Build a Strong Relationship with Your Doctor

You’ve waited several weeks to see your doctor, but after you leave the office you still have questions, and you don’t quite understand your diagnosis. If this sounds familiar, it’s time to improve your relationship with your physician.

A good patient-physician relationship can go a long way in helping you stay healthy — and getting the care you need when you’re not feeling well.

“Patients who take an active role in their care may not only feel more satisfied with their doctors, but also more in control over their own health and well-being,” says Rebecca Shragge, DO, an internal medicine physician at Scripps Coastal Medical Center Hillcrest.

Communication, respect and trust are keys to any healthy relationship. And the relationship with your health care provider should be no different. Here are eight ways to help you build a good patient-physician relationship and get the most out of your appointments.

1.   Be prepared for your appointment

Take a few minutes to prepare for your appointment with your physician so you can make the most of your time together. You may be able to message your concerns ahead of your appointment through a patient portal.

Common questions to consider include:

• Do you have a new symptom you want to discuss?

• Do you want to go over how a treatment is affecting your daily life?

• What side effects are common with a particular medication you are prescribed?

• Do you need vaccines, including the flu, pneumonia or shingles?

“Before your visit, make a list of your symptoms and how long each has been present,” suggests Dr. Shragge. “Write down what medications you’re taking, including vitamins and supplements, and the dosages for each.”

 If you need lab work or other tests, get them before your appointment so you and your doctor can go over them together

2. Prioritize health issues to discuss

Start your discussion with your physician with the most important health issue or question on your mind.

“Don’t put off things you really need to discuss until the end of the visit. Bring them up right away,” says Dr. Shragge.

3. Follow COVID safety precautions

Be prepared to follow COVID safety protocols before entering the clinic and at the doctor’s office, including wearing a face covering and physical distancing.

At Scripps, all physicians, staff members, patients and visitors are required to wear face coverings. Scripps also offers curbside check-in as an additional safety measure so that you can remain in your vehicle until an exam room is ready for your visit.

4. Bring a companion to your appointment when necessary

Bring a friend or loved one with you, especially if you feel like you have trouble retaining information or you are discussing something serious like cancer or heart disease. Be aware of any visitor restrictions in place due to COVID-19.

“Bringing a friend or family member along can be extremely helpful when it comes to asking questions and clarifying information, especially for older patients or anyone who is nervous about seeing the doctor, or someone who needs a language interpreter,” says Dr. Shragge.

5. Be honest with your physician

Your lifestyle and daily habits impact your health, and the information you share with your physician is confidential so be candid. If you are not honest about things, such as smoking or having a couple of cocktails daily or occasionally skipping your medications, your physician won’t have accurate information, and that can impact your care.

“Let your doctor know what has happened in your life since your last visit,” says Dr. Shragge “For instance, mention any changes you have noticed in your appetite, weight, sleep or energy level.”

Don’t feel embarrassed. Your doctor isn’t perfect, and he or she doesn’t expect you to be either.

6. Be sure you understand your care plan

Before you leave the doctor’s office, make sure all your questions have been answered or if you need to schedule a follow-up visit. Have a clear understanding of everything your doctor has told you about your condition and what you need to do, such as getting lab tests, taking medications and caring for yourself at home.

“If you’re not quite sure about something, don’t hesitate to ask for clarification before you leave,” says Dr. Shragge. “If you have questions once you get home, contact your health care team by calling the office or using an online patient portal to leave a message.”

7. Communicate with your physician, use patient portal

Many health care organizations offer patients a secure health portal in order to communicate with their physicians and manage their health records.

Scripps Clinic and Scripps Coastal Medical Center patients can use MyScripps, the online patient portal where you can check test results, schedule appointments, review your medical history and leave messages for your physician.

8. Follow your care plan

Follow your individualized care plan to get results and monitor progress. Your care plan may include tasks such as monitoring your blood sugar, getting more exercise or taking your blood pressure.

If a physician’s recommendation doesn’t sound doable or your medication isn’t working, let them know so you can re-evaluate and make adjustments to your plan.

Cardiff-by-the-Sea Ocean View Rentals

By: Cardiff Vacations

Cardiff-by-the-Sea is a beautiful, beach community, an independent part of the city of Encinitas, where you can find good vibes, great surfing spots, and many other fun local attractions. Cardiff has the perfect blend of relaxation and entertainment, being located in a serene natural location but still close to the city of San Diego (only 20 minutes away), where you are sure to find enjoyment for all tastes. 

Located in Cardiff-by-the-Sea, you will find Cardiff Vacations’ modern yet classy ocean view properties, ready to offer you the best vacation experience in the San Diego area. Owned by Alison and Julio Sanchez, the properties have an inspiring story of becoming what they are today. Before they become vacation rentals, they were Alison’s childhood home. When Alison’s mother got sick the couple moved in with her to care for her. When she passed away Alison and Julio had to decide what to do with the properties and, as there were so many memories tying them to this place, they decided to not sell, but renovate and rent them so that other people can get a taste of Cardiff’s magic.

