Since the onset of the pandemic, local hospitals have streamlined care for patients in a variety of ways. Learn what local experts have to say about managing chronic diseases during this time.
Now that we’re months into the “new normal,” you’re probably empowered with the most prevalent, basic knowledge to mitigate health risks for yourself and others in your community. You’ve heard reiterations that you should wash your hands often, wear a face covering and practice social distancing.
If you live with a chronic health condition, such as cancer, heart disease or diabetes, you’ve probably also heard that you might be more at risk for complications to arise should you contract the COVID-19 virus.
And you may have asked these questions:
-Do I need to take extra precautions to avoid the virus?
-How am I supposed to get the care I need?
-How do I prioritize my health without sacrificing the joys of life?
With information updating constantly, these questions can be tough to navigate. For answers, we’ve turned to physicians from our region’s local hospitals.
Dr. Victor Medina
When it comes to oncology, the definition of chronic illness can vary.
But for the most part, cancer is considered chronic if it’s non-curable, and therefore a patient will likely need several services in order to maintain their quality of life, says Dr. Victor Medina, a hematologist/oncologist at Northwestern Medicine Huntley Hospital.
“Statistically speaking, the most common cancers we see in the United States within men are prostate, lung and colon. In women, it’s breast, lung and colon,” Medina says. “We’re able to manage many cancers relatively well for many, many years, but unfortunately, others don’t do as well. Just because a cancer is indolent or slow growing doesn’t guarantee a person’s going survive for a long period of time. Every patient is different, and you can’t generalize.”
Individualized care is the crux of Medina’s work. He doesn’t try to convince his patients to undergo certain chemotherapies or other treatments. Certainly, he aims to reduce the amount of cancer present within a patient, but he also takes into consideration their comorbidities age, and, most importantly, their wishes.
“You know, some patients want to be very aggressive, and others don’t,” Medina says. “The way I describe this process to my patients is that they’re essentially the boss. I’m here to provide them with education and treatment options, and I’m only doing my job correctly if they’re able to make an educated decision. It’s completely up to them.”
Now with COVID-19 in the mix, Medina’s patients are facing new challenges. Before the pandemic, depression and anxiety were already common side effects of chronic cancer treatment. Now, as patients comply with social distancing and other safety measures, mental health services have become even more crucial.
“At our cancer center in McHenry, we’re very lucky to have numerous resources available,” Medina says. “We have various types of counselors available, whether it’s a grievance counselor, spiritual counselor, or even a financial counselor. And we certainly have licensed individuals who are able to provide psychological assistance. We’re working on building up these services in Huntley as well, hopefully in the near future.”
It’s up to Medina to help his patients understand the facts. Since cancer typically suppresses a patient’s immune system, patients are usually at a higher risk for acquiring infections in general. So, especially given the current times, Medina recommends that his patients avoid large gatherings.
However, his ultimate goal is to respect his patient’s wishes and provide them with the best quality of life possible.
“I certainly have been in a scenario where a patient’s goal was to make it to their child’s wedding. And if that’s their goal, certainly we are going to respect that goal and their wish to attend,” Medina says. “There’s a lot that someone can do – social distancing, wearing a mask – and hand washing, without a question, is one of the most important things that you can do to prevent a potential infection. Some patients are incredibly compliant and don’t want to take any risk, but certainly, you can do a lot of activities in a safe fashion and enjoy your life instead of just being quarantined at home.”
Medina also emphasizes that everyone continue regular cancer screenings, such as mammograms, colonoscopies and other examinations.
“People shouldn’t be afraid to reach out to our facilities for these services,” Medina says. “I would be more than glad to speak with a patient if they have questions or concerns. Sometimes it’s just a matter of providing reassurance and education.”
“I feel very passionate about what I do,” Medina adds. “As you can imagine, receiving a diagnosis of cancer is detrimental, and at that point, someone can be at the lowest point of their life. But if I can do anything to extend their life, or potentially cure their cancer – it’s something that’s very touching to me. I am very willing to go out of my way to help patients as much as possible throughout their treatment regimen, and they deserve that. Every patient deserves that.”
Dr. Jeffrey Smith
It’s important for patients with chronic cardiovascular disease to remain especially vigilant of their health, says Dr. Jeffrey Smith, cardiac electrophysiologist at Mercyhealth and clinical associate professor of medicine at the University of Illinois College of Medicine-Rockford.
“First of all, people with cardiac disease are going to have a harder time surviving COVID if they get it,” Smith says. According to the Centers for Disease Control, patients infected with COVID-19 who have underlying cardiovascular disease have an estimated mortality rate of 10.5% compared to the average mortality rate of 3.8%.
“But second of all, there’s the indirect cost of the patient’s health from interruptions in their routine medical care,” Smith adds. “My biggest concern – patients with congestive heart failure need frequent monitoring, usually with office visits. If they don’t get that care, they can end up severely short of breath and in the emergency room.”
