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Fear of Covid-19 Leads Other Patients to Decline Critical Treatment Fear of Covid-19 Leads Other Patients to Decline Critical Treatment
(about 1 hour later)
It was the call Lance Hansen, gravely ill with liver disease, had been waiting weeks for, and it came just before midnight in late April. A liver was available for him. He got up to get dressed for the three-hour drive to San Francisco for the transplant surgery.It was the call Lance Hansen, gravely ill with liver disease, had been waiting weeks for, and it came just before midnight in late April. A liver was available for him. He got up to get dressed for the three-hour drive to San Francisco for the transplant surgery.
And then he panicked.And then he panicked.
“Within five minutes after hanging up, he started hyperventilating,” his wife, Carmen, said. “He kept saying: ‘I’m going to get Covid, and then I’m going to die. And if I die, I want my family there.’ I couldn’t believe what I was hearing.”“Within five minutes after hanging up, he started hyperventilating,” his wife, Carmen, said. “He kept saying: ‘I’m going to get Covid, and then I’m going to die. And if I die, I want my family there.’ I couldn’t believe what I was hearing.”
She promised she would wait outside the hospital, as patients’ families were barred from entering. She warned that he might not get another chance at a new liver before it was too late. She told him he could die if he didn’t go. Still, Mr. Hansen, 59, refused.She promised she would wait outside the hospital, as patients’ families were barred from entering. She warned that he might not get another chance at a new liver before it was too late. She told him he could die if he didn’t go. Still, Mr. Hansen, 59, refused.
In a world seeded with anxiety, fear is gripping not just people who are ill with the coronavirus but those in urgent need of other medical care. Even as the number of Covid-19 cases declines in many places, patients with cancer, heart disease and strokes, among others, are delaying or forgoing critical procedures that could keep them alive. And as the virus reignites in pockets of the country, people are ignoring symptoms altogether, afraid to set foot in emergency rooms or even doctors’ offices.In a world seeded with anxiety, fear is gripping not just people who are ill with the coronavirus but those in urgent need of other medical care. Even as the number of Covid-19 cases declines in many places, patients with cancer, heart disease and strokes, among others, are delaying or forgoing critical procedures that could keep them alive. And as the virus reignites in pockets of the country, people are ignoring symptoms altogether, afraid to set foot in emergency rooms or even doctors’ offices.
Under orders from their states, many hospitals canceled elective surgeries like hip replacements as Covid-19 cases soared. Now most are gradually allowing the resumption of elective surgeries. But for these, as well as for more time-sensitive procedures like cardiac catheterizations, cancer surgery and blood tests or CT scans to monitor serious chronic conditions, doctors now find themselves spending hours on the phone trying to coax terrified patients to come in.Under orders from their states, many hospitals canceled elective surgeries like hip replacements as Covid-19 cases soared. Now most are gradually allowing the resumption of elective surgeries. But for these, as well as for more time-sensitive procedures like cardiac catheterizations, cancer surgery and blood tests or CT scans to monitor serious chronic conditions, doctors now find themselves spending hours on the phone trying to coax terrified patients to come in.
In a review of its claim and pre-authorization data for seven acute conditions, including heart attacks, appendicitis and aortic aneurysms, the insurance company Cigna Corporation found declines ranging from 11 percent for acute coronary syndromes to 35 percent for atrial fibrillation in the rate of hospitalizations over a recent two-month period. In a study published Tuesday in The New England Journal of Medicine, Kaiser Permanente reported a drop of nearly 50 percent in heart attack admissions in its Northern California hospitals.In a review of its claim and pre-authorization data for seven acute conditions, including heart attacks, appendicitis and aortic aneurysms, the insurance company Cigna Corporation found declines ranging from 11 percent for acute coronary syndromes to 35 percent for atrial fibrillation in the rate of hospitalizations over a recent two-month period. In a study published Tuesday in The New England Journal of Medicine, Kaiser Permanente reported a drop of nearly 50 percent in heart attack admissions in its Northern California hospitals.