At Cardiff Vacations, you can choose from three beautifully renovated villas: the Parkhouse, the Penthouse, and the cozy Seacottage. No matter which one you choose you are bound to have an amazing experience. The properties are fully furnished and equipped with everything you could need, including cooking utensils and some spices, so you don’t have to worry about a thing and fully enjoy your stay and explore all the local attractions. And the best part, the homes are located within walking distance to the beach and other major local attractions. 

The great perks of the properties include outside decks that offer some of the most amazing ocean views, where you can relax by the firepit, enjoy a glass of your favorite drink, let go of any stress and fully relax.  

Other features that will make your vacation even better:

• quartzite stone island and countertop with seating for 6

• luxurious bathrooms

• casual chic décor

• Turkish cotton towels

• the deck is furnished with an outside table, a grill, and a couch

• modern lighting & furniture

• washer & dryer

• free wi-fi

If you are planning a vacation to the sunny coast of San Diego, Cardiff-by-the-Sea is definitely a destination to be considered. If you would like to know more about the area and how to plan your vacation days to get the best out of your time here, check out Cardiff Vacations’ daily vacation planner for the latest events in the area and the most interesting attractions you can find here.

Can Loneliness Lead to Chronic Health Issues?

By: Scripps Healthcare

5 tips to combat loneliness and social isolation and boost health

For almost a full year, fear of the COVID-19 virus kept many people around the world confined to their homes, only interacting with colleagues, friends and relatives by phone or video. While the lockdown may have been necessary to reduce the spread of the virus, it contributed to the rise of two other significant health conditions: social isolation and loneliness.

These conditions are not the same, though they may be related. Social isolation is a lack of social contact with others, while loneliness is feeling alone or disconnected with or without social contact. Social isolation can cause some people to feel lonely, but even people who socialize often can feel lonely if their relationships are not satisfying or fulfilling.

The Centers for Disease Control and Prevention (CDC) says that both are public health risks that affect a significant number of people in the United States, especially older adults. One report found that more than one-third of adults age 45 and older feel lonely, and nearly one-fourth of those age 65 and older are socially isolated. Older adults are more likely to live alone, and factors, such as retirement, hearing loss, decreased mobility and illness, can limit their interactions with others.

Emotional pain can cause physical illness

Loneliness and isolation can lead to significant emotional and mental health issues; along with feeling disconnected, people experiencing loneliness may find it hard to trust others or may feel threatened. Like physical pain, emotional pain can activate the body’s stress responses. Over time, this can result in chronic inflammation and reduced immunity, which can raise the risk of chronic diseases.

“Research has linked social isolation and loneliness to higher risks for serious health conditions including high blood pressure, heart disease, stroke, obesity, depression, and anxiety,” says Michael Pham, DO, an internal medicine physician at Scripps Coastal Medical Center Carlsbad.

According to the CDC:

• Social isolation significantly increased a person’s risk of premature death from all causes.

• Social isolation was associated with about a 50% increased risk of dementia.

• Poor social relationships characterized by social isolation or loneliness were associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.

• Heart failure patients who experienced loneliness had nearly 4 times the average risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.

In addition, loneliness was associated with increasing depression, anxiety and suicide among both older and younger adults. In a June 2020 study, symptoms of anxiety, depression, substance use associated with COVID-19 and serious suicidal thoughts in the previous 30 days were most commonly reported by those ages 18–24.

5 tips to combat social isolation and loneliness

If you’re feeling isolated or lonely, or know someone who is, it’s important to take action to help prevent negative physical and emotional effects. Studies show that people who engage in meaningful, productive activities with others experience better moods, have a sense of purpose and tend to live longer. These tips can help alleviate isolation and loneliness:

1. Make self-care a priority. Exercise, eat healthy meals, get enough sleep and try to spend time outdoors every day.

2. Make an effort every day to connect with family or friends in person, over the phone, by text or online. Go for a walk with a friend or neighbor or play games together online.

3. Find an activity that you enjoy. Join an online book club, take a class or join a group that shares your interest. Check with your local community center or faith-based organization for options.

4. Consider adopting a pet if you can. Caring for a companion animal can be rewarding and comforting and can lower stress and blood pressure. If you can’t have a pet at home, look into volunteering at a local shelter or pet-sitting for a neighbor.

5. Volunteer at an organization that is meaningful to you. Becoming involved with a cause can ward off feelings of loneliness and help you meet people with similar interests.

