World
New Cases: 401,420 (⬆︎ .23%)
New Deaths: 8,565 (⬆︎ .22%)
USA
New Cases: 13,389 (⬆︎ .04%)
New Deaths: 393 (⬆︎ .06%)
Yesterday, June 18th, 2021
0 Vaccinated people
and
8,565 Un-Vaccinated people
were killed by COVID-19
176.3 million vaccinated
Including more than 148.5 million people who have been fully vaccinated in the United States.
In the last week, an average of 1.36 million doses per day were administered, a 22% increase over the week before.
"Back to normal" is an umbrella phrase that's going to be around for a while, and there's no telling what all it's going to entail.
And (I guess weirdly - ironically?), now that we're breaking through to the other side of the worst healthcare problem in a hundred years, there's a boatload of health issues we have to tackle, not the least of which is just how to go about talking to our clinicians about what's been going on since the last time we were able to see them.
Here in USAmerica Inc, we've never been all that good at being patients - our fucked up Demand-Based system is chock full of incentives that keep people away from their doctors - but now we have a shot at learning how to deal with our shit a little better.
The good news is that the pandemic has given us the perfect excuse. We can blame every little failing on our noble self-sacrificing efforts to stem the tide of the plague and blah blah blah.
And the bad news is exactly the same - we have a convenient excuse for everything.
All of which could mean we get to start over with a clean slate - tabula rasa, baby - which is also kind of an American thing.
We build it up - we fuck it up - we tear it down - we start again.
File it all under "Hopeful But Not Optimistic" - as usual.
How to make the most of your first doctor’s appointment in a while
Now that coronavirus pandemic restrictions are easing up, people are madly scheduling in-office doctor’s appointments that they had put on hold for a year or longer. That puts great pressure on you and your doctor to catch up on your health status, which may have changed while you were doing your best to live through an unprecedented challenge. Given that the average doctor’s appointment is only about 20 minutes, you’ll want to make every moment of your allotted time count.
Here are eight tips to help you get the most out of your in-person doctor’s appointment:
Ask for a longer appointment. If you have a lengthy list of symptoms and concerns to address, tell the receptionist that you have a lot to talk about, and that you’d like an extended appointment. “I think that’s very appropriate, especially coming out of the pandemic,” said Michael Hanak, an associate professor of family medicine at the Rush University Medical Center in Chicago.
Another option, Hanak said, is to ask if you can schedule a virtual visit first — “almost like a planning visit so you can make sure there’s time for the most important issues during the in-person visit.”
Take care of what you can ahead of time. Find out if there are any blood or imaging tests you can have performed before the appointment so that you can discuss the results during the visit, Hanak said. You may have several screening tests — breast, skin, or colon cancer, for example — to catch up on. A study found that from March 11, 2020 through May 21, 2020, the average weekly volume of imaging procedures declined 54 percent at Massachusetts General Hospital and 64 percent at its affiliated imaging centers; mammograms were the largest drop — 92 percent at all the locations.
If you can’t get all your screening tests done before the appointment, don’t sweat it; you can follow up on the results later, if necessary.
Record your latest health info. Use the patient portal to update the list of medications you’re taking — including prescription and over-the-counter drugs as well as vitamins and nutritional and herbal supplements — so that you won’t need to spend valuable time during the appointment doing this.
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If you take medication for hypertension or have diabetes, measure your blood pressure or blood sugar regularly in the days and weeks leading up to the visit and track the numbers in a log that you can take with you, advised Hiten Patel ofOhio State University Wexner Medical Center in Columbus. This way, your doctor will get a sense of how these conditions are trending over time, rather than simply getting a status snapshot during the visit.
Prioritize your issues. Before you go to the appointment, create an agenda and identify the top three to five concerns you’d like to address with your doctor, then start the conversation with those items, advised family physician Lou Edje, associate dean of graduate medical education at the University of Cincinnati Medical Center. “It’s usually while the doctor has a hand on the doorknob and is about to leave that the patient brings up the issue they really want to address because they had to build up to it,” Edje said. “Be explicit about why you’re there and what your chief complaints are.”
If a problem — such as incontinence, vaginal dryness or erectile dysfunction — is embarrassing to you, write it down and hand the paper to your doctor, who will lead the conversation from there. If you don’t get to all of your concerns during the visit, ask the doctor whether you should schedule a follow-up or if you can discuss the issues through email or the patient portal.
Be specific about what you’re experiencing. When describing a particular symptom, be sure to tell your doctor how it feels, when it started, what makes it better or worse and how it’s affecting or interfering with your life, said Donna Zulman, an assistant professor of primary care and population health at the Stanford University School of Medicine. Don’t limit your report to physical symptoms: In recent months, “many people have experienced mental health symptoms such as depression and anxiety and some are reluctant to bring those up,” Zulman noted. Your physician wants to help you so it’s best to engage in full disclosure, especially because “these are issues that affect other aspects of your health,” she said.
Be honest about your lifestyle habits. In particular, describe how your diet, your use of alcohol and caffeine and your exercise regimen have changed since the pandemic began. It’s important for your physician to be aware of how these practices may have evolved over the past year because they can influence your health risks and conditions in many different ways, Hanak said.
Don’t be embarrassed if you’ve been eating more or exercising less; you’ll be in good company on this front. Research has found that especially early in the pandemic, people’s intake of high-calorie or salty foods, screen time and use of tobacco, alcohol and cannabis increased considerably. Meanwhile, one study released this year found that the pandemic stay-at-home orders led to a decline in physical activity, while another found that participants had gained an average of 1.5 pounds per month they were sheltered in place.
Make sure you understand what you’re being told. Bring a pad and paper to the appointment so that you can take notes — or ask a family member or friend to accompany you and perform this task. If you don’t understand something your doctor says, ask clarifying questions until you get the picture. In particular, make sure you understand the diagnosis, including your doctor’s recommendations for treating it and why they’re important, Edje said.
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Review your doctor’s advice about medications, additional testing and lifestyle changes. Then “repeat back what you’ve heard to make sure you’re on the same page,” Zulman said. This last step is part of the “teach-back” communication technique, in which a clinician asks a patient to express in their own words the information they just heard. A 2017 study examining the quality of communication with parents in pediatric clinical encounters and found that the teach-back technique was associated with more patient-centered communication, which enables the patient, or parent, to make informed decisions about whether to act on the information that’s presented and how.
Formulate a follow-up plan. Before you leave the doctor’s office, discuss how you’ll implement any recommended changes, what you can do to prevent a chronic condition from worsening, and whether you need any follow-up lab tests, imaging procedures or visits to a specialist or therapist.
“Every visit should end with some piece of anticipatory guidance such as when you should touch base again or what red flags to watch for,” Hanak added. Following up with your doctor should be easier than in the past, he said, with the options of virtual visits or phone-based visits. “One of the silver linings of the pandemic has been opening up other areas of access for health care.”
