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Covid-19 and Sports – Episode 41, To Your Health With Dr. Jim Morrow

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Covid-19 and Sports
North Fulton Studio
Covid-19 and Sports - Episode 41, To Your Health With Dr. Jim Morrow
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Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Covid-19 and Sports – Episode 41, To Your Health With Dr. Jim Morrow

Dr. Morrow discusses various considerations around Covid-19 and sports, questions of safety, and much more. Dr. Morrow also offers an update on the Covid-19 vaccine. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Covid-19 misconceptionsDr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

Covid-19 and Sports

  • To date, limited data are available on COVID-19 and its effects on children and adolescents.
    • We know that those with severe presentations
      • (hypotension, arrhythmias, requiring intubation or extracorporeal membrane oxygenation [ECMO] support, kidney or cardiac failure)
      • or with multisystem inflammatory syndrome in children (MIS-C)
      • must be treated as though they have myocarditis
      • and restricted from exercise and participation for a duration of 3 to 6 months.
      • These athletes must be cleared to resume participation by their primary care physician
        • and appropriate pediatric medical subspecialist, preferably in consultation with a pediatric cardiologist.
        • Cardiac testing (EKG, echocardiogram, 24-hour Holter monitor, exercise stress test, and if warranted, cardiac resonance imaging) must have returned to normal, before return to activity.
      • Those with moderate symptoms must be asymptomatic for at least 14 days
        • and obtain clearance from their primary care physician before return to exercise and competition.
        • Any individual who has current or a history of positive cardiac symptoms,
          • who has concerning findings on their examination,
          • or who had moderate symptoms of COVID-19, including prolonged fever,
          • should have an EKG performed and potentially be referred to a pediatric cardiologist for further assessment and clearance.
  • The question still remains about what to do with others infected with SARS-CoV-2
    • or who had close contact with an individual with COVID-19.
    • Because of the growing literature about the relationship between COVID-19 and myocarditis,
      • all children and adolescents with exposure to SARS-CoV-2, regardless of symptoms,
        • require a minimum 14-day resting period
        • and must be asymptomatic for >14 days before returning to exercise and/or competition.
        • Because of the limited information on COVID-19 and exercise, the AAP strongly encourages that all patients with COVID-19 be cleared for participation by their primary care physician.
        • The focus of their return to participation screening should be for cardiac symptoms,
          • including but not limited to chest pain,
          • shortness of breath,
          • fatigue,
          • palpitations,
          • or syncope.
        • All individuals with a history of a positive test result for SARS-CoV-2 should have a gradual return to physical activity.
          • If primary care physicians have any questions regarding their patients’ readiness to return to competition,
            • they should not hesitate to consult with and refer individuals to the appropriate pediatric medical subspecialist.

What Could Happen?

  • There are complications that will stay with a Covid-19 patient for the rest of their lives.
    • The severe complications are
      • pulmonary fibrosis
      • and myocarditis.
      • The likelihood is that in order to develop these complications,
        • a patient will likely have to be moderately ill,
        • that is, having been hospitalized
        • and likely to have required supplemental oxygen therapy.
      • But there is still not a lot of data about this.
    • What is obvious now, that was not obvious at all obvious early on, is that young people are at risk.
      • They are at risk of contracting the virus
      • and they are at risk of having a moderate or severe case.
      • We have already had one football player, in California, die from complications caused by Covid-19.
        • There could be many more.
      • Because of these possibilities,
        • two conferences in the Power 5 decided not to play football this year.
        • They felt that it might be safer in the Spring of 2021.
        • I am not sure what they thought was going to change by then.
      • Recently, the Big Ten conference has reversed their position and decided to play.
        • The main reason cited is advances in availability of testing.

Testing, Covid-19 and Sports

  • The ACC is conducting coronavirus testing three times per week
  • The updated Medical Advisory Group report requires all team members to be tested
    • within three days of game day.
    • one test must be performed the day before kickoff, and must be conducted by a third party the ACC office selects.
    • another test must be done 48 hours after the game.
    • In addition, every student-athlete who tests positive for COVID-19 will undergo a cardiac evaluation that includes an
      • electrocardiogram,
      • a troponin test
      • and an echocardiogram before a phased return to exercise.
      • Many ACC schools already had procedures in place to screen for any possible heart issues.

Should parents and other spectators attend their children’s sports practices and games?

  • Parents/guardians should follow current local regulations for social distancing and use of cloth face coverings when considering game attendance.
    • Attending outdoor events may bear less risk than indoor events with less space and ventilation.
      • No one should attend any sports function as a spectator if they are exhibiting signs or symptoms of COVID-19.
      • Parents and other spectators with high-risk health conditions should strongly consider not attending indoor events or events held outdoors where appropriate social distancing cannot be maintained.
      • Live streaming or recording of athletic events, when available, may allow individuals who are unable to attend to participate in viewing events.

Covid-19 Vaccine Development – Episode 39, To Your Health With Dr. Jim Morrow

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Covid-19 Vaccine
North Fulton Studio
Covid-19 Vaccine Development - Episode 39, To Your Health With Dr. Jim Morrow
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Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Covid-19 Vaccine Development – Episode 39, To Your Health With Dr. Jim Morrow

On this edition of “To Your Health,” Dr. Morrow talks about the potential for a Covid-19 vaccine and the path of its development. Dr. Morrow also gives his thoughts on starting this fall’s college football season. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Covid-19 misconceptionsDr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

Episode 39:  Vaccinating Against Sars-Co-V2

My take on college football before a vaccine:

If a college allows students to be on campus, I can’t see why they would not allow football and other sports to be played.  The players are at no more risk than the students when they attend house parties and other social functions where we all know many will not be distancing or wearing masks.

If a college does not allow students on campus, then I can’t see how they can allow players to get together and practice and play. The risk is the same for both groups and just because the football players generate an enormous amount  of money for the school and the town, they should not be out to risk greater than the average student is exposed to.

I believe that if colleges test enough, prefer daily, then games could be safely played.  But absolutely every person who will be on the field should be tested the day of the game.  I don’t know enough about the logistics of testing yet to know how that would be done, but I do know from the testing machine that we plan to implement at Morrow Family Medicine that it is possible if your pockets are deep enough. And these colleges pockets are plenty deep.

Generalities About Vaccines

  • To make a vaccine, you must know what it is about an infectious agent that makes your body respond to it.
    • What makes you create antibodies?
  • With SarsCoV-2, it appears to be the spike protein.
    • That is the part that creates the crown-like appearance that gives it the name coronavirus.
    • When it attaches to your body, it creates proteins that are foreign and cause the problems you have from the infection.
  • If we can introduce the spike protein into your body without the viral mechanism,
    • then you can create antibodies to the virus without getting an infection.
    • If you are later exposed to the virus itself,
      • you have the antibodies already in place,
      • they attach to the spike protein
      • and prevent infection.
  • That is a gross simplification of the process, but I think it makes the point.
  • Up till now, the fastest we were able to make a vaccine was a little over four years –
  • that was the mumps vaccine.
  • Now, in this pandemic, all of our vaccine related infrastructure has been pointed to making this vaccine.
  • Because of that, the entire process will be much faster for this vaccine.
  • There are currently two main types of vaccines being developed.
  • One is in mRNA vaccine that has never been developed before.
  • The other is an adenovirus vaccine that is similar to some vaccines in the past.
    • This vaccine uses a chimpanzee common cold virus and there will be elements of the coronavirus genome inserted into that virus.
  • In both cases the vaccine will create proteins in the body that will cause antibodies to be produced which would recognize the coronavirus should you be infected.

