The grocery shelves are empty and most of us have been to at least 3 different places just to find toilet paper.  Many of my new moms can’t even find formula for their babies.  Is there a shortage?  No, but there is a manufactured shortage fueled by hysteria.  At this point, one might wonder what is more dangerous the coronavirus (COVID 19), or the fear and anxiety that has been generated by the media?

1. So, let’s compare COVID 19 to the flu for a second.  Which is more likely to kill you? The answer is the flu.  As of March 7, 2020, 38 million people in the U.S. have been affected by the flu.  Somewhere around 390,000 have been hospitalized, and somewhere around 23,000 people have died.  In fact, the hospitalization rate for influenza in children 0-4 and adults 18-49 is the highest ever, even higher than H1N1.  To date, Covid 19 has affected nearly 50,000 people in the US and about 650 people have died.  The mortality (or death) rate from the seasonal flu is typically around 0.1%.  The mortality rate for Covid 19 currently stands at a little over 1% in the US.  What this means is if you get COVID 19, you are more likely to die than if you get the flu; however, you are far more likely to get the flu than COVID 19.  So, statistically, at this point, you are far more likely based on probability to die from influenza than you are from COVID 19.  Despite these numbers and the big push for a coronavirus vaccine, only around 40% of the population is amenable to the influenza vaccine that could potentially save more lives.
2. That being said, I am definitely not telling you to ignore the current recommendations of social distancing or taking appropriate sanitary precautions and following guidelines set by the governments.  Even though up to 20% or more of those infected may have no symptoms, coronavirus is still a very serious illness for those who become ill.  Who does this virus affect?  Those most at risk of death are the elderly, especially those with chronic disease.  The mortality rate for those over age 65 with chronic diseases is 16%.  By following these precautions, we are decreasing exposure and the chance that this age group will contract a disease that is way more deadly for them than a healthy 20-year-old (the chance of a healthy person younger than 55 dying from coronavirus is <1%; for those 85 or older, it could be anywhere from 10-27%).  As for pregnant women, the good news is that coronavirus does not appear to cross the placenta to the baby, but just like for the flu, pregnant women are at a slightly higher risk for severe respiratory symptoms because their immune system is a bit compromised in order to prevent rejection of their growing baby.
3. One of the biggest concerns for many is a comparison of our healthcare with Italy-they don’t have enough ICU beds, ventilators or even enough space to bury the dead.  Fortunately, there are a lot of differences between Italy and the US.  In Italy, 25% of its population is over the age of 65 (thank you Mediterranean diet!).  In the US, only 16% of the population is over the age of 65.  The number of critical care beds per 100,000 people in the US is 34.7.  The number of critical care beds per 100,000 people in Italy is 12.5.  So, not only is there a disparity in patient population, but it is also present in the healthcare infrastructure that is contributing to the higher mortality rate that we are seeing in Italy compared to the US.  These factors contribute to a mortality rate in Italy is currently at 9%!  This does not mean that we should be falsely reassured, though.  The U.S. population is 5 times higher than Italy, and this is going to be a huge strain on our health care system.  Covid 19 has also shown that we may benefit from reassessing our production/supply chains for medical devices/pharmaceuticals as we find decreased availability of medical supplies and medications for sick patients and healthcare providers. 
4. There will be lots of lessons to learn from COVID 19.  This will test our preparedness in adversity, and it will teach us how to be better equipped for large-scale health crises in the future.  Importantly, though, we cannot lose our humanity and touch with reality.  Stocking enough toilet paper for 1 year is not going to make you immune to COVID 19, and in fact, it may help facilitate its spread.  If the rest of us have to go to three different stores to find a roll of toilet paper, it increases our exposure to others.  This could negate the effects of social distancing that we have been practicing for the past week.  All those hours of being cooped up in the house and driving each other crazy, and the only benefit will be a really clean bum 😉 

Dr. Pam

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Image via Pexels

Let’s face it: Nobody wants to wake up on Monday morning and start a new work week. However, the Sunday Scaries
— that feeling of anxiety at the midpoint of the weekend — can make Monday that much worse. And by stressing out, you can lose the joy of half your weekend. Here are a few resources that can help you prepare for the week ahead.
 
Your Home, Your Sanctuary
 
Your overall attitude is partly determined by how you feel when you’re spending time at home. Here’s how to make your space a sanctuary.
 
57 Inspiring DIY Fire Pit Ideas and Plans to Make S’mores with Your Family
8 Must-See Features for the Ultimate Spa Bathroom Makeover
5 Tips to Create a Relaxing Bedroom
Room-by-Room Stress Reducers for Your Home
 
Feed the Senses
 
Sight, sound, touch, and taste also make a difference in how we perceive stressors.
 
The 10 Most Relaxing Songs in the World, According to Science, Ranked
21 of the Most Comforting TV Shows to Watch When You're Stressed
Reduce Stress Using the 5 Senses
 
Exercise Does a Body (and Mind) Good
 
Exercise really is nature’s medicine. Whether you want to walk or spend the weekend trekking the backcountry, the more you move, the better you’ll feel.
 
Can Exercise Help Treat Anxiety?
The Pacer Blog: Walking, Health, and Fitness
10 of the Best Weekend Backpacking Trips in the US
 
Monday does not have to be a terrible “four-letter word.” The above links are full of great information to help you get your entire family mentally prepared to enjoy the weekend, and then tackle the week ahead.

Elena Stewart

As a definite meat-eater married to a definite vegetarian, we have certainly discussed the health aspects of eating meat (or not).  Now that there’s a new spin on typically meat-based dishes, we’ve had a chance to rehash some of those discussions, and after doing some research, here’s what we’ve found.