At the University of Rochester Medical Center in Rochester, N.Y., emergency room visits dropped by 50 percent, and many of the patients who do come have waited too long to seek treatment. They “are presenting late with strokes and heart attacks,” said Dr. Michael Apostolakos, the system’s chief medical officer. “Or they’re not showing up until they can barely breathe from heart failure.”At the University of Rochester Medical Center in Rochester, N.Y., emergency room visits dropped by 50 percent, and many of the patients who do come have waited too long to seek treatment. They “are presenting late with strokes and heart attacks,” said Dr. Michael Apostolakos, the system’s chief medical officer. “Or they’re not showing up until they can barely breathe from heart failure.”
In Newark, emergency medical services teams made 239 on-scene death pronouncements in April, a fourfold increase from April 2019. Fewer than half of those additional deaths could be attributed directly to Covid-19, said Dr. Shereef Elnahal, president and chief executive of Newark’s University Hospital.In Newark, emergency medical services teams made 239 on-scene death pronouncements in April, a fourfold increase from April 2019. Fewer than half of those additional deaths could be attributed directly to Covid-19, said Dr. Shereef Elnahal, president and chief executive of Newark’s University Hospital.
Declining crucial, potentially lifesaving treatment might seem irrational. Mental health experts explain that anxiety affects the part of the brain involved in thinking and planning for the future. It arises when that part, the prefrontal cortex, doesn’t have enough information to accurately predict what lies ahead, causing the brain to spin scenarios of dread.Declining crucial, potentially lifesaving treatment might seem irrational. Mental health experts explain that anxiety affects the part of the brain involved in thinking and planning for the future. It arises when that part, the prefrontal cortex, doesn’t have enough information to accurately predict what lies ahead, causing the brain to spin scenarios of dread.
Enter panic.Enter panic.
“If you have anxiety and then you exacerbate that by watching the news and reading social media, that’s where you get panicked,” said Dr. Jud Brewer, a psychiatrist and behavioral neuroscientist at Brown University. “And the rational, thinking parts of the brain stop functioning well when we’re panicked.”“If you have anxiety and then you exacerbate that by watching the news and reading social media, that’s where you get panicked,” said Dr. Jud Brewer, a psychiatrist and behavioral neuroscientist at Brown University. “And the rational, thinking parts of the brain stop functioning well when we’re panicked.”
Panic, in turn, can lead to impulsive behavior and dangerous decisions, Dr. Brewer and others said.Panic, in turn, can lead to impulsive behavior and dangerous decisions, Dr. Brewer and others said.
“People are saying: ‘So I’m having a heart attack. I’m going to stay home. I’m not going to die in that hospital,’” said Dr. Marlene Millen, a primary care physician at the University of California, San Diego. “I’ve actually heard that a few times.”“People are saying: ‘So I’m having a heart attack. I’m going to stay home. I’m not going to die in that hospital,’” said Dr. Marlene Millen, a primary care physician at the University of California, San Diego. “I’ve actually heard that a few times.”
Dr. Suzanne George, an oncologist at the Dana-Farber Cancer Institute in Boston, has patients on oral chemotherapy regimens who refuse to come in for lab work. Cancer patients on chemotherapy are at particularly high risk of becoming severely ill if they contract the coronavirus.Dr. Suzanne George, an oncologist at the Dana-Farber Cancer Institute in Boston, has patients on oral chemotherapy regimens who refuse to come in for lab work. Cancer patients on chemotherapy are at particularly high risk of becoming severely ill if they contract the coronavirus.
“They don’t want to leave their house so we can take tests to ensure that they’re receiving their chemotherapy safely,” Dr. George said, adding that blood tests are crucial for early detection of potentially severe side effects.“They don’t want to leave their house so we can take tests to ensure that they’re receiving their chemotherapy safely,” Dr. George said, adding that blood tests are crucial for early detection of potentially severe side effects.