It’s important for cardiac patients to remain aware of their cholesterol and glucose numbers so that they don’t fall into the “danger zone” of nearing stroke or heart attack, Smith adds. Since the pandemic began, telehealth has played a huge factor in providing patients with appropriate medical care. During telehealth appointments, Smith can evaluate his patient’s overall health and look for early signs of decompensation, or heart failure, and even diagnose arrhythmias, or irregular heart rhythms, that may have developed since the patient’s last appointment.
Telehealth appointments are also an opportunity for patients to maintain accountability, Smith adds. In addition to seeking medical care for chronic conditions, patients can strive for a heart-healthy lifestyle by prioritizing exercise and a healthy diet.
“We have the opportunity to counsel them,” Smith says. “If patients aren’t seeing their doctors, and if they’re under stress because of what’s going on in the world, then they might not be following a good diet and exercise plan, or they might fall back into the habit of smoking or drinking again. Having contact with a caregiver, whether it’s now in person or by telehealth, helps reinforce the importance of being compliant with those lifestyle modifications.”
In addition to telehealth, another way for patients to receive socially distant care is to take advantage of Mercyhealth’s drive-through blood testing program at its Rockford-Riverside campus.
“It’s very important to monitor blood thinners, because if patients are skipping their blood tests, their blood could get so thin that they could have a severe bleeding complication, or the blood could gel up and they could have a stroke,” Smith explains. “So, now you can make an appointment to drive up and have your blood tested without even needing to get out of the car.”
Regardless of whether someone has a chronic heart condition or not, Smith reminds people that it’s always important to go to the emergency room if you’re experiencing chest pain, shortness of breath, or any sign of stroke, such as a facial droop, inability to speak or weakness on half of the body.
“In the first few weeks of COVID, hospitalizations for heart attack dropped by 40 to 50%,” Smith says. “It’s not because people weren’t having heart attacks, it’s because they weren’t going to the hospital. And some studies have revealed that out-of-hospital cardiac arrest rates went up around 25%. That’s probably because people aren’t coming to the hospital when they need to.”
“The bottom line is, it’s really important for patients to seek acute cardiac care if they have symptoms, and to continue their chronic cardiac care,” Smith adds.
Dr. Przemyslaw (Peter) Lastowiecki
For the most part, diabetes is an incurable condition, says Dr. Przemyslaw (Peter) Lastowiecki, endocrinologist with AMITA Health Alexian Brothers Medical Center, in Elk Grove Village. However, diabetes can be effectively managed for many years.
“For the patient, it requires lifestyle adjustments and sacrifices in terms of their time and effort,” Lastowiecki says.
Gradually, he helps patients to understand the impact of their lifestyle choices, particularly related to diet, exercise and medications. Like many other chronic illnesses, treating diabetes requires an individualized plan of action. If a patient exhibits signs of decompensation, Lastowiecki meets with them more often, sometimes once every one or two weeks. Typically, however, he sees his patients about once every three months to help keep them on a healthy track.
Goals may differ from patient to patient, but for the most part, Lastowiecki’s main long-term objective is to help his patients live longer and healthier. Unmanaged, diabetes can lead to various levels of complications, including increased risk of heart attack and stroke. Short-term, however, goals revolve around normalizing a patient’s glucose levels to make sure it’s as close to normal as possible on a day-to-day basis.
“Now, research shows over and over that scaring people does not work,” he says. “You could say, ‘Well, there are risks for kidney failure,’ and so on, but to really help the patient, you have to build a relationship with them and help them understand that it’s not going to be an immediate improvement. To convince people to do such sacrifices, it really takes time and effort.”
In the wake of COVID-19, Lastowiecki’s job now also involves encouraging patients to comply with safety guidelines, in addition to the support he gives in terms of a patient’s treatment regimen. Since diabetic patients are more likely to have complications should they contract the virus, Lastowiecki encourages his patients to be more diligent than the average person about implementing safety recommendations.
“The most effective recommendation is social distancing and avoidance of unnecessary contact,” he says. “So, I do advise my patients to avoid large gatherings, unnecessary meetings, and contact with people whose behaviors you cannot control, such as people who won’t wear masks, or people who won’t wear masks correctly. Thinking ahead and planning is the best strategy.”
Though he does see many of his patients in person, Lastowiecki can also effectively treat patients remotely via telemedicine. He’s willing to do whatever the patient is most comfortable with.
“There’s something intangible about interpersonal contact that I think is important, however, diabetes is probably the best example of a chronic condition that can be managed by telemedicine, since so much depends on interpretation of data,” Lastowiecki says. “A big part of being diabetic involves documenting your blood sugar – patients oftentimes keep track with an app on their phones – and interpreting this data is a substantial portion of my interactions with the patient. Since that can be done safely from remote interactions, telemedicine is well-suited for diabetes.”
One of the most empowering things Lastowiecki can do for his patients is to educate them in a way that’s both honest and empathetic.
“As the physician, it is extremely rewarding how, when dealing with chronic conditions, you get to build relationships that last for years, and very often decades,” Lastowiecki says. “It’s a marathon, not a sprint, and my approach to each patient will differ depending on the patient themselves.”