Sunday 30 August 2020

Hospitals should not allow visitors

My mom has just been in hospital for two full days, two nights and a morning for a hip replacement operation. As a result of covid, visitors were not permitted. And I'm glad!

Post-op, my mom spent most of her time in hospital sleeping off the anaesthetic, resting, seeing the physio and being monitored by the nursing staff - the usual regular blood pressure checks, drip maintenance, catheter check and removal, meds at set intervals, meals. It can be a busy time being a patient.

I was quite happy to let her rest and then have whatsapp contact with her when she was awake and I was there to pick her up on release.

My mom, Liz. Back from the hospital after two days and two nights there for a hip replacement.

From her side, she appreciated not having visitors too. She could drift in and out of sleep, not worry about how she looked and she didn't have to smile at other people's visitors either. Less noise too.

She spoke to some of her attending nursing staff about how they felt about the ban on visitors and they all appreciated that there were no visitors so that they could get on with their jobs of caring for patients and not attending to visitor whims and enquiries, which really disrupts their work.

It seems that wards at the hospital have been better arranged to group similar patients together. My mom was in a ward dedicated solely to orthopaedic patients. They're in-and-out in a few days and aside from needing some kind of bodywork, they are not ill and they are fully conscious and functional.

Of course, not all patients are as 'straight forward' as orthopaedic. There are patients with major illnesses, strokes, accident victims, terminal patients, unconscious patients and the like who spend not just two days in hospital. Adults and children can be in hospital for weeks (or months!).

So this is where I will add a disclaimer to the title of this post that says 'hospitals should not allow visitors'. Patients that have routine, elective surgery, and any other kinds of patients that are in-and-out in a few days and nights, do not need visitors. For their own healing and recovery, and for distraction-free, improved effectiveness of the nursing staff. And diminished spread of illness (from the visitors!). Mobile phones and wifi are a blessing and the patient can choose when to communicate - between sleeps.

We selfishly want to visit loved ones to satisfy our own need to see them, when what they really need is a whole lot of rest with no demand on their focus or conversational skills. They have enough disruptions with the nursing activities around them.

For critically ill patients, those rushed to hospital in an emergency and long-term patients, limited visitors would be beneficial (for the patient and the worried family). I'm not sure how many visitors maternity patients would welcome during their first days with their baby? I'm sure most would be happy for just the company of their partner and brief, limited visits from parents / sibling / in-laws (if any - they could just wait for her to go home)?

The flip side of not permitting visitors, is that there are always stories (true stories!) of patients left unattended for hours, drips that run dry, incorrect medication dosages that are given, meds that are not administered... And these errors are picked up by visitors. Do visitors keep nursing staff more accountable when the patient is unable to check themselves?

Optimistically, I reckon that with no visitors and minimised distractions in regular wards, nursing staff will be better able to do their jobs (less errors and neglect) and that patients can recover, rest and return home faster.

Sunday 23 August 2020

Do you know about Covid Toe?

 A couple of weeks ago my mom read an article in the New York Times about COVID Toe, one of many other Covid-19 symptoms. She sent it to me because I had chilblains for the very first time ever in my life in June. A chilblain is a painful, red inflammation on one or more toes that is usually associated with exposure to cold.

I've always been one of those people that rarely gets cold feet and I'll happily walk around inside in winter in just a pair of socks or crocs.

At first, I thought the red irritation on the second toe of my left foot was due to one of those pricky grass seeds that can penetrate your skin. We get them out here, I'm always on trails and they do try to burrow in through the front of my running shoes. I've had this before but it goes away in a day or three. This time, the inflammation persisted and got worse and more red over the next few days. I checked for seeds and splinters but couldn't find a cause for the irritation. My toe was sore - not agony or even very painful - but kind of a pricky itch that I could feel all the time. What was weird too is that it 'progressed' to the side and underside of the next-door toe too.

My mom first mentioned the possibility of a chilblain - something completely outside my scope of reference. I looked it up, checked some pictures and sure enough, this looked like exactly what I had. 

I became more conscientious, wearing thicker socks - or even two layers of socks - while working at my desk as well as slippers and making sure that my feet didn't get cold. It took a few weeks to clear. The skin on the worse toe was discoloured for a while and it is still shows signs from the swelling but is totally healed otherwise.