What’s So Difficult About Vaccines

  • Since humans haven’t previously been exposed to the novel coronavirus (SARS-CoV-2), our bodies aren’t well equipped to deal with being infected by it.
    • A vaccine would allow the body to safely develop an immune response to COVID-19 that could prevent or control infection.
  • But it takes time to develop safe and effective vaccines –
  • It’s becoming quicker to develop new vaccines than it was in the past
    • as we can build on research from vaccines used for other diseases.
    • During outbreaks, more resources and funding may also become available,
      • which can speed up the process.
    • Products might also be considered for use even before being formally granted licenses to control the disease in severely affected areas during emergencies.
  • The development of a potential novel coronavirus vaccine is being partly led by experts who were already developing vaccines for other coronaviruses.

Steps to a Vaccine 

Basic understanding of the virus

  • In the past, most studies of human viruses looked at how the virus altered or affected human or animal cells in the lab.
    • Scientists first identify the proteins and sugars on the surface of the viruses or infected cells,
    • then study whether these proteins can be used to produce an immune response.
  • In the present case, this stage was made easier for researchers after Chinese scientists found and published the genetic sequence of novel coronavirus in January.
    • Researchers worldwide have been able to identify the structure of proteins that make up the virus,
      • create a genetic history of the family of viruses,
      • and determine when the first human was infected.
    • It also enabled diagnostic testing kits to be developed, and lets researchers identify potential treatment options.

Vaccine candidates

  • The process may involve isolating the live virus before inactivating or weakening it and
    • then determining whether this modified virus,
    • which is known as a vaccine candidate,
    • might produce immunity in people.
  • Sometimes the live virus is not part of the process.
    • Instead, its genetic sequence is used to make the vaccine.
    • The genetic sequence can also be used to make recombinant proteins,
      • a vaccine production method that has been used before for vaccines like hepatitis B.
  • Researchers now know how to manufacture and test the relevant vaccine
    • and check it has been made properly.
    • They even know about likely doses, including how many doses will be needed to build immunity.
    • This background knowledge speeds up the development of each new vaccine made using the same technology.

Pre-clinical testing

  • Initial safety testing is usually carried out in animals to give an idea of responses in humans.
    • These are also used to see how effective the vaccine is at preventing the disease,
    • and allows researchers to adapt the vaccine.
  • During an outbreak, different research groups often work together to speed up this process.

Clinical trials – testing in humans

  • This step is where many promising potential vaccines fail.
  • There are three phases of a clinical trial:
    • Phase 1: Testing on a few dozen healthy volunteers,
      • looking at how safe the vaccine is,
      • and if it has any adverse effects;
    • Phase 2: Testing on several hundred people for efficacy, a “target population”
      • who are ideally those most at risk of the disease;
      • Thanks to Operation Warp Speed,
        • a federally funded program to speed vaccine production,
        • most companies are combining Phase 2 and Phase 3.
      • Phase 2 is primarily performed to ensure the company that the vaccine they have developed will work on the target population.
        • This is where many vaccines die,
          • ending the spend for that company.
        • If the company can avoid this phase,
          • or combine it with Phase 3,
          • they can save millions of dollars
          • and also cut months or even years off of the process.
        • Phase 3: Testing on several thousand people for efficacy and safety.
          • Trials of 30,000 or more people are required in Phase 3.
        • Russia has recently released a vaccine without going through Phase 3,
          • setting off all kinds of alarms in the scientific community.
        • Through these phases the vaccine needs to show it’s safe,
          • leads to a strong immune response,
          • and provides effective protection against the virus.
          • During an outbreak, experimental vaccines may be used in severely affected populations if they’re at high risk of disease, before progressing to regulatory approval

Production

  • Once a vaccine has been produced at a small scale and passed safety tests, it can be used in clinical trials.
    • However, significant manufacturing capacity,
      • such as infrastructure,
      • personnel
      • and equipment,
      • will be needed to produce large quantities of a vaccine for use.
    • Quality control is also needed.
      • All of these processes are very carefully monitored.
      • Once licensed, policy must be developed to decide how to prioritize those who should be vaccinated, such as those in the most high-risk groups and locations.
    • Along the way, if any of these vaccine “candidates” are shown to be unsafe or ineffective,
      • researchers must return to the laboratory to develop a new candidate.
      • This is why vaccine development can be a long and uncertain process.

Attention Deficit Disorder (ADD) – Episode 37, To Your Health With Dr. Jim Morrow

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attention deficit disorder
North Fulton Studio
Attention Deficit Disorder (ADD) - Episode 37, To Your Health With Dr. Jim Morrow
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attention deficit disorder
Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Attention Deficit Disorder (ADD) – Episode 37, To Your Health With Dr. Jim Morrow

On this edition of “To Your Health,” Dr. Morrow discusses attention-deficit disorder: how to recognize it, how a doctor diagnoses it and treatment options. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Covid-19 misconceptionsDr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

What is attention-deficit disorder (ADD)? 

  • Attention-deficit disorder (ADD) is a group of behaviors.  
  • It used to also be called attention deficit disorder (ADD).  
  • ADD is common in children and adults.  
  • People who have ADD have trouble paying attention in school, at home, or at work.  
  • Even when they try to concentrate, they find it hard to pay attention.  
  • Children who have ADD may be more active or impulsive than what is typical for their age.  
  • These behaviors cause problems in friendships, learning, and behavior.  
  • For this reason, children who have ADD are sometimes seen as being “difficult” or as having behavior problem 
  • Some people who have ADD may have other conditions as well.  
  • These could include learning disabilities,  
  • anxiety,  
  • depression,  
  • oppositional defiant disorder (ODD),  
  • bipolar disorder,  
  • and Tourette syndrome. 

Symptoms of attention-deficit disorder (ADD) 

  • People who have ADD have  
  • difficulty organizing things,  
  • listening to instructions,  
  • remembering details,  
  • and/or controlling their behavior.  
  • This can make it difficult to get along with other people at home,  
  • at school,  
  • or at work. 
  • A person with ADD who has difficulty paying attention will have 6 or more of the following symptoms: 
  • Has difficulty following instructions. 
  • Has difficulty keeping attention on work or play activities at school,  
  • work,  
  • and home. 
  • Loses things needed for activities at school,  
  • work,  
  • and home. 
  • Appears not to listen. 
  • Doesn’t pay close attention to details. 
  • Seems disorganized. 
  • Has trouble with tasks that require planning ahead. 
  • Forgets things. 
  • Is easily distracted. 
  • A person with ADD who is hyperactive or impulsive will have at least 6 of the following symptoms: 
  • Fidgety. 
  • Runs or climbs inappropriately. 
  • Can’t play quietly. 
  • Blurts out answers. 
  • Interrupts people. 
  • Can’t stay in seat. 
  • Talks too much. 
  • Is always on the go. 
  • Has trouble waiting his or her turn.

What causes attention-deficit disorder (ADD)? 

  • People who have ADD do not make enough chemicals in certain areas in the brain that are important for organizing thoughts.  
  • Without enough of these chemicals, the organizing centers of the brain don’t work well.  
  • This is thought to be the cause of ADD.  
  • The shortage of chemicals may be due to a person’s genes (research shows that ADD is more common in people who have  
  • a close family member with the disorder),  
  • environment,  
  • or physical development.  
  • Recent research also links smoking and other substance abuse during pregnancy to ADD.  
  • Exposure to environmental toxins, such as lead, can also be a factor. 

How is attention-deficit disorder diagnosed? 