Dr. George said the fear she was seeing a few weeks ago had abated slightly. Still, she said, “we will all need to come together to help people feel safe.”Dr. George said the fear she was seeing a few weeks ago had abated slightly. Still, she said, “we will all need to come together to help people feel safe.”
Most hospitals and outpatient clinics have made changes designed to keep patients and staff members safe. Many are testing patients and certain workers. In many hospitals, Covid-19 patients are kept in separate units. Masks are usually mandated for both patients and clinicians. Cleaning protocols have been turbocharged. As a result, experts say, the risk of acquiring Covid-19 when going into a hospital is very low.Most hospitals and outpatient clinics have made changes designed to keep patients and staff members safe. Many are testing patients and certain workers. In many hospitals, Covid-19 patients are kept in separate units. Masks are usually mandated for both patients and clinicians. Cleaning protocols have been turbocharged. As a result, experts say, the risk of acquiring Covid-19 when going into a hospital is very low.
But one of the common safety measures — banning visitors, even close family members — is a huge reason for patients’ fear and apprehension.But one of the common safety measures — banning visitors, even close family members — is a huge reason for patients’ fear and apprehension.
“The hospital was an ominous, nerve-racking and scary place for patients even before Covid,” said Dr. Lisa VanWagner, a transplant hepatologist at Northwestern Medicine in Chicago. “Now you take a stressful situation like a pandemic and you tell people that they cannot have their normal support system while they’re in the hospital, and that really magnifies those fears.”“The hospital was an ominous, nerve-racking and scary place for patients even before Covid,” said Dr. Lisa VanWagner, a transplant hepatologist at Northwestern Medicine in Chicago. “Now you take a stressful situation like a pandemic and you tell people that they cannot have their normal support system while they’re in the hospital, and that really magnifies those fears.”
Transplant specialists around the country describe patients like Mr. Hansen, 59, who turn down organs because they are worried about being exposed to Covid-19 patients or because they cannot have a close relative or friend with them in the hospital.Transplant specialists around the country describe patients like Mr. Hansen, 59, who turn down organs because they are worried about being exposed to Covid-19 patients or because they cannot have a close relative or friend with them in the hospital.
David Rivera, 54, who has liver cancer, declined a liver in late March at Northwestern. In an interview, he said he feared the deceased donor could be infected with the virus.David Rivera, 54, who has liver cancer, declined a liver in late March at Northwestern. In an interview, he said he feared the deceased donor could be infected with the virus.
Dr. VanWagner, who is on the transplant team at Northwestern, said Mr. Rivera had turned down the liver despite being told the donor had tested negative for Covid-19. Still, the hospital could not guarantee that the liver was free of the coronavirus, though Dr. VanWagner and others said the chances that a liver donor who had tested negative would transmit the virus to a recipient were exceedingly low.Dr. VanWagner, who is on the transplant team at Northwestern, said Mr. Rivera had turned down the liver despite being told the donor had tested negative for Covid-19. Still, the hospital could not guarantee that the liver was free of the coronavirus, though Dr. VanWagner and others said the chances that a liver donor who had tested negative would transmit the virus to a recipient were exceedingly low.
Dr. VanWagner said Mr. Rivera needed a transplant before his cancer could progress. “His window is closing,” she said. “You can only go so long before you run out of chances.”Dr. VanWagner said Mr. Rivera needed a transplant before his cancer could progress. “His window is closing,” she said. “You can only go so long before you run out of chances.”
Mr. Hansen said he now regretted the decision he made last month and would accept the next liver that became available.Mr. Hansen said he now regretted the decision he made last month and would accept the next liver that became available.
“I just freaked out,” Mr. Hansen said by phone recently, his voice weak and faint. “I should have gone, but I just freaked out.”“I just freaked out,” Mr. Hansen said by phone recently, his voice weak and faint. “I should have gone, but I just freaked out.”
Health system administrators are redoubling their efforts to convince patients that it’s safe to come into hospitals and outpatient clinics, even as testing for hospital personnel and patients remains spotty.Health system administrators are redoubling their efforts to convince patients that it’s safe to come into hospitals and outpatient clinics, even as testing for hospital personnel and patients remains spotty.
