April 8, 2020 – Spring began a few weeks ago and – particularly after this past weekend – it became clear it was time to say Goodbye to Three Girls on a Sled whose carefree ride in the snow takes us back to a time before we had ever thought much about coronavirus and COVID was NO-VID.
Typically, our spring banner includes outdoor, spring activities (duh), but Young Girl and Online School seemed – given our present circumstances – to be a better fit.
[Aside: Of course, if your home is more like mine, this picture would need to include another, younger sister and some dispute about one of them “breathing too loud” and a father – numb to the sibling conflict – working feverishly to be sure the WiFi will produce enough bandwith for school and his office’s Zoom meeting that is scheduled to begin now.]
If you had some pressing things you wanted to discuss at a well visit that is on the delayed list, consider scheduling a TeleHealth visit (see below)
All sick child care was moved to the Brier Creek office – with a few twists:
Twist #1 – Curbside clinic was initiated for children with symptoms suspicious of possible coronavirus
Twist #2 – TeleHealth visits are becoming our new normal as a way to safely evaluate patients without the fear of increasing potential exposures
All RCAM staff are now wearing masks and gloves – at both offices – add to that lots of hand washing and not touching your face and cleaning rooms after every patient
All of these changes were made to be as safe as possible yet still available to our patient families, to reduce exposures, and to slow the spread of coronavirus / COVID-19.
TeleHealth Visits have some limits though I am surprised at how typically they can identify something treatable or rule out the need to come to our office or the Urgent Care or the Emergency Department.
He hit the ground running. Brian would probably describe it more like a chase – as in it felt like he was being chased by a lion – as his first week on the job was highlighted by a pandemic.
Brian has been great. More about him later, but it is about time we introduced him to our extended RCAM-ily.
If you see someone in our office wearing a tie that doesn’t feature Sponge Bob (Dr. Sena) – that is more than likely Brian – give him a big Hello and Welcome.
Given the circumstances of his first month, he could probably use the encouragement.
I am sure that everyone could use some encouragement.
The response of our administrative staff and nurses has been spectacular. The general day-to-day pressure on a pediatric staff is underrated, and now they quite suddenly have found themselves on one of the front lines of a pandemic.
They have handled some tough circumstances with a lot of grace and professionalism.
As pediatricians, we’ve had to work together even more than we usually do – Zoom meeting almost daily – making new plans and changing protocols that we just wrote. We have found another gear with how we work with and relate to one another and personally that has been great.
Patients and their families have even asked if they can help.
We have been gifted at least one box of N95 masks and numerous homemade masks.
Finally, the Raleigh pediatric medical community really stepped up. Specifically, Oberlin Road Pediatrics and Carolina Kids Pediatrics both sought us out directly. As it turns out, we didn’t need the help, but it meant a lot to hear from them, and we hope to return the favor sometime.
That’s how we’re all going to get through this – finding ways to help each other out.
Epilogue: Somewhat Related
For anyone still reading this, I had this post all ready to go late Sunday night.
I saved it to my computer and walked upstairs to say good night to my daughters.
When I returned, my screen looked entirely different.There were characters I had never seen before – and about 80% of my original post was completely gone. I tried to pull up the post I had saved, yet somehow that had been updated to the now-80%-gone post.
Sitting two feet away from me was the cause: Buddy, our orange tabby cat.
He has a penchant for getting comfortable in odd places – for example, he loves climbing and lying on top of backpacks.
He is also well known in our house – as pictured here in what I call “Exhibit A” – for getting comfortable on my computer keyboard.
The post finally got done and I believe I have been forgiven for the words that came out of my mouth that night.
Happy Easter to everyone!
Try to enjoy what you can about being locked down with people who are likely pretty important to you – and try to ignore all of their loud breathing.
“CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.”
We wish our office could offer all patients a mask but supplies are limited. Therefore,,,,
…RCAM is asking families who come into our office to bring their own masks if at all possible.
There is a lot of information available online about how to make and use a mask.
March 22, 2020 – The Wake County Health Department this weekend gave RCAM the go ahead to open both offices.
Therefore, we will open at 10:00am on Monday morning after finishing some office cleaning (after Monday we will open at our regular time each day)
We will continue operating similar to our previous pandemic plan but with a few twists that include the addition of TeleHealth Visits.
Sick Child Care:
1-Nurse Phone Triage
If you have a concern about your child – like usual – call the office and our front desk will take a message and one of our nurses will call you back
If our nurse can’t help you, she will schedule you to see one our doctors for an online TeleHealth Visit
2-Nurse Triage to TeleHealth Visit
As described in earlier posts, this is a video chat with an RCAM pediatrician who will use methods available to them at that time to assess and make recommendations about how best to treat your child
The TeleHealth Visit is proving to be very important in our effort to limit our patients’ exposures
The TeleHealth Visit typically ends with the pediatrician’s plan for treatment
In cases where the pediatrician decides that the patient will need an in-person assessment, they will be scheduled to be seen in the Brier Creek Sick Clinic or the Brier Creek Curbside Clinic.