  • A doctor will be better able to diagnose ADD when getting information about your child’s behavior.  
  • It may take information from several people who know your child (teachers, daycare providers).  
  • Your doctor also may have forms or checklists that you and your child’s teacher can complete.  
  • This will help you and your doctor compare your child’s behavior with other children’s behavior. 
  • Unfortunately, many people try to diagnose themselves by using a quiz or a checklist they find in a magazine or see on TV.  
  • However, it’s best to see your doctor.  
  • Some of the questions your doctor may ask you or about your child include: 
  • Do you have problems with paying attention and being hyperactive?  
  • Do you have a hard time keeping your temper or staying in a good mood? 
  • Do you have problems staying organized or being on time? 
  • Do these problems happen to you at school, work and at home? 
  • Do family members and friends see that you have problems in these areas? 
  • Do you have any physical or mental health problems that might affect your behavior?  
  • (Your doctor may give you a physical exam and do tests to see if you have any medical problems with symptoms that are like ADD.) 
  • Your doctor will probably want to test your child’s vision and hearing if these tests haven’t been done recently.  
  • A person diagnosed with ADD will have had symptoms for at least 6 months. 
  • If your doctor is uncertain about an ADD diagnosis, he or she may want to give you or your child medicine to see if it makes a difference.  
  • However, a trial of medicine alone is not enough to diagnose ADD. 
  • Also, it might be hard for your doctor to tell if your child has ADD.  
  • Many children who have ADD aren’t hyperactive in the doctor’s office.  
  • Your doctor may ask you to fill out a questionnaire regarding your child’s behavior patterns.  
  • Eventually, your doctor may want your child to see someone who specializes in children’s behavior. 
  • The American Academy of Family Physicians (AAFP) recommends that any child 4 through 18 years of age should be evaluated for ADD if they have  
  • academic or behavioral problems,  
  • and symptoms of inattention,  
  • hyperactivity,  
  • or impulsivity. 

Can attention-deficit disorder (ADD) be prevented or avoided? 

  • ADD cannot be prevented or avoided.  
  • However, doctors believe that avoiding smoking and substance abuse during pregnancy can lower the baby’s risk of developing ADD.  
  • Still, there’s no guarantee that doing everything right during pregnancy will protect a baby from developing ADD.  
  • Additionally, exposure to environmental toxins, such as lead, also can be a risk factor for ADD.  

Attention-deficit disorder (ADD) treatment 

  • Some of the medicines used to treat ADD are called psycho-stimulants.  
  • They include Ritalin,  
  • Adderall,  
  • Concerta,  
  • Vyvanse 
  • and a few others.  
  • These medicines have a stimulating effect in most people.  
  • However, they have a calming effect in people who have ADD.  
  • These medicines improve attention and concentration  
  • and decrease impulsive and overactive behaviors.  
  • Your doctor may consider other non-stimulant medicines, such as  
  • clonidine,  
  • desipramine,  
  • imipramine,  
  • and bupropion. 
  • All medicines have side effects.  
  • Psycho-stimulants may decrease your appetite and cause a stomachache or a headache.  
  • The loss of appetite can cause weight loss in some people.  
  • This side effect seems to be more common in children.  
  • Some people have insomnia (trouble sleeping).  
  • Other possible side effects include fast heartbeat, chest pain, or vomiting.  
  • To avoid or reduce the side effects of psycho-stimulants, follow these tips: 
  • Use the lowest possible dose that still controls the hyperactivity or inattention.  
  • Your doctor will work with you to find the right dose. 
  • Take the medicine with food if it bothers your stomach. 
  • Ask your doctor if you can skip the medicines on the weekends. 
  • Offer healthy snacks to children who lose weight while taking medicine for ADD. 
  • Take the medicine 30 to 45 minutes before a meal.  
  • Lunchtime doses can be given at school for some children.  
  • If your child can’t take this medicine at school, tell your doctor.  
  • He or she might suggest a long-acting form of the medicine instead. 
  •  If you are taking the long-acting form of this medicine, do not crush, break, or chew it before swallowing it. 
  • It’s important to take the medicine the way your doctor prescribes it.  
  • Follow your doctor’s advice, even if you think the medicine isn’t working.  
  • Medicines used to treat ADD have been shown to improve a person’s ability to do specific tasks.  
  • This includes paying attention or having more self-control.  
  • The length of time a person will need to take medicine depends on each person.  
  • Some people only need to take medicine for 1 to 2 years.  
  • Others need treatment for many more years.  
  • In some people, ADD may continue into adolescence and adulthood. 
  • People who have ADD should be checked regularly by their doctors.  
  • If your child has ADD, your doctor may suggest that he or she take a break from his or her medicines once in a while to see if the medicine is still necessary.  
  • School breaks or summer vacation might be best. 
  • AAFP suggests several treatment recommendations.  
  • Preschool-aged children (4-5 years of age) should be treated with behavior therapy as the first line of treatment.  
  • The medicine methylphenidate may be prescribed if behavior treatment does not provide significant improvement.  
  • This medicine also should be prescribed if ADD is interfering with the child’s friendships,  
  • home,  
  • and school life at a moderate to severe level.  
  • Elementary school-aged children (6-11 years of age) should be treated with FDA-approved medicine for ADD and behavioral therapy.  
  • Adolescents (12-18 years of age) should be treated with FDA-approved medicine for ADD and may be treated with behavioral therapy.  
  • In all cases, medicine doses should be measured and adjusted to achieve maximum benefit with few adverse effects. 

Living with attention-deficit disorder (ADD) 

  • Symptoms of ADD often get better as children grow older and learn to adjust.  
  • Hyperactivity usually stops in the late teenage years.  
  • But about half of children who have ADD continue to be easily distracted, have mood swings, hot tempers, and are unable to complete tasks.  
  • Children who have loving, supportive parents or guardians who work together with school staff, mental health workers, and their doctor have the best chance of becoming well-adjusted adults. 
  • Children who have ADD may be difficult to parent.  
  • They may have trouble understanding directions.  
  • Their constant state of activity can be challenging for adults.  
  • Some children benefit from counseling or from structured therapy.  
  • Families may benefit from talking with a specialist in managing ADD-related behavior and learning problems. 
  • Children who have ADD also tend to need more structure and clearer expectations.  
  • You may need to change your home life a bit to help your child. Here are some things you can do to help: 
  • Make a schedule. 
  • Make simple house rules. 
  • Make sure your directions are understood. 
  • Reward good behavior. 
  • Make sure your child is supervised all the time. 
  • Watch your child around his or her friends. 
  • Set a homework routine. 
  • Focus on effort, not grades. 
  • Talk with your child’s teachers.

What about Adult ADD? 

  • Adults may have ADD as well as children.  
  • This is a relatively new way of thinking.  
  • Previously, many physicians felt that adults with symptoms like those of ADD were due more to depression and anxiety than ADD.  
  • This thinking has changed somewhat.   
  • An adult with symptoms of ADD also needs to be tested in order to begin treatment.  
  • Treatment is almost always some form of medication, usually the stimulants. 
  • Untreated ADD can present as severe anxiety. It is important to make the distinction.

