COVID-19: Our New Routine – PediaCast 457

Show Notes

Description

  • In the midst of a pandemic, life goes on. This week we discuss new routines and an important job that never stops: parenting! Dr Yolanda Evans is our guest. She is a pediatrician and mother living in the Seattle epicenter of COVID-19. We hope you can join us!

Topics

  • COVID-19 
  • Coronavirus Pandemic 
  • Family Routines 

Guest

Links 

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 1: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone. And welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike coming to you from my home, because when I'm not working clinical shifts, I am social distancing just like all of you. 

Welcome to the program. It's Episode 457 for March 25th, 2020. We're calling this one "COVID-19: Our New Routine". 

So here we are in the midst of a historic pandemic caused by the SARS-CoV-2 virus, which results in a potentially severe and life-threatening respiratory illness called COVID-19.

0:01:12

Now, we covered both the virus and the disease in considerable detail. That was Episode 455, COVID-19: What You Need To Know. Our best chance of fighting this pandemic with the least loss of life is by acting upon too tried and true public health interventions known as social distancing and flattening the curve. 

Now, these are needed in order to prevent our healthcare system form becoming overwhelmed, which could not only result in hundreds of thousands or even over a million COVID deaths, but also loss of life from the other things that happen to people, like heart attacks, strokes, cancer complications, car accidents. Because the healthcare system, if it's swamped with the virus and all that illness, it is unable to adequately respond to those everyday emergencies. 

0:02:07

So, until we have better treatment, or a vaccine or the virus goes away because maybe warm humid weather arrives, but we do not know that for sure, or a miracle occurs and the pandemic just fizzles out on its own, which is unlikely. Unless these things occur, our current hope depends on social distancing and flattening the curve. 

We cover these topics also in great detail, that was last week, Episode 456, COVID-19: Social Distancing and Flattening the Curve. And I will put links to both 455 and 456, so lots of good background information for you on this whole situation in the show notes for this episode, 457, over at pediacast.org.

This week, I want to turn away from the doom and gloom for just a bit because the fact of the matter is, most people will live through this pandemic. We certainly want to minimize pain and suffering and death which is why we are seeing extraordinary actions including school closings, event cancellations, and orders to stay home, and shelter in place. 

0:03:19

But in the midst of this uncertain time, and as we progress to the other side of the pandemic, which don't get me wrong, it's going to be a long journey, but we will get there. In the meantime, we still have to live our lives. We have to settle into a new normal and new routines because parents still have to be parents, we still need to raise our kids, right? The pandemic does not shut down parenting.

So today, we're going to turn our attention to these new routines as I chat with a fellow pediatrician who is also a parent in the Seattle, Washington. So her family is in one of the US epicenters of COVID-19. They've got a lot of it going on in their neighborhood. 

0:04:03

Dr. Yolanda Evans is our guest today. More specifically, she's an Adolescent Medicine doctor so she takes care of teenagers, but she also takes care of younger kids at home. Her children are 18 months, five years, and seven years. And like all of us, they are staying home and adjusting to new routines.

We'll talk about how the pandemic is shaping those routines both at home and on the job, so stay tuned for that conversation. Before we get to Dr. Evans, I would like to remind you the best way to keep your family safe and to prevent COVID-19 illness in your house is to first and foremost, follow the directions of your local public health officials. 

And those directions are going to be available at their website and their social media platforms, so wherever you live, find your local health department, your state health department, either one of those and they should have terrific information for you that you can find easily with an Internet search.

0:05:02

Beyond that, we want to wash our hands frequently. Soap and water is preferred, alcohol-based hand sanitizer in a pinch. You want to lather for 20 seconds and in order to help you do that that, just pick a song that you know is, whatever lyrics you're going to sing in your head or out loud, you're going to do for about 20 seconds. That's the ideal amount of time. 

Coughs and sneezes, you're going to the inside of your elbow or a tissue. If it's a tissue, throw that tissue away and then always wash your hands  after you cough or sneeze, again, for 20 seconds with soap and water.

Avoid touching your face with unwashed hands. Clean and disinfect commonly touched household surfaces every day, and that includes countertops and tables, doorknobs, light switches, sinks, faucets, toilet handles, with a household cleaner that kills bacteria and viruses.

Absolutely stay home if you are sick, including if you just have a little cold. And avoid close contact with sick people, including those who just have a little cold. 

