What You Need to Know about the Coronavirus (2019-nCoV)

A new (novel) virus, called the coronavirus (2019-nCoV), has alarmed the public and health care providers alike in recent weeks. It emerged from Wuhan, Hubei Province, China, and has rapidly spread to Australia, Canada, France, Japan, Macau, Malaysia, Nepal, Taiwan, Thailand, South Korea, Singapore, Vietnam, and the United States. The first cases were reported on December 31, 2019, according to LiveScience.com. 

Early indications are that the virus may have come from the Huanan seafood market. It was initially thought to be connected to human infection from animals sold at the market who carried the coronavirus. But continued infection in people with no connection to the market has pointed to human-to-human infection. At this point, it is unknown how the virus is being spread. It appears to be spreading during the incubation period, before a person begins to develop symptoms, making it especially dangerous.

Symptoms are believed to appear from 2-14 days after exposure. Common symptoms are fever, cough, and fatigue. Some less common symptoms are coughing up blood or sputum that may be blood-tinged, headache, and diarrhea. Complications have included acute respiratory distress syndrome, anemia, acute cardiac injury, and secondary infection. 

Treatment for now consists of supporting the patient's systems while the body fights the disease. No antiviral treatment has been effective against 2019-nCoV. Corticosteroids have been administered in some cases, but it is unknown whether these treatments were beneficial. Trials are now being conducted to find effective treatments and a vaccine against the disease.

Currently, the Centers for Disease Control and Prevention (CDC) is recommending that those who either have the disease or are being tested for it wear a mask. This may prevent the transmission of disease through larger fluid droplets. But according to Fox News, Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University, and the medical director of the National Foundation for Infectious Diseases, has warned that wearing surgical face masks won't prevent the spread of the disease.

A respirator may be more effective if worn correctly. But for now, conscientious hand-washing is recommended. The CDC has listed the following ways to minimize exposure to this virus:

• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces.

Sources: 

https://www.livescience.com/new-china-coronavirus-faq.html

https://www.contagionlive.com/

https://www.foxnews.com/health/do-surgical-masks-protect-against-coronavirus

https://www.cdc.gov/coronavirus/index.html

https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html

A Walk Through Thoracic Park

This last Thursday I spent the day completing my quadriplegia son's care needs. Friday I spent screaming at the nearby hospital. Saturday I was home again catching up on my son's care.

I am a caregiver. This is my life. If you care for someone you love, you understand.

The screams didn't last all day Friday, just when I tried to get off the MRI table after the imaging on my spine was complete. My muscles froze into one solid spasm. I couldn't move, and it felt like my back was being broken into two pieces. A series of primal screams escaped from me that felt like my soul had leaked out. I was finally able to make it to a wheelchair, where I was taken down to ER.

The two MRI techs who helped me are probably in counseling today. One of them kept mumbling to me, "I'm so sorry. I'm so sorry."

After hours in the waiting room, hunched over in a wheelchair, dressed in hospital scrubs, and clutching my belongings, I was finally taken back to an exam room. There I found some relief and answers to my pain. I also had time to think about the experience. What did they do right at that hospital? And what, if anything, could they have done to help me?

What they got right.

1. I had had to cancel my original appointment in radiology due to snowy weather and bad roads. The roads had cleared up, so I drove on up and appealed to them to work me in. They not only got me in, they did it so quickly I barely had time to pay for the new purse I found at the gift shop. It takes a lot of pain to keep me out of a gift shop.

2. They had two baskets of pens at the check-in. One was labeled "Clean," and one was labeled "Dirty." As a nurse who is OCD about infection control, I was very impressed by this kind of dedication to cleanliness.

3. The room (when I finally got to one) smelled and felt clean. The privacy curtain looked new. Everything appeared well-organized.

4. The health providers took time to listen to my concerns and took my perspective into account when writing orders.

How they could improve.

1. Training personnel on how to assist patients with mobility problems. I had warned them about my intense back spasms and doubts about being to get off the table. They quickly assured me they would take care of helping me back up. But in the midst of the spasms, I had to instruct the tech on how to press and massage the back muscle to release the spasm. It was the only way I got on my feet long enough to make it to a wheelchair. 

2. Listening first before making an assumption about a patient's needs. After setting me in the waiting room to tough out the pain, they came and got me once. I thought I was going to a room, but they wheeled me down to have a CT. When I told the tech I couldn't get down flat again then, she mistook my hesitation for fear of the test and proceeded to instruct me on how it wouldn't take long and wasn't scary. I responded a bit testily that I was a nurse, had no problems with getting a CT (I had just endured the MRI tube), and that my problem was getting off the table. I was returned to the waiting room.

3. Remembering that pain, though not a visible sign of disease or injury, is a significant symptom. As I sat in the waiting room, others came and went. I obviously don't know why they were there, but I have a lot more respect for those who arrive in an emergency department in pain. I understand the struggle those departments have with people who are on the hunt for pain killers. But I can't take narcotic pain killers. Two or three ibuprofen would have helped.

I finally got seen and am on the mend. Thank God I have still been able to care for my son through my own health saga. And I thank God for a loving family and faithful friends who have stepped in to pray for us and assist us on the rough days.

What are your stories as you walk through your own caregiving experience? Do you have ideas that could improve the quality and delivery of healthcare in your area? We'd love to hear them.