The Right to Try Act – Episode 36, To Your Health With Dr. Jim Morrow

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Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

To Your Health With Dr. Jim Morrow – Episode 36, The Right to Try Act

The federal Right to Try Act, enacted in 2018, opens new treatment pathways for terminally ill patients who have exhausted their government-approved options. On this edition of “To Your Health,” Dr. Morrow discusses various aspects of the law. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Covid-19 misconceptionsDr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

The Right to Try Act

 

  • On May 30, 2018, President Donald Trump signed S.204, the Right to Try Act.
    • The Right to Try Act opens a new pathway for terminally ill patients who have exhausted their government-approved options
    • and can’t get into a clinical trial to access treatments.
    • Although 41 states have passed Right to Try laws, the signing of S.204 makes Right to Try the law of the land,
      • creating a uniform system for terminal patients seeking access to investigational treatments.
  • Who qualifies for Right to Try?
    • To be eligible for Right to Try, a patient must meet the following conditions:
    • Be diagnosed with a life-threatening disease or condition;
    • Have exhausted approved treatment options;
    • Be unable to participate in a clinical trial involving the eligible investigational drug, as certified by a doctor, who is in good standing with her licensing organization and will not be compensated directly by the manufacturer for so certifying; and
    • Give written informed consent regarding the risks associated with taking the investigational treatment.
  • What is a life-threatening disease or condition?
    • Federal law defines a life-threatening disease or condition as:
      • “Diseases or conditions where the likelihood of death is high unless the course of the disease is interrupted”
  • What drugs or treatments qualify for Right to Try?
    • The treatments available under the law must meet the following conditions:
    • Have completed an FDA-approved Phase 1 clinical trial;
    • Be in an active clinical trial intended to form the basis of an application for approval
      • or be the subject of an application for approval that has been filed with the FDA; and
    • Be in ongoing active development or production and not discontinued by the manufacturer or placed on clinical hold.
  • I do not live in a state with a Right to Try law. Can I still use Right to Try?
      • 204 makes Right to Try the law of the land.
      • So long as a patient and treatment meet the qualifications of the federal law, Right to Try applies, regardless of whether the patient’s state adopted Right to Try.
  • Does medical cannabis qualify?
    • Right to Try only applies to treatments that have completed an FDA-approved Phase 1 clinical trial and remain under study in an active clinical trial.
    • If there is a Phase 2 or 3 clinical trial for medical cannabis as a treatment of an underlying terminal condition, it may qualify.
  • Does a treatment that is already FDA-approved for something else qualify for Right to Try?
    • Doctors may already prescribe treatments ‘off-label.’
      • Off-label means prescribing an FDA approved treatment for a condition, dose, or population other than what the FDA approved.
      • Therefore, no special permission is needed for a physician to prescribe treatments that are approved for other conditions.
      • Right to Try applies to treatments that are being given to patients in clinical trials but are not already FDA approved.
  • What can companies charge for treatments?
    • Federal law bans companies from making a profit on any drug or treatment that has not been approved by the FDA,
    • but the law does allow companies to recover the costs that are directly related to providing an individual treatment.
    • Existing regulations govern what can and cannot be included in the calculation for determining the direct costs that can be charged.
  • This means that a patient could be charged for the direct costs of providing their individual treatment,
    • but the company cannot make a profit.
  • How will payment work?
    • Just like with the FDA’s existing Expanded Access program, insurance companies and taxpayer-funded healthcare programs like Medicaid or Medicare are not required to cover the cost of investigational treatments,
      • but they may choose to do so.
      • Some insurance companies have covered the costs of investigational treatments used by patients under state Right to Try laws, but others have not.
      • Each patient’s cost situation will be different and determined by their individual insurance company or program and their own financial resources.
  • How do I initiate a request?
    • The patient, the patient’s representative, or physician should send a letter to the drug manufacturer’s director of compassionate use or other designated representative to discuss options for access.
  • Where can I find a list of potential treatments?
    • If your physician is not yet aware of investigational treatments, there are several websites that can assist in locating potential treatments:
      • https://clinicaltrials.gov/
        https://platform.emergingmed.com/find-clinical-trials/cri#partnerhome
        https://www.cancer.gov/about-cancer/treatment/clinical-trials/search
  • Is a drug company required to make a treatment available?
      • Drug companies are not required to provide treatments to patients under Right to Try laws.
      • It would not be appropriate to force companies to provide treatments that they do not think are the right fit for a patient
        • or if they do not have enough supply to provide the treatment outside of its clinical trial.
  • Can I make my doctor submit a request for a treatment I want to try?
      • Doctors have a responsibility to ensure that patients are given treatments that they believe, in their professional opinion, could help them.
      • A doctor who does not think a treatment will help is not obligated to make a request for the treatment.
      • In addition, doctors who pursue treatments under Right to Try must be in good standing with their state licensing or certifying board,
        • and they cannot be compensated for certifying that patients qualify for Right to Try.
  • How will a company decide if they will give me the treatment?
    • Each company will develop its own process and procedures for approving Right to Try requests.

Source:  https://righttotry.org/

Debunking Medical Myths – Episode 35, To Your Health With Dr. Jim Morrow

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Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

To Your Health With Dr. Jim Morrow – Episode 35, Medical Myths

Vaccines cause the flu. We only use 10% of our brains. You’re more likely to get sick in cold weather. Dr. Morrow covers a number of medical beliefs we’ve picked up throughout life which we need to reconsider and discard. Listen in to find out what is true and what is a myth. (And we also celebrate Dr. Morrow’s birthday!) “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Covid-19 misconceptionsDr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

Debunking Medical Myths

 

  • Myth: Flagyl and Alcohol will make you sick
  • Just not the case. A study of college students showed that even when drunk, metronidazole did not make anyone sick. 
  • Myth: Medicine expires after a year
  • Just not the case. Just because a date has passed does not mean that the antibiotics you got a year ago turned to poison or suddenly stopped working. It just does not happen. 
  • The expiration actually refers to the fact that the prescription itself expires, not the medicine. 
  • any refills you have are no longer valid.

 

  • Myth: Vaccines can cause the flu (and autism).
  • Although the body can develop a low-grade fever in response to any vaccine, rumors that a flu shot can cause the flu are an outright lie 
  • The flu shot does contain dead flu viruses, but they are, well, dead. 
  • A dead virus cannot be resurrected to cause the flu  
  • As for vaccines causing autism, this myth was started in 1998 with an article in the journal The Lancet.  
  • In the study, the parents of eight (yes, only eight) children with autism said they believed their children acquired the condition after they received a vaccination against measles, mumps and rubella (the MMR vaccine).  
  • Since then, rumors have run rampant despite the results of many studies.  
  • For example, a 2002 study in The New England Journal of Medicine of 530,000 (yes, a whopping 530,000) children found no link between vaccinations and the risk of a child developing autism.

 

  • Myth: Supplements always make you healthier.

  • Vitamin supplements may be not only ineffectual but even dangerous, studies have shown.  
  • For example, a study published in 2016 showed that some older women who take calcium supplements may face an increased risk of dementia. 
  • And in a huge review of 20 years of supplement research published in 2015, researchers found that taking high doses of vitamins may be linked with an increased risk of cancer. 
  • Aside from these possible long-term risks, reports have suggested that supplements can cause damage in the short term too.  
  • A report published in 2016 found that a man in Pennsylvania who took Ayurvedic herbal supplement developed lead poisoning.  
  • Another report, also published in 2016, showed that a 4-year-old boy in England went to the ER after taking a slew of “natural” supplements, and developing vitamin D toxicity. 
  • The FDA does not require supplements to be regulated in the same way that drugs are, which can be a real problem.  
  • As a result, the safety of many supplements has not been rigorously studied.  
  • Furthermore, supplement bottles can sport unsubstantiated claims and even make errors in dosage recommendations, she said.

 

  • Myth: Cold weather makes you sick.

  • This myth is common around the world, but it is just not true.  
  • Studies have shown we may feel more cold symptoms — real or imaginary — when we are chilled (after all, a cold is called a “cold” for a reason),  
  • but the temperature itself does not make us more susceptible to viruses.  
  • This has been known since at least 1968, when a study in The New England Journal of Medicine showed what happened when researchers exposed chilly people to the rhinovirus (one cause of the common cold). 
  • It turned out that whether they were shivering in a frigid room or in an icy bath, people were no more likely to get sick after sniffing cold germs than they were at more comfortable temperatures. 
  • Cold air also does not make a difference in people’s recovery time from a cold. In fact, although the research is in its early stages, it is possible that being exposed to cold may even help your body in some way. 
  • However, it’s unclear how chilly conditions might affect the germs themselves.  
  • Research has shown that two common causes of colds — rhinoviruses and coronaviruses — may thrive at colder temperatures,  
  • and that the flu may spread most effectively under cold, dry conditions. 
  • Some scientists speculate that colds are more common in cooler months because people stay indoors more, interacting more closely with one another and giving germs more opportunities to spread.

