail after my youngest son graduated. They have made their May/June 2020 issue virtual and downloadable as a pdf. The entire issue is devoted to “Navigating a world reshaped by covid-19” and has some thoughtful insights that you might enjoy. I have put the link below.

Finally, I had a patient ask me this week whether he should spray Lysol disinfectant spray on his hands after going out. This is probably not a good idea because it is designed to clean hard surfaces and not as a hand sanitizer and can therefore be harsh for the skin. Hand sanitizer like Purell is a good option when you cannot wash your hands and I keep a bottle in the car to use after going grocery shopping or to the pharmacy. But the very best option is still hand washing with soap and water for 20-30 seconds. The corona virus is scary because we can’t see it, but it is very sensitive to soap, which breaks down the fatty (lipid) outer layer of the virus and kills it. But our skin also needs to be protected. I have put a link below with hand washing tips on how to protect your hands-spoiler alert- the dermatologists recommend that you apply moisturizer to your hands after you wash with “ointments or creams containing mineral oil or petrolatum” and say that “the ones you squeeze out of a tube are more effective than products you pump out of a bottle” .

So be safe, wash (and moisturize!) your hands, and we hope to be seeing you back in the office soon.