“Our goal is to spend almost all our marketing dollars over the next year around the safety of our institution,” said Dr. Stephen Klasko, chief executive of Jefferson Health, a 14-hospital system based in Philadelphia.“Our goal is to spend almost all our marketing dollars over the next year around the safety of our institution,” said Dr. Stephen Klasko, chief executive of Jefferson Health, a 14-hospital system based in Philadelphia.
Some doctors are helping patients with chronic illnesses rethink aspects of their care. Updated June 24, 2020
For the past 21 years, Rob Russo, 45, has been living with a rare type of gastrointestinal cancer that has spread to his liver. For years, he made regular trips from his home in Queens to Dana-Farber in Boston. When the pandemic hit, Mr. Russo’s oncologist helped him transfer much of his care to Memorial Sloan Kettering Cancer Center and NewYork-Presbyterian/Weill Cornell Medical Center in New York. Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. Some doctors are helping patients with chronic illnesses rethink aspects of their care.
For the past 21 years, Rob Russo, 45, has been living with a rare type of gastrointestinal cancer that has spread to his liver. For years, he made regular trips from his home in Queens to Dana-Farber in Boston. When the pandemic hit, Mr. Russo’s oncologist helped him transfer much of his care to Memorial Sloan Kettering Cancer Center and NewYork-Presbyterian/Weill Cornell Medical Center in New York.
At the end of April, Mr. Russo needed a procedure at Weill Cornell to unclog a stent that was keeping his biliary duct open. Before the procedure, Mr. Russo’s mind churned with scenarios: The place was teeming with the virus. What if someone with asymptomatic coronavirus infected him, and he needed to be hospitalized? And what if that meant never seeing his wife again?At the end of April, Mr. Russo needed a procedure at Weill Cornell to unclog a stent that was keeping his biliary duct open. Before the procedure, Mr. Russo’s mind churned with scenarios: The place was teeming with the virus. What if someone with asymptomatic coronavirus infected him, and he needed to be hospitalized? And what if that meant never seeing his wife again?
“She could drop me off, and it’s the last time we’d see each other,” he said.“She could drop me off, and it’s the last time we’d see each other,” he said.
Like others interviewed for this story, Mr. Russo found that once he had arrived at the hospital, he felt safe. Multiple safety precautions were taken. The procedure went well. But before the procedure, he was tested for the coronavirus. The test came back positive. Now he’s quarantined on a separate floor in his house.Like others interviewed for this story, Mr. Russo found that once he had arrived at the hospital, he felt safe. Multiple safety precautions were taken. The procedure went well. But before the procedure, he was tested for the coronavirus. The test came back positive. Now he’s quarantined on a separate floor in his house.
Mary Anne Oldford, 72, who has an advanced form of sarcoma, a rare cancer, runs an online support group called the Sarcoma Sunflower Brigade. Members make a point of not bringing up Covid-19, but when Ms. Oldford asked them recently to weigh in on their anxiety related to the coronavirus, she got responses that illustrated various shades of sheer terror. One woman told the group that every time she has to go in for a scan, or blood work, “I have a borderline meltdown.”Mary Anne Oldford, 72, who has an advanced form of sarcoma, a rare cancer, runs an online support group called the Sarcoma Sunflower Brigade. Members make a point of not bringing up Covid-19, but when Ms. Oldford asked them recently to weigh in on their anxiety related to the coronavirus, she got responses that illustrated various shades of sheer terror. One woman told the group that every time she has to go in for a scan, or blood work, “I have a borderline meltdown.”
Ms. Oldford, who herself has been terrified to go for blood tests, came up with a solution for herself. She found a clinic that agreed to do her blood draws at home.Ms. Oldford, who herself has been terrified to go for blood tests, came up with a solution for herself. She found a clinic that agreed to do her blood draws at home.