 

  • Myth: We use only 10 percent of our brains.

  • Motivational speakers and other self-help gurus have been promoting this one since as early as 1907,  
  • as a way to encourage people to tap into some latent capacity, But these people were not basing the proclamation on sound science. 
  • Today, scientists can look at any brain scan, measuring activity at any given time, and have a big laugh at this myth. The idea lingers in popular culture because we want to think we haven’t reached our full potential.

 

  • Myth: Sugar turns kids into little monsters.

  • It can be hard to find a parent who does not believe this 
  • In one particularly clever study among a slew of studies finding sugar’s nil effect on unruliness,  
  • kids were given Kool-Aid sweetened with aspartame, a compound that contains no sugar.  
  • Researchers told half of the parents the Kool-Aid contained sugar, and told the other half the truth. 
  • The parents in the study who thought their kids were riding a sugar high reported their children were uncontrollable and overactive.  
  • But a sensor on the kids’ wrists that measured activity level said the opposite:  
  • The kids were actually acting subdued.  
  • The study was published in the Journal of Abnormal Child Psychology in 1994 
  • Sugar is often given at times when the rules are loosened and there are lots of other kids around, like birthday parties and holidays.

 

  • Myth: You need to stay awake if you’ve had a concussion.

  • Anyone who may have a concussion should seek medical attention,  
  • but the condition is rarely severe or life-threatening.  
  • Warnings that people need to stay awake after incurring a concussion most likely grew out of a misunderstanding about a particular type of head injury —  
  • one that involves brain bleeding and that causes people to have a “lucid period,” followed by a coma or even death.  
  • But this is very uncommon and doesn’t pertain to people with normal concussions 
  • If you’ve been evaluated by a doctor, and he has said that you have a mild regular concussion, you don’t need to worry that someone has to wake you up every hour.

 

  • Myth: Chewing gum stays in your stomach for 7 years.

  • Although it is true that many of the ingredients in gum —  
  • such as elastomers, resins and waxes —  
  • are indigestible, that does not mean they hang out in your guts for seven years.  
  • Plenty of what you eat — even things you are recommended to eat, such as fiber — is indigestible.  
  • But the digestive system is a robust piece of organic machinery, and anything it can’t absorb, it moves along.  
  • Despite the stickiness and strange consistency of gum, it passes right through your digestive tract.

 

  • Myth: Reading in the dark or sitting too close to the TV ruins your eyesight.

  • Dim light — or alternatively, staring into the multicolored tube at close range — can undoubtedly make your eyes work so hard they hurt.  
  • But there is no evidence that these practices cause long-term damage. 
  • The TV myth may have started in the 1960s, and at that time, it may have been true.  
  • Some early color TV sets emitted high amounts of radiation that could have caused eye damage,  
  • but this problem has long been remedied, and today’s TV and computer monitors are relatively safe 
  • If you or your child tend to sit so close to the computer or TV that it hurts the eyes, it may be a good idea to get checked for nearsightedness.  
  • However, sitting too close does not create a need for glasses even if getting glasses can remedy the habit. 

  • Myth: You should drink at least 8 glasses of water a day.

  • The eight-glasses-a-day myth likely started in 1945, when the Food and Nutrition Board of the National Research Council said adults should take in about 2.5 liters of water a day  
  • (equivalent to about eight glasses, or two-thirds of a gallon).  
  • Although most media outlets reported that as fact and stopped there,  
  • the council actually went on to explain that most of the 2.5 liters comes from food.  
  • the recommendation should be amended to the following: Drink or eat about eight glasses of fluid a day.

 

  • Myth: You should wait an hour after eating before you go swimming.

  • This myth has ruined many summer afternoons,  
  • forcing young and old to swelter in the heat while cool waters beckoned,  
  • all because they were careless enough to down a PB&J.  
  • Let the ban be lifted:  
  • There is no special reason not to swim after eating,
  • It’s true that any type of vigorous exercise can be uncomfortable (although not dangerous) after an overwhelming feast.  
  • But for most of us whose waterfront dining experience includes sand-dusted chips and soggy sandwiches, that is hardly a concern.  
  • And cramps can happen anytime, whether you’ve eaten or not.  
  • If you are swimming in waters so rough that a charley horse will mean the death of you, you should probably swim elsewhere. 

 

  • Myth: Fingernails and hair continue to grow after death.

  • This myth is actually just a misperception, and for many years, most physicians couldn’t disprove it, even though they couldn’t quite explain it. 
  • Here’s what really happens to your nails and hair after you die:  
  • As the body’s skin is drying out, soft tissue, especially skin, is retracting. 
  •  The nails appear much more prominent as the skin dries out.  
  • The same is true, but less obvious, with hair. As the skin is shrinking back, the hair looks more prominent or sticks up a bit.

 

  • Myth: Shaved hair grows back faster, coarser and darker.

  • Here’s a myth you can debunk yourself by paying attention to your own hair after shaving.  
  • You may notice that new hair grows in with a blunt edge on top.  
  • Over time, that blunt edge gets worn down, making it seem thicker than it really is.  
  • But why might recently shaved hairs seem darker than their nonshaved counterparts?  
  • It could be that those newly spouted hairs haven’t yet been bleached by the sun 
  • But if you don’t trust your own experimental skills, there’s other evidence that this myth isn’t reality.  
  • A clinical trial conducted in 1928 compared hair growth  in shaved patches to hair growth in unshaved patches. 

 

  • Myth: Eating turkey makes you drowsy.

  • Your excuse for taking a nap after dinner on Thanksgiving just went out the window.  
  • While turkey does contain a chemical called tryptophan that is known to cause drowsiness,  
  • your serving of Thanksgiving bird doesn’t contain any more of the chemical than a similar-size serving of chicken or beef 
  • So why do people feel so sleepy after a Thanksgiving feast?  
  • It could be the overall quantity of food you eat on this holiday that makes you drowsy.  
  • Those heaping mounds of carbohydrates on your plate (think dinner rolls and mashed potatoes),  
  • plus a few alcoholic beverages, will almost certainly make you feel tired.

 

  • Myth: Ulcers are caused by spicy food and stress.

  • If you think your ulcers are acting up because of the curry you ate last night for dinner, think again.  
  • Although doctors once believed that ulcers were caused by stress, lifestyle choices or spicy foods, they now know that most ulcers are actually caused by the bacterium Helicobacter pylori. 
  • Ulcers — sores that develop in the lining of the esophagus, stomach or the first part of the small intestine — can also be caused by certain medicines.  
  • Aspirin, NSAIDs and iron tablets are the most common culprits

  • Myth: Poinsettias are toxic.

  • Poinsettias aren’t toxic.  
  • The plants can make people sick,  
  • but there have been no definitive cases of a person dying from exposure to a poinsettia plant. 
  • In a paper published in the Southern Medical Journal in 1996, researchers reviewed 22,793 cases of poinsettia exposure that were reported to poison control centers over a seven-year period.  
  • They found that not one of those cases was fatal. The most severe reactions reported were stomachaches and cramping. 
  • The myth about poinsettias being toxic may have come from a case, reported in 1919, of a 2-year-old in Hawaii who allegedly died after ingesting parts of the plant, according to a 2012 article in the Western Journal of Emergency Medicine. But the child’s death was never confirmed, nor was the cause of death.

  • Myth: Chicken noodle soup cures … everything.

  • Everybody’s heard that chicken soup is supposedly the best cure for whatever ails you.  
  • But does this delicious food really help you get better when you’re sick? 
  • Unfortunately, no.  
  • The combination of hot broth and yummy veggies is more of a comfort than a cure 
  • However, some research suggests that chicken noodle soup may work well as a placebo.  
  • In other words, it may convince you that you’re getting better. 