“If feelings of isolation or loneliness are affecting your emotional or physical health, talk to your doctor,” says Dr. Pham. “Be very honest about how you’re feeling and how it is affecting your life. Your doctor can offer suggestions and resources to help you feel better and improve your quality of life.”

Top 3 Things to do in Encinitas for the Best Summer Vacation

by Cardiff Vacations

Encinitas is a lovely beach city in the northern area of San Diego County, best known as a world-class surfing destination. Also known as “The Flower Capital of the World” because of its great collection of gardens and nurseries, Encinitas offers a wide selection of local attractions and provides fun for all ages and tastes. If you are planning a getaway in the area this summer, here are the top things to do in Encinitas that will ensure you have the best vacation experience:

1. Enjoy a fun Day at a Local Beach

Parallel to the historic Highway 101 you will find some of the best hidden gems in San Diego’s North County Coastal region, Encinitas’ beaches. Here you can find:

•  legendary surf spots, 

• terrain that varies from pristine sandy beaches to rocky bluffs overlooking the ocean,

• authentic beach culture,

• great snorkeling areas,

• tide pools.

If you’re not sure which of the beautiful Encinitas’ beaches to choose during your stay, here is a brief overlook at some of the most popular ones:

• Cardiff State Beach

The Cardiff State Beach is a great family-friendly, dog-friendly beach with lots of parking spots and two access points, one in the north and the other in the south. The north access point is right next to the entrance to the beautiful San Elijo Lagoon. 

The south access point is known as Seaside Beach, it is a popular location for surfers and the two reefs make it a great location for diving as well. When the tide is out, the reefs get exposed and you get the chance to discover interesting sea creatures in the tide pools.  

• San Elijo Beach

San Elijo Beach, located further North from Cardiff State Beach, stretches from San Elijo Lagoon all the way up to Swami's State Beach in Encinitas, where you can find a lovely campground for overnight camping. 

This beach is many's favorite because of its location, and beautiful scenery. The views as you walk down to Cardiff-by-the-Sea from Encinitas are sure to blow you away.

• Swami's Beach

As an internationally-known surf spot, Swami’s Beach draws in surfers from all over the world, being possibly one of the best surfing spots in all of California. It is especially popular in the fall-winter season when waves can reach heights over 10 feet. 

Besides being such an incredible surfing destination, Swami’s Beach is also a very strong spiritual location. Home to the Self-Realization Fellowship Temple, Swami’s is one of the places where yoga history was first born in the US.  

2. Visit the San Elijo Lagoon Ecological Reserve

As mentioned above, the San Elijo Lagoon is located right next to the northern access point of Cardiff State Beach. This 1,000-acre lagoon is one of US' largest remaining coastal wetlands. Here you can walk through seven miles of trails and discover a diversity of plants and animals, including:

• 300 species of plants, 

• 26 mammal species, 

• at least 23 species of fish, 

• more than 300 bird species.

The San Elijo Lagoon Ecological Reserve is a great vacation destination if you are traveling with your kids as there are many educational activities happening here all the time, such as:

• guided weekend tours

• Children’s Story Time

• nature-themed family days and festivals

• cultural and natural exhibits

3. Admire Gorgeous Views While Hiking Some of the Best Trails in San Diego

With stunning coast to mountain landscape, ocean views and beautiful diverse wetlands, the Encinitas area is bound to amaze you with some of the best hiking trails San Diego County has to offer. The trails vary in difficulty and some of them are also kid friendly so you can enjoy them during your family vacation. Here are some of the best hiking trails around Encinitas that we recommend you check out:

• Crest Canyon Open Space Preserve Loop Trail

Located in Del Mar Heights Rd, San Diego, the Crest Canyon trail is a hidden gem, perfect for a family hike, nestled in the western corner of the San Dieguito River Park. This is a 2.1 miles long trail, accessible all year round, good for all skill levels that offers beautiful views and a chance to see the rare Torrey pine trees. Besides hiking, you can also enjoy some bird-watching here.  

• La Orilla Trail

La Orilla Trail is located near Cardiff-by-the-Sea, starting at the San Elijo Ecological Lagoon, and reaching the little more challenging Annie Canyon’s Trail.  It is 3 miles long, out and back, and is accessible all year round. At the beginning of the trail you can admire local Eucalyptus trees and native wild desert grapevines and along the way you can also enjoy the beautiful local wildflowers and birds.

• Annie Canyon's Trail

Annie Canyon’s Trail has beautiful rugged wilderness hiking paths located in an ecological reserve, near Solana Beach, Encinitas. This trail is just a bit more difficult due to its steep and at times really narrow pathways. It is still family friendly though and your kids will love safely climbing around the rocks.  Once you reach the viewpoint up top you can admire a stunning ocean view. 

• Manchester Preserve Hiking Trails

The Manchester Preserve is like an oasis in the middle of the city of Encinitas comprised of a network of trails that are a little bit more challenging to the untrained but that offer a chance of wildlife sightings. A short loop around the reserve will take you about an hour or less.