0:06:05

Absolutely no physical contact with at-risk folks, even if you are seemingly healthy. And by at-risk folks, we mean those over the age of 60 and anyone at any age including children who have a history of heart disease, chronic lung disease, cancers, so they're on chemotherapy, or immune system problems.

However, use digital technology to check in with them often. Keep them company. Find and meet their needs. We're all in this together. An as much as we want to beat coronavirus, we also want to stamp out loneliness and anxiety and depression to our best ability. And then finally, maintain strict physical distancing when you go out and about for essentials or for essential work by keeping at least six feet between you and other  individuals.

What do you do if your child gets sick? First and foremost, supportive care at home, rest, fluids, fever reducers. However, if you're worried about your child's symptoms, call your doctor for guidance. They can really talk you through what you need to do at home, when you need to come in, when you need to go to an urgent care center, when you need to go to an emergency room. And they can give you specific directions for calling ahead and making sure that your child is safe once they arrive. 

0:07:21

Telehealth is gearing up and will likely persist as a viable option on the other side of this pandemic. So that's one thing I think that is really going to mature quickly, are telehealth options.

Couple more reminder before we get started, don't forget, you can find PediaCast in all sorts of places. We are in the Apple Podcasts app, Google Podcast, iHeart Radio, Spotify, SoundCloud and most mobile apps for iOS and Android.

Reviews are helpful wherever you listen to PediaCast. We always appreciate when you take a moment to share your thoughts about the program.

And we love connecting with you on social media. You will find us on Facebook, Twitter, LinkedIn and Instagram. Simply search for PediaCast. 

0:08:02

We also have that contact link at pediacast.org if you'd like to write in with a comment or a question. 

And as always, I want to remind you the information presented in our program is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your doctor. 

Also, your use of this audio program is subject to PediaCast Terms of Use Agreement which you can find at pediacast.org. 

Let's take a quick break. We will get Dr. Yolanda Evans connected with the studio and then we'll be back to talk more about our new routine. That's coming up right after this.

[Music]

0:09:11

Dr. Mike Patrick: Dr. Yolanda Evans is an associate professor of Pediatrics at the University of Washington and clinical director for the Division of Adolescent Medicine at Seattle Children's Hospital. She's also a mom and, like the rest of us, faces many challenges in her work and in her home as she, like us, adjust to new schedules and routines in light of the COVID pandemic.

That's our topic today, new schedules and routines. So, let's give a warm PediaCast welcome to Dr. Yolanda Evans. Thank you so much for joining us, today.

Dr. Yolanda Evans: Yeah, thank you, Dr. Mike, so much for having me. I'm excited to be here. 

Dr. Mike Patrick: Yeah, I really appreciate it. And I know all of our schedules right now are crazy and just finding time to be able to chat a little bit is so much appreciated by me and I'm sure the rest of the audience as well. 

So, I want to start with your family because really, I think, in addition to the disease itself, one of the things we're really focused on right now, is we all sort of shelter in place and practice physical distancing. 

0:10:08

I'm using that word instead of social distancing because we really can still be social these days. But we're really thinking about our families. So why don't we start with just let us know what your family is like? Who do you have at home?

Dr. Yolanda Evans: Right. So my husband and I have three kids. So, me and my husband and then we have an 18-month-old daughter, a five-year-old daughter, and a seven-year-old daughter. They're all there. 

Dr. Mike Patrick: Yeah, that is really busy. So, the 18-month-old really has no clue what's going on, right? Other than things are weird.

[Laughter]

Dr. Mike Patrick: But for your five-year-old and seven-year-old, how are you sort of explaining to them what's happening in their world because it's really been turned upside down?

Dr. Yolanda Evans: The seven-year-old kind of understand that there's a virus, like a cold going around and that it's really contagious and that we have to make a lot of changes. So, she kind of gets it and understand the handwashing and everything. The five-year-old is just kind of sad she's not at school seeing her friends. She doesn't really understand that.

0:11:15

Dr. Mike Patrick: Yeah, that's really tough. And inside the home itself then, you probably had to really change your family routine. In what ways has that changed?

Dr. Yolanda Evans: Usually, we're kind of like most families. I feel like we're always on the go. The kids are in their activities. We do a lot of group things and playdates. So, we're always out and about, and we've had to really shift our schedule to try to give them some kind of structure without the going out and about, which have been really tough for me, my husband, and the kids.