[Source:  livescience.com]

 

Covid-19 Misconceptions and Straight Talk – Episode 34, To Your Health With Dr. Jim Morrow

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Covid-19 misconceptions
Dr. Jim Morrow, Host of “To Your Health”

Covid-19 Misconceptions and Straight Talk – Episode 34, To Your Health With Dr. Jim Morrow

Dr. Morrow corrects some Covid-19 misconceptions, such as comparing Covid-19 to the flu. He also delivers straight talk on wearing masks, conspiracy theories about Covid-19 being man-made, whether it’s safe to fly, and more. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Covid-19 misconceptionsDr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

MORE ON COVID-19

  • This virus is more easily transmitted than the flu virus.
    • It is a much worse disease than the flu.
  • Respiratory distress occurs when your immune system produces cytokines o and the lungs get very inflamed
    • and this inflammation causes fluid and debris to be deposited into the lungs
  • Attacks the heart and kidneys also. o Cardiomyopathy
    • Renal failure – dialysis
  • Causes blood clots, venous and arterial. PE, strokes.
  • At first and for a long time we thought it was not affecting children.
    • Now, we know that is not true.
    • Attacks the blood vessels in young children and causes a condition known as Kawasaki’s Disease or a Kawasaki-like Disease.
      • This is pathologic changes that seem to result from an exaggerated immune response to a pathogen in patients with genetic susceptibility.
  • Hydroxychloroquine has been shown not to be effective and, in some cases, harmful in Covid-19.
    • Has finally been put to bed. o Increased mortality if given late
  • Remdesivir might work.
    • o Patients are often much worse in the second week of the disease.  o This has to be given IV early.
    • Hard to do that.
    • Very short supply of this
  • Total cases have started to plateau in the US, but with social distancing waning somewhat and states opening up, we will definitely see a bump in cases.
  • Bacteremia: o Week 2-3 o Can be septic
    • Can be fatal
  • Second trimester miscarriages are being linked to this infection
  • Peds: Multi-inflammatory Syndrome
  • Fever
  • Median age is ten – up to 20
  •  Rash
  • Swelling of nodes in neck
  • Most get conjunctivitis, red eyes and red and cracked lips o Fuzzy thinking o Nausea o Diarrhea o Abd pain
  • Some heart involvement – LV dysfunction o This is still rare but definitely happening o Responds to therapy:
    • IV-Ig;
    • steroids
  • The healthcare system has been spared the overwhelming push that would have made all of this dramatically worse.
  • Masks:
    • Wear one anytime in public.
    •  They protect others from you.
    • 44% of people in a NY study who had NO symptoms were found to be positive for having the disease at the time they had no symptoms.
  • Viral Testing:
      • Lots of false positive and negative tests o Saliva test, approved by FDA.
      • At home tests available. Nasal swab
        • letsgetchecked.com
      • about $100
      • about a 4 day turn around
  • Antibody Tests:
    • There are three antibodies that are tested for in most of these tests.
      • IgA, a respiratory antibody.
    • One that is produced in response to a respiratory infection. As opposed to a stomach bug or what people insist on calling a “stomach flu”, even though that does not exist.
    • IgM
    • one that you produce acutely as you are in the midst of an active infection.
    • IgG
    • One you make that is at the end of an infection and the one that lasts the longest, giving you some degree of immunity to an infection you have already had.
  • IgA and IgM can cross react with the coronaviruses that cause the common cold, mainly 229E and OC43.
  • IgG is specific for the type of virus that caused a particular infection, such as SARS-CoV-2.
  • So, if you get the antibody test, you are looking for a positive IgG antibody to know if you were infected with or exposed to this novel coronavirus.
  • We presume that this infers some degree of immunity but we really are not certain of that yet.
  • ACE inhibitors and ARBs: stay on them if you take them. They could actually benefit you
  • Aspirin: stay on it
  • Allergy meds: stay on them; Covid-19 does not cause sneezing. Period.
  • You need to understand that scientists are accustomed to saying “I don’t know”
  • but the public is accustomed to us having all the answers.
  • For the past 75 years, when it comes to infections and public health issues, the public has come to expect medicine to know what’s what.
    • But this is a totally new virus.
      • It’s like the time of Louis Pasteur when scientists did not know everything,
      • or hardly anything compared to today.
    • Information that I learned two weeks ago is being proven wrong this week.
    • Social media and the public’s access to information of all kinds,
      • most of it unproven,
      • is making it difficult to sort out fact from fiction.
    • People have a need to believe something,
      • so when they see someone who sounds knowledgeable, they want to believe it.
      • When it gives them an answer they want to believe it.
  • Late stage issues:
    • Prolonged positivity, up to 2 months
      • People get better,
    • then get worse,
    • PCR neg then wbc goes up,
    • inflammatory markers up.
    • Some are concerned about people getting reinfected…

o Late stage symptoms:

  • joint pain,
  • muscle pan,
  • leg pain,
  • think mucus.
  • Fever – to 102 for 2 months
  • Chronic diarrhea – we don’t understand this o
  • Making progress:
  • 9 weeks ago: 1.03 people were infected by an infected person. o 7 weeks ago: 86 o A few weeks ago: 0.76
  • Last week: Back to 1.03 after state opened back up

To Your Health With Dr. Jim Morrow:  Episode 33, Covid-19 Hard Truths and Science, with Dr. Manny Rodriguez, Infectious Disease Services of Georgia

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Infectious Disease Services of Georgia
North Fulton Studio
To Your Health With Dr. Jim Morrow:  Episode 33, Covid-19 Hard Truths and Science, with Dr. Manny Rodriguez, Infectious Disease Services of Georgia
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Infectious Disease Services of Georgia

To Your Health With Dr. Jim Morrow: Episode 33, Covid-19 Hard Truths and Science, with Dr. Manny Rodriguez, Infectious Disease Services of Georgia

Dr. Morrow discusses some Covid-19 hard truths and science with Dr. Manny Rodriguez, a Cumming-based infectious disease specialist. Myths on wearing face masks, a second wave, school reopening in the fall, are just a few of the topics covered in this episode. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

Dr. Manny Rodriguez, Infectious Disease Services of Georgia

Infectious Disease Services of Georgia
Dr. Manny Rodriguez, Infectious Disease Services of Georgia

Dr. Manuel D. Rodriguez received his Bachelors of Science degree in Psychobiology in 2000 from Florida Atlantic University. He continued on and received his Master’s degree in Biomedical Science from Barry University in 2002. In 2006, he obtained both his Doctor of Osteopathic Medicine and Master’s of Public Health from Nova Southeastern University in South Florida. After completing his Osteopathic internship at Palmetto General Hospital in Hialeah, Florida in 2007 he moved to Mobile, Alabama where he completed his residency at University of South Alabama in 2010 and stayed on as Chief Medical Resident for an additional year. In 2011, he and his family moved to Washington, DC where he completed his fellowship in Infectious Diseases at The George Washington University in 2013.

Throughout his training he has received numerous teaching awards, and since joining IDSGA has been asked to lecture on Infectious Disease topics at both local and state conferences. He is currently Board Certified in Infectious Disease and Internal Medicine and has professional affiliations with the Alpha Omega Alpha Medical Honor Society, the American College of Physicians where he serves as a member of the Council of Young Physicians, the American Osteopathic Association, and the Infectious Disease Society of America.

In his spare time, he enjoys cooking, reading, hiking and spending time with his family.

More information is available at the Infectious Disease Services of Georgia website.