To truly comprehend all of what the Encinitas area has to offer, it would be best to experience it firsthand so I suggest next time you are thinking of going on your vacation, seriously consider Encinitas as your vacation destination, as you are bound to have a great time here.  

About the author: Julio Sanchez is the proud owner of Cardiff Vacations, a luxury vacation rentals business in the coastal area of Cardiff-by-the-Sea, Encinitas, CA.

My Doctor Is Not In, Can I See an NP or a PA?

by Scripps Healthcare

Nurse practitioners and physician assistants can both treat you

Your cough isn’t getting any better after a week. Your throat is aching now. But when you try to make an appointment, your primary care doctor is not available.

You’re asked if you’d like to see someone sooner. A nurse practitioner (NP) or physician assistant (PA) can see you in the morning.

Not sure what to do? Or the difference between physician assistants and nurse practitioners?

There are differences in their training and requirements. But both are licensed health care providers who can treat patients. And as their ranks grow, they are helping to increase access to health care for millions of Americans.

“Nurse practitioners and physician assistants are highly qualified medical professionals who can provide the same general care services as physicians,” says Carol Coloma, NP, a family nurse practitioner at Scripps HealthExpress in San Marcos.

In contrast to a nurse or medical assistant, who can take your weight and blood pressure and prepare you to see the doctor, a NP and PA can examine and treat you. Both hold advanced education degrees and extensive medical training.

Nurse practitioners and physician assistants in primary care

The number of NPs and PAs has steadily risen since the 1960s when programs for these medical professions began largely in response to a nationwide shortage of primary care physicians. Today, there are more than 325,000 licensed NPs, and about 140,000 certified PAs, practicing in the United States in a variety of health care settings.

At Scripps, NPs and PAs staff more than a dozen Scripps HealthExpress walk-in clinics. These convenient clinics — located at Scripps Clinic and Scripps Coastal Medical Center sites across San Diego County — provide same-day care for minor illnesses and injuries. Primary care teams made up of primary care physicians, NPs and PAs are also common at Scripps primary and specialty care offices.

Nurse practitioner’s role and scope of practice

Both PAs and NPs must have completed specific educational requirements and training programs in order to be able to treat patients. NPs and PAs provide the same general care services as physicians, including:

• Conducting physical exams

• Diagnosing and treating common, routine and acute illnesses

• Ordering and interpreting lab tests and X-rays

• Prescribing medication

What’s the difference between an NP and a PA?

Although their roles are similar, NPs and PAs have some differences in background and training.

NP programs are based on the nursing model and have a strong population focus. All applicants must be registered nurses (RNs) before they can complete the graduate-level education and clinical training needed to earn an NP degree.

NP licensing is done at the state level, generally by the board of nursing for the state in which the NP will practice. Certification is sometimes required to obtain a license. Certification is granted by national organizations in specialty areas of nursing practice.

Understanding the NP’s role

In addition to providing general care, NPs generally play a greater role in patient education and counseling than PAs. They focus on illness prevention and staying well. Most NPs specialize in primary care areas, such as family medicine, gerontology, women’s health, pediatrics or acute care.

A handful of states require NPs to practice in collaboration with a physician, including California, or under a physician’s direct supervision. Many states allow NPs to practice without any physician involvement.

Understanding the PA’s role

Physician assistant programs are master's level programs. Students must complete at least two years of college coursework in basic and behavioral sciences before applying to a PA program. Many PA programs also require prior health care experience with hands-on patient care.

Most students have a bachelor’s degree and about three years of health care experience before entering a PA program, according to the American Academy of Physician Assistants.

PA programs are based on the medical model and are more disease-centered. In addition to classroom and laboratory instruction, PAs complete clinical rotations in areas such as primary care, surgery, pediatrics and emergency medicine. PAs practice in medicine in all settings, including primary, emergency and surgical subspecialties.

The designation of PA-C, or physician assistant-certified, means the PA has been certified by the National Commission on Certification of Physician Assistants. Like NPs, many PAs pursue additional education to focus in a specific area.

Most states, including California, require PAs to have an agreement with a specific physician in order to practice.

PA vs. NP

So how do you know whether to see the doctor or a PA or NP?

“When you are faced with the choice of seeing an NP or PA right away or waiting for a physician, it’s generally better to get in and be seen,” Coloma says.

For coughs, earaches, rashes and other routine ailments, it’s fine to see an NP or PA. “Both work under the supervision of a physician and will discuss your care with him or her in case your problem turns out to be something more serious,” Coloma says.

Coloma adds, “The PA or NP will make sure your doctor is aware of your condition and proper actions are taken to provide the care you need.”