Dr. Mike Patrick: Does your husband work outside of the home? Does he have a job where he still has to go and then who's watching the kids when you guys are working?

0:12:03

Dr. Yolanda Evans: So, fortunately, he's not working outside of the home. He's flexible. He's actually a driver right now for hire, and so he's just been not driving and being at home with the kids. But it's really stressful on him, too, because he doesn't get that break away. He's constantly trying to entertain them, keep them busy.

Dr. Mike Patrick: And I'm sure there are a lot of parents who are in that kind of position and maybe they weren't necessarily the day-to-day primary caregiver for kids and that can be really stressful for them as well, right? 

Dr. Yolanda Evans: Right. And he usually is the one doing kind of the school pickup to drop-off, but he's got a window in the middle where there's some self time. He can work on projects, do his own thing, and there's no downtime with the way that the kids are not home right now. You're kind of on all the time.

Dr. Mike Patrick: Yeah, absolutely. Now, here in Ohio, we just went into... In fact, tonight, at 11:59 p.m. is when the stay-at-home order goes into place. So that then there is only essential travel, only essential businesses are open. Basically, everyone else just needs to shelter in place and stay home.

0:13:17

I understand that at least as of our recording right now, that's not necessarily true for the entire state of Washington. But is it some areas of Seattle have declared that, is that correct? 

Dr. Yolanda Evans: So, one of the cities a little but north of Seattle has declared that in Everett, Washington. But so far, in Seattle, we don't have the full shelter in place in effect just yet. But I think all of us realize it's probably coming.

Dr. Mike Patrick: Yeah, and hopefully, a lot of people are already doing that. Physical distancing themselves. Or you're not seeing that, as there's still a lot of people out and about. 

Dr. Yolanda Evans: I think this is a place where people are always outside, always outdoors. And even just this weekend, we thought, okay, we'll take the kids on a hike to go get outside. There were so many people out that we ended up leaving, because it just wasn't possible to keep the six feet of distance between each other. It isn't safe.

0:14:19

Dr. Mike Patrick: It's so concerning. And as we see pictures of beaches in California and then Florida and lots of public places where people are still gathering, I really think like the folks in Italy are just wanting to scream at us right now, that "This is important. You got to take this seriously." 

And physical distancing of at least six feet and certainly not groups of more than ten. I mean, really, we shouldn't even be talking about groups anymore. We just really need to stay home in order to prevent catastrophe in this country. 

Dr. Yolanda Evans: Exactly.

Dr. Mike Patrick: I'm sorry, I'm getting into the gloom and doom again. And I really told myself we're going to be more positive compared to last week. 

And so, in terms of structure then for your kids, what does their daily routine look like? How are you keeping and how is your husband keeping them from really going stir-crazy? 

0:15:12

Dr. Yolanda Evans: You know, it's really funny to talk about this now because just the last night, the seven-year-old and I wrote out a daily schedule because she was asking for it.

Dr. Mike Patrick: I love that. Yeah, yeah, that's funny that she, "Hey, mom, I need this." 

Dr. Yolanda Evans: So, we have an easel in our kitchen where the kids will write little notes and things. And she actually wrote out, "Okay, in the morning, I'm going to wake up, wash my face, brush my teeth. And I'm going to eat breakfast and we're going to do some yoga." 

And she had her set time. "Then, I'll work on schoolwork. And then, we'll go outside and play on the deck and then we'll come back in. And then, we'll have some screen time on the iPad. But Papa will put on the timer. And then, we'll eat again."

0:16:00

And so, she kind of have in her mind a routine that she wanted to do, which was great.

Dr. Mike Patrick: Yeah, yeah. I love that. And I think some kids may not think of that on their own, but if presented with that opportunity, it could almost be like a game. And then, you could sit down together and figure out what that routine is going to look like. And then maybe even mix it up, like "Okay, it's been a week of this. Let's sort of change things up a little bit." Maybe introduce some new things or do it in a different order. And I think a lot of kids would just love that structure. And they have a say.

Dr. Yolanda Evans: Yeah, exactly. And she actually really... You know, in their classroom, they have opportunities to earn little trinkets and gifts and things. And she really like the idea of coming up with some set things that she can do to earn some privileges and some ideas. So maybe if she completed all of her homework assignment, and it got checked off, she can earn extra few minutes on the iPad. Or she could earn some Slime or glitter or things like that.