Questions/Topics Discussed in this Episode:

  • Mitigation as opposed to complete shut-down
  • On re-opening, what do you anticipate as far as the almost inevitable bump in cases?
  • What might a “second wave” look like?
  • Masks and social distancing
  • Dr. Fauci seems to go against the grain, if you can believe what you see on social media and YouTube.
  • Hydroxychloroquine
  • Remdesivir
  • Antibody testing
  • Saliva for testing?
  • Mutations versus Strains
  • Man-made or a Lab Accident?
  • Could this have been prevented?
  • What do you predict for schools in the fall?
  • Touching on the issue of so many unknowns

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

To Your Health With Dr. Jim Morrow:  Episode 32, Stress in a Pandemic with Dr. Brooke Jones, Fresh Start for the Mind, and a Covid-19 Update

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stress in a pandemic
North Fulton Studio
To Your Health With Dr. Jim Morrow:  Episode 32, Stress in a Pandemic with Dr. Brooke Jones, Fresh Start for the Mind, and a Covid-19 Update
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Stress in a Pandemic
Dr. Jim Morrow, Morrow Family Medicine, and Dr. Brooke Jones, Fresh Start for the Mind

To Your Health With Dr. Jim Morrow:  Episode 32, Stress in a Pandemic with Dr. Brooke Jones and a Covid-19 Update

Dr. Morrow discusses dealing with stress in a pandemic with Dr. Brooke Jones, Fresh Start for the Mind. Dr. Morrow also shares a Covid-19 update, which includes a debunking of the “Plandemic” video and comments on the ineffectiveness of hydroxychloroquine.  “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

Dr. Brooke Jones, Fresh Start for the Mind

stress in a pandemic
Dr. Brooke Jones, Fresh Start for the Mind

In 2013, Dr. Brooke Jones branched out on her own to open a mental health practice, Fresh Start for the Mind. She wanted a practice that incorporated the mind, body, and spirit. Her love for psychological evaluations became evident in the Alpharetta and surrounding communities. As referrals grew, so did Fresh Start.

Fresh Start for the Mind is a comprehensive mental health practice that provides counseling, psychological evaluations, psychiatry and medication management, coaching, and nutrition support to children, adults, and families. Since its inception in 2013, Fresh Start has grown to over 30 staff members and has maintained a reputation for providing quality and heart-felt services. Fresh Start has three facilities and proudly serves patients in and around Suwanee, Stockbridge, and Canton, GA.

You can find out more at their website or call Fresh Start at 404-808-1161.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

Coronavirus Update

  • Hydroxychloroquine has been shown not to be effective and in some cases harmful in Covid-19.
  • Patients are often much worse in the second week of the disease.
  • Total cases have started to plateau in the US, but with social distancing waning somewhat and states opening up, we will definitely see a bump in cases.
  • The healthcare system has been spared the overwhelming push that would have made all of this dramatically worse.
  • Masks:
    • Wear one anytime in public.
    • They protect others from you.
    • 44% of people in a NY study who had NO symptoms were found to be positive for having the disease at the time they had no symptoms.
  • Antibody Tests:
    • There are three antibodies that are tested for in most of these tests.
      • IgA, a respiratory antibody.  
        • One that is produced in response to a respiratory infection. As opposed to a stomach bug or what people insist on calling a “stomach flu”, even though that does not exist.
      • IgM 
        • one that you produce acutely as you are in the midst of an active infection.
      • IgG
        • One you make that is at the end of an infection and the one that lasts the longest, giving you some degree of immunity to an infection you have already had.
    • IgA and IgM can cross react with the coronaviruses that cause the common cold, mainly 229E and OC43.
    • IgG is specific for the type of virus that caused a particular infection, such as SARS-CoV-2.
    • So, if you get the antibody test, you are looking for a positive IgG antibody to know if you were infected with or exposed to this novel coronavirus.
    • We presume that this infers some degree of immunity but we really are not certain of that yet.
    • ACE inhibitors and ARBs: stay on them if you take them. They could actually benefit you
    • Aspirin: stay on it
    • Allergy meds: stay on them; Covid-19 does not cause sneezing. Period.
  • “Plandemic” video: so many people sent this to me.
    • It is complete bunk.
    • You need to understand that scientists are accustomed to saying “I don’t know”
      • but the public is accustomed to us having all the answers.
    • For the past 75 years, when it comes to infections and public health issues,
      • the public has come to expect medicine to know what’s what.
    • But this is a totally new virus.
      • It’s like the time of Louis Pasteur when scientists did not know everything,
      • or hardly anything compared to today.
    • Information that I learned two weeks ago is being proven wrong this week.
    • Social media and the public’s access to information of all kinds,
      • most of it unproven,
      • is making it difficult to sort out fact from fiction.
    • People have a need to believe something,
      • so when they see someone who sounds knowledgeable,
      • they want to believe it.
      • When it gives them an answer they want to believe it.
      • Well, don’t believe one word in that video. Not one.

 

Stress in a Pandemic

Outbreaks can be stressful

    • The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for people. 
      • Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. 
  • Coping with stress in a pandemic will make you, the people you care about, and your community stronger.
  • Stress in a pandemic can include
    • Fear and worry about your own health and the health of your loved ones
    • Changes in sleep or eating patterns
    • Difficulty sleeping or concentrating
    • Worsening of chronic health problems
    • Worsening of mental health conditions
    • Increased use of alcohol, tobacco, or other drugs
  • Everyone reacts differently to stressful situations
    • How you respond to the outbreak can depend on 
      • your background,
      • the things that make you different from other people, 
      • and the community you live in.

Our Guest Today:

Brooke Jones,  Psychologist and Owner, Fresh Start for the Mind

Fresh Start for the Mind is a comprehensive mental health practice that provides counseling, psychological evaluations, psychiatry and medication management, coaching, and nutrition support to children, adults, and families.  Since it’s inception in 2013, Fresh Start has grown to over 30 staff members and has maintained a reputation for providing quality and heart-felt services.  Fresh Start has three facilities and proudly serves patients in and around Suwanee, Stockbridge, and Canton, GA.  

Question/Topics in this interview:

  • What have been some common reactions you’ve seen in response to COVID-19 pandemic?
  • Do you have any advice on how to help children cope with these changes?
  • What are some specific examples of self-care and how would you recommend our listeners make this apart of their routine?
  • How can I support a loved one, who may be directly or indirectly affected by COVID-19?
  • If I needed help with managing stress, anxiety, depression, or anger – weather it’s directly or indirectly related to COVID, or in general, where can I find help?
  • Do you have any advice on how to help children cope with these changes?
  • What are some specific examples of self-care and how would you recommend our listeners make this apart of their routine?
  • How can I support a loved one, who may be directly or indirectly affected by COVID-19?

Outbreaks can be stressful (cont’d)

  • People who may respond more strongly to stress in a pandemic include
    • Older people and people with chronic diseases who are at higher risk for severe illness from COVID-19
    • Children and teens
    • People who are helping with the response to COVID-19, like doctors, other health care providers, and first responders
    • People who have mental health conditions including problems with substance use
  • Take care of yourself and your community
    • Taking care of yourself, 
      • your friends, 
      • and your family can help you cope with stress. 
      • Helping others cope with their stress can also make your community stronger.
  • Ways to cope with stress
    • Take breaks from watching, 
    • reading, 
    • or listening to news stories, 
      • including social media. 
      • Hearing about the pandemic repeatedly can be upsetting.
  • Take care of your body.
    • Take deep breaths, stretch, or meditate
    • Try to eat healthy, well-balanced meals.
    • Exercise regularly, get plenty of sleep.
    • Avoid alcohol and drugs
    • Make time to unwind. Try to do some other activities you enjoy.
    • Connect with others. Talk with people you trust about your concerns and how you are feeling.