Pet First Aid Kits

by Veterinary Specialty Hospital

Every pet parent’s worst fear is having something bad happen to their beloved friend, which is why we are happy to share our Pet First Aid Kit tool with you! Having one of these handy can prevent an injury from becoming worse while you head to the vet, and will give you peace of mind that when an accident does happen, you're prepared! We hope that your pet never has an accident, but if they do, VSH Sorrento Valley and VSH North County are here for you!

 Continue reading: https://www.ethosvet.com/blog-post/pet-first-aid-kits/

How to Schedule a Mammogram During Coronavirus Pandemic: What to Know

How to Schedule a Mammogram During Coronavirus Pandemic: What to Know

by Scripps Healthcare

Screening mammograms and COVID-19 vaccines are important

Scheduling an annual screening mammogram remains the best way to detect any early signs of breast cancer. However, some people have had questions about scheduling a mammogram during the COVID-19 pandemic. How safe are health facilities? Can I postpone my mammogram? Can the COVID-19 vaccine affect my mammogram?

Let’s start with what hasn’t changed. Breast cancer is still the second most common cancer among women in the United States according to the Centers for Disease Control and Prevention (CDC). Research shows it is easier to treat breast cancer when it is caught early. A screening mammogram is used to look for signs of breast cancer in women who don’t have any breast symptoms or problems.

Health care facilities, like those at Scripps, are still safe places for mammograms, with enhanced precautions in place to protect patients, doctors, nurses and staff from potential exposure to the coronavirus.

“If you are overdue for one, we encourage you to schedule your annual screening mammogram and work with your doctor if you have any questions,” says Rebecca Hsu, MD, a diagnostic radiologist at Scripps MD Anderson Cancer Center and Scripps Clinic. “Regular mammograms are the best tests doctors have to find breast cancer early.”

COVID vaccine and mammograms

If you are unable to schedule your screening mammogram before receiving the COVID-19 vaccine, doctors recommend having your mammogram done a minimum of four weeks after receiving your second vaccine dose. This applies to two-dose vaccines by Moderna and Pfizer.

The reason for this recommendation is that some women who receive these vaccines develop swollen lymph nodes, usually under the arm on the same side of the body where the vaccine was injected. This is a normal immune reaction to the vaccine and generally subsides within four weeks. It’s not yet known if the recently approved Johnson & Johnson vaccine may have a similar effect.

Scripps experts are raising awareness about timing considerations for scheduling screening mammograms and the COVID-19 vaccine.

“Because enlarged lymph nodes can be seen on mammograms, patients due for their annual screening mammograms are encouraged to schedule their mammograms either before they have received the first dose of the vaccine or at least four weeks after they have received the second dose. This will reduce the chances of getting called back for additional imaging due to the enlarged lymph nodes,” Dr. Hsu says.

Under normal circumstances, swollen lymph nodes are a sign of breast cancer and would raise concern appearing on a mammogram and would require further testing.

If you get vaccinated first and do not want to miss a scheduled mammogram, make sure to tell your doctor about your vaccination to help get the most accurate mammogram reading.

Is it safe to delay a screening mammogram?

For patients of average risk, postponing an annual screening mammogram a month or two during the pandemic should not affect the risk of breast cancer.

“If you are significantly overdue for a mammogram, it is especially important to make and keep your mammogram appointment,” Dr. Hsu says.

A delay is only recommended for screening mammograms, where the patient has no breast cancer symptoms. There should be no delay if the patient has symptoms.

A diagnostic mammogram is used to look at a woman’s breast if she has breast symptoms or if a change is seen on a screening mammogram. A diagnostic mammogram may include extra views of the breast that aren’t part of screening mammograms.

You should contact your doctor right away if you notice changes in your breasts or are experiencing unusual symptoms.

Be on the lookout for the warning signs of breast cancer. Consult with your doctor if you develop any of these symptoms:

• Bloody or clear nipple discharge that occurs without squeezing the nipple

• Breast dimpling or puckering

• Swollen, red or warm breasts

• Changes in size or shape

• A hard knot or thickening in the underarm area or inside the breast

• A scaly, itchy rash or sore on the nipple

• Inversion (pulling inward) of the nipple or breast

• Pain in one spot that doesn’t go away in two to three weeks

How safe are breast care locations?

If you’re a Scripps patient, don’t hesitate to schedule a doctor’s visit to discuss a medical issue, change of health status or for a preventive visit, including a mammogram, due to concerns about COVID-19.

“We have extensive safety procedures and protocols in place to protect patients, doctors, nurses, staff members and anyone else who enters a Scripps facility,” says Ghazala Sharieff, MD, MBA, Scripps chief medical officer, clinical excellence and experience.