0:17:03

Dr. Mike Patrick: That's wonderful. And I saw on social media, someone had incorporated Monopoly money into that kind of a thing. So they had, you know, this is how you earn money, and it was basically doing your homework, attending class, if you are doing distance learning. Or if you are doing at home learning, whatever those lessons are could earn you money. 

And then, of course, chores in the house can earn you, like, "Okay, straighten your room and you get a 10-dollar Monopoly bill." And then, then they have a menu of what they could spend that money on. And I thought that was just brilliant. 

Dr. Yolanda Evans: That's brilliant, have a menu of what you could just spend it on. But I think that's just a great idea because she's definitely very aware of activities that she can earn.

Dr. Mike Patrick: Now, in terms of you and your husband, are you getting any sort of adult time? Are the kids going to bed at a certain hour as well? Or with all the disruption, are they staying up later? And how are you handling kind of the marriage relationship?

0:18:01

Dr. Yolanda Evans: That's part of why we needed to schedule because with the Daylight Savings, it's just brighter and brighter and brighter. And so, the kids are staying up later and later and later. And we don't have our time together. And so, my ulterior motive for the schedule was to keep the kids going to bed on time and waking up on time, so that we can have our own time. Our usual date night babysitter can't come to fill in.

Dr. Mike Patrick: Yeah, you have to kind of figure out how to do a date night at home, right?

[Laughter]

Dr. Yolanda Evans: Exactly, exactly. We're trying to, at least once a week, just watch a movie after they go to bed, just to have some time together.

Dr. Mike Patrick: And we're being inundated with so much news. And I find, I'm not sure if you're the same, the more news I watch, the more my anxiety level creeps up because we're hearing the places that are the worst right now. And then, that gives us some anticipation that, oh, is it going to be like that here? 

0:19:06

Although, with physical distancing, we're really trying to prevent that in each and every community. But as we hear stories of what's out there, it can be pretty scary. So, I love that you're watching the movie at least once a week, but we really do need to balance the news watching with other stuff, right?

Dr. Yolanda Evans: Yeah, we try. We definitely try to make it a movie that just has nothing to do with anything going on or a show that had nothing to do with any of the real world events exactly for that reason, to kind of distance ourselves from the anxiety that goes along with all of this. We're constantly being bombarded with it, too. So it's really challenging. 

Dr. Mike Patrick: And I've said this before, I think the anxiety can really disrupt our lives and interfere with our daily functioning as we're isolated. But at the same time, it can also be protective, right? I mean, a little bit of anxiety in a situation like this goes a long way to say, "Hey, I need to listen to my public health officials and really distance and take this seriously to protect me and my family."

0:20:16

Dr. Yolanda Evans: Definitely. And I'm definitely an optimist, so I've been seeing this as a way to spend more time with my family because we're always on the go so much, that I feel like we don't usually take a couple of minutes to sit down together at a meal or to just kind of do those things where we're checking in with the kids, we're playing a game with them. And so, I'm kind of loving it in a way that we're forced to be together all in one space.

Dr. Mike Patrick: Yeah, that has been a recurring conversation at work when I do my job in the emergency department or urgent cares I have to go in. The doctors and nurses and other staff, we've really been talking about that, that there's more connection with our family than there has been in a very long time. 

0:21:06

And so, of course, we didn't want to take a global pandemic to change kind of our hurry-and-go lifestyle. But this is a silver lining that we may get coming out of this, if we remember what it's like to spend time and relax, right? 

Dr. Yolanda Evans: And it's been really fun, too. I think having the technology to be able to video chat with family and friends that we may not usually check in with. We may get a quick text to say happy birthday. Now, we're doing a video call. It's actually been kind of nice in that regard too, that I've seen people virtually that I don't usually talk to because we're all checking in with each other. 

Dr. Mike Patrick: Yeah, that's really been great. So, I want to talk about the change in your work schedule as well. So, you are an adolescent medicine doctor. So, you see teenagers. But with these stay-at-home orders, those folks who don't have urgent medical needs and have to be seen now, how are you handling their appointments at this point?

0:22:06

Dr. Yolanda Evans: So, we are basically converting all of our visits to telehealth, so either telemedicine visit or a telephone visit. And then just leaving the in-person for the really urgent ones, like the kids who might end up needing a hospitalization or something and trying to really limit the amount of people in our workspace and doing a lot of visits from home.