To Your Health With Dr. Jim Morrow: Episode 31, Telemedicine and Georgia Opens Up

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telehealth
North Fulton Studio
To Your Health With Dr. Jim Morrow: Episode 31, Telemedicine and Georgia Opens Up
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telehealth
Dr. Jim Morrow, Host of “To Your Health”

To Your Health With Dr. Jim Morrow: Episode 31:  Telemedicine and Georgia Opens Up

Dr. Morrow offers his thoughts on Gov. Brian Kemp’s “opening” of Georgia, as well as a thorough discussion of telemedicine, its pros and cons, and how he is using telemedicine currently to treat patients at Morrow Family Medicine.  As always, Dr. Morrow responds to listener emails and feedback, including one from a disgruntled tinnitus sufferer. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

telemedicine

 

Dr. Morrow’s Show Notes

Coronavirus Update

 

Worldwide cases: 2,561,915

Total Deaths: 177,200

Total Recovered: 679,819

Total Hospitalized in the US: 120,268

Hospitalized in Georgia: 3,779

Incidence rate: 198.89 per 100,000 persons

Antibody test not yet generally available and the tests have a cross reactivity with some of the common cold CVs.

The average number of people who become infected by an infectious person is declining in every state. See this at rt.live.

 

Telemedicine Facts

  • According to Healthcare Business & Technology,
    • Almost 75% of all doctor, urgent care, and ER visits “are either unnecessary or could be handled safely and effectively over the phone or video,”
  • MedCity Newsreports that 90% of healthcare executives say their organizations are developing or already have a telehealth application.
  • The majority of healthcare organizations are increasing or maintaining their telehealth investments this year.
  • According to the American Hospital Association, about 20% of Americans live in rural areas without easy access to primary care or specialist medical services.
  • A survey conducted by American Well found that 65% of consumers want to use telehealth
  • According to the American Hospital Association, more than three-fourths of hospitals are currently using or implementing telehealth.

Pre-Pandemic Situation

 Limited Medicare coverage impeded the expansion of telehealth services.

    • Current statute restricts most telehealth services to patients located in
      • rural areas and
      • in specific settings (such as a hospital or physician office),
      • covers only a limited number of services, and
      • allows only real-time, two-way video conference capabilities.
  • Changes needed include:
    • widespread elimination of geographic and setting locations requirements so patients outside of rural areas can benefit from telehealth;
    • expanding the types of technology that can be used, including remote monitoring; and
    • covering all services that are safe to provide, rather than a small list of approved services.
  • Additional research is needed to evaluate telehealth.
    • Research and experience under the Medicare program suggest that policymakers’ concerns about increased access to telehealth leading to increased spending may be overstated,
      • particularly when weighed against the potential benefits in quality, patient experience and efficiency.
      • However, there are insufficient studies on the cost-benefits of telehealth outside of a limited number of services.
    • Federal programs to expand broadband need to be simplified.
      • According to the FCC, 34 million Americans still lack access to adequate broadband.
      • And, there is a large digital divide, with almost 40 percent of those living in rural areas lacking access.
        • The FCC has a program that supports broadband adoption, but it is administratively burdensome and provides an insufficient level of subsidy for remote health care providers.
          • While the FCC has taken positive steps by increasing the subsidy, we need even greater federal investment in broadband access, particularly in rural areas.
        • More and better research is needed for other conditions and newer technologies, such as remote monitoring of patients.
      • Telehealth connects patients to vital health care services through
        • videoconferencing,
        • remote monitoring,
        • electronic consults
        • and wireless communications.
        • By increasing access to physicians and specialists,
          • telehealth helps ensure patients receive
            • the right care,
            • at the right place,
            • at the right time.
          • Currently, 76 percent of U.S. hospitals connect with patients and consulting practitioners at a distance through the use of video and other technology.
            • Almost every state Medicaid program has some form of coverage for telehealth services,
              • and private payers are embracing coverage for many telehealth services.
              • However, there are barriers to wide adoption of telehealth.
              • Medicare generally still limits coverage and payment for many telehealth services, lagging behind other payers.
              • The Medicare program recently expanded coverage for telehealth services for stroke patients and substance use treatment in response to statutory changes.
              • Medicare also expanded payments to clinicians for virtual check-ins.
                • While promising,
                  • these incremental steps are not sufficient.
                • In addition, limited access to adequate broadband services hampers the ability of some rural facilities to deploy telehealth.
                • The challenge of cross-state licensure also looms as a major issue.
                • Other policy and operational issues include credentialing and privileging,
                  • online prescribing,
                  • privacy and security
                  • and fraud and abuse.
                • The federal government needs to do more to increase the use of telehealth.

Telemedicine and Covid-19

  • Healthcare is seeing a surge of direct-to-consumer telemedicine providers
    • operating at a large scale
    • helping to provide care to patients who might be wondering if they need care after exhibiting potential symptoms associated with the novel coronavirus.
  • Simultaneously we’re also seeing a rapidly increasing need for on-demand acute care via telemedicine.
    • This includes ICU programs offering intensive care for the most critical patients.
      • However, tele-triage is exploding in terms of the number of use-cases that involves determining when a patient presents in the emergency department whether they need to be issued a bed or if they can be seen in another area within the hospital in order to keep the patient safe and to reduce potential exposures.
    • This helps to limit providers’ exposure to the virus and other infectious diseases.
  • If a hospital worker is exposed without adequate protection, they’d be put into self-quarantine for 14 days
    • Using acute telemedicine for tele-triage is helping keep staff in a low-risk category for infection
      • by completely eliminating exposure for those doctors or other hospital staff.
  • Unfortunately, providers and policymakers are playing catch-up with telehealth technologies right now
    • and are just beginning to recognize that they are essential solutions for keeping potentially infected individuals out of hospitals and doctors’ offices
    • As this public health crisis continues to escalate, however,
      • telemedicine is quickly gaining recognition as a critical tool to slow the spread of COVID-19
    • There are three primary roles for telehealth technologies during this crisis
      • The first:
        • to screen patients remotely rather than having them visit the practice or hospital.
        • They can be used to triage patients with cold and flu-like symptoms and to remotely care for those who don’t need medical intervention or could receive care at home.
        • By keeping potentially infected individuals out of hospitals and doctors’ offices, the healthcare system can lower the risk of transmission to other patients and healthcare staff.
      • Second:
        • To help provide routine care for patients with chronic diseases who are at high risk if exposed to the virus
      • And third:
        • Providers and their staff are not immune to infection and are at increased risk for contracting COVID-19 due to their continuous exposure to infected patients
          • Once tested and confirmed, these providers will be quarantined and become unavailable to the healthcare system just when it needs them most.

Limitations of Telehealth

  • Inability for most clinicians to fully examine a patient
    • The hardware exists to do this but it is expensive and has limitations
  • Limitations in broadband and device access
  • Laboratory testing not possible
  • In cases where patients are using on-demand telemedicine services that connect them with a random healthcare provider, care continuity suffers.
  • A patient’s primary care provider may not have access to records from those other visits and end up with an incomplete history for the patient.
    • Service provider shuffling increases the risk that a doctor won’t know a patient’s history or have notes about care routines.
  • Healthcare laws, reimbursement policies, and privacy protection rules struggle to keep up with this fast-growing industry.
    • As a healthcare provider, you want to promote best practices when approaching telemedicine.
  • While major developments have been made to telehealth reimbursement over the past couple years, it still remains a common stumbling block for providers interested in telemedicine.

The Bottom Line

  • Telehealth helps increase health care value and affordability.
    • Virtual care technology saves patients time and money,
      • reduces patient transfers,
      • emergency department and urgent care center visits,
      • and delivers savings to payers.
    • In addition, telehealth helps address physician burnout by reducing clinicians’ drive times and allowing more time for patients.

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