Prisma Health: Covid-19 & How It May Affect Your Next Doctor's Visit

Melissa Milligan

For those who may not know, Dr. Robin LaCroix is the Pediatric Department Chair, Medical Director of the Children’s Hospital, and Infectious Disease Specialist at Prisma Health. She is a mother of two sons and a longtime Greenville resident. She granted me an interview at the beginning of the coronavirus onset, roughly eight weeks ago, and I was able to follow back up with her last week.

Friday evening, I had a good conversation with Dr. LaCroix. I wanted to pick her brain on where we stand with the virus and how we should protect ourselves in this “re-opening phase.” I was concerned as I had recently traveled to Hendersonville with our children on a day trip and on the way back witnessed a rather busy Red Box that was not being sanitized between uses. Furthermore, I observed no masks being worn and absolutely no hand hygiene being performed after the use of the communal box. I know and I am sorry if you were one of the patrons that thought a crazy woman was staring, but I was curious to who had maybe sanitizer or wipes in their car. Out of the several customers utilizing this box, no one cleaned their hands but put them straight away on the steering wheel and pulled out. Which had me questioning safety for many people who would use these same machines. Dr. LaCroix assured me that yes, this was a risk, but a low risk because of the open-air environment and the sun with UV rays that would not allow the virus to live very long if at all.

These concerns of mine led me to ask Dr. LaCroix the top three things we need to be doing right now to protect our families. Here is what she said her top 3 would be:

STILL, focus on hand hygiene! This is our number one defense in stopping the spread. Wash your hands. Stick with the tried and true soap and water, use hand sanitizer (if you can find it), or remember 70% rubbing alcohol will also do the job.
Minimize hard surface contact. As you are out and treat contact with every hard surface as if it has the potential of harboring this virus. The fact is we cannot pinpoint for every surface how long the virus can remain alive and active—so treat every surface as if it is there and take the proper cleaning measures and hand hygiene precautions.
Focus on your family unit—by this she told me, it is ok to be out and about in open areas with your family unit, but practice the CDC recommendations of the social distance of 6 ft between your family unit and others. She also said to be sure to mask up when you are in a place where the 6 ft rule is not properly followed, like in the grocery store with narrow aisles and more shoppers. When you are a healthy individual by having your mask on and others masked you are putting two layers of protection between you and any risk of exposure. The supermarkets near my house have done an amazing job with arrows and directions “in and out” of aisles but face it—most of us (and by us I mean me) missed those marked signs the first time we walked in, weren’t wearing masks, and had some encroachment going on in our 6 foot bubble while securing our groceries and stockpiling toilet paper.

Mental Health Impacts

As our conversation continued, we began to talk about the importance of focusing on mental health, not only for ourselves but for our children as well. I asked about playing in the park and about how to handle the numerous requests from the roaming band of restless neighbor kids, who before all this played frequently together in everyone’s yards. Do we let them or not? She said, “You have to weigh all the risks”. The key to staying connected and mentally healthy is a balancing act.

From our conversation I learned that you have to weigh not only the health risk of the isolation from COVID 19 but the mental health risks as well. It is important to remember that when you choose to interact with others you have to keep in mind that you are now exposing them to everyone you have come in contact with and vice versa. It is still better to keep to your own family unit while we begin to open back up, it certainly is not a time for a free for all, no holds barred type of reaction.

She did have these recommendations to offer that can help us navigate this constantly changing time for all of us:

Keep a routine. Your children thrive on a routine. They know what to expect next when a routine is followed. That is why they are missing school so much. It was a structured and routine day for them—it offers stability and security when they have a routine. So keep a routine as best as you can. Have the same bedtime routine, wake up, homework, outside time, etc. It does not mean your routine can’t have flexibility in it, but prepare your children ahead of time for what the day might bring. If you had to choose one thing to keep in a routine it should be bedtime. They still need adequate rest for energy and growth.

Focus on interactive things with your children. Dr. LaCroix recommends fun with bubbles, chalk art in the driveway, watercolor painting, and activities similar to these. Get your kids away from screen time and out doing things that allow them to express themselves. You join in too, mom and dad—these activities are a great time of connecting with your children. Who knows you might find out you are raising a Picasso!?!

Keep connected! Connectivity is key in this isolating time. Have a regularly scheduled time to connect with others. Dr. LaCroix mentions that iPads, tablets, and phones are great for connecting with grandparents, family, and friends. Make time in your week or every couple of weeks to connect with someone on these devices with facetime, zoom, google meet, or numerous other apps making electronic visits possible. It does not replace in-person visits, but it keeps you connected while we are apart—and all in this thing together! Something she has done in her neighborhood was a cul-de-sac huddle. Everyone brings their lawn chairs to the end of their driveways and can talk to each other while keeping a safe distance. For children, they can talk and play with their friends but cannot leave their yards. Kids are creative and it works out for everyone. Staying connected is just done a little more outside of the box, like instead of forgoing the family reunion make it a zoom reunion. You might just find it a little more enjoyable and personal getting to sit down and talk to each other, even if it has to be done via a computer/device screen.

Meditation. Take time to practice your faith or think reflectively. In such a busy world we had been living in, now is the time to enjoy the slowdown and appreciate these moments while we have them. Talk a walk, sit in your yard, or enjoy reading a book—just take the time to meditate in some way.

Our conversation circled back around to the future of our clinics as most of them have drastically had to change their workflow, processes, and service delivery. I asked her about when we might see clinics opening back up as they once were and how “televisits” might impact future visits.

I don’t know about you but I have kind of enjoyed the convenience of online medical services and I am personally at a “love and not sure what to think” kind of crossroads with other visit processes. Dr.LaCroix has mentioned to me that with summer coming up the consideration is the heat and curbside services (that keep patients and families waiting in their vehicles during the visit or until the room is ready for their visit) may need to be rethought. With these and other considerations in mind, we will begin to see different plans being implemented and followed in different practices.

Most practices are working on the “one way in” and “one way out” of the office for sick and well visits in addition to having separate waiting areas and limiting the numbers of those waiting. However, she did not have a hard timeline as to when we will see practices fully open back up to pre-virus functioning. Part of this reason is as we proceed through the summer and into the fall, we will have to monitor virus activity. Like we discussed in our first interview, “the hard thing about this virus is that we just don’t know.”

While we have learned much in the last eight weeks there is still much more to be learned. I asked her about the future of “televisits” and she did say that we have come a long way in being able to provide quality care electronically and that there will be the next evolution of this process.

Dr. LaCroix indicated that many patients are more satisfied with this mode because it eliminates waiting room time and time away from school and work. One example she talks about is a dermatologist appointment. If a teen is being seen for acne and has a routine check-up to monitor the condition being treated, utilizing an online appointment is much more convenient and doens’t require the student to possibly miss school.

To be honest as a former teacher and mom, I really like the convenience of this idea. Of course, she tells me though that for more serious issues the in-person visits will always be made available. Some pretty cool things to look for though on the cutting edge of technology and medicine will be connected kits that could contain a blood pressure cuff and other self-monitoring equipment that would easily transfer diagnostic information to your doctor during your telehealth appointment! We are learning through this whole situation, that where there is a will there is a way!

I concluded our conversation with one last thought for our readers–this is what she said, “Enjoy this time as a parent. Especially if you are working from home or are no longer working and are caring for your children. While it is stressful sometimes working from home with small children, this is time you normally wouldn’t have had with them. In a sense, this whole situation has been a gift of time. We don’t know how long it will last so make the most of it!”

Let’s all do just that…