Dr. Mike Patrick: Let me ask first, was this something that you already had set up before the pandemic occurred and so you're able to just sort of transition more patients into that system? Or did you have to build something really quickly from the ground up?

Dr. Yolanda Evans: Kind of little of both. So, we have to pretty much build our processes for converting visits and getting all the telephone encounters, all the scripting and everything, all the fee sheets and all of that done in real time.  

0:23:01

And for telemedicine, too, a few of us had been doing telemedicine for a year. I'm one of those providers. But we have to get really creative with, okay, usually, we would have people check in at one of the regional clinics. And I'd be seeing them in my office. So, what platforms can we use to check in with people from home and how do we do that? So, we're doing that right now in real time.

Dr. Mike Patrick: And you mentioned that you're doing these telehealth visits both from your office and from home as well, is that right?

Dr. Yolanda Evans: Yeah, a lot of people are using different software platforms to be able to keep their personal information private. So, you can create a virtual backdrop or make the hospital phone number show up, so it's not your personal phone number.

And then, we do need somebody here in the office to be kind of that urgent provider, too. So, if we're that, then we come in. Or if we got three little kids at home in the background making noise, we are coming in to the office. 

0:24:06

Dr. Mike Patrick: Yeah, that can present some challenges for professionalism, and especially when you're creating or at least expanding a system rapidly and you do have some providers that need to stay home or it's safer for them to stay home. That can present challenges in terms of still you're home and doing telemedicine but were still professionals and creating that image. How are you handling that aspect of it?

Dr. Yolanda Evans: That is challenging. Just to kind of put it out there. It's really been a challenge because even in my home, which I do have the ability to go into a space that's fairly private, the kids know I'm there. So, they're constantly coming in and asking for things. And so, it's been hard for me to maintain that professionalism for an entire stretch. I can do one meeting or one visit, but for a full block of time, it's really hard. 

0:25:04

And so, I've actually been coming to the office and trying to time the visits where I'm going to be on phone or on telemedicine with the time that I need to be here, anyway. So trying to consolidate.

Dr. Mike Patrick: It's kind of a double-edge sword because you want to maintain professionalism but at the same time, there is some connectedness that I think parents can relate. Like when I'm going crazy with what my kids are doing and I see my pediatrician on telemedicine having the same issue with their kids, you kind of have more empathy for each other, I think.

Dr. Yolanda Evans: It's true. It's a fine balance. And I don't have the balance just yet, I'm still working on it. But I think I'll be really creative with our solutions in the coming...

Dr. Mike Patrick: Yeah, absolutely. Like everyone's had one to two weeks to sort of ramp this whole thing up.

Now, in terms of your community, did you have the one on the toilet paper that everybody else has had?

[Laughter]

0:26:05

Dr. Yolanda Evans: You know, so we did hear. Fortunately, I usually plan ahead a little bit anyways, so I had enough products just from going to the store the weekend before. So, we're okay for a little bit. But the shelves are completely empty for almost everything like staples, sugar, and flour, toilet paper, paper towels, soap. It's all really really empty.

Dr. Mike Patrick: We use Instacart frequently where you put in your grocery list and someone does the shopping for you. And usually, you get exactly what you want. They can come an hour later if you need them do. And now, my wife looked this morning and the earliest that someone can get a stuff is Friday. So that's five days away. 

And then, a lot of the things that we wanted, there were shortages. And so, it's tough and yet, I hear on the news that the supplies are okay. It's just people grabbing stuff up as soon as it gets in.

0:27:06

Dr. Yolanda Evans: I was just going to comment on that too, that one of the things that's been a positive in this is that our neighbors, we've been relying on each other more for that. So, if one of us does make a store run and we see a reserve, we're texting each other like, "Hey, I'm at the store. I see toilet paper. Do you need any? They have a limit of two." 

So, we've been able to use, we have three-day grocery, we've been texting back and forth.

Dr. Mike Patrick: No, that's great. And then, do they, they just drop it off outside your door?

Dr. Yolanda Evans: They're not coming in. We're not touching each other but they just drop it at the door.

Dr. Mike Patrick: Oh, that is great. You bring up a good point, because I've seen questions in social media. People saying is it okay, as long as it's just my neighbors, if they come over for a dinner party or three kids down the street, could they come over for a playdate?