And then she read the article by chance and sent it with a note saying, "Maybe this is what you had?".

The one dermatologist mentioned in the article used to see four or five cases a year. Now they're seeing dozens of cases of people, like me, who have never had chilblains before. And in summer too!

Apparently most cases have been in children, teens and young adults and it is thought that chilblains 'may reflect a healthy immune response to the virus'.

I searched for more articles on Covid toes and enjoyed this one, also in the New York Times, on 'The Many Symptoms of Covid-19'. 

Did I have chilblains caused by letting my feet get too cold in my very, very cold home office or did I have Covid Toes that developed as a result of a healthy immune response to the virus in the absence of any other symptoms?

In the second article, a whole bunch of seemingly random symptoms are mentioned - things that can be passed off as a bad day on a training run or tiredness for some unknown reason. 

These past months I've had the following at intervals: tight hip flexors while running - first time in my life (for a few days), slight rash (tiny bumps only, not itchy or red - went away in a day or two) above my knees, sore knee, a run of mild headaches, and slightly upset stomach. No fever, no coughing, no sore throat.

These can be easily explained (respectively) by: sitting too long and too cold at my deck, constant wearing of tights / pants in winter, as a result of some misstep on a run, spending too long on my computer, not drinking enough and stress, and something I ate / from the awful water in our town. These are all highly likely.

Rapid antibody tests are still to become readily available here and they are not necessarily conclusive but I'm keen to take one.

This is one test that I hope would be positive because it is more pleasant to pin these anomalies on Covid rather than stress, working too much and getting older.

Monday 10 August 2020

Handbag handout

With Women's Day celebrated on 9 August, there are often women-focused initiatives. One of our parkrun ladies passed a flyer on to me that asked for donations of handbags that are no longer used and also toiletry products to go into the bags.

I passed the flyer on to my bookclub friends and so the wheels began turning. One of the women has a side business in handbags and she tries a lot of them. She gave me six of her used, but in great condition, bags. I hit Clicks and took advantage of 3-for-2 specials on basics like bath soap, body lotion, face cloths, tooth brushes, tooth paste, deodorant and the like. I also had some crochet headbands and flowers on hand to add. 

My mom and I provided contents for four bags and we also handed in the other two bags to be filled with content provided by others.

While walking around Clicks, I was thinking about women (same applies to men and children) in absolute dire straits. Shampoo or food on the table. Of course, food. But there is something to be said for being able to brush your teeth and scrub your skin to feel fresh and clean.

A bottle of store-brand shampoo is at least R40/bottle. Toothbrushes are at least R10 to R15 each - but purchased in a pack of two so that's R30. Toothpaste is R12 at least. Same for a bar of soap. 

And then there are 'feminine hygiene products'. Sanitary pads are not cheap! I've had a mooncup and washable, reusable products for years but these are not cheap purchases (even though they last for years and years) and they also rely on you having access to clean water - which is not a given if you have no home. What if you can't afford the R22 for a pack of pads? 

I have very few toiletries. I don't need any more than what I have. Shampoo, conditioner, soap, a big tub of rich aqueous cream that I use for body and face (this dry highveld sucks every inch of moisture from your skin), toothbrush and toothpaste (also mouthwash and dental floss), sunblock, lip balm, deo, razor, face cloths, nail brush. That's about it for what I use daily.

I do have a stash of a few other items collected over time - bought by me (like a bottle of tissue oil, nail polish etc) or received as gifts (other body lotions or shower gels). I enjoy these and work my way through them.

And I do have toilet paper. 

And so when I wash my face in the morning - using my face cloth and water - and then brush my teeth; or when I take a shower after a run, wash my hair, scrub off the dirt from running trails, I am thankful for this special privilege of having a hot shower, dry towel and a tub of cream. 

This handbag initiative is such a 'simple' one but what a lovely and thoughtful initiative it actually is. In the big picture, food, warmth and shelter are key. Everything else is an extra. 

The parkrun lady who coordinated things on this side, delivered a boot-load (full car trunk) of filled bags today to the lady who started this initiative in our area. 

A few dozen women will receive a bag filled with the next layer of essentials. These hygiene products may allow a few women to feel that bit more fresh and clean. I'd say 'pampered'. Yes. But for me the basics are about hygiene and just feeling fresh enough to make it through the day ahead.