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Robin Dawson, RN, UPMC, taking a blood pressure of a patient last year before the beginning of the COVID-19 pandemic.

 

As the COVID-19 pandemic rages on, more people are seeking ways to avoid exposure. One way is by reducing the need for in-person medical attention, whenever possible. The best way to do that is by proactively caring for your mind and body. So some local medical professionals offer some helpful suggestions on how to monitor and maintain your health at home.

Mental health

Anxiety and depression have increased in the face of COVID and its periphery challenges. “Anxiety is one of those incredibly common conditions,” says Dr. Matthew Wolcott, of Family Medicine of Evangelical. “You’re not alone in this. It’s something that to a certain degree everyone struggles with.”

Knowing how to deal with the struggle before it gets out of control, is key. Wolcott suggests avoiding triggers such as television, radio, and social media. Instead, “Find your happy place,” he said. “Take 15 minutes for yourself every single day. Don’t feel guilty about it.” In fact, taking time for yourself will allow you to better provide care for others around you. Doing something you love generates neurotransmitters in your brain that allow you to function better. Wolcott encourages both exertional and non-exertional activities to boost both mind and body. “Nonexertional” could be anything like art, music, crafts, or visiting a new place — something that you do just for you.

Get moving

Regarding “exertional” activities, “Don’t worry about calories or trends,” Wolcott said. “If you are doing something you are passionate about, most of the time you will be able to keep up with that and stay committed to it. Physical exercise, he said, will give you “an endorphin bump and help to reduce stress,” while the physical body will also benefit.

Dr. Robin Spangler, of UPMC Primary Care in Lewisburg, agrees. She encourages people to do “anything you would enjoy doing, because that’ something you’re going to stick with.”

“Anything that gets you out of your seat is better than nothing,” she added.

She especially encourages older individuals who haven’t been regularly exercising, to start small and gradually build up to something more. She said the goal is “30 minutes a day of somewhat vigorous exercise.”

Dr. Deepak Sapkota, internal medicine at Geisinger Medical Center, suggests purchasing a pedometer or utilizing similar apps on your smart device to measure the number of steps you take each day. For an adult, that’s usually an average of 4,000 to 18,000. “If you’re taking more than 10,000 steps,” he said, “that usually means you are getting enough exercise and burning through calories.”

Wolcott said weight-lifting exercises, even if you can handle just a few different exercises, a few sets, two to three times a week, can also help strengthen your bones. Bone health is also improved by taking a lower dose of vitamin D.

Watch what you eat and monitor your weight

“Between winter and restrictions from COVID, people aren’t as active as they might be at other times,” Spangler said. “There is a tendency to gain weight right now.”

She said the goal for most people should be eating more fruits and vegetables and avoiding less processed foods.

According to Sapkota, it’s good to get into the habit of calorie counting. He explains that for individuals between the ages of 20 and 50, 2,000 to 2,500 calories a day are necessary to maintain weight. If your goal is to lose weight, he said by cutting those calories to about 1,500 a day, you can lose approximately a pound every week.

Spangler confirmed that “cutting calories by 500 a day would lead to a healthy amount of weight loss.” She suggests that people continue eating the foods they like, since most won’t stick with a drastic change in diet long-term. Instead, “Just cut back on portion sizes, and foods that are higher in calories eat less frequently and in smaller amounts.” Fruits and vegetables, she said, are low in calories, and if you eat more of them and drink more water (and avoid sugary drinks), you’ll feel full.

For a greater chance at weight loss success, Wolcott suggests setting a lighter goal. “Aim for a longer period of time to get it done,” he said. “If you’re focused on improving your health and enjoying what you’re doing, usually weight loss comes as a secondary benefit.”

He encourages his patients to write down, or utilize apps, to keep track of what they eat, so that they are aware and better able to avoid pitfalls. And don’t be too hard on yourself if you’re not seeing results. Do what you can, shoot for your goal, and make moderate changes each week that you can sustain long-term.

Sapkota said it’s important for patients with or with an underlying risk for heart failure to monitor their weight every day.

“If their weight goes up more than two pounds in a day or five pounds in a week, that is concerning,” he said, “and they should consult a doctor. That usually means they are retaining fluid and might need medication.”

