NAU's COVID-19 Policy
March 21, 2020

Prescribing Netflix: Dr. Brennan, an ER physician, shares on how to best respond to COVID-19

Speaker 1: 

Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Donna Lee: 

Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee. I am Donna Lee. Dr. Mistry is off today, so we have in our partner, Dr. Chris Yang. Welcome back.

Dr. Yang: 

Hey, great to be here.

Donna Lee: 

You can reach us during the week at (512) 238-0762 as always. Our email addresses armormenshealth@gmail.com. So send us those questions, but we also have Dr. Brenner back, so we want to continue the discussion about what to do right now in Austin, Texas.

Dr. Yang: 

So Dr. Brenner, if you missed the last segment, he’s an emergency department physician here in town. We talked briefly last segment about which patients should not come to the emergency room. Dr. Brenner, which ones should come in?

Dr. Brenner: 

So this is when it gets more gray. If, again, mild symptoms probably can weather the storm at home, but if you are having high fevers, lethargy, just absolutely zapped of energy, and most importantly, chest pain or shortness of breath, particularly to the point where you’re maybe a little bit confused, things aren’t seeming like their normal selves, you’re acting a little bit differently or a family member or loved one, friends are acting differently–that absolutely needs to go to the emergency room, immediately needs to be evaluated. If it’s a moderate fever, 101/102 which responding to Tylenol, you’re kind of in a gray zone. If, but if you are at the point where you’re really short of breath, you feel like you’re breathing fast, you feel like you can’t catch your breath, drenching sweats, it’s probably time to get to the emergency room and relatively quickly.

Dr. Yang: 

So high fever, we’re saying more than 102 Fahrenheit, you should definitely come in?

Dr. Brenner: 

Again, the gray area. 100.4 is sort of the cutoff for what we consider a true temperature, but if you are in the 102/103/104 range, you’re getting into a pretty uncomfortable zone. Now, if the temperature is responding to Tylenol, and you take your Tylenol every 4 to 6 hours and your temperature goes down to 98/99, you really feel fine when you’re on the Tylenol, you’re eating fine, you’re drinking fine, you feel like you’re breathing fine, you’re just feel sick–you’re probably going to be fine. If you’re at the point where you are gasping for air, if you are just really feeling like you’re having a horrible sensation in your chest, chest pressure, chest discomfort, you need to get evaluated, we need to make sure there’s not a pneumonia cooking on top of this virus.

Dr. Yang: 

Now, you know there’s a lot of talk right now about washing your hands. What’s the proper way to wash? Do you need to have the alcohol base wash? Do you need to have the hand sanitizers?

Donna Lee: 

Do you sing the alphabet?

Dr. Brenner: 

20 seconds is the magic number. This is per Dr. Sanjay Gupta who is, you know, everybody’s favorite television doctor.

Dr. Yang: 

Except for Grey’s anatomy maybe.

Dr. Brenner: 

Well, certainly–that goes without saying. So a good 20 seconds and a good antibacterial soap is probably just fine for hand washing. These can be picked up any pharmacy, any Walgreens, CVS, any grocery store, there is certainly going to be a run on them. But those are typically just fine. The anti bacterial hand sanitizers, couple of drops. You don’t need to soak your hands. You don’t need to run all the way up to your elbow. The most important thing for hand washing is make sure you get under your fingernails in between your fingers and don’t forget to do the thumbs.

Donna Lee: 

I didn’t think about that.

Dr. Yang: 

Yeah. And we don’t want people to be making their own hand sanitizer–that’s definitely a no no.

Donna Lee: 

Is that a thing?

Dr. Brenner: 

Oh, it’s very much a thing.

Dr. Yang: 

And so I saw that some of the perfume houses in France, they were changing their production over to make hand sanitizer.

Dr. Brenner: 

So are some of the distilleries.

Donna Lee: 

So what else do we need to know, Dr Brenner? We got lots of people scared of there to stay calm.

Dr. Yang: 

Yeah, I had a question for you. You know, there’s been a run of on toilet paper, as everyone knows. Is there a reason for that?

Dr. Brenner: 

Yes, because people are insane.

Dr. Yang: 

Okay.

Dr. Brenner: 

And that is clinical.

Dr. Yang: 

Okay. Well, outside of clinical insanity–diarrhea, is there…are there GI symptoms from Corona Virus?

Dr. Brenner: 

This is actually kind of the new hot topic, as some patients have been presenting with very mild symptoms for in terms of fever, in terms of cough, but have been having some GI symptoms and diarrhea included, and it’s often times the presenting symptom, the first thing to show up. If this is the case, this is probably a very mild case of Corona, which is obviously good news. But in terms of stocking up for toilet paper, it still doesn’t justify it at all.

Dr. Yang: 

And people who just have mild diarrhea, they should not be coming to the emergency department, correct?

Dr. Brenner: 

There is literally zero scenario in the universe where someone with mild diarrhea should ever come to the emergency department. I said, I was going to say come to the [inaudible]…correct. They’re just, it’s unfathomable to me how many people, regardless of what’s going on right now, who will show up to the emergency room with a very mild stomach ache, upset stomach and/or diarrhea.

Donna Lee: 

They’re just freaking out?

Dr. Brenner: 

Correct.

Dr. Yang: 

Okay. Now, if someone has pretty bad anxiety, you know, because of all of that, because of people fear-mongering on the internet and you know, not here on this radio station, but other places, you know, what should they do?