Those safety precautions include:

• Curbside check-in through the MyScripps mobile app

• Asking that patients visit their doctor without a companion, if possible

• Screening for everyone entering a facility

• Requiring all physicians, staff members, patients and visitors to wear face masks or coverings

• Rigorous cleaning and disinfecting protocols for all facilities and equipment

Steps you can take to protect yourself from COVID

In addition to wearing a face covering, you can take other steps to reduce your risk when you go to your doctor’s office, including:

• Practice social distancing in waiting rooms.

• Practice proper hygiene by washing your hands frequently with soap and warm water for at least 20 seconds.

• Use hand sanitizer before and after your visit.

• Avoid touching communal surfaces in the office, such as doorknobs and elevator buttons, as much as possible.

• Avoid touching your face, eyes, nose and mouth.

• Do not come in if you are feeling sick or have a fever or cough.

While a mammogram takes only a short while to complete, it does involve close contact between a patient and medical professional.

“We have safety measures in place for every step of your visit and we encourage you to ask questions about how we do breast imaging,” Dr. Hsu says.

COVID-19 Screening Questions: Honest Answers Are Important

COVID-19 Screening Questions: Honest Answers Are Important

Concealing COVID symptoms at medical offices puts many at risk

by Scripps Healthcare

There is a growing concern among health care providers regarding patients who fail to disclose they have symptoms of COVID-19 before entering a medical facility.

“Waiting until you are in an exam room to disclose to your doctor that you have COVID-19 or COVID symptoms is simply too late,” says Ghazala Sharieff, MD, MBA, Scripps chief medical officer, acute care, clinical excellence and experience. “Accurate information affects the way we approach personal protective equipment and the rooms we may put patients in. It protects health workers, patients and visitors.”

Everyone entering a Scripps Health treatment facility must be screened for COVID-19 by answering questions about possible symptoms and/or exposure for the coronavirus. The screening tool is only one of several added safety measures Scripps has taken to help prevent the spread of the virus — but it is a vital one that is dependent on honest answers from patients in order to be effective.

“It’s important to answer screening questions carefully and not rush the process just to make your appointment on time or because you’re afraid you won’t be seen if you say you have a symptom,” Dr. Sharieff says. “You will receive the care you need regardless of your symptoms.”

COVID concealment

A recent study in the Journal of Health Psychology found that people who had tested positive for COVID-19 or had symptoms weren’t always honest about their condition around others.

The study surveyed 451 adults in the United States and found women were more likely to disclose health symptoms than men, and older adults were more honest about COVID-19 status and behaviors than younger people.

“Often, lying feels easier and safer than being honest,” says Leah Welch, PhD, a psychologist at Scripps Health. “The study showed approximately one-third of participants who had tested positive denied having symptoms when asked by others and more than one-half reported some level of concealment of their symptoms.”

Why we lie

“Concealing key health information can protect ourselves and our image, but then, negatively impact others,” according to Welch. “It’s important that we do all we can to keep ourselves and others safe, and not jeopardize the health of others.”

Honest disclosures about COVID-19 diagnosis, symptoms and behaviors are imperative to help monitor the spread of the virus and protect the health of the community.

“Concealing your COVID status to the screeners upon entry not only impedes efforts to slow the spread of the virus, but it also can risk the health of the doctors and staff who are taking care of you if they are not alerted to take the proper precautions,” says Dr. Sharieff.

If you suspect you may have COVID, please call the COVID nurse line at 888-261-8431 or use a virtual care options.

Don’t be afraid to seek care due to fears of COVID-19

Health officials urge people not to delay any time-sensitive care for a medical condition due to fears of coronavirus. Medical facilities that follow recommended COVID-19 safety measures are still safe places to visit.

“People also should not hesitate to seek emergency care  because their condition may require rapid or advanced treatments that are only available in a hospital setting,” Dr. Sharieff says.

COVID safety at Scripps

At Scripps, safety measures have been implemented at all facilities, including:

• Screenings for everyone entering facilities

• Required face coverings for all physicians, staff and patients

• Curbside check-in option and social distancing in waiting rooms

• Rigorous cleaning and disinfection for all facilities and equipment

• Dedicated entrance and isolated zones for patients with coronavirus symptoms

• Limited visitors to all Scripps facilities

How Does COVID-19 Affect Older Adults?

Six ways to prevent illness, social isolation and lonelinessOlder adults – especially those with medical conditions – have been hit hard by COVID-19 and need extra support.

Those age 65 and older account for 80 percent of coronavirus-related deaths, according to the Centers for Disease Control and Prevention (CDC). People 85 and older have the highest risk of severe illness from COVID-19.

Many seniors are staying safe by staying home and social distancing, but are now at increased risk of social isolation and loneliness, which can result in depression, anxiety and other health problems.

Fortunately, many services are available to help seniors stay safe and socially engaged during the pandemic. These services include food delivery, online exercise programs and other free or low-cost offerings through public health services.