Wolcott said the holidays is a common time for heart failure cases, as people consume a lot of salty foods. He urges living in moderation and cutting back salt intake. “If you’re used to using the salt shaker, I don’t expect you to quit,” he said. “If you usually do four shakes, go to two.”

Get quality sleep

Healthy adults should be getting 6 to 9 hours of quality sleep each night. Sapkota said it’s something to especially keep track of these stressful days, as a loss of a job or anxiety and depression, can cause sleep disturbance. He encourages the use of a smart device to track your sleep, if you’re tech-savvy.

Spangler said it’s common in our society for people to be sleep deprived. But enough quality sleep is necessary for improving your immune system.

“If you are waking up before your alarm clock goes off in the morning, you’re probably getting enough sleep,” she said. “If you’re dragging yourself out of bed in the morning, you’re probably not getting enough.”

Some common complaints from patients regarding sleep struggles are feelings of getting poor sleep, restlessness, and daytime fatigue, Wolcott said. He said such patterns can worsen other health conditions like blood pressure issues and heart disease. If you have a spouse or significant other, he advises asking them to provide feedback on how you’re sleeping, and to watch for signs such as snoring or breathing pauses which would mean apnea.

Wolcott also advises turning off televisions and smart devices about one and a half hours before bedtime, as they will get your mind “amped” instead of quieting down. Certain wavelengths they create can also affect quality sleep. Also, if you take sleep medications or drink alcohol to go to sleep, you might fall asleep more quickly, but you’re not getting the deeper levels your body requires. Without quality sleep, he said, your body could suffer from memory impairment and daytime fatigue.

Wolcott said the bed should be used only for intimacy and sleep, and he advises against sitting in bed to watch television, text, or be on your computer. And if you awake at night with anxiety or thoughts racing through your mind, keep a notebook by your bed, write down what you are thinking or need to remember. This will free you from your thought process and allow you to return to sleep more quickly.

Monitor blood pressure

Whether or not you have a history of high blood pressure, it’s worth purchasing a blood pressure kit at a local drug store and keeping track of your numbers. According to Spangler, the target blood pressure rate is around 120 over 80. Treatment would be required if those numbers rise to above 140 over 90.

Those numbers will fluctuate, she said, “depending on how active you are, what you’ve eaten, and the time of day it is.” So regularly taking your blood pressure will allow you to see consistent trends, and if it’s trending high, write down your numbers, what you were doing at the time, and take that information to your doctor for review. Sapkota suggests getting a kit that goes around the arm, rather than the wrist. “The wrist cuffs are extremely sensitive to body positions,” he said, “and might not give accurate readings every time.” When you put the cuff around your arm, hold your arm at the same level as your heart for the most accurate reading. He suggests that you don’t take your blood pressure right after drinking coffee or when you come back from a workout session – both things that will cause your numbers to spike. Instead, rest first for 15 to 30 minutes.

Some blood pressure kits will also monitor your pulse rate, or heart rate. Sapkota said normal, healthy heart rates will run between 60 and 90, depending on the person. If your normal heart rates runs closer to 60 and is now trending at 90, or vice versa, then it’s something you’ll want to talk to a doctor about. Sapkota said symptoms of an elevated and low heart rate include palpitations and dizziness.

Measure oxygen levels

If you are diagnosed with COVID or develop respiratory track or flu-like symptoms, an oximeter is a good tool to have on hand. Sapkota said they can be purchased at a drugstore or online. The device measures the oxygen saturation in the blood, and most also provide the heart rate. He said normal oxygen saturation is more than 90 percent. Anything below that, and he advises seeing a doctor.

Monitor blood sugar

A blood glucose checking kit can be purchased at a drugstore, and is especially a good idea for patients who are diabetic or pre-diabetic. Sapkota said a pre-diabetic patient can easily become diabetic by being less active. He suggests using the kit to check your levels each morning before breakfast. Normal levels, when fasting, is less than 126. If more than 126, or especially if it’s higher than 200, contacting your doctor is crucial. Just as concerning is if your sugar levels are running consistently below 90. Lower or high sugar levels might require medication adjustments.

Treat bowel irregularities and reflux

Wolcott said about 40 percent of Americans suffer from reflux, and much of the problem is diet-related. Skipping meals, he said, can create more acid and more pain, so “Don’t make excuses for not eating breakfast,” he said, even if it’s just a granola bar, yogurt, apple or orange. Avoid trigger foods such as chocolate, caffeine, nicotine, alcohol, and acidic dishes such as tomato-based foods.