0:28:01

But really, the fact that some people don't have that very many symptoms with COVID-19, you can easily pass that on, and your neighbor can remain without symptoms and then pass it on to another person, who passes it on to a high-risk person. I mean, even just getting together for a quick dinner with neighbors could end up killing someone.

Dr. Yolanda Evans: Exactly. I think of it not just the neighbor but all the people that they've come into contact with over the last two weeks, I'm interacting with them, too. So, we're basically sticking with our family that lives in our home. We're not having any real-time neighbor visits, playdates or any of that social interaction that we usually we think would be okay in the situation to do that. 

Dr. Mike Patrick: Yeah, absolutely. And another question I've gotten is playgrounds. Like is it okay if no one is at the playground if my kids play on the play equipment? But that's really not a good idea either, is it?

0:29:00

Dr. Yolanda Evans: No. I have the same thought. We actually have been over the weekend walked up to our local school but specifically did not touch the playground equipment. They have a big field where the kids could run without interacting with anything. So, we did it with that, but I was very adamant with my kids, like "Okay, we're not going to the play equipment because I can't wipe it all down. I can't ensure that it's been clean." 

Dr. Mike Patrick: Yeah. And you don't know who is there, even five minutes, they've been gone five minutes. So it looks like the place is empty, but it really isn't. And another kid who maybe just had a little runny nose or no symptoms at all and touched the equipment. And then you come along and touched it and that could be a problem. 

Dr. Yolanda Evans: Exactly. It's the same for I think about like just, yeah, going to play tennis or to, you know just , it's just really you don't who's been there and who's touched it. And it's just not a risk that I'm willing to take. 

Dr. Mike Patrick: Yeah, same thing can be said for going out to the store and getting essentials and getting groceries. And I mentioned Instacart, but then you worried is the person who shopped for it, have they had symptoms? Or maybe no symptoms, but they have, they're a carrier for COVID. Or the person who is stocking the shelves. 

0:30:18

And so, it does... I mean, you still have to live your life and get your staples, but you just have to be thinking about these things. And perhaps wiping down bags and boxes and things as they come in the house.

Dr. Yolanda Evans: I mean, it's something to think about. It's really challenging when you think about how many things we all touched and who has all touched it. But you're right, we have to keep with our life, and we need food and supplies. So, there's some risks in our life that we have yet to balance it.

Dr. Mike Patrick: Yeah, we're doing the best we can. But for many of us, there's more we can do, especially as we see images of people who aren't taking physical distancing seriously. 

0:31:01

Now, what about your faith community? Not just yours, but maybe you've heard other's, friends, family or patients, in your area, what sort of things are faith communities, churches, synagogues, other gatherings, what are they doing to sort of keep in touch with their fellow people?

Dr. Yolanda Evans: I think the faith communities are such an important part of social supports. And so, I know for our neighborhood, they've switched to virtual connections, so they have like the small groups that meet virtually. And then, they're basically recording at the worship service that will happen in a larger group and streaming it. 

So, it's been really good to have that connection. And similarly, I think for my kids too, some of their groups too that we are doing more virtual connections, like scheduling a virtual time whenever people can join that we're going to be on, come say hi. So that they keep some connection with their support group.

0:32:10

Dr. Mike Patrick: That's really great. And our church has basically done the same thing, too. In fact, they had just got a Zoom account to do this. And now, the next thing I know, there's almost every day of the week, there's some groups that's meeting through the Zoom connection. 

And I think back to the pandemics, like 1918, we are really well suited for physical distancing in our day and age compared to ever in the past. 

Dr. Yolanda Evans: Absolutely. I was thinking about that yesterday too, how fortunate we are to be able to have not just a phone so you can hear the voice, but video so that you can actually see people, and the ability to connect in real time, and not have to wait for a letter to arrive or things like that, either. It's just amazing.

0:33:00

And the home entertainment, I mean think about, how we all have different streaming devices, and we have broadband Internet. And we have different technologies that we're constantly be entertained as well at home. 

Dr. Mike Patrick: Speaking of entertainment, as pediatricians, we always say limit screen time and put the screens down, do other things. And that's still true, but we do have to provide some wiggle room, right? For parents in today's situation, correct? 

Dr. Yolanda Evans: Yes. And I think it's kind of use your judgement. There's so much value in the interaction with our family members or the people that live with us in real time and not in front of the screen. But we also have to have some connection. So, the screen time to connect with friends, family, relatives, it's really a beneficial screen time I think in this situation.