First of all, what’s this “fake” meat made of?  Meat alternatives generally start with a plant-based protein such as soy, pea, wheat or potatoes.  Mushrooms can also be a foundation of synthetic meats.  The “blood” that comes out after a big bite of your rare burger is produced either from beet juice or leghemoglobin, the plant version of the protein that makes your red blood cells red.  Given the variety of sources of plant-based “meats,” be sure to check the ingredients for any triggers of food allergies.  Also, as there are a number of oils and other preservatives, sometimes there can be some GI sensitivities as well, so it’s probably best to see how your body responds before downing a meat substitute breakfast sandwich followed by a plant-based burger for lunch and some faux fried-chicken for dinner.

Is it really healthy?  One of the most common misconceptions about a meat-free diet is that it’s inherently healthy.  A cinnamon roll for breakfast, cheese pizza for lunch, and fries with a milk shake for dinner is technically vegetarian, but it’s not healthy.  Unfortunately for many meat substitutes, while base ingredients like pea protein can be very healthy, the amount of salt and additives you have to add to convince my taste buds that I’m devouring a juicy hamburger renders most of the health benefits a moot point.  The caloric content is roughly equivalent, the few grams of fat you save are replaced by carbs, and you’ve increased the salt content by about 25%.  You do end up with less cholesterol and a little more fiber, but you’ve lost a few grams of protein.  You may also lose out on some of the benefits of eating meat to begin with, which are vitamin B12 and iron (these micronutrients are often deficient in vegetarians).  Lastly, we don’t really have any studies regarding the longterm health effects of meat substitutes and the additives needed to make them taste like meat.

So, there’s not really any benefits?  From a health standpoint, a greasy burger or fried chicken (real or fake) isn’t going to be the foundation of anyone’s healthy diet, but there are a few advantages of fake “meat.”  First, there’s no need to inject antibiotics or hormones to make an animal grow faster and increase food production.  Also, to be fair, there is noticeably less impact on the environment to grow vegetables than animals for food.

What’s a person to do then?  From a health standpoint, we do note increased health benefits from a plant-based diet, although that’s probably not one based entirely on meat substitutes, at least with how these are produced now.  As for real meats, less processed is generally preferred, and free range, antibiotic-free and hormone-free are going to be the best options with regards to health.  When it comes to choosing some of the healthiest meat of all, wild game is another strong contender.  These animals tend to have the leanest meat as they are inherently free range, and it also guarantees avoidance of hormones and antibiotics while having the added advantage of increasing exercise for the hunter.

In the end, whether eating real meat or fake, moderation is going to be key, and be sure to keep an eye on the ingredients in those foods, especially synthetic ones.  Cooking for yourself will give you even more control over your food ingredients, and to maximize your health benefits, try making the foundation of your meals unprocessed vegetables and fruits.  It turns out that when your mom made you eat your vegetables before you could go play, she knew what she was talking about after all 😊

Dr. Nick

What causes varicose veins in pregnancy?  During pregnancy your blood volume increases.  However, because the large pregnant uterus places pressure on the inferior vena cava (the large vein that brings blood back to the heart), the rate at which blood flows back from your legs to your pelvis decreases.  This puts an enormous strain on your veins.  This pressure in addition to hormones such as progesterone which can dilate veins causes blood to pool in the veins which stretches the vein walls and can cause veins to swell twist and bulge.  

Where do they show up?  Varicose veins are large swollen dilated vessels that show up in the lower half of your body.  They are most common in your legs but can show up in the vulva or rectum (aka hemorrhoids in the rectal area).  When they swell above the surface of the skin, the have this lumpy purple unsightly appearance and can affect 10 to 20% of pregnant women. 

Are they dangerous?  While varicose veins are pretty ugly in appearance, they are usually harmless and will recede after pregnancy.  That being said, look out for development of ulcers or marked difference in the swelling in one leg compared to the other as these could indicate more concerning issues such as venous insufficiency or deep vein thrombosis.  Either of these conditions would require more urgent evaluation.

What can I do to minimize varicose veins when I am pregnant?  Not all women get varicose veins when they are pregnant.  However, if you have had varicose veins in a previous pregnancy, the likelihood of getting them with a subsequent pregnancy is high.  Also, this can be genetic.  So, if your mother had bad varicose veins, the likelihood that you will develop them is higher. 

​What can I do about varicose veins and prevent their appearance from getting worse? 

1. Exercise: Moving is key.  Even if it’s just walking and not more intense exercise than a slow stroll- it is important to stay active. Exercise is important for maintaining good circulation. 
2. Keep the blood flowing.  Whenever sitting, try to keep your legs elevated- helps that blood get back to the heart. 
3. Compression: using compression socks or support hose will help counteract the downward pressure of your pregnant belly and give the circulation in your lower extremities that extra push upwards. 
4. If you have hemorrhoids (varicose veins essentially around the rectum), try to do what you can to minimize constipation and the need to strain.  Fluid and fiber intake are key.  Add stool softeners and fiber supplements if necessary. 
5. Try to stick to the weight gain recommendations for pregnancy.  For women with a normal bmi, the weight gain recommendation is 25-35 pounds.  Extra weight gain increases the demands on your circulatory system. 

For most women, the appearance of varicose veins improves significantly after delivery.  However, if yours are persistent there are different aesthetic procedures available to decrease their appearance.  Wait until you have had all your babies before pursuing one of these options.  Talk to your provider about what’s out there to help!!!

​Dr. Pam

Graphic created by USA Vein Clinics