“Perfection is not possible,” he said. “Just try to be moderate.”

If reflux is left go, it can eat away at the tissue in the lower part of the esophagus and could eventually develop into cancer.

One of the biggest mistakes people make, Wolcott said, is laying down on the couch right after eating dinner. For proper digestion, he said our bodies need about 30 to 45 minutes in an upright position after eating.

Common bowel irregularities are constipation and irritable bowel syndrome, which can be reduced by drinking plenty of water, increasing fiber in your diet, and staying active. He said over-the-counter medications such as Miralax and Metamucil can also help reduce the chance of bowel pain, bleeding, and potentially requiring a colonoscopy at an earlier age.

Protect your kidneys

For proper kidney health and to reduce your chances of developing a kidney stone, it’s important to drink lots of water. Signs of trouble could include feelings of dryness, dizziness, and tiredness. Wolcott said the amount of water a person needs may differ according to their body size. But a good way to know if you’re drinking enough water is if you have clear urine. Wolcott said it’s also helpful to reduce your salt intake as well as consumption of over-the-counter anti-inflammatory medications that could develop into kidney injuries. If you do take medications, take them with plenty of food and water, always follow the recommendations, and don’t take more than one type.

Reduce risk of dementia and Alzheimer’s

Reduce stress, stimulate your neurons, and stay active – these are keys to improving your mental acuity and preventing the onset of cognitive disease, according to Wolcott.

He suggests working on a new puzzle, or learning a new instrument or language. “The more active, the more benefits,” he said. A higher intake of olive oil and omega 3 fatty acids, such as those found in wild-caught oil fishes like mackerel and salmon, are also beneficial. You can maintain brain function by eating a more plant-based diet of fruits and vegetables, green tea, raw walnuts, and foods rich in vitamins B, C, D and E, he said.

On the other hand, foods that can actually precipitate cognitive disease are sugars, charred and deep-fried foods, and artificial sweeteners.

Care for your skin

During this time of year, many may experience seasonal dryness in their skin. Wolcott suggests buying fragrance-free lotions, and dabbing your skin after getting out of the shower, while you’re still somewhat wet. This will lock in the moisture and hopefully reduce your chance of cuts and skin infections.

Also keep in mind that skin cancer is common and can be avoided by regularly applying UV sun protection. Sapkota said it’s also important to be aware of any changes in your skin, such as new bumps, lumps or moles that are growing larger – at which point a doctor should be seen.

Care for your feet.

“No one should lose a foot from infection,” Wolcott said, “but it happens quite regularly.” That’s due to most people not paying attention to their feet and detecting problems such as open sores early on. This is especially something to pay attention to if you have lost sensation in your feet from diabetes or from an accident of some kind.

“Take a periodic look at your feet,” Wolcott said. “It will only take you a few seconds.

He urges making an investment in a “good part of supportive running shoes.”

Don’t smoke

According to Spangler, if you’re a smoker, quitting “is the single most important thing that you can do” to improve your health. If you are struggling to quit, she suggests buying over-the-counter nicotine patches.

It’s important to remember that though there are many things you can do to be proactive about your health, there are some things that still require those in-person medical visits. Spangler urges individuals to come when they need too and encourages them to find comfort in the fact that most doctors office are safe, since they are regularly cleaned and monitored.

Spangler especially emphasizes the need for regular screenings.

“There’s no way to do a mammogram at home,” she said, adding that it might be ok to put these regular checkups on hold for a month or two, but “a year might not be so good”.

Sapkota urges individuals to pay close attention to signs – alarms - that indicate an in-person medical visit is necessary. In addition to the watching signs of COVID complications these days, he said it’s also time to see a doctor if you see blood in the stool, or black stool that could mean bleeding in the colon or intestines. You should also see a doctor if you have blood in the urine, or pinkish urine.

In addition, Sapkota said, “If you’re losing weight unintentionally, like 20 pounds in three months, and you didn’t want to — it can be because of cancer or some kind of infection.

You can also regularly monitor your temperature that can help detect infections. Sapkota said infections can cause both high and lower temperatures. Anything more than 100 degrees or lower than 95 degrees, is concerning, he said.

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