“We want our seniors, especially those most at risk for severe illness from COVID-19, to stay home as much as possible during the pandemic and to have a support system in place that can help ensure their safety and well-being at home,” says Alexander Meilan, DO, an internal medicine physician at Scripps Clinic Torrey Pines.

Dr. Meilan recommends the following:

1.   Don’t hesitate to seek emergency and non-emergency care

Don’t delay going to the emergency room or calling 911 for any medical emergency. Emergency departments have COVID-19 prevention plans to keep their patients and staff safe.

Staying in contact with your doctor is important especially for seniors with chronic conditions. In many cases, non-emergency visits can be done via telemedicine. In some cases, an in-person visit is necessary, such as getting an annual flu shot.

Caregivers can help their seniors download a telemedicine app to their smart phones or tablets and teach them how to use it. Make sure the app has privacy features to protect patient health information.

2.   Stay connected, prevent loneliness

Older adults should have a plan to safely stay in touch with family and friends during the pandemic to help prevent the ill-effects of social isolation and loneliness.

“Older adults should have someone they can reach out to if they need help getting food, medicine and other supplies. If they live alone, regular human contact can mean a lot to their health and well-being,” says Dr. Meilan.

Regularly scheduled phone calls, video conferences, texting and emails can help make up for a lack of in-person contact.

Caregivers can help their seniors set up and understand video conferencing options, such as FaceTime or Zoom.

3.   Stay physically active

Getting exercise may seem harder with gyms closed or concerns about going to one when they open. Many options are available to stay active without risk of exposure during the pandemic.

Find fun and creative ways to stay active at home. Join an online exercise class or find an exercise video for seniors on YouTube.

Go out for a walk. Make sure to wear a mask, especially if physical distancing is going to be difficult. Caregivers can join their seniors in a walk but should also take precautions.

Staying active may be harder for older adults with medical conditions that limit their ability to regularly exercise. The CDC recommends 150 minutes of moderate-intensity aerobic exercise per week but says those who cannot do this much should stay as physically active as their abilities and conditions will allow.

According to the CDC, regular exercise:

• Improves sleep

• Improves balance and reduces risk of falling

• Improves joint mobility

• Extends years of active life

• Helps prevent weak bones and muscle loss

• Delays onset of cognitive decline.

4.   Check delivery and pick up options

For those who have concerns about going out to buy groceries due to COVID-19 or who lack transportation or have limited physical mobility, look for grocery stores that offer pickup and delivery services to reduce their risk of exposure. Ask if they offer discounts or free delivery for seniors. Consider asking a neighbor or other family member to do the shopping for you.

For those who prefer to shop in person, look for stores that offer senior-only hours. Make sure they require customers to wear face covering. Get in and out of the store as quickly as possible.

Caregivers who shop for food for their seniors can set aside time for conversation after delivering groceries to help prevent loneliness.

5.   Prevent falls at home

More time at home may increase the chances of an accidental fall that results in injury. Learn how to reduce the risk of falling at home.

Make home safer, for example, by removing loose rugs, adding handrails to stairs and hallways if needed and keeping adequate lighting in dark areas.

Also:

• Schedule a risk assessment for falls with health care provider.

• Stay active, focus on balance, strength training and flexibility exercises.

• Schedule annual vision and hearing exams.

• Manage medications, understand their side effects.

6.   Make a list of resources

Create a list of organizations to contact for information, health care services

including mental health or counseling as well as food and other support.

• San Diego County’s Aging and Independence Services provides an array of services, including access to home-based support services, meals and counseling help.

• Elderhelp of San Diego provides community-based solutions through staff and volunteers committed to helping older adults live independently in their own homes.

• Stay at Home. Save Lives. Check in is a statewide campaign in California to help combat isolation and food insecurity among people 65 and older.

• AARP Foundation's Connect2Affect program provides information, and options for older people to stay socially connected.

• The federal Substance Abuse and Mental Health Services Administration has a hotline, 800-662-HELP (4357), to help people find counseling services in their area.

COVID-19 testing from Scripps Healthcare

FAQs on Coronavirus Diagnostic and Antibody Testing 

By Scripps Healthcare

What are the different types of COVID-19 tests and what do they all mean?

Because of the rapid developments in testing, there has been some confusion around the different types of COVID-19 tests being offered. Here is what you need to know about testing being offered at Scripps Health:

Coronavirus (COVID-19) Tests

What is it?

The CDC recommends a COVID-19 test called a nasopharyngeal swab which checks samples from your respiratory system (such as swabs of the inside of the nose) to tell you if you currently have an infection with SARS-CoV-2, the virus that causes COVID-19. 

How does it work?