[NOTE: You may schedule a TeleHealth Visit without talking to nurse first; just call and ask for a TeleHealth Visit]
3a-Nurse Triage to TeleHealth to Brier Creek Sick Clinic
All sick care will be seen at Brier Creek
3b-Nurse Triage to TeleHealth to Brier Creek Curbside Clinic
All acute illnesses with cough and or fever will be seen curbside in your car
Well Child Care:
1-Urgent Well Child Care
The RCAM pediaricias feel like these are the well visits that should be completed as close to regular schedule as possible:
Children under two years old who need vaccines
The 4 or 5 year old who needs vaccines
2-Non-Urgent Well Child Care
All other well child visits are considered non-urgent and could be put off for now
TeleHealth EXCEPTION: if you have a concern that often gets discussed at well visits – things like sleep problems, constipation, focus issues, anxiety, etc., a TeleHealth Visit can be scheduled. Because that is done online via a video chat, it can be done at just about anytime.
3-Follow-Up Visits for Asthma, ADHD, Birth Control, Anxiety, Depression, etc.
These visits would be scheduled as a TeleHealth Visit
Thanks for hanging in there with us.
Having our clinic shut down due to an individual with an indeterminate result was a bit jarring. We support our health department wholeheartedly though and admire the important work that they are doing right now.
We are all in this together, and your child’s health and safety are our number one priority.
March 18, 2020 – Today we just learned that an individual who was in our Duraleigh office between March 12th and March 17th may have coronavirus disease 2019 (COVID-19). This individual’s test came back inconclusive, so we can’t say for sure.
It is not likely that any patient or family had prolonged contact with this individual, but out of an abundance of caution, upon learning of the possibly positive test, we took the following steps:
We immediately closed the Duraleigh Office.
We contacted the Wake County Health Department regarding next steps.
The Health Department was given a list of individuals who may have been exposed.
Employees with significant contact with this individual have been placed on a 2-week quarantine.
We are contacting a professional service to perform a deep clean of the Duraleigh office to eradicate any possible viral particles that could be presnt.
We will be contacting patients who were in the office at the time that this individual was present. If you do not receive a call, then you were not in our office at the same time as this individual.
From the time it became apparent that COVID-19 would be an issue for our community, the pediatricians at RCAM have been in almost constant dialogue about how best to meet the needs of our patients.
We stopped our walk-in appointments so that all potentially ill patients coming spoke with a nurse to determine the best and safest way to be assessed. We moved all well care to our Duraleigh office. We moved all sick care to our Brier Creek office and for patients at particular risk for COVID-19, we instituted a “Curbside Clinic” where patients could be evaluated and in some cases tested while still in their car.
The Brier Creek sick clinic and “Curbside Clinic” are both still operating and we hope to have the Duraleigh office re-open very soon.
We will not re-open before we have taken the necessary steps – patient’s and their family’s safety is just as important as being open and available..
This situation is unprecedented at RCAM, and, this weekend, the pediatricians of RCAM have made some unprecedented adjustments regarding how RCAM will operate during this pandemic.
…We are OPEN and operating at our typical capacity – just some changes to the flow of how we do things to keep things as safe as possible for our patients.
No walk-in appointments
Well children appointments will be seen at our Duraleigh office
Sick children appointments will be seen at our Brier Creek office
To further limit exposures, children being assessed for coronavirus disease will be evaluated in their car at the Brier Creek office
MORE DETAIL / EXPLANATION:
1. No Walk-In Appointments at Duraleigh and Brier Creek Office
All walk-in appointments are suspended until further notice
For the time being, it is important that we speak to you directly to set up your appointment
ALL office visits will be by appointment only
2. Only Well Children Will Be Seen at Our Duraleigh Office
Well visits will by appointment only and only at the Duraleigh office
Most follow-up visits, medication rechecks, well ear rechecks, etc. can be seen at the Duraleigh office as long as the patient is well
Sick individuals may not accompany the well check (no sick siblings; no sick parents; everyone in your party needs to be well)
3. Sick Children Will Be Evaluated at Our Brier Creek Office
Sick children would include any acute (short-term), infectious illness
Also, any illness with fever (temp of 100.4F or more) or cough
It will also include anything that can look similar to that (and that may include something that may also look like seasonal allergies)
4. Children Being Assessed for Coronavirus:
All visits are by appointment only
We will attempt to get as much medical information by phone
These patients will be evaluated at Brier Creek while they are still in their car
These patients should not enter the Brier Creek building (or the Duraleigh building)
A Word About Testing For COVID-19
Test availability is limited
Because of limited testing, we will only test when it is clinically necessary
There has to be One Final Word…
We are going to do our best to help your child. Everyone is a little more distracted with all the news and all the changes out there. We have committed to being patient with each other and patient with you.
We appreciate the good will that you extend to us – to our administrative staff, our nurses, and our physicians.