Dr. Brenner: 

The most important thing is to take a deep breath when you’re 10 feet away from people and just try to let your rational mind take over. Everybody is amped up right now. Everybody’s running in the red, and panic just makes it that much worse. If you listen, depression and anxiety, mental, any type of mental disorder is a very real thing, and it still has to be treated. But you must do your best to stay calm. Let your condition not manifest itself to make other conditions worse. That being said, if call your doctor, call your psychiatrist, call your social worker, call your counselor, your psychotherapist, whoever–talk to them and they will quite literally get you over this hump.

Donna Lee: 

Mhmm. Get you some help.

Dr. Brenner: 

Correct.

Dr. Yang: 

Yeah. I think one thing that you know, I want to stress is that there’s a lot of people online, you know there’s a lot of people on the radio, who are saying things that aren’t correct. And I think if people want to go to a reliable source, you know the CDC, the Centers for Disease Control and Prevention, their website has guidelines for patients. They have, you know, accurate information for patients. That website is cdc.gov, and that’s a pretty good accurate place to get information about Coronavirus.

Dr. Brenner: 

Couldn’t agree more. And then I would also say that the statistics you see, the numbers, you see the death rates, the mortality rates–to basically just ignore those. All the numbers, all the data that’s coming in, is still in its infancy, and the numbers just are not accurate. They’re not portraying exactly what’s going on. So, I mean, watch the news, get your information, but understand that they’re reporting purely based on that day’s data, which will change it just–exponentially–24 hours from now, a week from now, two weeks from now…So take it all with a grain of salt. And the most important thing is to just take care of yourself. Yes. Stay calm, take care of yourself, wash your hands, stay–social distancing is a good practice. Don’t do anything insane. Don’t start licking handrails or door knobs…

Dr. Yang: 

…or ice cream.

Dr. Brenner: 

Yeah.

Dr. Yang: 

Sounds like a terrible movie.

Dr. Yang: 

You know, look out for your neighbors. You know, don’t go coughing into their rooms, but you know, if they need help getting groceries, if they need help, definitely offer some help.

Donna Lee: 

Right? We talked about that earlier, too, with Dr. Abikhaled. There’s all those apps now, the neighborhood apps and you can jump on and help your neighbor out.

Dr. Yang: 

There’s a thing, there’s a phrase that’s been out there a lot called “flatten the curve.” You know, what does that mean?

Dr. Brenner: 

So this is a sort of a colloquial, epidemiological term, and it’s the pretty important for disease control. Right now, because we were testing so bad and just inefficiently and just overall lack of testing, it looks like this virus is raging out of control. The actual curve of it is an exponential curve of positive cases. So from a couple a day, to 10 a day, to 100 a day, to 1,000 a day, and it just looks awful. “Flattening of the curve” refers to limiting continued viral expansion, and instead of 1,000 new cases a day and 5,000 next day becomes 1,000 a day, to 1,000 a day, to 1,000 a day. And then subsequently will start to dip. And if you can control spread with the techniques we discussed, you can quote unquote “flatten the curve.”

Donna Lee: 

Yeah, Dr. Abikhaled had mentioned that as well earlier, so I’m sure you can Google more information. What was the website again? CDC…

Dr. Yang: 

Cdc.gov.

Donna Lee: 

Gotcha.

Dr. Yang: 

All right, so we only have a couple minutes left. Why don’t we put out kind of the most important information. Dr Brenner, which patients should go to the ER, which persons should not?

Dr. Brenner: 

Most importantly, go to the ER–trouble breathing, confusion, severe chest pain, high fever (101/102/103/104) that’s not responding to Tylenol…go to the ER. Number one most important thing to do is go to the ER. If you have a low grade fever, 99/99.5, a little headache, little cough–do not go to the ER. If you’re confused, call your doctor. If you want some more clarity, check in with your healthcare provider. But if it’s very mild symptoms, just assume you’re positive, lockdown for 2 weeks, fire up the Netflix and stay home.

Donna Lee: 

I hate that this is going on, but I kind of want to just go home and watch Netflix for 2 weeks. Is that okay to say out loud?

Dr. Yang: 

Yeah.

Donna Lee: 

Really, I hate that this is going on, but I just want to watch Netflix.

Dr. Yang: 

Next week will be from Donna’s house.

Donna Lee: 

We have a little makeshift studio. We’re just going to set right up. Awesome. Well that was really informative. I know there’s tons of information out there, but like we said, go to the proper source, and don’t go to Facebook. I went to Facebook earlier and it was just craziness.

Dr. Brenner: 

Yeah, don’t go to Facebook.

Donna Lee: 

I mean just living in Austin is just crazy. So, learn your information, know your information, don’t panic and I appreciate you guys so much. It’s been a fast hour that went by, so if anybody has any questions for Dr. Yang or Dr. Brenner, you can email us during the week at armormenshealth@gmail.com. That’s armormenshealth@gmail.com. Our website is armormenshealth.com. Thank you guys so much for this hour wrapping up with us. I appreciate it.

Dr. Brenner: 

It was great. Thank you.

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Well, y’all have a wonderful rest of your day and tune in when you can! Thanks so much. Have a great day.

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The Armor Men’s Health Hour is brought to you by Urology Specialists of Austin. For questions or to schedule an appointment, please call (512) 238-0762 or online at armour men’s health.com.

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