A care provider in protective gear will ask about your symptoms and take your temperature. They will then put a special 6-inch cotton swab up both sides of your nose and move it around for about 15 seconds. It won’t hurt, but it might be uncomfortable. We then test the fluid on the swab to detect the presence of the virus.

Because of recent advances, test results are available very quickly.

How can I get tested for COVID-19?

Scripps Health is testing people with moderate symptoms of COVID-19, especially those who are at higher risk. This includes health care workers, older adults, and patients with compromised immune systems or chronic medical conditions such as diabetes, heart disease, chronic lung disease and chronic kidney or liver disease. 

Scripps is also testing all patients for COVID-19 who are being admitted to our hospitals, obstetric patients and those scheduled for surgery. 

If you suspect you have symptoms of COVID-19, please call our nurse line at 888-261-8431 before coming in or use one of our virtual care options.

When will I get my results?

If you are tested at an outpatient testing facility, you can expect test results in less than 24 hours. 

If you are tested as a patient admitted to a Scripps hospital or in one of our Emergency Departments, your care team will quickly receive your results typically within 2 hours.

Can the COVID-19 test ever produce false negatives?

False negatives are an issue with any test. This may be because the amount of the virus in your sample is so low, it can't even be detected or because not enough of your sample was taken for an accurate reading.

“At Scripps, we are well aware of the potential for false negatives, and our strategy has been to use universal precautions, in that all health care workers in our system wear a surgical mask while in a patient care area, wear fresh gloves with every patient, and perform meticulous hand hygiene,” says Ghazala Sharieff, MD, MBA, Scripps chief medical officer, clinical excellence and experience. “Also, if we have a strong suspicion for COVID, we don’t rely on a single negative test and we retest as needed.”

What Happens After I Get Tested?

A positive COVID-19 test means you currently have or recently had the virus. Monitor your symptoms and get medical help right away if you have trouble breathing, confusion, or bluish lips or face.

Learn more about taking steps to avoid spreading the virus here. 

If you test negative for COVID-19, you probably were not infected at the time your sample was collected. However, that does not mean you will not get sick. It is possible that you were very early in your infection when your sample was collected and that you could test positive later. Or you could be exposed later and then develop illness. In other words, a negative test result does not mean you won’t get sick later. This means you could still spread the virus.

Coronavirus Antibody Testing

What is it?

Commonly referred to as “antibody testing,” "antigen testing" or "serology" – this test is not used to diagnose COVID-19. Rather, it is a blood test to determine if you have been exposed to COVID-19 at any point in the past – in which case your body would have created antibodies in response to the infection. An antibody is a protein made by our bodies in response to an infection. Once created, antibodies typically help the body fight off an infection.  

How do I get the COVID antibody test?

Scripps Health currently is offering antibody testing in very limited circumstances. Antibody testing requires an order from a physician. Patients with questions about antibody testing should contact their doctor. For more information about antibody testing, visit the CDC. 

Is there any benefit to COVID-19 serology test?

There is still much uncertainty about the value and use of testing for antibodies related to the new coronavirus.

The CDC is still studying and determining the exact benefits to antibody testing. The antibody test provides an estimate of how many people have been infected in order to determine how many in the public remain at risk. This may help with trends and future predictions about the progression of the pandemic.

“Having antibodies to the virus does not guarantee a person will not contract it again. We just don’t know enough about this virus yet,” says Dr. Sharieff. 

COVID-19 Plasma Infusion Study

What is it?

The COVID-19 plasma study is a relatively new clinical study that offers treatment to critically ill COVID-19 patients. This is not a diagnostic test or an antibody test. Scripps is the first health care provider in San Diego County to use an experimental therapy as a possible treatment for COVID-19 patients.

How does it work?

Convalescent plasma therapy takes plasma donated by someone who has recovered from COVID-19 and transfuses it into a hospitalized patient currently battling a serious COVID-19 infection. 

“The idea behind the treatment is that people who have fully recovered from COVID-19 have antibodies in their plasma that can attack the virus when transfused into patients with serious, active disease,” says Dr. Sharieff. “The hope is that the plasma will be helpful to very sick COVID-19 patients and speed their recovery.”

While the therapy is still experimental, the FDA is allowing physicians to use plasma from recovered patients to treat those with “serious or immediately life-threatening COVID-19 infections” under an emergency approval system.

Is this treatment working so far?

“Plasma therapy treatment is relatively new, and we are studying its benefits every day,” says Dr. Sharieff. “So far, initial results for Scripps Health patients appear to be promising.”

How to Donate Convalescent Plasma

If someone you know has tested positive for COVID-19 and recovered, they are likely eligible to donate plasma. The American Red Cross recently started a national program to collect and distribute plasma, and current supply is low. Plasma can also be donated through the Scripps Bone Marrow Transplant/Apheresis program by contacting Michelle Meyer at meyer.michelle@scrippshealth.org.