She advises others in the support group to push for effective alternatives. “If you’re afraid and you’re frozen, you have to somehow reach out and just say, ‘Please help me figure out how to do this so that I’m not so scared,’” she said.She advises others in the support group to push for effective alternatives. “If you’re afraid and you’re frozen, you have to somehow reach out and just say, ‘Please help me figure out how to do this so that I’m not so scared,’” she said.
Bill Sieber, a psychologist at U.C.S.D., said the key for fearful patients was to develop a semblance of control over their predicament. “Control is key,” Dr. Sieber said. “If you can’t control the fact that your spouse can’t come into the recovery room, ask what you can control.”Bill Sieber, a psychologist at U.C.S.D., said the key for fearful patients was to develop a semblance of control over their predicament. “Control is key,” Dr. Sieber said. “If you can’t control the fact that your spouse can’t come into the recovery room, ask what you can control.”
Dr. Sieber also recommended working through episodes of panic with breathing. “We can control our breathing in a major way,” he said. “Breathing signals the brain to calm down.” One step he suggested was taking one extra second to prolong an exhalation.Dr. Sieber also recommended working through episodes of panic with breathing. “We can control our breathing in a major way,” he said. “Breathing signals the brain to calm down.” One step he suggested was taking one extra second to prolong an exhalation.
Controlled breathing helped Megan Jennings. Ms. Jennings, 36, who lives near Seattle, was determined to save the life of her 7-year-old niece, who has a congenital liver disease, by donating a portion of her own liver.Controlled breathing helped Megan Jennings. Ms. Jennings, 36, who lives near Seattle, was determined to save the life of her 7-year-old niece, who has a congenital liver disease, by donating a portion of her own liver.
It was a fraught decision not just for Ms. Jennings but also for the University of Washington transplant team.It was a fraught decision not just for Ms. Jennings but also for the University of Washington transplant team.
“This child was getting sicker, and we had to make a decision whether we would move forward with bringing a live donor into our hospital, which had a lot of Covid at what turned out to be the peak of our surge,” said Dr. Scott Biggins, chief of hepatology at UW Medicine.“This child was getting sicker, and we had to make a decision whether we would move forward with bringing a live donor into our hospital, which had a lot of Covid at what turned out to be the peak of our surge,” said Dr. Scott Biggins, chief of hepatology at UW Medicine.
Ms. Jennings used a variety of breathing techniques to overcome a standing fear of hospitals and surgery, now compounded by a dread of the coronavirus.Ms. Jennings used a variety of breathing techniques to overcome a standing fear of hospitals and surgery, now compounded by a dread of the coronavirus.
“Being able to slow my breathing, feeling my body, and ground myself, staying mindful of what was happening around me, helped me stop my brain from rattling off craziness,” Ms. Jennings said. The surgery lasted seven hours.“Being able to slow my breathing, feeling my body, and ground myself, staying mindful of what was happening around me, helped me stop my brain from rattling off craziness,” Ms. Jennings said. The surgery lasted seven hours.
After a five-day hospital stay, with no visitors, she was finally discharged. But a few days after she returned home, her wound became infected, and she had no choice but to return to the hospital to have the incision reopened and cleaned. The doctors in the emergency room recommended that she spend the night in the hospital, but there was a limit to how much anxiety she could tolerate. She insisted that she be shown how to care for the wound at home.After a five-day hospital stay, with no visitors, she was finally discharged. But a few days after she returned home, her wound became infected, and she had no choice but to return to the hospital to have the incision reopened and cleaned. The doctors in the emergency room recommended that she spend the night in the hospital, but there was a limit to how much anxiety she could tolerate. She insisted that she be shown how to care for the wound at home.
“There was no way I was going to be admitted,” she said, and she left the hospital at 3:30 a.m.“There was no way I was going to be admitted,” she said, and she left the hospital at 3:30 a.m.
Sleep-deprived and foggy from a painkiller, she slept for two hours in her car. Then she drove herself home.Sleep-deprived and foggy from a painkiller, she slept for two hours in her car. Then she drove herself home.