And then, of course, the virtual learning environment is how we're going to get everybody through this in terms of the school piece. And the working, if we're fortunate enough to have a job where we can work virtually, then that's really helpful. 

0:34:14 

For all of us who have all of that, we do have to keep in mind those who don't and how we are going to keep them connected. And how we are going to keep them going, too.

Dr. Mike Patrick: That is really so important. That's one thing I think that family can do to advocate at the community level and with groups. Of course, you have to advocate virtually. But with social media, it's easy to do, even with municipalities. But having that connection and providing Internet service to those who may not have had the ability to have that in the past is really important to keep those family safe and connected. And that shouldn't be something that's just for those who can afford it, I don't think in this sort of situation. 

Dr. Yolanda Evans: Yeah, it's a really interesting thing to try to advocate for and how can our organizations that offer us the Internet service provide, can they provide some free Wi-Fi for certain periods of time to different neighborhoods? It will be really really amazing during this time. 

0:35:15

Dr. Mike Patrick: Yeah, absolutely. And I know one of the providers in our local area, for anyone who is doing online learning with school, they will provide Internet.

Dr. Yolanda Evans: That's great.

Dr. Mike Patrick: So, at reasonable rates and working with families to make that happen. So, I think that's important.

And then, there's all sorts of things. Services that schools, other than learning, the schools provide for families and as I think about folks who need meals through schools, that can be a real issue too. And we're fortunate here that in Ohio, all school meals are continuing. And each district gets to figure out how they're going to provide those meals. Is that something that's been talked about in your community, too?

Dr. Yolanda Evans: Definitely. With the first announcement of school closure, in that same email chain, they talked about the burden of not having those school meals on family's budgets and recognizing that for many kids, they're reliant on the meals. And not only the meals, but maybe the school is the most supportive environment. We're putting them on an environment that's unsupportive and that they're really working had to address that. 

0:36:24

So we have breakfast and lunch being offered to all the kids in the districts in various different areas. And people have gotten creative with how they're if they're delivering the meals or opening it up to the public to pick up the meals, too. So, it's been really good to see that. 

Dr. Mike Patrick: And that's something that families... If that's an issue, as the listener, if in your community that's not happening really, a place where families and parents can step up and sort of help guide the communities to provide those kinds of services, if that's not being done in your area.

Dr. Yolanda Evans: Definitely.

Dr. Mike Patrick: Can really make a difference for lots of kids.

Dr. Yolanda Evans: Yeah.

0:37:02

Dr. Mike Patrick: And then, finally, I wanted to talk about sort of self-care and sleep and exercise and eating and meals. These are all important things. And actually, we've been given the lecture really to maybe spend a little bit more time in those things, right? 

Dr. Yolanda Evans: Yeah, I mean, the sleep is definitely hard. Like we were talking about the schedule's off, but I think the heart that I'm realizing is that the need for self-care is big, like part of the built-in structure like a morning routine to do a little bit like five minutes of meditation prayer, like mindfulness, a little bit of stretching. And then, I've been getting on the stationary bike till I just go or doing the stairs at our house. Like I have to move my body a bit or just it's really the stress kind of just seeps in.

0:38:00

Dr. Mike Patrick: And a good time to unplug from the news is well before you go to bed because that anxiety level rises as you watch this sensational news stories. And then, you go to bed and you have trouble falling asleep or you wake up a couple of hours later and your mind is racing. 

Dr. Yolanda Evans: Yeah, I definitely rely on my library app because I have my books on there that I could read or listen to. And that's a really big way for me to relax, it's just through reading. So been leaning on that, too.

Dr. Mike Patrick: Yeah, absolutely. And have you used this time to find some new recipes?

[Laughter]

Dr. Yolanda Evans: Yes, actually, that's the other part. That's part of why I have to exercise because we've been actually sitting down and eating home-cooked meals more, which is great. But it's also a lot more intake that I would usually take in. So, having full-on Sunday breakfast, every day of the week is not the usual. It's fun but it's also like, "Oh, I don't if this is a sustainable practice." 

0:39:11

Dr. Mike Patrick: Our dishwasher's getting way more of a workout than it has in a long time. 

Dr. Yolanda Evans: Exactly.

[Laughter]

Dr. Mike Patrick: And this also is part of that self-care health kind of stuff that our institution has put together, one of the things that I found helpful is when I eat that home-cooked meal is to set a ten-minute timer and try to eat about half pf what's on my plate in ten minutes. And then a five minutes timer where you don't eat, and then another ten-minute timer to finish up.

And what I find is that if you eat a little slower and then let your blood sugar kind of come up, your brain starts to tell you you're full. And so, you don't end up eating as many calories because you fill up faster. Or if you scarf it all done, you typically overeat. So anyway, we found out to be incredibly helpful.

Dr. Yolanda Evans: Yeah, I think I'm finding that if I cook less, or we make a little bit... Because we would cook to save the leftovers for lunch throughout the week or that kind of thing. So, we make a bigger portion. 

0:40:09

But I'm finding, like okay, I need to actually decrease... The timer's a good idea and like decreasing that I think I don't need to save it.

Dr. Mike Patrick: Yeah and put it in a smaller plate. And then, you'll find... So, if you just ate all of that... And here we're being health coaches now. But if you just ate all of that quickly, of course, you're going to put more on that plate, but if you do eat slower, and then you feel full, then maybe that smaller plate is enough. But the food is... We've really been playing with new recipes and having fun with that.

At the same time, you do want to support local businesses. And a lot of restaurants still have takeout or delivery, but then again, you worry about exposures. And so, I just want to reassure families that the same concerns that you have is universal right now. And well, all around the world, really, right?

Dr. Yolanda Evans: Right. Exactly, I think we're all in this together We're all around this earth together. And so, we're all struggling with the same challenges and trying to find the same benefits as much as possible to keep it positive. 

0:41:13

Dr. Mike Patrick: Yeah, absolutely. Well, we really appreciate you taking time to stop and talk to us. I want to encourage families and I've mentioned this before, that it's really important that you get good sound sources of information. And of course, Nationwide Children's Hospital and Seattle Children's Hospital are both going to have wonderful sources of information at their website, on Facebook, on Twitter, LinkedIn, Instagram, all the social media channels.

So those are at least two places that you can find good information that you can trust and rely on. And of course, the CDC, Centers for Disease Control and Prevention and your local public health departments are also going terrific places to get information during this pandemic.

So, Dr. Yolanda Evans, Adolescent Medicine at Seattle Children's Hospital, thank you once again so much for stopping by and visiting us. 

0:42:02

Dr. Yolanda Evans: Thank you for having me. 

[Music]

Dr. Mike Patrick: We are back with just enough time to say thanks once again to all of you for taking time out  of your day and making PediaCast a part of it. Really do appreciate that. 

Also, thanks to our guest this week, Dr. Yolanda Evans, Adolescent Medicine physician at Seattle Children's Hospital.

We do have several links for you in the show notes this week to Episode 455, COVID-19: What You Need to Know, and Episode 456, COVID-19: Social Distancing and Flattening the Curve. If you go to the show notes page for either of those two episodes, we have tons of information and resource links for you. So be sure to check those out. 

We also created a playlist on SoundCloud with all of our COVID-19 episodes and I'll put a link to that in the show notes for today's episode as well.

0:43:18

Don't forget, you can find PediaCast in all sorts of places. Please think about subscribing to our programs. So, you have the newest episodes right there available for you. We are in Apple Podcasts, Google Podcast, iHeart Radio, Spotify, SoundCloud, and most mobile podcast apps for iOS and Android.

We have a landing site where you'll find our entire archive of past programs, all of our show notes, transcripts, our Terms of Use Agreement and that handy contact page if you would like to ask a question or suggest a COVID-19 specific topic. Since we're all living through this right now, I think all of our future topics here for a little while are at least going to be done through the lens of the pandemic because that's really all-encompassing in our life.

Now, that doesn't mean all of the difficult topics, there's good things, too. And we're going to be talking about many of those as we progress on. But if you do have something particular in mind, please do let me know. All of those things, by the way, are available at pediacast.org.

0:44:16

Reviews are helpful wherever you listen to PediaCast. We always appreciate when you take a moment to share your thoughts about the program.

And, we love connecting with you on social media. You'll find us on Facebook, Twitter, LinkedIn and Instagram. Simply search for PediaCast.

Thanks again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy, stay home, and stay involved with your kids. So long, everybody.

[Music]

Announcer 1: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.

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